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At least 73 records · Page 4Linked to original sources
PubMed2003

[Foot injury as a rare cause of scendosporiosis with fetal outcome].

After an attempted suicide with a fall from a height of 5 m, a 33 year old male suffered a subarachnoidal haemorrhage, an instable fracture of the second lumbar vertebra as well as a soft-tissue decollément in the vicinity of the right heel. Despite surgical management, the comatose patient showed slow wound-healing of the heel, making revision-surgery necessary 10 days after the first treatment. Fungi were histologically recognised, and subsequent culturing identified Scedosporium apiospermum. Systemic antimycotic therapy with itraconazol (800 mg/d) was immediately initiated. Despite this, S. apiospermum was repeatedly found in wound swabs over the following 2 weeks. After 4 weeks, a radiographically verified osteomyelitis of the calcaneus was diagnosed and local debridement was once again performed. After 5 days, an MRI of the cranium suggested an abscess in the posterior horn of the left lateral ventricle. Itraconazol was altered to voriconazol (4 mg/kg body weight). Neurosurgical opening of the abscess and subsequent culturing once again showed S. apiospermum. CT-scans performed over the following period showed an increase in lesions in the brain suggestive for numerous abscesses. At 78 days after the initial trauma, the still comatose patient died due to a massive cerebral haemorrhage. Microbiological assessment of the soil at the site of injury revealed S. apiospermum.

Adult↗
PubMed1986

[X-ray examination of foot injuries].

Fractures and luxations of the phalanges, metatarsus, tarsus and their joints are discussed. Correct radiological projections, knowledge of their pitfalls and a systematical interpretation are necessary for correct diagnosis.

Calcaneus↗
PubMed2006

A degloving foot injury in a traffic accident.

An unusual human remain found on a road became one key to reconstruct the traffic accident. A woman was found dead on a snow-covered road. Her left foot showed a large deficit of skin and underlying fat tissue. The detached skin and tissue were found into her left sock and shoe lying at a distance of 23 m from the body. There were multiple fractures on her back and occipital cranial bone. Severe injuries revealed in heart, liver, and brain. The neck remained intact. These findings suggested that her back has been strongly hit by the object with the flat surface, for example, the front side of a cab-over or truck, from behind at a high speed. Furthermore, the degloving injury in her left foot suggested that a vehicle ran over the foot which faced the vehicle. We reconstructed the accident as follows. Firstly the wheel of the vehicle ran over the victim's foot, and then, the victim turned away from the vehicle. Finally, the front side hit her twisted body from behind, resulting in a traumatic degloving injury.

Accidents, Traffic↗
PubMed2004

Multislice CT in imaging of trauma of the spine, pelvis and complex foot injuries.

Multislice CT (MSCT) has greatly enhanced the performance of CT scanners and has vastly improved imaging of musculoskeletal trauma. Fast, high resolution scanning is now possible. In our institution, MSCT is an essential part of the imaging of the traumatized patient. The advantages of volume imaging, such as multiplanar reconstructions (MPRs) with near isotropic viewing, three-dimensional imaging and thick slice (wedge) MPRs (mimicking conventional radiographs), enable more accurate assessment of complex anatomical areas such as the spine, pelvis and foot. We discuss the general principles of scanning for musculoskeletal trauma and describe our experience of MSCT of the traumatized spine, pelvis and foot.

Clinical Protocols↗
PubMed2005

[Surgical management of landmine foot injuries in the orthopedic and trauma clinic of Ziguinchor regional].

The aim of this work was to discribe the lesions caused by the use of blasting landmines among civilians in south Senegal, and to evaluate their surgical management. The prospective study, which was conducted from February 2001 to September 2002, took place in the orthopedics and trauma clinic of the Ziguinchor regionle hospital. The average age of the patients was 22, and they included 13 men and 2 women. In 12 cases, the lesions were unilateral and bilateral in 3 cases. Surgical management began with an assessment of the lesions using the classification of Coupland and De Wind. Treatment was based on a pre-established protocol in order to end up with a stump of good quality. The major lesion would consist in one or both lower limbs crushed or amputated. It would be open and of the I- type according to Coupland and De Wind. Lesions as a result of several shrapnel impact and burns were considered as associated lesions with the main lesion. Six patients presented an infection of the stump. Some stumps healed completely after about 15 days, and some took no more than 75 days before closing up. Only one stump needed grafting. All our patients had the advantage of a casting off. The young and rural people were the most vulnerable. Lesions were rather distal-based. Infection delayed healing. No matter what the form of the lesion, there was always a partial loss of a limb. Landmine feet injuries as serious lesions. The objective of the surgical treatment is to facilitate the further use of a prosthesis.

Adolescent↗
PubMed2002

Biomechanical analysis of fatigue-related foot injury mechanisms in athletes and recruits during intensive marching.

An integrative analysis, comprising radiographic imaging of the foot, plantar pressure measurements, surface electromyography (EMG) and finite element (FE) modelling of the three-dimensional (3D) foot structure, was used to determine the effects of muscular fatigue induced by intensive athletic or military marching on the structural stability of the foot and on its internal stress state during the stance phase. The medial/lateral (M/L) tendency towards instability of the foot structure during marching in fatigue conditions was experimentally characterised by measuring the M/L deviations of the foot-ground centre of pressure (COP) and correlating these data with fatigue of specific lower-limb muscles, as demonstrated by the EMG spectra. The results demonstrated accelerated fatigue of the peroneus longus muscle in marching conditions (treadmill march of 2 km completed by four subjects at an approximately constant velocity of 8 km h-1). Severe fatigue of the peroneus longus is apparently the dominant cause of lack of foot stability, which was manifested by abnormal lateral deviations of the COP during the stance phase. Under these conditions, ankle sprain injuries are likely to occur. The EMG analysis further revealed substantial fatigue of the pre-tibial and triceps surae muscles during intensive marching (averaged decreases of 36% and 40% in the median frequency of their EMG signal spectra, respectively). Incorporation of this information into the 3D FE model of the foot resulted in a substantial rise in the levels of calcaneal and metatarsal stress concentrations, by 50% and 36%, respectively. This may point to the mechanism by which stress fractures develop and provide the biomechanical tools for future clinical investigations.

Adolescent↗
PubMed1998

[Dislocated cuboid fracture. Clinical aspects and therapy of a rare foot injury].

Fractures of the cuboid are very rare. During the last 10 years four patients with isolated fractures of the cuboid have been treated in our hospital. The displaced fractures were treated by open reduction, bone grafting where necessary, and internal fixation. At the time of follow-up the results concerning pain and function were good to excellent and better than those previously reported for conservative treatment. We recommend this treatment for fractures with displacement of one or more of the articular surfaces or with shortening of the lateral arch of the foot.

Adolescent↗
PubMed1994

Free flaps in the reconstruction of foot injury. 4 (1-7) year follow-up of 24 cases.

We reconstructed in 24 patients, traumatic tissue loss in the foot with 10 lateral arm flaps and 14 scapular flaps. The mean follow-up was 4 (1-7) years. There was 1 flap loss, and 1 patient was amputated because of septic ankle arthrodesis. Healing with stable skin and scar was achieved in the remaining patients. Only patients with additional serious skeletal injury had reduced walking ability.

Adolescent↗
PubMed1989

The rehabilitation of overuse foot injuries in athletes and dancers.

Overuse injuries in athletes and dancers provide a challenge to the diagnostic acumen and rehabilitative and preventive skills of the medical community. The challenge is intensified when the primary lesion is located in the foot, whose levers, arches, and pulleys are responsible for absorbing shock, as well as converting a mobile adapter into a rigid lever for propulsion. A thorough knowledge of these active and passive mechanisms is essential for the appropriate and expeditious management of overuse syndromes. Sports and dance medicine health practitioners must also explore and comprehend the kinesiology of the sports and/or dance activity prevalent among their clientele. Furthermore, in order to determine the etiology and make judicious recommendations, clinicians must familiarize themselves with the density and inclines of popular running and dancing surfaces within their referral area. Rehabilitation of the foot requires a multifaceted approach. Physical therapists dealing with these problems need to develop expertise in manual techniques, along with clinical competency in laser, electrical, and thermal modalities. Reduction of predisposing factors is of utmost importance in the successful management of overuse injuries, and often requires greater skill and attention than does the treatment of the primary lesion.

Athletic Injuries↗
PubMed2001

[The Ottawa ankle guidelines: analysis of their validity as clinical decision guidelines in the indication of X-rays for ankle and/or middle-foot injuries].

OBJECTIVE: To analyse the validity of the Ottawa ankle guidelines (OAG) as clinical decision guidelines in the indications of X-rays for ankle and/or middle-foot traumas in primary care. DESIGN: Observational, with application of the OAG and prospective measurement of the results.Setting. Hospital casualty. PATIENTS: Adults who attended casualty for ankle or middle-foot traumas between 1st June 1999 and 31th March 2000. Criteria for exclusion were: under 18, pregnancy, grave sensory and/or awareness disturbances, multi-trauma or multi-contusion patients, traumas over a week old, skin lesions as side-effects of the trauma, X-ray in other department, high inflammation or oedema hindering palpation of bone protuberances. MEASUREMENTS: Application of the OAG and X-ray on all patients, regardless of the result of the OAG. Calculation of sensitivity, negative predictive value, specificity and positive predictive value. RESULTS: 56 of a sample of 494 patients had a fracture (11.34%), 34 in the malleolus area (6.9%) and 22 in the middle-foot area (4.44%). OAG sensitivity was 96.43% (95% CI, 94.8-98). Negative predictive value was 97.22% (95.77-98.67). Specificity was 15.98% (12.75-19.21), and positive predictive value was 12.8% (9.86-15.74). CONCLUSIONS: The OAG are valid in primary care as guidelines to decide whether to request X-rays for patients with ankle or middle-foot traumas.

Adolescent↗
PubMed2004

Ankle and foot injuries: analysis of MDCT findings.

OBJECTIVE: The purpose of our study was to assess MDCT findings and the advantages of MDCT compared with radiography in patients referred to a level 1 trauma center for diagnostic evaluation of acute ankle and foot trauma. MATERIALS AND METHODS: During a period of 37 months, 388 patients underwent MDCT of the ankle and foot due to an acute trauma. Imaging studies (MDCT and radiography) were retrospectively reevaluated with respect to fracture location, fracture type, and mechanism of injury, and findings from the primary radiographs of the ankle and foot were compared with MDCT findings. RESULTS: Of the 388 patients, 344 (89%) had one or more fractures in the ankle or foot. A total of 517 fractures were found in all anatomic regions: ankle, calcaneus, talus, midfoot, and forefoot. The three most common occult fractures in the ankle not detected on primary radiography were isolated fractures of the posterior and medial malleolus and Tillaux fractures. The calcaneus was the most commonly fractured bone, and the sensitivity of radiography in the detection of calcaneal fractures was 87%. The sensitivity of radiography in the detection of talar fractures was 78%, whereas it was only 25-33% in the detection of midfoot fractures. A Lisfranc fracture-dislocation was not detected on primary radiography in five (24%) of 21 cases. The three main injury mechanisms were falling from a height (164 patients [48%]), a simple fall (68 patients [20%]), and a traffic accident (47 patients [14%]). CONCLUSION: In patients with injuries from high-energy polytrauma and in those with complex ankle and foot fractures, the sensitivity of radiography is only moderate to poor; in these cases, MDCT is recommended as the primary imaging technique.

Adolescent↗
PubMed1988

The rehabilitation of overuse foot injuries in athletes and dancers.

Overuse injuries in athletes and dancers provide a challenge to the diagnostic acumen and rehabilitative and preventive skills of the medical community. The challenge is intensified when the primary lesion is located in the foot, whose levers, arches, and pulleys are responsible for absorbing shock, as well as converting a mobile adapter into a rigid lever for propulsion. A thorough knowledge of these active and passive mechanisms is essential for the appropriate and expeditious management of overuse syndromes. Sports and dance medicine health practitioners must also explore and comprehend the kinesiology of the sports and/or dance activity prevalent among their clientele. Furthermore, in order to determine the etiology and make judicious recommendations, clinicians must familiarize themselves with the density and inclines of popular running and dancing surfaces within their referral area. Rehabilitation of the foot requires a multifaceted approach. Physical therapists dealing with these problems need to develop expertise in manual techniques, along with clinical competency in laser, electrical, and thermal modalities. Reduction of predisposing factors is of utmost importance in the successful management of overuse injuries, and often requires greater skill and attention than does the treatment of the primary lesion.

Athletic Injuries↗