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Sample records for acromioclavicular joint reconstruction

  1. Acromioclavicular Joint Reconstruction.

    Science.gov (United States)

    Scillia, Anthony J; Cain, E Lyle

    2015-12-01

    Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle. PMID:27284528

  2. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

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    Marchie Anthony

    2009-01-01

    Full Text Available We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations.

  3. Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

    Institute of Scientific and Technical Information of China (English)

    Devendra Kumar Chouhan; Uttam Chand Saini; Mandeep Singh Dhillon

    2013-01-01

    Objective:Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate.Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management.We present our experience in managing these patients surgically.Methods:We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically.Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis.Results:All the patients were able to perform daily activities from an average of the 14th postoperative day.All patients felt an improvement in pain,with decrease in average visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points),Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively.These results improved or at least remained stationary on midterm follow-up,and no deterioration was recorded at an average follow-up of 46 months.Conclusion:This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis.Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

  4. A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

    OpenAIRE

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five ...

  5. Acromioclavicular joint reconstruction using the LockDown synthetic implant: a study with cadavers.

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    Taranu, R; Rushton, P R P; Serrano-Pedraza, I; Holder, L; Wallace, W A; Candal-Couto, J J

    2015-12-01

    Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer. PMID:26637681

  6. Management of acromioclavicular joint injuries.

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    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  7. Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

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    Wang Chaoliang

    2015-01-01

    Full Text Available We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100. The results were excellent in eight patients (66.7% and good in four patients (33.3%. Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

  8. Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

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    Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

    2016-01-01

    Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

  9. Acromioclavicular joint injuries: diagnosis and management.

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    Simovitch, Ryan; Sanders, Brett; Ozbaydar, Mehmet; Lavery, Kyle; Warner, Jon J P

    2009-04-01

    Acromioclavicular joint injuries represent nearly half of all athletic shoulder injuries, often resulting from a fall onto the tip of the shoulder with the arm in adduction. Stability of this joint depends on the integrity of the acromioclavicular ligaments and capsule as well as the coracoclavicular ligaments and the trapezius and deltoid muscles. Along with clinical examination for tenderness and instability, radiographic examination is critical in the evaluation of acromioclavicular joint injuries. Nonsurgical treatment is indicated for type I and II injuries; surgery is almost always recommended for type IV, V, and VI injuries. Management of type III injuries remains controversial, with nonsurgical treatment favored in most instances and reconstruction of the acromioclavicular joint reserved for symptomatic instability. Recommended techniques for stabilization in cases of acute and late symptomatic instability include screw fixation of the coracoid process to the clavicle, coracoacromial ligament transfer, and coracoclavicular ligament reconstruction. Biomechanical studies have demonstrated that anatomic acromioclavicular joint reconstruction is the most effective treatment for persistent instability.

  10. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

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    Gobezie Reuben

    2009-01-01

    Full Text Available Abstract Background Symptomatic Acromioclavicular (AC dislocations have historically been surgically treated with Coracoclavicular (CC ligament reconstruction with transfer of the Coracoacromial (CA ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57. Results Postoperative ASES and pain significantly improved in all patients (p = 0.001. Radiographically, 16 (94% maintained reduction, and only 1 (6% had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability.

  11. Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

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    Sengupta S

    2007-11-01

    Full Text Available Abstract Background Acromioclavicular injuries are common in sports medicine. Surgical intervention is generally advocated for chronic instability of Rockwood grade III and more severe injuries. Various methods of coracoclavicular ligament reconstruction and augmentation have been described. The objective of this study is to compare the biomechanical properties of a novel palmaris-longus tendon reconstruction with those of the native AC+CC ligaments, the modified Weaver-Dunn reconstruction, the ACJ capsuloligamentous complex repair, screw and clavicle hook plate augmentation. Hypothesis There is no difference, biomechanically, amongst the various reconstruction and augmentative methods. Study Design Controlled laboratory cadaveric study. Methods 54 cadaveric native (acromioclavicular and coracoclavicular ligaments were tested using the Instron machine. Superior loading was performed in the 6 groups: 1 in the intact states, 2 after modified Weaver-Dunn reconstruction (WD, 3 after modified Weaver-Dunn reconstruction with acromioclavicular joint capsuloligamentous repair (WD.ACJ, 4 after modified Weaver-Dunn reconstruction with clavicular hook plate augmentation (WD.CP or 5 after modified Weaver-Dunn reconstruction with coracoclavicular screw augmentation (WD.BS and 6 after modified Weaver-Dunn reconstruction with mersilene tape-palmaris-longus tendon graft reconstruction (WD. PLmt. Posterior-anterior (horizontal loading was similarly performed in all groups, except groups 4 and 5. The respective failure loads, stiffnesses, displacements at failure and modes of failure were recorded. Data analysis was carried out using a one-way ANOVA, with Student's unpaired t-test for unpaired data (S-PLUS statistical package 2005. Results Native ligaments were the strongest and stiffest when compared to other modes of reconstruction and augmentation except coracoclavicular screw, in both posterior-anterior and superior directions (p WD.ACJ provided additional

  12. Acromioclavicular joint injuries: anatomy, diagnosis, and treatment.

    Science.gov (United States)

    Willimon, S Clifton; Gaskill, Trevor R; Millett, Peter J

    2011-02-01

    Acromioclavicular (AC) joint injuries are common in athletic populations and account for 40% to 50% of shoulder injuries in many contact sports, including lacrosse, hockey, rugby and football. The AC joint is stabilized by static and dynamic restraints, including the coracoclavicular (CC) ligaments. Knowledge of these supporting structures is important when identifying injury and directing treatment. Management of AC injuries should be guided by severity of injury, duration of injury and symptoms, and individual patient factors. These help determine how best to guide management, and whether patients should be treated surgically or nonsurgically. Treatment options for AC injuries continue to expand, and include arthroscopic-assisted anatomic reconstruction of the CC ligaments. The purpose of this article is to review the anatomy, diagnostic methods, and treatment options for AC joint injuries. In addition, the authors' preferred reconstruction technique and outcomes are presented.

  13. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

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    Naziri, Qais; Williams, Nadine; Hayes, Westley; Kapadia, Bhaveen H.; Chatterjee, Dipal; Urban, William P.

    2016-01-01

    Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC) joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18) embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years) were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE) suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001). The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25). Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft. PMID:27163106

  14. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    Directory of Open Access Journals (Sweden)

    Naziri Qais

    2016-01-01

    Full Text Available Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18 embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001. The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25. Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft.

  15. Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical technique

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    Sandmann Gunther H

    2012-10-01

    Full Text Available Abstract Purpose In this retrospective study we investigated the clinical and radiological outcome after operative treatment of acute Rockwood III-V injuries of the AC-joint using two acromioclavicular (AC cerclages and one coracoclavicular (CC cerclage with resorbable sutures. Methods Between 2007 and 2009 a total of 39 patients fit the inclusion criteria after operative treatment of acute AC joint dislocation. All patients underwent open reduction and anatomic reconstruction of the AC and CC-ligaments using PDS® sutures (Polydioxane, Ethicon, Norderstedt, Germany. Thirty-three patients could be investigated at a mean follow up of 32±9 months (range 24–56 months. Results The mean Constant score was 94.3±7.1 (range 73–100 with an age and gender correlated score of 104.2%±6.9 (88-123%. The DASH score (mean 3.46±6.6 points, the ASES score (94.6±9.7points and the Visual Analogue Scale (mean 0.5±0,6 revealed a good to excellent clinical outcome. The difference in the coracoclavicular distance compared to the contralateral side was Conclusion Open AC joint reconstruction using AC and CC PDS cerclages provides good to excellent clinical results in the majority of cases. However, radiographically, the CC distance increased significantly at final follow up, but neither the amount of re-dislocation nor calcifications of the CC ligaments or osteoarthritis of the AC joint had significant influence on the outcome. Level of evidence Case series, Level IV

  16. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

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    Zhang Jingwei

    2014-07-01

    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  17. Surgical treatment of a concurrent type 5 acromioclavicular joint dislocation and a failed anterior glenohumeral joint stabilization.

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    Rashid, Abbas; Lawrence, Christopher; Tytherleigh-Strong, Graham

    2016-10-01

    Traumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery. PMID:27660658

  18. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

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    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  19. Operative treatment of acromioclavicular joint dislocation:a new technique with suture anchors

    Institute of Scientific and Technical Information of China (English)

    Zhang Jingwei; Li Min; He Xianfeng; Yu Yihui; Zhu Limei

    2014-01-01

    Objective:To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation.Methods:Twenty-eight patients with acute traumatic Rockwood Ⅲ,Ⅳ and Ⅴ dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited.All patients underwent open reduction combined with suture anchors.Function was evaluated using the ConstantMurley shoulder score.Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3,6 and 12 months.Results:Two cases with fixation loosening were not included in final statistical analysis.Other patients obtained full joint reposition on immediate postoperative radiographs.Follow-up was performed with an average of 15.6 months (range,12-19).After early range of motion exercises,96.2% of the patients (25/26) could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months.There was no infection.Average Constant-Murley score was 96.3 points (range,94-100)and mean Taft shoulder rating was 10.7 points (range,8-12) at 12 months.Conclusion:The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation.

  20. Epidemiology of Isolated Acromioclavicular Joint Dislocation

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    Claudio Chillemi

    2013-01-01

    Full Text Available Background. Acromioclavicular (AC joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood’s criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2% had an isolated AC dislocation, and 3 (2.8% were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5 : 1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation.

  1. Septic arthritis of the acromioclavicular joint: an uncommon location.

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    Martínez-Morillo, Melania; Mateo Soria, Lourdes; Riveros Frutos, Anne; Tejera Segura, Beatriz; Holgado Pérez, Susana; Olivé Marqués, Alejandro

    2014-01-01

    Septic pyogenic arthritis of the acromioclavicular joint is a rare entity that occurs in immunosuppressed patients or those with discontinuity of defense barriers. There are only 15 cases described in the literature. The diagnosis is based on clinical features and the isolation of a microorganism in synovial fluid or blood cultures. The evidence of arthritis by imaging (MRI, ultrasound or scintigraphy) may be useful. Antibiotic treatment is the same as in septic arthritis in other locations. Staphylococcus aureus is the microorganism most frequently isolated. Our objective was to describe the clinical features, treatment and outcome of patients diagnosed with septic arthritis of the acromioclavicular joint at a Rheumatology Department. We developed a study with a retrospective design (1989-2012). The medical records of patients with septic arthritis were reviewed (101 patients). Those involving the acromioclavicular joint were selected (6 patients; 6%).

  2. Three Endobutton plates in reconstruction of coracoclavicular ligament for the dislocations of the acromioclavicular joint%三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    吕书军; 曹勇; 洪晔; 蒋栋; 周广(钅监)

    2012-01-01

    目的 探讨三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位的初步临床疗效.方法 对25例肩锁关节脱位患者应用三Endobutton钢板解剖重建喙锁韧带治疗的临床疗效进行分析.结果 25例均获随访,时间14~29个月.X线检查证实肩锁关节脱位均完全复位.肩关节外展活动范围术前为40°~80°,术后为140°~150°.肩关节功能按Constant标准,评分术前为(66.5±3.2)分,术后3个月为(90.5±2.3)分,术后6个月为(93.5±3.1)分.结论 三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位固定确实,不损伤关节面,术后患者可以早期功能锻炼,无需二次手术,疗效满意.%Objective To evaluate the clinical results of three Endobutton plates in reconstruction of coracoclavicular ligament for the dislocations of the acromioclavicular joint. Methods 25 patients with the dislocations of the acromi-oclavicular joint were reviewed retrospectively. The Constant evaluation system were used to analyze the clinical effects of triple button plates technique. Results All patients obtained the follow-up and the time was 14 to 29 months. Preoperative shoulder abduction range was 40° to 80°. Postoperative abduction range was 140° to 150°. Pre-operative shoulder function according to the standard of Constant score was 66. 5 ± 3. 2 points. After 3 months, Constant score was ( 90. 5 ± 2. 3 ) points, and 6 months Constant score was ( 93. 5 ± 3. 1 ) points. Conclusions The treatment of dislocations of acromioclavicular joint by using reconstruction of coracoclavicular ligament has satisfactory functional outcome and a few trauma in joint surface, without the secondary operation.

  3. Arthroscopic coracoclavicular ligament reconstruction for Rockwood type Ⅲ acromioclavicular joint dislocations%肩关节镜下喙锁韧带重建术治疗 RockwoodⅢ型肩锁关节脱位的疗效研究

    Institute of Scientific and Technical Information of China (English)

    李奉龙; 姜春岩

    2015-01-01

    目的:分析采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效。方法回顾性研究2013年2月至2014年1月连续收治并获得随访的21例 Rockwood Ⅲ型肩锁关节脱位患者的资料。其中男性17例,女性4例。平均年龄42.8岁,平均受伤到手术时间11.1 d。所有患者均于肩关节镜下应用同种异体肌腱重建喙锁韧带并高强度缝线捆扎固定喙锁间隙治疗肩锁关节脱位。术后定期随访,记录患侧肩关节活动范围,并采用疼痛视觉模拟评分(visual analogue score,VAS)、ASES(American shoulder and elbow surgeons)评分及 UCLA(university of California Los Angeles)评分评价患者肩关节功能状况;同时拍摄肩关节正位、侧位及腋位 X 线片,评估是否有肩锁关节复位丢失。结果21例患者术后平均随访(14.6±3.9)个月。末次随访时肩关节平均前屈上举为173.9°±10.3°,体侧外旋为59.5°±14.3°,内旋为第12胸椎体水平,平均 UCLA 评分为(34.1±2.5)分,平均 ASES 评分为(95.5±4.7)分,平均 VAS 评分(0.3±0.6)分。末次随访拍摄肩关节 X 线片未发现肩锁关节复位丢失。结论采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效满意,患者术后可获得良好的肩关节功能。%Background Dislocation of the acromioclavicular joint is a common injury of shoulder girdle.For the dislocation of acromioclavicular joint of Rockwood type Ⅰ and type Ⅱ,patient can obtain satisfactory result from conservative treatment; For the severe dislocation such as Rockwood type Ⅳ and type Ⅴ,operative treatment should be a good choice.However,for the patients of Rockwood type Ⅲ dislocation,the treatment is still controversial.With the development of minimally invasive technique,arthroscopic ligament reconstruction is gradually widely used in the treatment of acromioclavicular joint dislocation.Shoulder arthroscopic operation has the

  4. 空心钉固定联合半腱肌肌腱重建喙锁韧带治疗Ⅲ度肩锁关节脱位%The clinical effect of coracoclavicular ligament reconstruction by hollow screw associated with semitendinosus ligament in grade Ⅲ acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    周江军; 朱治宇; 赵敏; 吕仁发; 张立; 陈荣剑

    2012-01-01

    目的 探讨空心钉固定联合半腱肌肌腱重建喙锁韧带治疗Ⅲ度肩锁关节脱位的疗效.方法 对22例Ⅲ度肩锁关节脱位患者行空心钉固定联合半腱肌肌腱重建喙锁韧带治疗.结果 患者均获随访,时间10~32个月.肩关节功能恢复良好,局部畸形消失,未见复发.参照Karlsson疗效评定标准:A级18例,B级4例.结论 该手术方法设计符合生物力学的要求,方法简单,复位作用良好,是治疗Ⅲ度新鲜肩锁关节脱位有效方法.%Objective To study the effect of coracoclavicular ligament reconstruction by hollow screw associated with semitendinosus ligament in grade Ⅲ acromioclavicular joint dislocation. Methods 22 patients with grade Ⅲ acromio-clavicular joint dislocation were treated by hollow screw associated with semitendinosus ligament. Results 22 cases were follow up for 10 ~32 months. According to Karlsson criteria evaluation standard, the clinical outcomes were A in 18 cases, B in 4 cases. All cases had good shoulder joint function, the local deformity was disappeared, no recurrence cases were found. Conclusions Hollow screw associated with semitendinosus ligament is a simple and effective method for grade Ⅲ acromioclavicular joint dislocation. The operation method accords with biomechanics, and acromioclavicular joint reduction is good.

  5. Endobutton technique for the treatment of acute acromioclavicular joint dislocations

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    Raif Özden

    2014-06-01

    Full Text Available Objective: Acromioclavicular (AC joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients, and grade III AC joint dislocation (3 patient according to Rockwood classification. The coracoclavicular (CC interval and AC joint were reduced using two endobuttons. One endobutton was fitted on the clavicle and the second was placed at the undersurface of the coracoid. Outcomes were assessed with the Constant shoulder score and visual analog pain scale. Results: All the patients had powerful intraoperative fixation. Immediately after surgery, and 6 weeks, and 1 year postoperative radiographs showed adequate reduction of the CC distance and the AC joint. The mean Constant shoulder score was 89 (88–92 in the injured shoulder and 90 (88–93 in the uninjured shoulder. There was no statically significant difference between the injured and normal shoulder in terms of Constant shoulder score and there was no complication during the process. Conclusion: This technique is a safe and effective method for providing fixation for the AC joint.

  6. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

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    Qingjun Liu, Jianyun Miao, Bin Lin, Zhimin Guo

    2012-01-01

    Full Text Available Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate.Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months.Results: The mean Constant score was 94 (range, 78 to 100. The results were excellent in 12 patients (75.0%, good in 3 patients (18.8% and satisfactory in 1patient (6.2%. Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients.Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique.

  7. Static and functional ultrasonographic picture shoulder and acromioclavicular joints in normal and at hypermobility

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    Litvin Yu.P.

    2012-01-01

    Full Text Available Studying of anatomy humeral and acromioclavicular joints according to static and functional ultrasonography in norm and at hypermobility was an objective of this research. For the decision of an object in view we had been surveyed 45 persons at the age from 15 till 59 years (middle age has made 32,4±1,6 year, from them 32 men and 13 women. To clinical signs of hypermobility an investigated contingent have divided on two groups: the basic – 15 patients and control – 30 patients. It is established that humeral and acromioclavicular joints on ultrasonograms the features have display of elements. In research are described not changed soft tissue and bone structures, and also variants of their normal structure. By means of functional ultrasonography the basic signs of instability humeral and acromioclavicular joints have been defined.

  8. Nonoperative management of a sagittal coracoid fracture with a concomitant acromioclavicular joint separation

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    Thomas Kristen

    2010-01-01

    Full Text Available Separation of the acromioclavicular joint in conjunction with a coracoid fracture is a rare injury. Treatment decisions are traditionally based on the level of the fracture, the status of the coracoclavicular ligament and the activity level of the patient. We present a novel coracoid fracture pattern treated nonoperatively in a young, active patient and a thorough review of the literature regarding this topic.

  9. Surgical treatment of an aseptic fistulized acromioclavicular joint cyst: a case report and review of the literature.

    Science.gov (United States)

    Murena, Luigi; D'angelo, Fabio; Falvo, Daniele A; Vulcano, Ettore

    2009-01-01

    An acromioclavicular joint cyst is an uncommonly reported condition, which seems to result from a massive rotator cuff tear and degenerative osteoarthritis of the acromioclavicular joint. We present the case of an 81-year-old man affected by an acromioclavicular joint cyst, associated to a massive rotator cuff tear, proximal migration of the humeral head and osteoarthritis of the gleno-humeral joint. The mass was 7 x 2.5 cm in size and the overlying skin presented a fistula that drained clear synovial-like fluid. Plain X-ray examination of the left shoulder showed proximal migration of the humeral head migration and osteoarthritis of the gleno-humeral joint, and further MRI evaluation confirmed the clinical diagnosis of a complete rotator cuff tear and observed a large subcutaneous cyst in communication with the degenerative acromioclavicular joint. The patient underwent surgical excision of the cyst and lateral resection of the clavicle to prevent disease recurrence. To the best of our knowledge, this is the first reported case of an acromioclavicular joint cyst complicated by an aseptic fistula resulting from multiple aspirations. PMID:19918423

  10. Suture Anchors Joint Proximally Based Conjoined Tendon Transfer for Coracoclavicular Ligament Reconstruction in Treatment of Acromioclavicular Separation%应用缝合锚结合联合腱外侧半肌腱重建喙锁韧带治疗肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    赵杨; 赵健; 鲁世荣; 王雷; 秦晓霖; 魏巍; 王春光

    2011-01-01

    Objective: To determine the best operation treating acromioclavicular, through different treatment effect by different operation way. Methods: 60 acromioclavicular separation patients were divided randomly into the two groups as follows: the treatment group which were treated by suture anchors combining proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction in treatment of acromioclavicular separation and the control group which were treated by operation with Kirschner wires and tension band inner fixation. The evaluation of treatment effect were maked at 3 and 6 months after the treatment for every patient, including the total evaluation by JOA, the comparison by JOA score, Pain score according to the VAS, and the safety evaluation. Results:The total evaluation by JOA and the comparison by JOA score were showed that the treatment group were better than the control group (P<0.05) and the joint pain in the treatment group is lighter than that in the control group at 3 and 6 months after the treatment the blank control model group (P<0.05). Conclusion: It is a effective and safe method that using suture anchors combining Proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction separation treat acromioclavicular separation.%目的:观察治疗肩锁关节脱位的不同手术方式的治疗效果,以确定最佳的手术方法.方法:将60例肩锁关节脱位病人随机分为治疗组和对照组,分别采用缝合锚结合联合腱外侧半肌腱反转移位重建喙锁韧带辅助颈腕吊带制动的治疗方法及克氏针张力带内固定方法,术后3个月及6个月对患者进行JOA总体情况评定、JOA评分比较、肩锁关节疼痛VAS评定情况比较及安全性评价.结果:应用缝合锚结合联合腱外侧半肌腱反转移位重建喙锁韧带辅助颈腕吊带制动治疗肩锁关节脱位3个月及6个月后JOA总体评定情况结果及JOA评分结果优于克氏针张力

  11. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    Science.gov (United States)

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  12. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

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    Yoshihiro Onada

    2016-01-01

    Full Text Available Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP, and typically present with ipsilateral acromioclavicular joint (ACJ dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia.

  13. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation.

    Science.gov (United States)

    Onada, Yoshihiro; Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  14. Acroplate--a modern solution for the treatment of acromioclavicular joint dislocation.

    Science.gov (United States)

    Cîrstoiu, C; Rădulescu, R; Popescu, D; Ene, R; Circotă, G; Bădiceanu, Corina

    2009-01-01

    Two main ways to fix the reduction were imposed in surgical treatment of the acromioclavicular joint dislocations: fixation with trans acromioclavicular pin (Phemister method) and fixation with plate and screws type acroplate. The purpose of the present paper work is to compare immediate and later postoperative results between the two types of surgical interventions. During 2005-2007, 37 surgical reductions and fixation of acromioclavicular joint dislocations were performed in the Orthopedic-Traumatology Clinic of SUUB. In 17 cases a fixation with screws and plates type acroplate has been performed and in 20 cases with pins using the Phemister method. Sex ratio: 31 men and 8 women. Patients were aged between 17 and 56 years old. Follow up at 6 weeks, 3, 6, 12 and 18 post-operatory months. Osteosintesis material removing was done postoperatively, at 4 weeks in case of acroplate's and at 6 weeks in case of the pins. All patients treated of fixation with plate and screws acroplate type had a favorable evolution/development, starting with the shoulder joint mobilization at 24 hours postoperatively, with a complete recovery 4 weeks after the operation, at the same time with the ablation, and without immediate other late complications. As far as the patients treated by using the Phemister method are concerned, they were applied an immobilization, postoperatively. Desault bandage or the scarf for a period between 1 and 3 weeks, beginning with the shoulder joint mobilization later on and a full recovery after a minimum of 6 weeks. However, 3 of the cases showed a migration of one or both pins. Following the study, a more rapid recovery resulted, complete, and without complications of mobility in the shoulder joint, when using plate type acroplate vs pin. PMID:20108536

  15. Comparative study on treating complete dislocation of acromioclavicular joint with three different methods

    Institute of Scientific and Technical Information of China (English)

    林斌; 练克俭; 郭林新; 郭志民; 庄泽民; 刘庆军; 周亮

    2004-01-01

    Objective: To comparatively study complete dislocation of acromioclavicular joint treated with three different methods.Methods:A total of 96 patients (81 males and 15 females, aged 16-59 years, mean =45 years) with complete dislocation of acromioclavicular joint were treated with Dewar's operation ( Group A, n = 32), internal fixation with Kirschner tension band wires ( Group B, n = 44), or internal fixation with Wolter plates ( Group C, n = 20 ),respectively, in this study. Eighty-five patients suffered from acute dislocations and eleven from chronic dislocations. Results: The patients were followed up for 50 months on an average. According to Karlsson's standard, in Group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In Group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In Group C, 15 patients were assessed as good, 4 as fair and 1 as poor. The good and fair rates were significantly different between Group A and Group B, and between Group C and Group B, but no statistical difference was found between Group A and Group C. The operating time was ( 52.36 ± 7.24 ) minutes, ( 67.43 ± 8.11) minutes and (69.73 ±8.04) minutes in Groups A, B and C, respectively. And the hospitalizing fees were (2 400 ±270) yuan, (2 100±190) yuan and (8450±360) yuan in Groups A, B and C, respectively. Conclusions: Dewar's operation is a good and safe method with shorter operating time and lower hospitalizing fee for treating complete dislocation of acromioclavicular joint. The method is simple without the need of a second operation to remove the implants and with few complications.

  16. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

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    Khalid D Mohammed

    2016-01-01

    Full Text Available This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome.

  17. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion.

    Science.gov (United States)

    Mohammed, Khalid D; Stachiw, Danielle; Malone, Alex A

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  18. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Science.gov (United States)

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

  19. 锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位%Clavicular hook plate and coracoacromial ligament transferred to reconstruct coracoclavicular ligament in treatment of acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    张峰; 陈晓波; 刘郑生; 韩雪

    2012-01-01

    目的 探讨锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位的疗效.方法 选择河北满城县医院2008 年6月-2011 年4 月收治的肩锁关节脱位患者40 例的临床资料,其中20 例采用锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗( 研究组),20 例采用锁骨钩钢板加张力带治疗( 对照组),观察两组治疗效果.结果 两组术前术后均采用Lazzcano 标准评价肩关节功能,两组术后肩关节功能均较治疗前明显改善(P<0.05).研究组治疗后肩关节功能优良率高于对照组(P<0.05).两组切口均甲级愈合,均未出现螺钉松动和断裂.结论 锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位较锁骨钩钢板加张力带治疗术后肩关节功能优良率高,且固定牢靠,安全有效.%Objective To study the therapeutic effect of combined clavicular hook plate and coracoclavicular ligament reconstruction on dislocation of acromiclavicular joint. Methods Forty patients with dislocation of acromioclavicular joint admitted to our hospital from June 2008 to April 2011 were divided into study group(n=20) and control group(n=20). Patients in study group were treated with combined clavicular hook plate and coracoacromial ligament reconstruction while those in control group were treated with combined clavicular hook plate and tension belt to observe their therapeutic effect. Results The shoulder function of patients in two groups before and after operation was assessed according to the Lazzcano standards, which was significantly better after operation than before operation(P<0.05). The excellent rate of shoulder function was significantly higher in study group than in control group after operation(P<0.05). The incisions healed quite well with no screw loosening and fracture. Conclusion Combined clavicular hook plate and coracoclavicular ligament reconstruction is a safe and effective procedure for dislocation of acromioclavicular

  20. Bioabsorbable Suture Anchor Migration to the Acromioclavicular Joint: How Far Can These Implants Go?

    Directory of Open Access Journals (Sweden)

    Giovanna Medina

    2014-01-01

    Full Text Available Few complications regarding the use of bioabsorbable suture anchors in the shoulder have been reported. What motivated this case report was the unusual location of the anchor, found in the acromioclavicular joint which, to our knowledge, has never been reported so far. A 53-year old male with previous rotator cuff (RC repair using bioabsorbable suture anchors presented with pain and weakness after 2 years of surgery. A suspicion of retear of the RC led to request of a magnetic resonance image, in which the implant was found located in the acromioclavicular joint. The complications reported with the use of metallic implants around the shoulder led to the development of bioabsorbable anchors. Advantages are their absorption over time, minimizing the risk of migration or interference with revision surgery, less artifacts with magnetic resonance imaging, and tendon-to-bone repair strength similar to metallic anchors. Since the use of bioabsorbable suture anchors is increasing, it is important to know the possible complications associated with these devices.

  1. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries

    DEFF Research Database (Denmark)

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus;

    2014-01-01

    Optimal treatment for the unstable acromioclavicular (AC) joint remains a highly debated topic in the field of orthopaedic medicine. In particular, no consensus exists regarding treatment of grade III injuries, which are classified according to the Rockwood classification by disruption of both th...

  2. 全关节镜下治疗肩锁关节脱位%Arthroscopic treatment of acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    汪国友; 沈骅睿; 曾胜强; 徐平; 邓凯; 扶世杰

    2014-01-01

    Background The dislocation of acromioclavicular joint is a common injury clinically. This study is to investigate the treatment of acute acromioclavicular joint dislocation (Rockwood typeⅢ)and compare the clinical effect of two different ways of coracoclavicular ligament reconstruction. Methods We select the patients with fresh Rockwood type Ⅲ to V dislocation of acromioclavicular joint from January 2008 to June 2013.After randomization,1 6 cases received the reconstruction of coracoclavicular and acromioclavicular ligament arthroscopically with semitendinosus tendon (autogenous group).Among them,12 were males and 4 were females,aged 1 6-62 years old,the average age is 39.8 years old.They were followed up for 9-39 months,the average follow-up was 25.6 months;13 cases underwent the reconstruction of coracoclavicular ligament with the double Endobutton plate and Ethibond suture (Ethibond suture group),including 9 cases of male,4 cases of female,aging from 1 9 to 57 years old,the average age is 36.5 years old,were followed up for 12-35 months with a mean follow-up of 1 9.6 months.The reason of injury:12 cases of traffic injuries,9 cases of sports injury,4 cases of fall,bruise in 2 cases and 2 cases of other injuries.The time between injury to operation was 3-1 1 d,averagely 6 d.8 patients were accompanied by SLAP injury of shoulder joint (5 cases of autologous ligament group,3 cases of Ethibond suture group),3 patients were accompanied by rotator cuff injury (1 cases of autologous ligament group,2 cases of Ethibond suture group).2 patients were combined with glenohumeral joint cartilage injury (1 case of autologous ligament group 1 case,1 case of love help group),2 patients were combined with Bankart injury (both in autologous ligament group ), 1 patient was combined with glenoid fracture (Ethibond suture group).The age,sex,cause of injury,injury side and time from getting injured to operation of the two groups are without significant differences (P >0

  3. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Directory of Open Access Journals (Sweden)

    Tae-Soo Park

    2016-01-01

    Full Text Available Background: Symptomatic acromioclavicular joint (ACJ lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42-70 years. The mean duration of followup was 6 years and 2 months (range 4-8 years 10 months. The results were evaluated using the University of California Los Angeles (UCLA shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly ( P < 0.001. There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor.

  4. Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection

    OpenAIRE

    Ehud Atoun; Artan-Athanasios Bano; Alexander Van Tongel; Ali Narvani; Giuseppe Sforza; Ofer Levy

    2014-01-01

    Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an a...

  5. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Science.gov (United States)

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  6. 修复Ⅲ度肩锁关节脱位:带线锚钉重建喙锁韧带的生物力学变化%Treatment of Tossy III acromioclavicular joint dislocation:biomechanical change of anchor-reconstructed coracoclavicular ligament

    Institute of Scientific and Technical Information of China (English)

    韩冰; 冯晖; 陈烁; 王德广; 张传开

    2015-01-01

    BACKGROUND:The commonly used methods of repairing the acromioclavicular joint dislocation are Kirschner wire tension band internal fixation, clavicular hook internal fixation and suture anchor internal fixation. Each method has their advantages and disadvantages. Both Kirschner wire and clavicular hook require secondary surgery to remove the internal fixators, and their design is not based on the biomechanical principle. OBJECTIVE:To reconstruct coracoclavicular ligament using anchor and perform biomechanical tests. METHODS:Ten shoulder antisepsis specimens were numbered and each specimen was tested by three trials. (1) Stretching coracoclavicular ligament: Specimens were fixed on the biomechanical machine and were tensile until the ligament was ruptured, the maximum failure load was recorded. (2) Reconstruction of coracoclavicular ligament using an anchor: Coracoclavicular ligment was reconstructed using an anchor, then specimens were fixed on the biomechanical machine and were tensile until the ligament was ruptured, the maximum failure load was recorded. (3) Reconstruction of coracoclavicular ligament using two anchors: Coracoclavicular ligment was reconstructed using two anchors, then specimens were fixed on the biomechanical machine and were tensile until the ligament was ruptured, the maximum failure load was recorded. RESULTS AND CONCLUSION:Coracoclavicular ligament fracture load was (413.0±123.48) N; the failure load was (345.1±111.23) N in an anchor group and 465.3±100.64 N in two anchors group. When coracoclavicular ligament is reconstructed using an anchor, the stress is concentrated under external forces, which is prone to the extraction of anchor and the failure of surgery, biomechanical data showed that the fracture load is lower than the coracoclavicular ligament, so the reconstruction is not reliable; when coracoclavicular ligament is reconstructed using two anchors, the stress is dispersed, which meet the biological features and the

  7. Axial and tangential views of the acromioclavicular joint: the introduction of new projections

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei; ZHAGN Qi; SU Yan-ling; ZHANG Ze-kun; HOU Zhi-yong; PAN Jin-she; ZHANG Xiao-lin; ZHANG Ying-ze

    2012-01-01

    Background Routine anteroposterior radiographs of the acromioclavicular (AC) joint with or without weight bearing have limitations in demonstrating the AC joint.Transarticular fixation with Kirschner wire is a treatment choice for AC dislocations.However,percutaneous fixation of the AC joint is technically demanding.The C-arm fluoroscopy can be used as routine intraoperative guidance to facilitate this procedure.The current study aims to introduce new projections,the axial and tangential views of AC joint,to help evaluate the severity of the injury and facilitate the percutaneous procedure.Methods Three shoulder specimens were used to find the projection directions of the axial and tangential views of the AC joint by using the digital radiography (DR) unit.The axial and tangential views were taken of 20 adult volunteers by referencing the projection directions determined in the shoulder specimens.The angles showed on the DR system and the angles between the coronal plane of the body and the vertical plane of the flat panel detector (FPD) during taking these radiographs were recorded.The C-arm fluoroscopy unit was used to take the axial and tangential views referencing the angles measured on the DR system.Routine anteroposterior radiographs of the AC joint were taken on the volunteers.The minimal distances from the distal clavicle to the acromion were measured on both tangential and anteroposterior radiographs.The data was statistically analyzed.Results The clear axial and tangential radiographs of AC joints of the volunteers were obtained using both DR and C-arm fluoroscopy units.The angles demonstrated on the DR window are (20.8±2.4)° for male and (18.3±2.3)° for female.During taking the axial views,the angles between the coronal plane of the body and vertical plane of FPD are (23.3±3.2)° for male and (20.1±2.4)° for female.During taking tangential views,the corresponding angles are (117.5±3.7)° for male and (113.1±3.3)° for female.On the tangential

  8. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    Science.gov (United States)

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  9. Radiographic changes in the operative treatment of acute acromioclavicular joint dislocation – tight rope technique vs. K-wire fixation

    International Nuclear Information System (INIS)

    Operative treatment of higher degree acromioclavicular joint luxation is common. A new option is made available by the tight rope technique. It claims to provide adequate outcome with the use of a minimally invasive technique. First clinical studies justified its medical use, but the equivalence to established surgical methods remains unclear. We therefore analyzed radiographic data from patients that were treated with the tight rope system (TR) and compared them to those treated with K-wires (KW) fixation. Retrospective study with inclusion criteria: surgery for acromioclavicular joint luxation between 2004 and 2011, classified as Rockwood type III, no concomitant injury, first event injury. We compared pre- and post-operative X-rays with those taken at the end of treatment. Clinical data from follow-ups and radiographic data were evaluated. The main outcome variable was the remaining distance between the acromion and clavicle (ACD), as well as the coracoid process and clavicle (CCD). 27 patients (TR: n=16; KW: n=11) with comparable demographics and injury severity were included. Surgery reduced ACD (TR: p=0.002; KW: p<0.001) and CCD (TR: p=0.001; KW: p=0.003). Heterotopic ossification or postoperative osteolysis was not significantly associated with either one of the procedures. Three patients (18.75%) in the TR group showed impaired wound healing, migrating K-wires were recorded in 2 patients (18.2%) and impingement syndrome occurred in 1 patient (9.1%) with K-wires. Posttraumatic arthritis was not seen. There was a loss of reduction in 2 cases within the TR-group (12.51%) and 1 in the KW-group (9.1%). At last follow up, ACD and CCD were wider in both groups compared to the healthy side. This study shows that the Tight rope system is an effective alternative in the treatment of higher degree acromioclavicular luxation and comparable to the established methods

  10. Acromioclavicular joint separations grades I-III: a review of the literature and development of best practice guidelines.

    Science.gov (United States)

    Reid, Duncan; Polson, Kate; Johnson, Louise

    2012-08-01

    Acromioclavicular joint (ACJ) separation injuries are common injuries among sporting populations. ACJ separations are graded according to severity from grade I being a mild sprain to grade VI, which is severe dislocation with displacement. There is consensus in the literature that grade I-III ACJ separations are managed conservatively and grades IV-VI are managed surgically. Despite conservative care being recommended for lesser grades of injury, there is very little evidence in the literature as to what constitutes conservative care. Therefore, the purpose of this paper was, first, to review the relevant anatomy and kinematics of the ACJ and, second, to review the literature relating to current evidence of conservative management of ACJ injury. Using this data, a best practice guideline for conservative rehabilitation in grade I-III ACJ separations was developed. For the conservative management, a literature search was undertaken using the following databases in the Auckland University of Technology's electronic library resources; MEDLINE, CINAHL, SPORTDiscus™ and the Cochrane Library. The following keywords or phrases were used: 'acromioclavicular joint separations', 'injury', 'dislocations', 'rehabilitation', 'conservative care', 'physiotherapy' and 'exercise'. A total of 24 articles was identified. There were no randomized controlled trials (RCTs) that investigated conservative treatment for grade I-III ACJ sprains. Therefore, a narrative review was formulated covering the anatomy and biomechanics of the ACJ, injury mechanisms and relevant literature reviewed covering rehabilitation principles. Conservative management of grade I-III ACJ separations is still the main recommendation following this review. A best practice guideline for managing grade I-III ACJ separations is presented to help guide clinicians until well constructed RCTs are carried out to improve the conservative management of ACJ injuries. PMID:22784232

  11. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

    Directory of Open Access Journals (Sweden)

    Sood Aman

    2008-01-01

    Full Text Available Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall

  12. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    Institute of Scientific and Technical Information of China (English)

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明

    2013-01-01

    目的:研究关节镜下缝线钢板增强喙锁韧带术治疗肩锁关节脱位的近期治疗效果。方法2010年3月至2011年3月,在关节镜下使用膝关节韧带重建技术的缝线钢板(德国 ASCULAP 公司, B′BRAUN)增强重建喙锁韧带(三角韧带与斜方韧带),治疗 Rockwood Ⅲ型9例、Ⅴ型3例新鲜肩锁关节脱位。行 X线片、美国肩肘关节外科医师(America Shoulder Elbow Surgeons,ASES)评分和 Constant 评分,随访12~18个月。结果 ASES 评分:术前28.7分,术后86.9分;Constant 评分:术前24分,术后91分。治疗组 X线片显示,肩锁关节复位良好。术后1年,91.7%(11/12)病例获得满意治疗效果,83.3%(10/12)恢复到术前运动水平,仅有1例出现肩锁关节半脱位。结论关节镜下缝线钢板喙锁韧带增强术治疗肩锁关节脱位,早期可以获得满意的治疗效果,术后复位良好,并发症少。%Objective Acromioclavicular joint dislocation is commonly seen in shoulder joint injuries. Dysfunction as well as pain and discomfort usually occurred when the integrity of shoulder is damaged,for the acromioclavicular (AC)joint is involved in the connection between the scapula and the body as well as the activities of shoulder joint.Therefore,a consensus has been reached to treat severe AC joint dislocation by surgery.Based on different anatomical and functional cognition,methods for AC joint dislocation are various,which are typically performed by incision to reconstruct its stability and restore function.Attempts had been made by many doctors in the reconstruction of AC joint dislocation with the development of arthroscopy.From March 2010 to March 2011,obvious therapeutic effect was obtained in treating Rockwood type Ⅲ and Ⅴ AC joint dislocation arthroscopically with the suture plate used for the reconstruction of ligaments of knee joint to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament).Methods From March 2010 to March 2011

  13. Treatment of Rockwood type Ⅲ acromioclavicular joint dislocation with endobutton technique%应用 Endobutton 带袢钢板技术治疗RockwoodⅢ型肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    宋哲; 张堃; 朱养均; 李忠; 庄岩; 魏巍; 杨娜

    2015-01-01

    ,distal clavicle and coracoid.The fascias of deltoid muscle and trapezius muscle were divided along the long axis of clavicle and the periosteum was stripped to expose the distal clavicle.The interal between deltoid and pectoralis major muscle was opened and the medial and lateral boarders of coracoid was prepared.The residual coraco-clavicle ligament was reserved.The articular space of acromioclavicular joint was examined and the ruptured fibrous cartilage disc was removed.After reduction of acromioclavicular joint,one Kirschner wire was drilled through the articular surface from the lateral end of acromion to provisionally keep the joint in place.A 1.0 mm guide pin was drilled from distal clavicle into the base of coracoid perpendicularly,3.5 mm canulated drill bit drilled a bone tunnel along the guiding pin.The distance from the surface of clavicle to the base of coracoid was measured with depth scale.The Endobutton was selected properly.A shuttle wire was used to pull the button loop out of clavicle and left the button under coracoid.The distal clavicle was reduced with compression.The loop was pulled upward and the other Endobutton without loop was put into the loop with acutenaculum.First,the Endobutton was laid on its side with sutures pierced through its two holes. Then the Endobutton was laid flat and made sure to attach to the base of coracoid without sliding.The sutures were tightened and knotted to make the Endobutton without loop fixed on the loop.The reconstruction of conoid ligament was finished.Then the suture on the coracoclavicular ligament was tightened and knotted.The wound was irrigated.The acromioclavicular joint capsule was repaired and the deltoid and trapezius muscle were reconstructed at the distal clavicle.The incision was closed layer by layer.(3 )Post-operative management and outcome evaluation:Antibiotics were given to prevent infection for 24-48 hours.The shoulder was protected by a sling for 1 -2 weeks.Pendulum exercise began after pain relief and

  14. Conjoined tendon and coracoacromial ligament transfer in the treatment of RockwoodIII acromioclavicular joint dislocation:anatomical and clinical validation%联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位:解剖学及临床试验验证

    Institute of Scientific and Technical Information of China (English)

    王治洲; 伊力哈木•托合提; 徐超; 侯彦杰; 郭洪亮; 甘子明; 张爱红

    2015-01-01

      结果与结论:①尸体解剖形态学研究结果:试验获得了肩锁关节及其周围组织、肌皮神经较为详细的形态学参数,为该部位手术提供了解剖学资料。②临床病例分析结果:11例RockwoodⅢ型患者行联合腱外侧半肌腱与喙肩韧带内侧半肌腱双束共同重建喙锁韧带治疗肩锁关节脱位,随访2-24个月,平均美国肩肘外科协会评分为92.3分,平均Constant-Murley肩关节功能评分为90.4分,平均美国加州大学洛杉矶分校评分31.6分,平均目测类比评分1.4分,平均肩关节简明测试问卷肯定答案为8个,总体优良率为91%(10/11)。1例患者修复结果较差。课题通过解剖重建肩锁关节的静态稳定性结构(如喙锁韧带)和动态稳定性结构(如关节囊、斜方肌和三角肌)实现了肩锁关节的解剖复位。总而言之,联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位是一种有效的修复方法。%BACKGROUND:There are many surgical methods for treatment of acromioclavicular joint dislocation. Through various internal fixation materials (such as hook plate, screws, K-wire, etc.), we can achieve the initial stability and restoration of the acromioclavicular joint. But these internal fixators can cause varying degrees of occupancy and damage to the acromioclavicular joint, and the joint reduction often miss after removal of the internal fixators. OBJECTIVE:To use conjoined tendon and coracoacromial ligament transfer for coracoclavicular ligament reconstruction in the repair of RockwoodIII acromioclavicular joint dislocation, to provide the theoretical foundation through the autopsy, and to analyze the clinical efficacy based on clinical fol ow-up results. METHODS:(1) Autopsy morphology research:From September 2012 to November 2012, total y 46 adult cadaveric human shoulders were dissected in the Department of Anatomy, Xinjiang Medical University. The anatomical

  15. The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

    Directory of Open Access Journals (Sweden)

    Vestri Anna R

    2009-12-01

    Full Text Available Abstract Background This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects. Methods The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ. One-hundred healthy volunteers were recruited as a control group. Results The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result and 2.2% in the control group (p Conclusions Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.

  16. Tratamento artroscópico da luxação acromioclavicular aguda com âncoras Arthroscopic treatment of acute acromioclavicular joint dislocation using suture anchors

    Directory of Open Access Journals (Sweden)

    Leonardo Muntada Cavinatto

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados clínicos e radiográficos de uma série de casos com diagnóstico de Luxação Acromioclavicular (LAC Aguda, tratados através da fixação coracoclavicular com âncoras por via artroscópica. MÉTODO: Vinte pacientes apresentando LAC com menos de 30 dias de evolução foram operados pela técnica da estabilização coracoclavicular com âncoras por via artroscópica. Duas âncoras metálicas com dois fios cada, foram inseridas no coracóide. Os fios foram amarrados sobre a clavícula passando por túneis transósseos claviculares. Para a avaliação radiográfica, foi utilizada a medida comparativa da distância coracoclavicular com o lado contralateral e a avaliação funcional através dos escores de Constant e UCLA o seguimento foi de seis meses. RESULTADO: Dos vinte casos inicialmente selecionados, seis necessitaram de novo procedimento cirúrgico e foram excluídos do estudo. Dos quatorze pacientes restantes, apenas dois mantiveram redução da articulação acromioclavicular, enquanto os demais apresentaram algum grau de desvio no decorrer da evolução. Desconsiderando os pacientes excluídos, os escores de Constant e UCLA tiveram média 94,79 (82-100 e, 32,64 (26-35, respectivamente. CONCLUSÃO: A técnica apresentou um alto índice de perda da redução ao longo da evolução de seis meses. A avaliação funcional apresentou resultado satisfatório com escore médio elevado de Evidência: Nível de Evidência: Nível III, estudo retrospectivo.OBJECTIVE: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (AAD treated by arthroscopic coracoclavicular fixation with suture anchors. METHOD: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2

  17. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease

    Science.gov (United States)

    Carrera, Guillermo; Baynes, Keith; Mautz, Alan; DuBois, Melissa; Cerniglia, Ross; Ryan, Lawrence M.

    2016-01-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (phistory of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p=0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition. PMID:23609408

  18. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.

    Science.gov (United States)

    Parperis, Konstantinos; Carrera, Guillermo; Baynes, Keith; Mautz, Alan; Dubois, Melissa; Cerniglia, Ross; Ryan, Lawrence M

    2013-09-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p = 0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p = 0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition.

  19. Treatment of Chronic Acromioclavicular Joint Dislocation in a Paraplegic Patient with the Weaver-Dunn Procedure and a Hook-Plate

    Science.gov (United States)

    Godry, Holger; Citak, Mustafa; Königshausen, Matthias; Schildhauer, Thomas A.; Seybold, Dominik

    2016-01-01

    In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible. In this case the Weaver-Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first post-operative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers. PMID:27433301

  20. Mid-term results after operative treatment of rockwood grade III-V Acromioclavicular joint dislocations with an AC-hook-plate

    Directory of Open Access Journals (Sweden)

    Kienast B

    2011-02-01

    Full Text Available Abstract Acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. Several static and dynamic operative procedures with or without primary ligament replacement have been described. Between February 2003 and March 2009 we treated 313 patients suffering from Rockwood III-V lesions of the AC joint with an AC-hook plate. 225 (72% of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (VAS-scale was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%. Constant score showed an average of 92.4 of 100 possible points with 89% excellent and good results and 11% satisfying results. All patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6%. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. We observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. We can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-V dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function.

  1. Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation%关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位

    Institute of Scientific and Technical Information of China (English)

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    优,1例良。患者均对治疗效果满意。结论采用关节镜下四骨道四袢双束固定方法修复急性肩锁关节 Rockwood-Ⅴ型脱位,生物固定牢固,手术创伤小,并且避免了双袢单骨道应力过于集中、拉力线单薄等缺点,是治疗急性肩锁关节 Rockwood Ⅴ型损伤较好的方法。%Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the

  2. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位%Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the coracoid neck is the center between the two preparatively drilled bone tunnels.Make the cross line vertical to line P,and the bone tunnels are located in the I and II quadrant.The distance between two bone tunnels is 6 mm.(3 )Surgical techniques:According to the data of preoperative measurement of bone tunnel,the self

  3. Anatomic Reconstruction of the Proximal Tibiofibular Joint.

    Science.gov (United States)

    Warner, Brent T; Moulton, Samuel G; Cram, Tyler R; LaPrade, Robert F

    2016-02-01

    Proximal tibiofibular joint (PTFJ) instability can be easily missed or confused for other, more common lateral knee pathologies such as meniscal tears, fibular collateral ligament injury, biceps femoris pathology, or iliotibial band syndrome. Because of this confusion, some authors believe that PTFJ instability is more common than initially appreciated. Patients with PTFJ subluxation may have no history of inciting trauma or injury, and it is not uncommon for these patients to have bilateral symptoms and generalized ligamentous laxity. Currently, the optimal surgical treatment for patients with chronic PTFJ instability is unknown. Historically, a variety of surgical treatments have been reported. Initially, joint arthrodesis and fibular head resection were recommended. More recently, temporary screw fixation, nonanatomic reconstruction with strips of the biceps femoris tendon or iliotibial band, and reconstruction with free hamstring autograft have been described. The purpose of this report is to present our surgical technique for treatment of chronic PTFJ instability using an anatomic reconstruction of the posterior ligamentous structures of the PTFJ with a semitendinosus autograft. PMID:27274455

  4. Tratamento artroscópico da luxação acromio-clavicular pelo método "tight rope" (arthrex® Arthroscopic treatment of acromioclavicular joint dislocation by tight rope technique (arthrex®

    Directory of Open Access Journals (Sweden)

    Luis Alfredo Gómez Vieira

    2009-02-01

    Full Text Available OBJETIVO: Apresentar a técnica cirúrgica artroscópica pelo método "Tight Rope" e a avaliação dos resultados com esta técnica no tratamento da luxação acrômio-clavicular aguda. MÉTODOS: entre agosto de 2006 e maio de 2007, 10 ombros de 10 pacientes com luxação acrômio-clavicular aguda foram submetidos a tratamento artroscópcio pela técnica Tight Rope-Arthrex®. O seguimento mínimo foi de 12 meses, com média de 15 meses. A idade variou de 26 e 42 anos com média de 34 anos. Todos os pacientes eram do sexo masculino. Todos os pacientes foram atendidos na fase aguda da lesão sendo avaliados por radiologia simples (série trauma. Os pacientes foram acompanhados semanalmente no primeiro mês e a cada três meses após o procedimento artroscópico. A avaliação clínica foi feita por meio dos critérios da University of Califórnia at Los Angeles (UCLA. RESULTADOS: Todos os pacientes operados agudamente encontravam-se satisfeitos com os resultados do tratamento cirúrgico artroscópico com uma média de 32,5 pontos na escala de avaliação da UCLA. CONCLUSÃO: O tratamento artroscópico da luxação acrômio-clavicular aguda pelo método "Tight Rope" é uma técnica cirúrgica minimamente invasiva que mostrou-se eficiente para o tratamento destas lesões.OBJECTIVE: Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. METHODS: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University

  5. The treatment of the acute acromioclavicular joint dislocation with LARS artificial ligament:a preliminary report%应用LARS人工韧带治疗急性肩锁关节脱位的初步报告

    Institute of Scientific and Technical Information of China (English)

    陈爱民; 鹿楠; 叶添文; 杨鹏; 朱磊; 李菁

    2014-01-01

    Background Currently,the clinical perspectives of surgical treatment for Tossy Ⅲacromioclavicular(AC)joint dislocations are relatively identical.Due to the post-traumatic ruptures of the acromioclavicular ligament and coracoclavicular(CC)ligament which are used to maintain stability of the joint,the clavicle moves backward and upward,and the upper arm and the scapula drops downward for the gravity of the upper arm and the influence of the sternocleidomastoid muscle.Since such complications as reduction difficulties,redislocation after external fixation,pressure ulcers of the skin,and so forth are particularly prone to occur in the conservative therapy,the operative treatment is more inclined to be adopted for the Tossy Ⅲ dislocation of the AC joint.With the single repair and fixation of the CC ligament,redislocation is likely to happen after implant removal because the ruptured ligaments healed as scar tissue.Therefore,this study uses an operative method of reconstructing and augmenting the CC ligament with LARS artificial ligament for the treatment of Tossy Ⅲ AC joint dislocation,and evaluates its clinical effect.Methods From November 2006 to July 2009,8 patients with acute AC joint dislocation of Tossy Ⅲ were admitted into our hospital.Five patients were male and 3 were female,and their ages ranged from 21 to 45.Sides:3 injuries were on the left and 5 were on the right.Seven patients suffered from falling on the ground,and 1 patient was inj ured in a traffic accident.All the patients were treated with LARS artificial ligaments to reconstruct the CC ligament.Constant score and VAS score were adopted in clinical evaluation.Zanca view of the bilateral AC joint and the axillary radiograph of the affected shoulder joint were employed for imaging evaluation.All the patients were simple Tossy Ⅲ dislocation of AC joint with no trauma of other parts and skin breakdown.Regular pre-operative examinations and evaluations were carried out after admission,and LARS

  6. 锁骨钩钢板置入治疗Rockwood Ⅲ型肩锁关节脱位%Clavicular hook plate implantation for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    张建华; 聂宇; 周永焕; 王光勇; 敦先礼; 李有方; 周廷玉; 钟斌

    2012-01-01

    背景:多数学者主张手术治疗RockwoodⅢ型肩锁关节脱位,以恢复肩锁关节周围稳定结构的正常解剖,使之在无张力的条件下愈合.目的:观察锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位的临床疗效.方法:选择2005-12/2008-06宜昌市夷陵区医院骨科和五峰土家族自治县人民医院骨科收治的Rockwood Ⅲ型肩锁关节脱位患者56例,采用锁骨钩钢板置入进行治疗,分别于置入前、置入后1年取出内固定前、取出内固定后3个月采用目测类比评分、美国肩肘外科医师评分、Constant肩关节评分系统评分进行评定,比较钢板置入前后患者肩关节功能的变化及有无并发症发生.结果与结论:全部患者均顺利完成手术且获得随访,随访时间15~30个月,平均20个月.均在1年左右取出锁骨钩钢板,行喙锁韧带修复者32例,未行喙锁韧带修复者24例.取出内固定后肩锁关节脱位复发2例,均未行喙锁韧带修复.本组有2例出现肩痛、异物感,无内固定失败病例.术后1年取内固定前目测类比评分较术前降低,美国肩肘外科医师评分、Constant肩关节评分系统评分较术前升高(P < 0.01);取内固定后3个月目测类比评分较术后1年取内固定前降低,美国肩肘外科医师评分、Constant肩关节评分系统评分较术后1年取内固定前升高(P < 0.05).提示锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位,操作简单,创伤较小,是一种比较理想的内固定.%BACKGROUND: Surgical therapy has been frequently used to treat Rockwood type Ⅲ acromioclavicular joint dislocation to restore normal anatomy of stable structures around the acromioclavicular joint and heal free of tension.OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on Rockwood type Ⅲ acromioclavicular joint dislocation.METHODS: A total of 56 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were selected from

  7. 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位%Management of chronic acromioclavicular joint dislocation with hook plate and fascia lata graft

    Institute of Scientific and Technical Information of China (English)

    祝李霖; 黄东; 吴伟炽; 刘晓春; 余超群

    2016-01-01

    目的 探讨锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位的临床疗效.方法 回顾性分析2012年5月至2014年3月应用锁骨钩钢板联合阔筋膜治疗的16例RoekwoodⅢ型陈旧性肩锁关节脱位患者资料,男10例,女6例;年龄19~57岁,平均34.7岁;左侧7例,右侧9例.均为直接暴力致伤,受伤至手术时间为8 ~ 54周,平均12.4周.末次随访时采用上肢功能评分(DASH)及视觉模拟评分(VAS)评定肩部功能及疼痛情况,采用Karlsson评价标准评定疗效. 结果 术后切口均一期愈合,肩锁关节脱位均得到纠正,无血管、神经损伤.所有患者术后获6~18个月(平均12个月)随访.术后复查无钢板断裂、螺钉松动、关节再脱位等情况发生.末次随访时患者DASH评分[(25.42±8.34)分]及肩关节VAS评分[(2.22±1.70)分]均优于术前[(43.72±12.35)、(6.33±1.37)分],差异有统计学意义(P<0.05);按Karlsson评价标准评定疗效:优10例,良4例,可2例. 结论 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位可恢复肩关节动力平衡及稳定性,具有固定牢靠、术后关节活动早、并发症少等优点.%Objective To evaluate the therapeutic efficacy of hook plate and fascia lata graft in management of chronic acromioclavicular joint dislocation.Methods From May 2012 to March 2014,a total of 16 cases of chronic acromioclavicular joint dislocation (Rockwood type Ⅲ) were treated with hook plate and fascia lata graft.They were 10 men and 6 women,from 19 to 57 years of age (mean,34.7 years).Seven cases were at the left side and 9 at the right side.All injuries resulted from direct violence.The time from injury to surgery ranged from 8 to 54 weeks (mean,12.4 weeks).At the final follow-ups,the shoulder function was assessed using the Quick Version of the Disabilities of the Arm,Shoulder and Hand Score (DASH) and visual analogue scale (VAS),and the efficacy using Karlsson's evaluation system.Results All surgical wounds

  8. Type RockwoodIII in the treatment of small incision of clavicular hook plate for acromioclavicular joint dislocation in 66 cases%小切口锁骨钩钢板治疗RockwoodIII型肩锁关节脱位66例

    Institute of Scientific and Technical Information of China (English)

    李克军; 邹方亮; 邹孝军; 杨志乐

    2013-01-01

      Objective To summarize the operation method and clinical effect of dislocation of small incision of clavicular hook plate in treatment of type RockwoodIII shoulder. Methods From 2004 January ~ 2012 year in January, the treatment of 66 cases of RockwoodIII type acromioclavicular joint dislocation were treated with clavicular hook plate, with only the clavicular hook plate, repair of acromioclavicular joint capsule and the acromioclavicular ligament, not deliberately repair of coracoclavicular ligament. Reset X ray to evaluate the postoperative dislocation of acromioclavicular joint, shoulder joint function exercise. Remove the clavicular hook plate in 9 ~ 18 months after operation, 11 months after operation on the average. Through the bilateral shoulder joints in patients with normal and weight-bearing flms, evaluation of acromioclavicular joint dislocation after operation, after taking out the internal fixation of shoulder joint function and repair and no repair of coracoclavicular ligament of shoulder joint function infuence. Results All cases were followed up, followed up for 15 ~ 32 months, an average of 20 months follow-up, according to the function evaluation standard patients, excellent in 40 cases, good in 26 cases. Conclusion The small incision of clavicular hook plate in treatment of acromioclavicular joint dislocation with RockwoodIII type acromioclavicular joint anatomic and biomechanical characteristics, reliable fxation, coracoclavicular ligament can repair, postoperative early functional exercise, is worthy of promotion.%  目的总结小切口锁骨钩钢板治疗RockwoodIII型肩锁关节脱位的手术方法和临床疗效。方法2004年1月至2012年1月,应用锁骨钩钢板治疗66例RockwoodIII型肩锁关节脱位,术中仅行锁骨钩钢板固定,修复肩锁关节关节囊和肩锁韧带,未刻意修复喙锁韧带。术后X光片评估肩锁关节脱位的复位,行肩关节功能锻炼。锁骨钩钢板在术后9~18

  9. Acromioclavicular septic arthritis and sternoclavicular septic arthritis with contiguous pyomyositis.

    Science.gov (United States)

    Corey, Sally A; Agger, William A; Saterbak, Andrew T

    2015-03-01

    Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.

  10. Ankle and shoulder joint reconstruction using soft tissue allografts

    International Nuclear Information System (INIS)

    Full text: Lateral Collateral Ligament Insufficiency is a common complication of injury to the ankle joint. This needs reconstruction of the torn ligament as the joint instability gives rise to frequent giving way at the ankle joint. It can be reconstructed using autologous peroneus brevis tendon. The authors prefer to reconstruct using deep frozen (-80 degree C) non-gamma irradiated tibialis anterior or tibialis posterior tendon allograft procured by NUH Tissue Bank. The graft must be at least between 18-22 cm long. The procedure employed is a first stage Brostrom Procedure repairing the anterior talo-fibula ligament using Mitek sutures. In the second stage the Calcaneofibular ligament is reconstructed using a figure of eight tendon reconstruction via drill holes in the fibular above and the calcaneum below. Twelve cases have been reconstructed this way with good results. When injury is sustained to the Acromia-clavicular (AC) Joint, for type 3 to 5 AC Joint Dislocation and in manual labourers, reconstruction is needed. The author's preferred method is a 2 stage procedure using deep frozen (-80 degree C), non gamma-irradiated fascia lata allografts procured by NUH Tissue Bank. In the first stage the dislocated AC Joint is reduced and held in position by transfixation using 2 baby Steinmann Pins and repair of torn corac clavicular ligaments. The second stage consisted of reconstruction with rolled-up fascia lata figure of eight allograft tendon between the clavicle and the coracoid process. The 2 pins are removed after 6 weeks and the shoulder mobilised. 10 cases have been done with good results. Two cases showed mild subluxation of the AC joint due to slight loss of the reduction performed during the operation. (Author)

  11. COMPARATIVE ANALYSIS OF AUTOGRAFT TECHNIQUE AND CLAVICULAR HOOK PLATE IN GRADE 3 ACROMIOCLAVICULAR DISLOCATIONS

    Directory of Open Access Journals (Sweden)

    Rahul Narayan

    2016-04-01

    Full Text Available OBJECTIVE To evaluate clinical outcome of clavicular hook plate and autograft technique in the surgical treatment of Rockwood Grade-III acromioclavicular joint dislocation. METHODS Fifteen patients were operated using standard clavicular hook plate and another fifteen patients were operated using autograft technique. After a minimum follow-up of one year, clinical assessment was done using Constant-Murley Score. Statistical evaluation was done using SPSS ver. 21.0. RESULTS Mean age group was 31.44±7.8 years. Average constant shoulder score for the hook plate group was 81.3 (Range 74–89 and that for autograft technique group was 91.7 (Range 88–97. CONCLUSION Autograft technique was found to be superior in terms of functional outcome when compared to clavicular hook plate. Such superiority can be attributed to the biologic nature of coracoclavicular ligament reconstruction in the autograft technique.

  12. Reconstruction of coracoclavicular ligament by excision and semi-inversion of conjoined tendon at the distal clavicle and allograft tendon transfer for treatment of acromioclavicular separation%锁骨远端切除联合腱外侧半反转辅助异体肌腱移植重建喙锁韧带治疗肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    孙策勇; 朱以明; 李奉龙; 姜春岩; 彭明学; 王自鸿

    2015-01-01

    .4 years (range,from 21.7 to 64.1 years).The mean time from injury to surgery was 12.2 days (range,from 3 to 20 days).According the Rockwood classification,6 cases were type Ⅲ,6 type Ⅳ and 42 type Ⅴ.All the patients were routinely followed up after the surgery.The visual analogue scale (VAS),American Shoulder and Elbow Surgeons (ASES) and Constant-Murley scores were used to evaluate the postoperative shoulder function.Postoperative radiograph was taken for each patient to evaluate the loss of reduction of the acromioclavicular joint.Results The mean follow-up time was 64.2 months (range,from 48.6 to 92.2 months).At the final follow-up,the average forward elevation was 170.0° (range,from 160° to 180°),external rotation 57.8° (range,from 40° to 80°) and internal rotation T8 level (range,from T2 to T12),respectively.The average VAS,ASES and Constant-Murley scores were 0.7 (range,from 0 to 4),90.4 (range,from 81.7 to 100.0) and 90.9 (range,from 83.0 to 100.0),respectively.Tenderness on the distal clavicle was found in 12 patients (22.2%).Partial loss of reduction was found in 6 patients with type Ⅴ fracture (11.1%).No complete loss of reduction was found in any case.Conclusion Most patients may obtain good shoulder function and no loss of reduction at mid-and long-term follow-ups after their acromioclavicular separation has been treated by reconstruction of coracoclavicular ligament by excision and semi-inversion of conjoined tendon at the distal clavicle and allograft tendon transfer.

  13. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    Directory of Open Access Journals (Sweden)

    Neda Hashemi-Sadraei

    2014-01-01

    Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  14. Elbow joint stability following experimental osteoligamentous injury and reconstruction

    DEFF Research Database (Denmark)

    Deutch, Søren R; Jensen, Steen Lund; Tyrdal, Stein;

    2003-01-01

    Elbow joint dislocation was simulated in cadaveric specimens to quantify laxity induced by radial head and coronoid process lesions, either alone or in combination with collateral ligament insufficiency. The effects of lateral ligament reconstruction and radial head prosthesis replacement were also...

  15. Diagnostic challenges in acromioclavicular septic arthritis.

    Science.gov (United States)

    Williams, Mark

    2016-01-01

    A 69-year-old man with Klinefelter's syndrome presented with a painful shoulder and staphylococcal sepsis. He received intravenous antibiotics while investigations were performed to locate the source of infection. MRI demonstrated infection in the acromioclavicular joint (ACJ). The patient clinically improved and a further 5 weeks of oral antibiotics were given. He remained asymptomatic at 2-year follow-up. Although ACJ septic arthritis is rare, independent of immune-competent status, a high index of suspicion is essential for prompt diagnosis. The condition presents additional diagnostic challenges due to unfamiliarity, the challenges of interpreting imaging, desire for radiological guided arthrocentesis and low volume aspirates. Overcoming these pitfalls is essential to avoid significant morbidity and mortality. PMID:27257000

  16. Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection

    Directory of Open Access Journals (Sweden)

    Masahide Fujiki

    2015-01-01

    Full Text Available Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication. We reviewed four patients who had undergone resection of osteosarcomas of the femur, placement of a prosthetic knee joint, and rotationplasty with vascular reconstruction from 2010 to 2013. The mean interval between prosthetic joint replacement and rotationplasty was 10.4 years and the mean interval between the diagnosis of prosthesis infection and rotationplasty was 7.9 years. Rotationplasty was successful in all patients; however, in one patient, arterial thrombosis developed and necessitated urgent surgical removal and arterial reconstruction. All patients were able to walk independently with a prosthetic limb after rehabilitation. Although there is no consensus regarding the most appropriate method of vascular management during rotationplasty for revision of infected prosthetic joints, vascular transection and reanastomosis is a useful option.

  17. Relação anatômica do nervo supraescapular com o processo coracoide, articulação acromioclavicular e acrômio Anatomical relationship of the suprascapular nerve to the coracoid process, acromio clavicular joint and acromion

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2010-06-01

    Full Text Available OBJETIVO: Estabelecer a relação anatômica do nervo supraescapular (NSE localizado na fossa supraescapular com a borda medial da base do coracoide, face articular acromial da articulação acromioclavicular e a borda anterolateral do acrômio. MÉTODOS: Foram dissecados 16 ombros de 16 cadáveres, sendo nove masculinos e sete femininos, mensurando com auxílio do paquímetro a distância do nervo supraescapular (na sua passagem sob o ligamento transverso com pontos fixos determinados na borda medial da base do processo coracoide, na face articular do acrômio da articulação acromioclavicular e na borda anterolateral do acrômio, correlacionando com a idade e o sexo. Foram excluídos cadáveres com intervenção cirúrgica prévia. RESULTADOS: Com relação à medida do nervo supraescapular, na sua fossa à borda medial da base do processo coracoide, obtivemos uma média de 3,9cm (variando de 3,1cm a 5,2cm; com relação à articulação acromioclavicular, a média foi de 4,7 (3,9cm a 5,2cm; e, com relação à borda anterolateral do acrômio, a média foi de 6,1cm (5,7cm a 6,8cm. CONCLUSÃO: É fundamental o conhecimento exato da anatomia dos nervos da região anterior do ombro para evitar lesões iatrogênicas e para conseguir resultados satisfatórios no tratamento cirúrgico das doenças do ombro, seja ele realizado de forma aberta ou artroscópica.OBJECTIVE: To establish the anatomic relationship of the suprascapular nerve (SSN located in the suprascapular notch to the medial border of the base of the coracoid process, the medial acromial surface of the acromioclavicular joint and the anterolateral edge of the acromion. METHODS: We dissected 16 shoulders of 16 cadavers, 9 males and 7 females. The distance from the suprascapular nerve (in its course beneath the transverse ligament to certain fixed points in the medial base of the coracoid process was measured with the aid of a caliper, as well as to the articular surface of the acromion

  18. Joint Image Reconstruction and Segmentation Using the Potts Model

    CERN Document Server

    Storath, Martin; Frikel, Jürgen; Unser, Michael

    2014-01-01

    We propose a new algorithmic approach to the non-smooth and non-convex Potts problem (also called piecewise-constant Mumford-Shah problem) for inverse imaging problems. We derive a suitable splitting into specific subproblems that can all be solved efficiently. Our method does not require a priori knowledge on the gray levels nor on the number of segments of the reconstruction. Further, it avoids anisotropic artifacts such as geometric staircasing. We demonstrate the suitability of our method for joint image reconstruction and segmentation from limited data in x-ray and photoacoustic tomography. For instance, our method is able to reconstruct the Shepp-Logan phantom from $7$ angular views only. We demonstrate the practical applicability in an experiment with real PET data.

  19. Bayesian PET image reconstruction incorporating anato-functional joint entropy

    Science.gov (United States)

    Tang, Jing; Rahmim, Arman

    2009-12-01

    We developed a maximum a posterior (MAP) reconstruction method for positron emission tomography (PET) image reconstruction incorporating magnetic resonance (MR) image information, with the joint entropy between the PET and MR image features serving as the regularization constraint. A non-parametric method was used to estimate the joint probability density of the PET and MR images. Using realistically simulated PET and MR human brain phantoms, the quantitative performance of the proposed algorithm was investigated. Incorporation of the anatomic information via this technique, after parameter optimization, was seen to dramatically improve the noise versus bias tradeoff in every region of interest, compared to the result from using conventional MAP reconstruction. In particular, hot lesions in the FDG PET image, which had no anatomical correspondence in the MR image, also had improved contrast versus noise tradeoff. Corrections were made to figures 3, 4 and 6, and to the second paragraph of section 3.1 on 13 November 2009. The corrected electronic version is identical to the print version.

  20. Joint regularization for spectro-temporal CT reconstruction

    Science.gov (United States)

    Clark, D. P.; Badea, C. T.

    2016-03-01

    X-ray CT is widely used, both clinically and preclinically, for fast, high-resolution, anatomic imaging; however, compelling opportunities exist to expand its use in functional imaging applications. For instance, spectral information combined with nanoparticle contrast agents enables quantification of tissue perfusion levels, while temporal information details cardiac and respiratory dynamics. In previous work, we proposed and demonstrated a projection acquisition and reconstruction strategy for 5D CT (3D + dual-energy + time) which recovered spectral and temporal information without substantially increasing radiation dose or sampling time relative to anatomic imaging protocols. The approach relied on the approximate separability of the temporal and spectral reconstruction sub-problems, which enabled substantial projection undersampling and effective regularization. Here, we extend this previous work to more general, nonseparable 5D CT reconstruction cases (3D + muti-energy + time) with applicability to K-edge imaging of exogenous contrast agents. We apply the newly proposed algorithm in phantom simulations using a realistic system and noise model for a photon counting x-ray detector with six energy thresholds. The MOBY mouse phantom used contains realistic concentrations of iodine, gold, and calcium in water. Relative to weighted least-squares reconstruction, the proposed 5D reconstruction algorithm improved reconstruction and material decomposition accuracy by 3-18 times. Furthermore, by exploiting joint, low rank image structure between time points and energies, ~80 HU of contrast associated with the Kedge of gold and ~35 HU of contrast associated with the blood pool and myocardium were recovered from more than 400 HU of noise.

  1. Joint image reconstruction and sensitivity estimation in SENSE (JSENSE).

    Science.gov (United States)

    Ying, Leslie; Sheng, Jinhua

    2007-06-01

    Parallel magnetic resonance imaging (pMRI) using multichannel receiver coils has emerged as an effective tool to reduce imaging time in various applications. However, the issue of accurate estimation of coil sensitivities has not been fully addressed, which limits the level of speed enhancement achievable with the technology. The self-calibrating (SC) technique for sensitivity extraction has been well accepted, especially for dynamic imaging, and complements the common calibration technique that uses a separate scan. However, the existing method to extract the sensitivity information from the SC data is not accurate enough when the number of data is small, and thus erroneous sensitivities affect the reconstruction quality when they are directly applied to the reconstruction equation. This paper considers this problem of error propagation in the sequential procedure of sensitivity estimation followed by image reconstruction in existing methods, such as sensitivity encoding (SENSE) and simultaneous acquisition of spatial harmonics (SMASH), and reformulates the image reconstruction problem as a joint estimation of the coil sensitivities and the desired image, which is solved by an iterative optimization algorithm. The proposed method was tested on various data sets. The results from a set of in vivo data are shown to demonstrate the effectiveness of the proposed method, especially when a rather large net acceleration factor is used. PMID:17534910

  2. Acromioclavicular Joint Dislocation of Types Rockwood Ⅲ, Ⅳ and Ⅴ Treated with Coracoclavicular Bolt Combined with Beak-shoulder Ligament Shif%喙锁螺钉结合喙肩韧带移位治疗Rockwood Ⅲ型、Ⅳ型、Ⅴ型肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    谢伟; 郑建平; 黎高明; 吴向科; 傅格深

    2012-01-01

    [目的]探讨喙锁螺钉结合喙肩韧带移位治疗RockwoodⅢ型、Ⅳ型、Ⅴ型肩锁关节脱位的临床疗效.[方法]对32例RockwoodⅢ型、Ⅳ型、Ⅴ型肩锁关节脱位患者采用喙锁螺钉结合喙肩韧带移位治疗,采用Karlasson标准,分析其临床疗效.[结果]术后随访9~21个月,平均13个月,其中A级28例,B级4例,术后均未出现神经血管损伤、螺钉失败等严重并发症.[结论]喙锁螺钉结合喙肩韧带移位是治疗肩锁关节脱位一种有效的治疗方法.%[Objective] To investigate the effects of acromioclavicular joint dislocation of types Rockwood Ⅲ, IV and V treated with coracoclavicular bolt combined with beak-shoulder ligament shift. [Method] Take Karlasson standard to 32 cases, analyse the clinical effect. [Result]Followed up for 9~ 21m after operation, 28 cases were of level A, 4 level B, without nerve or vessel injury or failure bolt or other severe complication. [Conclusion] Coracoclavicular bolt combined with beak-shoulder ligament shift is an effective method for acromioclavicular joint dislocation.

  3. Reconstruction of the hip joint in children after septic coxitis

    Directory of Open Access Journals (Sweden)

    Михаил Павлович Тепленький

    2016-06-01

    Full Text Available Background.Surgical treatment of destructive dislocations is problematic, and controversial. Treatment options range from active monitoring to complex multistage reconstruction protocols.Materials and methods.The results of treatment of 17 children with disruptive dislocation of the hip (class IV according to the Choi classification are presented. The mean age at which treatment was started was 6.3 ± 0.5 years (range: 3-9 years. Treatment strategies included formation of the weight-bearing contact of the proximal femur and acetabulum and ilium osteotomy using an Ilizarov frame. The follow-up period lasted from 2 to 11 years. Clinical results were assessed using Colton’s criteria. Assessment of the radiology findings included the anatomy relations and congruence of the articular surfaces. The patients were divided into two groups, according to age, for data analysis.Results.The majority (88% of the children had positive anatomical and functional outcomes. The functional results were good (12-15 points, satisfactory (9-11 points, and unsatisfactory (8 points for 3, 5, and 1, respectively, among 3-6 year olds and 2, 6, and 0, respectively, among 7-9 year olds. The distribution of joint congruence types I, III, and IV was 2, 4, and 3, respectively, in the younger group and 1, 6, and 1, respectively, in the older group.Conclusion.The use of reconstructive surgery using the Ilizarov apparatus in children with a defect of the proximal femur creates conditions for the adaptation of incongruent articular components without causing decompensation of the joint.

  4. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery using computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Wolford, Larry M

    2015-02-01

    Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time requirement in preparation of concomitant orthognathic and temporomandibular joint (TMJ) prostheses cases. The concomitant TMJ and orthognathic surgery-computer-assisted surgical simulation technique increases the accuracy of combined cases. In order to have flexibility in positioning of the total joint prosthesis, recontouring of the lateral aspect of the rami is advantageous.

  5. COMPARATIVE ANALYSIS OF AUTOGRAFT TECHNIQUE AND CLAVICULAR HOOK PLATE IN GRADE 3 ACROMIOCLAVICULAR DISLOCATIONS

    OpenAIRE

    Rahul Narayan; Ojas

    2016-01-01

    OBJECTIVE To evaluate clinical outcome of clavicular hook plate and autograft technique in the surgical treatment of Rockwood Grade-III acromioclavicular joint dislocation. METHODS Fifteen patients were operated using standard clavicular hook plate and another fifteen patients were operated using autograft technique. After a minimum follow-up of one year, clinical assessment was done using Constant-Murley Score. Statistical evaluation was done using SPSS ver. 21.0. RES...

  6. MRI reconstruction with joint global regularization and transform learning.

    Science.gov (United States)

    Tanc, A Korhan; Eksioglu, Ender M

    2016-10-01

    Sparsity based regularization has been a popular approach to remedy the measurement scarcity in image reconstruction. Recently, sparsifying transforms learned from image patches have been utilized as an effective regularizer for the Magnetic Resonance Imaging (MRI) reconstruction. Here, we infuse additional global regularization terms to the patch-based transform learning. We develop an algorithm to solve the resulting novel cost function, which includes both patchwise and global regularization terms. Extensive simulation results indicate that the introduced mixed approach has improved MRI reconstruction performance, when compared to the algorithms which use either of the patchwise transform learning or global regularization terms alone.

  7. Joint reconstruction strategy for structured illumination microscopy with unknown illuminations

    CERN Document Server

    Labouesse, Simon; Idier, Jérôme; Bourguignon, Sébastien; Negash, Awoke; Liu, Penghuan; Sentenac, Anne

    2016-01-01

    The blind structured illumination microscopy (SIM) strategy proposed in (Mudry et al., 1992) is drastically revisited in this paper, unveiling the mechanism that drives the super-resolution in the method. A much improved numerical implementation is also provided for the reconstruction problem under the image positivity constraint. This algorithm rests on a new preconditioned proximal iteration faster than existing solutions, paving the way to 3D and real-time 2D reconstruction.

  8. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

    Science.gov (United States)

    Carofino, Brad C; Mazzocca, Augustus D

    2010-03-01

    The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery. PMID:20188267

  9. Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

    Directory of Open Access Journals (Sweden)

    Mário Chaves Correa

    2011-10-01

    months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture.

  10. Towards disparity joint upsampling for robust stereoscopic endoscopic scene reconstruction in robotic prostatectomy

    Science.gov (United States)

    Luo, Xiongbiao; McLeod, A. Jonathan; Jayarathne, Uditha L.; Pautler, Stephen E.; Schlacta, Christopher M.; Peters, Terry M.

    2016-03-01

    Three-dimensional (3-D) scene reconstruction from stereoscopic binocular laparoscopic videos is an effective way to expand the limited surgical field and augment the structure visualization of the organ being operated in minimally invasive surgery. However, currently available reconstruction approaches are limited by image noise, occlusions, textureless and blurred structures. In particular, an endoscope inside the body only has the limited light source resulting in illumination non-uniformities in the visualized field. These limitations unavoidably deteriorate the stereo image quality and hence lead to low-resolution and inaccurate disparity maps, resulting in blurred edge structures in 3-D scene reconstruction. This paper proposes an improved stereo correspondence framework that integrates cost-volume filtering with joint upsampling for robust disparity estimation. Joint bilateral upsampling, joint geodesic upsampling, and tree filtering upsampling were compared to enhance the disparity accuracy. The experimental results demonstrate that joint upsampling provides an effective way to boost the disparity estimation and hence to improve the surgical endoscopic scene 3-D reconstruction. Moreover, the bilateral upsampling generally outperforms the other two upsampling methods in disparity estimation.

  11. Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction

    Science.gov (United States)

    Wang, Lei

    2016-01-01

    [Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength. PMID:27512270

  12. Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Wang, Lei

    2016-07-01

    [Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength. PMID:27512270

  13. Custom Anatomical 3D Spacer for Temporomandibular Joint Resection and Reconstruction.

    Science.gov (United States)

    Green, John Marshall; Lawson, Sarah T; Liacouras, Peter C; Wise, Edward M; Gentile, Michael A; Grant, Gerald Thomas

    2016-03-01

    Two cases are presented using a two-stage approach and a custom antibiotic spacer placement. Temporomandibular reconstruction can be very demanding and accomplished with a variety of methods in preparation of a total joint and ramus reconstruction with total joint prostheses (TMJ Concepts, Ventura, CA). Three-dimensional reconstructions from diagnostic computed tomography were used to establish a virtually planned resection which included the entire condyle-ramus complex. From these data, digital designs were used to manufacture molds to facilitate intraoperative fabrication of precise custom anatomic spacers from rapidly setting antibiotic-impregnated polymethyl methacrylate. Molds were manufactured using vat polymerization (stereolithography) with a photopolymer in the first case and powder bed fusion (electron beam melting) with Ti6AL4V for the second. Surgical methodology and the use of molds for intraoperative spacer fabrication for each case are discussed. PMID:26889353

  14. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery.

  15. Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.

    Science.gov (United States)

    Tuman, Jeffrey; Diduch, David R; Baumfeld, Joshua A; Rubino, L Joseph; Hart, Joseph M

    2008-05-01

    Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery.

  16. Joint infection unique to hamstring tendon harvester used during anterior cruciate ligament reconstruction surgery.

    Science.gov (United States)

    Tuman, Jeffrey; Diduch, David R; Baumfeld, Joshua A; Rubino, L Joseph; Hart, Joseph M

    2008-05-01

    Joint infection after anterior cruciate ligament (ACL) reconstruction is a rare but important clinical issue that must be resolved quickly to prevent secondary joint damage and preserve the graft. After careful analysis, we observed 3 infection cases within a 12-month period after ACL reconstruction, which represented an abnormally elevated risk. All reconstructions were performed by the same surgeon and used hamstring tendon allograft. For each surgery, the Target Tendon Harvester (DePuy Mitek, Raynham, MA) was used to harvest hamstring tendons. Through our review, we learned that this instrument was sterilized while assembled. It is our belief that ineffective sterilization of this hamstring graft harvester served as the origin for these infections. We have determined that appropriate sterilization technique involves disassembly of this particular hamstring tendon harvester before sterilization because of the tube-within-a-tube configuration. We have since continued to use the Target Tendon Harvester, disassembling it before sterilization. There have been no infections in the ensuing 12 months during which the surgeon performed over 40 primary ACL reconstructions via hamstring autograft. The information from this report is intended to provide arthroscopists with information about potential sources of infection after ACL reconstruction surgery. PMID:18442698

  17. Lateral collateral ligament reconstruction for chronic varus instability of the hallux interphalangeal joint.

    Science.gov (United States)

    Cho, Jaeho

    2014-01-01

    Chronic varus instability of the hallux interphalangeal joint is a rare injury, and only a few reports of this injury have been published. In some studies, this injury has been related to taekwondo. Taekwondo is an essential martial art in the Korean military. We have described a case of varus instability of the hallux interphalangeal joint in a professional soldier who had practiced taekwondo for 5 years and the surgical outcome after reconstruction of the lateral collateral ligament with the fourth toe extensor tendon.

  18. Kinematic reconstruction of the human arm joints in robot-aided therapies with Hermes robot.

    Science.gov (United States)

    Bertomeu-Motos, Arturo; Morales, Ricardo; Lledo, Luis D; Diez, Jorge A; Catalan, Jose M; Garcia-Aracil, Nicolas

    2015-08-01

    This paper presents a kinematic reconstruction algorithm for the variables of the human arm joints in robot-aided neurorehabilitation therapies. The presented algorithm uses the end effector of a rehabilitation robot and an accelerometer placed onto the upper arm to compute accurate values of the human arm chain. The goal of this algorithm is to obtain the joint values of the patient's arm to provide objective information to the therapist about the progress of the patient and to study the effectiveness of these kind of therapies. PMID:26736479

  19. 应用不同手术方法治疗陈旧性肩锁关节脱位的疗效分析%Review of the results of different operative procedures for old acromioclavicular dislocation

    Institute of Scientific and Technical Information of China (English)

    吴其常; 卞传华; 苗旭漫

    2001-01-01

    目的比较分析应用不同手术方法治疗陈旧性肩锁关节脱位的疗效。方法对43例陈旧性肩锁关节脱位患者分别应用单纯切开复位克氏针内固定(9例);切开复位内固定并肩锁关节韧带重建(14例);切开复位内固定并喙突上移(20例)三种手术方法进行治疗,术后平均随访4.8年,对其自觉症状、上肢肌力、肩关节功能和肩锁关节间隙等改善程度进行比较。结果三种术式的优良率分别为33%(3/9)、50%(7/14)和74%(15/20)。单纯切开复位克氏针内固定法的疗效与切开复位内固定并肩锁韧带重建法相比,差异无显著性意义(P>0.05),两者与切开复位内固定并喙突上移法比较,差异有显著性意义(均P 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

  20. Extensor-mechanism-reconstruction of the knee joint after traumatic loss of the entire extensor apparatus.

    Science.gov (United States)

    Raschke, D; Schüttrumpf, J P; Tezval, M; Stürmer, K M; Balcarek, P

    2014-06-01

    Injuries to the extensor apparatus of the knee joint have an incidence of 0.5% to 6%. Although previous studies have described the advantages and disadvantages of operative treatment in cases of patellar tendon rupture, patella fracture or quadriceps tendon lesions, a report on the reconstruction of the extensor apparatus after traumatic loss of the patella, the patellar tendon, the tibial tuberosity and parts of the lateral quadriceps muscle is absent from the literature. We present the case of a young motorcyclist who underwent a reconstruction of the extensor apparatus using autologous tendon grafts. At a 24-month follow-up, the patient has a nearly physiological range of motion of the knee joint and is able to cope well with everyday life.

  1. Predictors of Lateral Compartment Joint Space Difference at a Minimum of Two Years after ACL Reconstruction

    Science.gov (United States)

    Jones, Morgan H.; Reinke, Emily; Duryea, Jeffrey; Fleming, Braden C.; Obuchowski, Nancy; Winalski, Carl S.; Spindler, Kurt P.

    2016-01-01

    Objectives: ACL reconstruction effectively restores knee stability and allows a return to athletic activities after ACL injury, but patients are still at higher risk of developing post-traumatic OA. Patient reported outcomes from the Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort of over 1500 patients undergoing ACL reconstruction showed no increase in OA symptoms (KOOS subscale) at 2 or 6 years after surgery. Therefore, identification of structural changes of OA that may precede the onset of symptoms is of critical importance for determining risk factors for the initiation and progression of post-traumatic OA in addition to measuring the effectiveness of potential disease-modifying treatments. One structural measure of OA is radiographic joint space width (JSW). We previously demonstrated that meniscus treatment and age predict narrower medial compartment JSW. Methods: 335 patients from the MOON cohort (154 males, 181 females, median age 18 years at the time of surgery) were recruited at a minimum of 2 years following surgery for on-site evaluations including bilateral metatarsophalangeal joint (MTP) radiographs to assess JSW. To minimize bias related to pre-existing knee injury or OA, subjects were 35 years or younger, were injured playing a sport, had primary ACL reconstruction without prior meniscus or articular cartilage surgery, did not undergo subsequent ACL revision, and had a surgically normal contralateral knee. Radiographic JSW was measured in the lateral compartment of both knees using a validated semiautomated method. The association of age, sex, BMI, meniscus treatment, and articular cartilage treatment with lateral compartment JSW differences (JSD) between the reconstructed and normal knees was examined using multivariable generalized linear models. The Holm-Bonferroni method was used to account for multiple comparisons. Results: The mean lateral compartment JSW was 7.73 mm and (95% CI 7.61-7.85 mm) for ACL

  2. Reconstruction with autologous pasteurized whole knee joint I: experimental study in a rabbit model.

    Science.gov (United States)

    Ahmed, Adel Refaat; Watanabe, Hideomi; Takagishi, Kenji

    2003-01-01

    Hyperthermia-treated bone has been used for skeletal reconstruction after resection of malignant bone tumors, and more favorable results have been seen after pasteurization than after autoclaving or boiling. Pasteurization destroys malignant cells while preserving the bone-inducing property. All previous experimental models have studied replantation of bone segments, but reconstruction of joints is more important clinically. We studied the effects of extracorporeal hyperthermia on the reintegration of autologous whole knee joint grafts over a period of 16 weeks in a rabbit model. The whole knee joint was resected from 32 animals, heat-treated at 65 degrees C for 30 min, and replanted. In the control group, resection and replantation were performed without heat treatment. Reintegration was assessed by macroscopic analysis, histology, histochemistry, and radiography. Reintegration of the pasteurized group showed excellent remodeling during the 16 weeks, similar to the control groups. Responses to the pasteurization and the subsequent reintegration of cartilage, menisci, and ligaments were similar at 4, 8, 12, and 16 weeks with no significant difference between the two groups, although cartilage degradation seemed to occur earlier in the study group than in the control group. These results suggest that pasteurization may be superior to other cell-lethal treatments for autotransplantation of the whole joint currently available.

  3. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    Science.gov (United States)

    Rout, Debesh Kumar; Nayak, Bibhuti Bhusan; Choudhury, Arun Kumar; Pati, Ajit Kumar

    2014-01-01

    We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique. PMID:25190925

  4. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    Directory of Open Access Journals (Sweden)

    Debesh Kumar Rout

    2014-01-01

    Full Text Available We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique.

  5. Comparative study of surgical treatment of acromioclavicular luxation

    Directory of Open Access Journals (Sweden)

    Kezunović Miroslav

    2013-01-01

    Full Text Available Background/Aim. Acromioclavicular (AC luxations most often affect athletes. The published results regarding the treatment of AC joint luxations vary. Each method has its advantages and disadvantages, so there is still no consensus on the best method of treatment. The aim of this study was to review the results of a number of surgical approaches to stabilization of AC joint recorded over the span of five years. Methods. This study was based on the data acquired from the analysis of 28 patients with AC luxation surgically treated in the Clinical Center of Montenegro. One group of 16 patients underwent the traditional AO method (with transfixation of AC joint with Kirschner wire and Zuggurtung tension bands or the Bosworth method (using the coracoclaviculartransfixation screw - Zugg-Bosw group. The second group of 12 patients underwent a newer techinque with the Hook plate (Hook plate group. Results. All the patients had AC luxation of higher degree, stage IV-VI acording to the Rockwood scale. The average age of the two groups was very similar, with 28 being the average age of the Zugg-Bosw group, and 25 of the Hook plate group. Most patients were males (82%, injured mostly during athletic activity (75%-83%. Complications were more common and more complex in the Zugg-Bosw group, with 2 early and 8 late comlications. There are only 3 late complications in the Hook plate group, but with no significant statistical difference (p = 0.19; t = -1.34; df = 27. With respect to the subjective patient satisfaction following the treatment, the Hook plate group gave significantly better evaluations (4.4 ± 0.19(p = 0.007; t = 2.95; df = 27. Constant score showed no significant statistical difference (p = 0.078; t = 1.8; df = 27. The Hook plate group had a better median score (90 ± 0.18 with respect to the Zugg-Bosw group (85 ± 0.40. Conclusion. The Hook plate method achieved somewhat better results, which indicate that this method is one of the ways to ensure

  6. Joint Simultaneous Reconstruction of Regularized Building Superstructures from Low-Density LIDAR Data Using Icp

    Science.gov (United States)

    Wichmann, Andreas; Kada, Martin

    2016-06-01

    There are many applications for 3D city models, e.g., in visualizations, analysis, and simulations; each one requiring a certain level of detail to be effective. The overall trend goes towards including various kinds of anthropogenic and natural objects therein with ever increasing geometric and semantic details. A few years back, the featured 3D building models had only coarse roof geometry. But nowadays, they are expected to include detailed roof superstructures like dormers and chimneys. Several methods have been proposed for the automatic reconstruction of 3D building models from airborne based point clouds. However, they are usually unable to reliably recognize and reconstruct small roof superstructures as these objects are often represented by only few point measurements, especially in low-density point clouds. In this paper, we propose a recognition and reconstruction approach that overcomes this problem by identifying and simultaneously reconstructing regularized superstructures of similar shape. For this purpose, candidate areas for superstructures are detected by taking into account virtual sub-surface points that are assumed to lie on the main roof faces below the measured points. The areas with similar superstructures are detected, extracted, grouped together, and registered to one another with the Iterative Closest Point (ICP) algorithm. As an outcome, the joint point density of each detected group is increased, which helps to recognize the shape of the superstructure more reliably and in more detail. Finally, all instances of each group of superstructures are modeled at once and transformed back to their original position. Because superstructures are reconstructed in groups, symmetries, alignments, and regularities can be enforced in a straight-forward way. The validity of the approach is presented on a number of example buildings from the Vaihingen test data set.

  7. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2014-01-01

    Full Text Available Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg’s gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD.

  8. Multi-view TWRI scene reconstruction using a joint Bayesian sparse approximation model

    Science.gov (United States)

    Tang, V. H.; Bouzerdoum, A.; Phung, S. L.; Tivive, F. H. C.

    2015-05-01

    This paper addresses the problem of scene reconstruction in conjunction with wall-clutter mitigation for com- pressed multi-view through-the-wall radar imaging (TWRI). We consider the problem where the scene behind- the-wall is illuminated from different vantage points using a different set of frequencies at each antenna. First, a joint Bayesian sparse recovery model is employed to estimate the antenna signal coefficients simultaneously, by exploiting the sparsity and inter-signal correlations among antenna signals. Then, a subspace-projection technique is applied to suppress the signal coefficients related to the wall returns. Furthermore, a multi-task linear model is developed to relate the target coefficients to the image of the scene. The composite image is reconstructed using a joint Bayesian sparse framework, taking into account the inter-view dependencies. Experimental results are presented which demonstrate the effectiveness of the proposed approach for multi-view imaging of indoor scenes using a reduced set of measurements at each view.

  9. Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints.

    Science.gov (United States)

    Umer, Masood; Rashid, Haroon; Umer, Hafiz Muhammad; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  10. Surgical treatment of acromioclavicular dislocation with coracoclavicular screw and double Endobutton plate%喙锁螺钉与双Endobutton钢板治疗肩锁关节脱位的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨杰; 赵友明; 孙辽军; 洪建军; 孔建中; 杨雷; 窦海成; 邵荣学

    2011-01-01

    Objective To evaluate and compare the clinical outcome of coracoclavicular screw and double Endobutton plate in treatment of acromioclavicular dislocation ( Rockwood Ⅲ-Ⅴ ). Methods Twenty-eight patients with Rockwood Ⅲ-Ⅴ acromioclavicular dislocation were subjected to surgical reconstruction from January 2008 to October 2009. The coracoclavicular screw was performed in 14 patients and the double Endobutton plate in the other 14 patients. Clinical evaluation was performed by using Constant score and subject should value (SSV) in both groups, and the preoperative and postoperative radiographs, curative effects and complications were compared. Results The patients in two groups were followed up for a range of 6-25 months (average 12.6 months) , which showed higher postoperative Constant score and SSV score than preoperation in both groups (P<0.05). But the postoperative Constant sore and postoperative SSV score in the double Endobutton group were (89.8 ±8.3) points and (85.7 ±7. 3) points respectively, significantly better than (78. 0 ± 10. 3) points and (71. 8 ±9. 7) points respectively in the coracoclavicular screw group ( P < 0.05). The radiologic measurement showed no significant difference in regard of the coracoclavicular distance three months after operation in two groups (P>0.05). Conclusions The double Endobutton plate can attain significantly superior clinical outcomes for Rockwood Ⅲ-Ⅴ acromioclavicular dislocation compared with the coracoclavicular screw. The surgical technique of reconstructing the coracoclavicular ligament through anatomical approach will be the future trend in treatment of the acromioclavicular joint dislocation.%目的 探讨喙锁螺钉与双Endobutton钢板治疗Rockwocd Ⅲ~Ⅴ型肩锁关节脱位的临床疗效,并对两者进行对比研究.方法自2008年1月至2009年10月收治Rockwood Ⅲ~Ⅴ型肩锁关节脱位患者28例,电脑随机抽样分为两组,14例采用喙锁螺钉治疗,另14例采用

  11. Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint

    Directory of Open Access Journals (Sweden)

    Michiel A. J. van de Sande

    2014-01-01

    Full Text Available The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint.

  12. Limb-threatening ischemia secondary to a congenital acromioclavicular remnant.

    Science.gov (United States)

    Enlow, Jonathan M; McGregor, Walter E

    2009-07-01

    Upper extremity vascular compromise from thoracic outlet syndrome is rare and is usually the result of a "cervical rib," anterior scalene muscle abnormality, or clavicular trauma. We report a case of acute axillary artery thrombosis secondary to a congenital acromioclavicular remnant in a 40-year-old woman.

  13. 3D tracking the Brownian motion of colloidal particles using digital holographic microscopy and joint reconstruction

    CERN Document Server

    Verrier, Nicolas; Fournel, Thierry

    2015-01-01

    In-line digital holography is a valuable tool for sizing, locating and tracking micro- or nano-objects in a volume. When a parametric imaging model is available, Inverse Problems approaches provide a straightforward estimate of the object parameters by fitting data with the model, thereby allowing accurate reconstruction. As recently proposed and demonstrated, combining pixel super-resolution techniques with Inverse Problems approaches improves the estimation of particle size and 3D-position. Here we demonstrate the accurate tracking of colloidal particles in Brownian motion. Particle size and 3D-position are jointly optimized from video holograms acquired with a digital holographic microscopy set up based on a "low-end" microscope objective ($\\times 20$, $\\rm NA\\ 0.5$). Exploiting information redundancy makes it possible to characterize particles with a standard deviation of 15 nm in size and a theoretical resolution of 2 x 2 x 5 nm$^3$ for position under additive white Gaussian noise assumption.

  14. Simulated and reconstructed climate in Europe during the last five centuries: joint evaluation of climate models performance and the dynamical consistency of gridded reconstructions

    Science.gov (United States)

    José Gómez-Navarro, Juan; Bothe, Oliver; Wagner, Sebastian; Zorita, Eduardo; Werner, Johannes P.; Luterbacher, Jürg; Raible, Christoph C.; Montávez, Juan Pedro

    2015-04-01

    This study jointly analyses European winter and summer temperature and precipitation gridded climate reconstructions and a regional climate simulation reaching a resolution of 45 km over the period 1501-1990. In a first step, the simulation is compared to observational records to establish the model performance and to identify the most prominent caveats. It is found that the regional simulation is able to add value to the driving global simulation, which allows it to reproduce accurately the most prominent characteristics of the European climate, although remarkable biases can also be identified. In a second step, the simulation is compared to a set on independent reconstructions. The high-resolution of the simulation and the reconstructions allows to analyse the European area for nine sub-areas. An overall good agreement is found between the reconstructed and simulated climate variability across different areas, supporting a consistency of both products and the proper calibration of the reconstructions. However, biases appear between both datasets, that thanks to the evaluation of the model performance carried out before, can be attributed to deficiencies in the simulation. Although the simulation responds to external forcing, it largely differers with reconstructions in their estimates of the past climate evolution for European sub-regions. In particular, there are deviations between simulated and reconstructed anomalies during the Maunder and Dalton minima, i.e. the simulated response is much stronger than the reconstructed. This disagreement is to some extent expected given the prominent role of internal variability in the regional evolution of temperature and precipitation. However the inability of the model to reproduce any warm period similar to that recorded around 1740 in the reconstructions indicates fundamental limitations in the simulation that preclude reproducing exceptionally anomalous conditions. Despite these limitations, the simulated climate is a

  15. Equilibrium reconstruction based on core magnetic measurement and its applications on equilibrium transition in Joint-TEXT tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.; Zhuang, G., E-mail: ge-zhuang@hust.edu.cn; Jian, X.; Li, Q.; Liu, Y.; Gao, L.; Wang, Z. J. [State Key Laboratory of Advanced Electromagnetic Engineering and Technology, Huazhong University of Science and Technology, Wuhan 430074 (China)

    2014-10-15

    Evaluation and reconstruction of plasma equilibrium, especially to resolve the safety factor profile, is imperative for advanced tokamak operation and physics study. Based on core magnetic measurement by the high resolution laser polarimeter-interferometer system (POLARIS), the equilibrium of Joint-TEXT (J-TEXT) plasma is reconstructed and profiles of safety factor, current density, and electron density are, therefore, obtained with high accuracy and temporal resolution. The equilibrium reconstruction procedure determines the equilibrium flux surfaces essentially from the data of POLARIS. Refraction of laser probe beam, a major error source of the reconstruction, has been considered and corrected, which leads to improvement of accuracy more than 10%. The error of reconstruction has been systematically assessed with consideration of realistic diagnostic performance and scrape-off layer region of plasma, and its accuracy has been verified. Fast equilibrium transitions both within a single sawtooth cycle and during the penetration of resonant magnetic perturbation have been investigated.

  16. An edge-preserving algorithm of joint image restoration and volume reconstruction for rotation-scanning 4D echocardiographic images

    Institute of Scientific and Technical Information of China (English)

    GUO Qiang; YANG Xin

    2006-01-01

    A statistical algorithm for the reconstruction from time sequence echocardiographic images is proposed in this paper.The ability to jointly restore the images and reconstruct the 3D images without blurring the boundary is the main innovation of this algorithm. First, a Bayesian model based on MAP-MRF is used to reconstruct 3D volume, and extended to deal with the images acquired by rotation scanning method. Then, the spatiotemporal nature of ultrasound images is taken into account for the parameter of energy function, which makes this statistical model anisotropic. Hence not only can this method reconstruct 3D ultrasound images, but also remove the speckle noise anisotropically. Finally, we illustrate the experiments of our method on the synthetic and medical images and compare it with the isotropic reconstruction method.

  17. Joint palaeoclimate reconstruction from pollen data via forward models and climate histories

    Science.gov (United States)

    Parnell, Andrew C.; Haslett, John; Sweeney, James; Doan, Thinh K.; Allen, Judy R. M.; Huntley, Brian

    2016-11-01

    We present a method and software for reconstructing palaeoclimate from pollen data with a focus on accounting for and reducing uncertainty. The tools we use include: forward models, which enable us to account for the data generating process and hence the complex relationship between pollen and climate; joint inference, which reduces uncertainty by borrowing strength between aspects of climate and slices of the core; and dynamic climate histories, which allow for a far richer gamut of inferential possibilities. Through a Monte Carlo approach we generate numerous equally probable joint climate histories, each of which is represented by a sequence of values of three climate dimensions in discrete time, i.e. a multivariate time series. All histories are consistent with the uncertainties in the forward model and the natural temporal variability in climate. Once generated, these histories can provide most probable climate estimates with uncertainty intervals. This is particularly important as attention moves to the dynamics of past climate changes. For example, such methods allow us to identify, with realistic uncertainty, the past century that exhibited the greatest warming. We illustrate our method with two data sets: Laguna de la Roya, with a radiocarbon dated chronology and hence timing uncertainty; and Lago Grande di Monticchio, which contains laminated sediment and extends back to the penultimate glacial stage. The procedure is made available via an open source R package, Bclim, for which we provide code and instructions.

  18. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

    Directory of Open Access Journals (Sweden)

    Adam Czaplicki

    Full Text Available The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05 in peak knee extension and flexion torques, hamstring/quadriceps (H/Q strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age.

  19. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Czaplicki, Adam; Jarocka, Marta; Walawski, Jacek

    2015-01-01

    The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age.

  20. Long-term bone tissue reaction to polyethylene oxide/polybutylene terephthalate copolymer (Polyactive) in metacarpophalangeal joint reconstruction.

    Science.gov (United States)

    Waris, Eero; Ashammakhi, Nureddin; Lehtimäki, Mauri; Tulamo, Riitta-Mari; Törmälä, Pertti; Kellomäki, Minna; Konttinen, Yrjö T

    2008-06-01

    The poly-L/D-lactide 96/4 joint scaffolds are used to engineer fibrous tissue joints in situ for the reconstruction of metacarpophalangeal joints. In this experimental study, a supplementary elastomeric stem made of Polyactive 1000PEO70PBT30 (a segmented block copolymer of polyethylene oxide and polybutylene terephtalate with 70/30 PEO/PBT ratio) was used to anchor the joint scaffold in the arthroplasty space. Eleven resected fifth metacarpophalangeal joints of minipig were reconstructed and evaluated radiologically and histologically for 3 years. Plain joint scaffold and Swanson silicone implant arthroplasties (11 of each) in metacarpophalangeal joints of minipig served as controls. Altogether fore limbs of eighteen minipigs were operated for the study. Deleterious tissue reaction with dramatic signs of osteolysis and inflammatory foreign-body reaction was observed around the Polyactive stems. The mean maximum diameter of the osteolytic stem cavity was statistically wider when compared to the mean maximum diameter of Swanson implant group during the first postoperative year. Numerous osteoclasts were found at the margins of the osteolytic areas. No direct bone contact could be seen. At 1 year osteoblastic regeneration and formation of new trabecular bone followed. Finally the foreign-body reaction settled, but the adjoining bones were at this stage highly sclerotic and composed of coarse trabeculae. In contrary to previous in vivo studies suggesting biocompatibility, osteoconductivity and capability to bond to bone, Polyactive 1000PEO70PBT30 stem in this setting caused massive osteolytic lesions and foreign-body reactions. PMID:18336902

  1. Hip-joint and abductor-muscle forces adequately represent in vivo loading of a cemented total hip reconstruction.

    NARCIS (Netherlands)

    Stolk, J.; Verdonschot, N.J.J.; Huiskes, R.

    2001-01-01

    Using finite element analyses, we investigated which muscle groups acting around the hip-joint most prominently affected the load distributions in cemented total hip reconstructions with a bonded and debonded femoral stem. The purpose was to determine which muscle groups should be included in pre-cl

  2. Osteochondroma of the Temporomandibular Joint Treated by Means of Condylectomy and Immediate Reconstruction with a Total Stock Prosthesis

    Directory of Open Access Journals (Sweden)

    Miguel-Angel Morey-Mas

    2010-10-01

    Full Text Available Background: Osteochondromas are one of the most common benign tumours of bone, but they are rare in the craniofacial region. These condylar tumours have been variably treated, including resection through local excision or condylectomy with or without reconstruction.Methods: A case of osteochondroma of the mandibular condyle and cranial base arising concurrently in the 76 years old patient was presented. The surgical excision of the skull base lesion and condylectomy with immediate reconstruction of temporomandibular joint was applied.Results: Based on the history, clinical examination and radiographic findings, osteochondroma of the skull base was diagnosed, with a concurrent lesion of the condylar process. Treatment methods for this patient included excision of the skull base tumour and condylectomy with immediate temporomandibular joint reconstruction using appropriately sized stock total temporomandibular joint prosthesis. At the 24 month follow-up, patient was free of pain and her maximal incisal opening was maintained, with no radiographic evidence of tumour recurrence or failure of the device.Conclusions: Temporomandibular joint stock total replacement prosthesis became a good option to reconstruct both the fossa and the condyle in a one-stage surgery, due to the fact that both the condylar/mandibular and the fossa implants were stable in situ from the moment of fixation, with a good outcome at 24 month follow-up, with no loosening of the screws nor failure of the device.

  3. Non-operative treatment of a fracture to the coracoid process with acromioclavicular dislocation in an adolescent

    Directory of Open Access Journals (Sweden)

    Vera Pedersen

    2014-08-01

    Full Text Available Coracoid process fractures are rare and often associated with dislocations of the acromioclavicular (AC joint. There is little evidence about the treatment of these injuries in adolescents, but the few case reports published recommend surgery. We report a case of a dislocated epiphyseal fracture to the base of the coracoid process with AC joint dislocation in a 14-year-old ice-hockey player following direct impact to his left shoulder. Since magnetic resonance tomography revealed intact AC and coracoclavicular ligaments, we initiated non-operative treatment with immobilization and unloading of the shoulder by an abduction brace allowing limited rotation for 6 weeks. This treatment resulted in complete recovery after 8 weeks and return to full sports on first league level after 3 month. In conclusion, non-operative treatment of coracoid base fractures with concomitant AC-joint injury in the adolescent can result in excellent functional results and early recovery.

  4. Anatomy assisted PET image reconstruction incorporating multi-resolution joint entropy

    International Nuclear Information System (INIS)

    A promising approach in PET image reconstruction is to incorporate high resolution anatomical information (measured from MR or CT) taking the anato-functional similarity measures such as mutual information or joint entropy (JE) as the prior. These similarity measures only classify voxels based on intensity values, while neglecting structural spatial information. In this work, we developed an anatomy-assisted maximum a posteriori (MAP) reconstruction algorithm wherein the JE measure is supplied by spatial information generated using wavelet multi-resolution analysis. The proposed wavelet-based JE (WJE) MAP algorithm involves calculation of derivatives of the subband JE measures with respect to individual PET image voxel intensities, which we have shown can be computed very similarly to how the inverse wavelet transform is implemented. We performed a simulation study with the BrainWeb phantom creating PET data corresponding to different noise levels. Realistically simulated T1-weighted MR images provided by BrainWeb modeling were applied in the anatomy-assisted reconstruction with the WJE-MAP algorithm and the intensity-only JE-MAP algorithm. Quantitative analysis showed that the WJE-MAP algorithm performed similarly to the JE-MAP algorithm at low noise level in the gray matter (GM) and white matter (WM) regions in terms of noise versus bias tradeoff. When noise increased to medium level in the simulated data, the WJE-MAP algorithm started to surpass the JE-MAP algorithm in the GM region, which is less uniform with smaller isolated structures compared to the WM region. In the high noise level simulation, the WJE-MAP algorithm presented clear improvement over the JE-MAP algorithm in both the GM and WM regions. In addition to the simulation study, we applied the reconstruction algorithms to real patient studies involving DPA-173 PET data and Florbetapir PET data with corresponding T1-MPRAGE MRI images. Compared to the intensity-only JE-MAP algorithm, the WJE

  5. Joint Reconstruction of Absorbed Optical Energy Density and Sound Speed Distribution in Photoacoustic Computed Tomography: A numerical Investigation

    CERN Document Server

    Huang, Chao; Schoonover, Robert W; Wang, Lihong V; Anastasio, Mark A

    2015-01-01

    Photoacoustic computed tomography (PACT) is a rapidly emerging bioimaging modality that seeks to reconstruct an estimate of the absorbed optical energy density within an object. Conventional PACT image reconstruction methods assume a constant speed-of-sound (SOS), which can result in image artifacts when acoustic aberrations are significant. It has been demonstrated that incorporating knowledge of an object's SOS distribution into a PACT image reconstruction method can improve image quality. However, in many cases, the SOS distribution cannot be accurately and/or conveniently estimated prior to the PACT experiment. Because variations in the SOS distribution induce aberrations in the measured photoacoustic wavefields, certain information regarding an object's SOS distribution is encoded in the PACT measurement data. Based on this observation, a joint reconstruction (JR) problem has been proposed in which the SOS distribution is concurrently estimated along with the sought-after absorbed optical energy density ...

  6. Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Yang Yong; Huey Y.Tien; Kannan K.Kumar; Chen Shanlin; Li Zhongzhe; Tian Wen; Tian Guanglei

    2014-01-01

    Background Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthdtis.The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence.Methods From January 2008 to January 2011,19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University,USA.The follow-up period was an average of 13.9 months.Pain,grip strength,tip pinch strength,range of motion,and radiographic measurements were recorded.Based on first metacarpal subsidence,the cases were classified in to mild,moderate,and severe.Clinical outcomes of the groups were evaluated and compared.Results Grip strength improved from 18.6 kg to 20.5 kg,and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery.Radial abduction and palmar abduction improved after surgery.Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure.Visual analogue scores (VAS) were significantly reduced,from 6.6 to 0.5.Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space.The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively.Between the various groups (mild,moderate and severe metacarpal subsidence),there was no difference in grip strength,tip pinch strength,thumb range of motion,and VAS.Conclusions Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion.However,LRTI cannot maintain the arthroplasty space.Compared with the preoperative radiographs,the metacarpal subsided more than 50

  7. Moments of muscular strength of knee joint extensors and flexors during physiotherapeutic procedures following anterior cruciate ligament reconstruction in males.

    Science.gov (United States)

    Czamara, Andrzej

    2008-01-01

    The objective of this paper was to evaluate maximal muscular strength moments of knee joint extensors and flexors in males subjected to physiotherapeutic procedures. 120 males were selected for the study. The first group consisted of 54 patients who underwent a 6 month physiotherapy programme following anterior cruciate ligament (ACL) reconstruction. The control group comprised 54 males without knee joint injuries. The measurement of muscular strength moments was performed in healthy and affected knee joint flexor and extensor muscles postoperatively, during the 13th and 21st week of physiotherapy. The patients' results were next compared with the results obtained in the control group. During the 13th week of physiotherapy, the values of postoperative maximal strength moments in knee joints were significantly lower compared to the results obtained in non-operated limbs and in the control group. The introduction of individual loads adjusted to the course of ACL graft reconstruction and fixation in the bone tunnel resulted in the improvement of maximal muscle strength values in the patients' knee joints from 13 to 21 weeks postoperatively. During the 21st week of physiotherapy, the values of the muscular strengths in the operated limbs were similar to those obtained in non-operated limbs of the patients and in the control group.

  8. Partial arthroscopic trapeziectomy with ligament reconstruction to treat primary thumb basal joint osteoarthritis.

    Science.gov (United States)

    Desmoineaux, P; Delaroche, C; Beaufils, P

    2012-11-01

    Since the outcome of partial trapeziectomy is not always satisfactory, we proposed using arthroscopy to perform partial trapeziectomy and to perform ligament reconstruction with the abductor pollicis longus tendon. A tendon strip was left intact at its insertion at the base of the first metacarpal and then slipped into the trapeziectomy space. It was fixed into a blind tunnel at the base of the second metacarpal with a bioabsorbable interference screw. Forty-nine patients were surgically treated between 2006 and 2009. With an average follow-up of 3.6 years, 83.5% of patients were satisfied with the procedure; 96% of thumbs were stable and 74% were pain free. The average recovery time was 4.5 months. There were four cases of radial nerve branch irritation and one case of flexor carpi radialis tendinitis; there were no cases of complex regional pain syndrome. This minimally-invasive technique is a less-aggressive treatment approach for thumb carpometacarpal joint arthritis, which simplify postoperative recovery. PMID:23098774

  9. Effect of 12 Weeks of Accelerated Rehabilitation Exercise on Muscle Function of Patients with ACL Reconstruction of the Knee Joint.

    Science.gov (United States)

    Lee, Joong-Chul; Kim, Ji Youn; Park, Gi Duck

    2013-12-01

    [Purpose] To examine changes in the knee joint's isokinetic muscle functions following systematic and gradual rehabilitation exercises lasting for 12 weeks for male and female patients who underwent anterior cruciate ligament (ACL) reconstruction. Differences in muscle functions between the uninvolved side (US) and the involved side (IS) before surgery, differences in muscle functions between US and IS after rehabilitation exercises lasting for 12 weeks, and changes in muscle functions on US and IS between before and after surgery were analyzed to examine the effects of accelerated rehabilitation exercises after ACL reconstruction. [Subjects] The study subjects were 10 patients, five females and five males, who underwent ACL reconstruction performed by the same surgeon. [Methods] As a measuring tool, a Biodex Multi-joint system 3pro (USA), which is an isokinetic measuring device, was used to examine the flexion and extension forces of the knee joint. During isokinetic muscle strength evaluation, the ROM of US was set to be the same as that of IS for consistency of measurement. [Results] At 60°/s, the isokinetic muscle functions of the females did not show any significant change between before and after surgery in any of the variables on both US and IS. At 60°/s, the isokinetic muscle functions of the males did not show any significant change between before and after surgery in the peak torque, average power, and entire work done on US. In extension, peak torque on IS did not show any significant change.

  10. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus

    Science.gov (United States)

    Bielecki, J.; Giacomelli, L.; Kiptily, V.; Scholz, M.; Drozdowicz, K.; Conroy, S.; Craciunescu, T.; Kempenaars, M.

    2015-09-01

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET.

  11. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus

    Energy Technology Data Exchange (ETDEWEB)

    Bielecki, J.; Scholz, M.; Drozdowicz, K. [Institute of Nuclear Physics, Polish Academy of Sciences, PL-31342 Krakow (Poland); Giacomelli, L. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Istituto di Fisica del Plasma “P. Caldirola,” Milano (Italy); Kiptily, V.; Kempenaars, M. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Conroy, S. [CCFE, Culham Science Centre, Abingdon OX14 3DB (United Kingdom); Department of Physics and Astronomy, Uppsala University (Sweden); Craciunescu, T. [IAP, National Institute for Laser Plasma and Radiation Physics, Bucharest (Romania); Collaboration: EUROfusion Consortium, JET, Culham Science Centre, Abingdon OX14 3DB (United Kingdom)

    2015-09-15

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET.

  12. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus.

    Science.gov (United States)

    Bielecki, J; Giacomelli, L; Kiptily, V; Scholz, M; Drozdowicz, K; Conroy, S; Craciunescu, T; Kempenaars, M

    2015-09-01

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET. PMID:26429441

  13. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    International Nuclear Information System (INIS)

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  14. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    Energy Technology Data Exchange (ETDEWEB)

    Lalone, Emily A; Fox, Anne-Marie V; Jenkyn, Thomas R; King, Graham J W; Johnson, James A; Peters, Terry M [Biomedical Engineering, University of Western Ontario, London (Canada); Kedgley, Angela E [Wolf Orthopaedic Biomechanics Lab, Fowler Kennedy Sports Medicine Clinic, London (Canada); Athwal, George S, E-mail: tpeters@robarts.ca [Hand and Upper Limb Centre, St. Joseph' s Hospital, London, Canada (CT Scanning Location) (Canada)

    2011-10-21

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  15. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation.

    Science.gov (United States)

    Kawaguchi, Kohei; Tanaka, Sayo; Yoshitomi, Hiroki; Nagai, Ichiro; Sato, Wakyo; Karita, Tasturo; Kondo, Taiji

    2015-05-01

    Sternoclavicular joint dislocations account for figure-of-eight" using the ipsilateral gracilis tendon. Surgical outcome was successful, based on the Rockwood SC joint rating scale, and the patient maintained excellent stability even after 2 years. This new surgical technique offers superior stability, without harvest site morbidity, to patients with rare, severe, and chronic sternoclavicular joint dislocation. Level of evidence IV. PMID:24722676

  16. Joint Cross-Range Scaling and 3D Geometry Reconstruction of ISAR Targets Based on Factorization Method.

    Science.gov (United States)

    Lei Liu; Feng Zhou; Xue-Ru Bai; Ming-Liang Tao; Zi-Jing Zhang

    2016-04-01

    Traditionally, the factorization method is applied to reconstruct the 3D geometry of a target from its sequential inverse synthetic aperture radar images. However, this method requires performing cross-range scaling to all the sub-images and thus has a large computational burden. To tackle this problem, this paper proposes a novel method for joint cross-range scaling and 3D geometry reconstruction of steadily moving targets. In this method, we model the equivalent rotational angular velocity (RAV) by a linear polynomial with time, and set its coefficients randomly to perform sub-image cross-range scaling. Then, we generate the initial trajectory matrix of the scattering centers, and solve the 3D geometry and projection vectors by the factorization method with relaxed constraints. After that, the coefficients of the polynomial are estimated from the projection vectors to obtain the RAV. Finally, the trajectory matrix is re-scaled using the estimated rotational angle, and accurate 3D geometry is reconstructed. The two major steps, i.e., the cross-range scaling and the factorization, are performed repeatedly to achieve precise 3D geometry reconstruction. Simulation results have proved the effectiveness and robustness of the proposed method. PMID:26886991

  17. Joint Cross-Range Scaling and 3D Geometry Reconstruction of ISAR Targets Based on Factorization Method.

    Science.gov (United States)

    Lei Liu; Feng Zhou; Xue-Ru Bai; Ming-Liang Tao; Zi-Jing Zhang

    2016-04-01

    Traditionally, the factorization method is applied to reconstruct the 3D geometry of a target from its sequential inverse synthetic aperture radar images. However, this method requires performing cross-range scaling to all the sub-images and thus has a large computational burden. To tackle this problem, this paper proposes a novel method for joint cross-range scaling and 3D geometry reconstruction of steadily moving targets. In this method, we model the equivalent rotational angular velocity (RAV) by a linear polynomial with time, and set its coefficients randomly to perform sub-image cross-range scaling. Then, we generate the initial trajectory matrix of the scattering centers, and solve the 3D geometry and projection vectors by the factorization method with relaxed constraints. After that, the coefficients of the polynomial are estimated from the projection vectors to obtain the RAV. Finally, the trajectory matrix is re-scaled using the estimated rotational angle, and accurate 3D geometry is reconstructed. The two major steps, i.e., the cross-range scaling and the factorization, are performed repeatedly to achieve precise 3D geometry reconstruction. Simulation results have proved the effectiveness and robustness of the proposed method.

  18. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction

    OpenAIRE

    Xiangkai Zhang; Tomoki Aoyama; Ryota Takaishi; Shinya Higuchi; Shigehito Yamada; Hiroshi Kuroki; Tetsuya Takakuwa

    2015-01-01

    This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D) reconstruction using episcopic fluorescence image capture (EFIC). Cruciate ligaments of Wister rat embryos between embryonic day (E) 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate l...

  19. Fast Monte Carlo based joint iterative reconstruction for simultaneous 99mTc/ 123I SPECT imaging.

    Science.gov (United States)

    Ouyang, Jinsong; El Fakhri, Georges; Moore, Stephen C

    2007-08-01

    Simultaneous 99mTC/ 123I SPECT allows the assessment of two physiological functions under identical conditions. The separation of these radionuclides is difficult, however, because their energies are close. Most energy-window-based scatter correction methods do not fully model either physical factors or patient-specific activity and attenuation distributions. We have developed a fast Monte Carlo (MC) simulation-based multiple-radionuclide and multiple-energy joint ordered-subset expectation-maximization (JOSEM) iterative reconstruction algorithm, MC-JOSEM. MC-JOSEM simultaneously corrects for scatter and cross talk as well as detector response within the reconstruction algorithm. We evaluated MC-JOSEM for simultaneous brain profusion (99mTc-HMPAO) and neurotransmission (123I-altropane) SPECT. MC simulations of 99mTc and 123I studies were generated separately and then combined to mimic simultaneous 99mTc/ 123I SPECT. All the details of photon transport through the brain, the collimator, and detector, including Compton and coherent scatter, septal penetration, and backscatter from components behind the crystal, were modeled. We reconstructed images from simultaneous dual-radionuclide projections in three ways. First, we reconstructed the photopeak-energy-window projections (with an asymmetric energy window for 1231) using the standard ordered-subsets expectation-maximization algorithm (NSC-OSEM). Second, we used standard OSEM to reconstruct 99mTc photopeak-energy-window projections, while including an estimate of scatter from a Compton-scatter energy window (SC-OSEM). Third, we jointly reconstructed both 99mTc and 123I images using projection data associated with two photo-peak energy windows and an intermediate-energy window using MC-JOSEM. For 15 iterations of reconstruction, the bias and standard deviation of 99mTc activity estimates in several brain structures were calculated for NSC-OSEM, SC-OSEM, and MC-JOSEM, using images reconstructed from primary

  20. Painful knee joint after ACL reconstruction using biodegradable interference screws- SPECT/CT a valuable diagnostic tool? A case report

    Directory of Open Access Journals (Sweden)

    Hirschmann Michael T

    2010-09-01

    Full Text Available Abstract With the presented case we strive to introduce combined single photon emission computerized tomography and conventional computer tomography (SPECT/CT as new diagnostic imaging modality and illustrate the possible clinical value in patients after ACL reconstruction. We report the case of a painful knee due to a foreign body reaction and delayed degradation of the biodegradable interference screws after ACL reconstruction. The MRI showed an intact ACL graft, a possible tibial cyclops lesion and a patella infera. There was no increased fluid collection within the bone tunnels. The 99mTc-HDP-SPECT/CT clearly identified a highly increased tracer uptake around and within the tibial and femoral tunnels and the patellofemoral joint. On 3D-CT out of the SPECT/CT data the femoral graft attachment was shallow (50% along the Blumensaat's line and high in the notch. At revision arthroscopy a diffuse hypertrophy of the synovium, scarring of the Hoffa fat pad and a cyclops lesion of the former ACL graft was found. The interference screws were partially degraded and under palpation and pressure a grey fluid-like substance drained into the joint. The interference screws and the ACL graft were removed and an arthrolysis performed. In the case presented it was most likely a combination of improper graft placement, delayed degradation of the interference screws and unknown biological factors. The too shallow and high ACL graft placement might have led to roof impingement, chronic intraarticular inflammation and hence the delayed degradation of the screws. SPECT/CT has facilitated the establishment of diagnosis, process of decision making and further treatment in patients with knee pain after ACL reconstruction. From the combination of structural (tunnel position in 3D-CT and metabolic information (tracer uptake in SPECT/CT the patient's cause of the pain was established.

  1. [Diagnosis of the temporomandibular joint dysfunction by graphic reconstruction of mandibular movements].

    Science.gov (United States)

    Arutiunov, S D; Khvatov, I L; Arutiunov, D S; Nabiev, N V; Tuturov, N S

    2003-01-01

    A total of 974 patients with suspected abnormalities of the temporomandibular joint (TMJ) were examined; diseases were detected in 371 patients. The test group consisted of 40 patients, control group of 18 patients. Analysis of the results of graphic recording of mandibular movements and clinical x-ray data in patients of the main and control groups helped develop the strategy for the diagnosis of TMJ dysfunction, based on the functional methods of examination (oral functionography and non-oral axiography).

  2. FUNCTIONAL OUTCOME FOLLOWING RECONSTRUCTION FOR CHRONIC ISOLATED DORSAL DISTAL RADIOULNAR JOINT INSTABILITY BY FULKERSON-WATSON METHOD-A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Santhamoorthy

    2014-10-01

    Full Text Available BACKGROUND: Chronic isolated distal radioulnar joint instability is a relatively rare entity. Several methods of reconstruction were available to stabilize the joint and each method has some advantage over others. We proposed to assess the functional outcome following reconstruction of chronic dorsal distal radio ulnar instability using extra articular reconstruction by Fulkerson – Watson method. AIM: To assess the functional outcome following reconstruction for chronic isolated dorsal distal radio ulnar instability using Fulkerson –Watson method. METHODS: We conducted a prospective study in five patients over three years from 2010 to 2013 with chronic isolated dorsal distal radio ulnar instability who were treated by Fulkerson-Watson method of reconstruction. All patients underwent MRI evaluation before surgery to assess ligament pathology and for adequacy of sigmoid notch. Arthroscopy performed in all patients. Functional outcomes were assessed using VAS score, quick-DASH score and Mayo wrist score at every 6 months follow-up. Radiological assessment done using plain x-rays at each follow up. RESULTS: Three patients required Arthroscopic debridement for TFCC. All five patients had achieved stability at distal radio ulnar joint after surgery and remained so till their last follow up. One patient had persistent pain near ulnar styloid. The average loss of motion for pronation was 10 degrees and supination was 3 degrees in reference to the normal side. All except one patient achieved ulnar grip strength of >90 % compared to normal side. The mean pre and postoperative VAS score, quick-DASH score, Mayo wrist score were 76.6 and 17.2, 37.3 and 11.3, 45 and 77 respectively. CONCLUSION: Though extra articular reconstruction for DRUJ by Fulkerson-Watson method is non-anatomical, the procedure is simple than intra articular reconstruction and gives similar functional outcome like intra articular reconstructions as shown by our results.

  3. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction.

    Directory of Open Access Journals (Sweden)

    Xiangkai Zhang

    Full Text Available This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D reconstruction using episcopic fluorescence image capture (EFIC. Cruciate ligaments of Wister rat embryos between embryonic day (E 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate ligaments and the cross angle of the cruciate ligaments were measured. The shape of cruciate ligaments was clearly visible at E17. The lengths of the anterior cruciate ligament (ACL and posterior cruciate ligament (PCL increased gradually from E17 to E19 and drastically at E20. Distances between attachment points to the femur and tibia gradually increased. The ACL angle and PCL angle gradually decreased. The cross angle of the cruciate ligaments changed in three planes. The primordium of the 3D structure of rat cruciate ligaments was constructed from the early stage, with the completion of the development of the structures occurring just before birth.

  4. Surgical Reconstruction with the Remnant Ligament Improves Joint Position Sense as well as Functional Ankle Instability: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Kamizato Iwao

    2014-01-01

    Full Text Available Introduction. Chronic functional instability—characterized by repeated ankle inversion sprains and a subjective sensation of instability—is one of the most common residual disabilities after an inversion sprain. However, whether surgical reconstruction improves sensorimotor control has not been reported to date. The purpose of this study was to assess functional improvement of chronic ankle instability after surgical reconstruction using the remnant ligament. Materials and Methods. We performed 10 cases in the intervention group and 20 healthy individuals as the control group. Before and after surgical reconstruction, we evaluated joint position sense and functional ankle instability by means of a questionnaire. Results and Discussion. There was a statistically significant difference between the control and intervention groups before surgical reconstruction. Three months after surgery in the intervention group, the joint position sense was significantly different from those found preoperatively. Before surgery, the mean score of functional ankle instability in the intervention group was almost twice as low. Three months after surgery, however, the score significantly increased. The results showed that surgical reconstruction using the remnant ligament was effective not only for improving mechanical retensioning but also for ameliorating joint position sense and functional ankle instability.

  5. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance☆

    Science.gov (United States)

    Faria, Rafael Salomon Silva; Ribeiro, Fabiano Rebouças; Amin, Bruno de Oliveira; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi Filho, Cantídio Salvador; Batista, Cleber Gonçalves; Brasil Filho, Rômulo

    2015-01-01

    Objective To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation. Methods Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments. Results A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient. Conclusion Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%. PMID:26229916

  6. Comparison of Short-term Complications Between 2 Methods of Coracoclavicular Ligament Reconstruction

    Science.gov (United States)

    Rush, Lane N.; Lake, Nicholas; Stiefel, Eric C.; Hobgood, Edward R.; Ramsey, J. Randall; O’Brien, Michael J.; Field, Larry D.; Savoie, Felix H.

    2016-01-01

    Background: Numerous techniques have been used to treat acromioclavicular (AC) joint dislocation, with anatomic reconstruction of the coracoclavicular (CC) ligaments becoming a popular method of fixation. Anatomic CC ligament reconstruction is commonly performed with cortical fixation buttons (CFBs) or tendon grafts (TGs). Purpose: To report and compare short-term complications associated with AC joint stabilization procedures using CFBs or TGs. Study Design: Cohort study; Level of evidence, 3. Methods: We conducted a retrospective review of the operative treatment of AC joint injuries between April 2007 and January 2013 at 2 institutions. Thirty-eight patients who had undergone a procedure for AC joint instability were evaluated. In these 38 patients with a mean age of 36.2 years, 18 shoulders underwent fixation using the CFB technique and 20 shoulders underwent reconstruction using the TG technique. Results: The overall complication rate was 42.1% (16/38). There were 11 complications in the 18 patients in the CFB group (61.1%), including 7 construct failures resulting in a loss of reduction. The most common mode of failure was suture breakage (n = 3), followed by button migration (n = 2) and coracoid fracture (n = 2). There were 5 complications in the TG group (25%), including 3 cases of asymptomatic subluxation, 1 symptomatic suture granuloma, and 1 superficial infection. There were no instances of construct failure seen in TG fixations. CFB fixation was found to have a statistically significant increase in complications (P = .0243) and construct failure (P = .002) compared with TG fixation. Conclusion: CFB fixation was associated with a higher rate of failure and higher rate of early complications when compared with TG fixation. PMID:27504468

  7. Systematics of glenohumoral and acromioclavicular arthritis; Systematik der glenohumeralen und akromioklavikulaeren Arthrose

    Energy Technology Data Exchange (ETDEWEB)

    Seifarth, A. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Roemer, F. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Universitaetsklinikum Erlangen, Radiologisches Institut, Erlangen (Germany)

    2015-03-01

    A common risk factor for osteoarthritis (OA) of the glenohumeral joint is instability and is often observed as a sequel to dislocation. Altered biomechanics will ultimately result in joint degeneration including osteophyte development at the lower margin of the humerus, glenoidal cartilage loss and surface deformity. An OA of the glenohumeral joint is often coexistent with soft tissue derangement of the shoulder. In advanced stages defects of the rotator cuff and OA of the glenohumeral joint may accelerate disease progression. Degenerative changes of the acromioclavicular joint (AC joint) are commonly seen in older persons with only modest correlation with clinical symptoms. Symptomatic OA of the AC joint is often concomitantly observed with degenerative changes of the glenohumeral joint. Standard radiographs are the basis of a structural assessment of shoulder OA but lack correlation with clinical symptoms and are insensitive for the detection of early degenerative changes. Magnetic resonance imaging (MRI) provides increased sensitivity for the detection of cartilage defects and reveals relevant soft tissue changes, such as lesions of the glenoid labrum and capsuloligamentous structures, which are seen in conjunction with instability. It is also the method of choice to detect clinically relevant bone marrow edema-like lesions or synovial changes that are associated with symptomatic OA. Standard radiographs are not applicable for detection of early degenerative changes. Once OA is suspected clinically, MRI is the method of choice for further structural assessment. The administration of an intravenous contrast agent is useful for assessing synovitis, which commonly correlates with clinical disease manifestations. For preoperative and surgical planning of joint replacement, MRI or CT should be used. (orig.) [German] Eine haeufige Ursache der Omarthrose ist die Mikro- und Makroinstabilitaet, oft infolge von Luxationen. Bei veraenderter Biomechanik kommt es im Verlauf

  8. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ozkan Kose

    2015-01-01

    Full Text Available Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively.

  9. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    Science.gov (United States)

    Kose, Ozkan; Canbora, Kerem; Guler, Ferhat; Kilicaslan, Omer Faruk; May, Hasan

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively. PMID:26491588

  10. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    OpenAIRE

    Ozkan Kose; Kerem Canbora; Ferhat Guler; Omer Faruk Kilicaslan; Hasan May

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively.

  11. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players

    OpenAIRE

    Lee, Myungchun; SUNG, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, SoJung; Kim, Seungho; Kim, Jooyoung

    2016-01-01

    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG...

  12. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle. PMID:27423250

  13. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  14. 关节镜下ACL重建术后关节感染诊疗进展%Diagnosis and treatment progress of joint infection after arthroscopic ACL reconstruction

    Institute of Scientific and Technical Information of China (English)

    区永亮(综述); 黄华扬(审校)

    2015-01-01

    Nowadays arthroscopic anterior cruciate ligament (ACL) reconstruction has been used widely due to its good therapeutic efficacy, but the following joint infection after ACL reconstruction often causes destructive outcomes such as articular cartilage destruction, joint stiff and chronic osteomyelitis, which should be paid much attention for clinician. There existed varied of factors resulted in joint infection after arthroscopic ACL reconstruction with non-unified diagnosis standards. Early diagnosis and reasonable choice of therapeutic protocol are of important significance for enhancing ligament reservation rate and joint stability. Once given incorrect or delayed treatment, the rehabilitation of joint function would not be very ideal. Current situation and research hot spots of epidemiology, etiology, diagnosis, treatment and prognosis of joint infection after arthroscopic ACL reconstruction were reviewed in this paper.%关节镜下前交叉韧带(ACL)重建术临床应用广泛,疗效良好,但术后关节感染往往导致关节软骨破坏、关节强直、慢性骨髓炎等破坏性结局,临床医师需高度重视。导致关节镜下ACL重建术后关节感染的因素多种多样,诊断标准仍未统一,早期诊断及治疗方案的合理选择对于提高韧带保留率和关节稳定性具有重要意义,如处理不当或延误治疗,往往导致关节功能恢复不佳。该文围绕关节镜下ACL重建术后关节感染的流行病学、病因、诊断、治疗及预后等方面的现状和研究热点进行综述。

  15. The Possibilities of Full-Color Three-Dimensional Reconstruction of Biological Objects by the Method of Layer-By-Layer Overlapping: Knee Joint of a Rat

    Directory of Open Access Journals (Sweden)

    Terpilovskiy A.A.

    2015-12-01

    Full Text Available The article has a goal to demonstrate capabilities of layer-by-layer overlapping method for 3D-reconstruction of knee joint. The model object was chosen for this research to provide the base for new methods in diagnostics and treatment of human orthopedic diseases. We used the original technology of high-precision grinding and compared the ability of quantitative analysis of bone and cartilage tissue on 3D models to the capabilities of classical morphometry of histological slices. Obtained digitized images of thin sections (1200-2600 on each of the 8 joints had a pixel size of 8 x 8 μm, with a vertical step grinding 8 μm. Its software processing allows for the construction of a virtual slice with an offset and slope, required for the adequate visualization of the biological structures. The developed method of high-precision grinding allows obtaining series of digitized cross-sectional images of biological objects, so the virtual object created on its base, is almost devoid of spatial deformations and distortions of color. Morphometric analysis of these 3D reconstructions in terms of precision and informativeness is not inferior, and according to some indicators it exceeds the quantitative study of serial histological sections. The reconstruction, obtained using the high-precision grinding, can be used to create virtual museum exhibits, atlases and manuals in various biological sciences, based on morphological approach to the cognition of its objects. Another application of reconstruction is to convert them into virtual simulators on the principles of augmented reality or into the models for 3D printing of physical simulators and working prototypes for medicine, veterinary, animal science and related areas. This will be of most value where an MRI or histological reconstruction did not provide full three-dimensional picture.

  16. A novel technique for the reconstruction of resected sternoclavicular joints: A case report with a review of the literature

    Directory of Open Access Journals (Sweden)

    Waseem M Hajjar

    2013-01-01

    Full Text Available Sternal metastasis in thyroid cancer is an uncommon occurrence with only a handful of cases of chest wall resections being done. Sternal reconstruction for both primary and secondary tumors has been performed using various techniques and materials such as the mesh, methyl acrylate resin, and steel plates; however, this is a case of papillary thyroid cancer involving the sternum in a 50-year-old woman who had resection of the sternum with reconstruction using titanium bars and clips (STRATOS system fixed to the clavicles with an underlying Proceed mesh. STRATOS system showed good recovery postoperatively. The functional results were excellent with the patient being able to perform all daily activities unassisted after 1 month and almost complete range of motion with acceptable limitations in power of the shoulder muscles after 2 months. We have reviewed all the English language publications of the subject by doing Medline search for the last 25 years and we present here the surgical management of this pathology with our novel approach by using the titanium steel bars to stabilize both medial aspects of the resected clavicles as a promising therapy for manubrial reconstruction and clavicular fixation.

  17. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players.

    Science.gov (United States)

    Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

    2016-02-01

    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field.

  18. 膝关节ACL重建术研究进展%Current research on ACL reconstruction for knee joint

    Institute of Scientific and Technical Information of China (English)

    李欢; 王珂杰; 严伟洪

    2013-01-01

    As an effective treatment for anterior cruciate ligament (ACL) injuries, technique of ACL reconstruction has been developed in recent years. Focus on treatment for ACL injuries, graft choice, bone tunnel preparation and selection, graft fixation, and improvement methods for tendon-bone healing, the latest research development of ACL construction were reviewed in this paper.%前交叉韧带(ACL)重建术作为治疗ACL损伤的有效治疗手段,近年来发展快速。该文围绕ACL损伤治疗方法,ACL重建术移植物选择、骨隧道制备和选择、移植物固定方式以及促进腱骨愈合方法等方面,综述膝关节ACL重建术的最新研究进展。

  19. Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

    Science.gov (United States)

    Kawasaki, Yoshiteru; Hirano, Tetsuya; Miyatake, Katsutoshi; Fujii, Koji; Takeda, Yoshitsugu

    2014-07-01

    Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

  20. Dose reconstruction for the Urals population. Joint Coordinating Committee on Radiation Effects Research, Project 1.1 -- Final report

    Energy Technology Data Exchange (ETDEWEB)

    Degteva, M.O. [Urals Research Center for Radiation Medicine, Chelyabinsk (Russian Federation); Drozhko, E. [Branch 1 of Moscow Biophysics Inst., Ozersk (Russian Federation); Anspaugh, L.R. [Lawrence Livermore National Lab., CA (United States); Napier, B.A. [Pacific Northwest National Lab., Richland, WA (United States); Bouville, A.C. [National Cancer Inst., Bethesda, MD (United States); Miller, C.W. [Centers for Disease Control and Prevention, Atlanta, GA (United States)

    1996-02-01

    This work is being carried out as a feasibility study to determine if a long-term course of work can be implemented to assess the long-term risks of radiation exposure delivered at low to moderate dose rates to the populations living in the vicinity of the Mayak Industrial Association (MIA). This work was authorized and conducted under the auspices of the US-Russian Joint Coordinating Committee on Radiation Effects Research (JCCRER) and its Executive Committee (EC). The MIA was the first Russian site for the production and separation of plutonium. This plant began operation in 1948, and during its early days there were technological failures that resulted in the release of large amounts of waste into the rather small Techa River. There were also gaseous releases of radioiodines and other radionuclides during the early days of operation. In addition, there was an accidental explosion in a waste storage tank in 1957 that resulted in a significant release. The Techa River Cohort has been studied for several years by scientists from the Urals Research Centre for Radiation Medicine and an increase in both leukemia and solid tumors has been noted.

  1. Dose reconstruction for the Urals population. Joint Coordinating Committee on Radiation Effects Research, Project 1.1 -- Final report

    International Nuclear Information System (INIS)

    This work is being carried out as a feasibility study to determine if a long-term course of work can be implemented to assess the long-term risks of radiation exposure delivered at low to moderate dose rates to the populations living in the vicinity of the Mayak Industrial Association (MIA). This work was authorized and conducted under the auspices of the US-Russian Joint Coordinating Committee on Radiation Effects Research (JCCRER) and its Executive Committee (EC). The MIA was the first Russian site for the production and separation of plutonium. This plant began operation in 1948, and during its early days there were technological failures that resulted in the release of large amounts of waste into the rather small Techa River. There were also gaseous releases of radioiodines and other radionuclides during the early days of operation. In addition, there was an accidental explosion in a waste storage tank in 1957 that resulted in a significant release. The Techa River Cohort has been studied for several years by scientists from the Urals Research Centre for Radiation Medicine and an increase in both leukemia and solid tumors has been noted

  2. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.

    Science.gov (United States)

    Schnorenberg, Alyssa J; Slavens, Brooke A; Wang, Mei; Vogel, Lawrence C; Smith, Peter A; Harris, Gerald F

    2014-01-01

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

  3. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate.

    Science.gov (United States)

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Lian, Kejian

    2012-01-01

    Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP) in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases) and type IIB (6 cases). Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months). No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks). According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  4. Surgical Treatment for Unstable Distal Clavicle Fracture with Micromovable and Anatomical Acromioclavicular Plate

    Directory of Open Access Journals (Sweden)

    Qingjun Liu, Jianyun Miao, Bin Lin, Kejian Lian

    2012-01-01

    Full Text Available Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases and type IIB (6 cases. Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months. No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks. According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  5. Reconstrucción de la articulación temporomandibular (ATM: prótesis aloplástica Reconstruction of the temporomandibular joint (TMJ: alloplastic prostheses

    Directory of Open Access Journals (Sweden)

    C. Goizueta Adame

    2005-02-01

    Full Text Available La incapacidad de desarrollar sistemas inertes eficaces para la sustitución completa de la articulación temporo-mandibular durante décadas ha generado una variedad de soluciones biológicas para un problema biomecánico. Los injertos autólogos no ofrecen garantías en funcionalidad, simetría, o estabilidad oclusal; resultan técnicamente más complejos y tienen mayor potencial morbilidad. El paciente candidato a reconstrucción completa de la ATM debe contar con la posibilidad de una prótesis si otras opciones fracasan. La reconstrucción aloplástica garantiza estabilidad oclusal, técnica sencilla y reproducible, estancia hospitalaria predecible y baja tasa de complicaciones con los sistemas protésicos actuales. Siempre van a existir pacientes en los que ésta sea la única opción, por lo tanto es primordial la medición de la magnitud de las fuerzas implicadas en la mecánica de la ATM para poder diseñar prótesis en base a modelos fiables como en otras articulaciones en las que ya han resuelto el problema.Incapabability to develop effective inert systems to total temporomandibular joint substitution during decades has genered several biologic solutions for a biomecanic question. Autologous grafts don´t offer security in functioning, simmetry, or oclusal estability; its have more coplex technique and more potencial morbility. Alloplastic reconstruction guarantees oclusal stability, single and reproducible technique, predictable time in hospital, and low morbility with actual prosthetic systems. Patients whos prostheses is only one option are going to exist always, so that it is primordial measures of magnitude of implicated strenghts in TMJ mecanic to can design prosthesis based on reliable models like others articulations which have just resolved the question.

  6. EFFECTS OF THE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTIONS ON THE STRESS DISTRIBUTION OF THE TIBIO-FEMORAL JOINT%ACL单束/双束重建对胫股关节应力分布影响

    Institute of Scientific and Technical Information of China (English)

    黄荣瑛; 徐强; 许勇刚; 郑红光

    2011-01-01

    该文基于正常膝关节的MRI图像数据,构建正常/单束/双束韧带重建胫股关节整体模型,通过对这3个关节整体模型分别加载单一负荷(轴向力)及组合负荷(轴向力和扭矩)进行有限元仿真,得到3个整体模型在两类负荷作用下的应力分布;通过从整体模型的应力云图中提取股骨、胫骨、关节软骨、半月板及后交叉/内侧/外侧韧带的表面应力等进行对比分析,得到ACL单束/双柬重建对胫股关节各组织应力分布的影响。结果表明:1)股骨,胫骨的高应力区位于股骨/胫骨与韧带的连接部位及胫骨与腓骨的接触部位,除单束重建在组合载荷作用下股骨与内侧韧带%Based on MRI images of the normal human knee, the normal, single-bundle and double-bundle ligaments reconstruction models of tibio-femoral joint were built. In the experiment, single load (axial force) and combined loads (axial force and torque) were applied to these models for the finite element simulation to obtain the stress distribution. Then we acquired stress distributions of the femur, tibia, articular cartilage, meniscus, posterior cruciate, medial collateral and the lateral collateral ligament to make a comparison between the stress distributions before and after the ACL reconstruction. The results show that: 1) The high-stress areas of the femur/tibia are located in the connection parts of the femur/tibia and ligament and the contact area between tibia and fibular. Meanwhile, the stresses on the tibia/femur after the reconstruction are close to those on the normal joint except for that the maximum stress in the junction between the femur and the MCL after singie-bundle reconstruction under the combined loads exceeds that on the normal joint; 2) Single-bundle reconstruction can lead to the increment of the equivalent stress on femoral/tibial cartilages and the medial meniscus while double

  7. Biological and biomechanical properties of reconstructing anterior cruciate ligament of knee joint%膝关节前交叉韧带重建的生物学及生物力学特性

    Institute of Scientific and Technical Information of China (English)

    李俊敏; 李增炎

    2005-01-01

    目的:通过总结前交叉韧带重建的生物学及生物力学特性,探讨早期锻炼对膝关节前交叉韧带重建后移植物愈合及膝关节运动功能恢复的作用.资料来源:应用计算机检索MEDLINE1970-01/2004-01期间有关膝关节前交叉韧带重建及其生物力学特征的文献,检索词"anterior cruciate ligament,knee ioint,biomechanics",并限定文章语言种类为英文.资料选择:对资料进行初审,选择有关膝关节前交叉韧带重建及其生物力学特征的文献,开始查找全文.选择随机对照类文章,当同一作者有多篇文章时,选择病例数最多的予以纳入;排除综述类及Mete分析类文章.质量评价主要考察资料的真实性,调查、实施过程是否严密.资料提炼:共检索到46篇有关膝关节前交叉韧带重建及其生物力学特征的文章,29篇符合以上纳入标准,排除的17篇文章中,9篇为小样本分析,8篇为综述类或Mete分析类文章.资料综合:通过了解正常前交叉韧带的生物力学特征制定重建措施及康复计划指导.重建后前交叉韧带动物实验提示膝关节运动功能恢复均不理想,而人体实验结果优于动物.随机对照实验表明,前交叉韧带重建后立即持重不增加膝关节的松弛性,反而有利于减轻髌骨疼痛.结论:前交叉韧带损伤重建后固定膝关节,限制关节周围肌肉收缩活动,导致韧带、关节及周围肌肉运动功能受限.早期康复锻炼可以减轻疼痛,改善关节软骨代谢,防止关节囊挛缩,有助于重建后膝关节前交叉韧带运动功能的恢复.%OBJECTIVE: To probe into the function of early exercises on healing of grafts after anterior cruciate ligament (ACL) reconstruction and on motor function recovery of knee joint by summarizing biology and biomechanical properties of ACL reconstruction.DATA SOURCES: The relevant literatures on ACL reconstruction of knee joint and its biomechanical properties were looked up in

  8. 数字医学在膝关节三维重建中的应用%Application of digital medicine in the three-dimensional reconstruction of the knee joint

    Institute of Scientific and Technical Information of China (English)

    徐伟; 周庭永; 钱学华; 刘本菊; 李林宏; 张慧; 吕发金

    2011-01-01

    Objective:To explore the methods for reconstruction and visualization of three-dimensional (3D) models of knee joint.Methods: The MRI thin layer scanning data set of a donor' s right knee joint were used; two-dimensional image data were collected. The 3D models of knee joint including the bones, meniscus, cruciate ligaments and collateral ligaments were reconstructed by using Mimics software. The meniscus and ligaments were measured cross sectionally and tridimensionally. Results: The 3D models of knee joint were reconstructed successfully based on the MRI images by using Mimics. The model' s morph of the bones and soft tissues were vivid and the anatomy signal was limpid. The models reconstructed could be isplayed by different colors and combined randomly. The models could also be viewed in any direction by zooming in,zooming out,rotating and so on. The measured data of knee joint revealed that the sectioned information was the same as the spatial ones. Conclusion:The 3D models of knee joint which look veridical and accurate can not only be reconstructed explicitly by using MRI lamellate images, but also be measured. The reconstructed 3D models of the knee joint are helpful for anatomy teaching and study, and it can also establish the basis for the finite element analysis and virtual reality surgery.%目的:探索膝关节三维数字化模型的重建及可视化方法.方法:利用1例志愿者的右侧膝关节核磁共振成像(Magnetic resonallce imaging,MRI)薄层扫描数据,采集二维图像数据,应用Materialise公司的交互式医学图像控制系统(Materialises interactive medical image control system,Mimics)软件重建膝关节骨性结构及半月板、交叉韧带、侧副韧带等软组织的三维数字化模型,并对半月板和韧带进行断面测量和模型立体测量.结果:利用MRI数据,应用Mimics软件成功建立膝关节三维可视化模型,重建的膝关节骨性结构及相关软组织形态逼真,解剖学标志清晰,

  9. Via de acesso cirúrgico posterossuperior para o tratamento das luxações acromioclaviculares: resultados de 84 casos operados Posterosuperior surgical access route for treatment of acromioclavicular dislocations: results from 84 surgical cases

    Directory of Open Access Journals (Sweden)

    Danilo Canesin Dal Molin

    2012-10-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico de 84 luxações acromioclaviculares agudas com a utilização da via de acesso posterossuperior do ombro. MÉTODOS: Foram avaliados 84 casos de luxações acromioclaviculares agudas grau III da classificação de Allman-Tossy operados de novembro de 2002 a maio de 2010. A média de idade dos pacientes foi de 34 anos. O diagnóstico foi realizado por avaliação clínica e radiográfica. Os pacientes foram operados pela mesma equipe cirúrgica em até três semanas da data do trauma realizando-se a via de acesso posterossuperior do ombro com acesso ao topo da base do processo coracoide para colocação de duas âncoras utilizadas na redução da luxação. O seguimento mínimo foi de 12 meses. A avaliação clínica-radiográfica pós-operatória foi realizada pelos critérios de Karlsson modificados e do escore da Universidade da Califórnia em Los Angeles (UCLA. RESULTADOS: Dos 84 pacientes operados, 92,8% apresentavam resultados bons ou excelentes e 7,2% de resultados regulares ou fracos pelo escore de avaliação da UCLA. Pelos critérios de Karlsson modificados 76,2% foram avaliados como grau A, 17,9% como grau B e 5,9% como grau C. CONCLUSÃO: A VIA de acesso posterossuperior do ombro é uma nova opção para acesso ao processo coracoide e tratamento das luxações acromioclaviculares, com resultados clínicos e radiográficos equivalentes aos da literatura.OBJECTIVE: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. METHODS: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a

  10. 肩锁关节脱位的诊断与治疗%Diagnosis and treatment of acromioclavicular dislocation

    Institute of Scientific and Technical Information of China (English)

    黄高; 王金华; 孔建中

    2012-01-01

    The acromioclavicular dislocation is a type of common shoulder athletic injury in clinic , and its incidence accounted for 12% of the local sites injuries. At present,The acute dislocation of Rockwood type I , II was recommended to be managed non -operatively, while acute dislocation of type IV, V and VI operatively. But there still exist controversial in the treatment of acute dislocation of type III. In this peper, the authors have reviewed the current status of treatment of acromioclavicular dislocation .%肩锁关节脱位是临床常见的肩部运动损伤.目前,临床认为Rockwood Ⅰ、Ⅱ型急性脱位应行非手术治疗,Ⅳ、V及Ⅵ型急性脱位应行手术治疗,但对Ⅲ型急性脱位是采取非手术治疗还是手术治疗仍存在争议.本文对肩锁关节脱位的治疗现状进行综述.

  11. [Biomechanics of the ankle joint].

    Science.gov (United States)

    Zwipp, H

    1989-03-01

    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  12. Treatment of patients with acromioclavicular joint injuries (Rockwood II-VI) with modeled Kirschner wire and cortical screw

    Institute of Scientific and Technical Information of China (English)

    Ivan Viktorovich Borozda; Mikhail Anatolievich Danilov; Kirill Sergeevich Golokhvast

    2015-01-01

    Objective:To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture (Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods:Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group (n=120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires. Results:Its application allows, according to the evaluation scale of Constant and Murley (1987), 10%more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods. Conclusions: It is shown that the proposed author’s method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.

  13. Treatment of patients with acromioclavicular joint injuries(Rockwood II-VI) with modeled Kirschner wire and cortical screw

    Institute of Scientific and Technical Information of China (English)

    Ivan; Viktorovich; Borozda; Mikhail; Anatolievich; Danilov; Kirill; Sergeevich; Golokhvast

    2015-01-01

    Objective: To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture(Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods: Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group(n = 120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires.Results: Its application allows, according to the evaluation scale of Constant and Murley(1987), 10% more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods.Conclusions: It is shown that the proposed author’s method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.

  14. Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

    Directory of Open Access Journals (Sweden)

    Murdoch David M

    2007-02-01

    Full Text Available Abstract Background Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. Case presentation A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. Conclusion Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained.

  15. 夹马口节水改扩建工程渡槽接缝止水设计方案%Design Scheme for Joint Sealing of Aqueduct in Jiamakou Water-saving Reconstruction Project

    Institute of Scientific and Technical Information of China (English)

    徐睿

    2011-01-01

    Through the comparison and selection for the sealing types and sealing materials of joints of the aqueduct, the bond-type sealing plan is used in the joint sealing of the [/-shaped aqueduct in Jiamakou water-saving reconstruction project, which has good sealing effect and strong durability, and is simple in the construction and easy to guarantee the quality of the construction. After more than a year of practical application, it is demonstrated that the bond-type sealing method used in the project has a good effect and comprehensive functions, and is worth popularizing.%通过对渡槽接缝止水形式及止水材料的比选,确定夹马口节水改扩建工程U形渡槽接缝止水采用止水效果好、耐久性强、施工简单且质量容易保证的粘合式止水方案.经过一年多时间的实际运用,证明该工程所采用的粘合式止水,效果良好,功能全面,值得推广应用.

  16. CLINICAL APPLICATION OF ARTIFICIAL CONDYLAR PROCESS FOR RECONSTRUCTING TEMPOROMANDIBULAR JOINT%人工髁突假体在颞下颌关节重建中的临床应用

    Institute of Scientific and Technical Information of China (English)

    黄相道; 邵占英; 王发生; 段毅

    2012-01-01

    Objective To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Methods Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Results Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. Conclusion The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.%目的 探讨人工髁突假体应用于颞下颌关节重建的可行性及临床治疗效果.方法 2005年1月-2010年1月,对10例(11侧)患者应用人工髁突假体行颢下颌关节重建手术.男7例,女3例;年龄40~68岁,平均50岁.左侧7侧,右侧4侧.下颌骨肿瘤7例,病程9~24个月,平均15个月.双侧髁突囊内骨折3例,其中交通事故伤2例,高处坠落伤1例;伤后至入院时间分别为2、3、2d;骨

  17. Joint surface reconstruction and 4D deformation estimation from sparse data and prior knowledge for marker-less Respiratory motion tracking

    Energy Technology Data Exchange (ETDEWEB)

    Berkels, Benjamin; Rumpf, Martin [Institute for Numerical Simulation, Rheinische Friedrich-Wilhelms-Universität Bonn, 53115 Bonn (Germany); Bauer, Sebastian [Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen (Germany); Ettl, Svenja; Arold, Oliver [Institute of Optics, Information, and Photonics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen (Germany); Hornegger, Joachim [Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany and Erlangen Graduate School in Advanced Optical Technologies (SAOT), 91058 Erlangen (Germany)

    2013-09-15

    Purpose: The intraprocedural tracking of respiratory motion has the potential to substantially improve image-guided diagnosis and interventions. The authors have developed a sparse-to-dense registration approach that is capable of recovering the patient's external 3D body surface and estimating a 4D (3D + time) surface motion field from sparse sampling data and patient-specific prior shape knowledge.Methods: The system utilizes an emerging marker-less and laser-based active triangulation (AT) sensor that delivers sparse but highly accurate 3D measurements in real-time. These sparse position measurements are registered with a dense reference surface extracted from planning data. Thereby a dense displacement field is recovered, which describes the spatio-temporal 4D deformation of the complete patient body surface, depending on the type and state of respiration. It yields both a reconstruction of the instantaneous patient shape and a high-dimensional respiratory surrogate for respiratory motion tracking. The method is validated on a 4D CT respiration phantom and evaluated on both real data from an AT prototype and synthetic data sampled from dense surface scans acquired with a structured-light scanner.Results: In the experiments, the authors estimated surface motion fields with the proposed algorithm on 256 datasets from 16 subjects and in different respiration states, achieving a mean surface reconstruction accuracy of ±0.23 mm with respect to ground truth data—down from a mean initial surface mismatch of 5.66 mm. The 95th percentile of the local residual mesh-to-mesh distance after registration did not exceed 1.17 mm for any subject. On average, the total runtime of our proof of concept CPU implementation is 2.3 s per frame, outperforming related work substantially.Conclusions: In external beam radiation therapy, the approach holds potential for patient monitoring during treatment using the reconstructed surface, and for motion-compensated dose delivery

  18. Establishment of a cohort for the long-term clinical follow-up with dose reconstruction under the joint medical research project conducted by Sasakawa Memorial Health Foundation (Japan) and the Research Institute of Radiation Hygiene (Russia)

    International Nuclear Information System (INIS)

    The cohort of children in the western districts of the Bryansk Region of Russia exposed to radiation following the Chernobyl accident is described in this paper. The cohort was selected under the Joint Medical Research Project on Dosimetry Associated with the Chernobyl Accident conducted by Sasakawa Memorial Health Foundation (SMHF, Japan) and the Research Institute of Radiation Hygiene (RIRH, Russia). The subjects of the Research Project are those people residing in the most contaminated areas of Russia who was 0 to 10 years old at the time of exposure. At the moment the cohort comprises 1210 subjects, though this number may slightly decrease in course of a follow-up in view of migration of population. Most of cohort subjects were examined on their health status within the framework of the Chernobyl Sasakawa Health and Medical Cooperation Project (CSHMCP) from 1991-1996. In view of the main findings of studies in CSHMCP were thyroid abnormalities, selection of subjects was conducted on the basis of the credible estimates of thyroid dose. Preference for subjects to be included into the cohort was defined by the availability of health examination data from previous study (1991-1996) and individual dosimetry, environmental and social data that may prove useful for reconstruction of individual dose. The primary data analyzed for subjects selection are measurements of iodine-131 in the thyroid in May-June 1986, questionnaire data on individual food habits and early measurements of radiocesium in the body of subjects made by RIRH from May to September 1986. Plausible analytical models were applied to calculate thyroid dose from available data. Previously worked out methods of thyroid dose reconstruction using early measurement data of radiocesium content in the body and questionnaire data on individual consumption of locally produced milk were reevaluated. Basing on these analytical procedures, the individual thyroid dose was ascribed to each member of the cohort. The

  19. Reconstruction of anterior cruciate ligament of knee joint with single bundle allograft under arthroscopic%关节镜下应用单束同种异体肌腱重建膝关节前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    罗绍伟; 张平; 李文胜; 郑创义; 邱开封

    2016-01-01

    目的 探讨关节镜下采用同种异体肌腱解剖单束重建膝关节前交叉韧带(ACL)损伤的治疗效果.方法 对62例ACL断裂患者在关节镜下进行重建,采用同种异体肌腱作为移植物,在胫骨近端及股骨远端建立骨隧道,利用挤压钉对移植物进行固定.术后应用支具固定膝关节12周,按照Lysholm和Larson膝关节评分标准进行主观评估;对患者行Lachman试验进行客观评估,了解重建韧带的稳定性和膝关节的功能恢复情况.结果 Lysholm术前评分平均(43.1±2.1)分,术后韧带重建后随访时评分平均(91.0±2.3)分,术前与术后对比,差异有统计学意义(t=3.460,P=0.001).Larson术前评分平均(41.0±2.9)分,韧带重建后最终评分平均(90.1±3.5)分,术前与术后对比,差异有统计学意义(t=3.232,P=0.001).62例患者在最后复查时Lachman试验结果均为阴性.所有患者术后无膝关节感染、深静脉血栓及僵硬.在术后1年均能完全伸直,屈膝达到120度.随访期间未发生韧带再断裂.结论 关节镜下采用同种异体单束解剖重建前交叉韧带可以获得满意的临床疗效.%Objective To introduce the treatment efficacy of using allograft muscle ligament anatomical to rebuild anterior cruciate ligament (ACL) of knee joint under the arthroscopy.Methods Sixty-two cases patients with ACL rupture in anterior cruciate ligament reconstruction under arthroscopy.Allograft ligaments were used as graft,a bone tunnel was established in the proximal tibia and distal femur,and the graft was fixed by the extrusion screw.After the operation,the knee joint was fixed for 12 weeks,and the subjective evaluation was carried out according to the Lysholm and Larson knee score standards;in order to assess the stability of the ligament and the functional recovery of the knee joint,objective evaluation was carried out according to Lachman test in patients.Results The preoperative average Lysholm scale was (43.1±2.1) points,the final

  20. Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.

    Science.gov (United States)

    Bansal, V; Singh, S; Garg, N; Dubey, P

    2014-02-01

    This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients.

  1. To further improve the techniques for repair and reconstruction of skin and soft tissue defects around the knee joints%进一步提高膝关节周围皮肤软组织缺损的修复重建水平

    Institute of Scientific and Technical Information of China (English)

    黄晓元

    2015-01-01

    This article briefly summarizes the techniques for repair of skin and soft tissue defects around the knee joints as reported in 5 papers in this issue, including how to choose the skin flap, muscle flap, myocutaneous flap, and vascular anastomosis in recipient site.It is found that the anterolatera1 femoral flap, latissimus dorsi myocutaneous flap, and gastrocnemius flap are widely used in clinic with high survival rates, and they can be used for the repair of large soft tissue defects as well as the reconstruction of the knee joint function.

  2. Posttraumatic Temporomandibular Joint Disorders

    OpenAIRE

    Giannakopoulos, Helen E.; Quinn, Peter D.; Granquist, Eric; Chou, Joli C.

    2009-01-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding,...

  3. Surgical Treatment Experience of Patients With Acromioclavicular Dislocation%肩锁关节脱位患者的手术治疗体会

    Institute of Scientific and Technical Information of China (English)

    王凤彦

    2015-01-01

    目的:对肩锁关节脱位患者的手术治疗方法以及效果进行分析,并对手术治疗体会进行总结。方法选取于2013年11月~2014年8月期间在我院接受治疗的35例肩锁关节脱位患者,并对所有患者进行手术治疗,对手术方法和效果进行总结。结果按照Karlsson评价标准来评定术后疗效,优27例,占比77.1%,良5例,占比14.3%,差3例,占比8.6%,则本次研究的优良率为91.4%。结论对肩锁关节脱位患者采用手术治疗具有十分显著的临床效果,并且具有固定可靠、减少疼痛、防止肩部畸形以及获得较好的肩关节功能等诸多优点。%Objective To analyze surgical treatment method and its effect of patients with acromioclavicular dislocation and then summarize its surgical treatment experience.Methods Choose 35 patients with acromioclavicular dislocation who are received and treated in hospital from November 2013 to August 2014 and have them cured with surgical treatment and then make a summary of treatment experience.ResultsMake an evaluation on surgery treatment effect according to Karlsson standard, the result shows that 27 cases of performance are excellent, accounting 77.1%; 5 cases of performance are good, accounting 14.3%; and 3 cases of performance are bad, accounting 8.6%, the treatment excellence rate is up to 91.4%. Conclusion Surgical treatment is of efifcacy in treatment of patients with acromioclavicular dislocation; and such a treatment method has advantages of reliable fixation and pain alleviation, prevention form shoulder deformation and improvement of shoulder function; thus, surgical treatment is quite worthwhile to be promoted and applied clinically in treatment of acromioclavicular dislocation.

  4. Metatarsophalangeal joint medial collateral ligament reconstruction in the treatment of hallux valgus%跖趾关节内侧副韧带重建术治疗外翻

    Institute of Scientific and Technical Information of China (English)

    赵鸿声; 靖光武; 张建军; 黄吉利

    2012-01-01

    目的 探讨跖趾关节内侧副韧带重建加跖趾关节成形术治疗外翻疗效.方法 采用改良跖趾关节成形术治疗外翻23例(38足),并对趾畸形的矫正程度、疼痛症状的改善及行走功能的恢复等进行充分评估.结果 本组患者外翻角(HAV)及第一、二跖骨间夹角(IMA)术前、后比较,差异有统计学意义(P<0.05).术后随访(13.6±2.3)个月,疗效优28足,良8足,可1足,差1足,总优良率达94.7%.结论 跖趾关节内侧副韧带重建加跖趾关节成形术能够治疗多种中、重度外翻及合并趾跖关节炎患者,能有效改善足部外形及症状,恢复行走功能,并发症少.%Objective To investigate clinical effect of medial collateral ligament reconstruction and arthroplasty of metatarsophalangeal joint for the treatment of hallux valgus. Methods From 2006 to 2011,38 feet of 23 patients were treated with the modified operation. All patients were followed up and the degree of deformity correction, the improvement of pain and the recovery of walking function were fully e-valuated. Results After the surgery, there were significant differences in hallux valgus angle( HVA )and intermetatarsal angle( IMA )( P <0. 05 ). All the cases were followed up for( 13. 6 ± 2. 3 )months and an excellent outcome was found in 28 feet, good in 8, fair in 1 and poor in 1, the excellent and good rate was 94.7%. Conclusion The modified metatarsophalangeal joint arthroplasty is an effective method for patients with hallux valgus and extensor digitorum communis arthritis. It can markedly improve the appearance, release the symptoms, restore the function and reduce the complications.

  5. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  6. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  7. Coracoclavicular joint

    International Nuclear Information System (INIS)

    The coracoclvicular joint, a rear abnormality which may be the cause of pain in the shoulder and limitation of motion of the shoulder joint, is discussed. A case of coracoclvicular joint with shoulder pain was observed in 65 yrs old Korean male

  8. Experimental study on mechanical and biomechanical reconstruction of bone defect of long bone near joint%长骨近关节端骨缺损的力学和生物力学结构重建

    Institute of Scientific and Technical Information of China (English)

    胡春明; 张伟; 苏云; 王成学; 徐莘香; 卢宝顺

    2005-01-01

    reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can

  9. Wide resection and knee joint reconstruction for malignant tumors of the proximal tibia%胫骨上端恶性骨肿瘤广泛切除与重建

    Institute of Scientific and Technical Information of China (English)

    杨志平; 杨强; 李昕; 李振峰; 李建民

    2011-01-01

    bone tumors of proximal tibia,27 males and 18 females,28 years in average (range, 12 -62 years). The tumors,including 25 osteosarcomas,7 malignant giant cell tumors,6 chondrosarcomas,3 malignant fibrous histiocytomas,3 fibrosarcomas and 1 lymphoma were treated with wide resection which performed through anteromedial incision in 30 cases and anterolateral incision in 15. The superior tibiofibuiar joints were involved and the proximal tibia resected en bloc in 13. Two knee joints were involved and extraarticuler resection were performed. Partial tumorous bone was devitalized and replanted in 5 cases and the anterior tibial vessels were ligated in 28. The involved knee joints were reconstructed with domestic-made prostheses and soft tissue coverage was improved by medial or lateral gastrocnemius flap and sagittal split anterior tibial muscle flap in some patients which tibia was removed longer. Neoadjuvant chemotherapy were performed to the patients with osteosarcoma and malignant fibrous histiocytoma. [ Result] With an average follow-up of 4.6 years ( range,8 months -9 years ),local recurrences occurred in four cases and lung metastases in six cases. One patients with malignant fibrous histiocytoma of proximal tibia had metastasis to L* after 6 years postoperatively and was treated with total en bloc spondylectomy. The complications related to the prostheses included peri-prosthetic infection in 3, prosthetic dis-location in 3, prosthesis loosening in 2, peri-prosthesis fracturein 1 and prosthetic fracture in 1. The average range of motion were 92 degrees (50 - 120 degrees) with the 4.4 degrees (0 - 20 degrees) of average extension lag. According to the Musculoskeletal Tumor Society ( MSTS ) Scoring system, the average functional score was 76.7%. [ Conclusion ] Wide resection and reconstruction for malignant tumor of proximal tib-la I- highly demanding. To achieve the goal of Limb salvage and _■■?." function, il is necessary to employ standard reseolion lech

  10. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  11. Distal radioulnar joint injuries.

    Science.gov (United States)

    Thomas, Binu P; Sreekanth, Raveendran

    2012-09-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  12. Analysis of therapeutic effect of rehabilitation treatment improving function of knee joint following reconstruction anterior crucial ligament with allogenic achilles tendon under arthroscopy%跟腱重建前十字韧带术后康复治疗恢复膝关节功能的疗效分析

    Institute of Scientific and Technical Information of China (English)

    常青; 黄迅悟; 张晓鸥; 郑光新

    2002-01-01

    Objective Combining the reconstruction of anterior crucial ligament(ACL) with functional rehabilitation,we recover the injured knee as possible as can.Methods 38 patients received ACL reconstruction with allogenci Achilles tendon under arthroscopy.We reconstructed the injured ACL and the injured medial crucial ligament(MCL) by utilization of length of achiles tendon.Then we carried out different rehabilitations in accordance with special needs of the patients.Results The follow up was performed for more than 7 months in 34 cases.Lysholm method was used to evaluate patients' function before and after operation.Results showed average score was 53.8 preoperatively, and 84.2 postoperatively,the good rate was 84.4% .In the objective examination,anterior drawer test(ADT),31 cases were positive preoperatively,1 was positive postoperatively;lachman test:34 were positive preoperatively,1 was positive postoperatively;4 were weak positive postoperatively.There were 3 cases with pain of knee joints and 4 cases with limitation of activity of knee joints(5~ 20 degree) postopratively.Conclusion Combination of reconsgruction of ACL with allogenic achilles tendon and the functional rehabilitation can gain remarkable curative effect.

  13. Penile reconstruction

    Institute of Scientific and Technical Information of China (English)

    Giulio Garaffa; Salvatore Sansalone; David J Ralph

    2013-01-01

    During the most recent years,a variety of new techniques of penile reconstruction have been described in the literature.This paper focuses on the most recent advances in male genital reconstruction after trauma,excision of benign and malignant disease,in gender reassignment surgery and aphallia with emphasis on surgical technique,cosmetic and functional outcome.

  14. 关节镜下重建膝关节新鲜与陈旧前交叉韧带训练伤疗效对比分析%Comparison of the clinical outcome of knee joint reconstruction between fresh and old military training injury of ACL with arthroscopy

    Institute of Scientific and Technical Information of China (English)

    王兵; 王善超; 孙卫平; 董桂芝

    2012-01-01

    Objective To compare the clinical outcome of knee joint reconstruction of different operative period in treatment of military training injury of ACL. Methods ACL injuries were treated with knee joint reconstruction with semitendinosus tendon and gra-cilis tendon. 27 patients in the fresh group were treated in (5 ±0. 8) weeks and 19 patients in the old group were done in (76 ± 10.5) weeks. Results According to Lysholm knee function score, the excellent and good rates were 92. 5% in the fresh group and 78. 9% in the old group. The difference showed statistical significance (P < 0. 01). Conclusion Reconstruction of knee joint in military training with anthroscope can play better clinical effect in the early time than in the late time.%目的 比较部队官兵体能训练所致膝关节前交叉韧带(ACL)损伤手术时机对疗效的影响.方法 关节镜下对平均病程(5±0.8)周27例新鲜组和平均病程(76±10.5)周19例陈旧组ACL损伤,均以半腱肌和股薄肌为替代物进行手术重建.结果 按Lysholm评分,新鲜组和陈旧组ACL损伤的优良率分别为92.5%和78.9%,两组比较差异有显著统计学意义(P<0.01).结论 体能训练所致膝关节交叉韧带损伤早期关节镜手术重建的疗效优于晚期重建.

  15. Studies of welded joints

    Directory of Open Access Journals (Sweden)

    J. M. Krupa

    2010-07-01

    Full Text Available Studies of a welded joint were described. The joint was made as a result of the reconstruction of a truss and one of the possible means to make a repair. The studies were of a simulation character and were targeted at the detection of welding defects and imperfections thatshould be eliminated in a real structure. A model was designed and on this model the tests and examinations were carried out. The modelwas made under the same conditions as the conditions adopted for repair. It corresponded to the real object in shape and dimensions, and in the proposed technique of welding and welding parameters. The model was composed of five plates joined together with twelve beads.The destructive and non-destructive tests were carried out; the whole structure and the respective welds were also examined visually. Thedefects and imperfections in welds were detected by surface methods of inspection, penetration tests and magnetic particle flaw detection.The model of the welded joint was prepared by destructive methods, a technique that would never be permitted in the case of a realstructure. For the investigations it was necessary to cut out the specimens from the welded joint in direction transverse to the weld run. The specimens were subjected to metallographic examinations and hardness measurements. Additionally, the joint cross-section was examined by destructive testing methods to enable precise determination of the internal defects and imperfections. The surface methods were applied again, this time to determine the severity of welding defects. The analysis has proved that, fabricated under proper conditions and with parameters of the welding process duly observed, the welded joint has good properties and repairs of this type are possible in practice.

  16. Posttraumatic temporomandibular joint disorders.

    Science.gov (United States)

    Giannakopoulos, Helen E; Quinn, Peter D; Granquist, Eric; Chou, Joli C

    2009-05-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ. PMID:22110802

  17. 关节镜辅助下一期修复重建膝关节三联损伤疗效观察%Clinical effect of one-stage arthroscopically assisted repair and reconstruction on Triplicate injuries of knee joint

    Institute of Scientific and Technical Information of China (English)

    何建华; 谢水华; 王小鹏; 丁浩

    2015-01-01

    目的:探讨关节镜下一期修复重建膝关节三联损伤(前交叉韧带,内侧副韧带和内侧半月板损伤)的方法及效果。方法2009年10月-2014年6月,对21例膝关节三联损伤患者采用一期关节镜下手术,取腘绳肌腱(或同种异体肌腱)重建前交叉韧带,止点重建或缝合修复治疗内侧副韧带损伤,一期缝合或修整损伤的内侧半月板。结果术后均获随访6-30个月,平均16个月,术前Lysholm膝关节功能评分为(40.4±15.8)术后末次随访为(84.5±12.8),有显著改善。患者在0°和20°应力测试时稳定性均完全恢复。结论膝关节三联损伤可以一期在关节镜下完成重建及修复,早期有效恢复膝关节稳定性。%Objective To investigate one-stage arthroscopic repair and reconstruction of the triplicate Injuries of knee joint (anterior cruciate ligament,medial collateral ligament and medial meniscus). Methods From October 2009- June 2014,21 cases of knee joint injury were treated as taking arthroscopic operation with one stage ,The ACL was reconstructed using the hamstring tendon autograft (or tendon allograft),medial collateral ligament was repaired and reconstruction of the interdictory point,One-stage suture or trimmed medial meniscus injury. Results All cases were followed up for 6-30 months,average 16 months,Accord-ing to the Lysholm scale of knee function,preoperative was (40.4+15.8),the last follow-up was (84.5+12.8) after operation,has im-proved significantly. Patients with stress test stability were recovered in 0 degree and 20 degree. Conclusion The triplicate In-juries of knee joint can be reconstructed and repaired for one stage under the arthroscope ,early and effective recovery of knee joint stability.

  18. Labral reconstruction: when to perform and how

    Directory of Open Access Journals (Sweden)

    Brian J White

    2015-07-01

    Full Text Available Over the past decade, the understanding of the anatomy and function of the hip joint has continuously evolved, and surgical treatment options for the hip have significantly progressed. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. Procedures that maintain and preserve proper hip anatomy, such as labral repair and femoroacetabular impingement (FAI correction, have shown superior results, in terms of pain reduction, increased function, and ability to return to activities. Labral reconstruction is a treatment option that uses a graft to reconstruct the native labrum. The technique and outcomes of labral reconstruction have been described relatively recently, and labral reconstruction is a cutting edge procedure that has shown promising early outcomes. The aim of this article is to review the current literature on hip labral reconstruction. We will review the indications for labral reconstruction, surgical technique and graft options, and surgical outcomes that have been described to date. Labral reconstruction provides an alternative treatment option for challenging intra-articular hip problems. Labral reconstruction restores the original anatomy of the hip and has the potential to preserve the longevity of the hip joint. This technique is an important tool in the orthopaedic surgeon’s arsenal for hip joint treatment and preservation.

  19. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  20. Climate Reconstructions

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Paleoclimatology Program archives reconstructions of past climatic conditions derived from paleoclimate proxies, in addition to the Program's large...

  1. Laryngopharyngeal reconstruction

    OpenAIRE

    Kazi, Rehan A

    2006-01-01

    There is a high incidence of hypopharyngeal cancer is our country due to the habits of tobacco and alcohol. Moreover these cases are often detected in the late stages thereby making the issue of reconstruction very tedious and unpredictable. There are a number of options for laryngopharyngeal reconstruction available now including the use of microvascular flaps depending upon the patient’s fitness, motivation, technical expertise, size and extent of the defect. This article reviews the differ...

  2. Reconstrucción de la articulación temporomandibular postraumática con prótesis a medida: Planificación quirúrgica virtual Post-traumatic reconstruction with custom prosthesis of the temporomandibular joint: Computerized surgical planning

    Directory of Open Access Journals (Sweden)

    Aitor García Sánchez

    2011-06-01

    Full Text Available Introducción: Las nuevas técnicas de planificación quirúrgica virtual, como la tecnología CAD/CAM, así como los avances en biomateriales, permiten abordar casos cada vez más complejos de reconstrucción de la articulación temporomandibular. La planificación y la fabricación de dispositivos aloplásticos a medida permiten una adaptación excelente a las estructuras anatómicas. Las deformidades dentofaciales coexisten en muchas ocasiones con la afección articular. Con estos métodos de planificación es posible asociar procedimientos de cirugía ortognática, a la vez que reconstruimos la articulación temporomandibular en un solo tiempo quirúrgico. Material y métodos: En este artículo presentamos nuestra experiencia en la planificación virtual y posterior cirugía de 3 casos de anquilosis articular bilateral (6 articulaciones, con simulación de osteotomías, movimientos maxilomandibulares y diseño de prótesis totales aloplásticas a medida de la articulación temporomandibular. Conclusiones: El abordaje integral de la biomecánica articular, la relación intermaxilar y la oclusión dental es imprescindible para obtener resultados predecibles y satisfactorios. La planificación virtual y la utilización de dispositivos aloplásticos a medida permiten la reconstrucción total articular de una forma precisa y segura.Introduction: New virtual surgery planning techniques like CAD/CAM and advances in biomaterials have made it possible to undertake increasingly complex cases of temporomandibular joint reconstruction. The planning and preparation of custom alloplastic devices makes it possible to accurately accommodate anatomic structures. Dental and facial deformities often coexist with articular pathology. Using computerized planning methods, orthognathic surgery procedures can be combined with temporomandibular joint reconstruction in a single procedure. Material and methods: The authors' experience with computerized planning and

  3. Estudo transversal sobre o tratamento das lesões acrômioclaviculares agudas Transversal study about acute acromioclavicular lesions

    Directory of Open Access Journals (Sweden)

    Marcel Jun Sugawara Tamaoki

    2009-01-01

    Full Text Available OBJETIVO: O objetivo do presente estudo transversal é verificar como o ortopedista brasileiro interpreta as lesões acromioclaviculares quanto aos critérios para a indicação do tratamento cirúrgico ou não, seus métodos preferidos, as complicações mais frequentes e os resultados obtidos. MÉTODOS: Durante o 6º Congresso Brasileiro de Cirurgia do Ombro e Cotovelo (CBOC e o 38º Congresso Brasileiro de Ortopedia e Traumatologia (CBOT foram distribuídos 507 questionários, sendo considerados 478 para análise. RESULTADOS: Em relação ao tratamento das LAC tipo I e II, a maioria dos entrevistados utilizam métodos não cirúrgicos. Em contraposição nas LAC IV, V e VI 475 (99,4% dos entrevistados tratam essas lesões cirurgicamente. Nas LAC tipo III não existe uma definição na escolha do tratamento cirúrgico ou não cirúrgico para 386 (80,7% entrevistados, sendo que o fator mais importante para tomada de decisão para a maioria dos entrevistados é a atividade esportiva do paciente e a idade. CONCLUSÃO: Nas LAC tipo III não há consenso, sendo o tratamento determinado conforme as características do paciente, contudo na literatura atual há uma tendência para o tratamento não cirúrgico destas lesões.The objective of the present transversal study is to check how Brazilian orthopedists treat these injuries, their criteria for choosing the treatment, results and complications. METHODS: During the 6th Brazilian Congress of Shoulder and Elbow Surgery (CBOC and the 38th Brazilian Congress of Orthopaedics and Traumatology (CBOT 507 questionnaires were distributed (148 CBOC and 359 CBOT, with 478 being considered for analysis. RESULTS: Regarding type-I and -II ACIs, most of the respondents use traditional non-surgical methods. On the other hand, for type-IV, V and VI injuries, 475 (99.4% of the respondents indicate surgical methods. Concerning type-III injuries, there is no consensus in the selection between traditional and surgical

  4. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Energy Technology Data Exchange (ETDEWEB)

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

    2011-12-15

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  5. THE EFFECT OF THE ACL SINGLE-BUNDLE/DOUBLE-BUNDLE RECONSTRUCTION ON THE BIOMECHANICS OF TIBIO-FEMORAL JOINT AT DIFFERENT FLEXION ANGLES 1)%ACL单束/双束重建对多屈曲角位姿的胫股关节力学特性影响

    Institute of Scientific and Technical Information of China (English)

    徐强; 黄荣瑛; 许勇刚; 郭云飞; 郑红光

    2012-01-01

    flexion angle of 0° for the models A and B, the accuracy and validity of the pairs of models for healthy adult A were proved. After that, MRI images of the normal human knee at different flexion angles of 0°/25°/60°/80° were obtained through SONATA MAESTRO 1.5 T Scanning. Then, the corresponding 3D tibio-femoral joint models of normal/ACL single bundle/double bundle reconstruction were established. In the experiment, axial force and combined loads (axial force and torque) were applied to these models to analyze and compare the changes of the stress distribution of cartilages/meniscus/ligaments and the tension characteristic of ligaments before and after the ACL reconstruction. The results show that: (1) The stresses on cartilages and meniscus after ACL single bundle/double bundle reconstruction change with the flexion angles, and especially the stress distributions on the cartilages change significantly at some angle. (2) Single-bundle reconstruction can lead to the obvious increment of the equivalent stresses on cartilages and meniscus, and the maximum increment is to 40%. However, the corresponding values after double bundle reconstruction at different flexion angles are closer than that after single-bundle reconstruction. (3) Although ACL single-bundle reconstruction will reduce the equivalent stress on PCL, stress on medial/lateral collateral ligament will significantly increase at high-flexion angle. The maximum stress on MCL changes obviously with the flexion angles after double-bundle reconstruction, but the maximum stress on LCL and PCL show the corresponding trend to normal joint. (4) The average tension of MCL is higher than that of the other two after single or double bundle reconstruction. Besides, the tension characteristic of ligaments after the double-bundle reconstruction is closer to the normal joint than that after single-bundle. In short, considering the stress and tension of cartilages, meniscus and ligaments after ACL

  6. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  7. Joint imaging

    International Nuclear Information System (INIS)

    Joint imaging is a proven diagnostic procedure which has become indispensable to the detection and treatment of different joint diseases in almost all disciplines. The method is suited for early diagnosis of joint affections both in soft tissue and bone which cannot be detected by X-ray or other procedures. The local activity accumulation depends on the rate of metabolism and is visualized in the scan, which in turn enables the extension and floridity of focal lesions to be evaluated and followed-up. Although joint scans may often give hints to probabilities relevant to differential diagnosis, the method is non-specific and only useful if based on the underlying clinical picture and X-ray finding, if possible. The radiation exposure is very low and does not represent a hazard in cases of adequate assessment of indication. In pregnant women and children the assessment of indication has to be based on very strict principles. The method is suited for out-patient diagnosis and can be applied in all installations equipped with a gamma camera and a technetium generator. (orig.)

  8. Project Reconstruct.

    Science.gov (United States)

    Helisek, Harriet; Pratt, Donald

    1994-01-01

    Presents a project in which students monitor their use of trash, input and analyze information via a database and computerized graphs, and "reconstruct" extinct or endangered animals from recyclable materials. The activity was done with second-grade students over a period of three to four weeks. (PR)

  9. Vaginal reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  10. Vaginal reconstruction

    International Nuclear Information System (INIS)

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients

  11. Observation of the clinical effect of the occlusal reconstruction treatment on patients with temporomandibular joint disorder as well as severe dental abrasion%牙列重度磨耗伴颞下颌关节紊乱病咬合重建序列治疗临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄静莲; 曹云娟

    2012-01-01

    目的 观察分析牙列重度磨耗伴颞下颌关节紊乱病(TMD)患者咬合重建序列治疗的疗效.方法 选取牙列重度磨耗伴TMD患者11例,检查记录TMD及其相关症状,然后进行咬合重建序列治疗,治疗完成3个月、6个月及12个月后,将治疗后的TMD及其相关症状与治疗前相比较,对相关数据进行统计分析.结果 治疗后11例患者均感满意且咀嚼有力,关节弹响、关节疼痛及咬合干扰治疗前后的比较存在统计学意义(P<0.05).结论 咬合重建后,患者满意度较高,其TMD症状有明显改善,髁突位置在短期内无明显改善.%Objective Observe and analyse the clinical effect of the occlusal reconstruction treatment on patients with temporomandibular joint disorder(TMD) as well as severe dental abrasion. Methods 11 patients with TMD and severe abrasion were given occlusal reconstruction treatment after records of their situation of TMD and related symptoms. 3,6,12 months after operation,compare TMD and related symptorms with those before operation. Data were analysed statistically. Kelusts 11 patients given the treatment were all satisfied with the correct and effective occlusion. There were significantly statistical differences (P <0.05) in the comparison before and after the treatment in joint-snapping,joint-paining and occlusal interference. Conclusions Patients are highly satisfied after occlusal reconstruction , and their symptoms about TMD improve obviously. There was no variation of the mandibular condyle position in short time.

  12. Radio Reconstructions

    OpenAIRE

    Bulley, James; Jones, Daniel

    2013-01-01

    Radio Reconstructions is a sound installation which use indeterminate radio broadcasts as its raw material. Each piece is structured by a notated score, which controls its rhythm, dynamics and melodic contour over time. The audio elements used to enact this score are selected in real-time from unknown radio transmissions, by an autonomous software system which is continuously scanning the radio waves in search of similar fragments of audio. Using a technique known as audio mosaicing, hund...

  13. Application Value of MR and CT in the Diagnosis and Treatment and Re-construction of Injury of Cruciate Ligament of Knee Joint%MR与CT在膝关节交叉韧带损伤诊治重建的应用价值

    Institute of Scientific and Technical Information of China (English)

    门方禹

    2016-01-01

    目的 探究膝关节交叉韧带损伤诊治重建中MR与CT的应用价值. 方法 整群选取并回顾性分析2014年6月—2015年6月在该院收治的98例膝关节交叉韧带损伤患者临床资料,按诊治所用不同检查方法分为两组,观察组54例患者行MR诊治与重建, 对照组44例患者行CT诊治与重建, 比较两组ACL与PCL测量值. 结果 观察组ACL 的前内侧束长度(41.1±1.6)mm、后外侧束长度(16.6±1.6)mm、宽度(10.1±0.6)mm、厚度(5.8±0.6)mm 与对照组(40.6±1.5)mm、(16.3±1.4)mm、(9.8±0.9)mm、(5.6±0.9)mm比较差异无统计学意义(P>0.05),但观察组测量值略微优于对照组.结论 MR与CT在膝关节交叉韧带损伤诊治重建中均具较高的应用价值,但MR诊治重建效果略优于CT,两种检查检查技术均值得推广使用.%Objective To study the application value of MR and CT in the diagnosis and treatment and reconstruction of in-jury of cruciate ligament of knee joint. Methods The clinical materials of 98 cases of patients with injury of cruciate liga-ment of knee joint treated in our hospital from June 2014 to June 2015 were retrospectively analyzed and divided into two groups according to different diagnostic and treatment examination methods, the observation group (55 cases ) received MR diagnosis and treatment and reconstruction, the control group (44 cases ) received CT diagnosis and treatment and recon-struction, the measured values of ACL and PCL of the two groups were compared. Results The anterior medial bundle length of ACL, lateral bundle length of ACL, width and thickness were respectively (41.1±1.6)mm, (16.6±1.6)mm, (10.1± 0.6)mm and (5.8±0.6)mm in the observation and (40.6±1.5)mm, (16.3±1.4)mm, (9.8±0.9)mm and (5.6±0.9))mm in the control group, the comparison was not statistically significant (P>0.05), however, the measured value in the observation group was slightly better than that in the control group. Conclusion MR and CT in the diagnosis and

  14. MSCT reconstruction technique combined with fat suppression MR value in the diagnosis of occult fracture of knee joint%MSCT重建技术联合MR脂肪抑制技术在膝关节隐匿性骨折中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    赵星; 郭满涛

    2014-01-01

    Objective To evaluate multislice spiral CT (MSCT) multi planar reconstruction (MPR) and volume rendering (VR) reconstruction technique combined with magnetic resonance (MR) fat suppression value techniques in diagnosis of occult fracture of knee joint. Methods: review of 20 knee injury of knee joint and lateral X ray examination after, think no traumatic fracture patients, clinical suspected fracture patients, then underwent 16 slice spiral CT scan with 16 slice spiral CT, derived from the original data by the workstation for multi planar reformation (MPR) and volume rendering (VR) reconstruction images combined with axial images of fracture diagnosis, fol owed by MR examination and evaluation damage. Results of the 20 patients after MSCT reconstruction, 14 cases of CT and MR in patients with diagnosis of knee joint bone fracture with occult fracture; 2 cases of patients with MR diagnosis of local bone occult fracture, while CT and recombinant image not found the exact fracture line; conclusions MSCT in determining the fracture location was superior to X-ray and MR, MR no cortical bone fracture in the diagnosis of occult fracture is superior to CT, and MR in the diagnosis of ligament, meniscus injury and soft tissue injury and is superior to X-ray, CT scan and reconstruction.%目的:探讨多层螺旋CT(MSCT)多平面重组(MPR)及容积再现(VR)重建技术联合磁共振(MR)脂肪抑制技术在膝关节隐匿性骨折中的诊断价值。方法回顾20位膝关节外伤行膝关节正侧位X线检查后,认为无外伤性骨折的患者,临床高度怀疑骨折患者,再行16层螺旋C T平扫的患者,将16层螺旋CT所得原始数据经工作站进行多平面重组(MPR)及容积再现(VR)重建图像结合轴位图像做出对骨折的诊断,后行MR检查评价损伤状况。结果20例患者中经MSCT重建后,14例患者CT及MR骨折诊断出膝关节组成骨有隐匿性骨折;2例患者MR诊断出局部骨质隐

  15. 自体腓骨移植重建桡骨远端骨巨细胞瘤切除后的桡腕关节%Autogenous fibular transplantation and reconstruction of radiocarpal joint after en bloc excision of giant cell tumor of distal radius

    Institute of Scientific and Technical Information of China (English)

    张登君; 魏杰; 郭秀生; 宋洁富

    2013-01-01

    目的 评价吻合血管或不吻合血管的自体腓骨近端移植重建桡骨远端骨巨细胞瘤切除术后桡腕关节的方法和疗效. 方法 自2002年2月至2010年2月,对17例桡骨远端骨巨细胞瘤患者行瘤段切除术,之后应用吻合或不吻合血管的自体腓骨近端移植,重建桡腕关节.术后对重建的关节功能及影像学结果进行评价. 结果 17例均获得随访,时间2.0~5.5年,平均3.6年.3例行腓动脉吻合,3例行膝下外侧动脉吻合.所有切口Ⅰ期愈合,桡骨平均切除长度7.6 cm.所有移植骨均愈合,吻合血管移植的骨愈合时间平均为3.7个月;非吻合血管的为7.9个月.无局部复发及肺转移,无移植腓骨吸收等,1例出现尺腕关节间隙变窄,1例出现腕关节退变.术后2年,重建的腕关节平均活动度:背伸47°、掌屈30°、尺偏23°、桡偏14°、前臂旋前55°、旋后62°,握力为对侧的40% ~ 80%.MSTS评分平均为87.6%,其中优6例,良8例,中3例,优良率达82.4%.DASH上肢功能调查表平均为3.48分. 结论 应用自体腓骨近端移植重建桡骨远端骨巨细胞瘤切除术后的桡腕关节,能较好的保留腕关节的功能,是此处关节功能重建有效的方法.吻合血管移植更利于骨愈合,并发症相对较少.%Objective To evaluate the method and curative effect of reconstruction with vascularized or nonvascularized autogenous fibular transplantation of radiocarpal joint after en bloc excision of giant cell tumor of distal radius.Methods Seventeen cases with giant cell tumor of distal radius bone were treated by en bloc resection and reconstruction of wrist joint with vascularized or non-vascularized autogenous fibular transplantation.Postoperative wrist joint function and radiographic outcomes were evaluated.Results Seventeen cases were followed up from 2.0 to 5.5 years (average 3.6 years).Three cases were treated by peroneal artery anastomosis and other 3 cases by inferior lateral genicular

  16. Parallel MRI Reconstruction by Convex Optimization

    CERN Document Server

    Zhang, Cishen

    2014-01-01

    In parallel magnetic resonance imaging (pMRI), to find a joint solution for the image and coil sensitivity functions is a nonlinear and nonconvex problem. A class of algorithms reconstruct sensitivity encoded images of the coils first followed by the magnitude only image reconstruction, e.g. GRAPPA. It is shown in this paper that, if only the magnitude image is reconstructed, there exists a convex solution space for the magnitude image and sensitivity encoded images. This solution space enables formulation of a regularized convex optimization problem and leads to a globally optimal and unique solution for the magnitude image reconstruction. Its applications to in-vivo MRI data sets result in superior reconstruction performance compared with other algorithms.

  17. Afghanistan Reconstruction

    Institute of Scientific and Technical Information of China (English)

    Fu Xiaoqiang

    2006-01-01

    @@ The Karzai regime has made some progress over the past four years and a half in the post-war reconstruction.However, Taliban's destruction and drug economy are still having serious impacts on the security and stability of Afghanistan.Hence the settlement of the two problems has become a crux of affecting the country' s future.Moreover, the Karzai regime is yet to handle a series of hot potatoes in the fields of central government' s authority, military and police building-up and foreign relations as well.

  18. Evidence-based radiology (part 2): Is there sufficient research to support the use of therapeutic injections into the peripheral joints?

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Cynthia; Hodler, Juerg [Orthopaedic University Hospital of Balgrist, Radiology, Zuerich (Switzerland)

    2010-01-15

    This review article addresses the best evidence currently available for the effectiveness of injection therapy for musculoskeletal conditions involving the peripheral joints. The research is presented by anatomical region and areas of controversy and the need for additional research are identified. Randomized controlled trials, meta-analyses and systematic reviews are lacking that address the effectiveness of therapeutic injections to the sternoclavicular, acromioclavicular, ankle and foot joints. No research studies of any kind have been reported for therapeutic injections of the sternoclavicular joint. With the exception of the knee, possibly the hip and patients with inflammatory arthropathies, research does not unequivocally support the use of therapeutic joint injections for most of the peripheral joints, including the shoulder. Additionally, controversy exists in some areas as to whether or not corticosteroids provide better outcomes compared to local anesthetic injections alone. When viscosupplementation injections are compared to corticosteroids in patients with osteoarthritis of the knee, the evidence supports the use of viscosupplementation for more prolonged improvement in outcomes, with corticosteroids being good for short-term relief. (orig.)

  19. 锁骨钩钢板治疗Rockwood Ⅲ型肩锁关节脱位的治疗分析%Study of treatment of Rockwood type Ⅲ acromioclavicular dislocation with Hook plate

    Institute of Scientific and Technical Information of China (English)

    郭丹; 周海斌

    2012-01-01

    [Objective] To analyze shoulder pain and restricted movement after treatment with Hook plate about Rockwood type HI acromioclavicular dislocation patients. [Method] From February ,2008 to February,2011,35 Rockwood type Ⅲ acromioclavicular dislocation patients (23 male and 12 female,average age 42.4) were treated in our hospital. They were treated with Hook plate. Adjusted Constant-Murley score was used to evaluate shoulder function. The Average follow-up time were 13.5 months. [Result]In Rockwood type Ⅲ acromioclavicular dislocation,there were 11 cases with different grade shoulder pain and restricted movement in the 19 patients. The score difference was significant ( P < 0.05 ). [ Conclusion ] Rockwood type Ⅲ acromioclavicular dislocation,treated with Hook plate leads to high rate of shoulder pain and restricted movement,which is not beneficial to functional rehabilitation.%[目的]探讨Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗后肩关节疼痛、活动受限的原因.[方法]苏北人民医院和苏州大学附属第二医院自2008年2月~2011年2月共35例Rockwood Ⅲ型肩锁关节脱位病人,无骨折、神经损伤及血管损伤等其他合并伤,其中,男23例,女12例,平均42.4岁,行锁骨钩钢板手术治疗,术后按调整的Constant-Murley随访观察各病例肩关节恢复情况,平均随访13.5个月.[结果]35例Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗中,有11例出现不同程度的肩关节肩痛、活动受限的症状,统计检验无肩痛、活动受限症状病例与有肩痛、活动受限症状病例之间评分差异有统计学意义(P<0.05).[结论]Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗术后易出现肩痛、活动受限的症状,会明显影响肩关节功能恢复.

  20. Tracheal reconstructions.

    Science.gov (United States)

    Srikrishna, S V; Shekar, P S; Shetty, N

    1998-12-01

    Surgical reconstruction of the trachea is a relatively complex procedure. We had 20 cases of tracheal stenosis. We have a modest experience of 16 tracheal reconstructions for acquired tracheal stenosis. Two patients underwent laser treatment while another two died before any intervention. The majority of these cases were a result of prolonged ventilation (14 cases), following organophosphorous poisoning (11 cases), Guillain-Barré syndrome, bullet injury, fat embolism and surprisingly only one tumor, a case of mucoepidermoid carcinoma, who had a very unusual presentation. There were 12 males and 4 females in this series, age ranging from 12-35 years. The duration of ventilation ranged from 1-21 days and the interval from decannulation to development of stridor was between 5-34 days. Six of them were approached by the cervical route, 5 by thoracotomy and cervical approach, 2 via median sternotomy and 3 by thoracotomy alone. Five of them required an additional laryngeal drop and 1 required pericardiotomy and release of pulmonary veins to gain additional length. The excised segments of trachea measured 3 to 5 cms in length. All were end to end anastomosis with interrupted Vicryl sutures. We have had no experience with stents or prosthetic tubes. Three patients developed anastomotic leaks which were controlled conservatively. Almost all of them required postoperative tracheo-bronchial suctioning with fibreoptic bronchoscope. We had one death in this series due to sepsis. PMID:9914459

  1. NEW VISUAL METHOD FOR FREE-FORM SURFACE RECONSTRUCTION

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A new method is put forward combining computer vision with computer aided geometric design (CAGD) to resolve the problem of free-form surface reconstruction. The surface is first subdivided into N-sided Gregory patches, and a stereo algorithm is used to reconstruct the boundary curves. Then, the cross boundary tangent vectors are computed through reflectance analysis. At last, the whole surface can be reconstructed jointing these patches with G1 continuity(tangent continuity). Examples on synthetic images are given.

  2. Motor evoked potentials and spontaneous electromyography in reconstruction of pelvic fracture combined with sacroiliac joint dislocation%骨盆骨折合并骶髂关节脱位术中电生理监测技术的应用

    Institute of Scientific and Technical Information of China (English)

    陈艺; 林志雄; 黎文; 刘琦; 严广斌; 张姝江; 余楠生

    2013-01-01

    目的 探讨骨盆骨折合并骶髂关节脱位手术中应用电生理监测技术预防神经损伤的效果.方法 对需要手术治疗的骨盆骨折合并骶髂关节脱位患者,术中对术侧采用经颅电刺激运动诱发电位(TES-MEP)和自由肌电图(EMG)进行实时监测,观察其对坐骨神经和腰5神经根医源性损伤的预防效果.结果 骶髂关节复位固定时,术侧股二头肌、胫前肌、胫后肌MEP波幅下降,但波形均能引出.耻骨复位时,MEP波形稳定.因手术操作引发趾短伸肌、胫后肌短暂、高幅EMG反应,即刻提醒术者,避免频繁,粗暴骚扰神经组织.术后骶髂关节、耻骨复位良好,且未出现医源性神经损伤.结论 联合运用MEP和自由EMG实时监测能及时反映骨盆骨折合并骶髂关节脱位切开复位内固定术中坐骨神经及L5神经根受激惹情况和运动功能状态,提高手术精确性,值得在临床推广应用.%Objective To investigate the efficacy of nerve damage prevention using electrophysiological monitoring techniques during reconstruction of pelvic fracture combined with sacroiliac joint dislocation. Methods Intraoperative real-time monitoring by motor evoked potentials with trans-cranial electrical stimulation (TES-MEP) and spontaneous electromyogram (EMG) were performed during surgical treatment for the patient of pelvic fracture combined with sacroiliac joint dislocation. The preventive effects on iatrogenic injury of sciatic nerve and L5 nerve root were observed. Results The TES-MEP volatility of biceps femoris, tibialis anterior muscle and posterior tibial muscle dropped on the surgical side when resetting sacroiliac joint, but the waveform could be elicited. The TES-MEP waveform was stable when resetting pubis. Some short, high-amplitude EMG response appeared in extensor digitorum brevis and posterior tibial muscle due to surgical operation, so that the surgeons could be immediately aware of avoiding irritation for nerve tissues

  3. 基于美学修复目的咬合重建对颞下颌关节的影响%The effects of occlusal reconstruction of esthetic prosthetic to TemporoMandibular Joint

    Institute of Scientific and Technical Information of China (English)

    曹利; 越涑霞

    2012-01-01

    目的:探讨以美容为目的的固定修复治疗所形成的咬合重建对颞下颌关节可能产生的影响.方法:通过固定修复、咬合重建的方法对牙列不齐、面下1/3垂直距离较短的患者,按下颌息止颌位时的面下1/3垂直距离减去2- 3mm确定下颌位置并以此为标准进行修复治疗,使患者实现正常的面容及咬合形态,同时观察颞下颌关节(TMJ)的结构和功能的变化.结果:3例前牙超覆(牙合)、超覆盖,面下1/3垂直距离偏短的患者进行咬合重建,均恢复了正常的咬合形态,改善了咀嚼功能和容貌,同时1例伴有TMJ症状的患者TMJ症状消失.结论:对面下1/3垂直距离不足的咬合畸形患者恢复正常的咬合形态及面下1/3垂直距离,在改善容貌和咬合功能的同时,也去除了TMD的易感(occlusion)因素,对于缓解或解除TMD症状有良好的效果.%Objective To investigate the effects to the TMJ of patients who had malocclusion were treated occlusal reconstruction of esthetic prosthodontics. Methods Three patients, were crowded malalinment, Ⅱ were whole dental cross bite, Ⅲ were Angle Ⅱ malocclusion who had deep over bite,deep over jet.maxillary forward,mandibular retraction, decrease of vertical dimension and symptoms of TMD.Patients I and Ⅱ were alined teeth by fixed ceramic crowns,not changed mandibular position. Patient III were mowed mandible forward and downward according to the mandibular postural position and got occlusal reconstruction by fixed ceramic crowns. Results Three patients who had esthetic occlusal reconstruction rehabilitated normal articulation and improved masticatory movement and face.Symptoms of TMD of patient Ⅲ disappeared. Conclusion When patients of malocclusion were treated occlusal reconstruction of esthetic prosthodontics,the occlusal factors of TMD were removed and symptoms TMD eliminated.

  4. The Arthroscopic Superior Capsular Reconstruction.

    Science.gov (United States)

    Adams, Christopher R; Denard, Patrick J; Brady, Paul C; Hartzler, Robert U; Burkhart, Stephen S

    2016-01-01

    In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative. In this article, we describe our technique for the SCR. PMID:27552457

  5. Reconstructive Urology

    Directory of Open Access Journals (Sweden)

    Fikret Fatih Önol

    2014-11-01

    Full Text Available In the treatment of urethral stricture, Buccal Mucosa Graft (BMG and reconstruction is applied with different patch techniques. Recently often prefered, this approach is, in bulber urethra strictures of BMG’s; by “ventral onley”, in pendulous urethra because of thinner spingiosis body, which provides support and nutrition of graft; by means of “dorsal inley” being anastomosis. In the research that Cordon et al. did, they compared conventional BMJ “onley” urethroplast and “pseudo-spongioplasty” which base on periurethral vascular tissues to be nourished by closing onto graft. In repairment of front urethras that spongiosis supportive tissue is insufficient, this method is defined as peripheral dartos [çevre dartos?] and buck’s fascia being mobilized and being combined on BMG patch. Between the years 2007 and 2012, assessment of 56 patients with conventional “ventral onley” BMG urethroplast and 46 patients with “pseudo-spongioplasty” were reported to have similar success rates (80% to 84% in 3.5 year follow-up on average. While 74% of the patients that were applied pseudo-spongioplasty had disease present at distal urethra (pendulous, bulbopendulous, 82% of the patients which were applied conventional onley urethroplast had stricture at proximal (bulber urethra yet. Also lenght of the stricture at the pseudo-spongioplasty group was longer in a statistically significant way (5.8 cm to 4.7 cm on average, p=0.028. This study which Cordon et al. did, shows that conditions in which conventional sponjiyoplasti is not possible, periurethral vascular tissues are adequate to nourish BMG. Even it is an important technique in terms of bringing a new point of view to today’s practice, data especially about complications that may show up after pseudo-spongioplasty usage on long distal strictures (e.g. appearance of urethral diverticulum is not reported. Along with this we think that, providing an oppurtinity to patch directly

  6. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose...... of the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  7. Spacesuit mobility knee joints

    Science.gov (United States)

    Vykukal, H. C. (Inventor)

    1979-01-01

    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  8. 同种异体肌腱及自体腓骨短肌重建踝关节外侧副韧带的比较%Autologous peroneus brevis and allogeneic tendon to reconstruct lateral collateral ligament of the ankle joint

    Institute of Scientific and Technical Information of China (English)

    王成伟; 郭鹏超; 王雪; 帕尔哈提; 李璐兵; 白靖平

    2015-01-01

    BACKGROUND:Autologous peroneus brevis and alogeneic tendon are often used for reconstruction of lateral colateral ligament of the ankle joint, but these two kinds of materials have different histological and biomechanical properties. OBJECTIVE:To compare the clinical effects of autologous peroneus brevis and alogeneic tendon to reconstruct lateral colateral ligament of the ankle joint. METHODS: Sixty-six patients with chronic external ankle instability caused by old injury to lateral colateral ligament of the ankle joint were enroled, aged 15-63 years. The 34 of 66 patients underwent lateral ligament reconstruction using autologous peroneus brevis and the rest 32 patients received lateral ligament reconstruction using alogeneic tendon. After reconstruction, reaction time of the peroneous brevis, talar tilt angle and anterior talar translation, visual analog scale score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were compared between the two groups. RESULTS AND CONCLUSION:At the last folow-up, the visual analog scale score, tilt angle and anterior talar translation were lowered in the two groups compared with the previous (P < 0.05), and the AOFAS scores were increased significantly in the two groups (P < 0.05); the reaction time of the peroneous brevis was increased inthe autologous peroneus brevis group (P < 0.05) and decreased in the alogeneic tendon group (P < 0.05); the above-mentioned indexes had no difference between the two groups. These findings indicate that autologous peroneus brevis and alogeneic tendon have similar effects on the lateral ligament reconstruction in terms of postoperative ankle function, stability and activity levels, but the alogeneic tendon shows advantages on less trauma and shorter operation time.%背景:目前临床多采用自体腓骨短肌或同种异体肌腱移植重建踝关节外侧副韧带,但两种材料的组织学和生物力学特性不同.目的:对比自体腓骨短肌与同种异体肌腱重建

  9. International joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2001-01-01

    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  10. Estudio e intervencionismo ecoguiado de la articulación del hombro Ultrasound-assisted and interventionism study of shoulder joint

    Directory of Open Access Journals (Sweden)

    D. Benítez Pareja

    2012-10-01

    Full Text Available El hombro doloroso es una entidad que encontramos en nuestra práctica diaria con relativa frecuencia. Con la introducción de la ultrasonografía, se abre un campo novedoso ya que podemos explorar, localizar e infiltrar exactamente la zona lesionada. La ecografía permite una exploración en la misma consulta, así como la capacidad de realizar una exploración dinámica. El hombro se compone de 5 articulaciones: 3 verdaderas (esternoclavicular, acromioclavicular y glenohumeral y 2 denominadas falsas (subacromial y escapulotorácica. Siempre que sea posible, intentaremos realizar la punción en plano, intentando visualizar el trayecto completo de la aguja y la punta de la misma. En el intervencionismo del hombro esto es bastante fácil de conseguir puesto que se trata de estructuras muy superficiales. Es muy poco probable que se produzcan daños graves durante la infiltración del hombro. Tendremos especial cuidado de no puncionar estructuras vasculares.Painful shoulder is an entity that we find in our daily practice with relative frequency. With the introduction of ultrasound, opens a new field that we can explore, locate and exactly infiltrate the injured area. Ultrasound allows an exploration in the same act, as well as the ability to make a dynamic scanning. The shoulder is made up of 5 joint: true 3 (sternoclavicular, acromioclavicular and glenohumeral and 2 known as false (subacromial and thoracic scapula. Wherever possible, we will try to puncture in plane, trying to display the full path of the needle and the tip of it. In the interventionism of the shoulder, this is quite easy to get since it's very superficial structures. It is highly unlikely any serious damage during the infiltration of the shoulder. Take special care of non piercing vascular structures.

  11. Compare of 3 different types of closed reduction and internal fixation for the fresh complete acromioclavicular dislocation%3种闭合复位内固定法治疗新鲜肩锁关节全脱位的疗效比较

    Institute of Scientific and Technical Information of China (English)

    聂伟志; 谭远超; 杨茂清; 朱惠芳

    2011-01-01

    目的:比较3种闭合复位内固定法治疗新鲜肩锁关节全脱住的疗效.方法:136例新鲜肩锁关节全脱位患者,闭合复位后采用经皮"肩峰-锁骨"双枚钢针固定治疗31例(A组),采用经皮"肩峰-锁骨"双枚钢针固定+经皮缝合肩锁关节囊治疗45例(B组),采用经皮"肩峰一锁骨"双枚钢针固定+经皮"锁骨一喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗60例(c组,"三联固定"组),参照Karlsson评价标准比较3组疗效.结果:3组疗效之间的差异有统计学意义(x2=21.623,P=0.002),C组疗效优于B组(u=2.014,P=0.002),B组疗效优于A组(u=2.781,P=0.006).结论:经皮"肩峰-锁骨"双枚钢针固定+经皮"锁骨-喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗新鲜肩锁关节全脱位,疗效优于经皮"肩峰-锁骨"钢针固定+经皮缝合肩锁关节囊,更优于单纯"肩峰-锁骨"钢针固定.%Objective: To compare the curative effect of 3 different types of closed reduction and internal fixation on fresh complete acromioclavicular dislocation. Methods: 136 patients sustained complete acromioclavicular dislocation were divided into 3 groups. 31 cases in Group A were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem. 45 cases in Group B were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem. 60 cases in Group C were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem and fixation with a hollowed screw between the clavicle and the coracoid (three point fixation). The curative effects were evaluated according to Karlsson' s standard. Results: There was statistical difference in the curative effects between the 3 groups(x2 = 21. 623

  12. Neuromagnetic source reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, P.S.; Mosher, J.C. [Los Alamos National Lab., NM (United States); Leahy, R.M. [University of Southern California, Los Angeles, CA (United States)

    1994-12-31

    In neuromagnetic source reconstruction, a functional map of neural activity is constructed from noninvasive magnetoencephalographic (MEG) measurements. The overall reconstruction problem is under-determined, so some form of source modeling must be applied. We review the two main classes of reconstruction techniques-parametric current dipole models and nonparametric distributed source reconstructions. Current dipole reconstructions use a physically plausible source model, but are limited to cases in which the neural currents are expected to be highly sparse and localized. Distributed source reconstructions can be applied to a wider variety of cases, but must incorporate an implicit source, model in order to arrive at a single reconstruction. We examine distributed source reconstruction in a Bayesian framework to highlight the implicit nonphysical Gaussian assumptions of minimum norm based reconstruction algorithms. We conclude with a brief discussion of alternative non-Gaussian approachs.

  13. A Convex Optimization Approach to pMRI Reconstruction

    CERN Document Server

    Zhang, Cishen

    2013-01-01

    In parallel magnetic resonance imaging (pMRI) reconstruction without using estimation of coil sensitivity functions, one group of algorithms reconstruct sensitivity encoded images of the coils first followed by the magnitude only image reconstruction, e.g. GRAPPA, and another group of algorithms jointly compute the image and sensitivity functions by regularized optimization which is a non-convex problem with local only solutions. For the magnitude only image reconstruction, this paper derives a reconstruction formulation, which is linear in the magnitude image, and an associated convex hull in the solution space of the formulated equation containing the magnitude of the image. As a result, the magnitude only image reconstruction for pMRI is formulated into a two-step convex optimization problem, which has a globally optimal solution. An algorithm based on split-bregman and nuclear norm regularized optimizations is proposed to implement the two-step convex optimization and its applications to phantom and in-vi...

  14. Ankle reconstruction in type II fibular hemimelia

    OpenAIRE

    El-Tayeby, Hazem Mossad; Ahmed, Amin Abdel Razek Youssef

    2012-01-01

    Ankle reconstruction prior to limb lengthening for was performed in 13 patients with fibular hemimelia with complete radiological absence of the fibula (type II). There were different degrees of absence of metatarsal rays. The hindfoot deformity was a heel valgus in 12 patients and equinovarus in 1 patient. The patients’ ages ranged from 9 to 26 months. Excision of the fibular anlage was performed with lateral subtalar and ankle soft tissue releases to restore the ankle and subtalar joint rel...

  15. Clinical observation on reconstructing the anterior and posterior cruciate ligaments of knee joint with allograft-tendon by arthroscopy%关节镜下同种异体肌腱重建膝关节前后交叉韧带的临床观察

    Institute of Scientific and Technical Information of China (English)

    阳波; 谭雄进

    2014-01-01

    目的:比较关节镜下同种异体肌腱移植和自体肌腱移植重建膝关节前后交叉韧带的临床效果。方法将130例膝关节前后交叉韧带断裂的患者按手术方式的不同分为2组,观察组采用同种异体肌腱移植,对照组采用自体肌腱移植,观察患者临床疗效。结果观察组手术时间明显少于对照组(P0.05);2组患者术后Lysholm及Tengner评分均明显高于术前,2组差异有统计学意义(P0.05)。结论同种异体与自体肌腱重建ACL及PCL的疗效相近,是重建ACL及PCL良好的移植物。%Objective To compare the clinical effect of reconstructing the anterior and posterior cruciate ligaments of knee joint with al-lografttendon and autogenous tendon transplantation. Methods 130 patients with anterior and posterior cruciate ligaments of knee fractured were randomly divided into two groups:the observation group were given allogeneic tendon transplantation while the control group were autol-ogous tendon transplantation. Observed the clinical efficacy of the two groups. Results The operation time of the observation group was ob-viously less than control group(P0. 05);the Lysholm and Tengner score of the two groups were significantly higher compared with the preoperative scores with a statistically significant difference (P0. 05). Conclusion Allogeneic tendon transplantation has similar curative effect with autologous tendon transplantation, both of them are good transplantation material for anterior and posterior cruciate ligaments reconstruction.

  16. A comparison of two treatments of Rockwood type Ⅲ acromioclavicular dislocation%Rockwood Ⅲ型肩锁关节脱位两种治疗方法分析

    Institute of Scientific and Technical Information of China (English)

    郭丹; 周海斌

    2013-01-01

    目的 探讨Rockwood Ⅲ型肩锁关节脱位手术及保守两种方法治疗后效果及对肩关节功能恢复的影响.方法 苏北人民医院和苏州大学附属第二医院骨科自2008年2月-2010年2月66例Rockwood Ⅲ型肩锁关节脱位病人,其中女性29例,男性37例,平均41.6岁,分锁骨钩钢板手术治疗和背带式锁骨固定带保守治疗,按调整的Constant-Murley评分系统随访观察各病例肩关节恢复情况.结果 Rockwood Ⅲ型肩锁关节脱位中,35例锁骨钩钢板手术治疗病例中3例出现肩关节活动受限、肩痛症状,背带式锁骨固定带保守治疗组31例病人中3例出现肩关节活动受限、肩痛症状,统计检验手术治疗组与保守治疗组之间评分差异无统计学意义(P>0.05).结论 Rockwood Ⅲ型肩锁关节脱位手术治疗与保守治疗对功能恢复影响差异不明显.%Objective To evaluate two treatment methods in Rockwood type Ⅲ acromioclavicular dislocation patients,and to evaluate the influence of trement methods on shoulder function. Methods From February,2008 to February,2010,66 Rockwood type Ⅲ acromioclavicular dislocation patients( 37 male and 29 female,average age 41. 6 )were treated in the Northern Jiangsu People' s Hospital and the Second Affiliated Hospital of Soochow University, with operation used hook plate and conservative treatment by clavicle sling immobilization respectively. Adjusted Constant-Murley Scale was used to evaluate shoulder function. Results In Rockwood type Ⅲ acromioclavicular dislocation. There were 3 cases with shoulder painful and restricted symptoms in the 35 patients treated with operation. There were 3 cases with shoulder painful and restricted symptoms in the 31 patients treated with conservative treatment patients. The difference between operation and conservative treatment was not significant P >0.05 ). Conclusion In Rockwood type Ⅲ acromioclavicular dislocation,for operation and conservative treatment,we could not

  17. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series To use the sharing features ... 4 out of 4 Normal anatomy Overview The knee is a complex joint. It contains the distal ...

  18. Shoulder Joint Replacement

    Science.gov (United States)

    ... en because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary. Is Shoulder Joint Replacement for You? The decision to have ...

  19. Culture - joint fluid

    Science.gov (United States)

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  20. Breast reconstruction after mastectomy

    Directory of Open Access Journals (Sweden)

    Daniel eSchmauss

    2016-01-01

    Full Text Available Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays breast reconstruction should be individualized at its best, first of all taking into consideration oncological aspects of the tumor, neo-/adjuvant treatment and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction, as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue, the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction.

  1. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... reconstruction with or without radiotherapy. Current Opinion in Obstetrics and Gynecology 2011;23(1):44–50. [PubMed Abstract] Barry M, Kell MR. Radiotherapy and breast reconstruction: a meta-analysis. Breast ...

  2. Anterior Cruciate Ligament Reconstruction Using a Flexible Reamer System

    OpenAIRE

    Fitzgerald, Judd; Saluan, Paul; Richter, Dustin L.; Huff, Nathan; Schenck, Robert C.

    2015-01-01

    Anatomic reconstruction of the anterior cruciate ligament (ACL) has been shown to improve stability of the knee, particularly rotational stability, potentially leading to superior clinical outcomes and a shorter return to sport. Nonanatomic ACL reconstruction has been linked to graft failure and abnormal cartilage loading thought to contribute to progression of degenerative joint disease. Use of the far anteromedial portal (FAMP) to uncouple the tibial and femoral tunnels has led to improved ...

  3. Avaliação isocinética de 18 pacientes do sexo masculino submetidos à correção cirúrgica da luxação acromioclavicular aguda com seguimento mínimo de dois anos Isokinetic evaluation of eighteen male patients submitted to surgical corretion of acute acromioclavicular luxation with a minimum two-year follow-up

    OpenAIRE

    Flavio Almeida Salles; Américo Zoppi Filho

    2002-01-01

    Foram estudados 18 pacientes submetidos ao tratamento cirúrgico de luxação acromioclavicular aguda do grau III da classificação de ALLMAN-TOSSY, todos do sexo masculino com idade média de 36 anos, foram avaliados sob o ponto de vista isocinético com tempo de evolução variando de 24 até 127 meses. A avaliação isocinética foi realizada através de um dinamômetro computadorizado marca CYBEX® modelo 6000 na velocidade angular de 60º/segundo e demonstrou resultados significantes no movimento de abd...

  4. Reoperative midface reconstruction.

    Science.gov (United States)

    Acero, Julio; García, Eloy

    2011-02-01

    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed.

  5. Towards joint reconstruction of noise and losses in quantum channels

    CERN Document Server

    Piacentini, F; Traina, P; Lolli, L; Taralli, E; Monticone, E; Rajteri, M; Fukuda, D; Degiovanni, I P; Brida, G

    2016-01-01

    The calibration of a quantum channel, i.e. the determination of the transmission losses affecting it, is definitely one of the principal objectives in both the quantum communication and quantum metrology frameworks. Another task of the utmost relevance is the identification, e.g. by extracting its photon number distribution, of the noise potentially present in the channel. Here we present a protocol, based on the response of a photon-number-resolving detector at different quantum efficiencies, able to accomplish both of these tasks at once, providing with a single measurement an estimate of the transmission losses as well as the photon statistics of the noise present in the exploited quantum channel. We show and discuss the experimental results obtained in the practical implementation of such protocol, with different kinds and levels of noise.

  6. Experimental study of the subtalar joint axis: preliminary investigation.

    Science.gov (United States)

    Zographos, S; Chaminade, B; Hobatho, M C; Utheza, G

    2000-01-01

    An experimental study of the subtalar joint has been conducted with the aim of establishing its axis of movement as well as analysing the associated movement. For description of the axis, CT data for five positions of a single foot were reconstructed using a 3D programme, the 3D data was processed by Patran software. Measures of angular displacements were made from three amputated feet placed in a specially constructed foot frame. Four instantaneous axes of movement could be defined. Calculation of displacements showed an important rolling of the calcaneus (45 degrees). Tacking was evident in inversion, with an opposite displacement between the front and rear part of the calcaneus, whereas during eversion tacking affected only the rear part of the bone: these results were confirmed by 3D reconstructions. Henke's axis was described as that for the talonavicular joint, but acceptable for the subtalar joint. Several authors investigating the coordinates of this axis have reported large differences and described screw-like movements, the latter being incompatible with a fixed axis: instantaneous axes, however are compatible with a screw-like movement. The subtalar joint appears to work as a pivot joint during inversion and as a plane joint during eversion. Although Henke's axis has pedagogical value the subtalar joint has a series of instantaneous axes. PMID:11236321

  7. Recent advances in computational mechanics of the human knee joint.

    Science.gov (United States)

    Kazemi, M; Dabiri, Y; Li, L P

    2013-01-01

    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

  8. Recent Advances in Computational Mechanics of the Human Knee Joint

    Directory of Open Access Journals (Sweden)

    M. Kazemi

    2013-01-01

    Full Text Available Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling.

  9. Jointly Poisson processes

    CERN Document Server

    Johnson, D H

    2009-01-01

    What constitutes jointly Poisson processes remains an unresolved issue. This report reviews the current state of the theory and indicates how the accepted but unproven model equals that resulting from the small time-interval limit of jointly Bernoulli processes. One intriguing consequence of these models is that jointly Poisson processes can only be positively correlated as measured by the correlation coefficient defined by cumulants of the probability generating functional.

  10. Cosmic Tidal Reconstruction

    CERN Document Server

    Zhu, Hong-Ming; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2015-01-01

    The gravitational coupling of a long wavelength tidal field with small scale density fluctuations leads to anisotropic distortions of the locally measured small scale matter correlation function. Since the local correlation function is statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long wavelength tidal field and large scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present in detail a formalism for the cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales ($k\\lesssim0.1h/\\mathrm{Mpc}$). This is useful in the 21cm intensity mapping survey, where the long wavelength radial modes are lost due to foreground subtraction proces...

  11. Re-construction

    OpenAIRE

    Bernadette Marie Devilat

    2013-01-01

    Re-construct: to build again. The necessary reconstruction process after an earthquake can be seen as an opportunity to improve previous conditions. All damaged buildings undergo a renovation process in which every piece is carefully returned to its original place. The photograph shows roof reconstruction work in San Pedro de Alcántara, a heritage area in the central valley of Chile, which was particularly affected by the 2010 earthquake. 

  12. Temperature reconstruction analysis

    CERN Document Server

    Scafetta, N; Grigolini, P; Roberts, J; Scafetta, Nicola; Imholt, Tim; Grigolini, Paolo; Roberts, Jim

    2002-01-01

    This paper presents a wavelet multiresolution analysis of a time series dataset to study the correlation between the real temperature data and three temperature model reconstructions at different scales. We show that the Mann et.al. model reconstructs the temperature better at all temporal resolutions. We show and discuss the wavelet multiresolution analysis of the Mann's temperature reconstruction for the period from 1400 to 2000 A.D.E.

  13. 下胫腓联合损伤三种内固定方式稳定性重建生物力学评价%Biomechanical Evaluation for the Stability Reconstruction of Ankle Joints with Distal Tibiofibular Syn-desmosis Injury via 3 Different Internal Fixation Methods

    Institute of Scientific and Technical Information of China (English)

    费骏; 赖震; 吴新红; 王以进; 魏威

    2015-01-01

    Objective To investigate the biomechanics of the stability reconstruction of ankle joints with distal tibiofibular syndesmosis injury by means of three cortical single screw, three cortical two screws or three cortical two screws plus 1/3 tube type plate fixation, in order to provide a scientific basis for clinical selection of effective internal fixation method. Methods Lower limbs from 6 fresh adult cadaver were used to make standard ankle in-jury models and then were divided into normal group, distal tibiofibular syndesmosis injury group, fixation with three cortical single screw group(A1), fixation with three cortical 2 screws group(B1), and fixation with three cor-tical 2 screws plus 1/3 tube type and plate fixation group (C1). The load was applied on tibiofibular bone of the shank to simulate the 4 physiological movement of the foot, i.e. neutral position, plantar flexion(30o), dorsal flexion (20o), and supination external rotation, and the strength, stiffness, and stability of ankle joint were measured after-wards. Results After the distal tibiofibular syndesmosis injury, the strength and stiffness of the ankle joint signifi-cantly decreased compared to normal group: the stress intensity of the medial and lateral malleolus reduced by 21% and 39%, respectively; the stress intensity of the anterior and posterior malleolus decreased by 29% and 35%,respectively; the EF and GF reduced by 27% and 28%, respectively(all P0.05), and that in B1 and C1 groups were significantly higher than that in normal group(P0.05). The EF and GF in A1, B1, and C1 groups were higher than that in normal group (P0.05). Conclusion The fractured ankle treated with three cortical single screw fixation has similar mechanical properties to normal ankle, and those treated with other 2 methods have more strength. Too much strength may lead to decrease of joint activity compliance and stress increase, result-ing in screw loosening or fatigue fracture of the ankle syndesmosis.%目的:观测

  14. Flexor pulley reconstruction.

    Science.gov (United States)

    Dy, Christopher J; Daluiski, Aaron

    2013-05-01

    Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley. PMID:23660059

  15. Application of CT 3D reconstruction in diagnosing atlantoaxial subluxation

    Institute of Scientific and Technical Information of China (English)

    段少银; 林清池; 庞瑞麟

    2004-01-01

    Objective:To evaluate and compare the diagnostic value in atlantoaxial subluxation by CT three-dimensional (3D) reconstruction.Methods:3D reconstruction fimdings of 41 patients with atlantoaxiai subluxation were retrospectively analyzed, and comparisons were made among images of transverse section, multiplanar reformorting (MPR), surface shade display (SSD), maximum intensity project (MIP), and volume rendering (VR). Results:Of 41 patients with atlantoaxial subluxation, 31 belonged to rotary dislocation, 5 antedislocation, and 5 hind dislocation. All the cases showed the dislocated joint panel of atlantoaxial articulation.Fifteen cases showed deviation of the odontoid process and 8 cases widened distance between the dens and anterior arch of the atlas. The dislocated joint panel of atlantoaxial articulation was more clearly seen with SSD-3D imaging than any other methods. Conclusions:Atlantoaxial subluxation can well be diagnosed by CT 3D reconstruction, in which SSD-3D imaging is optimal.

  16. Mechanics of Sheeting Joints

    Science.gov (United States)

    Martel, S. J.

    2015-12-01

    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  17. Managing Joint Production Motivation

    DEFF Research Database (Denmark)

    Lindenberg, Siegwart; Foss, Nicolai Juul

    2011-01-01

    representations of actions and tasks; cognitively coordinate cooperation; and choose their own behaviors in terms of joint goals. Using goal-framing theory, we explain how motivation for joint production can be managed by cognitive/symbolic management and organizational design....

  18. JET Joint Undertaking

    International Nuclear Information System (INIS)

    The paper presents the progress report of the Joint European Torus (JET) Joint Undertaking, 1986. The report contains a survey of the scientific and technical achievements on JET during 1986; the more important articles referred to in this survey are reproduced as appendices to this Report. The last section discusses developments which might improve the overall performance of the machine. (U.K.)

  19. Creep of timber joints

    NARCIS (Netherlands)

    Van de Kuilen, J.W.G.

    2008-01-01

    A creep analysis has been performed on nailed, toothed-plates and split-ring joints in a varying uncontrolled climate. The load levels varied between 30% and 50% of the average ultimate short term strength of these joints, tested in accordance with ISO 6891. The climate in which the tests were perfo

  20. COMPARATIVE STUDY OF ARTHROSCOPIC SINGLE BUNDLE ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION AND NON-ANATOMICAL DOUBLE BUNDLE WITH SINGLE TIBIAL TUNNEL ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH SEMITENDINOSUS ± GRACILIS AUTOGRAFTS USING LAXOMETRY

    Directory of Open Access Journals (Sweden)

    Sivananda

    2016-01-01

    Full Text Available BACKGROUND The knee joint is the most commonly injured of all joints and the ACL is the most commonly injured ligament. Arthroscopic reconstruction of ACL has become gold standard in treating these injuries. AIM 1. To compare the short-term results of ACL reconstruction using single bundle (one Tibial + one Femoral tunnel and non-anatomical double-bundle (one Tibial + two Femoral tunnels techniques using Hamstrings (Semitendinosus ± Gracilis graft. 2. To evaluate ACL graft reconstruction stability measured by laxometry and to find out an association with clinical findings. MATERIAL & METHODS We performed a prospective study between 2014-2015 of 20 case of ACL injuries & compared single bundle reconstruction with Non – anatomical double Bundle reconstruction with semitendinosus ± Gracilis, Autograft using laxometry. CONCLUSION Arthroscopic Non-anatomical double ACL Reconstruction is Bio-mechanically stable reconstruction resembling anatomy of the ACL.

  1. 局部修复和(或)异体肌腱重建治疗急性膝关节后外侧复合结构损伤%Local suture repair and(or)allograft tendon reconstruction for acute posterolateral complex injuries of the knee joint

    Institute of Scientific and Technical Information of China (English)

    高石军; 李彤; 陆博; 邵德成; 陈竞青; 王建朝

    2011-01-01

    Objective To evaluate the surgical treatment of the acute posterolateral complex(PLC)injuries of knee joint and then observe the clinical outcome.Methods Twelve cases(12 knees)of acute PLC injuries were treated from May 2006 to October 2008.Patients' age ranged from 23 to 47 years old,average 31 years.There were 9 males and 3 females.Rebuild the anterior cruciate ligament(ACL)and posterior cruciate ligament(PCL)under arthroscope and then,locally suture the PLC injuries sites on those patients with PLC avulsion fraction.If there is PLC rupture,then locally suture the injury sites plus PLC reconstruction.Knee functions were evaluated by IKDC and Lysholm score.Results All patients were followed up for 12-18 months(mean,13.3 months).The preoperative range of motion was 118.00°±6.77°,which was 130.75°±3.05° after surgery.KT-1000 arthrometer measurement showed that the average posterior translation improved from(14.85+1.83)mm preoperatively to(4.18±1.88)mm postoperatively.Seven cases were normal(A grade),3 cases were nearly normal(B grade),1 abnormal(C grade),and 1 severely abnormal(D grade)according to IKDC standard.The preoperative Lysholm joint function score was 35-44,average 38.83 ±3.16,which was 79-91,average 84.92±3.73 after surgery.Conclusion To those acute PLC injuries with avulsion at the ligament extremities,locally suture should be taken.But for those with PLC rupture at the mid part of ligament,locally suture the injury sites plus PLC reconstruction helps get satisfactory outcome.%目的 探讨采用局部修复和(或)异体肌腱重建治疗急性膝关节后外侧复合结构(posterolateral complex,PLC)损伤的方法及疗效.方法 2006年5月至2008年10月,收治急性PLC损伤患者12例,男9例,女3例;年龄23~47岁,平均31岁;合并后十字韧带损伤9例,合并前、后十字韧带同时损伤3例.首先在关节镜下采用异体肌腱解剖重建前、后十字韧带,然后对于PLC两端附着点撕脱损伤的患者采用铆钉

  2. Strategies for joint appointments.

    Science.gov (United States)

    Royle, J; Crooks, D L

    1985-01-01

    The structure and policies governing joint appointments discussed above, are developed primarily through cooperation and collaboration between nursing service and education institutions. The joint appointee participates in the process of negotiation of salary, benefits and role responsibilities and exploration of the implications of the appointment for personal career development. Implementation and maintenance of the appointment requires the collaborative efforts of the joint appointee with both contracting agencies. Factors influencing the functioning of joint appointees have been identified and strategies to facilitate functioning presented. The joint appointee must be independent in thought and action yet adaptable to work within the boundaries of two social systems with differing values and expectations. Nursing management, peers and students can provide the support needed to overcome the frustrations and to achieve the rewards inherent in successful implementation of an exciting and innovative role. PMID:3852805

  3. Image Reconstruction. Chapter 13

    International Nuclear Information System (INIS)

    This chapter discusses how 2‑D or 3‑D images of tracer distribution can be reconstructed from a series of so-called projection images acquired with a gamma camera or a positron emission tomography (PET) system [13.1]. This is often called an ‘inverse problem’. The reconstruction is the inverse of the acquisition. The reconstruction is called an inverse problem because making software to compute the true tracer distribution from the acquired data turns out to be more difficult than the ‘forward’ direction, i.e. making software to simulate the acquisition. There are basically two approaches to image reconstruction: analytical reconstruction and iterative reconstruction. The analytical approach is based on mathematical inversion, yielding efficient, non-iterative reconstruction algorithms. In the iterative approach, the reconstruction problem is reduced to computing a finite number of image values from a finite number of measurements. That simplification enables the use of iterative instead of mathematical inversion. Iterative inversion tends to require more computer power, but it can cope with more complex (and hopefully more accurate) models of the acquisition process

  4. Image Magnification Method Using Joint Diffusion

    Institute of Scientific and Technical Information of China (English)

    Zhong-Xuan Liu; Hong-Jian Wang; Si-Long Peng

    2004-01-01

    In this paper a new algorithm for image magnification is presented. Because linear magnification/interpolation techniques diminish the contrast and produce sawtooth effects, in recent years, many nonlinear interpolation methods, especially nonlinear diffusion based approaches, have been proposed to solve these problems. Two recently proposed techniques for interpolation by diffusion, forward and backward diffusion (FAB) and level-set reconstruction (LSR), cannot enhance the contrast and smooth edges simultaneously. In this article, a novel Partial Differential Equations (PDE) based approach is presented. The contributions of the paper include:firstly, a unified form of diffusion joining FAB and LSR is constructed to have all of their virtues; secondly, to eliminate artifacts of the joint diffusion, soft constraint takes the place of hard constraint presented by LSR;thirdly, the determination of joint coefficients, criterion for stopping time and color image processing are also discussed. The results demonstrate that the method is visually and quantitatively better than Bicubic, FAB and LSR.

  5. Vascularized composite tissue part transfer for central hand defect reconstruction. Case report

    Science.gov (United States)

    Billig, Jessica; Johnson, Shepard P.; Ogawa, Takeshi; Chung, Kevin C.

    2016-01-01

    Injuries to the hand with loss of joints, tendons, nerves, and soft tissue may require complex, innovative reconstructive techniques to achieve a favorable functional and aesthetic outcome. We present a case of a manual laborer who sustained a multifaceted injury from a metal press machine with loss of composite structures including the long and ring finger metacarpophalangeal joints, flexor and extensor tendons, digital nerves, and dorsal/volar soft tissues. Reconstruction included using the spare parts technique for transferring his ring finger proximal interphalangeal joint as a pedicle to reconstitute the missing metacarpophalangeal joint of his long finger. The soft tissue from the ring finger was rearranged to provide aesthetic coverage of the hand with like-to-like reconstruction of the glabrous and non-glabrous skin. PMID:26710738

  6. Fatores preditivos para evolução insatisfatória de quadris instáveis na paralisia cerebral submetidos à reconstrução articular Predictive factors for unsatisfactory evolution of unstable hips in brain palsy submitted to joint reconstruction

    Directory of Open Access Journals (Sweden)

    Patrícia M. de Moraes Barros Fucs

    2006-01-01

    -dislocation and/or spastic dislocation in patients with Brain Palsy submitted to surgical reconstruction, upon soft parts, adductors and iliopsoas release, and Dega’s pelvic osteotomy combined to outer-rotation and shortening varusing sub-trochanteric femoral osteotomy. CASE SERIES AND METHODS: 58 patients (78 hips with sub-dislocation/ spastic dislocation submitted to surgical reconstruction were retrospectively assessed, both clinically and by X-ray studies, from October 1994 to August 2005. The minimum follow-up time was 12 months and the average was 53.6 months. Hips were classified into satisfactory and unsatisfactory according to the analysis of late postoperative acetabular index (AI and Reimers index (RI. The following variables were statistically analyzed: patient’s age at surgery time, postoperative follow-up period, and AI, RI X-ray parameters, cervicodiaphyseal angle (CD at preoperative, early postoperative and late postoperative periods. RESULTS: From the 78 hips assessed, 13 were classified as unsatisfactory because they presented a late postoperative AI higher or equal to 20 degrees, and a late postoperative RI higher or equal to 25%, and, after the statistical analysis of data, significance was reported only at early postoperative AI, late postoperative AI, late postoperative RI, and late postoperative CD. CONCLUSION: There is no variable that can predict an unsatisfactory postoperative evolution on joint reconstruction in cases of hip sub-dislocation and/ or spastic dislocation, but it was evidenced that stronger efforts must be employed when correcting the acetabular index during a surgical procedure.

  7. Anterior cruciate ligament reconstruction with allograft tendons.

    Science.gov (United States)

    Strickland, Sabrina M; MacGillivray, John D; Warren, Russell F

    2003-01-01

    Allograft tissue allows reconstruction of the ACL without the donor site morbidity that can be caused by autograft harvesting. Patients who must kneel as a part of their occupation or chosen sport are particularly good candidates for allograft reconstruction. Patients over 45 years of age and those requiring revision ACL surgery can also benefit from the use and availability of allograft tendons. In some cases, patients or surgeons may opt for allograft tendons to maximize the result or morbidity ratio. Despite advances in cadaver screening and graft preparation, there remain risks of disease transmission and joint infection after allograft implantation. Detailed explanation and informed consent is vitally important in cases in which allograft tissue is used.

  8. Anterior cruciate ligament reconstruction with allograft tendons.

    Science.gov (United States)

    Strickland, Sabrina M; MacGillivray, John D; Warren, Russell F

    2003-01-01

    Allograft tissue allows reconstruction of the ACL without the donor site morbidity that can be caused by autograft harvesting. Patients who must kneel as a part of their occupation or chosen sport are particularly good candidates for allograft reconstruction. Patients over 45 years of age and those requiring revision ACL surgery can also benefit from the use and availability of allograft tendons. In some cases, patients or surgeons may opt for allograft tendons to maximize the result or morbidity ratio. Despite advances in cadaver screening and graft preparation, there remain risks of disease transmission and joint infection after allograft implantation. Detailed explanation and informed consent is vitally important in cases in which allograft tissue is used. PMID:12735200

  9. Medial plica after reconstruction of anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    YIN Yu; WANG Jian-quan; HE Zhen-ming

    2009-01-01

    Background The medial plica may be caused by direct trauma or joint degeneration,which also could be iatrogenic.There have been few reports in the literature discussing incidence of the medial plica caused by an operation on the knee joint,specifically after the reconstruction of anterior cruciate ligament (ACL).In this study,we aimed to evaluate and analyze the relationship between the incidence of the medial plica and reconstruction of the ACL.Methods A retrospective case series study was conducted to review the findings of 1085 patients between 2003 and 2007,who underwent second-look arthroscopy after reconstruction of the ACL (between 2002 and 2006).The correlation of the incidence of medial plica with the stability of the knee joint,the time from onset of injury to reconstruction surgery,the associated injuries,and the rate of progress during postoperative rehabilitation were analyzed.Results We found that 722 patients had the structure of a medial plica.The incidence after reconstruction of the anterior cruciate ligament (66.5%) was significantly higher than usually reported.All these medial plica had avascular fibrotic and thickened edges.An excision of pathologic medial plica and fat pad synovial fringes were done.The incidences were significantly different between the two groups with their reconstruction operation time,from onset of injury to surgery (less than one month or over 2 years),and the progress rate of postoperative rehabilitation (knee flexion could not be over 90° in four weeks).The incidence was not different between the groups with knee stable conditions.Conclusions Medial plica is more common in patients after reconstruction of ACL.More associated injuries and more rehabilitation difficulties can increase the medial plica incidence.

  10. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  11. Rotationplasty for patients with osteosarcoma around the knee joint.

    Directory of Open Access Journals (Sweden)

    Kawai,Akira

    1995-08-01

    Full Text Available The results of rotationplasty for patients with osteosarcoma around the knee joint are presented. After an average observation period of 13.3 months, there has been no local recurrence or metastasis. The ankle joints (the new knee joints of the patients were able to support their body weight with an average range of motion of 75 degrees. All patients could walk well without crutches and without risk of the giving way phenomenon. The average rate of the functional evaluation according to the re-modified system by Enneking was 84.5% (range, 80.0-86.7%. No patient had psychological trouble in accepting the shortened and rotated extremity. The results show that rotationplasty is a useful reconstructive method for the treatment of osteosarcoma around the knee joint.

  12. Reconstructing Step by Step

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    On May 22,10 days after the Wenchuan earthquake in Sichuan Province,the State Council formed the Post-earthquake Reconstruction Planning Group,deciding to work out a general recon- struction plan within a period of three months. Sichuan was the worst-hit area of China,so reconstruction work there will have a direct influence on how plans proceed in other areas.On July 18,Beijing Review reporter Feng Jianhua interviewed Wang Guangsi,Vice Director of the Sichuan Development and Reform Commission,about Sichuan’s reconstruction plan.

  13. Hip joint replacement

    Science.gov (United States)

    ... may have problems with infection, loosening, or even dislocation of the new hip joint. Over time the artificial ... Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  14. Joint Injection/Aspiration

    Science.gov (United States)

    ... Working It Out: Common Techniques for Conflict Resolution Workplace Diversity & Team Performance CME & MOC Understanding MOC ACR's MOC ... infection is suspected, aspirating the joint to gather cultures is ... Communications and Marketing. This patient information is provided for ...

  15. MP Joint Arthritis

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon MP Joint Arthritis Email to a friend * required fields From * To * ... in to name and customize your collection. DESCRIPTION Arthritis is the wearing away of the cartilage at ...

  16. Temporomandibular Joint Disorder

    Science.gov (United States)

    ... 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More Than You Can Chew? Equilibration May Lessen TMD Pain Fender-benders: Source of TMD? First Comes ...

  17. Healthy Joints Matter

    Science.gov (United States)

    ... dietary supplements, such as green tea and various vitamins, to see if they can keep your joints ... body, such as your ears, nose, and windpipe. Fibromyalgia (fi-bro-my-AL-juh). A condition that ...

  18. Joint Quantum Institute

    Data.gov (United States)

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  19. Joint Venture Contracts

    OpenAIRE

    Pimentel, Dinarco

    2015-01-01

    Joint Venture contracts are contracting models typically designed to reach international markets. In spite of being used at the national level, a joint venture is based on single or multiple contracts between two individuals, two institutions, two organizations or two different entrepreneurial entities joining forces, meeting synergies to reach a common goal.Initially, these types of contracts were justifiable based on the need of different economic agents penetrating the most inaccessible ma...

  20. Joint contingency contracting

    OpenAIRE

    Johnson, Ellsworth K.; Paton, Bryan H.; Threat, Edward W.; Haptonstall, Lisa A.

    2005-01-01

    The purpose of this Master of Business Administration (MBA) Professional Report is to investigate and analyze the means by which Contingency Contracting Officers (CCO) can effectively operate in a Joint contingency environment and to validate the Defense Contract Management Agency's (DCMA) entry and exit criteria for contingency contracting missions. Joint contingencies encompass regional conflicts, humanitarian and peacekeeping missions, and international or domestic disaster relief missions...

  1. Prairie Reconstruction Initiative

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  2. Overview of Image Reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Marr, R. B.

    1980-04-01

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on Rn is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references. (RWR)

  3. The evolving breast reconstruction

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Gunnarsson, Gudjon Leifur

    2014-01-01

    The aim of this editorial is to give an update on the use of the propeller thoracodorsal artery perforator flap (TAP/TDAP-flap) within the field of breast reconstruction. The TAP-flap can be dissected by a combined use of a monopolar cautery and a scalpel. Microsurgical instruments are generally...... not needed. The propeller TAP-flap can be designed in different ways, three of these have been published: (I) an oblique upwards design; (II) a horizontal design; (III) an oblique downward design. The latissimus dorsi-flap is a good and reliable option for breast reconstruction, but has been criticized...... for oncoplastic and reconstructive breast surgery and will certainly become an invaluable addition to breast reconstructive methods....

  4. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2011-01-01

    Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two......-stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during...... of reoperation was significantly higher following the one-stage procedure. For both procedures, the majority of reoperations were due to asymmetry or displacement of the implant. In conclusion, non-radiated one- and two-stage delayed breast implant reconstructions are associated with substantial risks...

  5. On TPC cluster reconstruction

    CERN Document Server

    Dydak, F; Nefedov, Y; Wotschack, J; Zhemchugov, A

    2004-01-01

    For a bias-free momentum measurement of TPC tracks, the correct determination of cluster positions is mandatory. We argue in particular that (i) the reconstruction of the entire longitudinal signal shape in view of longitudinal diffusion, electronic pulse shaping, and track inclination is important both for the polar angle reconstruction and for optimum r phi resolution; and that (ii) self-crosstalk of pad signals calls for special measures for the reconstruction of the z coordinate. The problem of 'shadow clusters' is resolved. Algorithms are presented for accepting clusters as 'good' clusters, and for the reconstruction of the r phi and z cluster coordinates, including provisions for 'bad' pads and pads next to sector boundaries, respectively.

  6. Permutationally invariant state reconstruction

    CERN Document Server

    Moroder, Tobias; Toth, Geza; Schwemmer, Christian; Niggebaum, Alexander; Gaile, Stefanie; Gühne, Otfried; Weinfurter, Harald

    2012-01-01

    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, also an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a non-linear large-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex optimization, which has clear advantages regarding speed, control and accuracy in comparison to commonly employed n...

  7. High pressure ceramic joint

    Science.gov (United States)

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  8. Reconstruction Setting Out

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The earthquake-hit Yushu shifts its focus from rescuing survivors to post-quake reconstruction The first phase of earthquake relief, in which rescuing lives was the priority, finished 12 days after a 7.1-magnitude earthquake struck the Tibetan Autonomous Prefecture of Yushu in northwest China’s Qinghai Province on April 14, and reconstruction of the area is now ready to begin.

  9. Reconstructing baryon oscillations

    OpenAIRE

    Noh, Yookyung; White, Martin; Padmanabhan, Nikhil

    2009-01-01

    The baryon acoustic oscillation (BAO) method for constraining the expansion history is adversely affected by non-linear structure formation, which washes out the correlation function peak created at decoupling. To increase the constraining power of low z BAO experiments, it has been proposed that one use the observed distribution of galaxies to "reconstruct'' the acoustic peak. Recently Padmanabhan, White and Cohn provided an analytic formalism for understanding how reconstruction works withi...

  10. Reconstruction after mastectomy.

    Science.gov (United States)

    Bostwick, J

    1990-10-01

    Advances in materials and techniques, especially those involving transposition of muscle and skin flaps, have made breast reconstruction possible for most women who undergo mastectomy for breast cancer. The availability of this option can alleviate the breast and chest wall deformity that results from virtually all local treatment of breast cancer. It is essential that the reconstruction surgeon be part of the breast cancer management team from the beginning of treatment planning and that this surgeon work closely with the general surgeon, medical oncologist, and radiation therapist as well as the adjunctive treatment team members. The patient's clinical status and the type of local treatment will be significant determinants of the reconstructive options. For women with stage I breast cancer, these decisions may be based largely on the oncologist's local and adjunctive therapy procedures and the woman's desire to proceed or delay. For women with systemic disease, all members of the breast management team may need to agree on the advisability and timing of reconstruction. Central to all of the numerous decisions described in this paper regarding the timing, type, and extent of breast reconstruction is the primary goal of the entire team: the best possible management of the breast cancer itself. The promise of attractive, symmetric, and natural appearing breasts, complete with a symmetric nipple-areolar complex, has eased somewhat the diminishment of self-esteem and the threat to femininity that can accompany the loss of a breast. By lowering fear, the widely recognized availability of breast reconstruction may encourage more women to monitor their breasts and seek diagnosis of changes and may influence selection of the type of local treatment if cancer is detected. Because of the psychological and cultural significance of the breast, the reconstructive surgeon must be particularly sensitive to the psychological and aesthetic expectations of the patient. Even in

  11. Chalet. Reconstruction from Memory

    OpenAIRE

    Gheysen, Eva

    2015-01-01

    In the research project several design tactics are developed in order to counteract the phenomenon of experiential erosion. This particular project explored one of the tactics: Reconstruction from Memory. When reconstructing space from memory, isolated spatial fragments from the past are reformed into a new, decontextualized construct that represents the most memorable experiences evoked by that space. These memories give insight in which architectural features strongly affect our experience ...

  12. Cosmic tidal reconstruction

    Science.gov (United States)

    Zhu, Hong-Ming; Pen, Ue-Li; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2016-05-01

    The gravitational coupling of a long-wavelength tidal field with small-scale density fluctuations leads to anisotropic distortions of the locally measured small-scale matter correlation function. Since the local correlation function is known to be statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long-wavelength tidal field and large-scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present the theoretical framework of cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross-correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales (k ≲0.1 h /Mpc ), with the filter scale ˜1.25 Mpc /h . This is useful in the 21 cm intensity mapping survey, where the long-wavelength radial modes are lost due to a foreground subtraction process.

  13. Titanium Cable Bundling in Treatment of Acromioclavicular Dislocation%钛缆捆扎治疗肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    吴冬灵; 刘中国; 余跃伟

    2015-01-01

    Objective To investigate the effect of titanium cable in the treatment of the dislocation of the shoulder joint.Methods 28 cases of patients with dislocation of the shoulder joint were treated,and the clinical data were retrospectively analyzed.Results Al patients were folowed up for 3 to 12 months,and al the patients were folowed up for anatomic reduction. The average constant score was 91.4 points at the end of folow-up.Conclusion The use of titanium cable in the treatment of shoulder joint dislocation is significant.%目的:探讨钛缆捆扎治疗肩锁关节脱位的疗效。方法收集28例肩锁关节脱位患者进行治疗,并回顾性分析其临床资料。结果重建后随访3~12个月,所有患者术中、术后锁骨远端高度均达到解剖复位。终末随访时,平均Constant 评分为91.4分。结论采用钛缆捆扎治疗肩锁关节脱位疗效理想。

  14. Randomization Resilient To Sensitive Reconstruction

    CERN Document Server

    Wang, Ke; Fu, Ada Waichee

    2012-01-01

    With the randomization approach, sensitive data items of records are randomized to protect privacy of individuals while allowing the distribution information to be reconstructed for data analysis. In this paper, we distinguish between reconstruction that has potential privacy risk, called micro reconstruction, and reconstruction that does not, called aggregate reconstruction. We show that the former could disclose sensitive information about a target individual, whereas the latter is more useful for data analysis than for privacy breaches. To limit the privacy risk of micro reconstruction, we propose a privacy definition, called (epsilon,delta)-reconstruction-privacy. Intuitively, this privacy notion requires that micro reconstruction has a large error with a large probability. The promise of this approach is that micro reconstruction is more sensitive to the number of independent trials in the randomization process than aggregate reconstruction is; therefore, reducing the number of independent trials helps a...

  15. Joint ventures in medical services.

    Science.gov (United States)

    Rublee, D A

    1987-01-01

    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  16. Primordial density and BAO reconstruction

    CERN Document Server

    Zhu, Hong-Ming; Chen, Xuelei

    2016-01-01

    We present a new method to reconstruct the primordial (linear) density field using the estimated nonlinear displacement field. The divergence of the displacement field gives the reconstructed density field. We solve the nonlinear displacement field in the 1D cosmology and show the reconstruction results. The new reconstruction algorithm recovers a lot of linear modes and reduces the nonlinear damping scale significantly. The successful 1D reconstruction results imply the new algorithm should also be a promising technique in the 3D case.

  17. The temporomandibular joint

    International Nuclear Information System (INIS)

    Whilst the temporomandibular joint is in many ways unique, it is subject to all the diseases and disorders found in joints in other parts of the human skeleton. By far the most common disorder is injury, followed by arthropathy, acute and chronic dislocations, ankylosis, and in rare instances, neoplasms. The diagnosis and management of the temporomandibular joint are the primary responsibility of the oral surgeon. Nevertheless, this anatomical region is an area in which the cooperation of medical and dental disciplines may be required for the satisfactory conclusion of treatment. The more so when the disease process involves either associated psychosomatic illness or malignancy. The mainstay of the diagnosis is a careful radiological examination of the joint. There exists a delicate relationship between the dentition, the muscles of mastication, and the temporomandibular articulation, which is controlled by arthrokinetic reflex activity of the branches of the 5th cranial nerve. Imbalance between one or more of the components of this integrated system frequently leads to disturbances in function. Pain-dysfunction disorders constitute the larger part of temporomandibular joint disturbances generally encountered

  18. Dissimilar metals joint evaluation

    Science.gov (United States)

    Wakefield, M. E.; Apodaca, L. E.

    1974-01-01

    Dissimilar metals tubular joints between 2219-T851 aluminum alloy and 304L stainless steel were fabricated and tested to evaluate bonding processes. Joints were fabricated by four processes: (1) inertia (friction) weldings, where the metals are spun and forced together to create the weld; (2) explosive welding, where the metals are impacted together at high velocity; (3) co-extrusion, where the metals are extruded in contact at high temperature to promote diffusion; and (4) swaging, where residual stresses in the metals after a stretching operation maintain forced contact in mutual shear areas. Fifteen joints of each type were prepared and evaluated in a 6.35 cm (2.50 in.) O.D. size, with 0.32 cm (0.13 in.) wall thickness, and 7.6 cm (3.0 in) total length. The joints were tested to evaluate their ability to withstand pressure cycle, thermal cycle, galvanic corrosion and burst tests. Leakage tests and other non-destructive test techniques were used to evaluate the behavior of the joints, and the microstructure of the bond areas was analyzed.

  19. Periprosthetic Joint Infections

    Directory of Open Access Journals (Sweden)

    Ana Lucia L. Lima

    2013-01-01

    Full Text Available Implantation of joint prostheses is becoming increasingly common, especially for the hip and knee. Infection is considered to be the most devastating of prosthesis-related complications, leading to prolonged hospitalization, repeated surgical intervention, and even definitive loss of the implant. The main risk factors to periprosthetic joint infections (PJIs are advanced age, malnutrition, obesity, diabetes mellitus, HIV infection at an advanced stage, presence of distant infectious foci, and antecedents of arthroscopy or infection in previous arthroplasty. Joint prostheses can become infected through three different routes: direct implantation, hematogenic infection, and reactivation of latent infection. Gram-positive bacteria predominate in cases of PJI, mainly Staphylococcus aureus and Staphylococcus epidermidis. PJIs present characteristic signs that can be divided into acute and chronic manifestations. The main imaging method used in diagnosing joint prosthesis infections is X-ray. Computed tomography (CT scan may assist in distinguishing between septic and aseptic loosening. Three-phase bone scintigraphy using technetium has high sensitivity, but low specificity. Positron emission tomography using fluorodeoxyglucose (FDG-PET presents very divergent results in the literature. Definitive diagnosis of infection should be made by isolating the microorganism through cultures on material obtained from joint fluid puncturing, surgical wound secretions, surgical debridement procedures, or sonication fluid. Success in treating PJI depends on extensive surgical debridement and adequate and effective antibiotic therapy. Treatment in two stages using a spacer is recommended for most chronic infections in arthroplasty cases. Treatment in a single procedure is appropriate in carefully selected cases.

  20. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  1. Management of Temporomandibular Joint Reankylosis in Syndromic Patients Corrected with Joint Prostheses: Surgical and Rehabilitation Protocols

    Science.gov (United States)

    Clauser, Luigi C.; Consorti, Giuseppe; Elia, Giovanni; Tieghi, Riccardo; Galiè, Manlio

    2013-01-01

    Temporomandibular joint ankylosis (TMJA) is a severe disorder described as an intracapsular union of the disc-condyle complex to the temporal articular surface with bony fusion. The management of this disability is challenging and rarely based on surgical and rehabilitation protocols. We describe the treatment in two young adults affected by Goldenhar syndrome and Pierre Robin sequence with reankylosis after previous surgical treatments. There are three main surgical procedures for the treatment of TMJA: gap arthroplasty, interpositional arthroplasty, and joint reconstruction. Various authors have described reankylosis as a frequent event after treatment. Treatment failure could be associated with surgical errors and/or inadequate intensive postoperative physiotherapy. Surgical treatment should be individually tailored and adequate postoperative physiotherapy protocol is mandatory for success. PMID:24624260

  2. Augmented Likelihood Image Reconstruction.

    Science.gov (United States)

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M

    2016-01-01

    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction.

  3. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. PMID:26868932

  4. Transversely Compressed Bonded Joints

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Schmidt, Jacob Wittrup; Stang, Henrik

    2012-01-01

    The load capacity of bonded joints can be increased if transverse pressure is applied at the interface. The transverse pressure is assumed to introduce a Coulomb-friction contribution to the cohesive law for the interface. Response and load capacity for a bonded single-lap joint was derived using...... non-linear fracture mechanics. The results indicated a good correlation between theory and tests. Furthermore, the model is suggested as theoretical base for determining load capacity of bonded anchorages with transverse pressure, in externally reinforced concrete structures....

  5. Reconstructed Jets at RHIC

    CERN Document Server

    Salur, Sevil

    2010-01-01

    To precisely measure jets over a large background such as pile up in high luminosity p+p collisions at LHC, a new generation of jet reconstruction algorithms is developed. These algorithms are also applicable to reconstruct jets in the heavy ion environment where large event multiplicities are produced. Energy loss in the medium created in heavy ion collisions are already observed indirectly via inclusive hadron distributions and di-hadron correlations. Jets can be used to study this energy loss in detail with reduced biases. We review the latest results on jet-medium interactions as seen in A+A collisions at RHIC, focusing on the recent progress on jet reconstruction in heavy ion collisions.

  6. Population exposure dose reconstruction for the Urals Region

    International Nuclear Information System (INIS)

    This presentation describes the first preliminary results of an ongoing joint Russian-US pilot feasibility study. Many people participated in workshops to determine what Russian and United States scientists could do together in the area of dose reconstruction in the Urals population. Most of the results presented here came from a joint work shop in St. Petersburg, Russia (11-13 July 1995). The Russians at the workshop represented the Urals Research Center for Radiation Medicine (URCRM), the Mayak Industrial Association, and Branch One of the Moscow Biophysics Institute. The US Collaborators were Dr. Anspaugh of LLNL, Dr. Nippier of PNL, and Dr. Bouville of the National Cancer Institute. The objective of the first year of collaboration was to look at the source term and levels of radiation contamination, the historical data available, and the results of previous work carried out by Russian scientists, and to determine a conceptual model for dose reconstruction

  7. A FINE GRANULAR JOINT SOURCE CHANNEL CODING METHOD

    Institute of Scientific and Technical Information of China (English)

    Zhuo Li; Shen Lansun; Zhu Qing

    2003-01-01

    An improved FGS (Fine Granular Scalability) coding method is proposed in this letter, which is based on human visual characteristics. This method adjusts FGS coding frame rate according to the evaluation of video sequences so as to improve the coding efficiency and subject perceived quality of reconstructed images. Finally, a fine granular joint source channel coding is proposed based on the source coding method, which not only utilizes the network resources efficiently, but guarantees the reliable transmission of video information.

  8. Permutationally invariant state reconstruction

    DEFF Research Database (Denmark)

    Moroder, Tobias; Hyllus, Philipp; Tóth, Géza;

    2012-01-01

    -scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum...... likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex...

  9. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2012-01-01

    We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during...... of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast...

  10. Vertex Reconstruction in CMS

    CERN Document Server

    Chabanat, E; D'Hondt, J; Vanlaer, P; Prokofiev, K; Speer, T; Frühwirth, R; Waltenberger, W

    2005-01-01

    Because of the high track multiplicity in the final states expected in proton collisions at the LHC experiments, novel vertex reconstruction algorithms are required. The vertex reconstruction problem can be decomposed into a pattern recognition problem ("vertex finding") and an estimation problem ("vertex fitting"). Starting from least-square methods, ways to render the classical algorithms more robust are discussed and the statistical properties of the novel methods are shown. A whole set of different approaches for the vertex finding problem is presented and compared in relevant physics channels.

  11. Reconstruction of inflation models

    Energy Technology Data Exchange (ETDEWEB)

    Myrzakulov, Ratbay; Sebastiani, Lorenzo [Eurasian National University, Department of General and Theoretical Physics and Eurasian Center for Theoretical Physics, Astana (Kazakhstan); Zerbini, Sergio [Universita di Trento, Dipartimento di Fisica, Trento (Italy); TIFPA, Istituto Nazionale di Fisica Nucleare, Trento (Italy)

    2015-05-15

    In this paper, we reconstruct viable inflationary models by starting from spectral index and tensor-to-scalar ratio from Planck observations. We analyze three different kinds of models: scalar field theories, fluid cosmology, and f(R)-modified gravity. We recover the well-known R{sup 2} inflation in Jordan-frame and Einstein-frame representation, the massive scalar inflaton models and two models of inhomogeneous fluid. A model of R{sup 2} correction to Einstein's gravity plus a ''cosmological constant'' with an exact solution for early-time acceleration is reconstructed. (orig.)

  12. The point-source method for 3D reconstructions for the Helmholtz and Maxwell equations

    Science.gov (United States)

    Ben Hassen, M. F.; Erhard, K.; Potthast, R.

    2006-02-01

    We use the point-source method (PSM) to reconstruct a scattered field from its associated far field pattern. The reconstruction scheme is described and numerical results are presented for three-dimensional acoustic and electromagnetic scattering problems. We give new proofs of the algorithms, based on the Green and Stratton-Chu formulae, which are more general than with the former use of the reciprocity relation. This allows us to handle the case of limited aperture data and arbitrary incident fields. Both for 3D acoustics and electromagnetics, numerical reconstructions of the field for different settings and with noisy data are shown. For shape reconstruction in acoustics, we develop an appropriate strategy to identify areas with good reconstruction quality and combine different such regions into one joint function. Then, we show how shapes of unknown sound-soft scatterers are found as level curves of the total reconstructed field.

  13. A symptomatic coracoclavicular joint

    NARCIS (Netherlands)

    Cheung, T.F.S.; Boerboom, A.L.; Wolf, R.F.E.; Diercks, Ron

    2006-01-01

    Bilateral coracoclavicular joints were found in a 44-year-old male patient following a fall. He had an Indonesian mother and a Dutch father. Prior to the injury he was asymptomatic and had full range of movement in both shoulders but the trauma resulted in pain and limitation of movement in the left

  14. Joint Custody and Coparenting.

    Science.gov (United States)

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  15. Progression of stifle osteoarthrosis following reconstruction of the cranial cruciate ligament in 21 dogs

    International Nuclear Information System (INIS)

    Twenty-one dogs that had intraarticular reconstruction of the cranial cruciate ligament were examined clinically and radiographically to assess limb function and determine if there had been progression of osteoarthrosis in the affected stifle joints. The interval between surgery and follow-up examination varied from 1 to 47 months, mean = 14.9 +/-12.9 months standard deviation. Clinical variables that were assessed included lameness, palpable joint instability, articular crepitus, and joint swelling. Radiographic features that were evaluated included soft-tissue swelling/joint effusion, subchondral sclerosis, periarticular osteophyte and enthesiophyte formation, remodeling of femoral and tibial condyles, and resorptive changes in the intercondyloid fossa. The owners of all 21 dogs believed that the operation had improved their dog's condition because the frequency of lameness had decreased. However, palpable instability, crepitus, and joint swelling were detected frequently during physical examinations. Radiographs documented progression of osteoarthrosis in the operated upon stifle joints of all 21 dogs

  16. Kinematic analysis of the knee joint by cine MRI

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Akisada, Masayoshi; Anno, Izumi; Matsumoto, Kunihiko; Kuno, Shin-ya; Miyakawa, Shunpei (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine); Inouye, Tamon; Kose, Katsumi

    1989-08-01

    In order to obtain the MR imaging of a moving knee joint, we developed a drive system of the knee. A reciprocating reversible motor with a rope and pulleys drove a knee brace with the knee bending and extending every two seconds. Using photo sensor probe for gating cine acquisition, we got 16-time frames/cycle MR images. Such as articular cartilage, ligaments and synovial fluid, the fine components of a moving knee joint were clearly seen. In a dynamic display, these cine images demonstrated 'actual' movement of the knee joint. Moving joint fluid and defect of anterior cruciate ligament were demonstrated in the case of knee injury. These findings were not seen on static images. Cine MR imaging was also helpful for evaluating the chronic joint disease and ligament reconstruction. Through the use of the present drive system and cine acquisition, dynamic MR imaging of a moving knee joint is clearly demonstrated and it may provide useful information in the kinematic analysis of the normal and pathologic knee. (author).

  17. Reconstruction Setting Out

    Institute of Scientific and Technical Information of China (English)

    YIN PUMIN

    2010-01-01

    @@ The first phase of earthquake relief,in which rescuing lives was the priority,finished 12 days after a 7.1-magnitude earthquake struck the Tibetan Autonomous Prefecture of Yushu in northwest China's Qinghai Province on April 14,and reconstruction of the area is now ready to begin.

  18. Breast reconstruction - natural tissue

    Science.gov (United States)

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  19. Urogenital Reconstructive Surgery

    DEFF Research Database (Denmark)

    Jakobsen, Lotte Kaasgaard

    Urogenital reconstructive surgery Lotte Kaasgaard Jakobsen1 Professor Henning Olsen1 Overlæge Gitte Hvistendahl1 Professor Karl-Erik Andersson2 1 – Dept. of Urology, Aarhus University Hospital 2 – Dept. of Gynecology and Obstetrics, Aarhus University hospital Background: Congenital obstruction...

  20. Breast reconstruction: Correlation between different procedures, reconstruction timing and complications

    Directory of Open Access Journals (Sweden)

    Anđelkov Katarina

    2011-01-01

    Full Text Available Introduction. Improved psychophysical condition after breast reconstruction in women has been well documented Objective. To determine the most optimal technique with minimal morbidity, the authors examined their results and complications based on reconstruction timing (immediate and delayed reconstruction and three reconstruction methods: TRAM flap, latissimus dorsi flap and reconstruction with tissue expanders and implants. Methods. Reconstruction was performed in 60 women of mean age 51.1 years. We analyzed risk factors: age, body mass index (BMI, smoking history and radiation therapy in correlation with timing and method of reconstruction. Complications of all three methods of reconstruction were under 1.5-2-year follow-up after the reconstruction. All data were statistically analyzed. Results. Only radiation had significant influence on the occurrence of complications both before and after the reconstruction, while age, smoking and BMI had no considerable influence of the development of complications. There were no statistically significant correlation between the incidence of complications, time and method of reconstruction. Conclusion. Any of the aforementioned breast reconstruction techniques can yield good results and a low rate of re-operations. To choose the best method, the patient needs to be as well informed as possible about the options including the risks and benefits of each method.

  1. Shoulder Joint For Protective Suit

    Science.gov (United States)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  2. Joint Infection (Beyond the Basics)

    Science.gov (United States)

    ... for some deep joints (eg, hip, shoulder), surgical placement of a drainage tube. ARTIFICIAL JOINT INFECTION — People ... medications, the user is advised to check the product information sheet accompanying each drug to verify conditions ...

  3. MR evaluation of the knee following anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    This paper evaluates the role of MR imaging of the knee after anterior cruciate ligament (ACL) reconstruction. Seventy-five MR examinations were performed in 52 patients following ACL reconstruction with patellar tendon autografts. MR imaging demonstrated a well-defined autograft in 63 of 70 clinically stable autografts. Of 5 clinically lax reconstructions, none appeared will defined on MR images. Compared with the clinical examination, MR imaging was 90.7% accurate. MR imaging demonstrated time-related healing of the patellar tendon donor site, with persistent thickening indicative of tendinitis. Positions of the femoral and tibial bone tunnels could be assessed. Knee joint effusions tended to resolve completely within 7 months after operations, with the presence and degree of effusion in the earlier postoperative interval being unrelated to the clinical outcome. Ancillary disorders in the knee, such as meniscal tears and osteochondral defects, could also be evaluated in this postoperative population

  4. ARTHROSCOPIC RECONSTRUCTION OF ANTERIO R CRUCIATE LIGAMENT TEARS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Thimma Reddy

    2015-09-01

    Full Text Available BACKGROUND: Anterior knee instability associated with rupture of the ACL (Anterior Cruciate Ligament is a disabling clinical problem. The ACL has a poor capacity for intrinsic repair. Thus for patients who have knee symptoms related to ACL deficiency, one may consider ligament reconstruction as a means of stabilizing the T ibio - F emoral articulation and restoring high level function of the knee joint. Arthroscopically assisted ACLR ( ACL Reconstruction has the advantage of being minimally invasive, accurate graft placement, less disturbance of normal tissue resulting in quicker recovery and rehabilitation, minimal hospital stay and very less infection rate. MATERIAL AND METHODS: Between April 2012 to May 2013, 30 patients who underwent arthroscopic assisted ACL reconstructions using either bone - patellar tendon - bone auto graft ( BTB or Quadrupled hamstring auto graft ( QHG or Quadriceps tendon graft ( QTG in the Department of Orthopaedics and Traumatology, Osmania Medical College, Hyderabad, Andhra Pradesh is the material in our study. CONCLUSIONS : Arthroscopic reconstruction of Anterior Cruciate Ligament is a reliable, safe procedure. It helps in the early restoration of function and stability of the Knee joint and helps the patient to get back to his normal activity much earlier than with the traditional open surgical methods. The choice of the graft does not play a major role in the function of the knee in the long run.

  5. PET image reconstruction: mean, variance, and optimal minimax criterion

    Science.gov (United States)

    Liu, Huafeng; Gao, Fei; Guo, Min; Xue, Liying; Nie, Jing; Shi, Pengcheng

    2015-04-01

    Given the noise nature of positron emission tomography (PET) measurements, it is critical to know the image quality and reliability as well as expected radioactivity map (mean image) for both qualitative interpretation and quantitative analysis. While existing efforts have often been devoted to providing only the reconstructed mean image, we present a unified framework for joint estimation of the mean and corresponding variance of the radioactivity map based on an efficient optimal min-max criterion. The proposed framework formulates the PET image reconstruction problem to be a transformation from system uncertainties to estimation errors, where the minimax criterion is adopted to minimize the estimation errors with possibly maximized system uncertainties. The estimation errors, in the form of a covariance matrix, express the measurement uncertainties in a complete way. The framework is then optimized by ∞-norm optimization and solved with the corresponding H∞ filter. Unlike conventional statistical reconstruction algorithms, that rely on the statistical modeling methods of the measurement data or noise, the proposed joint estimation stands from the point of view of signal energies and can handle from imperfect statistical assumptions to even no a priori statistical assumptions. The performance and accuracy of reconstructed mean and variance images are validated using Monte Carlo simulations. Experiments on phantom scans with a small animal PET scanner and real patient scans are also conducted for assessment of clinical potential.

  6. Joint cumulants for natural independence

    OpenAIRE

    Hasebe, Takahiro; Saigo, Hayato

    2011-01-01

    Many kinds of independence have been defined in non-commutative probability theory. Natural independence is an important class of independence; this class consists of five independences (tensor, free, Boolean, monotone and anti-monotone ones). In the present paper, a unified treatment of joint cumulants is introduced for natural independence. The way we define joint cumulants enables us not only to find the monotone joint cumulants but also to give a new characterization of joint cumulants fo...

  7. CT图像后处理重建膝关节三维模型:3D-CT评估前交叉韧带重建后的骨道差异%Reconstruction of three-dimensional models of knee joint using CT image post-processing technique:evaluation of bone tunnel difference after anterior cruciate ligament reconstruction using three-dimensional computed tomography

    Institute of Scientific and Technical Information of China (English)

    高冠奇; 张克远

    2015-01-01

    背景:有研究表明影响前交叉韧带重建手术效果的因素主要取决于骨道的位置,而目前对骨道位置的研究仍存在一定争议。目的:探讨3D-CT对关节镜辅助下前交叉韧带重建后骨道评估的临床价值。方法:对2014年1月至8月收治的58例前交叉韧带损伤患者行关节镜下前交叉韧带重建。股骨端采用Endobutton固定,胫骨端使用可吸收界面钉固定。分别对58个膝关节进行双源CT扫描,使用CT图像后处理工作站重建膝关节三维模型,再现股骨外髁内侧壁及重建后单束骨道,胫骨平台及骨道。根据Lysholm评分分级办法,将随访时Lysholm评分≥80分病例作为优良组,80分以下为不良组,标记、测量股骨及胫骨骨道中心点的相对位置,比较两者的位置关系。结果与结论:3D-CT 三维重建法清晰地反映了膝关节前交叉韧带重建后的骨道及其出入口的位置、固定物及移植物等情况。膝关节功能优良组与不良组患者的术侧膝关节的股骨骨道中心位置之间差异有显著性意义(P 0.05)。结果证实,3D-CT能够清晰重建骨隧道及前交叉韧带移植物的图像,临床上可用于评估骨隧道定位与移植物走形的关系。%BACKGROUND:Studies have shown that factors affecting the outcomes of anterior cruciate ligament reconstruction mainly depend on the position of bone tunnels. However, there stil exists certain controversy over the researches on the position of bone tunnels. OBJECTIVE:To investigate the clinical value of three-dimensional computed tomography on postoperative evaluation of bone tunnel after anterior cruciate ligament reconstruction under arthroscopic assistance. METHODS:Fifty-eight patients with anterior cruciate ligament injury who received the treatment from January 2014 to August 2014 underwent anterior cruciate ligament reconstruction under arthroscopic assistance. The femoral end was fixed using an

  8. 8th International Workshop on Boosted Object Phenomenology, Reconstruction and Searches in HEP

    CERN Document Server

    2016-01-01

    BOOST2016 is the eighth of a series of successful joint theory/experiment workshops that bring together the world's leading experts from theory and LHC experiments to discuss the latest progress and develop new approaches on the reconstruction of and use of boosted decay topologies in order to search for new physics. This year, the workshop is jointly hosted by the University of Zurich and ETH Zurich.

  9. Achieving joint benefits from joint implementation

    Energy Technology Data Exchange (ETDEWEB)

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  10. JOINT VENTURES AMONG EXPORTING FIRMS

    OpenAIRE

    CHAUDHURI, Prabal Ray

    2000-01-01

    In this paper we examine the incentive for joint venture formation among exporting firms. We show that an increase in domestic demand increases the incentive for joint venture formation. An increase in world price, however, can either increase or decrease the incentive for joint venture formation.

  11. Joint hypermobility syndrome pain.

    Science.gov (United States)

    Grahame, Rodney

    2009-12-01

    Joint hypermobility syndrome (JHS) was initially defined as the occurrence of musculoskeletal symptoms in the presence of joint laxity and hypermobility in otherwise healthy individuals. It is now perceived as a commonly overlooked, underdiagnosed, multifaceted, and multisystemic heritable disorder of connective tissue (HDCT), which shares many of the phenotypic features of other HDCTs such as Marfan syndrome and Ehlers-Danlos syndrome. Whereas the additional flexibility can confer benefits in terms of mobility and agility, adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. There is hardly a clinical specialty to be found that is not touched in one way or another by JHS. Over the past decade, it has become evident that of all the complications that may arise in JHS, chronic pain is arguably the most menacing and difficult to treat. PMID:19889283

  12. JET Joint Undertaking

    International Nuclear Information System (INIS)

    The paper presents the annual report of the Joint European Torus (JET) Joint Undertaking, 1986. The report is divided into two parts: a part on the scientific and technical programme of the project, and a part setting out the administration and organisation of the Project. The first part includes: a summary of the main features of the JET apparatus, the JET experimental programme, the position of the Project in the overall Euratom programme, and how JET relates to other large fusion devices throughout the world. In addition, the technical status of JET is described, as well as the results of the JET operations in 1986. The final section of the first part outlines the proposed future programme of JET. (U.K.)

  13. Laundry joint venture.

    Science.gov (United States)

    Giancola, D; Voyvodich, M

    1984-12-01

    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  14. Joint International Accelerator School

    CERN Multimedia

    CERN Accelerator School

    2014-01-01

    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  15. Tibiofemoral cartilage contact biomechanics in patients after reconstruction of a ruptured anterior cruciate ligament.

    Science.gov (United States)

    Hosseini, Ali; Van de Velde, Samuel; Gill, Thomas J; Li, Guoan

    2012-11-01

    We investigated the in vivo cartilage contact biomechanics of the tibiofemoral joint in patients after reconstruction of a ruptured anterior cruciate ligament (ACL). A dual fluoroscopic and MR imaging technique was used to investigate the cartilage contact biomechanics of the tibiofemoral joint during in vivo weight-bearing flexion of the knee in eight patients 6 months following clinically successful reconstruction of an acute isolated ACL rupture. The location of tibiofemoral cartilage contact, size of the contact area, cartilage thickness at the contact area, and magnitude of the cartilage contact deformation of the ACL-reconstructed knees were compared with those previously measured in intact (contralateral) knees and ACL-deficient knees of the same subjects. Contact biomechanics of the tibiofemoral cartilage after ACL reconstruction were similar to those measured in intact knees. However, at lower flexion, the abnormal posterior and lateral shift of cartilage contact location to smaller regions of thinner tibial cartilage that has been described in ACL-deficient knees persisted in ACL-reconstructed knees, resulting in an increase of the magnitude of cartilage contact deformation at those flexion angles. Reconstruction of the ACL restored some of the in vivo cartilage contact biomechanics of the tibiofemoral joint to normal. Clinically, recovering anterior knee stability might be insufficient to prevent post-operative cartilage degeneration due to lack of restoration of in vivo cartilage contact biomechanics. PMID:22528687

  16. MR与CT应用于膝关节交叉韧带损伤诊治重建中的临床价值研究%Clinical Value of Application of MR and CT in Diagnosis and Treatment of the Reconstruction of the Cruciate Ligament Injury of Knee Joint

    Institute of Scientific and Technical Information of China (English)

    张艳梅

    2015-01-01

    目的:探讨MR与CT 在膝关节交叉韧带损伤诊治重建中的效果。方法观察组与对照组分别采用MR、CT行膝关节交叉韧带损伤诊治重建。结果两组前后交叉韧带测量值差异无统计学意义。结论MR效果稍优于CT。%Objective To study the MR and CT in the diagnosis and treatment of knee cruciate ligament injury effect of reconstruction. Methods The observation group and control group respectively by MR, CT diagnosis and reconstruction of knee cruciate ligament damage.Results The two groups before and after the cruciate ligament there was no statistically significant difference measurements.Conclusion The MR effect was slightly superior to CT.

  17. The Joint Cities

    Directory of Open Access Journals (Sweden)

    Romano Fistola

    2010-04-01

    Full Text Available The new connections, which high speed train allows to activate among the metropolitan systems, seem to be able to give life to new urban macro-structures for which the transfer time, among the main poles of the railway segment, becomes comparable to an inside moving into the city and therefore considered as an inter-functional mobility. The tunnel effect generated by the high speed connection seems to be able to allow a new temporal and functional joint among the metropolitan systems consequently supporting the possibility, for the users, to move themselves among the different urban functions belonging to the different cities. The birth of these urban aggregations seems to drive towards new megalopolis, which we can define for the first time with the term: joint-city. For this new metropolitan settlement it seems to be very interesting to investigate the constitutive peculiarities, the systemic articulation, its relational structures, the evolutionary scenarios, and so on. The urban functions (activities can be considered as structures of relationships between people that allows to define "organizational links" inside the community; the urban functions are located in specific places inside urban container or in open spaces. The urban functions represent the urban engines and the functional system can be thought as the “soul of the city", abstract but essential to its survival. In the definition set out here the analysis is carried out for many interconnected urban functional system points (specifically those in Rome and Naples. The new high speed railway has to be considered not only as a new channel of mobility between cities, but as a real possibility of joint between the functional systems of the two centres. A final consideration can be carried out in relation to the possibility of implementing new measures of governance of urban transformations considering the new macro-city: the "Joint City".

  18. Jet Joint Undertaking

    International Nuclear Information System (INIS)

    The paper presents the Jet Joint Undertaking annual report 1987. A description is given of the JET and Euratom and International Fusion Programmes. The technical status of JET is outlined, including the development and improvements made to the system in 1987. The results of JET Operation in 1987 are described within the areas of: density effects, temperature improvements, energy confinement studies and other material effects. The contents also contain a summary of the future programme of JET. (U.K.)

  19. Shoulder joint tuberculosis

    International Nuclear Information System (INIS)

    Despite the fact that joint tuberculosis is one of the most common forms of extrapulmonary tuberculosis, it is a disease entity that is very rare in Poland (less than 100 cases a year in the last 10 years). The symptoms are non-specific, and thus the disease is rarely taken into account in preliminary differential diagnosis. A 68-year-old female patient was admitted to the Internal Diseases Clinic due to oedema and pain of the right shoulder joint. The pain has been increasing for about 8 months. Physical examination revealed increased circumference and elevated temperature of the right shoulder joint. Limb function was retained. The full range of radiological and laboratory diagnostic examinations was performed, including the biopsy of the affected tissue which revealed the presence of Mycobacterium tuberculosis in the bacterial culture. Clinical improvement was obtained after introduction of TB drugs. Radiological diagnostic methods (X-ray, CT scans, MRI scans) provide high precision monitoring of articular lesions. However, the decisive diagnosis requires additional laboratory tests as well as histopathological and bacteriological assays

  20. The neuropathic joint.

    Science.gov (United States)

    Sequeira, W

    1994-01-01

    Neuropathic arthritis is a destructive arthropathy frequently associated with loss of proprioception. A third of patients, however, may have no demonstrable neurological deficit. Patients with diabetes, syphilis, syringomyelia and other neuropathies are particularly prone to developing this joint disease. The diagnosis of Charcot's joints should be considered in anyone who develops what appears to be a severe osteoarthritis or a transverse fracture of the tibia or fibula after minor trauma. Scoliosis with particularly destructive changes on radiography should prompt a search for syringomyelia or syphilis. The most common radiographic abnormalities are those of distension in 3D (Dislocation, Destruction and Degeneration). An atrophic form with resorption of the proximal humerus, most frequently described in syringomyelia, has been observed in diabetes. Loss of the distal end of the clavicle has not been described before in the neuropathies. These changes coupled with speckled calcification or shards of bone in the periarticular soft tissue confirm the diagnosis. Infection and CPPD crystal disease can be difficult to exclude. The joint fluid may be inflammatory and infection may be a complication. Treatment includes anti-inflammatories and splinting. Indications for surgery are limited. PMID:8070170

  1. Formation of tough composite joints

    Energy Technology Data Exchange (ETDEWEB)

    Brun, M.K. [GE Corporate Research and Development, Schenectady, NY (United States)

    1997-05-01

    Joints which exhibit tough fracture behavior were formed in a composite with a Si/SiC matrix reinforced with Textron SCS-6 fibers with either boron nitride or silicon nitride fiber coatings. In composites with BN coatings fibers were aligned uniaxially, while composites with Si{sub 3}N{sub 4}-coated fibers had a 0/90{degree} architecture. Lapped joints (joints with overlapping fingers) were necessary to obtain tough behavior. Geometrical requirements necessary to avoid brittle joint failure have been proposed. Joints with a simple overlap geometry (only a few fingers) would have to be very long in order to prevent brittle failure. Typical failure in these joints is caused by a crack propagating along the interfaces between the joint fingers. Joints of the same overall length, but with geometry changed to be symmetric about the joint centerline and with an extra shear surface exhibited tough fractures accompanied with extensive fiber pullout. The initial matrix cracking of these joints was relatively low because cracks propagated easily through the ends of the fingers. Joints with an optimized stepped sawtooth geometry produced composite-like failures with the stress/strain curves containing an elastic region followed by a region of rising stress with an increase of strain. Increasing the fiber/matrix interfacial strength from 9 to 25 MPa, by changing the fiber coating, increased matrix cracking and ultimate strength of the composite significantly. The best joints had matrix cracking stress and ultimate strength of 138 and 240 MPa, respectively. Joint failure was preceded by multiple matrix cracking in the entire composite. The high strength of the joints will permit building of structures containing joints with only a minor reduction of design stresses.

  2. Finite element analysis of human joints

    International Nuclear Information System (INIS)

    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described

  3. Finite element analysis of human joints

    Energy Technology Data Exchange (ETDEWEB)

    Bossart, P.L.; Hollerbach, K.

    1996-09-01

    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described.

  4. Arctic Sea Level Reconstruction

    DEFF Research Database (Denmark)

    Svendsen, Peter Limkilde

    method.For oceanographic purposes, the altimetric record over the Arctic Ocean is inferiorin quality to that of moderate latitudes, but nonetheless an invaluable set of observations. During this project, newly processed Arctic altimetry from the ERS-1/-2 and Envisat missions has become available......Reconstruction of historical Arctic sea level is very difficult due to the limited coverage and quality of tide gauge and altimetry data in the area. This thesis addresses many of these issues, and discusses strategies to help achieve a stable and plausible reconstruction of Arctic sea level from...... 1950 to today.The primary record of historical sea level, on the order of several decades to a few centuries, is tide gauges. Tide gauge records from around the world are collected in the Permanent Service for Mean Sea Level (PSMSL) database, and includes data along the Arctic coasts. A reasonable...

  5. Stochastic reconstruction of sandstones

    Science.gov (United States)

    Manwart; Torquato; Hilfer

    2000-07-01

    A simulated annealing algorithm is employed to generate a stochastic model for a Berea sandstone and a Fontainebleau sandstone, with each a prescribed two-point probability function, lineal-path function, and "pore size" distribution function, respectively. We find that the temperature decrease of the annealing has to be rather quick to yield isotropic and percolating configurations. A comparison of simple morphological quantities indicates good agreement between the reconstructions and the original sandstones. Also, the mean survival time of a random walker in the pore space is reproduced with good accuracy. However, a more detailed investigation by means of local porosity theory shows that there may be significant differences of the geometrical connectivity between the reconstructed and the experimental samples.

  6. Reconstructing holographic quintessence

    OpenAIRE

    Zhang, Xin

    2006-01-01

    The holographic dark energy model is an attempt for probing the nature of dark energy within the framework of quantum gravity. The dimensionless parameter $c$ determines the main property of the holographic dark energy. With the choice of $c\\geq 1$, the holographic dark energy can be described completely by a quintessence scalar field. In this paper, we show this quintessential description of the holographic dark energy with $c\\geq 1$ and reconstruct the potential of the quintessence as well ...

  7. LOFAR sparse image reconstruction

    Science.gov (United States)

    Garsden, H.; Girard, J. N.; Starck, J. L.; Corbel, S.; Tasse, C.; Woiselle, A.; McKean, J. P.; van Amesfoort, A. S.; Anderson, J.; Avruch, I. M.; Beck, R.; Bentum, M. J.; Best, P.; Breitling, F.; Broderick, J.; Brüggen, M.; Butcher, H. R.; Ciardi, B.; de Gasperin, F.; de Geus, E.; de Vos, M.; Duscha, S.; Eislöffel, J.; Engels, D.; Falcke, H.; Fallows, R. A.; Fender, R.; Ferrari, C.; Frieswijk, W.; Garrett, M. A.; Grießmeier, J.; Gunst, A. W.; Hassall, T. E.; Heald, G.; Hoeft, M.; Hörandel, J.; van der Horst, A.; Juette, E.; Karastergiou, A.; Kondratiev, V. I.; Kramer, M.; Kuniyoshi, M.; Kuper, G.; Mann, G.; Markoff, S.; McFadden, R.; McKay-Bukowski, D.; Mulcahy, D. D.; Munk, H.; Norden, M. J.; Orru, E.; Paas, H.; Pandey-Pommier, M.; Pandey, V. N.; Pietka, G.; Pizzo, R.; Polatidis, A. G.; Renting, A.; Röttgering, H.; Rowlinson, A.; Schwarz, D.; Sluman, J.; Smirnov, O.; Stappers, B. W.; Steinmetz, M.; Stewart, A.; Swinbank, J.; Tagger, M.; Tang, Y.; Tasse, C.; Thoudam, S.; Toribio, C.; Vermeulen, R.; Vocks, C.; van Weeren, R. J.; Wijnholds, S. J.; Wise, M. W.; Wucknitz, O.; Yatawatta, S.; Zarka, P.; Zensus, A.

    2015-03-01

    Context. The LOw Frequency ARray (LOFAR) radio telescope is a giant digital phased array interferometer with multiple antennas distributed in Europe. It provides discrete sets of Fourier components of the sky brightness. Recovering the original brightness distribution with aperture synthesis forms an inverse problem that can be solved by various deconvolution and minimization methods. Aims: Recent papers have established a clear link between the discrete nature of radio interferometry measurement and the "compressed sensing" (CS) theory, which supports sparse reconstruction methods to form an image from the measured visibilities. Empowered by proximal theory, CS offers a sound framework for efficient global minimization and sparse data representation using fast algorithms. Combined with instrumental direction-dependent effects (DDE) in the scope of a real instrument, we developed and validated a new method based on this framework. Methods: We implemented a sparse reconstruction method in the standard LOFAR imaging tool and compared the photometric and resolution performance of this new imager with that of CLEAN-based methods (CLEAN and MS-CLEAN) with simulated and real LOFAR data. Results: We show that i) sparse reconstruction performs as well as CLEAN in recovering the flux of point sources; ii) performs much better on extended objects (the root mean square error is reduced by a factor of up to 10); and iii) provides a solution with an effective angular resolution 2-3 times better than the CLEAN images. Conclusions: Sparse recovery gives a correct photometry on high dynamic and wide-field images and improved realistic structures of extended sources (of simulated and real LOFAR datasets). This sparse reconstruction method is compatible with modern interferometric imagers that handle DDE corrections (A- and W-projections) required for current and future instruments such as LOFAR and SKA.

  8. Orthotopic neobladder reconstruction

    OpenAIRE

    Chang, Dwayne T. S.; Nathan Lawrentschuk

    2015-01-01

    Orthotopic neobladder reconstruction is becoming an increasingly common urinary diversion following cystectomy for bladder cancer. This is in recognition of the potential benefits of neobladder surgery over creation of an ileal conduit related to quality of life (QoL), such as avoiding the need to form a stoma with its cosmetic, psychological and other potential complications. The PubMed database was searched using relevant search terms for articles published electronically between January 19...

  9. The art of reconstruction

    OpenAIRE

    Healey, Michael; Esson, Michael

    2011-01-01

    The ‘Art of Reconstruction Research Project’ is where re-skilling of plastic surgeons by artists is already in an embryonic phase. In integrating the required network of associated skills, expertise and experience, the research collaboration brings together artists within The Drawing Research Group of The Faculty of Art, Architecture and Design (AAD) and the distinguished work of Professor Mike Esson, Director, The International Drawing Research Institute (IDRI). Th...

  10. Optimized Quasi-Interpolators for Image Reconstruction.

    Science.gov (United States)

    Sacht, Leonardo; Nehab, Diego

    2015-12-01

    We propose new quasi-interpolators for the continuous reconstruction of sampled images, combining a narrowly supported piecewise-polynomial kernel and an efficient digital filter. In other words, our quasi-interpolators fit within the generalized sampling framework and are straightforward to use. We go against standard practice and optimize for approximation quality over the entire Nyquist range, rather than focusing exclusively on the asymptotic behavior as the sample spacing goes to zero. In contrast to previous work, we jointly optimize with respect to all degrees of freedom available in both the kernel and the digital filter. We consider linear, quadratic, and cubic schemes, offering different tradeoffs between quality and computational cost. Experiments with compounded rotations and translations over a range of input images confirm that, due to the additional degrees of freedom and the more realistic objective function, our new quasi-interpolators perform better than the state of the art, at a similar computational cost. PMID:26390452

  11. Laboratory characterization of rock joints

    International Nuclear Information System (INIS)

    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed

  12. Laboratory characterization of rock joints

    Energy Technology Data Exchange (ETDEWEB)

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses

    1994-05-01

    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  13. Canal Wall Reconstruction Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the advantages of canal wall reconstruction (CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years (mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction (CWR)mastoidectomy was performed in 31 ears and canal wall down (CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after (p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for

  14. Reconstruction of the perineum.

    Science.gov (United States)

    Wong, David Sau-Yan

    2014-09-01

    The pelvic and perineal regions are affected by a heterogeneous spectrum of pathologies, many with a tendency to recur. Extensive mutilation carries physical, sexual, and psychological sequelae. Primary reconstruction reduces morbidity and shortens recovery. Modern management calls for a multidisciplinary approach. Not uncommonly, patients come with previous surgery and/or chemoirradiation. They may also be elderly and debilitated. The literature on reconstruction of the perineum can be confusing because knowledge has evolved by an accumulation of isolated short reports of individual methods. This led to the lack of a unifying basis for nomenclature and a failure to relate specific techniques to their roles in repairing particular types of defects. This article gives an overall summary of the approaches in a structured and rational manner. Defects of the external pelvis and perineal lining are usually amenable to coverage with local or regional fasciocutaneous flaps, if primary closure or skin graft is not appropriate. These flaps depend on the integrity of the vascular territories of the internal pudendal, the upper medial thigh plexus, or the descending branches of the inferior gluteal. The location and extent of the resection usually determine the requirements of the reconstruction and may dictate the choice of options. When defects are pelviperineal, particularly when the vagina needs to be reconstructed, myocutaneous flaps are of proven advantage in dealing with both the resurfacing as well as providing the bulk needed to fill the pelvic cavity after extensive resections. The rectus, gluteus, and gracilis are the best known options. Owing to the intrinsic limitations with the gracilis flap, the rectus and gluteus flaps have largely superseded its role in most situations. The rectus flap, in particular, provides good bulk as well as reliable skin. The use of muscle sparing flaps based on the perforator principle in suitable instances has increasingly been

  15. A Computer Vision Method for 3D Reconstruction of Curves-Marked Free-Form Surfaces

    Institute of Scientific and Technical Information of China (English)

    Xiong Hanwei; Zhang Xiangwei

    2001-01-01

    Visual method is now broadly used in reverse engineering for 3D reconstruction. Thetraditional computer vision methods are feature-based, i.e., they require that the objects must revealfeatures owing to geometry or textures. For textureless free-form surfaces, dense feature points areadded artificially. In this paper, a new method is put forward combining computer vision with CAGD.The surface is subdivided into N-side Gregory patches using marked curves, and a stereo algorithm isused to reconstruct the curves. Then, the cross boundary tangent vector is computed throughreflectance analysis. At last, the whole surface can be reconstructed by jointing these patches withG1 continuity.

  16. Image reconstruction from phased-array data based on multichannel blind deconvolution.

    Science.gov (United States)

    She, Huajun; Chen, Rong-Rong; Liang, Dong; Chang, Yuchou; Ying, Leslie

    2015-11-01

    In this paper we consider image reconstruction from fully sampled multichannel phased array MRI data without knowledge of the coil sensitivities. To overcome the non-uniformity of the conventional sum-of-square reconstruction, a new framework based on multichannel blind deconvolution (MBD) is developed for joint estimation of the image function and the sensitivity functions in image domain. The proposed approach addresses the non-uniqueness of the MBD problem by exploiting the smoothness of both functions in the image domain through regularization. Results using simulation, phantom and in vivo experiments demonstrate that the reconstructions by the proposed algorithm are more uniform than those by the existing methods. PMID:26119418

  17. Anatomy-guided brain PET imaging incorporating a joint prior model

    International Nuclear Information System (INIS)

    We proposed a maximum a posterior (MAP) framework for incorporating information from co-registered anatomical images into PET image reconstruction through a novel anato-functional joint prior. The characteristic of the utilized hyperbolic potential function is determinate by the voxel intensity differences within the anatomical image, while the penalization is computed based on voxel intensity differences in reconstructed PET images. Using realistic simulated 18FDG PET scan data, we optimized the performance of the proposed MAP reconstruction with the joint prior (JP-MAP) and compared its performance with conventional 3D MLEM and 3D MAP reconstructions. The proposed JP-MAP reconstruction algorithm resulted in quantitatively enhanced reconstructed images, as demonstrated in extensive FDG PET simulation study. The proposed method was also tested on a 20 min Florbetapir patient study performed on the high-resolution research tomograph. It was shown to outperform conventional methods in visual as well as quantitative accuracy assessment (in terms of regional noise versus activity value performance). The JP-MAP method was also compared with another MR-guided MAP reconstruction method, utilizing the Bowsher prior and was seen to result in some quantitative enhancements, especially in the case of MR-PET mis-registrations, and a definitive improvement in computational performance. (paper)

  18. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Poul Frandsen concerning his assimilation into the new career structure. As the appellant has not objected, the report of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 13 to 24 January 2003. Human Resources Division Tel. 74128

  19. THE JOINT MONITORING COMMISSION

    Directory of Open Access Journals (Sweden)

    Helmoed-Römer Heitman

    2012-02-01

    Full Text Available The Joint Monitoring Commission (JMC was created to oversee the withdrawal of South African forces from the portion of Angola's southern Cunene province in which they had operated for some time, and its re-occupation by the Angolan Armed Forces (Fapla. It was to ensure that neither Swapo nor Cuban forces moved into this area as the South African Defence Force (SADF withdrew. The JMC consisted of SADF and Fapla headquarters (HQ personnel and infantry from both armies to monitor the area concerned. It operated in southern Angola from February 1984 to May 1985.

  20. Joint Advisory Appeals Board

    CERN Multimedia

    2003-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Aloïs Girardoz with regard to classification and advancement. As the appellant has not objected, the Board's report and the Director-General's decision will be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (N° 60) from 15 to 29 August 2003. Human Resources Division Tel. 74128

  1. JOINT ADVISORY APPEALS BOARD

    CERN Multimedia

    Personnel Division

    1999-01-01

    The Joint Advisory Appeals Board was convened to examine the appeal lodged by Mr Joào Bento with regard to residential category. As the appellant has not objected, the recommendations of the Board and the final decision of the Director-General are brought to the notice of the personnel in accordance with Article RÊVIÊ1.20 of the Staff Regulations.The relevant documents will therefore be posted on the notice boards of the Administration Building (N¡ 60) from 29 October to 12 November 1999.Personnel DivisionTel. 74128

  2. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  3. Optical rotary joint

    Science.gov (United States)

    May, R. G., Jr.

    1982-06-01

    The primary objective of this contract is the design, fabrication, and testing of an optical rotary joint which permits transmission of signals through optical fibers across the interface of two environments rotating relative to each other. Outstanding optical performance is achieved through the use of gradient index lenses to couple radiation across the separation between two fibers. The salient features of this device are bidirectional operation at two wavelengths (850 nm and 1300 nm), low insertion loss, low rotationally induced variation of attenuation, a seven-circuit electrical slip-ring assembly, and rugged construction. The device is designed to facilitate the application of future designs to pressurized, subsea environments.

  4. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  5. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel against the decision to grant him only a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 1 September to 14 September 2008. Human Resources Department (73911)

  6. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2007-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. The relevant documents will therefore be posted on the notice board of the Main building (Bldg. 60) from 24 September to 7 October 2007. Human Resources Department

  7. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main Building (Bldg. 500) from 26 May to 6 June 2008. Human Resources Department (73911)

  8. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board was convened to examine an internal appeal lodged by a member of the personnel with regard to the decision not to grant him an indefinite contract. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel, in accordance with Article R VI 1.18 of the Staff Regulations. These documents will therefore be posted on the notice board of the Main Building (Bldg. 60) from 21 January to 3 February 2008. Human Resources Department (73911)

  9. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2006-01-01

    The Joint Advisory Appeals Board was convened to examine an appeal lodged by a member of the personnel with regard to advancement. The person concerned has requested that the report of the Board and the final decision of the Director-General be brought to the notice of the personnel in accordance with Article R VI 1.20 of the Staff Regulations. The relevant documents will therefore be posted on the notice boards of the Administration Building (No. 60) from 24 March to 10 April 2006. Human Resources Department Tel. 74128

  10. Joint Advisory Appeals Board

    CERN Multimedia

    HR Department

    2008-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a member of the personnel with regard to the decision not to award him a periodic one-step advancement for the 2006 reference year. The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the notice of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be posted on the notice board of the Main building (Bldg. 500) from 17 March to 30 March 2008. Human Resources Department Tel. 73911

  11. Joint Advisory Appeals Board

    CERN Multimedia

    2013-01-01

    The Joint Advisory Appeals Board has examined the internal appeal lodged by a former member of the personnel, a beneficiary of the CERN Pension Fund, against the calculation of his pension in the framework of the Progressive Retirement Programme.   The person concerned has not objected to the report of the Board and the final decision of the Director-General being brought to the attention of the members of the personnel. In application of Article R VI 1.18 of the Staff Regulations, these documents will therefore be available from 26 July to 11 August 2013 at the following link. HR Department Head Office

  12. Lisfranc Joint Injuries

    Institute of Scientific and Technical Information of China (English)

    Lisa Chinn

    2009-01-01

    @@ The ankle and foot are the most common sites for athletic injuries.[1]Midfoot,or Lisfranc,injuries are the second most common foot injury and have a high in cidence in particular sports.They account for 4% of all football injuries per year,occurring frequently in linemen.[2]They are also common in equestrians,surfers,and windsurfers.[2]Lisfranc injuries are often misdiagnosed and if not treated properly can have lingering symptoms.It is estimated that Lisfranc joint injuries occur in 1 in every 55,000 persons every year.[3,4

  13. The treatment of Tossy Ⅲ acromioclavicular dislocation with the transposition of the cora-coacromial ligament and the clavicular hook plate%锁骨钩钢板加喙肩韧带转位治疗 Tossy Ⅲ型肩锁关节脱位

    Institute of Scientific and Technical Information of China (English)

    高俊; 李志华

    2016-01-01

    目的:探讨锁骨钩钢板加喙肩韧带转位治疗TossyⅢ型肩锁关节脱位的疗效。方法采用锁骨钩钢板加喙肩韧带转位治疗32例TossyⅢ型肩锁关节脱位患者。结果32例均获得随访,时间6~24个月。无伤口感染,无钢板螺钉松动、断裂及肩峰骨折等并发症。术后肩关节功能按Neer评分标准:优19例,良8例,可5例。结论采用锁骨钩钢板加喙肩韧带转位治疗TossyⅢ型肩锁关节脱位效果满意,具有操作简单、术后再脱位率低等优点。%Objective To explore the effect of the treatment of Tossy Ⅲacromioclavicular dislocation with the trans-position of the coracoacromial ligament and the clavicular hook plate .Methods 32 patients of Tossy Ⅲ acromiocla-vicular dislocation were treated with the transposition of the coracoacromial ligament and the clavicular hook plate . Results All 32 patients were followed up for 6~24 months.The complications such as wound infection ,screw loose-ning fracture ,acromion fracture were not found .Postoperative shoulder function was evaluated by Neer score stand-ard,the results showed excellent in 19 cases,good in 8 and fair in 5.Conclusions The use of the clavicular hook plate and the coracoacromial ligament transposition for treatment of Tossy Ⅲacromioclavicular dislocation has the ad-vantages of satisfactory results ,simple operation,and low dislocation rate ,and so on.

  14. Surgical reconstruction in diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Umid Shoyusupov

    2011-04-01

    Full Text Available Considerable morbidity upon spontaneous wound healing (phlegmons, osteomyelitis, and purulent osteoarthritis of metatarsophalangeal joint as well as loss of the diseased foot’s walking ability are among the reasons for transition to plastic surgery in management tactics. The longer foot lesion persists, the higher probability of amputation. Improvement of treatment of both wound and ulcer lesions by means of reconstructive surgery in patients with diabetic foot syndrome was the main aim of the study. Outcomes of treatment of 460 patients managed at the Center for the Scientific and Clinical Study of Endocrinology, within the period from 2001 to 2009 were analyzed. Size, form, depth and localization of a wound, tissue composition of the wound bed as well as circulation in skin flaps caused the choice of specific operation: autodermoplasty by Parin (with the split-thickness skin flap, local tissue plastic operation (with the sliding or inter-advancing skin flaps, flaps from previously amputated toe or Indian flaps, plastic operation with the controlled tissue tension or combined plastic operation. Reconstructive foot wound surgery allows restoring load-bearing function of the extremity much earlier in contrast to spontaneous healing, reducing incidence of post-operative and long-term complications, amputations and re-amputations, decreasing period of treatment.

  15. A dynamic 3D foot reconstruction system.

    Science.gov (United States)

    Thabet, Ali K; Trucco, Emanuele; Salvi, Joaquim; Wang, Weijie; Abboud, Rami J

    2011-01-01

    Foot problems are varied and range from simple disorders through to complex diseases and joint deformities. Wherever possible, the use of insoles, or orthoses, is preferred over surgery. Current insole design techniques are based on static measurements of the foot, despite the fact that orthoses are prevalently used in dynamic conditions while walking or running. This paper presents the design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion, and its use to show that foot measurements in dynamic conditions differ significantly from their static counterparts. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Engineering and clinical tests were carried out for the validation of the system. The accuracy of the system was found to be 0.34 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.44 mm (static case) and 2.81 mm (dynamic case). Furthermore, a study was performed to compare the effective length of the foot between static and dynamic reconstructions using the 4D system. Results showed an average increase of 9 mm for the dynamic case. This increase is substantial for orthotics design, cannot be captured by a static system, and its subject-specific measurement is crucial for the design of effective foot orthoses.

  16. Infections after reconstructions of anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Ristić Vladimir

    2014-01-01

    Full Text Available Introduction. Infections after anterior cruciate ligament reconstructions are rare, but, on the other hand, they are difficult to be treated. The aim of this study was to analyze causes of infections, risk factors, diagnostics, and possibilities of their prevention. Material and Methods. Seventeen deep infections (1.2% were found in 1425 patients who had undergone anterior cruciate ligament reconstructions. Fifteen patients were males and two were females. Out of 475 professional athletes nine (1.9% had this postoperative complication. Eleven patients with septic arthritis were allergic to penicillin. Three of them had immunosuppressive diseases. Results. Staphylococcus aureus was isolated in eleven cases (65%, other Staphylococcus and Streptococcus groups were found in four and three patients, respectively; while one patient had infection although the punctate was negative. Out of 965 patients with the patellar tendon grafts, ten (1.03% had this complication, while the incidence was 1.52% (7/460 in those with the hamstring grafts. Fifteen infections were acute with obvious symptoms within 14 days after surgery. Severe pain, limited range of motion, swelling of the knee joint and fever were the most common symptoms, while rubor and pus developed rarely. The infection was three times more frequent in the patients who had undergone surgery lasting more than 1.5 hour. Discussion and Conclusion. The following population groups are at risk of developing septic arthritis after anterior cruciate ligament reconstructions: professional athletes, those who are allergic to penicillin, and those with immunosuppressive diseases. Staphyllococus aureus is the most common cause of infection. The patients with the hamstring autografts have a higher risk than those with the patellar tendon grafts. Preventive measures that should be performed include aseptic conditions in operative rooms, irrigation of the graft before its placement into the bone tunnels

  17. Thumb Carpometacarpal Joint Stabilization in Ehlers-Danlos Syndrome--Case Report.

    Science.gov (United States)

    Breahna, Anca Nicoleta; Meads, Bryce Maurice

    2015-10-01

    We report the case of an 18-years-old patient with thumb carpometacarpal ligament laxity due to Ehlers-Danlos syndrome who was treated with trapezial opening wedge osteotomy combined with volar ligaments reconstruction. Two years postoperatively she is pain free and the thumb carpometacarpal joint is stable. PMID:26388011

  18. Jointly Sponsored Research Program

    Energy Technology Data Exchange (ETDEWEB)

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson

    2009-03-31

    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  19. Joint collaborative technology experiment

    Science.gov (United States)

    Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.

    2009-05-01

    Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.

  20. Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.

    2001-01-01

    Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

  1. Non-microsurgical breast reconstruction

    Directory of Open Access Journals (Sweden)

    Sharma Sheel

    2007-12-01

    Full Text Available Breast reconstruction after mastectomy should aim at resulting in an aesthetic outcome that matches the patient′s expectations and without interfering in the oncologic treatment. Whether the reconstruction is performed immediately or in a delayed fashion depends on various factors, which needs detailed attention. Autologous tissue, implants or both are used in the reconstruction. This article reviews the current concepts in these, with emphasis on non-microsurgical methods of using the autologous tissue for reconstruction. Breast conservation has become an accepted practice of treatment. Reconstruction in these situations as well as in an occasion when the surgery is done for failed breast conservation is discussed in detail. The article also reviews the various methods for nipple reconstruction available.

  2. OIG targets contractual joint ventures.

    Science.gov (United States)

    O'Hare, Patrick K

    2003-09-01

    A recent OIG Special Advisory Bulletin raises questions for providers involved in joint ventures. The Bulletin describes several characteristics that the OIG views as potentially suspect, including a referral stream controlled by the provider initiating the joint venture and the use of a wholly owned subsidiary of the provider to bill and collect for services. According to the OIG, profits paid by the subsidiary to the provider owner in such "suspect contractual joint ventures" could constitute illegal remuneration for referrals.

  3. Arthrography of the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Keyl, W.; Jaeger, M.

    1981-10-01

    The standardized examination technique and the clinical problems of the arthrographic mehtod applied on the knee joint is explained by the results obtained in 3000 examinations. Whereas the accuracy of the knee-joint arthrography provides a high degree in cases of meniscus lesions, computer tomography presents in chondral and capsular ligament lesions, and sonography in popliteal cysts better diagnostic information; but in any case arthroscopy gains more and more importance in knee-joint diagnostics.

  4. Goniometry in limited joint mobility

    OpenAIRE

    Gopinath, S.; Manoj, K.; Rubiya

    2012-01-01

    Aim: To study about the utility of goniometry in screening for limited joint mobility (LJM) in patients attending a secondary level Diabetic Clinic. Materials and Methods: Randomly selected data of 100 patients attending a secondary level diabetic clinic without any complications were used. Baseline neuropathy assessments, namely monofilament and biothesiometry were done. Range of movement around the ankle joint and 1 st metatarsal joint was done using goniometry. Both the results were compar...

  5. Reconstructing Experiences through Sketching

    CERN Document Server

    Karapanos, Evangelos; Hassenzahl, Marc

    2009-01-01

    This paper presents iScale, a survey tool that aims at eliciting users' experiences with a product from memory. iScale employs sketching in imposing a process in the reconstruction of one's experiences. Two versions of iScale, the Constructive and the Value-Account iScale, were motivated by two distinct theories on how people reconstruct emotional experiences from memory. These two versions were tested in two separate studies. Study 1 aimed at providing qualitative insight into the use of iScale and compared its performance to that of free-hand sketching. Study 2 compared the two iScale versions to a control condition: that of reporting one's experiences without employing any form of sketching. Significant differences between iScale and the "no-sketching" tool were found. Overall, iScale resulted in a) an increase in the number of experience reports that subjects provided, b) an increase in the amount of contextual information for the reported experiences, and c) an increase in subjects' accuracy in recalling...

  6. Reconstruction in Fourier space

    Science.gov (United States)

    Burden, A.; Percival, W. J.; Howlett, C.

    2015-10-01

    We present a fast iterative fast Fourier transform (FFT) based reconstruction algorithm that allows for non-parallel redshift-space distortions (RSDs). We test our algorithm on both N-body dark matter simulations and mock distributions of galaxies designed to replicate galaxy survey conditions. We compare solenoidal and irrotational components of the redshift distortion and show that an approximation of this distortion leads to a better estimate of the real-space potential (and therefore faster convergence) than ignoring the RSD when estimating the displacement field. Our iterative reconstruction scheme converges in two iterations for the mock samples corresponding to Baryon Oscillation Spectroscopic Survey CMASS Data Release 11 when we start with an approximation of the RSD. The scheme takes six iterations when the initial estimate, measured from the redshift-space overdensity, has no RSD correction. Slower convergence would be expected for surveys covering a larger angle on the sky. We show that this FFT based method provides a better estimate of the real-space displacement field than a configuration space method that uses finite difference routines to compute the potential for the same grid resolution. Finally, we show that a lognormal transform of the overdensity, used as a proxy for the linear overdensity, is beneficial in estimating the full displacement field from a dense sample of tracers. However, the lognormal transform of the overdensity does not perform well when estimating the displacements from sparser simulations with a more realistic galaxy density.

  7. LHCb; LHCb Jet Reconstruction

    CERN Multimedia

    Augusto, O

    2012-01-01

    The Large Hadron Collider (LHC) is the most powerful particle accelerator in the world. It has been designed to collide proton beams at an energy up to 14 TeV in the center of mass. In 2011, the data taking was done with a center of mass energy of 7 TeV, the instant luminosity has reached values greater than $4 \\times 10^{32} cm^{-2} s^{-1}$ and the integrated luminosity reached the value of 1.02 $fb^{-1}$ on the LHCb. The jet reconstruction is fundamental to observe events that can be used to test pertubative QCD (pQCD). It also provides a way to observe standard model channels and searches for new physics like SUSY. The anti-kt algorithm is a jet reconstruction algorithm that is based on the distance of the particles on the space $\\eta \\times \\phi$ and on the transverse momentum of particles. To maximize the energy resolution all information about the trackers and the calo...

  8. Biomaterials for craniofacial reconstruction

    Directory of Open Access Journals (Sweden)

    Neumann, Andreas

    2009-01-01

    Full Text Available Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region.For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull.The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc. does not exist. The different material types are (autogenic bone and many alloplastics such as metals (mainly titanium, ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.

  9. Reconstruction of symmetric Potts Models

    OpenAIRE

    Sly, Allan

    2008-01-01

    The reconstruction problem on the tree has been studied in numerous contexts including statistical physics, information theory and computational biology. However, rigorous reconstruction thresholds have only been established in a small number of models. We prove the first exact reconstruction threshold in a non-binary model establishing the Kesten-Stigum bound for the 3-state Potts model on regular trees of large degree. We further establish that the Kesten-Stigum bound is not tight for the $...

  10. Variable Joint Elasticities in Running

    Science.gov (United States)

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  11. Exercises in PET Image Reconstruction

    Science.gov (United States)

    Nix, Oliver

    These exercises are complementary to the theoretical lectures about positron emission tomography (PET) image reconstruction. They aim at providing some hands on experience in PET image reconstruction and focus on demonstrating the different data preprocessing steps and reconstruction algorithms needed to obtain high quality PET images. Normalisation, geometric-, attenuation- and scatter correction are introduced. To explain the necessity of those some basics about PET scanner hardware, data acquisition and organisation are reviewed. During the course the students use a software application based on the STIR (software for tomographic image reconstruction) library 1,2 which allows them to dynamically select or deselect corrections and reconstruction methods as well as to modify their most important parameters. Following the guided tutorial, the students get an impression on the effect the individual data precorrections have on image quality and what happens if they are forgotten. Several data sets in sinogram format are provided, such as line source data, Jaszczak phantom data sets with high and low statistics and NEMA whole body phantom data. The two most frequently used reconstruction algorithms in PET image reconstruction, filtered back projection (FBP) and the iterative OSEM (ordered subset expectation maximation) approach are used to reconstruct images. The exercise should help the students gaining an understanding what the reasons for inferior image quality and artefacts are and how to improve quality by a clever choice of reconstruction parameters.

  12. Unfavourable results in thumb reconstruction

    Directory of Open Access Journals (Sweden)

    Samir M Kumta

    2013-01-01

    Full Text Available The history of thumb reconstruction parallels the history of hand surgery. The attributes that make the thumb unique, and that the reconstructive surgeon must assess and try to restore when reconstructing a thumb, are: Position, stability, strength, length, motion, sensibility and appearance. Deficiency in any of these attributes can reduce the utility of the reconstructed thumb. A detailed assessment of the patient and his requirements needs to be performed before embarking on a thumb reconstruction. Most unsatisfactory results can be attributed to wrong choice of procedure. Component defects of the thumb are commonly treated by tissue from adjacent fingers, hand or forearm. With refinements in microsurgery, the foot has become a major source of tissue for component replacement in the thumb. Bone lengthening, osteoplastic reconstruction, pollicisation, and toe to hand transfers are the commonest methods of thumb reconstruction. Unfavourable results can be classified as functional and aesthetic. Some are common to all types of procedures. However each type of reconstruction has its own unique set of problems. Meticulous planning and execution is essential to give an aesthetic and functionally useful thumb. Secondary surgeries like tendon transfers, bone grafting, debulking, arthrodesis, may be required to correct deficiencies in the reconstruction. Attention needs to be paid to the donor site as well.

  13. Virtual 3-D Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Martin Paul Evison

    2000-06-01

    Full Text Available Facial reconstructions in archaeology allow empathy with people who lived in the past and enjoy considerable popularity with the public. It is a common misconception that facial reconstruction will produce an exact likeness; a resemblance is the best that can be hoped for. Research at Sheffield University is aimed at the development of a computer system for facial reconstruction that will be accurate, rapid, repeatable, accessible and flexible. This research is described and prototypical 3-D facial reconstructions are presented. Interpolation models simulating obesity, ageing and ethnic affiliation are also described. Some strengths and weaknesses in the models, and their potential for application in archaeology are discussed.

  14. Set Reconstruction on the Hypercube

    OpenAIRE

    Pebody, Luke

    2016-01-01

    Given an action of a group $G$ on a set $S$, the $k$-deck of a subset $T$ of $S$ is the multiset of all subsets of $T$ of size $k$, each given up to translation by $G$. For a given subset $T$, the {\\em reconstruction number} of $T$ is the minimum $k$ such that the $k$-deck uniquely identifies $T$ up to translation by $G$, and the {\\em reconstruction number} of the action $G:S$ is the maximum reconstruction number of any subset of $S$. The concept of reconstruction number extends naturally to ...

  15. Closed rupture of the flexor tendons caused by carpal bone and joint disorders.

    Science.gov (United States)

    Yamazaki, H; Kato, H; Hata, Y; Nakatsuchi, Y; Tsuchikane, A

    2007-12-01

    We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, cross-over transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213 degrees (range 170-265 degrees ). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0 degrees to 33 degrees on average (range 10 degrees -40 degrees ).

  16. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND GENERALIZED JOINT HYPERMOBILITY

    NARCIS (Netherlands)

    DIJKSTRA, PU; DEBONT, LGM; STEGENGA, B; BOERING, G

    1992-01-01

    Peripheral joint mobility of temporomandibular joint (TMJ) osteoarthrosis and internal derangement patients (n = 25) and of a control group (n = 29) was measured according to a rigidly standardized protocol, in order to study the relationships between TMJ osteoarthrosis and internal derangement and

  17. Index of Joint Condition for PVC push-fit joints

    NARCIS (Netherlands)

    Arsenio, A.M.; Vreeburg, J.H.G.; Rietveld, L.

    2014-01-01

    The Index of Joint Condition (IJC) for polyvinyl chloride (PVC) push-fit joints, discussed in this article, was derived from installation guidelines and from destructive laboratory tests. The IJC is presented in a graphical framework and is a powerful tool to employ in order to visualize and compare

  18. Temporomandibular joint arthrography

    International Nuclear Information System (INIS)

    The stress and occlusion disturbance are very important etiologic factors in the temporomandibular joint (TMJ) pain dysfunction syndromes. Authors performed TMJ arthrograms in the patients with TMJ problem such as pain, click sound, limited motion and locking, etc. The following results noted: 1. The arthrographic findings of 22 TMJ were analyzed. a) Normal: 6 cases b) Anterior disc displacement with rediction: 6 cases · Early reduction: 2 cases · Intermediate reduction: 3 cases · Late reduction: 1 case c) Anterior disc displacement without reduction: 6 cases · Two cases had adhesion between the posterior portion of disc and the posterior surfaces of the articular eminence. 2. Among 22 cases, the clinical findings of 16 cases (73%) were compatible with arthrographic findings. 6 cases showed disparity between them.

  19. Knee and Ankle Reconstruction With Reverse Anterolateral Thigh and Free Anterolateral Thigh Flap From One Donor Site.

    Science.gov (United States)

    Choi, KyeongBeom; Cho, JaeHo; Park, MyongChul; Park, Dong Ha; Lee, Il Jae

    2016-09-01

    Traditionally, the anterolateral thigh (ALT) free flap is used in distal lower extremity reconstruction. Reverse ALT flap has become one of the most popular choices for knee joint soft tissue defects. A 53-year-old man sustained a degloving injury in the right lateral side of the lower extremity from the lateral malleolar area to the knee joint area. The contamination was severe, necessitating serial debridement and negative pressure wound therapy. After 4 weeks, no more soft tissue necrosis was evident. No more microorganism growth was confirmed by swab culture. ALT free flap using proximal perforator was planned for lateral malleolar area reconstruction and reverse ALT flap using distal perforator was planned to cover knee joint after confirming the pedicle length was sufficient for simultaneous knee and lateral malleolar area reconstruction. PMID:27317019

  20. Fast Hadamard transforms for compressive sensing of joint systems: measurement of a 3.2 million-dimensional bi-photon probability distribution.

    Science.gov (United States)

    Lum, Daniel J; Knarr, Samuel H; Howell, John C

    2015-10-19

    We demonstrate how to efficiently implement extremely high-dimensional compressive imaging of a bi-photon probability distribution. Our method uses fast-Hadamard-transform Kronecker-based compressive sensing to acquire the joint space distribution. We list, in detail, the operations necessary to enable fast-transform-based matrix-vector operations in the joint space to reconstruct a 16.8 million-dimensional image in less than 10 minutes. Within a subspace of that image exists a 3.2 million-dimensional bi-photon probability distribution. In addition, we demonstrate how the marginal distributions can aid in the accuracy of joint space distribution reconstructions.

  1. Reconstructing the Alcatraz escape

    Science.gov (United States)

    Baart, F.; Hoes, O.; Hut, R.; Donchyts, G.; van Leeuwen, E.

    2014-12-01

    In the night of June 12, 1962 three inmates used a raft made of raincoatsto escaped the ultimate maximum security prison island Alcatraz in SanFrancisco, United States. History is unclear about what happened tothe escapees. At what time did they step into the water, did theysurvive, if so, where did they reach land? The fate of the escapees has been the subject of much debate: did theymake landfall on Angel Island, or did the current sweep them out ofthe bay and into the cold pacific ocean? In this presentation, we try to shed light on this historic case using avisualization of a high-resolution hydrodynamic simulation of the San Francisco Bay, combined with historical tidal records. By reconstructing the hydrodynamic conditions and using a particle based simulation of the escapees we show possible scenarios. The interactive model is visualized using both a 3D photorealistic and web based visualization. The "Escape from Alcatraz" scenario demonstrates the capabilities of the 3Di platform. This platform is normally used for overland flooding (1D/2D). The model engine uses a quad tree structure, resulting in an order of magnitude speedup. The subgrid approach takes detailed bathymetry information into account. The inter-model variability is tested by comparing the results with the DFlow Flexible Mesh (DFlowFM) San Francisco Bay model. Interactivity is implemented by converting the models from static programs to interactive libraries, adhering to the Basic ModelInterface (BMI). Interactive models are more suitable for answeringexploratory research questions such as this reconstruction effort. Although these hydrodynamic simulations only provide circumstantialevidence for solving the mystery of what happened during the foggy darknight of June 12, 1962, it can be used as a guidance and provides aninteresting testcase to apply interactive modelling.

  2. Gender Mainstreaming and Sustainable Post Disaster Reconstruction,

    OpenAIRE

    Yumarni, Tri; Amaratunga, Dilanthi; Haigh, Richard

    2013-01-01

    Gender inequalities are barriers to achieve sustainable post disaster reconstruction. Mainstreaming gender equality within post disaster reconstruction process can enhance sustainability of reconstruction. Based on a detailed literature review on post disaster reconstruction, this paper identifies pre-requisite conditions for mainstreaming gender within sustainable post disaster reconstruction as ; awareness of gender needs and concerns, a strong gender policy framework, women ...

  3. Saving Joint with Aerosol physics

    International Nuclear Information System (INIS)

    Full text: Using electro spray method to analyze wear debris from artificial joints. Well known aerosol techniques have been applied to determine the size distribution and concentration of wear particles found in joint fluids. The organic fraction (cells and large molecules) are removed by digestion. Knowing these data the risk of clogging of blood vessels can be medicinally reduced. (author)

  4. Structuring managed care joint ventures.

    Science.gov (United States)

    Williams, L

    1995-08-01

    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  5. 37 CFR 1.45 - Joint inventors.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... patent for an invention invented by them jointly, except as provided in § 1.47. (b) Inventors may...

  6. Markov Random Field Surface Reconstruction

    DEFF Research Database (Denmark)

    Paulsen, Rasmus Reinhold; Bærentzen, Jakob Andreas; Larsen, Rasmus

    2010-01-01

    A method for implicit surface reconstruction is proposed. The novelty in this paper is the adaption of Markov Random Field regularization of a distance field. The Markov Random Field formulation allows us to integrate both knowledge about the type of surface we wish to reconstruct (the prior...

  7. Ptychographic reconstruction of attosecond pulses

    CERN Document Server

    Lucchini, M; Ludwig, A; Gallmann, L; Keller, U; Feurer, T

    2015-01-01

    We demonstrate a new attosecond pulse reconstruction modality which uses an algorithm that is derived from ptychography. In contrast to other methods, energy and delay sampling are not correlated, and as a result, the number of electron spectra to record is considerably smaller. Together with the robust algorithm, this leads to a more precise and fast convergence of the reconstruction.

  8. In vitro study of knee stability after two-band two-tunnel posterior cruciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    MAO Yuan-qing; CHEN Bai-cheng; ZHU Zhen-an

    2006-01-01

    Objective: To compare the ability of three different reconstruction procedures in restoring the posterior displacement of tibia and the posterior stability of the knee joint from 0° to 120° flexion.Methods: Three posterior cruciate ligaments (PCL)reconstruction procedures were performed, namely twoband two-tunnel reconstruction, one-band anterior tunnel reconstruction and one-band posterior tunnel reconstruction. The posterior displacement of the tibia in relation to the femur was measured when a 200N posterior force was applied.Results: Within the flexion range of 0° to 30°, the displacement in the one-band posterior tunnel reconstruction showed little difference from that of an intact knee (P>0.05). But when the flexion exceeded 30°,especially when it exceeded 60°, the displacement in oneband posterior tunnel reconstruction was much greater than that of an intact knee (P < 0.01 ). In two-band two-tunnel reconstruction and one-band anterior tunnel reconstruction,the displacement was approximately the same as that of an intact knee ranging from 0° to 120° (P > 0.05), while a slight over-restriction might be found at some angles.Conclusions: Two-band reconstruction could effectively restrict the posterior displacement of the tibia and restore anterior, posterior stability of the knee joint within its full range of flexion. One-band anterior tunnel reconstruction also could maintain the posterior stability of the knee, while the result of one-band posterior tunnel reconstruction is the most unsatisfactory.

  9. Blob-enhanced reconstruction technique

    Science.gov (United States)

    Castrillo, Giusy; Cafiero, Gioacchino; Discetti, Stefano; Astarita, Tommaso

    2016-09-01

    A method to enhance the quality of the tomographic reconstruction and, consequently, the 3D velocity measurement accuracy, is presented. The technique is based on integrating information on the objects to be reconstructed within the algebraic reconstruction process. A first guess intensity distribution is produced with a standard algebraic method, then the distribution is rebuilt as a sum of Gaussian blobs, based on location, intensity and size of agglomerates of light intensity surrounding local maxima. The blobs substitution regularizes the particle shape allowing a reduction of the particles discretization errors and of their elongation in the depth direction. The performances of the blob-enhanced reconstruction technique (BERT) are assessed with a 3D synthetic experiment. The results have been compared with those obtained by applying the standard camera simultaneous multiplicative reconstruction technique (CSMART) to the same volume. Several blob-enhanced reconstruction processes, both substituting the blobs at the end of the CSMART algorithm and during the iterations (i.e. using the blob-enhanced reconstruction as predictor for the following iterations), have been tested. The results confirm the enhancement in the velocity measurements accuracy, demonstrating a reduction of the bias error due to the ghost particles. The improvement is more remarkable at the largest tested seeding densities. Additionally, using the blobs distributions as a predictor enables further improvement of the convergence of the reconstruction algorithm, with the improvement being more considerable when substituting the blobs more than once during the process. The BERT process is also applied to multi resolution (MR) CSMART reconstructions, permitting simultaneously to achieve remarkable improvements in the flow field measurements and to benefit from the reduction in computational time due to the MR approach. Finally, BERT is also tested on experimental data, obtaining an increase of the

  10. Evidence-Based ACL Reconstruction.

    Science.gov (United States)

    Rodriguez-Merchan, E Carlos

    2015-01-01

    There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACL) reconstruction. The purpose of this article is to answer the following questions: 1) Bone-patellar tendon-bone reconstruction (BPTB-R) or hamstrimg reconstruction (H-R); 2) Double bundle or single bundle; 3) Allograft or authograft; 4) Early or late reconstruction; 5) Rate of return to sports after ACL reconstruction; 6) Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE) search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analyses focused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II) of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years. PMID:25692162

  11. A FINE GRANULAR JOINT SOURCE CHANNEL CODING METHOD

    Institute of Scientific and Technical Information of China (English)

    ZhuoLi; ShenLanusun

    2003-01-01

    An improved FGS (Fine Granular Scalability) coding method is proposed in this letter,which is based on human visual characteristics.This method adjusts FGS coding frame rate according to the evaluation of video sequences so as to improve the coding efficiency and subject perceived quality of reconstructed images.Finally,a fine granular joint source channel coding is proposed based on the source coding method,which not only utilizes the network resources efficiently,but guarantees the reliable transmission of video information.

  12. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft.

  13. Arthroscopic capsule reconstruction in the hip using iliotibial band allograft.

    Science.gov (United States)

    Trindade, Christiano A C; Sawyer, Gregory A; Fukui, Kiyokazu; Briggs, Karen K; Philippon, Marc J

    2015-02-01

    The hip capsule has been identified as an important static stabilizer of the hip joint. Despite the intrinsic bony stability of the hip socket, the capsule plays a key role in hip stability, particularly at the extremes of motion, and the iliofemoral ligament is the most important stabilizer in extension and external rotation. Patients who do not undergo capsular closure or plication may continue to complain of hip pain and dysfunction postoperatively, likely because of microinstability or muscle invagination into the capsular defect, and high-resolution magnetic resonance imaging or magnetic resonance arthrography will identify the capsular defect. Seen primarily in the revision setting, capsular defects can cause recurrent stress at the chondrolabral junction. An attempt at secondary closure can be challenging because of capsular limb adherence to the surrounding soft tissues. Therefore reconstruction may be the only possible surgical solution for this problem. We describe our new surgical technique for arthroscopic hip capsular reconstruction using iliotibial band allograft. PMID:25973378

  14. System for three-dimensional biomechanical analysis of joints

    Science.gov (United States)

    Siebert, Markus; Englmeier, Karl-Hans; von Eisenhart-Rothe, Ruediger; Bringmann, Christoph; Eckstein, Felix; Bonel, H.; Reiser, Maximilian; Graichen, Heiko

    2002-04-01

    We developed 3D MR based image processing methods for biomechanical analysis of joints. These methods provide quantitative data on the morphological distribution of the joint cartilage as well as biomechanical analysis of relative translation and rotation of joints. After image data acquisition in an open MR system, the segmentation of the different joint structures was performed by a semi automatic technique based on a gray value oriented region growing algorithm. After segmentation 3D reconstructions of cartilage and bone surfaces were performed. Principal axis decomposition is used to calculate a reproducible tibia plateau based coordinate system that allows the determination of relative rotation and translation of the condyles and menisci in relation to the tibia plateau. The analysis of the femoral movement is based on a reproducible, semi automatic calculated epicondylar axis. The analysis showed a posterior translation of the meniscus and even more of the femur condyles in healthy knees and in knees with an insufficiency of the anterior cruciate ligament (ACL).

  15. General joint hypermobility and temporomandibular joint derangement in adolescents.

    OpenAIRE

    Westling, L; Mattiasson, A.

    1992-01-01

    Joint mobility was assessed in each member of an epidemiological sample of 96 girls and 97 boys, 17 years old, and graded by means of the hypermobility score of Beighton et al. Twenty two per cent of the girls and 3% of the boys could perform five or more of the nine manoeuvres. The prevalence of symptoms and signs of internal derangement in the temporomandibular joint was higher in adolescents with hypermobility of joints (score greater than or equal to 5/9). In subjects with a high mobility...

  16. Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report

    OpenAIRE

    Luca Guarda-Nardini; Daniele Manfredini; Marco Olivo; Giuseppe Ferronato

    2014-01-01

    Background: The literature on total alloplastic temporomandibular joint (TMJ) reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint p...

  17. [Treatment Strategies for Septic Arthritis of the Sternoclavicular Joint].

    Science.gov (United States)

    Kuhtin, O; Schmidt-Rohlfing, B; Dittrich, M; Lampl, L; Hohls, M; Haas, V

    2015-10-01

    Septic arthritis of the sternoclavicular joint (SCJ) is a relatively rare disease. Due to serious complications including mediastinitis and generalised sepsis early diagnosis and rapid onset of treatment are mandatory. The disease often affects immunocompromised patients, diabetics, or patients with other infectious diseases. The therapeutic options range from administration of antibiotics to extended surgery including reconstructive procedures. Apart from rare situations where conservative treatment with antibiotics is sufficient, joint resection followed by plastic surgical procedures are required. We present a retrospective analysis with data from two hospitals. From January 2008 to December 2012 23 patients with radiographically confirmed septic arthritis of various aetiology were included. Fourteen (60.8 %) male, nine (39.2 %) female patients with an average age of 60.3 ± 14.2 years (range: 23-88 years) with septic arthritis of the SCJ were treated. Seven (30.4 %) patients suffered from Diabetes mellitus, nine (39.1 %) had underlying diseases with a compromised immune system. In 14 (60.8 %) out of 23 patients a bacterial focus was detected. Only six (26 %) patients suffered from confined septic arthritis of the SCG, in 17 (73,9 %) patients osteomyelitis of the adjacent sternum, and the clavicle was present. In addition, 15 (65.2 %) patients already suffered from mediastinitis at the time of diagnosis, eight (35 %) patients even from septicaemia. In conclusion, septic arthritis requires an active surgical treatment. Limited incision of the joint and debridement alone is only successful at early stages of the disease. The treatment concept has to include the local joint and bone resection as well as complications like mediastinitis. After successful treatment of the infection, the defect of the chest wall requires secondary reconstructive surgery using a pedicled pectoralis muscle flap.

  18. Errors and Uncertainties in Dose Reconstruction for Radiation Effects Research

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.

    2008-04-14

    Dose reconstruction for studies of the health effects of ionizing radiation have been carried out for many decades. Major studies have included Japanese bomb survivors, atomic veterans, downwinders of the Nevada Test Site and Hanford, underground uranium miners, and populations of nuclear workers. For such studies to be credible, significant effort must be put into applying the best science to reconstructing unbiased absorbed doses to tissues and organs as a function of time. In many cases, more and more sophisticated dose reconstruction methods have been developed as studies progressed. For the example of the Japanese bomb survivors, the dose surrogate “distance from the hypocenter” was replaced by slant range, and then by TD65 doses, DS86 doses, and more recently DS02 doses. Over the years, it has become increasingly clear that an equal level of effort must be expended on the quantitative assessment of uncertainty in such doses, and to reducing and managing uncertainty. In this context, this paper reviews difficulties in terminology, explores the nature of Berkson and classical uncertainties in dose reconstruction through examples, and proposes a path forward for Joint Coordinating Committee for Radiation Effects Research (JCCRER) Project 2.4 that requires a reasonably small level of effort for DOSES-2008.

  19. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

    Directory of Open Access Journals (Sweden)

    Tokuhashi Yasuaki

    2010-05-01

    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  20. AORTOILIAC AND AORTOFEMORAL RECONSTRUCTION OF OBSTRUCTIVE DISEASE

    NARCIS (Netherlands)

    VANDENAKKER, PJ; VANSCHILFGAARDE, R; BRAND, R; VANBOCKEL, JH; TERPSTRA, JL

    1994-01-01

    This retrospective study evaluates our strategy to limit prosthetic reconstructions for aortoiliac obstructive disease to the diseased segments in 518 patients. There were 363 (70%) reconstructions without femoral anastomotic sites (FEM-0), 107 (21%) reconstructions with one femoral anastomotic site

  1. Multiview specular stereo reconstruction of large mirror surfaces

    KAUST Repository

    Balzer, Jonathan

    2011-06-01

    In deflectometry, the shape of mirror objects is recovered from distorted images of a calibrated scene. While remarkably high accuracies are achievable, state-of-the-art methods suffer from two distinct weaknesses: First, for mainly constructive reasons, these can only capture a few square centimeters of surface area at once. Second, reconstructions are ambiguous i.e. infinitely many surfaces lead to the same visual impression. We resolve both of these problems by introducing the first multiview specular stereo approach, which jointly evaluates a series of overlapping deflectometric images. Two publicly available benchmarks accompany this paper, enabling us to numerically demonstrate viability and practicability of our approach. © 2011 IEEE.

  2. Muscle strength after ACL reconstruction with bone tendon-bone patellar autograft tested by Cybex II dynamometer

    OpenAIRE

    Gogus, Abdullah; Taser, Omer; Eralp, Levent

    2004-01-01

    The Cybex II dynamometer is a device which offers isokinetic testing of different body joints and muscle groups, allowing precise, reproducible control of joint range of motion in keeping with specific rehabilitation goals. This system collects torque, work and power data, thus it can be used to identify and quantify functional musculoskeletal deficits. 25 patients with chronic anterolateral knee instability have been treated with ACL reconstruction using bone-tendon-bone patellar autograft a...

  3. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND TEMPOROMANDIBULAR-JOINT HYPERMOBILITY

    NARCIS (Netherlands)

    DIJKSTRA, PU; DEBONT, LGM; DELEEUW, R; STEGENGA, B; BOERING, G

    1993-01-01

    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion,

  4. 自体半腱肌肌腱微创重建踝关节外侧韧带的中期随访研究%Mid-term follow-up study of minimally invasive reconstruction of ankle joint lateral ligament with autologous semitendinosus tendon

    Institute of Scientific and Technical Information of China (English)

    胡牧; 徐向阳; 葛文涛; 李星辰; 刘津浩; 朱渊; 王碧波; 郭常军

    2014-01-01

    Objective To assess the results of a minimally invasive method for reconstructing the lateral ligaments of the ankle using a semitendinosus tendon autograft .Methods From September 2006 to June 2012, 58 patients ( 34 males, 24 females ) with chronic ankle instability underwent the lateral ligament reconstruction by a minimally invasive method with the semitendinosus autograft .The average age was 58.5 ( range, 17 to 62 ) years old.The semitendinosus tendon was harvested through two small incisions at the knee .For the ankle reconstruction , four small incisions of 5 mm each were made at the medial and lateral sides of the fibular tip , the talar neck, and the middle of the calcaneus .The anatomical reconstructions of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) were then performed through these small incisions .The mean follow-up time was (58.5 ±7.4) months, (range, 25 to 86 months ) .AOFAS, VAS questionnaires were used to evaluate the clinical outcomes , donor site morbidity and the patient satisfaction .The preoperative and postoperative stress tests were performed and the radiographic parameters were measured .Results The average opereation time of the autograft group was 75-98 min, (85.5 ±11.5) min in average, and the lasting time of the postoperative fever were 1.5-4 days, (2.5 ±1.2) days in average.In the autograft group, 46 patient were followed up, the follow-up time ranged from 25 to 86 months, (58.5 ±7.4) months in average.The average AOFAS score increased from (62.3 ±8.2) to (95.1 ±7.5) ( P <0.01).Six patients reported the residual instability on the uneven ground .Three patients of the autologous group reported the instability in daily life .No patient reported weakness or disability in the donor site .The satisfaction level of the autograft group was excellent in 31 patients and good in nine patients .Significant improvement of the talar tilt angle according to the stress radiographic parameters was noticed

  5. Joint ventures in health care.

    Science.gov (United States)

    Pelfrey, S; Theisen, B A

    1989-04-01

    To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for-profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability.

  6. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  7. Reconstructing human evolution

    CERN Document Server

    Cavalli-Sforza, M

    1999-01-01

    One can reconstruct human evolution using modern genetic data and models based on the mathematical theory of evolution and its four major factors : mutation, natural selection, statistical fluctuations in finite populations (random genetic drift), and migration. Archaeology gives some help on the major dates and events of the process. Chances of studying ancient DNA are very limited but there have been a few successful results. Studying DNA instead of proteins, as was done until a few years ago, and in particular the DNA of mitochondria and of the Y chromosome which are transmitted, respectively, by the maternal line and the paternal line, has greatly simplified the analysis. It is now possible to carry the analysis on individuals, while earlier studies were of necessity based on populations. Also the evolution of ÒcultureÓ (i.e. what we learn from others), in particular that of languages, gives some help and can be greatly enlightened by genetic studies. Even though it is largely based on mechanisms of mut...

  8. Facial Reconstruction and Rehabilitation.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature. PMID:27093062

  9. Orthotopic neobladder reconstruction

    Directory of Open Access Journals (Sweden)

    Dwayne T. S. Chang

    2015-01-01

    Full Text Available Orthotopic neobladder reconstruction is becoming an increasingly common urinary diversion following cystectomy for bladder cancer. This is in recognition of the potential benefits of neobladder surgery over creation of an ileal conduit related to quality of life (QoL, such as avoiding the need to form a stoma with its cosmetic, psychological and other potential complications. The PubMed database was searched using relevant search terms for articles published electronically between January 1994 and April 2014. Full-text articles in English or with English translation were assessed for relevance to the topic before being included in the review. Patients with neobladders have comparable or better post-operative sexual function than those with ileal conduits. They also have comparable QoL to those with ileal conduits. Orthotopic neobladder is a good alternative to ileal conduit in suitable patients who do not want a stoma and are motivated to comply with neobladder training. However, the selection of a neobladder as the urinary diversion of choice requires that patients have good renal and liver functions and are likely to be compliant with neobladder training. With benefits also come potential risks of neobladder formation. These include electrolyte abnormalities and nocturnal incontinence. This short review highlights current aspects of neobladder formation and its potential advantages.

  10. Facial Reconstruction and Rehabilitation.

    Science.gov (United States)

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature.

  11. Reconstruction tomography from incomplete projections

    International Nuclear Information System (INIS)

    In some instances, reconstruction radionuclide tomography must be carried out from projections that do not include projection values for all portions of the object to be reconstructed. This may occur, for example, when the field of view of the detector is limited, or when an opaque foreign body is present within the object. The effects of such incomplete projections upon reconstructions of computer-simulated phantoms were studied, using iterative and convolution methods. Several methods for reducing the resulting artifacts and inaccuracies are discussed

  12. Image Interpolation Through Surface Reconstruction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ling; LI Xue-mei

    2013-01-01

    Reconstructing an HR (high-resolution) image which preserves the image intrinsic structures from its LR ( low-resolution) counterpart is highly challenging. This paper proposes a new surface reconstruction algorithm applied to image interpolation. The interpolation surface for the whole image is generated by putting all the quadratic polynomial patches together. In order to eliminate the jaggies of the edge, a new weight function containing edge information is incorporated into the patch reconstruction procedure as a constraint. Extensive experimental results demonstrate that our method produces better results across a wide range of scenes in terms of both quantitative evaluation and subjective visual quality.

  13. A constrained variable projection reconstruction method for photoacoustic computed tomography without accurate knowledge of transducer responses

    CERN Document Server

    Sheng, Qiwei; Matthews, Thomas P; Xia, Jun; Zhu, Liren; Wang, Lihong V; Anastasio, Mark A

    2015-01-01

    Photoacoustic computed tomography (PACT) is an emerging computed imaging modality that exploits optical contrast and ultrasonic detection principles to form images of the absorbed optical energy density within tissue. When the imaging system employs conventional piezoelectric ultrasonic transducers, the ideal photoacoustic (PA) signals are degraded by the transducers' acousto-electric impulse responses (EIRs) during the measurement process. If unaccounted for, this can degrade the accuracy of the reconstructed image. In principle, the effect of the EIRs on the measured PA signals can be ameliorated via deconvolution; images can be reconstructed subsequently by application of a reconstruction method that assumes an idealized EIR. Alternatively, the effect of the EIR can be incorporated into an imaging model and implicitly compensated for during reconstruction. In either case, the efficacy of the correction can be limited by errors in the assumed EIRs. In this work, a joint optimization approach to PACT image r...

  14. First experiences with simultaneous skeletal and soft tissue reconstruction of noma-related facial defects.

    Science.gov (United States)

    Giessler, Goetz A; Borsche, André; Lim, Paul K; Schmidt, Andreas B; Cornelius, C-Peter

    2012-02-01

    Noma victims suffer from a three-dimensional facial soft-tissue loss. Some may also develop complex viscerocranial defects, due to acute osteitis, chronic exposure, or arrested skeletal growth. Reconstruction has mainly focused on soft tissue so far, whereas skeletal restoration was mostly avoided. After successful microvascular soft tissue free flap reconstruction, we now included skeletal restoration and mandibular ankylosis release into the initial step of complex noma surgery. One free rib graft and parascapular flap, one microvascular osteomyocutaneous flap from the subscapular system, and two sequential chimeric free flaps including vascularized bone were used as the initial steps for facial reconstruction. Ankylosis release could spare the temporomandibular joint. Complex noma reconstruction should include skeletal restoration. Avascular bone is acceptable in cases with complete vascularized graft coverage. Microsurgical chimeric flaps are preferable as they can reduce the number and complexity of secondary operations and provide viable, infection-resistant bone supporting facial growth.

  15. Nondestructive Evaluation of Double Bevel T-Joint by Tandem Array Ultrasonic Transducer

    Science.gov (United States)

    Shirahata, H.; Miki, C.; Yamaguchi, R.

    2003-03-01

    The double bevel T-joint is one of the most fundamental joints of steel bridges. Double bevel T-joint can be seen at beam-column connection of bridge pier. In the Japanese specifications, the welding should be full penetration. However, weld defect of incomplete penetration could be left in the joint due to the lack of quality control in welding. Fatigue cracks can be propagated from the weld defects. The authors developed a tandem array transducer. The tandem array transducer consists of 10 elements aligned in the same direction. Tandem scanning can be simulated by the transducer. Image reconstruction of incomplete penetration by synthetic aperture focusing technique was carried out. The test results showed sufficient detectability of incomplete penetration by the tandem array transducer. Height of incomplete of penetration could be estimated.

  16. Analytical and semi-analytical inverse kinematics of SSRMS-type manipulators with single joint locked failure

    Science.gov (United States)

    Xu, Wenfu; She, Yu; Xu, Yangsheng

    2014-12-01

    Redundant space manipulators, including Space Station Remote Manipulator System (SSRMS), Special Purpose Dexterous Manipulator (SPDM) and European Robotic Arm (ERA), have been playing important roles in the construction and maintenance of International Space Station (ISS). They all have 7 revolute joints arranged in similar configurations, and are referred to as SSRMS-type manipulators. When a joint is locked in an arbitrary position due to some failures, a 7R manipulator degrades to a 6R manipulator. Without a spherical wrist or three consecutive parallel joints, the inverse kinematics of the 6R manipulator is very complex. In this paper, we propose effective methods to resolve the inverse kinematics for different cases of any joint locked in an arbitrary position. Firstly, configuration characteristics of the SSRMS-type redundant manipulators are analyzed. Then, an existing of closed-form inverse kinematics is discussed for locking different joints. Secondly, D-H frames and corresponding D-H parameters of the new 6-DOF manipulator formed by locking a joint in an arbitrary position are re-constructed. A unified table is then created to describe the kinematics for all possible cases of single joint locking failure. Thirdly, completely analytical and semi-analytical methods are presented to solve the inverse kinematics equations, and the former is used for locking joint 1, 2, 6 or 7 while the latter for locking joint 3, 4 or 5. Finally, typical cases for single joint locking are studied. The results verify the proposed methods.

  17. 膝关节周围皮肤软组织缺损的修复%Repair of skin and soft tissue defects around the knee joints

    Institute of Scientific and Technical Information of China (English)

    谭谦; 许澎

    2015-01-01

    Skin and soft tissue defects around the knee joints are often accompanied by popliteal artery injury, patellar ligament injury, patellar fracture, and other deep tissue damage or exposure, making them challenging to repair.The principle is to repair the wound, reconstruct anatomical structure of the knee joint, and recover the knee joint function.At present the reconstruction with skin flap or myocutaneous flap is our priority.Local flap or myocutaneous flap can be used for repairing minor defects around the knee joints.Repairing with perforator flap, fascia flap, and free flap are main alternatives for covering larger and complex defects around the knee joints.During the treatment, a joint effort is mandatory, not only to repair the wound, but also to reconstruct vasculature, fix fracture, repair ligament, and finally recover the knee joint function.Therefore, the importance of multidisciplinary cooperation must be emphasized.Moreover, along with the development of new technologies, new methods, and new materials, perforator flap plays an important role in repairing skin and soft tissue defects around the knee joints.

  18. Update on rehabilitation following ACL reconstruction

    Directory of Open Access Journals (Sweden)

    John Nyland

    2010-09-01

    Full Text Available John Nyland, Emily Brand, Brent FisherDepartment of Orthopaedic Surgery, Division of Sports Medicine, University of Louisville, Louisville, KY, USAAbstract: As anterior cruciate ligament (ACL reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare

  19. US Joint Ventures 2014 revision

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — A joint venture is a self-directed partnership of agencies, organizations, corporations, tribes, or individuals that has formally accepted the responsibility of...

  20. Joint Performance and Planning System

    Data.gov (United States)

    US Agency for International Development — A joint State/USAID system hosted by State that integrates resource and performance information at the program level and enables more flexible and frequent entry of...

  1. Campus/Industry Joint Ventures.

    Science.gov (United States)

    McDonald, Eugene J.

    1985-01-01

    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  2. Joint audits - benefit or burden?

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    In this paper we examine whether there are perceived and observed benefits or burdens from using two audit firms instead of one. In 2005 the mandatory joint audit requirement was abolished in Denmark. This provides a unique setting for studying the consequences and implications of going from...... a joint audit regime to a single auditor/voluntary joint audit regime. The dataset used in this paper has been collected for the full population of non-financial Danish companies listed on the Copenhagen Stock Exchange (CSE) in the years 2004 and 2005. We find that a majority of firms perceive joint...... driving-force behind this seems to be initial price cuts due to competition. However, the results indicate that efficiency gains may also be part of the explanation. We do not find either a general or marginal Big Four effect in the Danish audit market....

  3. Torsion testing of bed joints

    DEFF Research Database (Denmark)

    Hansen, Klavs Feilberg; Pedersen, Carsten Mørk

    2008-01-01

    This paper describes a simple test method for determining the torsion strength of a single bed joint between two bricks and presents results from testing using this test method. The setup for the torsion test is well defined, require minimal preparation of the test specimen and the test can...... be carried out directly in a normal testing machine. The torsion strength is believed to be the most important parameter in out-of-plane resistance of masonry walls subjected to bending about an axis perpendicular to the bed joints. The paper also contains a few test results from bending of small walls about...... an axis perpendicular to the bed joints, which indicate the close connection between these results and results from torsion tests. These characteristics make the torsion strength well suited to act as substitute parameter for the bending strength of masonry about an axis perpendicular to the bed joints....

  4. Finishing touch to joint venture

    CERN Multimedia

    2003-01-01

    "A new process for polishing titanium and its alloys has been announced following an agreement between Bripol (an Anopol/Delmet joint venture) of Birmingham and the European Organisation for Nuclear Reseach (CERN) in Geneva" (1 paragraph).

  5. IRS memorandum limits joint ventures.

    Science.gov (United States)

    Herman, A W

    1992-08-01

    Based on a new memorandum, the Internal Revenue Service (IRS) will be looking at joint hospital/physician activities with greater attention to the nuances of public versus private benefit. As a result, hospitals face greater risk of losing their tax-exempt status in the maze of joint ventures, physician recruitment, and practice acquisition. To be successful, ventures will have to be backed by sound reasoning and thorough documentation.

  6. "Fraud alert": joint venture arrangements.

    Science.gov (United States)

    Vipperman, R M

    1989-01-01

    The Office of Inspector General of the Department of Health and Human Services recently issued a special "Fraud Alert" identifying those characteristics of joint venture arrangements that it views as indicators of potentially unlawful activity. As discussed in this article, participants in joint ventures should examine their arrangements to see if one or more of the questionable features are present, and, if so, should take steps to eliminate them, to the extent possible.

  7. Joint probabilities and quantum cognition

    CERN Document Server

    de Barros, J Acacio

    2012-01-01

    In this paper we discuss the existence of joint probability distributions for quantum-like response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  8. Hologram-reconstruction signal enhancement

    Science.gov (United States)

    Mezrich, R. S.

    1977-01-01

    Principle of heterodyne detection is used to combine object beam and reconstructed virtual image beam. All light valves in page composer are opened, and virtual-image beam is allowed to interfere with light from valves.

  9. Reconstruction techniques for optoacoustic imaging

    Science.gov (United States)

    Frenz, Martin; Koestli, Kornel P.; Paltauf, Guenther; Schmidt-Kloiber, Heinz; Weber, Heinz P.

    2001-06-01

    Optoacoustics is a method to gain information from inside a tissue. This is done by irradiating a tissue with a short light pulse, which generates a pressure distribution inside the tissue that mirrors the absorber distribution. The pressure distribution measured on the tissue-surface allows, by applying a back-projection method, to calculate a tomography image of the absorber distribution. This study presents a novel computational algorithm based on Fourier transform, which, at least in principle, yields an exact 3D reconstruction of the distribution of absorbed energy density inside turbid media. The reconstruction is based on 2D pressure distributions captured outside at different times. The FFT reconstruction algorithm is first tested in the back projection of simulated pressure transients of small model absorbers, and finally applied to reconstruct the distribution of artificial blood vessels in three dimensions.

  10. Vermilion Reconstruction with Genital Mucosa.

    Science.gov (United States)

    Müller-Richter, Urs D A; Weyandt, Gerhard H; Woeckel, Achim; Kübler, Alexander C

    2016-05-01

    Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity often lead to functional impairments. We present a case of multiple vermilion and skin resections of the upper lip. At the last step, we had to resect even the whole vermilion mucosa, including parts of the oral mucosa of the vestibule, leaving a bare orbicularis oris muscle. To reconstruct the mucosal layer, we used a mucosal graft from the labia minora and placed it on the compromised lip and the former transpositional flaps for the reconstructed skin of the upper lip with very good functional and aesthetic results. PMID:27579226

  11. Arapahoe NWR diversion reconstruction : Preliminary

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is a preliminary plan for a diversion reconstruction for Hubbard #2. Oklahoma #1, Dryer, Hill and Crowder sites on the Arapahoe National Wildlife Refuge.

  12. Provincial reconstruction teams improving effectiveness

    OpenAIRE

    Sellers, Cameron S.

    2007-01-01

    Provincial Reconstruction Teams (PRTs) are currently prominent constructs for stabilization and reconstruction in Afghanistan and Iraq. PRTs are composed of civil-military teams, including elements from coalition partners and the host-nation, and involve multiple military services and civilian agencies. Their missions are to extend the legitimacy of the central government throughout the country and to use Civil Military Operations (CMO) to counter anti-government forces. PRTs are prominent,...

  13. Erectile function after urethral reconstruction

    Institute of Scientific and Technical Information of China (English)

    Joshua Carlton; Maharshi Patel; Allen F. Morey

    2008-01-01

    Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however,regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function (EF) and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.

  14. Equilibrium Reconstruction in EAST Tokamak

    Institute of Scientific and Technical Information of China (English)

    QIAN Jinping; WAN Baonian; L. L. LAO; SHEN Biao; S. A. SABBAGH; SUN Youwen; LIU Dongmei; XIAO Singjia; REN Qilong; GONG Xianzu; LI Jiangang

    2009-01-01

    Reconstruction of experimental axisymmetric equilibria is an important part of toka-mak data analysis. Fourier expansion is applied to reconstruct the vessel current distribution in EFIT code. Benchmarking and testing calculations are performed to evaluate and validate this algorithm. Two cases for circular and non-circular plasma discharges are presented. Fourier ex-pansion used to fit the eddy current is a robust method and the real time EFIT can be introduced to the plasma control system in the coming campaign.

  15. MR-guided dynamic PET reconstruction with the kernel method and spectral temporal basis functions.

    Science.gov (United States)

    Novosad, Philip; Reader, Andrew J

    2016-06-21

    Recent advances in dynamic positron emission tomography (PET) reconstruction have demonstrated that it is possible to achieve markedly improved end-point kinetic parameter maps by incorporating a temporal model of the radiotracer directly into the reconstruction algorithm. In this work we have developed a highly constrained, fully dynamic PET reconstruction algorithm incorporating both spectral analysis temporal basis functions and spatial basis functions derived from the kernel method applied to a co-registered T1-weighted magnetic resonance (MR) image. The dynamic PET image is modelled as a linear combination of spatial and temporal basis functions, and a maximum likelihood estimate for the coefficients can be found using the expectation-maximization (EM) algorithm. Following reconstruction, kinetic fitting using any temporal model of interest can be applied. Based on a BrainWeb T1-weighted MR phantom, we performed a realistic dynamic [(18)F]FDG simulation study with two noise levels, and investigated the quantitative performance of the proposed reconstruction algorithm, comparing it with reconstructions incorporating either spectral analysis temporal basis functions alone or kernel spatial basis functions alone, as well as with conventional frame-independent reconstruction. Compared to the other reconstruction algorithms, the proposed algorithm achieved superior performance, offering a decrease in spatially averaged pixel-level root-mean-square-error on post-reconstruction kinetic parametric maps in the grey/white matter, as well as in the tumours when they were present on the co-registered MR image. When the tumours were not visible in the MR image, reconstruction with the proposed algorithm performed similarly to reconstruction with spectral temporal basis functions and was superior to both conventional frame-independent reconstruction and frame-independent reconstruction with kernel spatial basis functions. Furthermore, we demonstrate that a joint spectral

  16. Evaluation of reconstruction errors and identification of artefacts for JET gamma and neutron tomography

    Energy Technology Data Exchange (ETDEWEB)

    Craciunescu, Teddy, E-mail: teddy.craciunescu@jet.uk; Tiseanu, Ion; Zoita, Vasile [National Institute for Laser, Plasma and Radiation Physics, Magurele-Bucharest (Romania); Murari, Andrea [Consorzio RFX, Padova (Italy); Kiptily, Vasily; Sharapov, Sergei [CCFE Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Lupelli, Ivan [CCFE Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); University of Rome “Tor Vergata,” Roma (Italy); Fernandes, Ana [Instituto de Plasmas e Fusão Nuclear, Instituto Superior Técnico, Universidade de Lisboa, Lisboa (Portugal); Collaboration: EUROfusion Consortium, JET, Culham Science Centre, Abingdon OX14 3DB (United Kingdom)

    2016-01-15

    The Joint European Torus (JET) neutron profile monitor ensures 2D coverage of the gamma and neutron emissive region that enables tomographic reconstruction. Due to the availability of only two projection angles and to the coarse sampling, tomographic inversion is a limited data set problem. Several techniques have been developed for tomographic reconstruction of the 2-D gamma and neutron emissivity on JET, but the problem of evaluating the errors associated with the reconstructed emissivity profile is still open. The reconstruction technique based on the maximum likelihood principle, that proved already to be a powerful tool for JET tomography, has been used to develop a method for the numerical evaluation of the statistical properties of the uncertainties in gamma and neutron emissivity reconstructions. The image covariance calculation takes into account the additional techniques introduced in the reconstruction process for tackling with the limited data set (projection resampling, smoothness regularization depending on magnetic field). The method has been validated by numerically simulations and applied to JET data. Different sources of artefacts that may significantly influence the quality of reconstructions and the accuracy of variance calculation have been identified.

  17. Reconstruction of the thumb with osteofasciocutaneous reverse flap

    Directory of Open Access Journals (Sweden)

    Jevtović Dobrica

    2002-01-01

    Full Text Available This paper presents the experiences of the thumb reconstruction with osteofasciocutaneous reverse flap (OFCR flap. In the period between 1987 and 2000 the OFCR flap was used in 15 patients. The youngest of them was 18 and the oldest was 38 years of age. The average age was 25.4. All the patients had post-traumatic amputations. Defects on proximal phalangae and a part of metacarpal bone occurred in two cases. In one case there was an amputation on the base level of proximal phalanx and the metacarpophalangeal (MPH joint was preserved. In all cases of reconstruction the OFCR flap was used, which included antebrachial skin nerves that were anastomosed with digital nerve. The flap nutrition was carried out through the reverse circulation of a. radialis, and the venous drainage through the comitant vein of a. radialis. Superficial veins were not anastomosed. Secondary defects were covered with a free skin graft. All the flaps survived. The bone graft was healed in the period of eight weeks. The sensibility of this flap was regained in the period of three to six months after the surgery. The distance of two-point discrimination (TPD was increased for 30% compared to the same region on the other hand after six months. The opposition of the reconstructed thumb to the other fingers was possible, as well as abduction, adduction and normal grasp. The method of reconstruction of the amputated thumb with the OFCR flap was better than other classical methods because it allowed the reconstruction of all the structures in one surgical operation. The sensibility that was regained represented good protection from injuries. There were no functional damages on the secondary defect. The esthetic result was not good due to the lack of a fingernail.

  18. [Reconstruction of the thumb using a forearm osseofasciocutaneous reverse flap].

    Science.gov (United States)

    Jevtović, Dobrica; Dordević, Boban; Gacević, Milomir; Sijan, Goran

    2002-01-01

    This paper presents the experiences of the thumb reconstruction with osteofasciocutaneous reverse flap (OFCR flap). In the period between 1987 and 2000 the OFCR flap was used in 15 patients. The youngest of them was 18 and the oldest was 38 years of age. The average age was 25.4. All the patients had posttraumatic amputations. Defects on proximal phalangae and a part of metacarpal bone occurred in two cases. In one case there was an amputation on the base level of proximal phalanx and the metacarpophalangeal (MPH) joint was preserved. In all cases of reconstruction the OFCR flap was used, which included antebrachial skin nervs that were anastomosed with digital nerv. The flap nutrition was carried out through the reverse circulation of a. radialis, and the venous drainage through the comitant vein of a. radialis. Superficial veins were not anastomosed. Secondary defects were covered with a free skin graft. All the flaps survived. The bone graft was healed in the period of eight weeks. The sensibility of this flap was regained in the period of three to six months after the surgery. The distance of two-point discrimination (TPD) was increased for 30% compared to the same region on the other hand after six months. The opposition of the reconstructed thumb to the other fingers was possible, as well as abduction, adduction and normal grasp. The method of reconstruction of the amputated thumb with the OFCR flap was better than other classical methods because it allowed the reconstruction of all the structures in one surgical operation. The sensibility that was regained represented good protection from injuries. There were no functional damages on the secondary defect. The esthetic result was not good due to the lack of a fingernail. PMID:12557617

  19. Hip Labral Reconstruction: The "Kite Technique" for Improved Efficiency and Graft Control.

    Science.gov (United States)

    Bhatia, Sanjeev; Chahla, Jorge; Dean, Chase S; Ellman, Michael B

    2016-04-01

    Although the merits of labral reconstruction have been well established, the technical difficulty of presently used reconstruction techniques-particularly with graft passage and fixation-limit its efficacy and potentiates the risk of iatrogenic damage within the hip joint. The unwieldy nature of a floating labral graft anchored on one end may impede accurate fixation of the other end, which is critical for restoration of the fluid hip seal and preservation of graft integrity. In this technique narrative, we present a "kite technique" for introduction, control, and efficient fixation of a labral reconstruction graft. The principles of this method are founded on the belief that a soft-tissue graft in an arthroscopic environment is much easier to guide into position with 2 control sutures using a pulley system similar to flying a kite with 2 fly lines. Although we herein detail the technique as it applies to labral reconstruction in the hip, the concept of the kite technique may also be employed in arthroscopic-assisted soft-tissue reconstructions of other joints. PMID:27354954

  20. 12 CFR 347.107 - Joint ventures.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  1. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    Science.gov (United States)

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  2. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Directory of Open Access Journals (Sweden)

    Dariusz Witoński

    2013-01-01

    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

  3. Ankylosis of the temporomandibular joint. Follow-up of thirteen patients.

    Science.gov (United States)

    Schobel, G; Millesi, W; Watzke, I M; Hollmann, K

    1992-07-01

    We undertook a postoperative clinical study of 13 patients with ankylosis of the temporomandibular joints. The study consisted of an evaluation of the surgical concepts of resection and subsequent surgical reconstruction by osteotomy in previous height of the joint space and lining of the glenoid fossa with lyophilized dura. Early mobilization and aggressive physiotherapy are mandatory postoperative measures. According to the theory of mandibular growth as a result of functional matrix, early surgical intervention to correct ankylosis should be performed, regardless of the age of the patient, to prevent recurrence and later asymmetry or distoclusion.

  4. [Rehabilitation after arthroscopic anterior cruciate ligament reconstruction].

    Science.gov (United States)

    Smékal, D; Kalina, R; Urban, J

    2006-12-01

    Rehabilitation is an important part of therapy in patients who have had arthroscopic anterior cruciate ligament reconstruction. A well-designed rehabilitation program avoids potential graft damage and speeds up patients' return to their full function level. The course of rehabilitation depends on the type of surgery, mode of fixation and possible co-existing injury to the knee's soft tissues. The rehabilitation program presented here is based on the present-day knowledge of neurophysiological and biomechanical principles and is divided into five phases. In the pre-operative phase (I), the main objective is to prepare patients for surgery in terms of maximum muscle strength and range of motion. It also includes providing full information on the procedure. In the early post-operative phase (II) we are concerned with pain alleviation and reduction of knee edema. After suture removal we begin with soft techniques for the patella and post-operative physical therapy to reduce scarring. In the next post-operative phase (III) patients are able to walk with their full weight on the extremity operated on, and we continue doing exercises that improve flexor/extensor co-contraction. In this phase we also begin with exercises improving the patient's proprioceptive and sensorimotor functions. In the late post-operative phase (IV) we go on with exercises promoting proprioception of both lower extremities with the aim of increasing muscle control of the knee joints. In the convalescent phase (V) patients gradually return to their sports activities.

  5. Migrating bone shards in dissecting Charcot joints.

    Science.gov (United States)

    Forrester, D M; Magre, G

    1978-06-01

    Extensive periarticular calcification is characteristic of Charcot joints. Fragmentation of the articular margins of bone contributes to the bony detritus, but the majority forms de novo in the joint capsule. Occasionally the calcific debris is seen far removed from the joint. Dissection of a chronically distended joint along muscle planes is most commonly associated with the inflammatory joint disease of rheumatoid arthritis. Its occurrence in Charcot joints is documented by arthrography, which demonstrates continuity of the joint space and the distant calcifications. PMID:418652

  6. Reliable Gait Recognition Using 3D Reconstructions and Random Forests - An Anthropometric Approach

    DEFF Research Database (Denmark)

    Sandau, Martin; Heimbürger, Rikke V.; Jensen, Karl E.;

    2016-01-01

    Photogrammetric measurements of bodily dimensions and analysis of gait patterns in CCTV are important tools in forensic investigations but accurate extraction of the measurements are challenging. This study tested whether manual annotation of the joint centers on 3D reconstructions could provide...... expert annotated the data. Recognition based on data annotated by different experts was less reliable achieving 72.6% correct recognitions as some parameters were heavily affected by interobserver variability. This study verified that 3D reconstructions are feasible for forensic gait analysis...

  7. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Science.gov (United States)

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation.

  8. Reconstruction of anterior cruciate ligament and anterolateral ligament using interlinked hamstrings - technical note.

    Science.gov (United States)

    Ferreira, Marcio de Castro; Zidan, Flavio Ferreira; Miduati, Francini Belluci; Fortuna, Caio Cesar; Mizutani, Bruno Moreira; Abdalla, Rene Jorge

    2016-01-01

    Recent anatomical and biomechanical studies on the anterolateral ligament (ALL) of the knee have shown that this structure has an important function in relation to joint stability, especially when associated with anterior cruciate ligament (ACL) injury. However, the criteria for its reconstruction have not yet been fully established and the surgical techniques that have been described present variations regarding anatomical points and fixation materials. This study presents a reproducible technique for ALL and ACL reconstruction using hamstring tendons, in which three interference screws are used for fixation. PMID:27517028

  9. Lossy Broadcasting in Two-Way Relay Networks with Common Reconstructions

    CERN Document Server

    Timo, Roy; Kramer, Gerhard

    2010-01-01

    The broadcast phase (downlink transmission) of the two-way relay network is studied in the source coding and joint source-channel coding settings. The rates needed for reliable communication are characterised for a number of special cases including: small distortions, deterministic distortion measures, and jointly Gaussian sources with quadratic distortion measures. The broadcast problem is also studied with common-reconstruction decoding constraints, and the rates needed for reliable communication are characterised for all discrete memoryless sources and per-letter distortion measures.

  10. Measurement of functional recovery after an anterior cruciate ligament reconstruction in competitive athletes; development of a measuring method

    NARCIS (Netherlands)

    Reininga, I.HF; Lemmink, K.A.P.M.; Krijt, D.I.; Waninge, H.; Diercks, Ron; Stevens, M.

    2005-01-01

    Many athletes with an anterior cruciate ligament tear do not return to their original sport level after reconstruction, in spite of good results on clinical tests. After an anterior cruciate ligament tear, knee joint proprioception is shown to be decreased. This leads to the use of compensatory mech

  11. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  12. Induction brazing of complex joints

    DEFF Research Database (Denmark)

    Henningsen, Poul; Zhang, Wenqi; Bay, Niels

    2003-01-01

    Induction brazing is a fast and appropriate method for industrial joining of complex geometries and metal combinations. In all types of brazing processes it is important to heat the joint interface of the two materials to the same, high temperature. If one of the specimens is warmer than the other...... materials has large influence on the heating time and temperature distribution in induction heating. In order to ensure high and uniform temperature distribution near the interface of a joint between dissimilar materials the precise coil geometry and position is of great importance. The present paper...... presents a combined numerical and experimental method for fast determination of appropriate coil geometry and position in induction brazing tube-to-plate joints of different ratios between tube and plate thickness and different combinations of the materials stainless steel, brass and copper. The method has...

  13. Goniometry in limited joint mobility

    Directory of Open Access Journals (Sweden)

    S Gopinath

    2012-01-01

    Full Text Available Aim: To study about the utility of goniometry in screening for limited joint mobility (LJM in patients attending a secondary level Diabetic Clinic. Materials and Methods: Randomly selected data of 100 patients attending a secondary level diabetic clinic without any complications were used. Baseline neuropathy assessments, namely monofilament and biothesiometry were done. Range of movement around the ankle joint and 1 st metatarsal joint was done using goniometry. Both the results were compared. Inclusion Criteria: Selected 100 patients attending a secondary level diabetic clinic and on regular follow-up were included in the study. Exclusion Criteria: Sick patients requiring parenteral feeds, IV antibiotics, co-morbid conditions such as microvascular complication, autonomic gastroparesis, and diabetic foot infections were excluded from the study. Conclusion: Goniometric screening for LJM is a cheap and effective screening tool for detecting early structural deformity producing a higher plantar pressure and ulcer, and thereby preventing them at early stage.

  14. Joint US/German Conference

    CERN Document Server

    Gulledge, Thomas; Jones, Albert

    1993-01-01

    This proceedings volume contains selected and refereed contributions that were presented at the conference on "Recent Developments and New Perspectives of Operations Research in the Area of Production Planning and Control" in Hagen/Germany, 25. - 26. June 1992. This conference was organized with the cooperation of the FernuniversiHit Hagen and was jointly hosted by the "Deutsche Gesellschaft fur Operations Research (DGOR)" and the "Manufacturing Special Interest Group of the Operations Research Society of America (ORSA-SIGMA)". For the organization of the conference we received generous financial support from the sponsors listed at the end of this volume. We wish to express our appreciation to all supporters for their contributions. This conference was the successor of the JOInt ORSA/DGOR-conference in Gaithersburg/Maryland, USA, on the 30. and 31. July 1991. Both OR-societies committed themselves in 1989 to host joint conferences on special topics of interest from the field of operations research. This goal ...

  15. Denervation of the wrist joint.

    Science.gov (United States)

    Buck-Gramcko, D

    1977-01-01

    A collective review was made of the results of denervation of the wrist joint for painful restrictiorn of motion done in 313 patients and follow-up studies on 195 (average 4.1 years, ranging from 9 months to 14 years). Complete denervation was done in only 30, partial denervation in the others being done after testing with local anesthetic blocks. Sixty-nine of the patients retained a moble wrist without pain or with slight pain with heavy work. No evidence of Charcot-like joints was seen. Poorest results followed when the operation was done for sequelae of intra-articular fracture of the radius, fracture dislocations, unstable ligamentous support, joint surface destruction, or for those required to do heavy manual labor. Arthrodesis was done secondarily in nine patients. PMID:839055

  16. Leaving a joint audit system

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2014-01-01

    Purpose: The authors aim to exploit a natural experment in which voluntary replace mandatory joint audits for Danish listed companies and analyse audit fee implications of using one or two audit firms. Design/methodology/approach: Regression analysis is used. The authors apply both a core audit fee...... determinants model and an audit fee change model and include interaction terms. Findings: The authors find short-term fee reductions in companies switching to single audits, but only where the former joint audit contained a dominant auditor. The authors argue that in this situation bargaining power is more...... with the auditors than in a equally shared joint audit, and that the auditors' incentives to offer an initial fee discount are bigger. Research limitations/implications: The number of observations is constrained by the small Danish capital market. Future research could take a more qualitative research approach...

  17. Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

    Science.gov (United States)

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami

    2005-09-01

    In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help

  18. The reconstruction of inflationary potentials

    Science.gov (United States)

    Lin, Jianmang; Gao, Qing; Gong, Yungui

    2016-07-01

    The observational data on the anisotropy of the cosmic microwave background constraints the scalar spectral tilt ns and the tensor to scalar ratio r which depend on the first and second derivatives of the inflaton potential. The information can be used to reconstruct the inflaton potential in the polynomial form up to some orders. However, for some classes of potentials, ns and r behave as ns(N) and r(N) universally in terms of the number of e-folds N. The universal behaviour of ns(N) can be used to reconstruct a class of inflaton potentials. By parametrizing one of the parameters ns(N), ɛ(N) and φ(N), and fitting the parameters in the models to the observational data, we obtain the constraints on the parameters and reconstruct the classes of the inflationary models which include the chaotic inflation, T-model, hilltop inflation, s-dual inflation, natural inflation and R2 inflation.

  19. Network reconstruction from infection cascades

    CERN Document Server

    Braunstein, Alfredo

    2016-01-01

    Reconstructing propagation networks from observations is a fundamental inverse problem, and it's crucial to understand and control dynamics in complex systems. Here we show that it is possible to reconstruct the whole structure of an interaction network and to simultaneously infer the complete time course of activation spreading, relying just on single snapshots of a small number of activity cascades. The method, that we called Inverse Dynamics Network Reconstruction (IDNR), is shown to work successfully on several synthetic and real networks, inferring the networks and the sources of infection based on sparse observations, including single snapshots. IDNR is built on a Belief Propagation approximation, that has an impressive performance in a wide variety of topological structures. The method can be applied in absence of complete time-series data by providing a detailed modeling of the posterior distribution of trajectories conditioned to the observations. Furthermore, we show by experiments that the informat...

  20. Reconstructing Ancient Forms of Life

    Science.gov (United States)

    Benner, Steven A.

    1998-01-01

    Progress in the past three months has occurred in two areas, reconstruction of ancestral proteins and improved understanding of chemical features that are likely to be universal in generic matter regardless of its genesis. Ancestral ribonucleases have been reconstructed, and an example has been developed that shows how physiological function can be assigned to in vitro behaviors observed in biological systems. Sequence data have been collected to permit the reconstruction of src homology 2 domains that underwent radiative divergence at the time of the radiative divergence of chordates. New studies have been completed that show how genetic matter (or its remnants) might be detected on Mars (or other non-terrean locations.) Last, the first in vitro selection experiments have been completed using a nucleoside library carrying positively charged functionality, illustrating the importance of non-standard nucleotides to those attempting to obtain evidence for an "RNA world" as an early episode of life on earth.

  1. CURRENT CONCEPTS IN ACL RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Freddie H. Fu

    2008-09-01

    Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world

  2. Solder Joint Health Monitoring Testbed

    Science.gov (United States)

    Delaney, Michael M.; Flynn, James G.; Browder, Mark E.

    2009-01-01

    A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

  3. [Divorce and joint physical custody].

    Science.gov (United States)

    Golse, B

    2014-04-01

    This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome.

  4. Clinical applications of iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Eberl, S. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia). Department of PET and Nuclear Medicine

    1998-03-01

    Expectation maximisation (EM) reconstruction largely eliminates the hot and cold streaking artifacts characteristic of filtered-back projection (FBP) reconstruction around localised hot areas, such as the bladder. It also substantially reduces the problem of decreased inferior wall counts in MIBI myocardial perfusion studies due to ``streaking`` from high liver uptake. Non-uniform attenuation and scatter correction, resolution recovery, anatomical information, e.g. from MRI or CT tracer kinetic modelling, can all be built into the EM reconstruction imaging model. The properties of ordered subset EM (OSEM) have also been used to correct for known patient motion as part of the reconstruction process. These uses of EM are elaborated more fully in some of the other abstracts of this meeting. Currently we use OSEM routinely for: (i) studies where streaking is a problem, including all MIBI myocardial perfusion studies, to avoid hot liver inferior wall artifact, (ii) all whole body FDG PET, all lung V/Q SPECT (which have a short acquisition time) and all gated {sup 201}TI myocardial perfusion studies due to improved noise characteristics of OSEM in these studies; (iii) studies with measured, non-uniform attenuation correction. With the accelerated OSEM algorithm, iterative reconstruction is practical for routine clinical applications and we have found OSEM to provide clearly superior reconstructions for the areas listed above and are investigating its application to other studies. In clinical use, we have not found OSEM to introduce artifacts which would not also occur with FBP, e.g. uncorrected patient motion will cause artifacts with both OSEM and FBP.

  5. Cosmokinetics: A joint analysis of Standard Candles, Rulers and Cosmic Clocks

    OpenAIRE

    Nair, Remya; Jhingan, Sanjay; Jain, Deepak

    2011-01-01

    We study the accelerated expansion of the universe by using the kinematic approach. In this context, we parameterize the deceleration parameter, q(z), in a model independent way. Assuming three simple parameterizations we reconstruct q(z). We do the joint analysis with combination of latest cosmological data consisting of standard candles (Supernovae Union2 sample), standard ruler (CMB/BAO), cosmic clocks (age of passively evolving galaxies) and Hubble (H(z)) data. Our results support the acc...

  6. A Geometric Approach to Joint Inversion with Applications to Contaminant Source Zone Characterization

    OpenAIRE

    Aghasi, Alireza; Mendoza-Sanchez, Itza; Miller, Eric L.; Ramsburg, C. Andrew; Abriola, Linda M.

    2013-01-01

    This paper presents a new joint inversion approach to shape-based inverse problems. Given two sets of data from distinct physical models, the main objective is to obtain a unified characterization of inclusions within the spatial domain of the physical properties to be reconstructed. Although our proposed method generally applies to many types of inversion problems, the main motivation here is to characterize subsurface contaminant source-zones by processing down gradient hydrological data an...

  7. Successful Fusion of the Proximal Tibiofibular Joint with Osteogenic Protein-1 (OP-1) Augmentation

    OpenAIRE

    Delos, Demetris; Schneidkraut, Jason; Rodeo, Scott

    2012-01-01

    Proximal tibiofibular joint (PTFJ) instability is rare, but when encountered can be difficult to manage. Previously reported forms of treatment, including cast immobilization, soft tissue repairs and reconstructions, and fibular head resection have met with limited success. Another option is PTFJ arthrodesis—however, fusion can be difficult and ankle pain after surgery is not uncommon. In this report, we present a novel surgical technique used to treat PTFJ instability. It is a form of PTFJ a...

  8. Reconstructing WKB from topological recursion

    CERN Document Server

    Bouchard, Vincent

    2016-01-01

    We prove that the topological recursion reconstructs the WKB expansion of a quantum curve for all spectral curves whose Newton polygons have no interior point (and that are smooth as affine curves). This includes nearly all previously known cases in the literature, and many more; in particular, it includes many quantum curves of order greater than two. We also explore the connection between the choice of ordering in the quantization of the spectral curve and the choice of integration divisor to reconstruct the WKB expansion.

  9. Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques

    OpenAIRE

    Domnick, Christoph; Raschke, Michael J.; Herbort, Mirco

    2016-01-01

    The influences and mechanisms of the physiology, rupture and reconstruction of the anterior cruciate ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics. Often, other meniscal o...

  10. 7th International Workshop on Boosted Object Phenomenology, Reconstruction and Searches in HEP

    CERN Document Server

    2015-01-01

    BOOST2015 is the seventh of a series of successful joint theory/experiment workshops which bring together the world leading experts from theory and the Tevatron and LHC experiments to discuss the latest progress and develop new approaches on the reconstruction and use of boosted decay topologies as search tools for new physics. This year, the workshop is hosted by the University of Chicago.

  11. Proprioception and Clinical Results of Anterolateral Single-Bundle Posterior Cruciate Ligament Reconstruction with Remnant Preservation

    OpenAIRE

    Lee, Dung Chul; Shon, Oog Jin; Kwack, Byung Hoon; Lee, Sung Jun

    2013-01-01

    Purpose To evaluate the clinical and radiological results and proprioception following anterolateral single-bundle posterior cruciate ligament (PCL) reconstruction with remnant preservation for PCL injury. Materials and Methods Twenty patients with an isolated PCL injury (16 males and 4 females) were included in this study. The mean follow-up period was 61 months (≥24 months) and the mean age of the patients was 36 years. Knee joint instability was evaluated using posterior drawer stress radi...

  12. Chronic instability of the anterior tibiofibular syndesmosis of the ankle. Arthroscopic findings and results of anatomical reconstruction

    Directory of Open Access Journals (Sweden)

    Swierstra Bart A

    2011-09-01

    Full Text Available Abstract Background The arthroscopic findings in patients with chronic anterior syndesmotic instability that need reconstructive surgery have never been described extensively. Methods In 12 patients the clinical suspicion of chronic instability of the syndesmosis was confirmed during arthroscopy of the ankle. All findings during the arthroscopy were scored. Anatomical reconstruction of the anterior tibiofibular syndesmosis was performed in all patients. The AOFAS score was assessed to evaluate the result of the reconstruction. At an average of 43 months after the reconstruction all patients were seen for follow-up. Results The syndesmosis being easily accessible for the 3 mm transverse end of probe which could be rotated around its longitudinal axis in all cases during arthroscopy of the ankle joint, confirmed the diagnosis. Cartilage damage was seen in 8 ankles, of which in 7 patients the damage was situated at the medial side of the ankle joint. The intraarticular part of anterior tibiofibular ligament was visibly damaged in 5 patients. Synovitis was seen in all but one ankle joint. After surgical reconstruction the AOFAS score improved from an average of 72 pre-operatively to 92 post-operatively. Conclusions To confirm the clinical suspicion, the final diagnosis of chronic instability of the anterior syndesmosis can be made during arthroscopy of the ankle. Cartilage damage to the medial side of the tibiotalar joint is often seen and might be the result of syndesmotic instability. Good results are achieved by anatomic reconstruction of the anterior syndesmosis, and all patients in this study would undergo the surgery again if necessary.

  13. Post-traumatic instability of the metacarpophalangeal joint of the thumb.

    Science.gov (United States)

    Smith, R J

    1977-01-01

    Of eithty-six patients with collateral ligament instability of the metacarpophalangeal joint of the thumb, sixty-six (77 per cent) had ulnar and twenty (23 per cent) had radial instability, while in addition twenty-four had fractures and twenty-nine had volar subluxation of the proximal phalanx. Of the sixty-nine patients operated on, sixty-five had an abnormality of the ulnar or radial collateral ligament proper or of its attachment; two, subluxation of the extensor pollicis longus; and two, stretching of the adductor expansion. Stability was restored by collateral ligament repair or reconstruction, by fixation of a fracture fragment with a Kirschner wire, or by arthrodesis in all but five thumbs. Of the five patients who did not have stability of the metacarpophalangeal joint following surgery, three had had the collateral ligament sutured more than three weeks after injury and two had had reconstruction of the collateral ligament using a tendon graft. Early surgical treatment is recommended for all patients with post-traumatic instability of the metacarpophalangeal joint greater than 45 degrees and for those with volar subluxation of the proximal phalanx or a displaced fracture of the base of the proximal phalanx. Collateral ligament repair is indicated for patients operated on within three weeks of injury, and reconstruction of the ligament by means of a tendon graft is recommended for those treated more than three weeks after injury.

  14. What Determines Joint Venture Termination?

    DEFF Research Database (Denmark)

    Nielsen, Bo Bernhard

    2012-01-01

    Joint venture (JV) research continues to flourish as researchers seek to advance our understanding of why so many JVs fail. Cui and Kumar (this issue) take a contingency approach to explain how and why business relatedness may provide new insights as to what determines JV termination...

  15. Joint energy program makes progress

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ "Clean Energies Facing the Future," a cooperative research program jointly organized by CAS and the BP Group, has made encouraging progress, say experts at an annual sum-up workshop held on 31 July and I August at Tsinghua University in Beijing. The CAS Dalian Institute of Chemical Physics(DICP) has been entrusted as coordinator of the cooperative program between the two sides.

  16. Joint IGCP 499/SDS Meeting

    Institute of Scientific and Technical Information of China (English)

    Peter K(o)nigshof; Eberhard Schindler; Volker Wildez; Jurga Lazauskiene; M. Namik Yal(c)in

    2006-01-01

    @@ A major event of IGCP 499 in 2005 took place in Southern Siberia. In the tradition of successful joint meetings and field trips of Devonian IGCP projects and the international Subcommission on Devonian Stratigraphy (SDS), a very successful meeting was held at the Institute of Petroleum Geology,United Institute of Geology and Mineralogy of the Russian Academy of Sciences, Siberian Branch in Novosibirsk.

  17. The Rationale for Joint Mobilization.

    Science.gov (United States)

    Burkhardt, Sandy

    This paper presents an overview of the functions of connective tissue and the mechanisms of joint injury and contracture formation in relation to therapeutic exercise. The components of connective tissue operation are explained, including fibroblasts, macrophages, plasma cells, and collagen. An examination of the histology of connective tissue as…

  18. Arthrography of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

    Crespi Porro, R.; Zellner, A.; Puricelli, G.; Quaglia, R.; Chelazzi, G.

    1984-02-01

    Arthrography of the ankle joint was first carried out by Johnson and Palmer at the Military Hospital in Stockholm in 1940. Arthrography can be used for judging the integrity of the articular cartilage, of osteochondritis dissecans, arthritis or adhesive capsulitis. The literature shows, however, that more than 95% of the patients on whom this examination has been performed has suffered from acute trauma.

  19. Missed Monteggia fracture in children: Is annular ligament reconstruction always required?

    Directory of Open Access Journals (Sweden)

    Bhaskar Atul

    2009-01-01

    Full Text Available Background: Chronic (neglected radiocapitellar joint dislocation is one of the feared complications of Monteggia fractures especially when associated with subtle fracture of the ulna bone. Many treatment strategies have been described to manage chronic Monteggia fracture and the need for annular ligament reconstruction is not always clear. The purpose of this study is to highlight the management of missed Monteggia fracture with particular emphasis on utility of annular ligament reconstruction by comparing the two groups of patients. Materials and Methods: In a prospective study 12 patients with mean age of 7.4 years, who presented with neglected Monteggia fractures, were studied. All children underwent open reduction of the radiocapitellar joint. Five children (Group A were treated with angulation-distraction osteotomy of ulna and annular ligament reconstruction and six cases (Group B required only angulation-distraction osteotomy of ulna without ligament reconstruction. In one case an open reduction of the radiocapitellar joint was sufficient to reduce the radial head and this was included in Group B. The gap between injury and presentation was from 3 months to 18 months (mean 9 months. Ten patients were classified as Bado I, and one each as Bado II and III respectively. We used the Kim′s criteria to score our results. Result: The mean follow-up period was 22 months. All ulna osteotomies healed uneventfully. The mean loss of pronation was 15 degree in Group A and 10 degree in Group B. Elbow flexion improved from the preoperative range and no child complained of pain, deformity and restriction of activity. The elbow score was excellent in 10 cases, and good in two cases. Conclusion: Distraction-angulation osteotomy of the ulna suffices in most cases of missed monteggia fracture and the need for annular ligament reconstruction is based on intraoperative findings of radial head instability.

  20. Breast Reconstruction with Tissue Expansion

    Medline Plus

    Full Text Available RECONSTRUCTIVE BREAST SURGERY ALBANY MEDICAL CENTER HOSPITAL ALBANY, NY July 31, 2008 00:00:10 ANNOUNCER: Welcome to this OR-Live webcast presentation, brought to ... webcast screen and open the door to informed medical care. 00:00:28 DIMITRI KOUMANIS, M.D.: ...