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Pain management soft tissue injury

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https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#1
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28533626/nonhealing-progressive-stress-fractures-of-the-foot-in-a-13-year-old-basketball-player-is-vitamin-k-deficiency-a-risk-factor
#2
Meral Bayramoğlu, Nuray Ünlütürk
[Purpose] To report an adolescent male basketball player with nonhealing stress fractures of the foot and discuss the probable factors. [Subject and Methods] A 13-year-old basketball player presented with right foot pain. He had been playing basketball for three years and practicing 5 days/week. He denied any increase in daily training intensity. Magnetic resonance imaging confirmed stress fractures of the cuboid and cuneiform, with mild edema of the soft tissues between the tarsal bones and tenosynovitis of the flexor hallucis and flexor digitorum longi...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28481627/outcomes-after-percutaneous-reduction-and-fixation-of-low-energy-lisfranc-injuries
#3
Michael Vosbikian, Joseph T O'Neil, Christine Piper, Ronald Huang, Steven M Raikin
BACKGROUND: Lisfranc injuries are often missed initially or not anatomically reduced, leading to midfoot collapse, arthrosis, and pain. Operative management of these injuries is also fraught with complications, particularly with respect to the soft tissues. Wound dehiscence and infection are not uncommon. The goal of this study was to analyze the outcomes of a minimally invasive technique in reduction and percutaneous fixation of low-energy minimally displaced Lisfranc injuries and determine if it is a safe alternative to more traditional, open approaches...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#4
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28413130/arthroscopic-treatment-of-labral-tears-of-the-hip-in-adolescents-patterns-of-clinical-presentation-intra-articular-derangements-radiological-associations-and-minimum-2-year-outcomes
#5
Sivashankar Chandrasekaran, Nader Darwish, Edwin O Chaharbakhshi, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
PURPOSE: To report on patterns of clinical presentation, intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopy (HA) in patients 18 years or younger. METHODS: This study was a retrospective case series on patients 18 years or younger who had undergone HA for labral tears that had failed nonoperative management from April 2008 to April 2013 with a minimum 2-year follow-up. Exclusion criteria were previous hip conditions or surgery...
April 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28371497/staged-management-of-missed-lisfranc-injuries-a-report-of-short-term-results
#6
Pin Feng, Ya-Xing Li, Jia Li, Xiang-Yu Ouyang, Wei Deng, Yu Chen, Hui Zhang
OBJECTIVE: Lisfranc joint injury is a rare injury and can be easily missed at the initial treatment. Once ignored, late reduction is very difficult and requires extensive dissection. Surgical outcome is not as good as in the case of an early reduction. The aim of this cohort study was to analyze the midterm clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with old Lisfranc injuries. METHODS: Fifteen patients (16 feet) with missed Lisfranc injuries were treated with staged reduction...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28252476/athletic-hip-injuries
#7
T Sean Lynch, Asheesh Bedi, Christopher M Larson
Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28211591/magnetic-resonance-imaging-of-the-knee-an-overview-and-update-of-conventional-and-state-of-the-art-imaging
#8
Nicholas C Nacey, Matthew G Geeslin, Grady Wilson Miller, Jennifer L Pierce
Magnetic resonance imaging (MRI) has become the preferred modality for imaging the knee to show pathology and guide patient management and treatment. The knee is one of the most frequently injured joints, and knee pain is a pervasive difficulty that can affect all age groups. Due to the diverse pathology, complex anatomy, and a myriad of injury mechanisms of the knee, the MRI knee protocol and sequences should ensure detection of both soft tissue and osseous structures in detail and with accuracy. The knowledge of knee anatomy and the normal or injured MRI appearance of these key structures are critical for precise diagnosis...
February 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#9
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#10
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28068792/arthroscopic-reduction-and-internal-fixation-arif-of-a-comminuted-posterior-talar-body-fracture
#11
Rishin Kadakia, Jeff Konopka, Tristan Rodik, Samra Ahmed, Sameh A Labib
The talus is the second most common fractured tarsal bone. While their incidence may be low, talus fractures are severe injuries that can lead to long-term disability and pain. Displaced talar body fractures are typically treated through an open approach with the aim of obtaining anatomic reduction and stable fixation. There are several case reports in the literature demonstrating successful management of talus fractures arthroscopically. An arthroscopic approach minimizes soft tissue trauma, which can help decrease postoperative wound complications and infections...
January 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#12
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#13
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability. Following an initial patellar dislocation, nonoperative management with bracing and physical therapy is an acceptable option, despite limited evidence that operative management may improve functional outcome and reduce recurrent dislocations...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27824552/ehlers-danlos-syndrome-hypermobility-type-a-much-neglected-multisystemic-disorder
#14
REVIEW
Yael Gazit, Giris Jacob, Rodney Grahame
Ehlers-Danlos syndrome (EDS)-hypermobility type (HT) is considered to be the most common subtype of EDS and the least severe one; EDS-HT is considered to be identical to the joint hypermobility syndrome and manifests with musculoskeletal complaints, joint instability, and soft tissue overuse injury. Musculoskeletal complaints manifest with joint pain of non-inflammatory origin and/or spinal pain. Joint instability leads to dislocation or subluxation and involves peripheral joints as well as central joints, including the temporomandibular joints, sacroiliac joints, and hip joints...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27660598/chiropractic-management-of-musculoskeletal-symptoms-in-a-14-year-old-hockey-player-with-postconcussion-symptoms-a-case-report
#15
Harold M Olson, Michael J Tunning, Ronnie J Boesch
OBJECTIVE: The purpose of this study is to describe the chiropractic management of a student athlete with postconcussion syndrome. CLINICAL FEATURES: A 14-year-old male hockey player presented to a chiropractic clinic with postconcussion symptoms 13 days after his initial injury. He experienced an occipital headache with a pain rating of 8/10, upset stomach, blurry vision, nausea, dizziness, balance problems, a "foggy feeling," difficulty with concentration, difficulty with memory, fatigue, confusion, drowsiness, and irritability...
September 2016: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/27641592/how-to-use-price-treatment-for-soft-tissue-injuries
#16
Cormac Norton
Rationale and key points This article assists nurses to use the acronym PRICE (protection, rest, ice, compression and elevation) to guide the treatment of patients with uncomplicated soft tissue injuries to their upper or lower limbs. » Treatment of soft tissue injuries to limbs is important to reduce complications following injury, alleviate pain and ensure normal limb function is restored promptly. » Nurses should have an understanding of the rationale and evidence base supporting PRICE treatment of soft tissue injuries...
August 24, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27525185/chronic-ucl-injury-a-multimodal-approach-to-correcting-altered-mechanics-and-improving-healing-in-a-college-athlete-a-case-report
#17
Rachel Patrick, Josh McGinty, Ann Lucado, Beth Collier
BACKGROUND: Ulnar collateral ligament (UCL) tears and associated Tommy Johns surgical intervention from excessive and poor quality pitching has increased immensely-with more college and professional pitchers undergoing the surgery in 2014 alone than in the 1990s as a whole.(1) Faulty mechanics developed at young ages are often well-engrained by the late adolescent years and the minimal healing ability of the largely avascular UCL often leads to delayed safe return to sport.(2). PURPOSE: The purpose of this case study was to describe an innovative, multimodal approach to conservative management of a chronic UCL injury in a college-aged baseball pitcher...
August 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27335816/posterolateral-dislocation-of-the-knee-recognizing-an-uncommon-entity
#18
Colin Yl Woon, Mark R Hutchinson
Posterolateral dislocations of the knee are rare injuries. Early recognition and emergent open reduction is crucial. A 48-year-old Caucasian male presented with right knee pain and limb swelling 3 d after sustaining a twisting injury in the bathroom. Examination revealed the pathognomonic anteromedial "pucker" sign. Ankle-brachial indices were greater than 1.0 and symmetrical. Radiographs showed a posterolateral dislocation of the right knee. He underwent emergency open reduction without an attempt at closed reduction...
June 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27335643/implementation-of-a-shoulder-soft-tissue-injury-triage-service-in-a-uk-nhs-teaching-hospital-improves-time-to-surgery-for-acute-rotator-cuff-tears
#19
Marcus Bateman, Gareth Davies-Jones, Amol Tambe, David I Clark
Shoulder problems account for 2.4% of GP consultations in the United Kingdom and of those 70% are related to the rotator cuff. Many rotator cuff tears are of a degenerate nature but they can occur as a result of trauma in 8% of cases. Evidence suggests that patients with traumatic rotator cuff tears gain a better outcome in terms of pain and function if the tear is repaired early after injury. A specialist shoulder soft tissue injury clinic was set up in a large UK NHS teaching hospital with the primary purpose in the first year to halve the length of time patients with traumatic rotator cuff tears had to wait to consult a specialist and double the number of patients undergoing surgical repair within three months...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27078072/the-management-of-persistent-pain-from-a-branch-of-the-trifid-mandibular-canal-due-to-implant-impingement
#20
Sharifah Aljunid, Saif AlSiweedi, Phrabhakaran Nambiar, Wen-Lin Chai, Wei-Cheong Ngeow
The mandibular canal is a conduit that allows the inferior alveolar neurovascular bundle to transverse the mandible to supply the dentition, jawbone, and soft tissue around the lower lip. It is now acknowledged that the mandibular canal is not a single canal but an anatomical structure with multiple branches and variations. Iatrogenic injury to branches of the mandibular canal that carry a neurovascular bundle has been reported to cause injury to the main canal as severe as if the main canal itself is traumatized...
August 2016: Journal of Oral Implantology
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