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A L Sander, K Sommer, K Eichler, I Marzi, J Frank
Typical lesions of the carpal ligaments are mostly found after a fall on the wrist in hyperextension or as complex injuries after severe trauma, e. g. after a fall from a significant height, motorcycle accident or as accompanying lesions in multiple trauma. The typical mechanisms, patterns and diagnostic algorithms are well known for the common ligamentous injuries (e.g. scapholunate, lunotriquetral and perilunate); therefore, consistent diagnostic procedures and adequate therapy are increasingly performed after such lesions, e...
March 13, 2018: Der Unfallchirurg
Yukiko Kuroda, Ikuko Ohashi, Takuya Naruto, Kazumi Ida, Yumi Enomoto, Toshiyuki Saito, Jun-Ichi Nagai, Kenji Kurosawa
Ehlers-Danlos syndrome classical type (cEDS) is a connective tissue disorder characterized by skin hyperextensibility, atrophic scarring, and joint hypermobility. The condition typically results from mutations in COL5A1 or COL5A2 leading to the functional haploinsufficiency. Here, we report of a 24-year-old male with mild intellectual disability, dysmorphic features, and a phenotype consistent with cEDS. A copy number variant-calling algorithm from panel sequencing data identified the deletions exons 2-11 and duplications of exons 12-67 within COL5A1...
March 9, 2018: Congenital Anomalies
Joshua D Boucher, Jose Figueroa
Decreased active and passive range of motion (ROM) accompanied by pain in the shoulder is a common presentation for patients with frozen shoulder, and it can be difficult to restore normal function. Through the fascial distortion model, physicians can apply a manual technique to rapidly and effectively increase ROM and decrease pain. A 28-year-old man presented 18 months after sustaining a shoulder hyperextension injury. On active and passive ROM examination, he had approximately 90° of shoulder abduction and moderately reduced internal rotation associated with 8/10 pain...
March 5, 2018: Journal of the American Osteopathic Association
Kathryn E Hendee, Elena A Sorokina, Sanaa S Muheisen, Linda M Reis, Rebecca C Tyler, Vujica Markovic, Goran Cuturilo, Brian A Link, Elena V Semina
The PITX2 (paired-like homeodomain 2) gene encodes a bicoid-like homeodomain transcription factor linked with several human disorders. The main associated congenital phenotype is Axenfeld-Rieger syndrome, type 1 (ARS), an autosomal dominant condition characterized by variable defects in the anterior segment of the eye, an increased risk of glaucoma, craniofacial dysmorphism and dental and umbilical anomalies; in addition to this, one report implicated PITX2 in ring dermoid of the cornea and a few others described cardiac phenotypes...
March 1, 2018: Human Molecular Genetics
Haobo Wu, Chiyuan Ma, Yan Xiong, Shigui Yan, Lidong Wu, Weigang Wu
PURPOSE: To compare the clinical outcomes of double-bundle (DB) single-tibial tunnel technique and double-tunnel technique for ACL reconstruction in patients with knee hyperextension. METHODS: Defined as having constitutional hyperextension of greater than 10°, 56 patients with knee hyperextension who underwent ACL reconstruction were included in this study. To exclude concomitant lesions, preoperative magnetic resonance imaging (MRI) was performed in all knees...
March 5, 2018: Archives of Orthopaedic and Trauma Surgery
Priya Vijayvargiya, Michael Camilleri, Robert R Cima
A 22-year-old woman presented with 12 years of progressive constipation; she had increased joint flexibility, hyperextensible skin, and excessive perineal descent on examination. Radiological studies confirmed evidence of rectal evacuation disorder due to descending perineum syndrome, enterocele, and rectocele. In a wide genetic screen (∼611,000 single nucleotide polymorphisms), 4 variations were identified in COL1A1 gene ([rs72656352, Chr17: 50,185,535-50,185,539, deletion], [rs72654794, Chr17: 50,188,575, deletion], [rs72667023, Chr17: 50,198,170, deletion], [rs67828806, Chr17: 50,198,177 G→C])...
March 2018: Mayo Clinic Proceedings
Francesca Cortini, Chiara Villa
The Ehlers-Danlos syndromes (EDS) comprise a clinically and genetically heterogeneous group of heritable connective tissue disorders (HCTDs), characterised by joint hypermobility, hyperextensibility of the skin and tissue fragility that can induce symptoms from multiple organ systems. The latest EDS nosology distinguished thirteen subtypes with an overlap of phenotypic features, making the clinical diagnosis rather difficult and highlighting the importance of molecular diagnostic confirmation. Although the nervous system is not considered a primary target of the underlying molecular defect, recently, increasing attention has been focused on neurological manifestations of EDS...
February 27, 2018: Seizure: the Journal of the British Epilepsy Association
A Taha, S L M Bakker
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
Philip Rosinsky, Oren Sarig, Yehuda David, Amir Oron
Mallet finger is a common injury involving the extensor mechanism of the finger. It presents as an inability to extend the distal phalanx of the digit. In the right clinical setting, a thorough examination should be performed and supplemented by adequate radiographs. The mechanism of injury is usually a direct blow to an extended finger causing hyperflexion or hyperextension of the distal phalanx. Common occurrences are in young adults during sporting activities or in minor falls or trauma in osteoporotic individuals...
February 2018: Harefuah
Motoyoshi Morishita, Hidetaka Yamaguchi, Shota Yamagami, Mariko Kobayashi
Patients' with a hemiplegic gait and difficulties with activities of daily living may improve through intensive training of their paretic lower limbs. This study examined the possibility of improving their gait by immobilizing the non-paretic knee joint in extension and promoting weight shift toward the paretic side. Single-case ABABA studies were conducted, involving three patients with hemiplegia. The patients walked with their non-paretic knee joints immobilized in extension using a dial-lock knee orthosis during the intervention (B1 and B2) periods...
February 22, 2018: Physiotherapy Theory and Practice
Alexander B Dru, Paul S Kubilis, Gregory A Murad, Tyler Carney, Daniel J Hoh
BACKGROUND: Spontaneous thoracic ankylosis is a progressive degenerative process that predisposes patients to potentially highly unstable traumatic injuries. Acute hyperextension fractures result in dynamic instability putting the spinal cord at risk. OBJECTIVE: To describe preoperative radiographic characteristics of fractures of the ankylotic thoracic spine and relate findings to early postoperative radiographic and clinical outcomes. METHODS: A single center, retrospective review was performed of 28 surgically treated patients with fractures of the ankylotic thoracic spine...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Wei-Yu Jiang, Wei-Hu Ma, Yong-Jie Gu, Liu-Jun Zhao, Xu-Dong Hu, Liang Yu, Chao-Yue Ruan, Yun-Lin Chen, Yue-Ling Feng
OBJECTIVE: To evaluate the clinical effects of French door segmented laminectomy decompression for severe cervical OPLL complicated with spinal cord injury. METHODS: The clinical data of 38 patients with serious cervical OPLL complicated with spinal cord injury were retrospectively analyzed and these patients were treated with French door segmented laminectomy decompression and internal fixation from June 2012 to June 2014. There were 25 males and 13 females, aged from 42 to 78 years with an average of 58...
September 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
JiaNan Zhang, Yong Fan, Xin He, YiBin Meng, YunFei Huang, ShuaiJun Jia, JinPeng Du, QiNing Wu, DingJun Hao
PURPOSE: The purpose of this study was to compare and evaluate the safety and efficacy of percutaneous vertebroplasty at a hyperextension position (PVPHP) and percutaneous kyphoplasty at a hyperextension position (PKPHP) for the treatment of osteoporotic Kümmell's disease. METHODS: This study was a retrospective, single-centre study. There were 35 patients with osteoporotic Kümmell's disease who were analyzed. Twenty-two of them underwent PVPHP and the other 13 patients underwent PKPHP from January 2013 to January 2015...
February 14, 2018: International Orthopaedics
Jarret M Woodmass, Thomas L Sanders, Nick R Johnson, Isabella T Wu, Aaron J Krych, Michael J Stuart, Bruce A Levy
Injury to the posterolateral corner (PLC) of the knee can lead to both varus and rotational instability. Multiple PLC reconstruction techniques have been described, including one-tailed graft (fibula-based constructs) or two-tailed graft (combined fibula- and tibia-based constructs). The purpose of our study was to evaluate the clinical outcomes of anatomical two-tailed graft reconstruction of the PLC in the setting of multiligament knee injuries (MKLIs) with grade III varus instability. Patients were identified through a prospective MLKI database between 2004 and 2013...
February 14, 2018: Journal of Knee Surgery
Kazuaki Suzuki, Junichirou Hamada, Yoshihiro Hagiwara
No abstract text is available yet for this article.
February 7, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yaniv Steinfeld, Yaniv Keren, Elias Haddad
Introduction: Central cord syndrome (CCS) is an injury to the center of the spinal cord. It is well known as a hyperextension injury, but it has never been described as a surfing injury. Our report describes this injury in detail. Case presentation: A 35-year-old male novice surfer presented to the emergency department with acute tetraplegia following falling off his surfboard and hitting sea floor at a shallow beach break. He was rescued by a fellow surfer while floating in the sea and unable to raise his head above sea level...
2018: Spinal Cord Series and Cases
Marco Pappalardo, Vincent G Laurence, Yu-Te Lin
For painful, dysfunctional, posttraumatic metacarpophalangeal (MCP) joints, the free vascularized toe joint transfer may represent a good solution. Successful reconstruction is potentially limited, however, by 2 features of the traditional vascularized metatarsophalangeal (MTP) transfer: inadequate arc of flexion and insufficient soft tissue coverage. The solution to both of these dilemmas lies in the manner of utilizing the donor site. Because of its innate hyperextensibility, rotating the MTP 180° volar to dorsal provides the greatest arc of flexion in the reconstructed MCP...
February 2018: Journal of Hand Surgery
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
Khushboo K Dalal, Abraham M Joshua, Akshatha Nayak, Prasanna Mithra, Zulkifli Misri, Bhaskaran Unnikrishnan
INTRODUCTION: Knee hyperextension is seen in 40-68% of ambulating hemiparetics. If left untreated it may lead to laxity of posterior structures of knee resulting in early degeneration of knee leading to pain, reduced independence in activities of daily living (ADL), deformities and instability. In this study we hypothesize walking with bent knee attitude (prowling) along with proprioceptive training may help to reduce knee hyperextension during the stance phase of gait cycle. OBJECTIVE: To test the efficacy of prowling along with proprioceptive training on knee hyperextension range, dorsiflexion range and spatio temporal parameters of gait using Wisconsin gait scale (WGS) as compared to routine physiotherapy...
January 26, 2018: Gait & Posture
Shai Shrot, Clark T Johnson, W Christopher Golden, Ahmet A Baschat, Janine E Bullard, Aylin Tekes, Andrea Poretti, Emily Dunn, Thierry A G M Huisman
BACKGROUND AND PURPOSE: Persistent hyperextension of the fetal craniocervical junction or neck is one of several fetal positions commonly observed on prenatal imaging. Underlying fetal structural etiologies such as fetal neck masses and iniencephaly can be detected as causes of hyperextension. Caesarean delivery is considered in cases of vaginal delivery or obstructed labor for fear of cervical spinal cord injury. In this case series, we describe the prenatal magnetic resonance imaging (MRI) findings and their potential role in obstetric management and discuss postnatal outcomes in fetuses demonstrating prenatal imaging findings of persistent extreme hyperextension of the neck...
February 5, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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