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Sample records for ankle brachial indices

  1. Ankle Brachial Index

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    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. (Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (SE))

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one >=50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a >= 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population

  2. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto;

    2012-01-01

    BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...

  3. Elevated osteoprotegerin is associated with abnormal ankle brachial indices in patients infected with HIV: a cross-sectional study

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    Jang James J

    2010-03-01

    Full Text Available Abstract Background Patients infected with HIV have an increased risk for accelerated atherosclerosis. Elevated levels of osteoprotegerin, an inflammatory cytokine receptor, have been associated with a high incidence of cardiovascular disease (including peripheral arterial disease, or PAD, acute coronary syndrome, and cardiovascular mortality. The objective of this study was to determine whether PAD is prevalent in an HIV-infected population, and to identify an association with HIV-specific and traditional cardiovascular risk factors, as well as levels of osteoprotegerin. Methods One hundred and two patients infected with HIV were recruited in a cross-sectional study. To identify the prevalence of PAD, ankle-brachial indices (ABIs were measured. Four standard ABI categories were utilized: ≤ 0.90 (definite PAD; 0.91-0.99 (borderline; 1.00-1.30 (normal; and >1.30 (high. Medical history and laboratory measurements were obtained to determine possible risk factors associated with PAD in HIV-infected patients. Results The prevalence of PAD (ABI ≤ 0.90 in a young HIV-infected population (mean age: 48 years was 11%. Traditional cardiovascular risk factors, including advanced age and previous cardiovascular history, as well as elevated C-reactive protein levels, were associated with PAD. Compared with patients with normal ABIs, patients with high ABIs had significantly elevated levels of osteoprotegerin [1428.9 (713.1 pg/ml vs. 3088.6 (3565.9 pg/ml, respectively, p = 0.03]. Conclusions There is a high prevalence of PAD in young HIV-infected patients. A number of traditional cardiovascular risk factors and increased osteoprotegerin concentrations are associated with abnormal ABIs. Thus, early screening and aggressive medical management for PAD may be warranted in HIV-infected patients.

  4. Ankle-brachial index as indicator of chronic arterial insufficiency of the lower extremities and renal artery stenosis CT/DS angiography

    International Nuclear Information System (INIS)

    Full text: The aim is to validate the measurements of ankle -brachial index (ABI), as part of routine examination algorithm in conducting CTA/DSA of the extremities in patients suffering from PAD. Correlations between ABI values and renal artery stenosis. The present study includes 200 patients (138 men and 62 women, aged between 60 and 75 years). 130 of them were examined by a computer- tomography angiography - 95 men and 32 women. 70 patients were examined by digital subtraction angiography - 50 men and 20 women. Measurements of ankle-brachial index (ABI) were performed on all patients by measuring the systolic blood pressure on both brachial arteries and determine the peak pressure in both aa. dorsalis pedis. Statistical data processing. There are no patients in the study with ABI values above 0.7 that have established renal artery stenosis. All patients with severe atherosclerotic changes have values of the ABI below 0.7, and those with the most severe changes below 0.5. This fully corresponds to global data showing that values below 0.9 ABI show mild engagement, below 0.7 average, and below 0.5 severe involvement. According to the results of this survey sensitivity of ABI for renal arteries below 0.7 equals 100% and its specificity = 67.5%. For values of ABI below 0.5: Sensitivity =100%; Specificity = 83.85%. By determining ABI values both symptomatic and asymptomatic form of a PAD can be diagnosed. the method is fast, non-invasive, inexpensive and applicable everywhere. No special preparation of the patient is needed. The method can be used not only to assess the degree of commitment of the vessels of the lower limbs, but also as an indicator for the state of renal arteries in those patients

  5. [Measurement ofthe ankle-brachial pressure index (ABPI)].

    Science.gov (United States)

    Kulisić, Sandra Marinović

    2012-10-01

    Measurement of the ankle-brachial pressure index, also known as ankle-brachial index or ankle-arm index is a ratio of the ankle blood pressure and brachial blood pressure. It is easy to perform and allows for diagnosis and further definition of the severity of peripheral arterial disease with sensitivity 90% and specificity 98%. The test is not appropriate for mild arterial changes as in case of comorbidity. Its further objectives are to identify patients at an higher risk of cardiovascular events. PMID:23193828

  6. Ankle-brachial index in HIV infection

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    Martos Francisco

    2009-04-01

    Full Text Available Abstract Prognosis for patients with the human immunodeficiency virus (HIV has improved with the introduction of highly active antiretroviral therapy (HAART. Evidence over recent years suggests that the incidence of cardiovascular disease is increasing in HIV patients. The ankle-brachial index (ABI is a cheap and easy test that has been validated in the general population. Abnormal ABI values are associated with increased cardiovascular mortality. To date, six series of ABI values in persons with HIV have been published, but none was a prospective study. No agreement exists concerning the risk factors for an abnormal ABI, though its prevalence is clearly higher in these patients than in the general population. Whether this higher prevalence of an abnormal ABI is associated with a higher incidence of vascular events remains to be determined.

  7. Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults

    Science.gov (United States)

    ... Force Recommendations Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults The ... Recommendation | 1 Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with Ankle Brachial Index in Adults Potential ...

  8. Ankle brachial pressure index of normal, healthy, younger adults.

    Science.gov (United States)

    Niblo, Jane; Coull, Alison

    Doppler ultrasound and ankle brachial pressure index (ABPI) calculations are used in the assessment of lower limb vascularity, specifically to determine arterial deficiency. ABPI is important as it is used as an indicator when deciding management options for the treatment of leg ulceration. This study aimed to investigate the range of ABPI measurement, using Doppler ultrasound and sphygmomanometry in 36 young healthy adults aged 18-55 years. The findings show a mean ABPI in the left leg of 1.19 and a mean ABPI of 1.17 in the right leg which, while within the normal range, are consistently in the upper range and significantly higher than the acknowledged 'normal' midpoint of 1.0. It would appear that younger people will have ABPIs within the upper aspect of the normal range and well above the established norm of 1.0. PMID:24151719

  9. Genetic determinants of the ankle-brachial index

    DEFF Research Database (Denmark)

    Wassel, Christina L; Lamina, Claudia; Nambi, Vijay;

    2012-01-01

    Candidate gene association studies for peripheral artery disease (PAD), including subclinical disease assessed with the ankle-brachial index (ABI), have been limited by the modest number of genes examined. We conducted a two stage meta-analysis of ∼50,000 SNPs across ∼2100 candidate genes to...

  10. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  11. Ankle Brachial Pressure Index (ABPI): An update for practitioners

    OpenAIRE

    Al-Qaisi, Mo

    2009-01-01

    Mo Al-Qaisi1, David M Nott1, David H King2, Sam Kaddoura11Imperial College, London, UK; 2Broomfield Hospital, Chelmsford, Essex, UKAbstract: Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. The Ankle Brachial Pressure Index (ABPI) test is widely used by a diverse range of practitioners (in the community and hospital setting) in order to screen asymptomatic patients, diagnose patients with clinic...

  12. Ankle Brachial Pressure Index (ABPI: An update for practitioners

    Directory of Open Access Journals (Sweden)

    Mo Al-Qaisi

    2009-09-01

    Full Text Available Mo Al-Qaisi1, David M Nott1, David H King2, Sam Kaddoura11Imperial College, London, UK; 2Broomfield Hospital, Chelmsford, Essex, UKAbstract: Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. The Ankle Brachial Pressure Index (ABPI test is widely used by a diverse range of practitioners (in the community and hospital setting in order to screen asymptomatic patients, diagnose patients with clinical symptoms, and to monitor patients who have had radiological or surgical intervention. This paper explains the theoretical basis of the ABPI test, as well as the relevance of the common modifications of the test. It explores the background to the quoted normal ranges for the ABPI test. It reviews the large body of literature that has developed on the association between ABPI and cardiovascular risk, as well as ABPI as a predictor for cardiovascular morbidity and mortality, highlighting the evidence that can inform practice. The review looks critically at the limitations of the ABPI test, providing practitioners with an evidence-based update on the importance and challenges of standardizing ABPI methodology. This paper highlights the influence of the key technical aspects of the ABPI test that all practitioners need to consider in order to be able to make more reliable and informed management decisions based on ABPI findings.Keywords: ankle, brachial, pressure, index, ABPI, update

  13. Resting Doppler ankle brachial pressure index measurement: a literature review.

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    Sihlangu, Dorcus; Bliss, Julie

    2012-07-01

    Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Doppler ankle brachial pressure index (ABPI) is effective in diagnosing PVD , aid in determining aetiology of leg ulcers and is cost efficient in reducing the effects of atherosclerosis and cardiovascular events. The aim of this literature review was to review practitioners' experience in using Doppler ABPI, different skills used to measure ABPI and to examine practitioners' confidence in ABPI. The findings identified variation in method for Doppler measurement: including position of the artery, arm measurement, resting period and type of equipment for measuring blood pressure, variations in practitioners' training and experience have demonstrated variability in ABPI results. Although limited in number, the studies have demonstrated knowledge gap, and the need for training among health professionals. PMID:22875182

  14. Cardiovascular Risk Factors and Distributions of the Ankle-Brachial Index among Type 2 Diabetes Mellitus Patients

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    Badaruddoza Doza

    2012-01-01

    Full Text Available Background. The aim of present study is to observe the association between the levels of ankle-brachial index (ABI and cardiovascular risk factors among people with type 2 diabetes mellitus in north India. A cross-sectional study was carried out at a centre for heart and diabetic clinic in the state of Punjab on 1121 subjects (671 males and 450 females with type 2 diabetes mellitus. History of symptoms related to cardiovascular diseases was noted, and blood pressure and anthropometric measurements were recorded. Ankle-brachial index (ABI was measured using ultrasonic Doppler flow detector. Subjects with ABI ≤0.9 and ≥1.30 were classified as having low and high ABI, respectively. Females had a higher BMI and brachial-ankle pulse wave velocity (<0.001. Whereas, males had higher diastolic blood pressure and duration of type 2 diabetes mellitus. The differences of systolic blood pressure and ankle-brachial index were not found significant between the sexes. The prevalence of low ABI (<0.9 was 4.47% in men and 4.67% in women and high ABI (≥1.30 was prevalent in 14% of men and 10.45% of women. Age, BMI, baPWV, and blood pressures were significantly associated with ABI value in both sexes. The results suggested that the ABI might be used as a strong indicator for cardiovascular risk factors in type 2 diabetic subjects.

  15. Lower ankle-brachial index is associated with poor sleep quality in patients with essential hypertension

    OpenAIRE

    Yamaki, Michiyasu; Sato, Toshiaki; Fujii, Hiromi

    2015-01-01

    Background: The ankle-brachial index (ABI), ratio of leg blood pressure to arm blood pressure is used extensively as a screening test for stratification of cardiovascular risk. The problems in sleep disturbed nocturnal fall in blood pressure and may relate to development of hypertension. However, the role of sleep quality on ankle-brachial index remains unclear. Methods and Results: This study examined 101 patients with essential hypertension. We analyzed the association with ABI on age, sex,...

  16. Cardiovascular risk in white coat hypertension: an evaluation of the ankle brachial index.

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    Freitas, Dayana; Toneti, Adrielle Naiara; Cesarino, Evandro José; Desidério, Vagner Luis; Pacca, Sérgio de Figueiredo; Godoy, Simone de; Mendes, Isabel Amélia Costa; Marchi-Alves, Leila Maria

    2014-06-01

    The aim in this study was to identify the cardiovascular risk in patients suffering from white coat hypertension (WCH) by determining the ankle brachial index (ABI) with an automatic oscillometric sphygmomanometer. The study was undertaken in a Brazilian city between August 2010 and June 2011. The study variables were age, ethnic origin, marital status, education level, profession, weight, height, waist circumference, arm and ankle blood pressure (BP), and ABI. Analysis of variance was used for repeated measures and Tukey's test for multiple comparisons of means. The linear relationship between systolic BP levels and ankle brachial indices was verified using Pearson's correlation coefficient. Results were expressed as mean values ± standard errors of means, and differences were considered statistically significant when P < .05. Study participants were 135 subjects, including 37% normotensive, 37% hypertensive (HT), and 26% WCH patients. WCH individuals revealed intermediate risk in the analysis of the clinical variables. Alterations compatible with peripheral obstructive arterial disease and arterial calcification were observed only in the HT and WCH groups. These findings lead to the premise that WCH should not be viewed as a benign condition. The measurement of the ABI should be considered in the clinical approach of patients and professionals should use it as an instrument for cardiovascular risk assessment in routine health care delivery. PMID:24944169

  17. Ankle Brachial Index: simple non-invasive estimation of peripheral artery disease

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    Pieniak, Marcin; Cieślicki, Krzysztof; Żyliński, Marek; Górski, Piotr; Murgrabia, Agnieszka; Cybulski, Gerard

    2014-11-01

    According to international guidelines, patients with Peripheral Artery Disease (PAD) are burdened with high cardiovascular risk. One of the simplest, non-invasive methods for PAD detection is the ankle-brachial index (ABI) measurement. The ABI is calculated as the ratio of systolic blood pressure at the ankle (pressure in the posterior tibial artery or the dorsal artery) to the systolic pressure in the arm (in the brachial artery) when the body is in a horizontal position. The physiological value of the ABI is assumed to be between 1 and 1.3; however, these limits vary from study to study. A value less than 0.9 indicates PAD. Some authors propose also measuring the ABI on both sides of the body to highlight possible differences in blood pressure between the opposite arterial segments. The aim of this study was to perform a meta-analysis of the ABI diagnostic criteria used in different publications. Additionally, ABI measurements were performed on 19 healthy patients in age ranged from 20 to 63 years. The results showed a slight dependence between age and the differences between the values obtained from left and right sides of the body.

  18. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

    OpenAIRE

    Rosenbaum, David; Rodriguez-Carranza, Sandra; Laroche, Patrick; Bruckert, Eric; Giral, Philippe; Girerd, Xavier

    2012-01-01

    Objective To evaluate the accuracy of the ankle brachial index (ABI) measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France), an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation. Methods Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systoli...

  19. Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis

    DEFF Research Database (Denmark)

    Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva;

    2006-01-01

    We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....

  20. Correlation of Arterial Stiffness and Bone Mineral Density by Measuring Brachial-Ankle Pulse Wave Velocity in Healthy Korean Women

    OpenAIRE

    Kim, Nam-Lee; Suh, Heuy-Sun

    2015-01-01

    Background An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup. Methods We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity wa...

  1. Comparison of three measures of the ankle-brachial blood pressure index in a general population

    OpenAIRE

    Pan, Cheng-Rui; Staessen, Jan A.; Li, Yan; Wang, Ji-Guang

    2007-01-01

    The ankle-brachial blood pressure index (ABI) predicts cardiovasular disease. To our knowledge, no study has compared manual ABI measurements with an automated electronic oscillometric method in a population sample. We enrolled 946 residents (50.8% women; mean age, 43.5 years) from 8 villages in JingNing County, Zhejiang Province, P.R. China. We computed ABI as the ratio of ankle-to-arm systolic blood pressures from consecutive auscultatory or Doppler measurements at the posterior tibial and ...

  2. Aging Index using Photoplethysmography for a Healthcare Device: Comparison with Brachial-Ankle Pulse Wave Velocity

    OpenAIRE

    Hong, Kyung Soon; Park, Kyu Tae; Ahn, Jae Mok

    2015-01-01

    Objectives Recent studies have emphasized the potential information embedded in peripheral fingertip photoplethysmogram (PPG) signals for the assessment of arterial wall stiffening during aging. For the discrimination of arterial stiffness with age, the brachial-ankle pulse wave velocity (baPWV) has been widely used in clinical applications. The second derivative of the PPG (acceleration photoplethysmogram [APG]) has been reported to correlate with the presence of atherosclerotic disorders. I...

  3. PREVALENCE OF PERIPHERAL VASCULAR DISEASE IN CHRONIC ALCOHOLICS AS MEASURED BY ANKLE TO BRACHIAL INDEX

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    Raj Bahadur

    2015-08-01

    Full Text Available The ankle - brachial pressure index (ABI, which is the ratio of ankle to brachial systolic blood pressure, is the golden standard for the diagnosis of peripheral arterial disease (PAD and is a highly specific method for the assessment of vascular risk in otherwise asymptomatic patients . ABI value of individual with daily alcohol level >60g/d was significantly lower consumption of less than 60g/d had an inverse association with peripheral atherosclerosis whereas consumption of 60 g/d or more had a positive association. Studies have shown the sensitivity of ABPI is 90% with a corresponding 98% specificity for detecting hemodynamically significant (Serious stenosis >50% in major leg arteries, defined by angiogram. AIMS AND OBJECTIVES : To determine the prevalence of peripheral vascular disease in chronic alcoholics using ankle to brachial index and to compare the values of ankle brachial index in chronic alcoholics with age and sex matched healthy controls. MATERIALS AND METHODS : In the present study, 50 cases consuming more than 60gm of absolute alcohol per day for more than 12 months attending out p atient department and admitted were enrolled. 50 age and sex matched healthy controls who have never consumed alcohol (never drinkers were also enrolled . After taking detailed history using Doppler ultrasound blood flow detector mean systolic pressure in upper limb and lower limb was calculated and then the mean ABI was calculated. This value was then compared with variables like LDL levels, Triglycerides levels, age, clinical symptoms of PVD, alcohol consumption amount and duration. RESULTS: It was observed that mean ABI was significantly lower (<0.9 in 11(22% cases and majority of them were between age group of 41 - 50 years. Of these only 7(14% showed clinical symptoms of PVD. The prevalence of PVD was 66% in those who consumed 61 - 70 grams alcohol per day for around 6 - 10 years. Results were found to be statistically significant. CONCLUSION

  4. [Ankle-brachial pressure index as a predictor of future cardiovascular outcomes].

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    Topalusić, Iva; Valpotić, Ina; Marković, Asja Stipić

    2012-10-01

    Peripheral arterial occlusive disease is very common in the general population and it is mostly of atherosclerotic origin. About 50%-75% of patients are asymptomatic. Many studies have shown the ankle-brachial pressure index (ABPI) to be a simple and reliable test with high sensitivity (90%) and specificity (98%) in the diagnosis of hemodynamically relevant stenosis of an arterial segment and also in detection of asymptomatic patients. The values of ABPI ABPI > 1.40 is associated with arterial calcification and wall stiffening. This test is highly specific (92.7%) in predicting future cardiovascular and cerebrovascular risk and could provide a tool for more focused prevention strategies. PMID:23814974

  5. Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

    OpenAIRE

    Zhou, Fang; Zhang, Haifeng; Yao, Wenming; Mei, Hongbin; Xu, Dongjie; Sheng, Yanhui; Yang, Rong; Kong, Xiangqing; Wang, Liansheng; Zou, Jiangang; Yang, Zhijian; Li, Xinli

    2014-01-01

    Abstract The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity (baPWV), and the presence of the metabolic syndrome (MS) in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in our study population was 21.7%, 17.2% and 25.6% for the general population, males and females, respectively. With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density l...

  6. Die Variabilität des Ankle-Brachial-Index (ABI)

    OpenAIRE

    Groh, Sabine

    2009-01-01

    Die Reliabilität des Knöchel- Arm- Index (Ankle- Brachial- Index, ABI) unter den Bedingungen der täglichen Praxis war bislang noch unklar. Das Ziel dieser Studie war eine genaue Einschätzung aller Faktoren, die die Variabilität des ABI beeinflussen. Drei Untersuchergruppen mit unterschiedlicher Qualifikation führten Messungen durch. Um die Reliabilität zu beurteilen, wurden die Intra- Observer- Variabilität, die Inter- Observer- Variabilität sowie die wahre Differenz des ABI zwisc...

  7. Rheumatoid Arthritis and the Ankle-Brachial Pressure Index: Any Association?

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    Asso Fraidoon

    2014-02-01

    Full Text Available Purpose: Several studies tried to assess the influence of rheumatoid arthritis (RA on peripheral arteries and found an association with later development of intimal thickness and atherosclerosis. We tried to uncover the prevalence of subclinical peripheral vascular disease (PVD in rheumatoid arthritis patients. Materials and Methods: This case control-study had involved sixty patients who were diagnosed with rheumatoid. Forty age, gender, and body mass index-matched healthy individuals were selected as the control group. All participants were non-smokers, non-hypertensive, and non-diabetics and had a normal lipid profile. The presence of peripheral arterial disease was evaluated by measuring the ankle-brachial pressure index (ABPI at the level of each artery of the lower limbs. An index of ≤0.9 was considered abnormal and a possible reflection of an underlying PVD. Results: Twenty three (38% out of the 60 RA patients demonstrated one or more abnormal arteries while only 3 (7.5% out of the 40 control individuals had abnormal results (p-value <0.001. A statistically significant association was noted between abnormal ABPI and RA disease severity as indicated by C-reactive protein (P-value <0.003, ESR (P-value <0.002, and positive serum rheumatoid factor (P-value <0.01. However, age, gender, and disease duration showed no link with abnormal ABPI. Conclusion: A higher prevalence of abnormal ABPI, and hence a possible higher incidence of subclinical atherosclerosis, was found in patients with RA. Further analytic studies are required to assess the relationship of RA with PVD.

  8. ANKLE-BRACHIAL INDEX AND LDL-RECEPTOR GENE IN ASYMPTOMATIC SEVERE HYPERCHOLESTEROLEMIA

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    L. Vladimirova-Kitova

    2011-08-01

    Full Text Available The issue with the different levels of ankle-brachial index, as screening for LDL-receptor defective gene in newly detected asymptomatic severe hypercholesterolemia is less studied, but quite interesting. There have not been any studies on ankle-brachial index in patients with severe hypercholesterolemia in Bulgaria. Aim: To examine the difference between patients with severe hypercholesterolemia, who are carriers and non-carriers of LDL-R defective gene, with respect to their structural (ankle-brachial index characteristics of arterial wall. Methods and materials: 60 patients with documented severe hypercholesterolemia >7.5 mmol/l satisfying the Simon-Broom criteria for clinically established and probable Familial Hypercholesterolemia were studied. All of the patients had a negative stress echocardiography and not known coronary artery disease. The laboratory used was the Clinical Laboratory at the Medical University Plovdiv. The total cholesterol and triglycerides were measured with enzyme-colorimetry and cholesterol in high density lipoprotein and cholesterol in low density lipoprotein with direct automatic analyses. Apolipoproteins were calculated by immunoturbodimetric method. The biochemical analyzer Konelab 60i was used in all the measurements. Results: According to whether there were or were not molecular defects, patients were assigned to two groups: carriers (11 patients, 18 % and non-carriers (49 patients, 82 %.There was a statistically significant difference (p 0.05. We found no statistically significant difference between non-carriers and carriers with respect to body mass index (25.30 ± 0.40 vs 24.63 ± 0.45, respectively, t = 0.50; p > 0.05. There was not a statistically significant difference in levels of total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol between carries (p>0.05. The cholesterol x years. score was significantly higher in the carries (440.36 ± 0.25 mmol-y/L, than in the non-carries (390.30 ± 0

  9. The variability of ankle-arm blood pressure difference and ankle-brachial index in treated hypertensive patients.

    Science.gov (United States)

    Cao, Kaiwu; Xu, Jinsong; Sun, Hanjun; Li, Ping; Li, Juxiang; Cheng, Xiaoshu; Su, Hai

    2014-10-01

    The purpose of this study was to investigate whether ankle-arm blood pressure (BP) difference (An-a) and ankle-brachial index (ABI) are consistent in treated hypertensive patients with obvious BP variation. This study enrolled 414 hypertensive patients (200 males; mean age, 61.3 ± 13.3 years) admitted to our hospital. BP of four limbs was simultaneously measured using four automatic BP measurement devices on the day of admission, and three and six day after admission. The An-a differences on systolic BP (SBP), diastolic BP (DBP), mean artery pressure (MAP), and pulse pressure (PP) in both sides were calculated, respectively. The relative decrease amplitude (RDA) of BP was calculated using the formula: RDA = (BP1 - BPn)/BP1. The ABI of the right side was calculated. From the first to the third measurement, arm SBP and DBP levels of both arms significantly decreased (right arm: SBP: 163.7 ± 18.4, 147.7 ± 15.3 vs. 135.4 ± 11.7 mm Hg; P ankle SBP (right ankle: 182.1 ± 22.1, 147.7 ± 15.3 vs. 153.4 ± 16.6 mm Hg; P < .05) and DBP (84.8 ± 13.4, 79.9 ± 11.6 vs. 75.8 ± 9.8 mm Hg; P < .05) of both sides also significantly decreased. The mean An-a of three measurements of both sides was consistent at the levels of about 20 mm Hg on SBP and PP, 7 mm Hg on MAP, and 0 mm Hg on DBP. However, sABI gradually increased from the first to the third measurement.In treated hypertensive patients, the An-a differences on SBP, DBP, PP, and MAP are generally consistent, but sABI is associated with underlying SBP levels. PMID:25418490

  10. A correlation study between ankle brachial pressure index and the severity of coronary artery disease.

    Science.gov (United States)

    Benyakorn, Thoetphum; Kuanprasert, Sarun; Rerkasem, Kittipan

    2012-06-01

    Previous studies have shown that there was a correlation between low ankle brachial pressure index (ABPI) and the presence of the coronary artery disease (CAD). However, few studies have investigated the correlation between ABPI and the severity of CAD by using a scoring system. The authors aimed to investigate this correlation by using ABPI and CAD diagnosed by coronary angiography (CAG). A total of 213 consecutive patients awaiting CAG in Maharaj Nakorn Chiang Mai Hospital from July 2009 to November 2009 were enrolled in this study. The ABPI was measured before CAG. The severity of CAD was graded on CAG by using SYNTAX scores. The authors found a significantly negative correlation between ABPI and SYNTAX scores (correlation coefficient = -.172, P = .01). The authors concluded that ABPI appeared to correlate negatively with the severity of CAD in the Thai population. PMID:22561522

  11. Perceptions of the ankle brachial index amongst podiatrists registered in Western Australia

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    Chen Pamela Y

    2012-07-01

    Full Text Available Abstract Background The ankle brachial index (ABI is an objective diagnostic tool that is widely used for the diagnosis of peripheral arterial disease. Despite its usefulness, it is evident within the literature that many practitioners forgo using this screening tool due to limiting factors such as time. There is also no recommended technique for ABI measurement. The purpose of this study is to investigate the perceptions of the use of ABI clinically among Western Australian podiatrists. Methods This study was a cross sectional survey which evaluated the perceptions of the ABI amongst registered podiatrists in Western Australia. The study sample was obtained from the register of podiatrists listed with the Podiatrists Registration Board of Western Australia. Podiatrists were contacted by telephone and invited to participate in a telephone questionnaire. Chi-square tests were performed to determine if there was a statistically significant relationship between use of the ABI and podiatrists’ profile which included: sector of employment; geographical location; and length of time in practice. Results There is a statistically significant relationship (p=0.004 between podiatrists’ profile and the use of ABI, with higher usage in the tertiary hospital setting than in private practice. Length of time spent in practice had no significant impact on ABI usage (p=0.098. Time constraints and lack of equipment were key limiting factors to performing the ABI, and no preferred technique was indicated. Conclusion Western Australian podiatrists agree that the ABI is a useful tool for lower limb vascular assessment, however, various factors influence uptake in the clinical setting. This study suggests that a podiatrists’ profile has a significant influence on the use of the ABI, which may be attributed to different patient types across the various settings. The influence of time spent in practice on ABI usage may be attributed to differences in clinical

  12. The reliability of the ankle-brachial index in the Atherosclerosis Risk in Communities (ARIC) study and the NHLBI Family Heart Study (FHS)

    OpenAIRE

    Catellier Diane J; Heiss Gerardo; Chambless Lloyd E; Weatherley Beth D; Ellison Curtis R

    2006-01-01

    Abstract Background A low ankle-brachial index (ABI) is associated with increased risk of coronary heart disease, stroke, and death. Regression model parameter estimates may be biased due to measurement error when the ABI is included as a predictor in regression models, but may be corrected if the reliability coefficient, R, is known. The R for the ABI computed from DINAMAP™ readings of the ankle and brachial SBP is not known. Methods A total of 119 participants in both the Atherosclerosis Ri...

  13. Atypical leg symptoms: does routine measurement of the ankle brachial pressure index (ABPI) in primary care benefit patients?

    OpenAIRE

    Oesterling, Christine; Kalia, Amun; Chetcuti, Thomas; Walker, Steven

    2015-01-01

    Abstract Background : Managing patients with atypical leg symptoms in primary care can be problematic. Determining the ankle brachial pressure index (ABPI) may be readily performed to help diagnose peripheral arterial disease, but is often omitted where signs and symptoms are unclear. Question : Does routine measurement of ABPI in patients with atypical leg symptoms aid management increase satisfaction and safely reduce hospital referral? Methodology : Patients with atypical leg symptoms but ...

  14. The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

    OpenAIRE

    Sadeghi, Masoumeh; Tavasoli, Aliakbar; Roohafza, Hamidreza; Sarrafzadegan, Nizal

    2010-01-01

    BACKGROUND Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina. METHODS This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic informatio...

  15. The Relationship among Pulse Wave Velocity, Ankle-Brachial Pressure Index and Heart Rate Variability in Adult Males

    OpenAIRE

    Ahn, Jeong-Hwan; Kong, Mihee

    2011-01-01

    Background Pulse wave velocity (PWV) and ankle-brachial pressure index (ABI) are non-invasive tools to measure atherosclerosis and arterial stiffness. Heart rate variability (HRV) has proven to be a non-invasive powerful tool in the investigation of the autonomic cardiovascular control. Therefore, the purpose of this study was to determine the relationship among PWV, ABI, and HRV parameters in adult males. Methods The study was carried out with 117 males who visited a health care center from ...

  16. Oxidized low-density lipoprotein and ankle-brachial pressure index in patients with clinically evident peripheral arterial disease

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    Ruben Miguel Ayzin Rosoky

    2010-01-01

    Full Text Available OBJECTIVES: To investigate whether oxidized low-density lipoprotein is a suitable predictor of peripheral arterial disease severity. The role of oxidized low-density lipoprotein in the pathogenesis of atherosclerosis has already been investigated. Its relevance as a predictor of the appearance and worsening of coronary arterial disease is also well known. However, the same is not true regarding peripheral arterial disease. METHOD: Eighty-five consecutive patients with an ankle-brachial pressure index (ABPI < 0.9 and the presence of either intermittent claudication or critical lower leg ischemia were included. The plasma level of IgG autoantibodies against oxidized low-density lipoprotein was evaluated through an enzyme-linked immunosorbent assay. The results were categorized into quartiles according to the ankle-brachial pressure index (a marker of peripheral arterial disease severity, and significant differences were investigated with the Kruskal-Wallis test. RESULTS: There was no significant difference between the quartiles for this population (p = 0.33. No correlation was found between the ankle-brachial pressure index and oxidized low-density lipoprotein levels in subjects with clinically evident peripheral arterial disease with a wide range of clinical manifestations. CONCLUSIONS: Oxidized low-density lipoprotein is not a good predictor of peripheral arterial disease severity.

  17. Relationships between Brachial-Ankle Pulse Wave Velocity and Peripheral Neuropathy in Type 2 Diabetes

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    Byung Kil Ha

    2012-12-01

    Full Text Available BackgroundBrachial-ankle pulse wave velocity (baPWV is known to be a good surrogate marker of clinical atherosclerosis. Atherosclerosis is a major predictor for developing neuropathy. The goal of this study was to determine the relationship between baPWV and diabetic peripheral neuropathy (DPN in patients with type 2 diabetes.MethodsA retrospective cross-sectional study was conducted involving 692 patients with type 2 diabetes. The correlation between increased baPWV and DPN, neurological symptoms, and neurological assessment was analyzed. DPN was examined using the total symptom score (TSS, ankle reflexes, the vibration test, and the 10-g monofilament test. DPN was defined as TSS ≥2 and an abnormal neurological assessment. Data were expressed as means±standard deviation for normally distributed data and as median (interquartile range for non-normally distributed data. Independent t-tests or chi-square tests were used to make comparisons between groups, and a multiple logistic regression test was used to evaluate independent predictors of DPN. The Mantel-Haenszel chi-square test was used to adjust for age.ResultsPatients with DPN had higher baPWV and systolic blood pressure, and were more likely to be older and female, when compared to the control group. According to univariate analysis of risk factors for DPN, the odds ratio of the baPWV ≥1,600 cm/sec was 1.611 (95% confidence interval [CI], 1.072 to 2.422; P=0.021 and the odds ratio in female was 1.816 (95% CI, 1.195 to 2.760; P=0.005.ConclusionIncreased baPWV was significantly correlated with peripheral neuropathy in patients with type 2 diabetes.

  18. Importance of the ankle-brachial pressure index in the diagnosis of coronary artery disease in women with diabetes without anginal pain

    International Nuclear Information System (INIS)

    Clinical symptoms of coronary artery disease (CAD) are often atypical in women, particularly in those with diabetes mellitus. Therefore, a simple diagnostic test to identify a high-risk subset of women with diabetes who are likely to have CAD is important. A total of 407 consecutive patients (319 men and 88 women, age range 68±11 years) with suspected CAD, who were not complaining of anginal pain, were evaluated. Among these patients, 170 had diabetes. Stress myocardial perfusion imaging and simultaneous brachial and ankle blood pressure measurements were performed to obtain the ischemic total perfusion deficit (TPD) and ankle-brachial pressure index (ABI), respectively. Ischemic TPD was not significantly different between men and women, whereas ischemic TPD was significantly greater in diabetic patients than in non-diabetic patients (6.9±7.7% vs. 4.9±6.1%; P=0.005). In diabetic patients, ischemic TPD was not significantly different between men and women. However, women with ABI 10%, which is regarded as a scintigraphic indicator for coronary revascularization. (author)

  19. Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population?

    Institute of Scientific and Technical Information of China (English)

    Li Xin; Zheng Liang; Wu Juanli; Ma Yunsheng; Masanori Munakata; Oleski Jessica; Zhang Lijuan

    2014-01-01

    Background The prevalence of metabolic syndrome (MetS) increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity (baPVVV),a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation (IDF).Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic (ROC) curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was (45.35±8.27) years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences (X2=96.46,P <0.05) between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s (AUC=60.20%) to predict MetS among male group and 1 350.00 cm/s (AUC=70.90%) among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

  20. Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis.

    Science.gov (United States)

    Verberk, Willem J; Kollias, Anastasios; Stergiou, George S

    2012-09-01

    Measurement of the ankle-brachial index (ABI) using a Doppler device is widely used to identify subjects with peripheral artery disease (PAD), and those who are at high risk of cardiovascular disease. This paper presents a systematic review (Medline/PubMed, Embase and Cochrane) and meta-analysis of studies assessing the usefulness of automated oscillometric devices for ABI estimation and PAD detection compared with the conventional Doppler method. A total of 25 studies including 4186 subjects were analyzed. A random-effects model analysis showed that the average oscillometric ABI was similar to the Doppler ABI (mean difference ± s.e. 0.020 ± 0.018, P=0.3) but that the absolute differences were significant (0.048 ± 0.009, Parm-leg measurements resulted in a smaller difference between the average oscillometric ABI value and the average Doppler ABI value than did sequential measurements (-0.012 ± 0.022 vs. 0.040 ± 0.026, respectively, P<0.01). The average sensitivity and specificity of the oscillometric ABI estimation in PAD diagnosis was 69 ± 6% and 96 ± 1%, respectively (with Doppler ABI taken as the reference). These data suggest that an automated ABI measurement obtained by oscillometric blood pressure monitors is a reliable and practical alternative to the conventional Doppler measurement for the detection of PAD. To increase the sensitivity of the PAD diagnosis based on an oscillometric ABI, a higher threshold of 1.0 might be preferable. PMID:22739420

  1. Ankle-Brachial Index as a Prognostic Factor and Screening Tool in Coronary Artery Disease: Does it Work?

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    Zinat Nadia-Hatmi

    2015-10-01

    Full Text Available Background: Given the lack of consistency in the literature regarding the reliability of the ankle-brachial index (ABI as a valid screening tool and an independent risk indicator of cardiovascular events and mortality, we compared it with angiography as a reference standard test.Methods: This case-control study, conducted between 2010 and 2011 in Tehran Heart Center, recruited 362 angiographically confirmed cases of coronary artery disease (CAD and 337 controls. A standard protocol was used to measure the ABI and different CAD risk factors.Results: A low ABI had specificity of 99.7%, positive predictive value of 95.8%, negative predictive value of 49.8%, sensitivity of 64%, likelihood ratio of 24.07, and odds ratio (OR of 22.79 (95%CI: 3.06-69.76. The role of the associated risk factors was evaluated with OR (95%CI, with the variables including gender 3.15 (2.30-4.30, cigarette smoking 2.72 (1.86-3.99, family history 1.72 (1.17-2.51, diabetes 1.66 (1.15-2.4, and dyslipidemia 1.38 (1.02-1.88. In a multivariate model, the following variables remained statistically significantly correlated with CAD [OR (95%CI]: ABI 13.86 (1.78-17.62; gender 3.69 (2.43- 5.58; family history of CAD 2.18 (1.41-3.37; smoking 1.69 (1.08-2.64; age 1.04 (1.02-1.06.Conclusions: A low ABI had specificity of 99.7%; however, because of its low sensitivity (64%, we should consider CAD risk factors associated with a low ABI in order to use it as a first-line screening test.

  2. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

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    Rosenbaum D

    2012-04-01

    Full Text Available David Rosenbaum1,2, Sandra Rodriguez-Carranza1,3, Patrick Laroche4, Eric Bruckert1,2, Philippe Giral1,2, Xavier Girerd1,21Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière – Université Pierre et Marie Curie, 2Dyslipoproteinemia and Atherosclerosis Research Unit, National Institute for Health and Medical Research (INSERM and Pierre et Marie Curie University (UPMC – Paris VI, Paris, France; 3Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Endocrinología y Metabolismo, Delegación Tlalpan, México Distrito Federal; 4STACTIS, Paris, FranceObjective: To evaluate the accuracy of the ankle brachial index (ABI measured with the SCVL® (“screening cardiovascular lab”; GenNov, Paris, France, an automated device with synchronized arm and ankle cuffs with an automatic ABI calculation.Methods: Patients were consecutively included in a cardiovascular prevention unit if they presented with at least two cardiovascular risk factors. ABI measurements were made using the SCVL, following a synchronized assessment of brachial and ankle systolic pressure. These values were compared to the ABI obtained with the usual Doppler-assisted method.Results: We included 157 patients. Mean age was 59.1 years, 56.8% had hypertension, 22.3% had diabetes mellitus, and 17.6% were current smokers. An abnormal ABI was observed in 17.2% with the SCVL and in 16.2% with the Doppler. The prevalence rates of an abnormal ABI by patient measured with each device, ie, 15.7% (confidence interval [CI] 0.95: [11.8; 20.4] or 14.3% (CI 0.95: [10.7; 18.9], did not differ. The coefficient of variation of Doppler and SCVL measures was 15.8% and 15.1%, respectively. The regression line between the two measurement methods was statistically significant. The value-to-value comparison also shows a difference of mean equal to 0.010 (CI 0.95: [–0

  3. Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease

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    Allenberg Jens R

    2007-07-01

    Full Text Available Abstract Background The ankle brachial index (ABI is an efficient tool for objectively documenting the presence of lower extremity peripheral arterial disease (PAD. However, different methods exist for ABI calculation, which might result in varying PAD prevalence estimates. To address this question, we compared five different methods of ABI calculation using Doppler ultrasound in 6,880 consecutive, unselected primary care patients ≥65 years in the observational getABI study. Methods In all calculations, the average systolic pressure of the right and left brachial artery was used as the denominator (however, in case of discrepancies of ≥10 mmHg, the higher reading was used. As nominators, the following pressures were used: the highest arterial ankle pressure of each leg (method #1, the lowest pressure (#2, only the systolic pressure of the tibial posterior artery (#3, only the systolic pressure of the tibial anterior artery (#4, and the systolic pressure of the tibial posterior artery after exercise (#5. An ABI Results The estimated prevalence of PAD was lowest using method #1 (18.0% and highest using method #2 (34.5%, while the differences in methods #3–#5 were less pronounced. Method #1 resulted in the most accurate estimation of PAD prevalence in the general population. Using the different approaches, the odds ratio for the association of PAD and cardiovascular (CV events varied between 1.7 and 2.2. Conclusion The data demonstrate that different methods for ABI determination clearly affect the estimation of PAD prevalence, but not substantially the strength of the associations between PAD and CV events. Nonetheless, to achieve improved comparability among different studies, one mode of calculation should be universally applied, preferentially method #1.

  4. Association of Brachial-Ankle Pulse Wave Velocity and Cardiomegaly With Aortic Arch Calcification in Patients on Hemodialysis.

    Science.gov (United States)

    Shin, Ming-Chen Paul; Lee, Mei-Yueh; Huang, Jiun-Chi; Tsai, Yi-Chun; Chen, Jui-Hsin; Chen, Szu-Chia; Chang, Jer-Ming; Chen, Hung-Chun

    2016-05-01

    Aortic arch calcification (AoAC) is associated with cardiovascular and all-cause mortality in end-stage renal disease population. AoAC can be simply estimated with an AoAC score using plain chest radiography. The objective of this study is to evaluate the association of AoAC with brachial-ankle pulse wave velocity (baPWV) and cardiomegaly in patients who have undergoing hemodialysis (HD).We retrospectively determined AoAC and cardiothoracic ratio (CTR) by chest x-ray in 220 HD patients who underwent the measurement of baPWV. The values of baPWV were measured by an ankle-brachial index-form device. Multiple stepwise logistic regression analysis was used to identify the factors associated with AoAC score >4.Compared patients with AoAC score ≦4, patients with AoAC score >4 had older age, higher prevalence of diabetes and cerebrovascular disease, lower diastolic blood pressure, higher baPWV, higher CTR, higher prevalence of CTR ≧50%, lower total cholesterol, and lower creatinine level. After the multivariate stepwise logistic analysis, old age, cerebrovascular disease, high baPWV (per 100 cm/s, odds ratio [OR] 1.065, 95% confidence interval [CI] 1.003-1.129, P = 0.038), CTR (per 1%, OR 1.116, 95% CI 1.046-1.191, P = 0.001), and low total cholesterol level were independently associated with AoAC score >4.Our study demonstrated AoAC severity was associated with high baPWV and high CTR in patients with HD. Therefore, we suggest that evaluating AoAC on plain chest radiography may be a simple and inexpensive method for detecting arterial stiffness in HD patients. PMID:27175684

  5. Fysiologisten muuttujien vaikutus ja mittaustulosten välinen toistettavuus cardio-ankle vascular - & ankle-brachial indeksien mittaustuloksissa

    OpenAIRE

    Kantell, Niina

    2010-01-01

    Valtimojäykkyys on yksi tärkeä iäkkään väestön sydän- ja verisuonisairauksien riskitekijä, jonka yhtenä ilmenemismuotona on ateroskleroosi eli valtimonkovetustauti. Ateroskleroosin hoitamisen, diagnosoinnin ja sen estämisen kehittäminen ovat tulevaisuuden haasteita suurien sukupolvien ikään-tyessä, ja sen havainnoimiseen onkin kehitetty uusi laskennallinen indeksi, cardio-ankle vascular index eli CAVI-indeksi, joka perustuu jäykkyysparametri β:n, β = In(Ps/Pd)x(D/∆D), ja on riippumaton verenp...

  6. THE EFFECT OF REGULAR EXERCISE TRAINING DURING PREGNANCY ON POSTPARTUM BRACHIAL-ANKLE PULSE WAVE VELOCITY, A MEASURE OF ARTERIAL STIFFNESS

    OpenAIRE

    Ikuno Kawabata; Akihito Nakai; Atsuko Sekiguchi; Yuko Inoue; Toshiyuki Takeshita

    2012-01-01

    The aim of our study was to use brachial-ankle pulse wave velocity (baPWV) measurements to noninvasively assess the effect of exercise training on arterial stiffness in normal pregnant women. Arterial stiffness was assessed at the beginning of the early second trimester of pregnancy and 1 month after delivery in 17 women with normal singleton pregnancies who exercised regularly throughout pregnancy: 81 matched controls were used for comparison. No significant differences were observed in baPW...

  7. The reliability of the ankle-brachial index in the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS

    Directory of Open Access Journals (Sweden)

    Catellier Diane J

    2006-02-01

    Full Text Available Abstract Background A low ankle-brachial index (ABI is associated with increased risk of coronary heart disease, stroke, and death. Regression model parameter estimates may be biased due to measurement error when the ABI is included as a predictor in regression models, but may be corrected if the reliability coefficient, R, is known. The R for the ABI computed from DINAMAP™ readings of the ankle and brachial SBP is not known. Methods A total of 119 participants in both the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS had repeat ABIs taken within 1 year, using a common protocol, automated oscillometric blood pressure measurement devices, and technician pool. Results The estimated reliability coefficient for the ankle systolic blood pressure (SBP was 0.68 (95% CI: 0.57, 0.77 and for the brachial SBP was 0.74 (95% CI: 0.62, 0.83. The reliability for the ABI based on single ankle and arm SBPs was 0.61 (95% CI: 0.50, 0.70 and the reliability of the ABI computed as the ratio of the average of two ankle SBPs to two arm SBPs was estimated from simulated data as 0.70. Conclusion These reliability estimates may be used to obtain unbiased parameter estimates if the ABI is included in regression models. Our results suggest the need for repeated measures of the ABI in clinical practice, preferably within visits and also over time, before diagnosing peripheral artery disease and before making therapeutic decisions.

  8. Association of Ankle-Brachial Index and Aortic Arch Calcification with Overall and Cardiovascular Mortality in Hemodialysis

    Science.gov (United States)

    Chen, Szu-Chia; Lee, Mei-Yueh; Huang, Jiun-Chi; Shih, Ming-Chen Paul; Chang, Jer-Ming; Chen, Hung-Chun

    2016-01-01

    Peripheral artery occlusive disease and vascular calcification are highly prevalent in hemodialysis (HD) patients, however the association of the combination of ankle-brachial index (ABI) and aortic arch calcification (AoAC) with clinical outcomes in patients undergoing HD is unknown. In this study, we investigated whether the combination of ABI and AoAC is independently associated with overall and cardiovascular mortality in HD patients. The median follow-up period was 5.7 years. Calcification of the aortic arch was assessed by chest X-ray. Forty-seven patients died including 24 due to cardiovascular causes during the follow-up period. The study patients were stratified into four groups according to an ABI 4 or ≤4 according to receiver operating characteristic curve. Those with an ABI  4 (vs. ABI ≥ 0.95 and AoAC score ≤ 4) were associated with overall (hazard ratio [HR], 4.913; 95% confidence interval [CI], 1.932 to 12.497; p = 0.001) and cardiovascular (HR, 3.531; 95% CI, 1.070 to 11.652; p = 0.038) mortality in multivariable analysis. The combination of a low ABI and increased AoAC was associated with increased overall and cardiovascular mortality in patients undergoing HD. PMID:27608939

  9. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease.

    Science.gov (United States)

    Je, Hyung Gon; Kim, Bo Hyun; Cho, Kyoung Im; Jang, Jae Sik; Park, Yong Hyun; Spertus, John

    2015-01-01

    Improvement in quality of life (QoL) is a primary treatment goal for patients with peripheral arterial disease (PAD). The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ) and ankle-brachial index (ABI), and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p's PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization. PMID:25993299

  10. Correlation between Patient-Reported Symptoms and Ankle-Brachial Index after Revascularization for Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hyung Gon Je

    2015-05-01

    Full Text Available Improvement in quality of life (QoL is a primary treatment goal for patients with peripheral arterial disease (PAD. The current study aimed to quantify improvement in the health status of PAD patients following peripheral revascularization using the peripheral artery questionnaire (PAQ and ankle-brachial index (ABI, and to evaluate possible correlation between the two methods. The PAQ and ABI were assessed in 149 symptomatic PAD patients before, and three months after peripheral revascularization. Mean PAQ summary scores improved significantly three months after revascularization (+49.3 ± 15 points, p < 0.001. PAQ scores relating to patient symptoms showed the largest improvement following revascularization. The smallest increases were seen in reported treatment satisfaction (all p’s < 0.001. As expected the ABI of treated limbs showed significant improvement post-revascularization (p < 0.001. ABI after revascularization correlated with patient-reported changes in the physical function and QoL domains of the PAQ. Twenty-two percent of PAD patients were identified as having a poor response to revascularization (increase in ABI < 0.15. Interestingly, poor responders reported improvement in symptoms on the PAQ, although this was less marked than in patients with an increase in ABI > 0.15 following revascularization. In conclusion, data from the current study suggest a significant correlation between improvement in patient-reported outcomes assessed by PAQ and ABI in symptomatic PAD patients undergoing peripheral revascularization.

  11. Índice tornozelo-braço em pacientes hemodialíticos Ankle-brachial index in hemodialysis patients

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    Mariane Torres Uchôa

    2012-12-01

    . The ankle-brachial index was calculated for each artery of the lower limb. It was considered normal ankle-brachial index from 0.9 to 1.3. RESULTS: We diagnosed peripheral arterial disease and poorly compressible arteries in 26.9 and 30.8% of hemodialysis patients and in 33 and 22.7% of the Control Group. In hemodialysis patients, we found abnormal ankle-brachial index in 75% of symptomatic patients (p=0.005, in 67.3% of men and 31% of women (p<0.005, in 78.6% of the elderly, 34.8% of young adults (p<0.01, and 76.9% of diabetics (p<0.005 versus nondiabetic. These patients had a higher prevalence of severe peripheral arterial disease than the Control Group. CONCLUSIONS: Abnormal ankle-brachial index was very prevalent in the groups studied; however, hemodialysis patients had more severe changes, when compared to the Control Group. Diabetes mellitus, male gender, and advanced age were important risk factors for abnormal ankle-brachial index in hemodialysis patients. The ankle-brachial index was a good method of screening for the studied changes; therefore, we suggest the routine use in the management of hemodialysis patients.

  12. Effects of Levocarnitine on Brachial-Ankle Pulse Wave Velocity in Hemodialysis Patients: A Randomized Controlled Trial

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    Terumi Higuchi

    2014-12-01

    Full Text Available Background and Aims: Atherosclerotic cardiovascular disease is the most common cause of mortality in patients with end-stage kidney disease. Chronic kidney disease patients often exhibit a deficiency in l-carnitine due to loss during hemodialysis (HD. We studied the effects of l-carnitine supplementation on brachial-ankle pulse wave velocity (baPWV, a marker of atherosclerosis, in HD patients. Methods: This was a prospective, open-label, randomized, parallel controlled, multi-center trial testing the anti-atherosclerotic efficacy of oral l-carnitine administration (20 mg/kg/day. HD patients (n = 176, mean age, 67.2 ± 10.3 years old; mean duration of HD, 54 ± 51 months with plasma free l-carnitine deficiency (<40 μmol/L were randomly assigned to the oral l-carnitine group (n = 88 or control group (n = 88 and monitored during 12 months of treatment. Results: There were no significant differences in baseline clinical variables between the l-carnitine and control groups. l-carnitine supplementation for 12 months significantly increased total, free, and acyl carnitine levels, and reduced the acyl/free carnitine ratio. The baPWV value decreased from 2085 ± 478 cm/s at baseline to 1972 ± 440 cm/s after six months (p < 0.05 to 1933 ± 363 cm/s after 12 months (p < 0.001 of l-carnitine administration, while no significant changes in baPWV were observed in the control group. Baseline baPWV was the only factor significantly correlated with the decrease in baPWV. Conclusions: l-carnitine supplementation significantly reduced baPWV in HD patients. l-carnitine may be a novel therapeutic strategy for preventing the progression of atherosclerotic cardiovascular disease.

  13. Serum Thyrotropin Concentrations Are Not Associated with the Ankle-Brachial Index: Results from Three Population-Based Studies

    Science.gov (United States)

    Ittermann, Till; Lorbeer, Roberto; Tiller, Daniel; Lehmphul, Ina; Kluttig, Alexander; Felix, Stephan B.; Werdan, Karl; Greiser, Karin Halina; Köhrle, Josef; Völzke, Henry; Dörr, Marcus

    2015-01-01

    Background There is only limited data on the potential association between thyroid dysfunction and peripheral arterial disease (PAD). Objective The aim of our study was to investigate the potential association of thyroid function, as defined by serum concentrations of the clinically used primary thyroid function marker thyrotropin [i.e. thyroid-stimulating hormone (TSH)] and 3,5-diiodothyronine (3,5-T2), with the ankle-brachial index (ABI) as a marker of PAD. Methods We used data from 5,818 individuals from three cross-sectional population-based studies conducted in Northeast (SHIP-2 and SHIP-TREND) and Central Germany (CARLA). Measurement of serum TSH concentrations was conducted in one central laboratory for all three studies. In a randomly selected subpopulation of 750 individuals of SHIP-TREND, serum 3,5-T2 concentrations were measured with a recently developed immunoassay. ABI was measured either by a hand-held Doppler ultrasound using the Huntleigh Dopplex D900 or palpatorily by the OMRON HEM-705CP device. Results Serum TSH concentrations were not significantly associated with ABI values in any of the three studies. Likewise, groups of individuals with a TSH <0.3 mIU/l or with a TSH ≥3.0 mIU/l had no significantly different ABI values in comparison with individuals with a TSH in the reference range. Analyses regarding TSH within the reference range or serum 3,5-T2 concentrations did not reveal consistent significant associations with the ABI. No sex-specific associations were detected. Conclusions The results of our study do not substantiate evidence for an association between thyroid function and PAD, but further studies are needed to investigate the associations of overt forms of thyroid dysfunction with PAD. PMID:26601080

  14. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  15. Relationship Between Earlobe Crease and Brachial-ankle Pulse Wave Velocity in Non-hypertensive, Non-diabetic Adults in Korea

    OpenAIRE

    Choi, Sang In; Kang, Hee Cheol; Kim, Choon Ok; Lee, Seung Beom; Hwang, Won Ju; Kang, Dae Ryong

    2009-01-01

    OBJECTIVES Several studies have found a significant association between the presence of earlobe crease (ELC) and cardiovascular disease (CVD). Brachial-ankle Pulse Wave Velocity (baPWV) is a non-invasive and useful measure of arterial stiffness predicting cardiovascular events and mortality. However, few studies have reported the relationship between ELC and baPWV as a new measure of arterial stiffness. The purpose of this study was to determine whether ELC is related to baPWV in non-diabetic...

  16. PREVALENCE OF PERIPHERAL ARTERIAL DISEASE IN TYPE - 2 DIABETES MELLITUS AND ITS CORRELATION WITH CORONARY ARTERY DISEASE USING ANKLE - BRACHIAL INDEX

    Directory of Open Access Journals (Sweden)

    Basawaraj

    2015-02-01

    Full Text Available OBJECTIVES: Peripheral vascular disease is one of the macrovascular complications of diabetes mellitus. The purpose of this study was to examine the peripheral arterial disease (PAD complicating type 2 diabetes, in particular the influence of PAD on the risk of coronary artery disease. METHODS: Randomly selected T2DM pat ients admitted to Basaweshwara Teaching and General Hospital were included. In addition to a detailed history and physical examination, anthropometric parameters like body mass index was measured. Relevant laboratory investigations were performed. Modified Rose questionnaire was used to diagnose coronary artery disease (CAD. Colour Doppler examination of the arteries of the lower limbs was performed. A cut off of 7% were significant predictors of PAD. Older age, higher HbA1c levels microalbuminuria and deranged lipid profile were found to be significant predictors of CAD. CONCLUSION: We found evidence of PAD in 16% of type 2 dia betics using ankle brachial index. The prevalence of CAD was higher in patients with PAD. So there is definite and strong correlation between PAD and CAD. Thus the early diagnosis of PAD should alert the clinician to a high probability of underlying CAD. KEYWORDS: D i abetes mellitus; Coronary artery disease; Peripheral artery disease; Ankle - brachial index.

  17. The product of resting heart rate times blood pressure is associated with high brachial-ankle pulse wave velocity.

    Directory of Open Access Journals (Sweden)

    Anxin Wang

    Full Text Available OBJECTIVE: To investigate potential associations between resting heart rate, blood pressure and the product of both, and the brachial-ankle pulse wave velocity (baPWV as a maker of arterial stiffness. METHODS: The community-based "Asymptomatic Polyvascular Abnormalities in Community (APAC Study" examined asymptomatic polyvascular abnormalities in a general Chinese population and included participants with an age of 40+ years without history of stroke and coronary heart disease. Arterial stiffness was defined as baPWV≥1400 cm/s. We measured and calculated the product of resting heart rate and systolic blood pressure (RHR-SBP and the product of resting heart rate and mean arterial pressure (RHR-MAP. RESULTS: The study included 5153 participants with a mean age of 55.1 ± 11.8 years. Mean baPWV was 1586 ± 400 cm/s. Significant (P<0.0001 linear relationships were found between higher baPWV and higher resting heart rate or higher arterial blood pressure, with the highest baPWV observed in individuals from the highest quartiles of resting heart rate and blood pressure. After adjusting for confounding parameters such as age, sex, educational level, body mass index, fasting blood concentrations of glucose, blood lipids and high-sensitive C-reactive protein, smoking status and alcohol consumption, prevalence of arterial stiffness increased significantly (P<0.0001 with increasing RHR-SBP quartile (Odds Ratio (OR: 2.72;95%Confidence interval (CI:1.46,5.08 and increasing RHR-MAP (OR:2.10;95%CI:1.18,3.72. Similar results were obtained in multivariate linear regression analyses with baPWV as continuous variable. CONCLUSIONS: Higher baPWV as a marker of arterial stiffness was associated with a higher product of RHR-SBP and RHR-MAP in multivariate analysis. In addition to other vascular risk factors, higher resting heart rate in combination with higher blood pressure are risk factors for arterial stiffness.

  18. What Is the Clinical Utility of the Ankle-Brachial Index in Patients With Diabetic Foot Ulcers and Radiographic Arterial Calcification?

    Science.gov (United States)

    Álvaro-Afonso, Francisco Javier; Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2015-12-01

    The purpose of this study was to analyze the influence of radiographic arterial calcification (RAC) on the clinical interpretation of ankle-brachial index (ABI) values in patients with diabetic foot ulcers. We analyzed a retrospective clinical database of 60 patients with diabetic foot ulcers from the Diabetic Foot Unit (Complutense University, Madrid, Spain) between January 2012 and March 2014. For each patient, anteroposterior XR-plains were evaluated, and the ABI and toe-brachial index (TBI) were assessed by an experienced clinician. To analyze the correlation among quantitative variables, we applied the Pearson correlation coefficient. Fifty percent (n = 9/18) of our patients with a normal ABI and RAC had a TBI Pearson correlation coefficient among the ABI and TBI in patients with an ABI < 1.4 (n = 46) was lesser (r = .484, P = .001) than in patients with an ABI < 1.4 but without RAC (n = 21; r = .686, P = .001). ABI values between 0.9 and 1.4 would be falsely considered as normal and could underestimate the prevalence of PAD, especially in patients with neuropathy, diabetic foot ulcers, or RAC. PMID:26216917

  19. Brachial plexopathy

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2015-01-01

    Background Work-related upper limb disorders constitute a diagnostic challenge. However, patterns of neurological abnormalities that reflect brachial plexus dysfunction are frequent in limbs with pain, weakness and/or numbness/tingling. There is limited evidence about the association between...... occupational physical exposures and brachial plexopathy. Methods 80 patients with brachial plexopathy according to defined criteria and 65 controls of similar age and sex without upper limb complaints were recruited by general practitioners. Patients and controls completed a questionnaire on physical and....... The identified psychosocial relations were limited to measures reflecting physical exposures. Conclusions While the identified risk indicators have previously been associated to upper limb symptoms as well as to diagnosed disorders other than brachial plexopathy, this study indicates an association...

  20. Hubungan Antara Nilai Ankle Brachial Index Dengan Jumlah Arteri Koroner Yang Mengalami Stenosis dan Kejadian Kardiovaskular Setelah 6 Bulan Penderita Sindroma Koroner Akut di RS. H. Adam Malik Medan

    OpenAIRE

    Minaswary, Rinelia

    2016-01-01

    The presence of peripheral arterial disease in patients with coronary artery disease and especially with acute coronary syndrome (ACS), is associated with a poor cardiovascular disease. However, the majority of affected patients are assymptomatic and the condition is underdiagnosed. The ankle-brachial index (ABI) provides a simple method of diagnosis PAD. Aim of this study is to assess the usefulness of an abnormal ABI for identifying multivessel disease coronary artery disease in patient...

  1. Common Carotid Intima Media Thickness and Ankle-Brachial Pressure Index Correlate with Local but Not Global Atheroma Burden: A Cross Sectional Study Using Whole Body Magnetic Resonance Angiography

    OpenAIRE

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Carly L Adamson; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Andrew D Morris; Houston, J. Graeme

    2014-01-01

    Background Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods 50 patients with symptomatic peripheral arterial disease were recruited. CIMT...

  2. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden:A cross sectional study using whole body magnetic resonance angiography

    OpenAIRE

    Weir-McCall, Jonathan R.; Khan, Faisel; Lambert, Matthew A.; Carly L Adamson; Gardner, Michael; Gandy, Stephen J.; Ramkumar, Prasad Guntur; Belch, Jill J. F.; Struthers, Allan D.; Rauchhaus, Petra; Andrew D Morris; Houston, J. Graeme

    2014-01-01

    Background: Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA). Methods: 50 patients with symptomatic peripheral arterial disease were recruited. CI...

  3. Clinical significance of inter-arm pressure difference and ankle-brachial pressure index in patients with suspected coronary artery disease

    International Nuclear Information System (INIS)

    Although measuring blood pressure at the bilateral brachia is common in medical practice, its clinical significance in patients with suspected coronary artery disease (CAD) has not been fully clarified. The method of this study was to define the significance of inter-arm systolic blood pressure difference in patients with suspected CAD, and to assess the relationship between inter-arm pressure difference and CAD, simultaneous brachial and ankle blood pressure measurements and stress myocardial single-photon emission computed tomography (SPECT) were performed in 386 consecutive patients with suspected CAD, excluding those with previous myocardial infarction or coronary revascularization. Subclavian artery stenosis, defined as ≥15 mmHg inter-arm systolic blood pressure difference, was found in 27 patients (7%). Age (65±12 vs 65±11 years), male sex (21/27 vs 244/359), prevalence of hypertension (63% vs 56%), hypercholesterolemia (63% vs 62%), diabetes mellitus (33% vs 38%), cigarette smoking (44% vs 41%) and family history of CAD (15% vs 12%) were similar between patients with subclavian artery stenosis and those without. The incidence of decreased ankle-brachial pressure index (ABI) was higher (37% vs 12%, p=0.001), and percentage ischemic myocardium as assessed by SPECT was greater (9.0±8.5% vs 5.6±6.6%, p=0.05) in patients with subclavian artery stenosis than in those without. Furthermore, significant correlations were observed between inter-arm pressure difference and percentage ischemic myocardium (r=0.13; p=0.01), and ABI (r=-0.26, p<0.0001). Among 386 patients, 283 underwent coronary angiography, and 63% of those who had inter-arm blood pressure difference had CAD. Furthermore, 83% of those CAD patients had multi-vessel CAD, which is regarded as a high-risk subset for subsequent cardiac events. Inter-arm pressure difference is often found in patients with suspected CAD, and is associated with significant CAD and peripheral artery disease. Thus, inter

  4. Relationship between resistant hypertension and arterial stiffness assessed by brachial-ankle pulse wave velocity in the older patient

    Directory of Open Access Journals (Sweden)

    Chung CM

    2014-09-01

    Full Text Available Chang-Min Chung,1,2 Hui-Wen Cheng,2 Jung-Jung Chang,2 Yu-Sheng Lin,2 Ju-Feng Hsiao,2 Shih-Tai Chang,1 Jen-Te Hsu2,31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, 2Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 3Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanBackground: Resistant hypertension (RH is a common clinical condition associated with increased cardiovascular mortality and morbidity in older patients. Several factors and conditions interfering with blood pressure (BP control, such as excess sodium intake, obesity, diabetes, older age, kidney disease, and certain identifiable causes of hypertension are common in patients resistant to antihypertensive treatment. Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV, is increasingly recognized as an important prognostic index and potential therapeutic target in hypertensive patients. The aim of this study was to determine whether there is an association between RH and arterial stiffness. Methods: This study included 1,620 patients aged ≥65 years who were referred or self-referred to the outpatient hypertension unit located at a single cardiovascular center. They were separated into normotensive, controlled BP, and resistant hypertension groups. Home BP, blood laboratory parameters, echocardiographic studies and baPWV all were measured. Results: The likelihood of diabetes mellitus was significantly greater in the RH group than in the group with controlled BP (odds ratio 2.114, 95% confidence interval [CI] 1.194–3.744, P=0.010. Systolic BP was correlated in the RH group significantly more than in the group with controlled BP (odds ratio 1.032, 95% CI 1.012–1.053, P=0.001. baPWV (odds ratio 1.084, 95% CI 1.016–1.156, P=0.015 was significantly correlated with the presence of RH. The other factors were negatively correlated with the existence of RH.Conclusion: In

  5. Periodontal disease and atherosclerosis from the viewpoint of the relationship between community periodontal index of treatment needs and brachial-ankle pulse wave velocity

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    Hoshi Keika

    2006-05-01

    Full Text Available Abstract Background It has been suggested that periodontal disease may be an independent risk factor for the development of atherosclerosis. However, the relationship between periodontal disease and atherosclerosis has not been fully elucidated. This study aimed to assess the effects of periodontal disease on atherosclerosis. Methods The study design was a cross-sectional study. Subjects were 291 healthy male workers in Japan. We used the Community Periodontal Index of Treatment Needs (CPITN score, average probing depth and gingival bleeding index (rate of bleeding gums to assess the severity of periodontal disease. We also used the Brachial-Ankle Pulse Wave Velocity (baPWV as the index for the development of atherosclerosis. Results The unadjusted odds ratio (OR of atherosclerosis in relation to the CPITN score was 1.41 [95% CI: 1.16–1.73]. However, after adjustment for age, systolic blood pressure and smoking, the CPITN score had no relationship with atherosclerosis (adjusted OR: 0.91 [0.68–1.20]. Conclusion Our results show no relationship between mild periodontal disease and atherosclerosis after appropriate adjustments.

  6. Ankle-brachial blood pressure index predicts cardiovascular events and mortality in Japanese patients with chronic kidney disease not on dialysis.

    Science.gov (United States)

    Yoshitomi, Ryota; Nakayama, Masaru; Ura, Yoriko; Kuma, Kazuyoshi; Nishimoto, Hitomi; Fukui, Akiko; Ikeda, Hirofumi; Tsuchihashi, Takuya; Tsuruya, Kazuhiko; Kitazono, Takanari

    2014-12-01

    The ankle-brachial blood pressure index (ABPI) has been recognized to have a predictive value for cardiovascular (CV) events and mortality in general or dialysis populations. However, the associations between ABPI and those outcomes have not been fully investigated in predialysis patients. The present study aimed to clarify the relationships between ABPI and both CV events and mortality in Japanese chronic kidney disease (CKD) patients not on dialysis. In this prospective observational study, we enrolled 320 patients with CKD stages 3-5 who were not on dialysis. At baseline, ABPI was examined and a low ABPI was defined as ABPI were risk factors for CV events. It was demonstrated that age, a history of cerebrovascular disease and low ABPI were determined as independent risk factors for CV mortality. In addition, age, body mass index and low ABPI were independently associated with all-cause mortality. In patients with CKD, low ABPI during the predialysis period is independently associated with poor survival and CV events, suggesting the usefulness of measuring ABPI for predicting CV events and patient survival in CKD. PMID:25056682

  7. Ankle Brachial Index <0.9 Underestimates the Prevalence of Peripheral Artery Occlusive Disease Assessed with Whole-Body Magnetic Resonance Angiography in the Elderly

    Energy Technology Data Exchange (ETDEWEB)

    Wikstroem, J.; Hansen, T.; Johansson, L.; Lind, L.; Ahlstroem, H. [Dept. of Radiology and Dept. of Medical Sciences, Uppsala Univ. Hospital, Uppsala (Sweden)

    2008-03-15

    Background: Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies. Purpose: To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly. Material and Methods: WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side. Results: There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one {>=}50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a {>=} 50% stenosis in the pelvic or leg arteries. Conclusion: An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population.

  8. 三氧包裹治疗糖尿病足的踝肱压及趾肱压指数研究分析%Study on the ankle brachial pressure and toe brachial pressure index in the treatment of diabetic foot with three oxygen therapy

    Institute of Scientific and Technical Information of China (English)

    刘兴华; 邓跃生; 张遵峰

    2016-01-01

    Objective To study the ankle brachial pressure and toe brachial pressure index in the treatment of diabetic foot with three oxygen therapy. Methods From our hospital from September 2014 to September 2015, 100 cases of diabetic foot patients,all patients were randomly divided into two groups, the control group was treated with conventional therapy, and the observation group was treated with three oxygen therapy,50 patients in each group, the clinical efficacy of the two groups of patients and the ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were statistically analyzed and compared. Results The ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were performed in the control group treated by conventional therapy,there was no significant difference in the treatment before and after treatment, no significant difference (P > 0.05);the ankle brachial pressure index (ABPI) and toe brachial pressure index (TBPI) were used in the observation group treated with three oxygen therapy,before and after treatment were compared, the treatment was significantly better than before treatment, the difference was obvious, the curative effect was significant, and it was statistically significant (P<0.05). Conclusion Three oxygen therapy for diabetic foot, the effect is remarkable, for promoting the early recovery of diabetic foot patients, save the limb, improve the quality of life of patients with positive significance, it is worth widely used in clinical practice.%目的:对三氧包裹治疗糖尿病足的踝肱压及趾肱压指数进行研究分析。方法选取本院2014年9月~2015年9月收治的糖尿病足患者100例,按照随机数字表法将所有患者分为两组,分别为采用常规治疗方法进行治疗的对照组,和采用三氧包裹治疗的观察组,每组50例患者,对两组患者的临床疗效及踝肱压指数(ABPI)及趾肱压指数(TBPI)进行统计学分析和比较。结

  9. Peripheral artery disease assessed by ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis - CAREFUL Study: A national, multi-center, cross-sectional observational study

    Directory of Open Access Journals (Sweden)

    Tabak Omur

    2011-01-01

    Full Text Available Abstract Background To investigate the presence of peripheral artery disease (PAD via the ankle brachial index (ABI in patients with known cardiovascular and/or cerebrovascular diseases or with at least one risk factor for atherothrombosis. Methods Patients with a history of atherothrombotic events, or aged 50-69 years with at least one cardiovascular risk factor, or > = 70 years of age were included in this multicenter, cross-sectional, non-interventional study (DIREGL04074. Demographics, medical history, physical examination findings, and physician awareness of PAD were analyzed. The number of patients with low ABI ( Results A total of 530 patients (mean age, 63.4 ± 8.7 years; 50.2% female were enrolled. Hypertension and dyslipidemia were present in 88.7% and 65.5% of patients, respectively. PAD-related symptoms were evident in about one-third of the patients, and at least one of the pedal pulses was negative in 6.5% of patients. The frequency of low ABI was 20.0% in the whole study population and 30% for patients older than 70 years. Older age, greater number of total risk factors, and presence of PAD-related physical findings were associated with increased likelihood of low ABI (p Conclusion Our results indicate that advanced age, greater number of total risk factors and presence of PAD-related physical findings were associated with increased likelihood of low ABI. These findings are similar to those reported in similar studies of different populations, and document a fairly high prevalence of PAD in a Mediterranean country.

  10. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  11. The reliability of toe systolic pressure and the toe brachial index in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Perrin Byron M

    2010-12-01

    Full Text Available Abstract Background The Ankle Brachial Index is a useful clinical test for establishing blood supply to the foot. However, there are limitations to this method when conducted on people with diabetes. As an alternative to the Ankle Brachial Index, measuring Toe Systolic Pressures and the Toe Brachial Index have been recommended to assess the arterial blood supply to the foot. This study aimed to determine the intra and inter-rater reliability of the measurement of Toe Systolic Pressure and the Toe Brachial Index in patients with diabetes using a manual measurement system. Methods This was a repeated measures, reliability study. Three raters measured Toe Systolic Pressure and the Toe Brachial Index in thirty participants with diabetes. Measurement sessions occurred on two occasions, one week apart, using a manual photoplethysmography unit (Hadeco Smartdop 45 and a standardised measurement protocol. Results The mean intra-class correlation for intra-rater reliability for toe systolic pressures was 0.87 (95% LOA: -25.97 to 26.06 mmHg and the mean intra-class correlation for Toe Brachial Indices was 0.75 (95% LOA: -0.22 to 0.28. The intra-class correlation for inter-rater reliability was 0.88 for toe systolic pressures (95% LOA: -22.91 to 29.17.mmHg and 0.77 for Toe Brachial Indices (95% LOA: -0.21 to 0.22. Conclusion Despite the reasonable intra-class correlation results, the range of error (95% LOA was broad. This raises questions regarding the reliability of using a manual sphygmomanometer and PPG for the Toe Systolic Pressure and Toe Brachial Indice.

  12. Ankle pain

    Science.gov (United States)

    Pain - ankle ... Ankle pain is often due to an ankle sprain. An ankle sprain is an injury to the ligaments, which ... the joint. In addition to ankle sprains, ankle pain can be caused by: Damage or swelling of ...

  13. Evaluation of Arterial Stiffness in Patients with Behçet's Disease by Using Noninvasive Radiological Methods such as Intima-Media Thickness of the Carotid, Ankle-Brachial Pressure Index, Coronary Artery Calcium Scoring, and Their Relation to Serum Fetuin-A Levels: A Case-Control Study

    OpenAIRE

    Uyar, Belkız; Solak, Aynur; Genç, Berhan; Akyıldız, Muhittin; Şahin, Neslin; UYAR, İhsan Sami; Saklamaz, Ali

    2015-01-01

    Background Behçet's disease (BD) is a chronic, recurrent inflammatory systemic vasculitis. Evidence for increased atherosclerosis in BD has been observed. The relation between cardiovascular risk factors and increased atherosclerosis in patients with BD is still controversial. Objective We performed this study to evaluate arterial stiffness in patients with BD by using noninvasive radiological methods such as carotid artery intima-media thickness (CIMT), ankle-brachial pressure index (ABPI), ...

  14. Brachial plexopathy

    OpenAIRE

    Khadilkar, Satish V; Snehaldatta S Khade

    2013-01-01

    Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles....

  15. Comparison of ankle-brachial index measured by an automated oscillometric apparatus with that by standard Doppler technique in vascular patients

    DEFF Research Database (Denmark)

    Korno, M.; Eldrup, N.; Sillesen, H.

    2009-01-01

    was calculated twice using both the methods on both legs. MATERIALS AND METHODS: We tested the automated oscillometric blood pressure device, CASMED 740, for measuring ankle and arm blood pressure and compared it with the current gold standard, the hand-held Doppler technique, by the Bland-Altman analysis...

  16. Brachial plexus

    Science.gov (United States)

    The brachial plexus is a group of nerves that run from the lower neck through the upper shoulder area. These ... Damage to the brachial plexus nerves can cause muscle and sensation problems that are often associated with pain in the same area. Symptoms may ...

  17. 2型糖尿病足高危患者的踝肱指数与糖尿病足的关系%Relationship between ankle brachial index and diabetic foot in patients at high risk of type 2 diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张成宗

    2014-01-01

    目的:对2型糖尿病足高危患者的踝肱指数和糖尿病足的发生率关系进行分析,同时对相关的危险因素进行探讨,以期对糖尿病足的发生早期采取有效的措施。方法对我院收治的已经确诊的438例2型糖尿病患者进行研究,其中391例为非糖尿病足组,47例为糖尿病足组,所有的患者都要进行糖化血红蛋白、总胆固醇、甘油三酯等生化资料、踝肱指数的检查,对两组的临床检查资料和不同踝肱指数组的糖尿病患者数的差异进行比较。结果两组患者踝肱指数与患者病程、收缩压、糖尿病肾病发生率、视网膜病变发生率呈负相关(P均<0.01);不同的踝肱指数和糖尿病足组的患病率比较,踝肱指数和糖尿病足组的患病率类似“U”型分布,踝肱指数>1.31组中糖尿病足组的患者发病率为18.1%;0.9<踝肱指数≤1.3组的发病率为26.0%;0.7<踝肱指数≤0.9组的发病率为32.5%;0.5<踝肱指数≤0.7组的发病率为47.6%;而踝肱指数≤0.5组中的糖尿病足患者发病率达到64.29%,各组患病率进行比较有明显的差异。结论踝肱指数和糖尿病足呈负相关,踝肱指数减低或是出现异常的升高能对早期糖尿病足的发生进行预测,对踝肱指数异常的糖尿病足高危患者要采用积极有效的干预措施。%ObjectiveTo understand the relationship between the ankle brachial index and diabetic foot in patients at high risk of type 2 diabetic foot and also discuss the related risk factors, in order to propose the effective measures for the early development of diabetic foot.Methods438 patients diagnosed as type 2 diabetes in this hospital were studied, including 391 patients with non-diabetic foot and 47 patients with diabetic foot.All patients received the examination of biochemical information of glycosylated hemoglobin,total cholesterol and triglyceride,as well as ankle brachial index. The

  18. The run-off resistance (ROR) assessed on MR angiograms may serve as a valid scoring system in patients with symptomatic peripheral arterial disease (PAD) and correlates with the ankle-brachial pressure index (ABI)

    International Nuclear Information System (INIS)

    Objective: To investigate the correlation between the hemodynamic parameter ankle-brachial pressure index (ABI) and the run-off resistance (ROR) assessed on MR angiograms (MRA) in patients with peripheral arterial disease (PAD) Fontaine Stage I and II and its potential as reliable reporting system in clinical routine. Methods: Contrast-enhanced MRA was performed in 321 PAD patients using a 1.5 T MR scanner with moving bed technique. The ROR and resting ABI were determined in each patient's leg and correlation analysis was performed using the Pearson test. Results: A significant negative correlation (r = −.513; p < .001) between ROR (mean 11.03 ± 5.42) and resting ABI (mean .81 ± .26) was identified. An even more pronounced correlation was found in patients younger than median age who had higher ABI values (r = −.608; p < .001). Conclusion: The ROR scoring system evaluated in this series correlates better with the ABI than previously published scoring systems and could be suggested as reporting system for routine MRA evaluation.

  19. Brachial plexopathy.

    Science.gov (United States)

    Khadilkar, Satish V; Khade, Snehaldatta S

    2013-01-01

    Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN), often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Idiopathic hypertrophic brachial neuritis, a rare condition, is usually painless to begin with, unlike IBN. Hereditary neuralgic amyotrophy is an autosomal-dominant disorder characterized by repeated episodes of paralysis and sensory disturbances in an affected limb, which is preceded by severe pain. While the frequency of the episodes tends to decrease with age, affected individuals suffer from residual deficits. Neurogenic thoracic outlet syndrome affects the lower trunk of the brachial plexus. It is diagnosed on the basis of electrophysiology and is amenable to surgical intervention. Cancer-related brachial plexopathy may occur secondary to metastatic infiltration or radiation therapy. Traumatic brachial plexus injury is commonly encountered in neurology, orthopedic, and plastic surgery set-ups. Trauma may be a direct blow or traction or stretch injury. The prognosis depends on the extent and site of injury as well as the surgical expertise. PMID:23661957

  20. Brachial plexopathy

    Directory of Open Access Journals (Sweden)

    Satish V Khadilkar

    2013-01-01

    Full Text Available Brachial plexus injury can occur as a result of trauma, inflammation or malignancies, and associated complications. The current topic is concerned with various forms of brachial plexopathy, its clinical features, pathophysiology, imaging findings, and management. Idiopathic brachial neuritis (IBN, often preceded with antecedent events such as infection, commonly present with abruptonset painful asymmetric upper limb weakness with associated wasting around the shoulder girdle and arm muscles. Idiopathic hypertrophic brachial neuritis, a rare condition, is usually painless to begin with, unlike IBN. Hereditary neuralgic amyotrophy is an autosomal-dominant disorder characterized by repeated episodes of paralysis and sensory disturbances in an affected limb, which is preceded by severe pain. While the frequency of the episodes tends to decrease with age, affected individuals suffer from residual deficits. Neurogenic thoracic outlet syndrome affects the lower trunk of the brachial plexus. It is diagnosed on the basis of electrophysiology and is amenable to surgical intervention. Cancer-related brachial plexopathy may occur secondary to metastatic infiltration or radiation therapy. Traumatic brachial plexus injury is commonly encountered in neurology, orthopedic, and plastic surgery set-ups. Trauma may be a direct blow or traction or stretch injury. The prognosis depends on the extent and site of injury as well as the surgical expertise.

  1. 踝肱指数与趾肱指数在下肢动脉疾病诊断中的临床价值%Diagnostic value of ankle-brachial index and toe-brachial index in arterial disease of lower extremity

    Institute of Scientific and Technical Information of China (English)

    李岚; 刘道燕; 祝之明; 赵志钢; 闫振成; 倪银星; 孙芳; 孙靖; 徐兴森; 于浩; 李英莎

    2012-01-01

    Objective To investigate the clinical application and its influencing factors of ankle-brachial index (ABl) and toe-brachial index (TBI) in the diagnosis of arterial disease of lower extremity. Methods ABI and TBI were measured in 800 limbs of 402 patients with diabetes and/or hypertension hospitalized from July 2010 to February 2011 The patients were divided into narrow group (ABI<0.9), normal group (0.9≤ABI<1.3), and calcification group (ABI≤ 1.3) according to the value of ABI, and also into narrow group (TBI<0.7) and normal group (TBI≥ 0.7) according to the value of TBL The correlation of ABI with TBI was analyzed, and the differences in age, obesity parameters, biochemical indicators and other factors were compared between the groups. Influence of high-sensitivity C-reactive protein (hs-CRP) on ABI and TBI was further analyzed. Results Only when ABI<0.9, ABI and TBI have significant correlation (r=0.826, p<0.0l). When the group comparison based on ABI values, it was shown that the age and hs-CRP were significantly higher in the narrow group than in the normal group and calcification group (P<0.0l). The comparison between groups based on TBI values indicated that the age, systolic blood pressure and hs-CRP in the narrow group were significantly higher than those in the normal group (P<0.01 or P<0.05), ABI and TBI in the normal hs-CRP group were significantly higher than those in high hs-CRP group (P<0.05). Conclusion Hs-CRP may play an important role in the development and progression in peripheral arterial atherosclerosis. Therefore, ABI and TBI measurements in combination with hs-CRP level can improve early diagnosis of arterial disease of lower extremity%目的 探讨踝肱指数(ABI)、趾肱指数(TBI)在下肢动脉疾病诊断中的应用价值及其影响因素.方法 对2010年7月-2011年2月收治的402例糖尿病和(或)高血压患者的800条下肢行ABI和TBI检查,根据ABI结果分为狭窄组(ABI<0.9),正常组(0.9≤ABI< 1.3)

  2. Índice Tornozelo-Braquial (ITB determinado por esfigmomanômetros oscilométricos automáticos Assessing Ankle-Brachial Index (ABI by using automated oscillometric devices

    Directory of Open Access Journals (Sweden)

    Takao Kawamura

    2008-05-01

    Full Text Available FUNDAMENTO: Índice Tornozelo-Braquial (ITB é essencial na prática clínica, mas dificuldades técnicas na sua execução pelo padrão de referência Doppler vascular (DV tornam-no ainda pouco utilizado. OBJETIVO: Avaliar aplicabilidade da determinação do ITB com uso de esfigmomanômetros oscilométricos automáticos (EOA e sugerir a utilização dos índices delta-Bráquio-Braquial (delta-BB e delta-ITB como marcadores de risco cardiovascular. MÉTODOS: Estudo descritivo e observacional de 247 pacientes ambulatoriais (56,2% feminino, média 62,0 anos submetidos à determinação do ITB com aferição simultânea da pressão arterial (PA em membros superiores (MMSS e inferiores (MMII utilizando-se dois EOA (OMRON-HEM705CP. Nos casos em que não foi possível aferir PA em pelo menos um dos MMII utilizou-se DV. Os pacientes divididos em Grupo N (ITB normal: 0,91 a 1,30 e Grupo A (ITB alterado: 1,30 tiveram comparados entre si os valores de delta-ITB (diferença absoluta ITB/MMII e delta-BB (diferença absoluta PAS/MMSS. RESULTADOS: Utilizando-se EOA foi possível determinar ITB em 90,7%. Com dados do Grupo N determinaram-se valores de referência (VR no percentil 95 de delta-ITB (0-0,13 e delta-BB (0-8 mmHg. Quando comparado com o Grupo N, o Grupo A apresentou prevalência mais elevada tanto de delta-ITB (30/52 contra 10/195; Razão de Chances: 25,23; pBACKGROUND: Assessing Ankle-Brachial Index is an essential procedure in clinical settings, but since its measurement by the gold standard Doppler Ultrasonic (DU technique is impaired by technical difficulties, it is underperformed. OBJECTIVE: The aim of this study was to assess the efficacy of an automated oscillometric device (AOD by performing Ankle-Brachial Index (ABI assessments and to suggest delta brachial-brachial (delta-BB and delta-ABI as markers of cardiovascular risk. METHODS: In this observational and descriptive study, 247 patients (56.2% females, mean age 62.0 years had their

  3. Ankle Cheilectomy

    Science.gov (United States)

    ... removes a bone spur from the talus or tibia, which are bones of the ankle joint. X- ... Tendon Rupture Surgery Ankle Arthrodesis Ankle Arthroscopy Ankle Fracture Surgery Bulk Allograft Transplantation for Osteochondral Lesions of ...

  4. Ankle Fractures

    Science.gov (United States)

    ... during a car accident Symptoms Because a severe ankle sprain can feel the same as a broken ankle, ... the ligament -- this is also known as high ankle sprain. Depending on how unstable the ankle is, these ...

  5. Relationship between Blood Pressure Variability and Brachial-ankle Pulse Wave Velocity in Hypertensive Patients%高血压患者血压变异性与肱踝脉搏波传导速度的关系研究

    Institute of Scientific and Technical Information of China (English)

    王宁; 余振球

    2012-01-01

    目的 探讨高血压患者血压变异性与肱踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系.方法 选择原发性高血压患者313例,根据baPWV值,将其分为两组:baPWV正常组(baPWV<1 400 cm/s)87例,baPWV升高组(baPWV≥1 400 cm/s)226例.比较两组患者年龄、性别构成比、血糖、血脂、血肌酐、血尿酸、血压及血压变异性.结果 单因素分析显示,baPWV升高组患者的年龄、胆固醇、低密度脂蛋白、高密度脂蛋白、24 h平均收缩压、24 h收缩压变异性及24 h舒张压变异性均高于baPWV正常组(P<0.05),代入Logistic回归分析显示年龄、胆固醇、高密度脂蛋白、24 h平均收缩压、24 h收缩压变异性及24 h舒张压变异性与baPWV呈相关性(P<0.05).结论 高血压患者24 h收缩压变异性和舒张压变异性是影响baPWV的独立因素.%Objective To explore the relationship between blood pressure variability and brachial - ankle pulse wave velocity ( baPWV ) in hypertensive patients. Methods Totally 313 patients with essential hypertension were enrolled in this study and divided into normal baPWV group ( baPWV < 1 400cm/s, n =87 ) and high baPWV group ( baPWV≥1 400cm/s, n= 226 ) based on their baPWV values. Age, gender ratio, fasting blood glucose ( FBG ), blood lipids including cholesterol ( CHO ), low - density lipoprotein cholesterol ( LDL ), and high - density lipoprotein cholesterol ( HDL ), serum creatinine ( Cr ), blood uric acid ( UA ), blood pressure, and blood pressure variability were measured. Results Univariate analysis revealed that age, CHO, LDL, HDL, 24 - hour systolic blood pressure, 24 - hour systolic blood pressure variability, and 24 -hour diastolic blood pressure variability were significantly higher in high baPWV group than in normal baPWV group ( P <0. 05 ). Multivariate Logistic regression analysis indicated that age, CHO, HDL, 24 -hour systolic blood pressure, 24 -hour systolic blood pressure variability

  6. Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden: a cross sectional study using whole body magnetic resonance angiography.

    Directory of Open Access Journals (Sweden)

    Jonathan R Weir-McCall

    Full Text Available Common carotid intima media thickness (CIMT and ankle brachial pressure index (ABPI are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA.50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR. The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045, however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01 with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012, which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45, while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005.ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is

  7. 基于四肢同步检测踝臂指数的方法和临床研究%Detection Method and Clinical Research on Ankle Brachial Index Based on Synchronous Measurements of Four Limbs

    Institute of Scientific and Technical Information of China (English)

    全晓莉; 周南权; 古良玲; 李双

    2012-01-01

    Objective To find a new algorithm for detecting ankle brachial index (ABI) non-invasively by synchronous acquisition of four limbs pulse wave signals and cuff pressure wave signals basing on waveform characteristic method and amplitude coefficient method with priority rule. Methods The turning point was judged in certain range by calculating the difference of adjoining pulse waves and their relative ratio under priority rules. Results The method provided a solution to misjudgment problem of the turning point before systolic blood pressure and around average pressure. Many cases analyses and lots of clinical tests proved the algorithm effective and reliable. Conclusion ABI is a handy and dependable predictor of atherosclerosis, it is associated with conventional risk factors such as age, blood pressure, etc.%目的 利用优选法在波形特征法和幅度系数法的基础上提出1种同步采集四肢脉搏波信号和袖套压力波信号无创检测踝臂指数的新方法.方法 计算出相邻脉搏波的幅度差值和它们的相对比值,并利用优选法在一定范围内进行突变点的判断.结果 该方法能够解决将收缩压以前的点和平均压附近的点误判为突变点的问题,大量的病例分析和临床测试证实了该算法的有效性和可靠性.结论 踝臂指数是动脉硬化的一个简便可靠的预测因素,它与传统的动脉硬化危险因素如年龄、血压等有相关性.

  8. Predictive value of the ankle-brachial index in the evaluation of intermittent claudication Valor preditivo do índice tornozelo-braço na evolução de pacientes com claudicação intermitente

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    2000-04-01

    Full Text Available The purpose of this study was to determine whether the ankle-brachial index (ABI could be used to predict the prognosis for a patient with intermittent claudication (IC. We studied 611 patients prospectively during 28 months of follow-up. We analyzed the predictive power of using various levels of ABI - 0.30 to 0.70 at 0.05 increments - in terms of the measure's specificity (association with a favorable outcome after exercise rehabilitation therapy and sensitivity (association with a poor outcome after exercise rehabilitation therapy. We found that using an ABI of 0.30 as a cut-off value produced the lowest margin of error overall, but the predictive power was still low with respect to identifying the patients with a poor prognosis after non-aggressive therapeutic treatment. Further study is needed to perhaps identify a second factor that could increase the sensitivity of the test.O objetivo deste estudo foi determinar a evolução da distância de marcha de pacientes com claudicação intermitente relacionando com o índice tornozelo-braço (ITB e o valor deste índice como fator preditivo para o prognóstico desses pacientes. Observou-se prospectivamente a evolução de 611 pacientes durante 28 meses. Analisamos o valor preditivo do ITB inicial usando vários valores de corte - 0.30 a 0.70 em incrementos de 0.05 - em relação à especificidade (associação com uma evolução favorável após tratamento clínico e sensibilidade (associação com uma evolução desfavorável após tratamento clínico. Encontramos o ITB de 0.30 como o valor de corte produzindo a menor margem de erro, mas seu valor preditivo ainda foi baixo para identificar os pacientes com mau prognóstico para o tratamento não invasivo. Estudos adicionais são necessários para se identificar um fator adicional que possa aumentar a sensibilidade do teste.

  9. 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

  10. Relationship between resting heart rate and brachial-ankle pulse wave velocity in healthy Chinese population%静息心率与臂踝脉搏波传导速度的关系

    Institute of Scientific and Technical Information of China (English)

    陶杰; 李冬青; 董岩; 吴寿岭

    2014-01-01

    Objective To investigate the relationship between resting heart rate (RHR) and brachial-ankle pulse wave velocity (baPWV) in healthy Chinese population.Methods This was a retrospective cohort study,and a total of 5 852 participants were selected with stratified random sampling from the 101 510 workers of Tangshan Kailuan company who received the health examination during 2010-2011 including epidemiological investigation,biochemical indicators measurement and baPWV measurement.A total of 5 440 participants met the inclusion criteria (aged 40 years or older,without stroke,transient ischemic attack and myocardial infarction) and 5 153 participants (3 110 males,mean age (55.1 ± 11.8) years old) with integral data were finally recruited into the final analysis.The observation population was divided into four groups according to RHR collected during health examinations:quartile 1 (RHR≤63 beats/min,n =1 405) ; quartile 2 (63 beats/min < RHR≤69 beats/min,n =1 176) ; quartile 3 (69 beats/min < RHR ≤76 beats/min,n =1 322) ; quartile 4 (RHR > 76 beats/min,n =1 250).Multivariate logistic regression analysis was used to analyze the relationship between RHR and baPWV.Results (1) The mean baPWV was (1 586 ± 400) cm/s,and the detection rates of baPWV ≥1 400 cm/s was 61.8% (3 185/5 153).(2)The baPWV of quartile 1,2,3 and 4 were (1 511 ±338) cm/s,(1 533 ±329) cm/s,(1 574 ±368) cm/s and (1 734 ±462) cm/s,respectively,and the detection rates of baPWV≥ 1 400 cm/s were 54.7% (769/1 405),56.0% (658/1 176),63.1% (834/1 322) and 74.3%(929/1 150),respectively.(3) Multiple logistic regression analysis showed that the detection rates of baPWV were significantly higher in quartile 2,3 and 4 compared to quartile 1,and the OR values were 1.37 (95 % CI:1.11-1.69),1.96 (95 % CI:1.59-2.41) and 2.60 (95 % CI:2.07-3.25),respectively,after adjusting for age,gender and systolic blood pressure,body mass index,fasting blood glucose,triglyceride,total cholesterol

  11. Relação entre índice tornozelo-braquial e doença aterosclerótica carotídea Association between ankle-brachial index and carotid atherosclerotic disease

    Directory of Open Access Journals (Sweden)

    Augusto Cezar Lacerda Brasileiro

    2013-05-01

    Full Text Available FUNDAMENTO: A associação do índice tornozelo-braquial (ITB com a medida do complexo médio intimal das artérias carótidas (MCMI não está amplamente estudada. OBJETIVO: Objetivamos avaliar se pacientes com ITB 0,9. MÉTODOS: No período de janeiro a dezembro de 2011, recrutamos 118 pacientes (48 homens e 70 mulheres que tiveram seus ITB e MCMI mensurados. Os pacientes foram divididos em grupo 1 (ITB 0,9. Utilizamos os testes de Mann-Whitney, qui-quadrado e Fischer para comparações entre os grupos. Para avaliar correlação entre ITB e MCMI empregamos a correlação de Pearson. RESULTADOS: A prevalência de ITB 1,5 mm de 34,7%. Não houve diferença de características clínicas entre os grupos 1 e 2: idade média (64 ± 9 vs. 62 ± 7,2 anos, p = 0,1, homens (40% vs. 41%, p = 0,9, hipertensão (74% vs. 59%, p = 0,1, diabetes melito (54% vs. 35%, p = 0,051, dislipidemia 26% vs. 24%, p = 0,8, tabagismo (57% vs. 65%, p = 0,4. A prevalência de placa carotídea foi maior no grupo 1 (48,6% vs. 28,9%, p = 0,04. A correlação de Pearson entre o ITB e a MCMI foi de - 0,235, com valor de p = 0,01. CONCLUSÕES: Pacientes com ITB BACKGROUND: The association between the ankle brachial index (ABI and the measurement of intimal medial thickness (IMT has not been fully studied. OBJECTIVE: We aimed to evaluate whether the prevalence of carotid atherosclerosis was higher in patients with ABI 0.9. METHODS: From January 2011 to December 2011, 118 patients (48 men and 70 women were enrolled. ABI and IMT Measurements were performed in all patients. Patients were divided in Group 1 (ABI 0.9 according to ABI values. Mann-Whitney, Chi-square and Fischer tests were used for comparison among the groups. Pearson's correlation was used to assess correlation between ABI and IMT. RESULTS: The prevalence of ABI 1.5 mm was 34.7 %. Clinical characteristics were similar between groups 1 and 2: mean age (64 ± 9 vs. 62 ± 7.2 years, p = 0.1, male gender (40% vs. 41%, p

  12. Effect of blood lipid on the change of brachial-ankle pulse wave velocity among prehypertensive population%血脂水平对血压正常高值人群脉搏波传导速度的影响

    Institute of Scientific and Technical Information of China (English)

    王林; 帅平; 刘玉萍; 程幼夫; 杨华; 李婷欣; 龚立荣; 任姣姣; 王洪佳

    2014-01-01

    Objective To explore the effect of blood lipid and lipoprotein ratios on the change of brachial-ankle pulse wave velocity (baPWV) among prehypertensive subjects.Methods 11 611 subjects with normal blood pressure (BP) were divided into two groups,which was one with optimal blood pressure (B P < 120/80 mmHg) and the other with prehypertension (BP:120-139/80-89 mmHg).Height,weight,baPWV,fasting blood-glucose,TC,TG,LDL-C and HDL-C were detected.Results The abnormal rate ofbaPWV in prehypertension group was obviously higher than that in the optimal blood pressure group.For optimal blood pressure group,the abnormality of TG,TC,LDL-C,TC/HDL-C as well as LDL-C/HDL-C,caused the increase of baPWV significantly (P<0.001).For prehypertensive group,the abnormality of TC and LDL-C caused the significant increase of baPWV (P<0.001).Results from logistic regression analysis showed that except for age,BMI and fasting blood-glucose,TC/HDL-C increasing was the independent risk factor in optimal blood pressure group,while TG increasing was for the prehypertension group.Conclusion With different normal BP level,both abnormality of blood lipid and lipoprotein ratio were the independent risk factors for baPWV increasing.%目的 探讨血脂和脂蛋白比值对血压正常高值人群脉搏波传导速度的影响.方法 选择11 611名血压正常的健康体检者,分为正常血压值组(血压< 120/80 mmHg)和血压正常高值组(血压为120 ~ 139/80 ~ 89 mmHg).应用全自动动脉硬化仪测定人选者肱踝脉搏波传导速度(baPWV),同时测量身高、体重、FPG、TC、TG、HDL-C、LDL-C等指标,并计算HDL-C和TC/HDL-C比值、LDL-C/HDL-C比值.分析血脂和脂蛋白比值异常情况对不同血压组脉搏波传导速度的影响.结果 血压正常高值组的baPWV异常率均高于血压正常组.血压正常组中除HDL-C外,TC、TG、LDL-C、TC/HDL-C、LDL-C/HDL-C的升高均使baPWV的异常率显著增加(P<0.001).血压正常高值组中,TC

  13. Obstetric brachial plexus injury

    Directory of Open Access Journals (Sweden)

    Mukund R Thatte

    2011-01-01

    Full Text Available Obstetric brachial plexus injury (OBPI, also known as birth brachial plexus injury (BBPI, is unfortunately a rather common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various series and countries. Although spontaneous recovery is known, there is a large subset which does not recover and needs primary or secondary surgical intervention. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles and systematic review of the subject. In addition, the authors′ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Causes of OBPI, indications of primary nerve surgery and secondary reconstruction of shoulder, etc. are discussed in detail. Although all affected children do not require surgery in infancy, a substantial proportion of them, however, require it and are better off for it. Secondary surgery is needed for shoulder elbow and hand problems. Results of nerve surgery are very encouraging. Children with OBPI should be seen early by a hand surgeon dealing with brachial plexus injuries. Good results are possible with early and appropriate intervention even in severe cases.

  14. The foot and ankle

    International Nuclear Information System (INIS)

    Imaging of the foot and ankle can be difficult because of the complex anatomy. Familiarity with the bony and ligamentous anatomy is essential for proper evaluation of radiographic findings. Therefore, pertinent anatomy is discussed as it applies to specific injuries. Special views, tomography, arthrography, and other techniques may be indicated for complete evaluation of foot and ankle trauma

  15. Brachial plexus (image)

    Science.gov (United States)

    The brachial plexus is a group of nerves that originate from the neck region and branch off to give rise ... movement in the upper limb. Injuries to the brachial plexus are common and can be debilitating. If the ...

  16. Ankle arthroscopy

    Science.gov (United States)

    ... Failure of repair to heal Weakness of the ankle Injury to tendon, blood vessel, or nerve Before the ... A.M. Editorial team. Related MedlinePlus Health Topics Ankle Injuries and Disorders Endoscopy Browse the Encyclopedia A.D. ...

  17. Intensive Health Education for Patients with Diabetic Foot Based on Ankle-brachial Index and Vibration Perception Threshold%根据踝臂指数和感觉阈值实施糖尿病足强化健康教育

    Institute of Scientific and Technical Information of China (English)

    吴丽琴; 胡朝晖; 陈育群

    2012-01-01

    目的 观察对糖尿病患者根据踝臂指数和感觉阈值实施糖尿病足强化健康教育的效果.方法 对60例糖尿病患者实施踝臂指数和感觉阈值测定、足部评估,根据测定值和评估结果,对患者进行知识宣教和强化;对足部问题及时进行处理;给予糖尿病足部知识指导和生活方式指导.结果 干预后(出院时)60例糖尿病患者的足部皮肤干燥、皲裂、甲沟炎、皮肤损伤较干预前明显改善(P<0.05);干预后(出院3个月)患者对糖尿病足的重视程度提高,足部自护行为改善(P<0.05).结论 对糖尿病患者进行踝臂指数、感觉阈值测定和足部评估,并根据结果进行健康指导和干预,能明显提高健康教育效果;对于糖尿病足高危患者,在出院后给予进一步的电话随访,能强化其足部知识和改善生活方式,预防或减少糖尿病足的发生.%Objective To observe the effect of intensive health education for diabetic foot patients based on ankle-brae hi al index and vibration perception threshold.Methods After the determination of ankle-brachial index and vibration perception threshold and the evaluation of feet conditions,patients were received intensive health education and guidance for diabetic foot and life style.Results There existed less feet rhagadia,paronychia and skin damage after the education and patients' skin become less dehydrated as well (P<0,05),Three months after discharge,patients attached more importance to diabetic foot and conduct more self-care to their feet (P<0.05).Conclusion Health education based on ankle-brachial index and vibration perception threshold is beneficial to the improvement of patients' life style and their knowledge of feet conditions.

  18. A comparison between brachial and echocardiographic systolic time intervals.

    Directory of Open Access Journals (Sweden)

    Ho-Ming Su

    Full Text Available Systolic time interval (STI is an established noninvasive technique for the assessment of cardiac function. Brachial STIs can be automatically determined by an ankle-brachial index (ABI-form device. The aims of this study are to evaluate whether the STIs measured from ABI-form device can represent those measured from echocardiography and to compare the diagnostic values of brachial and echocardiographic STIs in the prediction of left ventricular ejection fraction (LVEF <50%. A total of 849 patients were included in the study. Brachial pre-ejection period (bPEP and brachial ejection time (bET were measured using an ABI-form device and pre-ejection period (PEP and ejection time (ET were measured from echocardiography. Agreement was assessed by correlation coefficient and Bland-Altman plot. Brachial STIs had a significant correlation with echocardiographic STIs (r = 0.644, P<0.001 for bPEP and PEP; r  = 0.850, P<0.001 for bET and ET; r = 0.708, P<0.001 for bPEP/bET and PEP/ET. The disagreement between brachial and echocardiographic STIs (brachial STIs minus echocardiographic STIs was 28.55 ms for bPEP and PEP, -4.15 ms for bET and ET and -0.11 for bPEP/bET and PEP/ET. The areas under the curve for bPEP/bET and PEP/ET in the prediction of LVEF <50% were 0.771 and 0.765, respectively. Brachial STIs were good alternatives to STIs obtained from echocardiography and also helpful in prediction of LVEF <50%. Brachial STIs automatically obtained from an ABI-form device may be helpful for evaluation of left ventricular systolic dysfunction.

  19. Ankle sprain (image)

    Science.gov (United States)

    An ankle sprain is a common injury to the ankle. The most common way the ankle is injured is when ... swelling, inflammation, and bruising around the ankle. An ankle sprain injury may take a few weeks to many ...

  20. Chronic Ankle Instability

    Science.gov (United States)

    ... ankle surgeon will ask you about any previous ankle injuries and instability. Then s/he will examine your ankle ... Weak ankles may be a result of previous ankle injuries, but in some cases they are a congenital ( ...

  1. Schwannoma of Brachial Plexus

    OpenAIRE

    Kumar, Ameet; Akhtar, Saeed

    2010-01-01

    Brachial plexus tumours are a rare entity. Schwannomas are benign nerve sheath tumours and only about 5% arise from the brachial plexus. Due to its rarity and complex anatomical location they can pose a formidable challenge to surgeons. We present a case of a young patient who presented with an axillary swelling three months after a lymph node biopsy from the same axilla, which turned out to be a Schwannoma arising for the medial cord of the brachial plexus.

  2. Sprained Ankles

    Science.gov (United States)

    ... Body I think my child has sprained her ankle. How can I tell for sure? Sprains are injuries to the ligaments that connect bones ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ...

  3. Efeito da terapia antirretroviral e dos níveis de carga viral no complexo médio-intimal e no índice tornozelo-braço em pacientes infectados pelo HIV Antirretroviral therapy effect in the intima-medio complex and ankle-brachial index in patients infected by HIV

    Directory of Open Access Journals (Sweden)

    Emmanuelle Tenório Albuquerque Madruga Godoi

    2012-06-01

    Full Text Available OBJETIVOS: Identificar precocemente a prevalência de aterosclerose, por causa do espessamento do complexo médio-intimal das carótidas comuns e do índice tornozelo-braço. Essas medidas foram relacionadas com os fatores de risco clássicos de aterosclerose e os específicos dos infectados pelo HIV (tempo de doença, tempo de tratamento, tipo de tratamento, tipo de terapia antirretroviral utilizada, CD4 e carga viral. MÉTODOS: Setenta casos infectados com o HIV foram avaliados pela medida automática do complexo médio-intimal nas carótidas e do índice tornozelo-braço. Consideraram-se os fatores de risco clássicos de aterosclerose (idade, sexo, hipertensão arterial sistêmica, tabagismo, hipercolesterolemia, hipertrigliceridemia, obesidade e história familiar de evento cardiovascular, as medidas antropométricas e as variáveis relacionadas ao HIV. O nível de significância assumido foi de 5%. RESULTADOS: O tempo médio de diagnóstico do HIV foi de 104,9 meses e de tratamento foi de 97,9 meses. Quanto ao tipo de tratamento, 47 (67,1% fizeram uso de inibidor de protease por mais de seis meses e 36 (51,4% estão em uso atualmente. O índice tornozelo-braço estava aumentado em um único paciente (0,7% e não se evidenciou espessamento do complexo médio-intimal em nenhum indivíduo. Não existiu associação significante da medida do complexo médio-intimal da carótida comum direita com nenhuma das variáveis analisadas. CONCLUSÕES: Indivíduos jovens, sob o uso de terapia antirretroviral por cinco anos ou mais, não apresentaram espessamento do complexo médio-intimal ou aumento do índice tornozelo-braço. Não houve diferença do espessamento do complexo médio-intimal associada ao tipo de esquema antirretroviral utilizado ou nível de carga viral.OBJECTIVES: To precociously identify the prevalence of atherosclerosis caused by thickening of the intima-media complex of the common carotid arteries and of the ankle brachial index

  4. Brachial Plexus Injuries in Adults: Evaluation and Diagnostic Approach

    OpenAIRE

    Sakellariou, Vasileios I.; Badilas, Nikolaos K.; Mazis, George A.; Stavropoulos, Nikolaos A; Kotoulas, Helias K.; Stamatios Kyriakopoulos; Ioannis Tagkalegkas; Sofianos, Ioannis P.

    2014-01-01

    The increased incidence of motor vehicle accidents during the past century has been associated with a significant increase in brachial plexus injuries. New imaging studies are currently available for the evaluation of brachial plexus injuries. Myelography, CT myelography, and magnetic resonance imaging (MRI) are indicated in the evaluation of brachial plexus. Moreover, a series of specialized electrodiagnostic and nerve conduction studies in association with the clinical findings during the n...

  5. Ankle replacement

    Science.gov (United States)

    ... Ankle weakness, stiffness, or instability Loosening of the artificial joint over time Skin not healing after surgery Nerve damage Blood vessel damage Bone break during surgery Dislocation of the ...

  6. Ankle replacement

    Science.gov (United States)

    ... to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is then inserted between the two metal parts. Screws maybe placed to stabilize your ankle. The surgeon ...

  7. Ankle sprain

    OpenAIRE

    Struijs, Peter AA; Kerkhoffs, Gino MMJ

    2010-01-01

    Injury of the lateral ligament complex of the ankle joint occurs in about one in 10,000 people a day, accounting for a quarter of all sports injuries. Pain may be localised to the lateral side of the ankle.Residual complaints include joint instability, stiffness, and intermittent swelling, and are more likely to occur after more extensive cartilage damage.Recurrent sprains can add new damage and increase the risk of long-term degeneration of the joint.

  8. Update on acute ankle sprains.

    Science.gov (United States)

    Tiemstra, Jeffrey D

    2012-06-15

    Ankle sprains are a common problem seen by primary care physicians, especially among teenagers and young adults. Most ankle sprains are inversion injuries to the lateral ankle ligaments, although high sprains representing damage to the tibiofibular syndesmosis are becoming increasingly recognized. Physicians should apply the Ottawa ankle rules to determine whether radiography is needed. According to the Ottawa criteria, radiography is indicated if there is pain in the malleolar or midfoot zone, and either bone tenderness over an area of potential fracture (i.e., lateral malleolus, medial malleolus, base of fifth metatarsal, or navicular bone) or an inability to bear weight for four steps immediately after the injury and in the emergency department or physician's office. Patients with ankle sprain should use cryotherapy for the first three to seven days to reduce pain and improve recovery time. Patients should wear a lace-up ankle support or an air stirrup brace combined with an elastic compression wrap to reduce swelling and pain, speed recovery, and protect the injured ligaments as they become more mobile. Early mobilization speeds healing and reduces pain more effectively than prolonged rest. Pain control options for patients with ankle sprain include nonsteroidal anti-inflammatory drugs, acetaminophen, and mild opioids. Because a previous ankle sprain is the greatest risk factor for an acute ankle sprain, recovering patients should be counseled on prevention strategies. Ankle braces and supports, ankle taping, a focused neuromuscular training program, and regular sport-specific warm-up exercises can protect against ankle injuries, and should be considered for patients returning to sports or other high-risk activities. PMID:22962897

  9. Acute ankle sprain: an update.

    Science.gov (United States)

    Ivins, Douglas

    2006-11-15

    Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ankle and Foot Rules provide clinical guidelines for excluding a fracture in adults and children and determining if radiography is indicated at the time of injury. Reexamination three to five days after injury, when pain and swelling have improved, may help with the diagnosis. Therapy for ankle sprains focuses on controlling pain and swelling. PRICE (Protection, Rest, Ice, Compression, and Elevation) is a well-established protocol for the treatment of ankle injury. There is some evidence that applying ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery. Functional rehabilitation (e.g., motion restoration and strengthening exercises) is preferred over immobilization. Superiority of surgical repair versus functional rehabilitation for severe lateral ligament rupture is controversial. Treatment using semirigid supports is superior to using elastic bandages. Support devices provide some protection against future ankle sprains, particularly in persons with a history of recurrent sprains. Ankle disk or proprioceptive neuromuscular facilitation exercise regimens also may be helpful, although the literature supporting this is limited. PMID:17137000

  10. MRI of brachial plexopathies

    Energy Technology Data Exchange (ETDEWEB)

    Sureka, J. [Department of Radiology, Christian Medical College, Vellore (India)], E-mail: drjyoticmch@rediffmail.com; Cherian, R.A.; Alexander, M.; Thomas, B.P. [Department of Radiology, Christian Medical College, Vellore (India)

    2009-02-15

    Magnetic resonance imaging (MRI) has become the primary imaging technique in the evaluation of brachial plexus pathology, and plays an important role in the identification, localization, and characterization of the cause. Improvements in MRI technique have helped in detecting changes in the signal intensity of nerves, subtle enhancement, and in detecting perineural pathology, thereby refining the differential diagnosis. The present review of the visualization of brachial plexus abnormalities using MRI is based on a review of 26 cases. The causes include trauma and a spectrum of non-traumatic causes, such as acute idiopathic/viral plexitis, metastases, immune-mediated plexitis, and mass lesions compressing the brachial plexus.

  11. Ankle ligament injuries

    Directory of Open Access Journals (Sweden)

    Per A.F.H. Renström

    1998-06-01

    Full Text Available Acute ankle ligament sprains are common injuries. The majority of these occur during athletic participation in the 15 to 35 year age range. Despite the frequency of the injury, diagnostic and treatment protocols have varied greatly. Lateral ligament complex injuries are by far the most common of the ankle sprains. Lateral ligament injuries typically occur during plantar flexion and inversion, which is the position of maximum stress on the anterotalofibular liagment (ATFL. For this reason, the ATFL is the most commonly torn ligament during an inversion injury. In more severe inversion injuries the calcaneofibular (CFL, posterotalofibular (PTFL and subtalar ligament can also be injured. Most acute lateral ankle ligament injuries recover quickly with nonoperative management. The treatment program, called "functional treatment," includes application of the RICE principle (rest, ice, compression, and elevation immediately after the injury, a short period of immobilization and protection with an elastic or inelastic tape or bandage, and early motion exercises followed by early weight bearing and neuromuscular ankle training. Proprioceptive training with a tilt board is commenced as soon as possible, usually after 3 to 4 weeks. The purpose is to improve the balance and neuromuscular control of the ankle. Sequelae after ankle ligament injuries are very common. As much as 10% to 30% of patients with a lateral ligament injury may have chronic symptoms. Symptoms usually include persistent synovitis or tendinitis, ankle stiffness, swelling, and pain, muscle weakness, and frequent giving-way. A well designed physical therapy program with peroneal strengthening and proprioceptive training, along with bracing and/or taping can alleviate instability problems in most patients. For cases of chronic instability that are refractory to bracing and external support, surgical treatment can be explored. If the chronic instability is associated with subtalar instability

  12. Brachial plexus neuropathy

    OpenAIRE

    Hubka, Michael J; King, Laurie; Cassidy, J. David; Donat, JR

    1992-01-01

    Branchial plexus neuropathy is characterized by acute onset of intense pain in the shoulder or arm followed shortly by focal muscle weakness. This presentation may mislead the clinician into diagnosing shoulder or cervical spine pathology. Although brachial plexus neuropathy is not common, it should be considered in the differential diagnosis of pain and weakness of the arm. We present a patient with brachial plexus neuropathy who was originally misdiagnosed as having a cervical disc herniation.

  13. Brachial plexus myoclonus.

    OpenAIRE

    Banks, G.; Nielsen, V K; Short, M P; Kowal, C D

    1985-01-01

    Rhythmic myoclonus in an arm began abruptly following an injury and persisted continuously for six years. Topographical EMG showed abnormal activity confined to muscles innervated by the axillary and radial nerves from the posterior cord of the brachial plexus. Abduction of the arm above horizontal level stopped myoclonus and EMG discharges. EEG was normal. It is suggested that the myoclonus was caused by mechanical irritation of the posterior cord of the brachial plexus.

  14. Clinical applications of transcutaneous oxygen pressure combined with ankle-brachial index in Type 2 diabetics with peripheral arterial disease%经皮氧分压联合踝臂指数在2型糖尿病合并下肢动脉病变中的临床应用

    Institute of Scientific and Technical Information of China (English)

    李梦娟; 李素梅; 汝燕; 王芳; 王菊梅; 荆春艳; 王东; 董林; 任安

    2011-01-01

    目的:比较经皮氧分压(transcutaneous oxygen pressure,TcPO2)与踝臂指数(ankle--brachial index,ABI)在2型糖尿病(Type 2 diabetes mellitus,T2DM)合并下肢动脉病变(peripheral arterial disease,PAD)中的应用价值,探讨TcPO2与ABI在PAD诊断及治疗中的意义.方法:368例T2DM患者(男性188例,女性180例),采用多通道经皮氧分压检测仪测定足背TcPO2.依据TcPO2水平分为无受损组、轻度受损组、重度受损组.同时,采用彩色双功能超声诊断仪测定踝动脉压/肱动脉压比值即ABI,依据ABI水平分为无病变组(ABI≥0.9)和PAD组(ABI <0.9).结果:PAD组与无病变组相比,年龄增大,病程延长,合并冠心痛者增多,空腹血糖、餐后2h血糖、糖化血红蛋白、尿肌酐均升高,TcPO2减低(p<0.05).相关分析显示:年龄、病程、空腹血糖、三酰甘油、糖化血红蛋白Alc、体质量指数与TcPO2水平呈负相关(P<0.05),高密度脂蛋白、ABI与TcPO2水平呈正相关(P<0.05);TcPO2与ABI检测结果的符合率为93.9%,敏感度为90.2%,特异度约为95.2%.结论:随着年龄、病程的延长以及尿白蛋白肌酐比值的增加,糖尿病患者PAD程度越严重,PAD程度随着ABI和TcPO2减低而加重;TcPO2联合ABI对早期诊断糖尿病PAD具有较高的临床价值.%Objective To compare the clinical application in diagnosis and therapy for Type 2 diabetes patients with perpheral arterial diease ( PAD) between transcutaneous oxygen pressure ( TcPO2 ) determination and ankle-brachial index (ABI). Methods A total of 368 Type 2 diabetics (188 males and 180 females) were recruited into the study. TcPO2 of the acrotarsium was detected by multiple-channel transcutaneous tissue oxygen tension survey meter. According to die TcPO2 level, diese patients were divided into a non-injury group, a mild injury group, and a severe injury group. Moreover,the ankle artery pressure and brachial artery pressure were determined by Doppler color ultrasonography

  15. Total ankle arthroplasty in France

    OpenAIRE

    Besse, Jean-Luc; Colombier, Jean-Alain; ASENCIO, Joseph; Bonnin, Michel; Gaudot, Fabrice; JARDE, Olivier; Judet, Thierry; MAESTRO, Michel; LEMRIJSE, Thibaut; LEONARDI, Christian; TOULLEC, Eric

    2010-01-01

    Objectives: After more than 10 years' experience in France, the French Foot Surgery Association (Association francaise de chirurgie du pied [AFCP]) presents an update on mobile-bearing ankle prostheses, based on a multicenter study. Meta-analysis - Biomechanics - Assessment and indications: A preliminary comparative metaanalysis of the literature studies on ankle and prosthesis biomechanics, reviews validated indications and contra-indications, and details clinical and radiological outcomes a...

  16. Brachial plexopathy after prone positioning

    OpenAIRE

    Goettler, Claudia E; Pryor, John P; Reilly, Patrick M

    2002-01-01

    Two cases of brachial plexus injury after prone position in the intensive care unit are described. Mechanisms of brachial plexus injury are described, as are methods for prevention of this unusual complication.

  17. Ankle clonus

    OpenAIRE

    Fareedy, Shoaib Bilal; Pathak, Ranjan

    2015-01-01

    Key Clinical Message Clonus is a series of involuntary, rhythmic, muscular contractions, and relaxations. It may be caused by interruption of the upper motor neuron fibers such as stroke, multiple sclerosis, or by metabolic alterations such as severe hepatic failure or serotonin syndrome. We present a video case of impressive left ankle clonus in a patient with old right middle cerebral artery stroke.

  18. Ankle sprain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000574.htm Ankle sprain - aftercare To use the sharing features on this ... help them move in the right ways. An ankle sprain occurs when the ligaments in your ankle are ...

  19. Clinical significance of brachial-ankle pulse wave velocity in healthy people classified by blood pressure and age%以年龄和血压分类的健康人群臂-踝脉搏波速度参考值的临床意义

    Institute of Scientific and Technical Information of China (English)

    陈大伟; 张婧; 姜树强; 刘超; 郑海芳; 靳英; 韩春雷; 王建昌

    2015-01-01

    目的:探讨以年龄和血压分类的一般健康人群的臂-踝脉搏波传导速度(baPWV)参考值的临床意义。方法选取30岁以上无心脑血管疾病的1750名健康体检者,收集 baPWV、血压、血糖、血脂、体质量指数、吸烟、饮酒及服药史等资料。结果校正年龄和血压后,糖尿病、降压和降脂药物与 baPWV 相关,排除这些因素的1237人作为参考值人群。baPWV 参考值随年龄和血压增加而增加。结论一般健康人群按年龄和血压分类的 baPWV 参考值,可为不同年龄段和血压状态下的健康体检人群判定 baPWV 检测结果和积极防治动脉硬化提供依据。%Objective To investigate the clinical significance of brachial-ankle pulse wave velocity(baP-WV)in healthy people who were classified by blood pressure and age.Methods A total of 1750 healthy subjects without cerebral-cardiovascular diseases in the physical examination were recruited.The data of baPWV,blood pres-sure,glucose,lipid,body mass index,smoking,alcohol drinking and drugs were collected.Results After adjusting for age and blood pressure,the diabetes,drugs for anti-hypertensive drugs and lipid-lowering drugs were related with baP-WV,and the rest 1237 persons without these factors were selected as control group.Conclusion The study provides the reference value of baPWV in healthy people classified by blood pressure and age,which may be valuable for the selection of baPWV test for people in different states of ages and blood pressure in health examination,and the preven-tion of arterial stiffness.

  20. 老年高血压患者踝肱指数及其与冠心病、脑卒中相关性的研究%Association of ankle-brachial index with clinical coronary heart disease, stroke in aged Chinese hypertensive men

    Institute of Scientific and Technical Information of China (English)

    丁一妹; 王玉; 李燕; 杨培; 刘敏艳; 刘亮; 朱平; 李小鹰

    2011-01-01

    目的:了解老年高血压患者外周动脉性疾病(PAD)患病率及其特点,重点研究踝肱指数(ABI)与冠心病、脑卒中相关性的临床意义.方法:入选我院和安贞医院门诊及住院老年男性高血压患者,无损伤周围血管检查仪测定患者踝肱指数、标准问卷调查及各项指标测量确定患者身体基线状况;任一侧肢体ABI≤0.9诊断为PAD,1.01-1.30为临界PAD.结果:244名坚持服用降压药物的老年男性高血压患者,15例除年龄、ABI外部分基线资料不全,平均年龄(76.47±9.75)岁,平均ABI值0.941±0.258,ABI分布频率最高的区间为1.01-1.30.其中85名为PAD患者,22名为临界PAD患者,135名为正常ABI高血压患者,2名ABI>1.3.PAD和临界PAD患者的ABI值、高血压控制率明显低于正常ABI患者(P0.05).PAD、临界PAD、冠心病和脑卒中患病率分别为35.1%、9.1%、64.0%、40.5%,不同年龄组PAD、临界PAD、冠心病和脑卒中的发生率有明显差异(P<0.05),且随着年龄的增加均同步大幅升高.进一步采用logistic回归分析对年龄、体重指数、高血压病程、收缩压、舒张压、高血压控制率、吸烟、饮酒、糖尿病、血脂异常等因素调校后,发现不同ABI水平与冠心病、脑卒中患病率有关(P<0.05),其患病率的OR值表明,ABI水平与冠心痛、脑卒中患病呈明显负相关.结论:老年高血压患者PAD患病率高,ABI降低与冠心痛、脑卒中患病明显相关.%Objective: To assess the clinical significance of ankle-brachial index(ABI) in aged Chinese hypertensive men and to determine the association of ABI with clinical coronary heart disease, stroke. Methods: Ankle-brachial index (ABI) was measured by means of peripheral vascular lab in aged hypertensive men from 301 Hospital and Anzhen Hospital while the clinical characteristics of the study population were investigated and collected. ABI≤0.9 was defined as peripheral arterial disease (PAD), 1.01 ~ 1 .30 as borderline

  1. Idiopathic Brachial Neuritis

    OpenAIRE

    Gonzalez-Alegre, Pedro; Recober, Ana; Kelkar, Praful

    2002-01-01

    Idiopathic brachial neuritis is a well defined clinical condition that most commonly affects young adults, seen usually by primary care physicians, neurologists or orthopaedic surgeons. Its onset is characterized by acute, aching shoulder pain lasting a few days to weeks, followed by progressive shoulder girdle and upper extremity weakness and atrophy, with a slow but progressive recovery of motor function over 6 to 18 months. Its early recognition can help avoid unnecessary and potentially h...

  2. Management of Brachial Plexus Injuries

    OpenAIRE

    J Gordon Millichap

    2005-01-01

    The results of early neurosurgical treatment of 58 infants with various types of brachial plexus birth injury have been compared with non-surgical intervention in 91 patients followed by a multidisciplinary team at the Brachial Plexus Program, Miami Children’s Hospital, FL.

  3. Adult traumatic brachial plexus injury

    Energy Technology Data Exchange (ETDEWEB)

    Rankine, J.J. E-mail: james.rankine@leedsth.nhs.uk

    2004-09-01

    Injury to the brachial plexus in the adult is usually a closed injury and the result of considerable traction to the shoulder. Brachial plexus injury in the adult is an increasingly common clinical problem. Recent advances in neurosurgical techniques have improved the outlook for patients with brachial plexus injuries. The choice of surgical procedure depends on the level of the injury and the radiologist has an important role in guiding the surgeon to the site of injury. This article will describe the anatomy and pathophysiology of traction brachial plexus injury in the adult. The neurosurgical options available will be described with emphasis on the information that the surgeon wants from imaging studies of the brachial plexus. The relative merits of MRI and CT myelography are discussed.

  4. Adult traumatic brachial plexus injury

    International Nuclear Information System (INIS)

    Injury to the brachial plexus in the adult is usually a closed injury and the result of considerable traction to the shoulder. Brachial plexus injury in the adult is an increasingly common clinical problem. Recent advances in neurosurgical techniques have improved the outlook for patients with brachial plexus injuries. The choice of surgical procedure depends on the level of the injury and the radiologist has an important role in guiding the surgeon to the site of injury. This article will describe the anatomy and pathophysiology of traction brachial plexus injury in the adult. The neurosurgical options available will be described with emphasis on the information that the surgeon wants from imaging studies of the brachial plexus. The relative merits of MRI and CT myelography are discussed

  5. Clinical significance of ankle brachial index in the prediction of chronic complication of type 2 diabetes mellitus%探讨踝肱指数对预测2型糖尿病慢性并发症的临床意义

    Institute of Scientific and Technical Information of China (English)

    白杨; 邓挺

    2014-01-01

    Objective To explore the clinical significance of ankle brachial index (ABI) in the prediction of vascular complication of type 2 diabetes mellitus, and to gain cognition of the differences between different range values in prediction.Methods The ABI of 298 cases with type 2 diabetes mellitus were analyzed, and these cases were divided into three groups. The normal group had 0.9

  6. Predictive value of ankle brachial index combined with serum high sensitivity C-reactive protein for extent of coronary artery disease%踝臂指数联合超敏C反应蛋白对冠状动脉病变的判定价值

    Institute of Scientific and Technical Information of China (English)

    张宁; 牛楠; 曲鹏; 王红艳

    2012-01-01

    目的:探讨踝臂指数(ABI)联合超敏C反应蛋白(hs-CRP)对冠状动脉病变的判定价值.方法:选择2010-09-12期间住院并行冠状动脉造影的120例患者,收集行冠状动脉造影前ABI及hs-CRP的数值,根据冠状动脉病变狭窄程度(Gensini积分评价)及病变血管数量进行分组.结果:以ABI<0.9及hs-CRP>3 mg/L为截断值,二者联合检测判定冠状动脉严重狭窄及多支病变的敏感度分别为85%和92%,特异度分别为69%和61%,与单用ABI或hs-CRP的方法比较,其敏感度均显著提高(均P<0.05),特异度有所下降.结论:ABI、hs-CRP的水平变化与冠状动脉的病变程度密切相关,对于冠状动脉严重狭窄及3支病变的判定,二者联合检测具有更高的实用价值.%Objective: To investigate whether the combination of ankle brachial index (ABI) and serum high sensitivity C-reactive protein (hs-CRP) could improve their diagnosis value for extent of coronary artery disease (CAD) in patients. Method: The study population consisted of 120 patients scheduled to undergo elective cardiac catheterization for suspected CAD (from September 2010 to December). Collected data included ABI and hs-CRP before underwent coronary angiography. According to the degree of coronary stenosis (estimated by Gensini score) and the number of coronary artery stenosis, all subjects were divided into different groups. Result: With ABI 3 mg/L as the cutoff value, combined the 2 methods to predict serious stenosis and multi-vessel CAD, the sensitivity was respectively 85%, 92%, and the specificity was respectively 69%, 61%. Compared with using ABI or hs-CRP alone, the sensitivity of the 2 joint detection for predicting CAD increased significantly (P<0. 05); the specificity decreased, but the difference was not statistically significant. Conclusion: ABI and hs-CRP are closely related to the extent of coronary artery disease, and the combination of ABI and hs-CRP may have higher practical value for

  7. Ankle Sprain Treatment

    Science.gov (United States)

    ... Ankle Sprain Treatment Page Content Article Body Acute ankle and foot injuries are common in athletes and other active young ... Phase I treatment involves resting and protecting the ankle to permit healing, to prevent further injury, and to control pain and swelling. Rest, protection ( ...

  8. Assessment of Ankle Injuries

    Science.gov (United States)

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  9. Ottawa ankle rules.

    OpenAIRE

    Stiell, I.

    1996-01-01

    The Ottawa ankle rule project demonstrated that more than 95% of patients with ankle injuries had radiographic examinations but that 85% of the films showed no fractures. A group of Ottawa emergency physicians developed two rules to identify clinically important fractures of the malleoli and the midfoot. Use of these rules reduced radiographic examinations by 28% for the ankle and 14% for the foot.

  10. Brachial plexus injury in newborns

    Science.gov (United States)

    ... and vascular disorders. In: Fenichel GM, ed. Neonatal Neurology . 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2006: ... CB, Kratz JR, Jelin AC, Gelfand AA. Child neurology: brachial plexus birth injury: what every neurologist needs ...

  11. MRI of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Es, H.W. van [Dept. of Radiology, St. Antonius Ziekenhuis, Nieuwegein (Netherlands)

    2001-02-01

    Magnetic resonance imaging is the imaging method of first choice for evaluating the anatomy and pathology of the brachial plexus. This review discusses the used imaging techniques, the normal anatomy, and a variety of pathologies that can involve the brachial plexus. The pathology includes primary and secondary tumors (the most frequent secondary tumors being superior sulcus tumor and metastatic breast carcinoma), radiation plexopathy, trauma, thoracic outlet syndrome, neuralgic amyotrophy, chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). (orig.)

  12. MRI of the brachial plexus

    International Nuclear Information System (INIS)

    Magnetic resonance imaging is the imaging method of first choice for evaluating the anatomy and pathology of the brachial plexus. This review discusses the used imaging techniques, the normal anatomy, and a variety of pathologies that can involve the brachial plexus. The pathology includes primary and secondary tumors (the most frequent secondary tumors being superior sulcus tumor and metastatic breast carcinoma), radiation plexopathy, trauma, thoracic outlet syndrome, neuralgic amyotrophy, chronic inflammatory demyelinating polyneuropathy (CIDP), and multifocal motor neuropathy (MMN). (orig.)

  13. MR imaging of brachial plexus

    International Nuclear Information System (INIS)

    The brachial plexus is a difficult region to evaluate with radiological techniques. MR imaging has great potentials for the depiction of the various anatomical structures of the branchial plexus - i.e., spinal ganglion, ventral nerve rami root exit of the neural foramina, trunks an cordes. Moreover, MR imaging, thanks to its direct multiplanarity, to its excellent soft-tissue contrast, and to its lack of motion artifacts, allows good evaluation of pathologic conditions in the branchial plexus, especially traumas and cancers. On the contrary CT, in spite of its high spatial resolution and good contrast, cannot demonstrate the anatomical structures of the brachial plexus. US detects superficials structures, and conventional radiographs depict only indirect changes in the adjacent lung apex and skeletal structures. From November 1989 to May 1990, 20 normal volunteers (15 males and 5 females; average age: 35 years) were studied with MR imaging. Multisection technique was employed with a dedicated coil and a primary coil. The anatomical structures of the brachial plexus were clearly demonstrated by T1-weighted sequences on the sagittal and axial planes. T2-weighted pulse sequences on the coronal plane were useful for the anatomical definition of the brachial plexus and for eventual tissue characterization. The correct representation of the anatomical structures of the brachial plexus allowed by MR imaging with author's standard technique makes MR imaging the most appropriate exam for the diagnosis of pathologic conditions in the brachial plexus, although its use must be suggested by specific clinical questions

  14. Responses of spinal dorsal horn neurons to foot movements in rats with a sprained ankle

    OpenAIRE

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon; Chung, Jin Mo

    2011-01-01

    Acute ankle injuries are common problems and often lead to persistent pain. To investigate the underlying mechanism of ankle sprain pain, the response properties of spinal dorsal horn neurons were examined after ankle sprain. Acute ankle sprain was induced manually by overextending the ankle of a rat hindlimb in a direction of plantarflexion and inversion. The weight-bearing ratio (WBR) of the affected foot was used as an indicator of pain. Single unit activities of dorsal horn neurons in res...

  15. MRI of ankle sprain

    International Nuclear Information System (INIS)

    We reviewed MR (magnetic resonance) studies in 54 patients with a sprained ankle. MR examination was able to depict the following injuries: lateral collateral ligamentous injuries, fluid collection in the peroneal tendon sheath, injury to the peroneal tendon, deltoid ligamentous injuries, the extent of subcutaneous soft tissue swelling, and various kinds of osseous injuries. A total of 21 patients underwent repair or reconstructive surgery to the lateral collateral ligaments, the findings of which were correlated with those on MR examination. MR diagnosis of anterior talofibular ligamentous injury was confirmed in 16/21; the discrepancy could be attributed to remodeling and/or reorganization which progressed during the time lapse between the MR examination and surgery in three, while the misdiagnosis resulted from the difficulty in distinguishing the acute tear from the injured scar in two. The calcaneofibular ligamentous injury was confirmed in 10/12; two false negatives were responsible for the difficulty in delineating its entire length on a single image and/or in differentiating between the attenuated star and the normal calcaneofibular ligament. MR imaging is a useful tool to use in deciding the surgical indication and predicting the prognosis of the patients with ankle sprain. (author)

  16. MRI of ankle sprain

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Gen [Dokkyo Univ., Mibu, Tochigi (Japan). School of Medicine

    1995-06-01

    We reviewed MR (magnetic resonance) studies in 54 patients with a sprained ankle. MR examination was able to depict the following injuries: lateral collateral ligamentous injuries, fluid collection in the peroneal tendon sheath, injury to the peroneal tendon, deltoid ligamentous injuries, the extent of subcutaneous soft tissue swelling, and various kinds of osseous injuries. A total of 21 patients underwent repair or reconstructive surgery to the lateral collateral ligaments, the findings of which were correlated with those on MR examination. MR diagnosis of anterior talofibular ligamentous injury was confirmed in 16/21; the discrepancy could be attributed to remodeling and/or reorganization which progressed during the time lapse between the MR examination and surgery in three, while the misdiagnosis resulted from the difficulty in distinguishing the acute tear from the injured scar in two. The calcaneofibular ligamentous injury was confirmed in 10/12; two false negatives were responsible for the difficulty in delineating its entire length on a single image and/or in differentiating between the attenuated star and the normal calcaneofibular ligament. MR imaging is a useful tool to use in deciding the surgical indication and predicting the prognosis of the patients with ankle sprain. (author)

  17. 脉压增大的高血压患者脉搏波传导速度、颈动脉内膜中层厚度和踝臂指数的检测现状%Examination status of pulse wave velocity, carotid artery intima-media thickness and ankle-brachial index in hypertensive patients with increased pulse pressure

    Institute of Scientific and Technical Information of China (English)

    隋辉; 马丽媛; 刘明波; 王文

    2014-01-01

    目的:了解脉压增大(脉压≥50 mmHg,1mmHg=0.133kPa)的高血压患者脉搏波传导速度(PWV)、颈动脉内膜中层厚度(IMT)和踝臂指数的检测现状。方法2011年4月至2012年9月,选取中国北部、南部和西部的96个大、中、小城市的709家医院进行的大型横断面调查。入选脉压增大(脉压≥50 mmHg)的高血压患者36259例。根据患者的血压水平、危险因素数量、靶器官损害和心血管疾患分为低危、中危、高危和很高危。根据脉压分为50~60 mmHg,60~70 mmHg和≥70 mmHg三层。询问病史(心血管病、脑血管病、肾脏病和糖尿病史)、吸烟史;记录PWV、IMT和踝臂指数的检查情况。现场测量血压、身高、体重、腰围。结果患者IMT、PWV和踝臂指数的检查率分别为20.7%、8.8%和7.8%,即未做IMT、PWV和踝臂指数检查的患者分别为79.3%、91.2%和92.2%。进一步分析,在检查的患者中, IMT(≥0.9 mm和粥样斑块)、PWV(>12 ms)和踝臂指数(≤0.9)异常的检出率分别为65.7%、40.9%和47.4%。IMT、PWV和踝臂指数异常的检出率在高危患者中分别为86.8%、68.5%和22.9%,在很高危患者中分别为66.1%、40.2%和48.2%。脉压50~60 mmHg,60~70 mmHg和≥70 mmHg组的IMT异常的检出率分别是39.3%,66.6%和80.7%;PWV异常的检出率分别是24.6%,43.0%和59.0%。结论我国城市中,脉压增大(≥50 mmHg)的高血压患者血管病变相关项目的检测率低。%Objective To get to know the examination status of pulse wave velocity (PWV), carotid artery intima-media thickness (CA-IMT) and ankle-brachial index (ABI) in hypertensive patients with increased pulse pressure (≥50 mmHg).Methods A large-scale cross-sectional survey was carried out in 709 hospitals in 96 large, medium and small cities in North, South and West China from Apr. 2011 to Sept. 2012. The patients (n=36259) were chosen and divided into low risk group, mid

  18. Foot, leg, and ankle swelling

    Science.gov (United States)

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot ...

  19. How to Tape an Ankle

    Science.gov (United States)

    ... to Tape a Toe How to Stretch Your Ankle After A Sprain How to Strengthen Your Ankle After a Sprain How to Prepare for Orthopaedic Foot or Ankle Surgery: Part III How to Prepare for Orthopaedic ...

  20. Ankle Sprains. A Round Table.

    Science.gov (United States)

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  1. True aneurysm of brachial artery.

    Science.gov (United States)

    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor

    2010-10-01

    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms. PMID:20865459

  2. Structure of the brachial plexus root and adjacent regions displayed by ultrasound imaging

    Institute of Scientific and Technical Information of China (English)

    Zhengyi Li; Xun Xia; Xiaoming Rong; Yamei Tang; Dachuan Xu

    2012-01-01

    Brachial plexuses of 110 healthy volunteers were examined using high resolution color Doppler ultrasound. Ultrasonic characteristics and anatomic variation in the intervertebral foramen, interscalene, supraclavicular and infraclavicular, as well as the axillary brachial plexus were investigated. Results confirmed that the normal brachial plexus on cross section exhibited round or elliptic hypoechoic texture. Longitudinal section imaging showed many parallel linear hypo-moderate echoes, with hypo-echo. The transverse processes of the seventh cervical vertebra, the scalene space, the subclavian artery and the deep cervical artery are important markers in an examination. The display rates for the interscalene, and supraclavicular and axillary brachial plexuses were 100% each, while that for the infraclavicular brachial plexus was 97%. The region where the normal brachial plexus root traversed the intervertebral foramen exhibited a regular hypo-echo. The display rate for the C5-7 nerve roots was 100%, while those for C8 and T1 were 83% and 68%, respectively. A total of 20 of the 110 subjects underwent cervical CT scan. High-frequency ultrasound can clearly display the outline of the transverse processes of the vertebrae, which were consistent with CT results. These results indicate that high-frequency ultrasound provides a new method for observing the morphology of the brachial plexus. The C7 vertebra is a marker for identifying the position of brachial plexus nerve roots.

  3. An epidemiological survey on ankle sprain.

    OpenAIRE

    Yeung, M S; Chan, K. M.; So, C H; Yuan, W Y

    1994-01-01

    Ankle sprain is a common sports injury and is often regarded as trivial by athletes and coaches. This epidemiological study was conducted among three categories of Hong Kong Chinese athletes: national teams, competitive athletes and recreational athletes. This study shows that as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance. This study indicates that a pro...

  4. Traumatic injuries of brachial plexus: present methods of surgical treatment Part II. Treatment policy for brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    M. L. Novikov

    2013-01-01

    Full Text Available The task of this paper is to familiarize practicing neurologists, neurosurgeons, traumatologists, and orthopedists with the current principles of diagnosis and treatment of different brachial plexus (BP injuries. Part I describes the anatomy of BP in detail, considers the main mechanisms of its injuries, and gives their current classification (Nervno-Myshechnye Bolezni (Neuromuscular Diseases 2012;4:19–27.Part II presents the author's approach to treatment of brachial plexus injuries according to the type of lesion and period of denervation: nonoperative methods; rehabilitation; preoperative management; indications for surgical treatment. The tactics and techniques of primary brachial plexus reconstructions are discussed in detail.

  5. A multimodal approach to ankle instability: Interrelations between subjective and objective assessments of ankle status in athletes.

    Science.gov (United States)

    Golditz, Tobias; Welsch, Goetz H; Pachowsky, Milena; Hennig, Friedrich F; Pfeifer, Klaus; Steib, Simon

    2016-03-01

    The aim of this retrospective cohort study is to investigate the association between different subjective and objective assessments of ankle function in a population of athletes with or without functional ankle instability (FAI). 29 athletes with a history of ankle spraining were divided into two groups according to their ankle status: 16 with FAI (initial ankle sprain with residual functional instability) (age 24.6 ± 3.1 years), and 13 COPERS (initial ankle sprain without residual instability) (age 25.3 ± 4.4 years). The assessment of each individual's ankle function was based on three approaches: The "functional-ankle-ability-measure" (FAAM) assessing subjective ankle functionality, measures of sensorimotor control as objective functional measurements and MRI-based T2-mapping as a quantitative marker of compositional joint status. Pearson's product-moment-correlation coefficient, student's t-test and analysis-of-variance were used for statistical analysis. Significant group differences existed for subjective ankle function (FAAM, p = 0.04) and MRI-data mainly in the medial compartment of the ankle joint (p ≤ 0.05). We found unique associations between T2-mapping results and sensorimotor scores in the COPER (r = -0.756-0.849), and "FAI"-group (r = 0.630-0.657). The location and magnitude differed between groups. No correlations existed between these measures and the FAAM. This exploratory study provides preliminary evidence for potential interrelations between various diagnostic measures of ankle function and structure in individuals with and without FAI. We found associations between MRI-results and selected measures of sensorimotor control, indicating a potential link between loss of ankle function and early joint degeneration. Despite these interrelations, each of the different assessment options appears to contain unique information on ankle functionality important in a clinical assessment. PMID:26309042

  6. Ankle sprain - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ... 4 out of 4 Normal anatomy Overview The ankle joint connects the foot with the leg. The ...

  7. Number of distal limb and brachial pressure measurements required when diagnosing peripheral arterial disease by laser Doppler flowmetry

    International Nuclear Information System (INIS)

    We examine the reliability of single and repeated blood pressure measurements at ankle, toe, and arm levels for the diagnosis of peripheral arterial disease (PAD) by laser Doppler flowmetry. Segmental pressures were measured in 200 patients with known or suspected PAD. Segmental indices were calculated using (1) one measurement [M-1], two measurements [M-2], or by a predefined reproducibility criterion (RC) as well as (2) by using one brachial blood-pressure (BBP-one) or correspondent to each segmental pressure (BBP-all) as reference. The agreement in diagnosis of PAD by Cohen's Kappa was κ = 0.930 when comparing RC to M-1, and κ = 0.977 when comparing RC to M-2. The same comparison showed excellent relative reliability for segmental indices (all intra-class correlation coefficients (ICC) ≥ 0.980). Diagnostic classification agreement for BBP-all versus BBP-one were κ = 0.831 for RC, κ = 0.804 for M-1, and κ = 0.847 for M-2. The relative reliability analysis showed excellent correlation in segmental indices (all ICC ≥ 0.957). The study shows minimal difference in segmental indices and diagnostic classification when comparing calculations based on the listed strategies. However, the study indicated that it is important to measure BBPs correspondent to each segmental pressure. (paper)

  8. Measurement characteristics of the ankle–brachial index: results from the Action for Health in Diabetes study

    OpenAIRE

    Espeland, Mark A.; Regensteiner, Judith G; Jaramillo, Sarah A.; Gregg, Edward; Knowler, William C.; Wagenknecht, Lynne E.; Bahnson, Judy; Haffner, Steven; Hill, James; Hiatt, William R.

    2008-01-01

    Many protocols have been used in clinical and research settings for collecting systolic blood pressure (SBP) measurements to calculate the ankle–brachial index (ABI); however, it is not known how useful it is to replicate measurements and which measures best reflect cardiovascular risk. Standardized measurements of ankle and arm SBP from 5140 overweight or obese individuals with type 2 diabetes were used to estimate sources of variation. Measurement characteristics of leg-specific ABI, as cal...

  9. Hydrocolonotherapy ankle joints after injuries

    Directory of Open Access Journals (Sweden)

    Volodymyr Muchin

    2016-02-01

    Full Text Available Purpose: to improve efficiency of gydrokinesitherapy by means of specially designed devices and monolasts for patients after ankle joint injuries. Material & Methods: there are pedagogical methods, clinical and radiological methods, anthropometric measurements and goniometry were used. Results: the author's technique of hydrokinesitherapy with application hydrokinesimechanotherapy device in the program of physical rehabilitation which provides optimum conditions for the recovery process was developed. Conclusions: the specially designed hydrokinesomechanotherapeutic device and monolasts are allow strictly controlled movement in all planes of the ankle joint, which contributes to the acceleration of the recovery; the conducted anthropometric and goniometric studies were indicate more rapid elimination of edema, increase movement amplitude, carries opposition to the development of contractures and muscle atrophy.

  10. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  11. Arthrography of the ankle

    International Nuclear Information System (INIS)

    As part of a clinical prospective investigation 102 patients with fresh ankle injuries underwent ankle arthrography and surgery for rupture of the lateral ligaments of the ankle. Three hypotheses concerning the improvement of the arthrographic diagnosis of rupture of the calcaneofibular ligament were tested. Two were rejected. Improvement in the diagnostic specificity was possible by combining arthrography with a stress inversion test, but the sensitivity of this combination was low. It was demonstrated that absence of peroneus sheath filling was a better diagnostic sign with good rather than with poor recess filling. (Auth.)

  12. MR imaging of the brachial plexus

    International Nuclear Information System (INIS)

    Determining the cause of brachial plexopathy is often difficult. MR imaging allows for direct visualization of this region in multiple planes with high soft-tissue contrast. This paper defines the normal anatomy of the brachial plexus and demonstrates the ability of MR imaging to evaluate varied pathology in this region. Fifty-five patients with brachial plexopathy were evaluated with either a 1.5-T (General Electric, Milwaukee) or a 0.35-T (Diasonics, South San Francisco) superconducting MR system. Multiplanar, multiecho spin-echo images were obtained with either dual-coil imaging or a body coil. Individual fascicles to the brachial plexus were clearly separated from the subclavian artery and vein, clavicle, and surrounding musculature. Abnormalities well seen with MR imaging included primary tumors in the region of the brachial plexus, tumors metastatic to the brachial plexus, direct extension of pancoast tumors, postradiation fibrosis, and posttraumatic lesions, including fracture and edema

  13. Arthrography of the ankle

    International Nuclear Information System (INIS)

    The contribution of artrography in the diagnosis of acute ligaments injuries of the ankle is discussed. The technique of examination is described. An anatomic review, diagnostic elements and the proceeding are presented emphasizing the lateral ligaments. (M.A.C.)

  14. Ankle fracture - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this ... Sit with your foot elevated higher than your knee at least 4 times a day Apply an ...

  15. Functional reconstruction following brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Cunyi Fan; Yudong Gu

    2007-01-01

    OBJECTIVE: To sum up the treatment of brachial plexus root avulsion and the progress in functional reconstruction and rehabilitation following brachial plexus root avulsion.DATA SOURCES: A search of Medline was performed to select functional reconstruction and rehabilitation following brachial plexus injury-related English articles published between January 1990 and July 2006, with key words of "brachial plexus injury, reconstruction and rehabilitation". Meanwhile, a computer-based search of CBM was carried out to select the similar Chinese articles published between January 1998 and July 2006,with key words of "brachial plexus injury, reconstruction and rehabilitation".STUDY SELECTION: The materials were checked primarily, and the literatures of functional reconstruction and rehabilitation of brachial plexus injury were selected and the full texts were retrieved.Inclusive criteria: ① Functional reconstruction following brachial plexus injury. ② Rehabilitation method of brachial plexus injury. Exclusive criteria: Reviews, repetitive study, and Meta analytical papers.DATA EXTRACTION: Forty-six literatures about functional reconstruction following brachial plexus injury were collected, and 36 of them met the inclusive criteria.DATA SYNTHESIS: Brachial plexus injury causes the complete or incomplete palsy of muscle of upper extremity. The treatment of brachial plexus is to displace not very important nerves to the distal end of very important nerve, called nerve transfer, which is an important method to treat brachial plexus injury.Postoperative rehabilitations consist of sensory training and motor functional training. It is very important to keep the initiativeness of exercise. Besides recovering peripheral nerve continuity by operation, combined treatment and accelerating neural regeneration, active motors of cerebral cortex is also the important factor to reconstruct peripheral nerve function.CONCLUSION: Consciously and actively strengthening functional

  16. Responses of spinal dorsal horn neurons to foot movements in rats with a sprained ankle.

    Science.gov (United States)

    Kim, Jae Hyo; Kim, Hee Young; Chung, Kyungsoon; Chung, Jin Mo

    2011-05-01

    Acute ankle injuries are common problems and often lead to persistent pain. To investigate the underlying mechanism of ankle sprain pain, the response properties of spinal dorsal horn neurons were examined after ankle sprain. Acute ankle sprain was induced manually by overextending the ankle of a rat hindlimb in a direction of plantarflexion and inversion. The weight-bearing ratio (WBR) of the affected foot was used as an indicator of pain. Single unit activities of dorsal horn neurons in response to plantarflexion and inversion of the foot or ankle compression were recorded from the medial part of the deep dorsal horn, laminae IV-VI, in normal and ankle-sprained rats. One day after ankle sprain, rats showed significantly reduced WBRs on the affected foot, and this reduction was partially restored by systemic morphine. The majority of deep dorsal horn neurons responded to a single ankle stimulus modality. After ankle sprain, the mean evoked response rates were significantly increased, and afterdischarges were developed in recorded dorsal horn neurons. The ankle sprain-induced enhanced evoked responses were significantly reduced by morphine, which was reversed by naltrexone. The data indicate that movement-specific dorsal horn neuron responses were enhanced after ankle sprain in a morphine-dependent manner, thus suggesting that hyperactivity of dorsal horn neurons is an underlying mechanism of pain after ankle sprain. PMID:21389306

  17. MR neurography of the brachial plexus

    International Nuclear Information System (INIS)

    Magnetic resonance neurography was used to directly image the brachial plexus in patients with clinically suspected brachial plexus neuritis. The authors obtained spectral presaturation with inversion recovery and short T1 inversion recovery images parallel to the long axis of nerves using neurovascular array coils in 17 patients. In seven patients, the images revealed nerve swelling and hyperintensity in the the brachial plexus. In three patients with zoster paresis of the shoulder or upper extremity the images revealed marked hyperintensity in the roots. Direct nerve imaging may prove to be helpful in evaluating patients with brachial plexus neuritis. (author)

  18. Ankle injuries in basketball players.

    Science.gov (United States)

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential. PMID:8536029

  19. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  20. Free functional gracilis muscle transfer in children with severe sequelae from obstetric brachial plexus palsy

    OpenAIRE

    Ocampo-Pavez Claudia; Bahm Jörg

    2008-01-01

    Abstract We present 4 children between 6 and 13 years suffering from severe sequelae after a total obstetric brachial plexus lesion resulting in a hand without functional active long finger flexion. They had successfully reanimated long finger flexion using a free functional gracilis muscle transfer. These children initially presented a total obstetric brachial plexus palsy without neurotisation of the lower trunk in an early microsurgical nerve reconstruction procedure. We describe our indic...

  1. MR imaging of the brachial plexus

    NARCIS (Netherlands)

    Es, Hendrik Wouter van

    2001-01-01

    In this retrospective study we describe the MR imaging findings in 230 consecutive patients with suspected pathology in or near the brachial plexus. These patients were studied from 1991 through to 1996. Chapter 2 describes the anatomy and the MR imaging techniques. As the anatomy of the brachial pl

  2. Neuromuscular hamartoma arising in the brachial plexus

    International Nuclear Information System (INIS)

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  3. Neuromuscular hamartoma arising in the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Lai, P.H.; Chen, C.; Yeh, L.R.; Pan, H.B. [Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan); Ho, J.T.; Hsu, S.S. [Department of Neurosurgery, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaosiung (Taiwan); Lin, S.L. [Department of Pathology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813, Kaohsiung (Taiwan)

    2004-03-01

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  4. Ankle Fractures Often Not Diagnosed

    Science.gov (United States)

    ... Not Diagnosed A A A | Print | Share Ankle Fractures Often Not Diagnosed Long-term complications result from ... patients: Total ankle replacements--similar to hip and knee replacements--were once reserved for geriatric patients but ...

  5. Doctor, I sprained my ankle.

    Science.gov (United States)

    How, Choon How; Tan, Ken Jin

    2014-10-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long‑term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle's range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  6. Acute injury of the ankle joint

    International Nuclear Information System (INIS)

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic. (orig.)

  7. Brachial neuritis following a corticosteroid injection.

    Science.gov (United States)

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment. (1) The injection of local anaesthetic and corticosteroid should be considered as a potential trigger for brachial neuritis. (2) Brachial neuritis should be considered in the differential diagnosis for patients presenting with severe arm pain and weakness. (3) The nerves originating from the upper trunk of the brachial plexus are most commonly affected. (4) The anterior interosseous nerve is involved in one-third of cases. PMID:24596414

  8. Short-term ankle motor performance with ankle robotics training in chronic hemiparetic stroke

    Directory of Open Access Journals (Sweden)

    Anindo Roy, PhD

    2011-05-01

    Full Text Available Cerebrovascular accident (stroke often results in impaired motor control and persistent weakness that may lead to chronic disability, including deficits in gait and balance function. Finding ways to restore motor control may help reduce these deficits; however, little is known regarding the capacity or temporal profile of short-term motor adaptations and learning at the hemiparetic ankle. Our objective was to determine the short-term effects of a single session of impedance-controlled ankle robot (“anklebot” training on paretic ankle motor control in chronic stroke. This was a double-arm pilot study on a convenience sample of participants with chronic stroke (n = 7 who had residual hemiparetic deficits and an equal number of age- and sex-matched nondisabled control subjects. Training consisted of participants in each group playing a target-based video game with the anklebot for an hour, for a total of 560 movement repetitions in dorsiflexion/plantar flexion ranges followed by retest 48 hours later. Task difficulty was adjusted to ankle range of motion, with robotic assistance decreased incrementally across training. Assessments included robotic measures of ankle motor control on unassisted trials before and after training and at 48 hours after training. Following exposure to the task, subjects with stroke improved paretic ankle motor control across a single training session as indexed by increased targeting accuracy (21.6 +/– 8.0 to 31.4 +/– 4.8, p = 0.05, higher angular speeds (mean: 4.7 +/– 1.5 degrees/s to 6.5 +/– 2.6 degrees/s, p 0.05 at 48 hours in both groups. Robust maintenance of motor adaptation in the robot-trained paretic ankle over 48 hours may be indicative of short-term motor learning. Our initial results suggest that the anklebot may be a flexible motor learning platform with the potential to detect rapid changes in ankle motor performance poststroke.

  9. X-Ray Exam: Ankle

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth X-Ray Exam: Ankle KidsHealth > For Parents > X-Ray Exam: Ankle Print A A A Text Size ... español Radiografía: tobillo What It Is An ankle X-ray is a safe and painless test that uses ...

  10. Footballer's ankle: a case report

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Footballer' s ankle is anterior bony spur or anterior impingement symptom of the ankle with anterior ankle pain, limited and painful dorsiflexion. The cause is commonly seen in athletes and dancers, and is probably due to repetitive minor trauma. The condition was firstly described by Morris;1 McMurray2 reported good results from excision of the spurs, naming it footballer's ankle. Opening resection of osteophytes of the anterior tibial and superior talar is an effective treatment for anterior impingement of the ankle.

  11. Traumatic injuries of brachial plexus

    International Nuclear Information System (INIS)

    The authors report their experience in 144 patients with traumatic brachial plexus injury who underwent Direct Cervical Myelography (DCM). Sometimes the diagnostic investigation was completed by CT. Various myelographic patterns are described: pseudomeningocele, missing sheet of the root, scarring lesions. In 9 cases only, myelography was not sufficient to provide a complete diagnosis. The examination showed all plexus roots lacerated in 14 patients, a monoradicular lesion in 75 cases, and no lesion in 26 cases. Twenty-one out of the 26 negative cases were confirmed during surgery, while in 2 patients an intracanalar injury was found, which had not been detected due to the presence of scars. Scars often compress healty roots, and may mask intracanalar injuries. In such cases, and when the spinal cord stretches towards the side of the lesion, Myelo-CT can be useful. DCM proved to be an extremely sensitive and specific method, which can be used as a first-choice radiological procedure in the study of traumatic injuries of the brachial plexus

  12. Absence of upper trunk of the brachial plexus

    OpenAIRE

    Adam, Ali H; Mohammed, Ammar M A; Grebballa, Abbas; Rizig, Sahar

    2011-01-01

    The brachial plexus is a complicated plexus supplying the upper limb. The brachial plexus is of great practical importance to the surgeon. It is encountered during operations upon the root of the neck, and hence it is in danger. Variations in the formation of the brachial plexus are common; and knowledge of the variation of the brachial plexus may be useful for surgeons, for improved guidance during supraclavicular block procedures, and for surgical approaches for brachial plexus. Here we rep...

  13. Ankle Injuries and Disorders

    Science.gov (United States)

    ... are sprains and fractures. A sprain is an injury to the ligaments. It may take a few weeks to many months to heal completely. A fracture is a break in a bone. You can also ... your joints. Ankle sprains and fractures are common sports injuries.

  14. Clinical experiences with three different designs of ankle prostheses.

    Science.gov (United States)

    Rippstein, Pascal F

    2002-12-01

    Until 1995, fusion was in our institution the only rational surgical option for a severe ankle arthrosis. Consistent reports about good mid- and long-term results with ankle replacement allowed us to change our minds. Ankle replacement became the gold standard and fusion was then almost totally banished. Because ankle arthrosis can be morphologically different from one patient to another, we soon believed that one single type of ankle prosthesis would not be the universal optimal solution for all patients. We therefore divided the ankle arthrosis into three groups. Each group shows the best solution from each of the ankle prostheses with which we had gained experience (Agility, STAR, and BP). The Agility prosthesis, which was indicated for ankles with extremely damaged geometry, did not restore sufficiently the ankle motion. Preoperatively stiff ankles remained stiff postoperatively. Additionally, significant residual pain was more likely to occur in those patients. These cases did not show significant advantages compared with ankle fusion, especially from a functional point of view. Fusion for these stiff ankles is therefore today our first treatment of choice. In our experience, the malleolar joints do not have to be replaced. Even a severe arthrosis at this level does not produce significant pain, provided that osteophytes have been removed and joint height has been restored by the implanted prosthesis. It is our strong belief that these malleolar joints are also less sensitive to pain, similar to the femoropatellar joint. For these reasons, a replacement of the malleolar joints and the resurfacing of the talar sides is not necessary. Leaving the talar sides untouched requires less bone resection and makes the implantation of the talar component easier. Although we obtained good results with the STAR prosthesis, we progressively abandoned it because of these reasons, and we preferred the BP prosthesis. The BP prosthesis works on the same biomechanic principle as

  15. Design of a simple, lightweight, passive-elastic ankle exoskeleton supporting ankle joint stiffness

    Science.gov (United States)

    Kim, Seyoung; Son, Youngsu; Choi, Sangkyu; Ham, Sangyong; Park, Cheolhoon

    2015-09-01

    In this study, a passive-elastic ankle exoskeleton (PEAX) with a one-way clutch mechanism was developed and then pilot-tested with vertical jumping to determine whether the PEAX is sufficiently lightweight and comfortable to be used in further biomechanical studies. The PEAX was designed to supplement the function of the Achilles tendon and ligaments as they passively support the ankle torque with their inherent stiffness. The main frame of the PEAX consists of upper and lower parts connected to each other by tension springs (N = 3) and lubricated hinge joints. The upper part has an offset angle of 5° with respect to the vertical line when the springs are in their resting state. Each spring has a slack length of 8 cm and connects the upper part to the tailrod of the lower part in the neutral position. The tailrod freely rotates with low friction but has a limited range of motion due to the stop pin working as a one-way clutch. Because of the one-way clutch system, the tension springs store the elastic energy only due to an ankle dorsiflexion when triggered by the stop pin. This clutch mechanism also has the advantage of preventing any inconvenience during ankle plantarflexion because it does not limit the ankle joint motion during the plantarflexion phase. In pilot jumping tests, all of the subjects reported that the PEAX was comfortable for jumping due to its lightweight (approximately 1 kg) and compact (firmly integrated with shoes) design, and subjects were able to nearly reach their maximum vertical jump heights while wearing the PEAX. During the countermovement jump, elastic energy was stored during dorsiflexion by spring extension and released during plantarflexion by spring restoration, indicating that the passive spring torque (i.e., supportive torque) generated by the ankle exoskeleton partially supported the ankle joint torque throughout the process.

  16. Radiodiagnosis of closed fractures of brachial plexus

    International Nuclear Information System (INIS)

    To clarify localization of brachial plexus (BP) root abruption, contrasting of spinal cord subarachnoidal space using X ray contrast preparation (myeloradiculography) is applied. Analysis of results of X-ray investigation in 91 patients is given. Typical symptoms of root abruption from the spinal cord on myelograms are described. it is shown that X ray contrast investigation is the main method in the diagnosis of brachial plexus injuries and selection of surgical treatment tactics

  17. Brachial Plexus Anatomy: Normal and Variant

    OpenAIRE

    Orebaugh, Steven L.; Williams, Brian A.

    2009-01-01

    Effective brachial plexus blockade requires a thorough understanding of the anatomy of the plexus, as well as an appreciation of anatomic variations that may occur. This review summarizes relevant anatomy of the plexus, along with variations and anomalies that may affect nerve blocks conducted at these levels. The Medline, Cochrane Library, and PubMed electronic databases were searched in order to compile reports related to the anatomy of the brachial plexus using the following free terms: "b...

  18. Neonatal brachial plexus palsy: a permanent challenge

    OpenAIRE

    Carlos Otto Heise; Roberto Martins; Mário Siqueira

    2015-01-01

    Neonatal brachial plexus palsy (NBPP) has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

  19. Neonatal brachial plexus palsy: a permanent challenge

    Directory of Open Access Journals (Sweden)

    Carlos Otto Heise

    2015-09-01

    Full Text Available Neonatal brachial plexus palsy (NBPP has an incidence of 1.5 cases per 1000 live births and it has not declined despite recent advances in obstetrics. Most patients will recover spontaneously, but some will remain severely handicapped. Rehabilitation is important in most cases and brachial plexus surgery can improve the functional outcome of selected patients. This review highlights the current management of infants with NBPP, including conservative and operative approaches.

  20. Brachial neuritis following a corticosteroid injection

    OpenAIRE

    Robinson, Matthew; Fulcher, Mark

    2014-01-01

    This report presents a case of brachial neuritis following a subacromial corticosteroid injection. The patient developed an anterior interosseous neuropathy shortly after the injection, with no other trigger being identified. This neuropathy has unfortunately not shown any sign of recovery at 2 years. The authors propose that corticosteroid injection be added to the list of possible triggering events of brachial neuritis and highlight the frequent use of oral corticosteroids in its treatment....

  1. Acute brachial neuritis following influenza vaccination

    OpenAIRE

    Shaikh, Maliha Farhana; Baqai, Tanya Jane; Tahir, Hasan

    2012-01-01

    Brachial neuritis following vaccination is an uncommon but clinically important presentation of severe shoulder and arm pain associated with globally reduced range of movement. It may be confused with the more common diagnoses of rotator cuff pathology, adhesive capsulitis (frozen shoulder), shoulder arthritis or cervical spondylosis. We present a case of acute brachial neuritis, which posed a clinical diagnostic challenge to emergency, acute medical and rheumatology clinicians.

  2. MR Imaging of the Brachial Plexus.

    OpenAIRE

    Es, Hendrik Wouter van

    2000-01-01

    In this retrospective study we describe the MR imaging findings in 230 consecutive patients with suspected pathology in or near the brachial plexus. These patients were studied from 1991 through to 1996. Chapter 2 describes the anatomy and the MR imaging techniques. As the anatomy of the brachial plexus and the related structures is quite complicated, we eventually use as protocol of choice a 3D volume acquisition for the best understanding of this complex anatomy. The advantages of this 3D v...

  3. Neurinomas of the brachial plexus: case report.

    Science.gov (United States)

    Forte, A; Gallinaro, L S; Bertagni, A; Montesano, G; Prece, V; Illuminati, G

    1999-01-01

    Neurinomas, also referred to as neurilemmomas and schwannomas, are rare benign tumours of the peripheral nerves, a low proportion of which arise from the brachial plexus. Authors report a case of an ancient schwannoma arising from the brachial plexus. The tumour, usually asymptomatic, may cause sensory radicular symptoms, or rarely motor deficits in the involved arm. Enucleation of the tumour from the nerve without damage to any of the fascicles is the correct treatment. PMID:10710825

  4. Return to Play Following Ankle Sprain and Lateral Ligament Reconstruction.

    Science.gov (United States)

    Shawen, Scott B; Dworak, Theodora; Anderson, Robert B

    2016-10-01

    Ankle sprains are the most common musculoskeletal injury occurring during athletics. Proper initial treatment with supportive pain control, limited immobilization, early return to weight bearing and range of motion, and directed physical therapy are essential for preventing recurrent injury. Reconstruction of the lateral ligaments is indicated for patients with continued instability and dysfunction despite physical therapy. Return to athletic activity should be reserved for athletes who have regained strength, proprioception, and range of motion of the injured ankle. Athletes with a history of an ankle sprain should be prophylactically braced or tapped to reduce risk of recurrent injury. PMID:27543408

  5. Ankle impingement syndromes

    International Nuclear Information System (INIS)

    Soft-tissue and osseous impingement syndromes can be an important cause of chronic ankle pain, particularly in the professional athlete. The classification of ankle impingement syndromes is based to their anatomical location around the tibiotalar joint. The most important impingement syndromes are anterolateral, anterior and posterior impingement with more recent studies describing posteromedial and anteromedial impingement. Usually conventional radiography is the first imaging technique to be performed as it allows assessment of potential bone abnormalities, particularly in anterior and posterior joint compartments. Computed tomography (CT) only plays a role in the assessment of the posterior impingement. Magnetic resonance (MR) imaging is regarded as the modality of choice as it is able to demonstrate both osseous and soft tissue changes, such as bone marrow edema, capsular and ligametous thickening, and localized synovitis. (orig.)

  6. Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve: evaluation of nerve viscoelastic properties

    Directory of Open Access Journals (Sweden)

    Hua Jin

    2015-01-01

    Full Text Available The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as embryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C 6 root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C 6 brachial plexus injury site (1 × 10 6 cells/mL, 3 μL/injection, 25 injections immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C 6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also significantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effectively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.

  7. Human amniotic epithelial cell transplantation for the repair of injured brachial plexus nerve:evaluation of nerve viscoelastic properties

    Institute of Scientific and Technical Information of China (English)

    Hua Jin; Qi Yang; Feng Ji; Ya-jie Zhang; Yan Zhao; Min Luo

    2015-01-01

    The transplantation of embryonic stem cells can effectively improve the creeping strength of nerves near an injury site in animals. Amniotic epithelial cells have similar biological properties as em-bryonic stem cells; therefore, we hypothesized that transplantation of amniotic epithelial cells can repair peripheral nerve injury and recover the creeping strength of the brachial plexus nerve. In the present study, a brachial plexus injury model was established in rabbits using the C6root avulsion method. A suspension of human amniotic epithelial cells was repeatedly injected over an area 4.0 mm lateral to the cephal and caudal ends of the C6 brachial plexus injury site (1 × 106 cells/mL, 3μL/injection, 25 injections) immediately after the injury. The results showed that the decrease in stress and increase in strain at 7,200 seconds in the injured rabbit C6 brachial plexus nerve were mitigated by the cell transplantation, restoring the viscoelastic stress relaxation and creep properties of the brachial plexus nerve. The forepaw functions were also signiifcantly improved at 26 weeks after injury. These data indicate that transplantation of human amniotic epithelial cells can effec-tively restore the mechanical properties of the brachial plexus nerve after injury in rabbits and that viscoelasticity may be an important index for the evaluation of brachial plexus injury in animals.

  8. Arthrography of the ankle

    International Nuclear Information System (INIS)

    Arthrography was performed in 105 cases with freshly sprained ankles and signs of rupture of the anterior talofibular ligament. They were subsequently operated upon. The arthrographic films were examined retrospectively to assess the value of different criteria for the differential diagnosis between rupture of the anterior talofibular ligament and combined rupture of this and the calcaneofibular ligament. The diagnostic value of arthrography was found to be high in isolated rupture of the anterior talofibular ligament, and is acceptable in the combined ruptures. (Auth.)

  9. MR imaging of the ankle

    International Nuclear Information System (INIS)

    To define the clinical role of MRI of the ankle joint, a total of 98 patients were investigated. In the evaluation of ligamentous injuy, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary. (orig.)

  10. Syndesmosis injuries of the ankle

    OpenAIRE

    Del Buono, Angelo; Florio, Antonietta; Boccanera, Michele Simone; Maffulli, Nicola

    2013-01-01

    Ankle syndesmosis injuries are relatively frequent in sports, especially skiing, ice hockey, and soccer, accounting for 1 %–18 % of all ankle sprains. The evolution is unpredictable: When missed, repeated episodes of ankle instability may predispose to early degenerative changes, and frank osteoarthritis may ensue. Diagnosis is clinical and radiological, but arthroscopy may provide a definitive response, allowing one to address secondary injuries to bone and cartilage. Obvious diastasis needs...

  11. How to Care for a Sprained Ankle

    Science.gov (United States)

    ... to Care for a Sprained Ankle Page Content Ankle sprains are very common injuries. There's a good chance ... to make sure no bones are broken. Most ankle sprains do not require surgery, and minor sprains are ...

  12. Hyaluronic acid as a treatment for ankle osteoarthritis

    OpenAIRE

    Sun, Shu-Fen; Chou, Yi-Jiun; Hsu, Chien-Wei; Chen, Wen-ling

    2009-01-01

    Viscosupplementation refers to the concept of synovial fluid replacement with intra-articular injections of hyaluronic acid (HA) for the relief of pain associated with osteoarthritis (OA). Intra-articular viscosupplementation was approved by the Food and Drug Administration (FDA) in 1997. It is currently indicated only for the treatment of pain associated with knee OA. However, OA can occur in several of the weight-bearing joints of the foot and ankle. Ankle OA produces chronic disability tha...

  13. Talofibular compartment of the ankle joint after recent ankle sprain

    International Nuclear Information System (INIS)

    The validity of predicting the condition of the anterior talofibular ligament from the shape of the lateral compartment of the ankle joint was investigated in patients with recent ankle sprain. The diagnostic value of the method was found to be restricted. (Auth.)

  14. Radiation-induced brachial plexopathy: MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wouter van Es, H. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Engelen, A.M. [Department of Radiation Therapy, University Hospital Utrecht, Utrecht (Netherlands); Witkamp, T.D. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Ramos, L.M.P. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Feldberg, M.A.M. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    1997-05-01

    Objective. To describe the MR imaging appearance of radiation-induced brachial plexopathy. Design. MR imaging was performed in two patients with the clinical diagnosis of radiation-induced brachial plexopathy and in one with surgically proven radiation fibrosis of the brachial plexus. Patients. Three patients who had had radiation therapy to the axilla and supraclavicular region (two with breast carcinoma and one with Hodgkin`s lymphoma) presented with symptoms in the arm and hand. To exclude metastases or tumor recurrence MR imaging was performed. Results and conclusion. In one patient, fibrosis showing low signal intensity was found, while in two patients high signal intensity fibrosis surrounding the brachial plexus was found on the T2-weighted images. In one case gadolinium enhancement of the fibrosis was seen 21 years after radiation therapy. It is concluded that radiation-induced brachial plexopathy can have different MR imaging appearances. We found that radiation fibrosis can have both low or high signal intensities on T2-weighted images, and that fibrosis can enhance even 21 years after radiation therapy. (orig.). With 3 figs.

  15. Role of dexamethasone in brachial plexus block

    International Nuclear Information System (INIS)

    To evaluate the effect of dexamethasone added to (lignocaine) on the onset and duration of axillary brachial plexus block. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital Rawalpindi, from September 2009 to March 2010. Patients and Methods: A total of 100 patients, who were scheduled for elective hand and forearm surgery under axillary brachial plexus block, were randomly allocated to group A in which patients received 40 ml 1.5% lidocaine with 2 ml of isotonic saline (0.9%) and group B in which patients received 40 ml 1.5% lidocaine with 2 ml of dexamethasone (8 mg). Nerve stimulator with insulated needle for multiple stimulations technique was used to locate the brachial plexus nerves. After the injection onset of action and duration of sensory blockade of brachial plexus were recorded at 5 minutes and 15 minutes interval. Results: Group A showed the onset of action of 21.64 ± 2.30 min and in group B it was 15.42 ± 1.44 min (p< 0.001). Duration of nerve block was 115.08 ± 10.92 min in group A and 265.42 ± 16.56 min in group B (p < 0.001). Conclusion: The addition of dexamethasone to 1.5% lignocaine solution in axillary brachial plexus block prolongs the duration of sensory blockade significantly. (author)

  16. Ultrasonography of ankle ligaments

    International Nuclear Information System (INIS)

    The lateral collateral ligament of the ankle is a complex of 3 ligaments: The anterior and posterior talofibular ligaments and the calcaneofibular ligament; these ligaments work together to support the lateral aspect of the ankle. The anterior talofibular (ATF) ligament (Fig. 1) runs from the anterior of the talus. The probe is placed in a slightly oblique position from the malleolus toward the forefoot. The ligament is hyperechoic when its fibres are perpendicular to the ultrasound beam (anisotropy artifact is present in ligaments as well as in tendons). It is approximately 2 mm thick and, during examination, must be straight and tight from one insertion point to the other, as seen in Fig. 2. The posterior talofibular (PTF) ligament, which runs from the posterior part of the malleolus to the posterior part of the talus, is difficult to see on US, being partially or sometimes completely hidden by the malleolus. The calcaneofibular ligament forms the middle portion of the lateral collateral ligament. It is tight between the inferior part of the lateral malleolus and the calcaneus, and runs in a slightly posterior oblique direction toward the heel (Fig. 3). The ligament lies on the deep surface of the fibular tendons, forming a hammock to fall deep on the calcaneus surface (Fig. 4). The calcaneofibular ligament is approximately 2-3 nun thick and is hyperechoic in the distal two-thirds only because of the obliquity of the proximal part. When examining this ligament, it is mandatory that the ankle be flexed dorsally; this stretches the ligament so that it can be seen clearly. (author)

  17. The Effects of Anesthetic Technique on Postoperative Opioid Consumption in Ankle Fracture Surgery

    DEFF Research Database (Denmark)

    Christensen, Kristian P; Møller, Ann M; Nielsen, Jesper Kjær;

    2015-01-01

    OBJECTIVES: To investigate the impact of common anesthetic techniques on postoperative opioid consumption in ankle fracture surgery. MATERIALS AND METHODS: We performed a retrospective cohort study on 622 patients with isolated ankle fractures undergoing primary reconstructive surgery. Patients...... anesthesia modalities reduce postoperative opioid consumption in ankle fracture surgery in comparison with GA. A benefit of PNBs is indicated possibly due to an improved pain profile. Our study is retrospective and cannot predict the exact magnitude of this benefit....

  18. Effects of Running Speed, Fatigue, and Bracing on Motor Control of Chronically Unstable Ankles

    OpenAIRE

    Webster, Courtney Ann

    2013-01-01

    Ankle sprains are among the most common injuries for participants in running and jumping sports. Following an initial sprain injury, many (30-40%) will develop chronic ankle instability (CAI), characterized by a perception of instability and repeated sprain injuries. Quasi-static test methods indicate poor postural stability and joint position sense (JPS) as associated motor control deficits. Little research, though, has investigated ankle motor control under dynamic (simulated sport) or fati...

  19. A one year prospective study on ankle stability and landing technique : The occurrence of ankle and knee injuries in elite ball team athletes

    NARCIS (Netherlands)

    Does, Henrike van der; Brink, M.S.; Lemmink, K.A.P.M.

    2014-01-01

    Background: In team sports lower extremity injuries account for more than 50% of all injuries, indicating the importance of early detection of athletes at risk. Objective: To investigate the predictive value of ankle stability and landing technique at baseline for ankle and knee injury occurrence du

  20. Herpetic Brachial Plexopathy: Application of Brachial Plexus Magnetic Resonance Imaging and Ultrasound-Guided Corticosteroid Injection.

    Science.gov (United States)

    Kim, Jeong-Gil; Chung, Sun G

    2016-05-01

    Herpes zoster, commonly known as shingles, is an infectious viral disease characterized by painful, unilateral skin blisters occurring in specific sensory dermatomes. Motor paresis is reported in 0.5% to 5% of patients. Although the mechanism of zoster paresis is still unclear, the virus can spread from the dorsal root ganglia to the anterior horn cell or anterior spinal nerve roots. It rarely involves the brachial plexus. We report a case of brachial plexitis following herpes zoster infection in which pathological lesions were diagnosed using brachial plexus magnetic resonance imaging and treated with ultrasound-guided perineural corticosteroid injection. PMID:26829085

  1. Radiation-induced brachial plexus paralysis

    International Nuclear Information System (INIS)

    Fifteen patients with radiation-induced brachial plexus paralysis were studied. Thirteen women had been treated for breast cancer. Two men developed symptoms and signs following radiation therapy for lung cancer. The brachial plexus paralysis initially was not static and progressed, but spontaneous arrest with permanent residual paralysis was seen in three patients. Three were noted to have intractable pain, but the major complaint of the remaining 12 was the inability to use their hands. The ten patients on whom an earlier operation directed at the brachial plexus had been performed were not relieved. Two of these were later considered excellent candidates for a tendon transfer in the hand. One did not desire surgery. The other underwent operation and showed marked improvement of her grasp and general hand function

  2. A novel technique of ultrasound-guided brachial plexus block in calves.

    Science.gov (United States)

    Iwamoto, Jiro; Yamagishi, Norio; Sasaki, Kouya; Kim, Danil; Devkota, Bhuminand; Furuhama, Kazuhisa

    2012-12-01

    An interventional ultrasound technique to increase the safety of surgical treatment of the calf forelimb was tested. First, the brachial plexus was evaluated using ultrasonography and then 2% lidocaine was injected under ultrasound guidance. Ultrasonically, the brachial plexus appeared as multiple hypoechoic areas surrounded by a hyperechoic rim or a hyperechoic structure characterised by multiple discontinuous lines. It was located between the omotransverse muscle and axillary artery and vein. The sensitive effect in the forelimb was seen mainly in the area supplied by the musculocutaneous nerve, indicating successful blockage in the nerve plexus. Out of the eight forelimbs, the motor effect was observed in seven forelimbs. These results suggest the clinical feasibility of ultrasound-guided brachial plexus block in bovine medicine, although further studies are needed to examine various approaches, including the sites of needle insertion and the appropriate volume and dosage of anaesthetic. PMID:22682007

  3. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  4. Ankle Bracing, Plantar-Flexion Angle, and Ankle Muscle Latencies During Inversion Stress in Healthy Participants

    OpenAIRE

    Kernozek, Thomas; Durall, Christopher J; Friske, Allison; Mussallem, Matthew

    2008-01-01

    Context: Ankle braces may enhance ankle joint proprioception, which in turn may affect reflexive ankle muscle activity during a perturbation. Despite the common occurrence of plantar-flexion inversion ankle injuries, authors of previous studies of ankle muscle latencies have focused on inversion stresses only.

  5. MRI diagnosis of brachial plexus preganglionic injury

    International Nuclear Information System (INIS)

    Objective: To evaluate MRI in diagnosing brachial plexus preganglionic injury. Methods: Twenty cases with brachial plexus preganglionic injury underwent MR scanning before operation. MR imaging was obtained by GE Signa EXCITE 1.5 T scanner. The scanning sequences included SE T1WI, FSE T2WI, T2WI STIR and 3 D Fast imaging employing steady state with phase cycled (3D-FIESTA-c). All the patients had exploration of the supraclavicular plexus and electrophysiology examination. And the accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were calculated with the standards of surgical and EMG results. Results: Among the 73 pairs of injured roots, MR imaging detected the abnormalities in 63 pairs. The accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 86.5% (83/96), 86.3% (63/73), 87.0% (20/23), respectively. The direct signs of brachial plexus preganglionic injury included (1) lack or mutilation of nerve root in 54 pairs (85.7%), (2) coarsening, bending, stiff course and unable to be traced to the intervertebral foramen continuously in 9 pairs (14.3%). The indirect signs included (1) cystic cerebrospinal fluid gathering in the vertebral canal, posttraumatic spinal meningocele in 46 pairs (73.0%), (2) abnormal shape of nerve sleeve in 13 pairs (20.6%), (3) displacement and deformity of spinal cord in 50 pairs (79.4%), (4) abnormal signal of paravertebral muscles in 19 patients. Conclusion: MRI can distinctly show the nerve rootlets within the vertebral canal, so it is helpful in making a correct diagnosis of brachial plexus preganglionic injuries. (authors)

  6. Radiation-included brachial plexus injury

    International Nuclear Information System (INIS)

    All 449 breast cancer patients treated with post-operative radiotherapy to the breast and lymph nodes between 1982 and 1984 have been followed for 3-5.5 years. In this group two different fractionation schedules were used, one five times a fortnight and one daily, both over 6 weeks. The calculated dose to the brachial plexus was 45 Gy in 15 fractions or 5e Gy in 30 fractions. These schedules are equivalent doses using the standard NSD formula. The diagnosis of a brachial plexus injury was made clinically and computed tomography from recurrent disease. The actuarial incidence of a radiation-induced brachial plexus injury for the whole group was 4.9% at 5.5 years. No cases were seen in the first 10 months following radiotherapy. The incidence rises between 1 and 4 years and then starts to plateau. When the large fraction size group is compared with the small fraction size group the incidence at 5.5 years is 5.9% and 1.0%, respectively (p 0.09). Two different treatment techniques were used in this group but were not found to contribute to the probability of developing a brachial plexud injury. It is suggested that radiation using large doses per fraction are less well tolerated by the brachial plexus than small doses per fraction; a commonly used fractionation schedule such as 45 Gy in 15 fractions may give unacceptably high brachial plexus morbidity; and the of small doses per fraction or avoiding lymphatic irradiation is advocated. (author). 13 refs.; 6 figs.; 1 tab

  7. Brachial plexus variations during the fetal period.

    Science.gov (United States)

    Woźniak, Jowita; Kędzia, Alicja; Dudek, Krzysztof

    2012-12-01

    The brachial plexus is an important nervous system structure. It can be injured during the perinatal period and by postnatal damage. The goal of this study was to assess human fetal brachial plexus variability. A total of 220 brachial plexuses were surgically prepared from 110 human fetuses aged 14-32 weeks of fetal life (50 females and 60 males) ranging in CRL from 80 to 233 mm. The study incorporated the following methods: dissectional and anthropological, digital image acquisition, digital image processing using Image J and GIMP software, and statistical methods (Statistica 9.0). Symmetry and sexual dimorphism were examined. Anomalies of the brachial plexuses were observed in 117 (53.18 %) cases. No sexual dimorphism was found. It was observed that cord variations occurred more often on the left side. Division variants (33.64 %) occurred most often, but also cords (18.18 %) as well as root nerves and terminal ramifications (15.90 %) were found. Trunk anomalies were rare and occurred in only 5.45 % of plexuses. Three height types of median nerve roots in combination with the nerve were distinguished. In one-third of cases, median nerve root connections were found below the axillary fossa and even half in the proximal part of the humerus. In conclusion, the brachial plexus was characterized for anatomical structural variability. Most often division and cord variations were observed. Anomalies occurred regardless of sex or body side except for cord variants. Brachial plexus variation recognition is significant from the neurosurgical and traumatological point of view. PMID:22945314

  8. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  9. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  10. Sports Injuries to the Foot and Ankle

    Science.gov (United States)

    ... FootNotes Newsletter Current Issue Archive Subscribe Home » Foot & Ankle Conditions » Sports Injuries to the Foot and Ankle A A A | ... page. Please enable Javascript in your browser. Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles ...

  11. Magnetic resonance neurography of the brachial plexus

    Directory of Open Access Journals (Sweden)

    Vaishali Upadhyaya

    2015-01-01

    Full Text Available Magnetic Resonance Imaging (MRI is being increasingly recognised all over the world as the imaging modality of choice for brachial plexus and peripheral nerve lesions. Recent refinements in MRI protocols have helped in imaging nerve tissue with greater clarity thereby helping in the identification, localisation and classification of nerve lesions with greater confidence than was possible till now. This article on Magnetic Resonance Neurography (MRN is based on the authors′ experience of imaging the brachial plexus and peripheral nerves using these protocols over the last several years.

  12. Predicting functional recovery after acute ankle sprain.

    Directory of Open Access Journals (Sweden)

    Sean R O'Connor

    Full Text Available INTRODUCTION: Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain. METHODS: A secondary analysis of data from adult participants (N = 85 with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive value of variables (age, BMI, gender, injury mechanism, previous injury, weight-bearing status, medial joint line pain, pain during weight-bearing dorsiflexion and lateral hop test recorded at baseline and at 4 weeks post injury were investigated for their prognostic ability. Recovery was determined from measures of subjective ankle function at short (4 weeks and medium term (4 months follow ups. Multivariate stepwise linear regression analyses were undertaken to evaluate the association between the aforementioned variables and functional recovery. RESULTS: Greater age, greater injury grade and weight-bearing status at baseline were associated with lower function at 4 weeks post injury (p<0.01; adjusted R square=0.34. Greater age, weight-bearing status at baseline and non-inversion injury mechanisms were associated with lower function at 4 months (p<0.01; adjusted R square=0.20. Pain on medial palpation and pain on dorsiflexion at 4 weeks were the most valuable prognostic indicators of function at 4 months (p< 0.01; adjusted R square=0.49. CONCLUSION: The results of the present study provide further evidence that ankle sprains have a variable clinical course. Age, injury grade, mechanism and weight-bearing status at baseline provide some prognostic information for short and medium term recovery. Clinical assessment variables at 4 weeks were the strongest predictors of recovery, explaining 50% of the variance in ankle function at 4 months. Further

  13. Nerve Transfers for Adult Traumatic Brachial Plexus Palsy (Brachial Plexus Nerve Transfer)

    OpenAIRE

    Rohde, Rachel S.; Wolfe, Scott W.

    2006-01-01

    Adult traumatic brachial plexus injuries can have devastating effects on upper extremity function. Although neurolysis, nerve repair, and nerve grafting have been used to treat injuries to the plexus, nerve transfer makes use of an undamaged nerve to supply motor input over a relatively short distance to reinnervate a denervated muscle. A review of several recent innovations in nerve transfer surgery for brachial plexus injuries is illustrated with surgical cases performed at this institution.

  14. Fractures of the ankle Fractures of the ankle

    OpenAIRE

    Taser, Omer; Goksan, Alp; Asik, Mehmet

    2004-01-01

    In this study 151 patients who were operated for the ankle fracture between 1980 and 1988 and also 277 patients who were conservatively treated between January 1987 and April 1988 in Orthopaedics and Traumatology Department of Istanbul Medical Faculty were taken into consideration. It has been seen that ankle fractures which comprised a high percent (%1.6) in all patients who applied to our emergency department. We showed that the ratio of patients who had operative treatment had been steadi...

  15. Magnetic resonance imaging in brachial plexus injury.

    Science.gov (United States)

    Caranci, F; Briganti, F; La Porta, M; Antinolfi, G; Cesarano, E; Fonio, P; Brunese, L; Coppolino, F

    2013-08-01

    Brachial plexus injury represents the most severe nerve injury of the extremities. While obstetric brachial plexus injury has showed a reduction in the number of cases due to the improvements in obstetric care, brachial plexus injury in the adult is an increasingly common clinical problem. The therapeutic measures depend on the pathologic condition and the location of the injury: Preganglionic avulsions are usually not amenable to surgical repair; function of some denervated muscles can be restored with nerve transfers from intercostals or accessory nerves and contralateral C7 transfer. Postganglionic avulsions are repaired with excision of the damaged segment and nerve autograft between nerve ends or followed up conservatively. Magnetic resonance imaging is the modality of choice for depicting the anatomy and pathology of the brachial plexus: It demonstrates the location of the nerve damage (crucial for optimal treatment planning), depicts the nerve continuity (with or without neuroma formation), or may show a completely disrupted/avulsed nerve, thereby aiding in nerve-injury grading for preoperative planning. Computed tomography myelography has the advantage of a higher spatial resolution in demonstration of nerve roots compared with MR myelography; however, it is invasive and shows some difficulties in the depiction of some pseudomeningoceles with little or no communication with the dural sac. PMID:23949940

  16. Shoulder deformities from obstetrical brachial plexus paralysis

    International Nuclear Information System (INIS)

    Abnormalities are described in the shoulders of 11 patients up to 17 years of age who have chronic brachial plexus paralyses from birth injuries. These abnormalities include a poorly formed and hypoplastic humeral head, a short abnormally formed clavicle, and a hypoplastic elevated scapula with a shallow glenoid fossa, inferiorly directed coracoid process, and abnormally tapered acromion. Four also had subluxated shoulders. (orig.)

  17. MR evaluation of brachial plexus injuries

    International Nuclear Information System (INIS)

    Ten cases of brachial plexus injury were subjected to magnetic resonance (MR) to demonstrate the roots, trunks, divisions or cord abnormalities. Both normal and abnormal brachial plexuses were imaged in sagittal, axial, coronal and axial oblique planes. Myelography, using water soluble contrast agents, was performed in seven cases. MR demonstrated one traumatic meningocele, one extradural cerebrospinal fluid (CSF) collection, trunk and/or root neuromas in four, focal root fibrosis in two and diffuse fibrosis in the remaining two cases. Results of MR were confirmed at surgery in four cases with neuromas, while myelography was normal in two and was not carried out in the remaining two. In two cases, where MR demonstrated diffuse fibrosis of the brachial plexus, myelography showed C7 and T1 traumatic meningocele in one and was normal in the other. Both these patients showed excellent clinical and electrophysiological correlation with MR findings and in one of them surgical confirmation was also obtained. In the other two cases with focal nerve root fibrosis, myelography was normal in one and showed a traumatic meningocele in another. Operative findings in these cases confirmed focal root fibrosis but no root avulsion was observed although seen on one myelogram. Focal fibrosis, however, was noted at operation in more roots than was observed with MR. Initial experience suggests that MR may be the diagnostic procedure of choice for complete evaluation of brachial plexus injuries. (orig.)

  18. Spinal Cord Involvement in Brachial Plexus Injury

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    The role of spinal cord plasticity after birth injury and recovery from obstetric brachial plexus lesions was investigated in newborn rats with selective crush injury to spinal roots C5 and C6, in a study at University Clinics of Vienna School of Medicine, Austria.

  19. Arthrography of the ankle sprains

    International Nuclear Information System (INIS)

    Ankle arthrography, by direct puncture of joint cavity, is considered to be a simple and accurate diagnostic method for a precise evaluation of ligamentous injury. Forty-seven cases of ankle arthrography were successively performed in the patients of acute ankle sprains. The purpose of this study is to demonstrate how ankle arthrography can delineate the pathologic anatomy in such cases. The results are as follows: 1. Thirty cases among forty seven revealed the findings of ligament tears. 2. For better diagnostic accuracy, the arthrography should be performed within 72 hrs. after injury. 3. The anterior talofibular ligament tears were the most common (twenty-nine cases) of all and seventeen of them revealed tears without association of any other ligament tears. 4. There were ten cases of calcaneofibular ligament tears and nine of them were associated with anterior talofibular ligament tears. 5. Three cases of anterior tibiofibular and one deltoid ligament tears were demonstrated

  20. Complications in Ankle Fracture Surgery

    OpenAIRE

    Ovaska, Mikko

    2014-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  1. MR neurography in traumatic brachial plexopathy

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyaya, Vaishali, E-mail: vshali77@yahoo.co.in [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Upadhyaya, Divya N. [Department of Plastic Surgery, King George Medical University, Shah Meena Road, Chowk, Lucknow 226 003 (India); Kumar, Adarsh [Department of Plastic Surgery, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India); Gujral, Ratni B. [Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007 (India)

    2015-05-15

    Highlights: • MR neurography is the imaging modality of choice in patients who have sustained brachial plexus injury. It is helpful in determining the level and extent of injury. • The authors have used a Visual Per-operative Scoring system to assess the usefulness of MR neurography in delineating the level and type of the lesion. • The imaging findings were classified based on the level of injury—root, trunk or cord. These findings were correlated with those seen on surgical exploration. A good correlation was found in the majority (65%) of patients and average correlation (30%) in others. - Abstract: Objectives: Imaging of the brachial plexus has come a long way and has progressed from plain radiography to CT and CT myelography to MRI. Evolution of MR imaging sequences has enabled good visualization of the small components of the plexus. The purpose of our study was to correlate the results of MR neurography (MRN) in patients with traumatic brachial plexopathy with their operative findings. We wanted to determine the usefulness of MRN and how it influenced surgical planning and outcome. Methods: Twenty patients with features of traumatic brachial plexopathy who were referred to the MRI section of the Department of Radiology between September 2012 and January 2014 and subsequently underwent exploration were included in the study. MR neurography and operative findings were recorded at three levels of the brachial plexus—roots, trunks and cords. Results: Findings at the level of roots and trunks were noted in 14 patients each and at the level of the cords in 16 patients. 10 patients had involvement at all levels. Axillary nerve involvement as a solitary finding was noted in two patients. These patients were subsequently operated and their studies were assigned a score based on the feedback from the operating surgeons. The MRN study was scored as three (good), two (average) or one (poor) depending on whether the MR findings correlated with operative

  2. Sonographic evaluation of brachial plexus pathology

    Energy Technology Data Exchange (ETDEWEB)

    Graif, Moshe; Blank, Anat; Weiss, Judith; Kessler, Ada [Department of Radiology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel); Martinoli, Carlo; Derchi, Lorenzo E. [Department of Radiology, University of Genoa, Genoa (Italy); Rochkind, Shimon [Department of Neurosurgery, Tel Aviv Sourasky Medical Center and the Sackler faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel); Trejo, Leonor [Department of Pathology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv (Israel)

    2004-02-01

    Pre-operative US examinations of the brachial plexus were performed with the purpose of exploring the potential of this technique in recognizing lesions in the region and defining their sonographic morphology, site, extent, and relations to adjacent anatomic structures, and comparing them to the surgical findings to obtain maximal confirmation. Twenty-eight patients with clinical, electro-conductive, and imaging findings suggestive of brachial plexus pathology were included in this study. There were four main etiology groups: post-traumatic brachial plexopathies; primary tumors (benign and malignant); secondary tumors; and post irradiation injuries. Twenty-one of the 28 patients underwent surgery. Advanced imaging (mostly MRI) served as an alternative gold standard for confirmation of the findings in the non-surgically treated group of patients. The US examinations were performed with conventional US units operating at 5- to 10-MHz frequencies. The nerves were initially localized at the level of the vertebral foramina and then were followed longitudinally and axially down to the axillary region. Abnormal US findings were detected in 20 of 28 patients. Disruption of nerve continuity and focal scar tissue masses were the principal findings in the post-traumatic cases. Focal masses within a nerve or adjacent to it and diffuse thickening of the nerve were the findings in primary and secondary tumors. Post-irradiation changes presented as nerve thickening. Color Doppler was useful in detecting internal vascularization within masses and relation of a mass to adjacent vessels. The eight sonographically negative cases consisted either of traumatic neuromas smaller than 12 mm in size and located in relatively small branches of posterior location or due to fibrotic changes of diffuse nature. Sonography succeeded in depicting a spectrum of lesions of traumatic, neoplastic, and inflammatory nature in the brachial plexus. It provided useful information regarding the lesion site

  3. Sonographic evaluation of brachial plexus pathology

    International Nuclear Information System (INIS)

    Pre-operative US examinations of the brachial plexus were performed with the purpose of exploring the potential of this technique in recognizing lesions in the region and defining their sonographic morphology, site, extent, and relations to adjacent anatomic structures, and comparing them to the surgical findings to obtain maximal confirmation. Twenty-eight patients with clinical, electro-conductive, and imaging findings suggestive of brachial plexus pathology were included in this study. There were four main etiology groups: post-traumatic brachial plexopathies; primary tumors (benign and malignant); secondary tumors; and post irradiation injuries. Twenty-one of the 28 patients underwent surgery. Advanced imaging (mostly MRI) served as an alternative gold standard for confirmation of the findings in the non-surgically treated group of patients. The US examinations were performed with conventional US units operating at 5- to 10-MHz frequencies. The nerves were initially localized at the level of the vertebral foramina and then were followed longitudinally and axially down to the axillary region. Abnormal US findings were detected in 20 of 28 patients. Disruption of nerve continuity and focal scar tissue masses were the principal findings in the post-traumatic cases. Focal masses within a nerve or adjacent to it and diffuse thickening of the nerve were the findings in primary and secondary tumors. Post-irradiation changes presented as nerve thickening. Color Doppler was useful in detecting internal vascularization within masses and relation of a mass to adjacent vessels. The eight sonographically negative cases consisted either of traumatic neuromas smaller than 12 mm in size and located in relatively small branches of posterior location or due to fibrotic changes of diffuse nature. Sonography succeeded in depicting a spectrum of lesions of traumatic, neoplastic, and inflammatory nature in the brachial plexus. It provided useful information regarding the lesion site

  4. MR neurography in traumatic brachial plexopathy

    International Nuclear Information System (INIS)

    Highlights: • MR neurography is the imaging modality of choice in patients who have sustained brachial plexus injury. It is helpful in determining the level and extent of injury. • The authors have used a Visual Per-operative Scoring system to assess the usefulness of MR neurography in delineating the level and type of the lesion. • The imaging findings were classified based on the level of injury—root, trunk or cord. These findings were correlated with those seen on surgical exploration. A good correlation was found in the majority (65%) of patients and average correlation (30%) in others. - Abstract: Objectives: Imaging of the brachial plexus has come a long way and has progressed from plain radiography to CT and CT myelography to MRI. Evolution of MR imaging sequences has enabled good visualization of the small components of the plexus. The purpose of our study was to correlate the results of MR neurography (MRN) in patients with traumatic brachial plexopathy with their operative findings. We wanted to determine the usefulness of MRN and how it influenced surgical planning and outcome. Methods: Twenty patients with features of traumatic brachial plexopathy who were referred to the MRI section of the Department of Radiology between September 2012 and January 2014 and subsequently underwent exploration were included in the study. MR neurography and operative findings were recorded at three levels of the brachial plexus—roots, trunks and cords. Results: Findings at the level of roots and trunks were noted in 14 patients each and at the level of the cords in 16 patients. 10 patients had involvement at all levels. Axillary nerve involvement as a solitary finding was noted in two patients. These patients were subsequently operated and their studies were assigned a score based on the feedback from the operating surgeons. The MRN study was scored as three (good), two (average) or one (poor) depending on whether the MR findings correlated with operative

  5. Radiology of chronic diseases of the ankle joint

    International Nuclear Information System (INIS)

    The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or

  6. Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot.

    Directory of Open Access Journals (Sweden)

    Yan Wang

    Full Text Available Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak.Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after surgery. These variations can provide

  7. Evaluation of the brachial plexus with MR imaging

    International Nuclear Information System (INIS)

    MR imaging allows excellent visualization of the brachial plexus, including its cervical, subscapular, and axillary course. The anatomy of the normal brachial plexus as it appears on 5-mm coronal (short TR) and axial (1st and 2nd spin-echo sequences) images obtained using a body coil at 1.5 T is presented. Normal findings are compared with examples of pathologic masses arising in or adjacent to each part of the brachial plexus. Selected surface coil views were useful in the evaluation of the proximal brachial plexus. The MR imaging demonstration of the morphology of mass lesions and their relationship to the brachial plexus is superior to CT demonstration and can be accomplished in little time and without the use of intravenous contrast media. Currently it is not possible to achieve sufficient detail to detect infiltrative, fibrotic, or atrophic processes unless these cause significant changes in the size, shape, or position of the brachial plexus

  8. Quantitative MRI and EMG study of the brachial plexus

    OpenAIRE

    Mahbub, Zaid Bin

    2014-01-01

    This thesis describes the development and applications of quantitative MRI and combined EMG and MRI study of Brachial Plexus. The protocols developed in this thesis have been used on normal healthy subjects, aiming at characterizing the tissues based on their MR and EMG parameters. The Brachial Plexus is the upper portion of the peripheral nervous system and controls the movements of shoulder and arms. Neurological disorders in the brachial plexus can result from cervical spondylotic neuro...

  9. A comparison of two approaches to brachial plexus anaesthesia

    OpenAIRE

    Rajib Hazarika; Tejwant Rajkhowa; Mridu Paban Nath; Samit Parua

    2016-01-01

    Background: A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulation technique for upper limb surgery. Methods: Eighty patients undergoing upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled into this study. The infraclavicular brachial plexus block was performed using the vertical technique (group I; N=40). The supraclavicular b...

  10. Malignant brachial plexopathy: A pictorial essay of MRI findings

    International Nuclear Information System (INIS)

    For imaging, the brachial plexus is a technically and anatomically challenging region of the peripheral nervous system. MRI has a central role in the identification and accurate characterization of malignant lesions arising here, as also in defining their extent and the status of the adjacent structures. The purpose of this pictorial essay is to describe the MRI features of primary and secondary malignant brachial plexopathies and radiation-induced brachial nerve damage

  11. Imaging tumours of the brachial plexus

    International Nuclear Information System (INIS)

    Tumours of the brachial plexus are rare lesions and may be classified as benign or malignant. Within each of these groups, they are further subdivided into those that are neurogenic in origin (schwannoma, neurofibroma and malignant peripheral nerve sheath tumour) and those that are non-neurogenic. Careful pre-operative diagnosis and staging is essential to the successful management of these lesions. Benign neurogenic tumours are well characterized with pre-operative MRI, appearing as well-defined, oval soft-tissue masses, which are typically isointense on T1-weighted images and show the ''target sign'' on T2-weighted images. Differentiation between schwannoma and neurofibroma can often be made by assessing the relationship of the lesion to the nerve of origin. Many benign non-neurogenic tumours, such as lipoma and fibromatosis, are also well characterized by MRI. This article reviews the imaging features of brachial plexus tumours, with particular emphasis on the value of MRI in differential diagnosis. (orig.)

  12. Myelography in obstetric palsies of brachial plexus

    International Nuclear Information System (INIS)

    The use of myelography in obstetric palsies of brachial plexus is aimed at diagnosing root avulsion.This kind of lesion appears as the disappearance of the slightly-transparent nerve roots which might be combined either with pseudo-meningocele or with deformation of radicular pouch. This study 69 operated patients who had previously undergone myelography have been considered. In 74.2% of cases mylographic findings were confirmed at surgery.False positives and false negatives were 9.7% and 3.2%, respectively. Uncorrect diagnoses were made in 12.9% of cases, because of misread lesions and uncorrect evaluation of their location, usually at the cervicol-dorsal junction.No side-effects were observed. Myelography appears thus to be extremely useful for both the preoperative evaluation and the choice of surgery in newborn children with obstetric palsy of the brachial plexus

  13. Bilateral brachial plexus blocks in a patient of hypertrophic obstructive cardiomyopathy with hypertensive crisis

    Directory of Open Access Journals (Sweden)

    Rohini V Bhat Pai

    2013-01-01

    Full Text Available Hypertrophic obstructive cardiomyopathy (HOCM is a challenge to anesthesiologists due to the complex pathophysiology involved and various perioperative complications associated with it. We present a 50-year-old man, a known case of HOCM, who successfully underwent emergency haemostasis, and debridement of the traumatically amputated right upper limb and the contused lacerated wound on the left forearm under bilateral brachial plexus blocks. His co-morbidities included hypertension (in hypertensive crisis and diabetes mellitus. He was full stomach and also had an anticipated difficult airway. The management included invasive pressure monitoring and labetalol infusion for emergent control of blood pressure. The regional anaesthesia technique required careful consideration to the dosage of local anaesthetics and staggered performance of brachial plexus blocks on each of the upper limbs to avoid local anaesthetic toxicity. Even though bilateral brachial plexus blocks are rarely indicated, it seemed to be the most appropriate anaesthetic technique in our patient. With careful consideration of the local anaesthetic toxicity and meticulous technique, bilateral brachial plexus blocks can be successfully performed in those patients where general anaesthesia is deemed to be associated with higher risk.

  14. The origin of the ankle

    CERN Document Server

    Codino, A; Codino, Antonio; Plouin, Francois

    2007-01-01

    The differential intensity of cosmic radiation shows a sequence of depressions referred to as "knees" in a large energy band above 10^15 eV. The global depression entailed in the complete spectrum with respect to the extrapolated intensity based on low energy data amounts to a maximum factor of 8, occurring at 5 x 10^18 eV, where flux measurements exhibit a relative minimum, referred to as the "ankle". It is demonstrated by a full simulation of cosmic ray trajectories in the Galaxy that the intensity minimum around the ankle energy is primarily due to the nuclear interactions of the cosmic ions with the interstellar matter and to the galactic magnetic field. "Ankles" signal the onset energies of the rectilinear propagation in the Milky Way at the Earth, being for example, 4 x 10^18 eV for helium and 6 x 10^19 eV for iron. The ankle, in spite of its notable importance at the Earth, is a local perturbation of the universal spectrum which, between the knee and the ankle, decreases by a round factor 10^9, regaini...

  15. Posterior Ankle Structure Injury During Total Ankle Replacement.

    Science.gov (United States)

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management. PMID:27291681

  16. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  17. Long term outcomes of inversion ankle injuries

    OpenAIRE

    Anandacoomarasamy, A; Barnsley, L; Grujic, L

    2005-01-01

    Background: Ankle sprains are common sporting injuries generally believed to be benign and self limiting. However, some studies report a significant proportion of patients with ankle sprains having persistent symptoms for months or even years.

  18. Evaluation of brachial plexus injury by MRI

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of MRI in brachial plexus injury. Methods: Total 98 patients with brachial plexus injury were examined by MRI before operation. Fifty-four of 98 patients MR imaging were obtained by 0.5 Tesla scanner and other 44 patients were obtained by 1.5 Tesla scanner. The scanning sequences include: SE T1WI, T2WI, FFE T2WI and T2WI SPIR. Exploration of the supraclavicular plexus was carried out and the MR imaging were compared with the operative finding in 63 patients. Thirty-five patients who had not surgery, were followed-up. Results: MR imaging found pre-ganglionic injuries in 45 patients and post- ganglionic injuries in 56 patients. Pre- and post- ganglionic injuries simultaneously in 16 patients among them. MR imaging can not find injury, sings in 13 patients. The positive rate was 86.73%. MR imaging finding of pre-ganglionic injuries include: (1) Spinal cord edema and hemorrhage, 2 patients (4.44%). (2) Displacement of spinal cord, 17 patients (37.78%). (3) Traumatic meningoceles, 37 patients( 82.22% ). (4) Absence of roots in spinal canal, 25 patients (55.56%). (5) Scarring in the spinal cnanl,24 patients (53.33%). (6) Denervation of erector spine, 13 patients (28.89%). MR imaging finding of post-ganglionic injuries include: (1) Trunk thickening with hypointensities in T2WI, 23 patients (41.07%). (2) Nerve trunk complete loss of continuity with disappeared of nerve structure, 16 patients (28.57%). (3) Continuity of nerve trunk was well with disappearance of nerve structure, 14 patients (25.00%). (4) Traumatic neurofibroma, 3 patients (5.36%). Conclusion: MR imaging can reveal Pre- and post- ganglionic injuries of brachial plexus simultaneously. MR imaging is able to determine the location (pre- or post- ganglionic) and extent of brachial plexus injury, provided important information for treatment method selection. (authors)

  19. Post-irradiation pareses of brachial plexus

    International Nuclear Information System (INIS)

    Damage of brachial plexus as a sequel of breast carcinoma radiotherapy in 5 patients of an average age of 48 years is described. Complaints first appeared on the average 17.4 months after irradiation. The condition is characterized by initial pain, motor disturbances, reflex alteration. Skin alterations, atrophies, depilations, pigmentations, telangiectases and fibrous changes, and also lymphedema have been recorded. The necessity is stressed of an early start of therapy; the prognosis, however, is not very optimistic. (M.D.). 8 refs

  20. Treatment Options for Brachial Plexus Injuries

    OpenAIRE

    Sakellariou, Vasileios I.; Badilas, Nikolaos K.; Stavropoulos, Nikolaos A; George Mazis; Kotoulas, Helias K.; Stamatios Kyriakopoulos; Ioannis Tagkalegkas; Sofianos, Ioannis P.

    2014-01-01

    The incidence of brachial plexus injuries is rapidly growing due to the increasing number of high-speed motor-vehicle accidents. These are devastating injuries leading to significant functional impairment of the patients. The purpose of this review paper is to present the available options for conservative and operative treatment and discuss the correct timing of intervention. Reported outcomes of current management and future prospects are also analysed.

  1. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ank...

  2. MRI of the brachial plexus: A pictorial review

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) of the brachial plexus is the imaging modality of first choice for depicting anatomy and pathology of the brachial plexus. The anatomy of the roots, trunks, divisions and cords is very well depicted due to the inherent contrast differences between the nerves and the surrounding fat. In this pictorial review the technique and the anatomy will be discussed. The following pathology will be addressed: neurogenic tumors of the brachial plexus and sympathetic chain, superior sulcus tumors, other tumors in the vicinity of the brachial plexus, the differentiation between radiation and metastatic plexopathy, trauma, neurogenic thoracic outlet syndrome and immune-mediated neuropathies.

  3. MRI of the brachial plexus: A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Es, Hendrik W. van [Department of Radiology, St. Antonius Hospital, Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein (Netherlands)], E-mail: h.es@antoniusziekenhuis.nl; Bollen, Thomas L.; Heesewijk, Hans P.M. van [Department of Radiology, St. Antonius Hospital, Nieuwegein, Koekoekslaan 1, 3435 CM Nieuwegein (Netherlands)

    2010-05-15

    Magnetic resonance imaging (MRI) of the brachial plexus is the imaging modality of first choice for depicting anatomy and pathology of the brachial plexus. The anatomy of the roots, trunks, divisions and cords is very well depicted due to the inherent contrast differences between the nerves and the surrounding fat. In this pictorial review the technique and the anatomy will be discussed. The following pathology will be addressed: neurogenic tumors of the brachial plexus and sympathetic chain, superior sulcus tumors, other tumors in the vicinity of the brachial plexus, the differentiation between radiation and metastatic plexopathy, trauma, neurogenic thoracic outlet syndrome and immune-mediated neuropathies.

  4. Magnetic resonance imaging of ankle ligaments and tendon injuries

    International Nuclear Information System (INIS)

    Today MRI allows evaluation of the integrity of injured ankle ligaments. The major difficulty in MRI is inconsistency in visualization by inadequate appreciation of the three-dimensional orientation of each ankle ligament. Using this technique, 52 patients with sprained ankles underwent MRI. The integrity of rupture of the collateral lateral ligaments was obtained in all 52 ankles. Full-lenght visualization is essential for evaluation of the ankle ligaments with MRI. In these 52 patients the angle of tilt on the stress X-ray was compared with the rate of MRI findings showing an injury affecting two ligaments. We found that none of the patients in whom the angle of lateral tilt was less than 5 had rupture of two laterial ligaments, while 32% of patients with angles of tilt of 6-14 and 42% of those with angles of tilt over 15 on stress X-ray had two ruptured lateral ligaments. The advantages of MRI are that it offers the best visualization of the extent of the tendon lesion. MRI, however, seems to be superior to US in detecting and quantifying lesions of the Achilles tendon. Therefore, MRI may be indicated in particularly difficult cases of tendons injuries in the foot. (orig.)

  5. [PARTICULAR QUALITIES OF DIAGNOSTIC ACUTE LATERAL ANKLE LIGAMENT INJURIES].

    Science.gov (United States)

    Krasnoperov, S N; Shishka, I V; Golovaha, M L

    2015-01-01

    Delayed diagnosis of acute lateral ankle ligaments injury and subsequent inadequate treatment leads to the development of chronic instability and rapid progression of degenerative processes in the joint. The aim of our work was to improve treatment results by developing an diagnostic algorithm and treatment strategy of acute lateral ankle ligament injuries. The study included 48 patients with history of acute inversion ankle injury mechanism. Diagnostic protocol included clinical and radiological examination during 48 hours and after 7-10 days after injury. According to the high rate of inaccurate clinical diagnosis in the first 48 hours of the injury a short course of conservative treatment for 7-10 days is needed with follow-up and controlling clinical and radiographic instability tests. Clinical symptoms of ankle inversion injury showed that the combination of local tenderness in the projection of damaged ligaments, the presence of severe periarticular hematoma in the lateral department and positive anterior drawer and talar tilt tests in 7-10 days after the injury in 87% of cases shows the presence of ligament rupture. An algorithm for diagnosis of acute lateral ankle ligament injury was developed, which allowed us to determine differential indications for surgical repair of the ligaments and conservative treatment of these patients. PMID:27089717

  6. Interscalenic approach to the cervico-brachial plexus.

    Science.gov (United States)

    Evenepoel, M C; Blomme, A

    1981-12-01

    The concept of a closed peri-neurovascular space surrounding the cervicobrachial plexus, introduced by A. Winnie, allows the blockade of the cervical and brachial plexuses by means of a single puncture technique. The single puncture has positive advantages: 1. The rapidity of the blockade; 2. The simplicity of the blockade; 3. Comfort for the patient. The landmarks are easy to make. As with epidural blockade, the injection level and the volume of local anesthetic determine the quality and extent of the block. The traditional indication is surgery of the shoulder and of the supraclavicular area. A new indication seems to be the implantation of a cardiac pacemaker. Complications often quoted in literature are Horner syndrome-a minor complication-and blockade of the ascending branches of the recurrent laryngeal nerve and of the phrenic nerve. The risk of a pneumothorax is almost nil. PMID:7324853

  7. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  8. Rehabilitation of Syndesmotic (High) Ankle Sprains

    OpenAIRE

    Williams, Glenn N; Allen, Eric J.

    2010-01-01

    Context: High ankle sprains are common in athletes who play contact sports. Most high ankle sprains are treated nonsurgically with a rehabilitation program. Evidence Acquisition: All years of PUBMED, Cochrane Database of Systematic Reviews, CINAHL PLUS, SPORTDiscuss, Google Scholar, and Web of Science were searched to August 2010, cross-referencing existing publications. Keywords included syndesmosis ankle sprain or high ankle sprain and the following terms: rehabilitation, treatment, cryothe...

  9. Osteoligamentous injuries of the medial ankle joint

    OpenAIRE

    Lötscher, P.; Lang, T. H.; Zwicky, L.; Hintermann, B; Knupp, M

    2015-01-01

    Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ank...

  10. The Incidence of Ankle Sprains in Orienteering.

    Science.gov (United States)

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  11. Acute Ankle Sprains in Primary Care

    NARCIS (Netherlands)

    R.M. van Rijn (Rogier)

    2010-01-01

    textabstractOf all injuries of the musculoskeletal system, 25% are acute lateral ankle sprains.1 In the USA and the UK there are about 23,000 and 5000 ankle sprains, respectively, each day. In the Netherlands approximately 600,000 people sustain an ankle injury each year, of those 120,000 occur duri

  12. Sports Injuries to the Foot and Ankle

    Science.gov (United States)

    ... the Foot and Ankle Text Size Print Bookmark Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles can certainly take a ... the injury risk factors while playing your favorite sport, see the topics listed below or read the ...

  13. Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to determine the effects of atlas selection based on different morphometric parameters, on the accuracy of automatic brachial plexus (BP) segmentation for radiation therapy planning. The segmentation accuracy was measured by comparing all of the generated automatic segmentations with anatomically validated gold standard atlases developed using cadavers. Methods and Materials: Twelve cadaver computed tomography (CT) atlases (3 males, 9 females; mean age: 73 years) were included in the study. One atlas was selected to serve as a patient, and the other 11 atlases were registered separately onto this “patient” using deformable image registration. This procedure was repeated for every atlas as a patient. Next, the Dice and Jaccard similarity indices and inclusion index were calculated for every registered BP with the original gold standard BP. In parallel, differences in several morphometric parameters that may influence the BP segmentation accuracy were measured for the different atlases. Specific brachial plexus-related CT-visible bony points were used to define the morphometric parameters. Subsequently, correlations between the similarity indices and morphometric parameters were calculated. Results: A clear negative correlation between difference in protraction-retraction distance and the similarity indices was observed (mean Pearson correlation coefficient = −0.546). All of the other investigated Pearson correlation coefficients were weak. Conclusions: Differences in the shoulder protraction-retraction position between the atlas and the patient during planning CT influence the BP autosegmentation accuracy. A greater difference in the protraction-retraction distance between the atlas and the patient reduces the accuracy of the BP automatic segmentation result

  14. Morphometric Atlas Selection for Automatic Brachial Plexus Segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Van de Velde, Joris, E-mail: joris.vandevelde@ugent.be [Department of Anatomy, Ghent University, Ghent (Belgium); Department of Radiotherapy, Ghent University, Ghent (Belgium); Wouters, Johan [Department of Anatomy, Ghent University, Ghent (Belgium); Vercauteren, Tom; De Gersem, Werner; Duprez, Fréderic; De Neve, Wilfried [Department of Radiotherapy, Ghent University, Ghent (Belgium); Van Hoof, Tom [Department of Anatomy, Ghent University, Ghent (Belgium)

    2015-07-01

    Purpose: The purpose of this study was to determine the effects of atlas selection based on different morphometric parameters, on the accuracy of automatic brachial plexus (BP) segmentation for radiation therapy planning. The segmentation accuracy was measured by comparing all of the generated automatic segmentations with anatomically validated gold standard atlases developed using cadavers. Methods and Materials: Twelve cadaver computed tomography (CT) atlases (3 males, 9 females; mean age: 73 years) were included in the study. One atlas was selected to serve as a patient, and the other 11 atlases were registered separately onto this “patient” using deformable image registration. This procedure was repeated for every atlas as a patient. Next, the Dice and Jaccard similarity indices and inclusion index were calculated for every registered BP with the original gold standard BP. In parallel, differences in several morphometric parameters that may influence the BP segmentation accuracy were measured for the different atlases. Specific brachial plexus-related CT-visible bony points were used to define the morphometric parameters. Subsequently, correlations between the similarity indices and morphometric parameters were calculated. Results: A clear negative correlation between difference in protraction-retraction distance and the similarity indices was observed (mean Pearson correlation coefficient = −0.546). All of the other investigated Pearson correlation coefficients were weak. Conclusions: Differences in the shoulder protraction-retraction position between the atlas and the patient during planning CT influence the BP autosegmentation accuracy. A greater difference in the protraction-retraction distance between the atlas and the patient reduces the accuracy of the BP automatic segmentation result.

  15. Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking.

    Science.gov (United States)

    Gehring, Dominic; Wissler, Sabrina; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    A thorough understanding of the functional aspects of ankle joint control is essential to developing effective injury prevention. It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24° inversion and 15° plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (-7%) and velocity (-4%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (-14%) and velocity (-11%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. PMID:24365326

  16. PILL series. Doctor, I sprained my ankle

    OpenAIRE

    How, Choon How; Tan, Ken Jin

    2014-01-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk o...

  17. Predisposing factors to lateral ankle injury in male comrades marathon runners

    Directory of Open Access Journals (Sweden)

    J. Hiemstra

    2009-02-01

    Full Text Available Introduction: More than two million people experience ankle ligament traumaeach year in the United States. Half of these are severe ligament sprains, however verylittle is known about the factors that predispose individuals to these injuries. The purpose of this study, (which was conducted as an undergraduate research project,was to find a correlation between the characteristics of height, weight and limbdominance and lateral ankle ligament injuries. Method: A  retrospective study was conducted on 114 ultra distance runners whoparticipated in the 2006 Comrades Marathon. During race registration, the runners’ height and weight were measuredafter answering a questionnaire regarding their training. Results: 114 runners responded to the questionnaire. From this cohort, 38 (33.3% had sustained previous lateral ankle injuries. Of these 38 injuries, 47.4% of the injuries occurred on the runner’s dominant limb and 36.8% occurred on thenon-dominant side. 15.8% of the runners sustained previous ankle injuries to both ankles. There was a low negative correlation coefficient of 0.24 with regards to weight as a risk factor. This indicated that the power of the correlationwas 5.93%. The study demonstrates that there is no correlation between an increase in weight and an increase in theincidence of ankle injury. The correlation coefficient indicated a low correlation between an increase in height and the incidence of ankle injury. However, the power of the correlation at 18.37% makes inaccurate any attempt to predict the height at which a runner would be at most risk for lateral ankle injury. Conclusion: Height and weight are not risk factors predisposing subjects to lateral ankle injury. In addition, the studyillustrated that there was no effect of limb dominance on the incidence of lateral ankle injury.

  18. A comparison of two approaches to brachial plexus anaesthesia

    Directory of Open Access Journals (Sweden)

    Rajib Hazarika

    2016-05-01

    Conclusions: Supraclavicular brachial plexus block may be easier to perform than infraclavicular brachial plexus block. The infraclavicular approach may be preferred to the supraclavicular approach when considering the complications. [Int J Res Med Sci 2016; 4(5.000: 1335-1338

  19. MR Imaging of Ankle Impingement Syndromes

    Directory of Open Access Journals (Sweden)

    Seyed Hassan Mostafavi

    2010-05-01

    Full Text Available Ankle impingement syndromes are characterized by painful friction of joint tissues. This is both the cause and the effect of altered joint biomechanics. The leading causes of impingement lesions are posttraumatic ankle injuries, usually ankle sprains, resulting in chronic ankle pain. "nBased on anatomic and clinical viewpoints, there are five types of ankle impingement syndromes:"n1. Anterolateral"n2. Anterior"n3. Anteromedial"n4. Posteromedial"n5. Posterior"nCareful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. MR imaging and MR arthrography are the most useful imaging methods for detecting the osseous and soft-tissue abnormalities present in these syndromes and for ruling out other potential causes of chronic ankle pain. "nThis presentation summarizes the MR imaging, and MR arthrography findings of ankle impingement syndromes.

  20. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player.

    Science.gov (United States)

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-07-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  1. Syndesmotic ankle sprains in athletes.

    Science.gov (United States)

    Williams, Glenn N; Jones, Morgan H; Amendola, Annunziato

    2007-07-01

    Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research. PMID:17519439

  2. The effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle.

    Science.gov (United States)

    Jeon, Kyoung-Kyu; Kim, Tae-Young; Lee, Sang-Ho

    2015-10-01

    [Purpose] The purpose of this study was to investigate the effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle joint. [Subjects] This study included 22 males in their twenties who were diagnosed with functional injury of the ankle joint. [Methods] To strengthen plantar flexion and dorsiflexion of the ankle joint, 8 weeks of weight, resistance band, and plyometric training, and training using props were performed. [Results] A medical examination by interview indicated that pain, swelling, instability, running, and support capacity of the ankle joint significantly improved with the strategic strength resistance exercise program. For the isokinetic peak torque of the ankles, significant differences were observed in right plantar flexion and bilateral dorsiflexion. [Conclusion] The strategic strength resistance exercise program is highly recommended for the functional stability of the ankle joint. Efficient exercise therapy is useful for muscle damage prevention, muscle strengthening, and functional interventions. PMID:26644696

  3. The effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle

    Science.gov (United States)

    Jeon, Kyoung-Kyu; Kim, Tae-Young; Lee, Sang-Ho

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of a strategic strength resistance exercise program on the isokinetic muscular function of the ankle joint. [Subjects] This study included 22 males in their twenties who were diagnosed with functional injury of the ankle joint. [Methods] To strengthen plantar flexion and dorsiflexion of the ankle joint, 8 weeks of weight, resistance band, and plyometric training, and training using props were performed. [Results] A medical examination by interview indicated that pain, swelling, instability, running, and support capacity of the ankle joint significantly improved with the strategic strength resistance exercise program. For the isokinetic peak torque of the ankles, significant differences were observed in right plantar flexion and bilateral dorsiflexion. [Conclusion] The strategic strength resistance exercise program is highly recommended for the functional stability of the ankle joint. Efficient exercise therapy is useful for muscle damage prevention, muscle strengthening, and functional interventions. PMID:26644696

  4. Idiopathic brachial plexus neuritis after laparoscopic treatment of endometriosis: a complication that may mimic position-related brachial plexus injury.

    Science.gov (United States)

    Minas, Vasileios; Aust, Thomas

    2013-01-01

    We report the case of a 37-year-old woman who developed idiopathic brachial plexus neuritis, also referred to as Parsonage-Turner syndrome, after laparoscopic excision of endometriosis. The differential diagnosis between this non-position-related neuritis and brachial plexus injury is discussed. The aim of this report was to raise awareness on this distressing postoperative complication. PMID:24183278

  5. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player

    OpenAIRE

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the S...

  6. West Nile virus-associated brachial plexopathy.

    Science.gov (United States)

    Chahil, Mandeep; Nguyen, Thy Phuong

    2016-01-01

    West Nile virus (WNV) is the most frequent cause of arbovirus infection in the USA. Only 20% of infected individuals are symptomatic. Less than 1% of symptomatic individuals display West Nile neuroinvasive disease. We report a rare case of WNV-associated brachial plexopathy in a young immunocompetent individual, without cerebrospinal fluid pleocytosis or encephalitis. Additionally, there was subjective and objective improvement after high-dose corticosteroids. This case adds to the clinical spectrum of WNV neuroinvasive disease. The literature regarding immunomodulatory treatment and WNV is reviewed. PMID:27030459

  7. Human Rabies with Initial Manifestations that Mimic Acute Brachial Neuritis and Guillain-Barré Syndrome

    OpenAIRE

    Rima El-Abassi; Maury, Joaquin S.; Craver, Randall D.; Lenay Santana-Gould; Austin J. Sumner; Enrique Segura-Palacios; Edward C. Mader Jr

    2012-01-01

    Introduction Human rabies can be overlooked in places where this disease is now rare. Its diagnosis is further confused by a negative history of exposure (cryptogenic rabies), by a Guillain-Barré syndrome (GBS) type of presentation, or by symptoms indicating another diagnosis, eg, acute brachial neuritis (ABN). Case presentation A 19-year-old Mexican, with no past health problems, presented with a two-day history of left shoulder, arm, and chest pain. He arrived in Louisiana from Mexico five ...

  8. Anatomy of the ankle ligaments: a pictorial essay

    NARCIS (Netherlands)

    P. Golanó; J. Vega; P.A.J. de Leeuw; F. Malagelada; M.C. Manzanares; V. Götzens; C.N. van Dijk

    2010-01-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the

  9. SYNDESMOTIC ANKLE INJURY REHABILITATION EXERCISE PACKAGE FOR ICE HOCKEY PLAYERS

    OpenAIRE

    Kuznetsov, Vitali

    2013-01-01

    SYNDESMOTIC ANKLE INJURY REHABILITATION EXERCISE PACKAGE FOR ICE HOCKEY PLAYERS Kuznetsov, Vitali Satakunnan ammattikorkeakoulu, Satakunta University of Applied Sciences Degree Programme in Physiotherapy November 2013 Supervisor: Bärlund, Esa Number of pages: 42 Appendices: 2 Keywords: ankle, ice hockey, ice hockey injuries, high ankle sprain, ankle sprain rehabilitation, ankle injury prevention __________________________________________________________________ ...

  10. Motor cortex neuroplasticity following brachial plexus transfer

    Directory of Open Access Journals (Sweden)

    Michael Biggs

    2013-08-01

    Full Text Available In the past decade, research has demonstrated that cortical plasticity, once thought only to exist in the early stages of life, does indeed continue on into adulthood. Brain plasticity is now acknowledged as a core principle of brain function and describes the ability of the central nervous system to adapt and modify its structural organization and function as an adaptive response to functional demand. In this clinical case study we describe how we used neuroimaging techniques to observe the functional topographical expansion of a patch of cortex along the sensorimotor cortex of a 27 year-old woman following brachial plexus transfer surgery to re-innervate her left arm. We found bilateral activations present in the thalamus, caudate, insula as well as across the sensorimotor cortex during an elbow flex motor task. In contrast we found less activity in the sensorimotor cortex for a finger tap motor task in addition to activations lateralised to the left inferior frontal gyrus and thalamus and bilaterally for the insula. From a pain perspective the patient who had experienced extensive phantom limb pain before surgery found these sensations were markedly reduced following transfer of the right brachial plexus to the intact left arm. Within the context of this clinical case the results suggest that functional improvements in limb mobility are associated with increased activation in the sensorimotor cortex as well as reduced phantom limb pain.

  11. Imaging tumours of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, Asif [Department of Radiology, The Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, HA7 4LP, Stanmore (United Kingdom)

    2003-07-01

    Tumours of the brachial plexus are rare lesions and may be classified as benign or malignant. Within each of these groups, they are further subdivided into those that are neurogenic in origin (schwannoma, neurofibroma and malignant peripheral nerve sheath tumour) and those that are non-neurogenic. Careful pre-operative diagnosis and staging is essential to the successful management of these lesions. Benign neurogenic tumours are well characterized with pre-operative MRI, appearing as well-defined, oval soft-tissue masses, which are typically isointense on T1-weighted images and show the ''target sign'' on T2-weighted images. Differentiation between schwannoma and neurofibroma can often be made by assessing the relationship of the lesion to the nerve of origin. Many benign non-neurogenic tumours, such as lipoma and fibromatosis, are also well characterized by MRI. This article reviews the imaging features of brachial plexus tumours, with particular emphasis on the value of MRI in differential diagnosis. (orig.)

  12. Value of special investigations of desion of the external tendon of the ankle joint

    International Nuclear Information System (INIS)

    The advantage of special radiological investigations after damage of the external tendon of the ankle joint is absolutely certain. Clinical findings, functional X-ray pictures, and for some cases arthrography of the ankle joint render the correct diagnosis. Merely functional X-ray pictures will not always be sufficient, although sometimes this has been pretended. Experiences are described and indications for arthrography are pointed out. Arthrography certainly is the most accurate method for investigations of lesions of the external tendon of the ankle joint. Nevertheless is should only be performed for special cases and after critical interpretation of the functional X-ray pictures, because it is a rather invasive method. (orig.)

  13. Effectiveness of an outside-the-boot ankle brace in reducing parachuting related ankle injuries

    OpenAIRE

    Schmidt, M.; Sulsky, S; Amoroso, P.

    2005-01-01

    Objectives: To examine the efficacy of an outside-the-boot parachute ankle brace (PAB) in reducing risk of ankle injury to army paratrooper trainees and to identify inadvertent risks associated with PAB use.

  14. Safety and efficiency of the Ottawa Ankle Rule in a Swiss population with ankle sprains

    OpenAIRE

    Can, U; Ruckert, R; Held, U; Buchmann, P; Platz, A; Bachmann, L M

    2008-01-01

    OBJECTIVES: We examined the accuracy of the Ottawa Ankle Rule (OAR) to rule out ankle and mid-foot fractures in patients presenting with acute ankle sprain and differences of accuracy between surgeons and non-surgeons. DESIGN: Prospective cohort study. SETTING: Swiss urban secondary care centre. PARTICIPANTS: Between September 2001 and October 2002 359 patients presented with a case of ankle sprain. Of these, 251 patients both met recruitment criteria and provided data for this study. A group...

  15. Ottawa Ankle Rules and Subjective Surgeon Perception to Evaluate Radiograph Necessity Following Foot and Ankle Sprain

    OpenAIRE

    Pires, RES; Pereira, AA; Abreu-e-Silva, GM; Labronici, PJ; Figueiredo, LB; Godoy-Santos, AL; Kfuri, M

    2014-01-01

    Background: Foot and ankle injuries are frequent in emergency departments. Although only a few patients with foot and ankle sprain present fractures and the fracture patterns are almost always simple, lack of fracture diagnosis can lead to poor functional outcomes. Aim: The present study aims to evaluate the reliability of the Ottawa ankle rules and the orthopedic surgeon subjective perception to assess foot and ankle fractures after sprains. Subjects and Methods: A cross-sectional study was ...

  16. Sonographic anatomy of the ankle

    OpenAIRE

    Precerutti, M.; Bonardi, M.; Ferrozzi, G.; Draghi, F.

    2013-01-01

    Ankle sonography is one of the most commonly ordered examinations in the field of osteoarticular imaging, and it requires intimate knowledge of the anatomic structures that make up the joint. For practical purposes, the examination can be divided into four compartments, which are analyzed in this pictorial essay: the anterior compartment, which includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; the accessory peroneus tertius tendon; and the extens...

  17. Hydrocolonotherapy ankle joints after injuries

    OpenAIRE

    Volodymyr Muchin; Oleksandr Zviriaka

    2016-01-01

    Muchin V., Zviriaka O. Purpose: to improve efficiency of gydrokinesitherapy by means of specially designed devices and monolasts for patients after ankle joint injuries. Material & Methods: there are pedagogical methods, clinical and radiological methods, anthropometric measurements and goniometry were used. Results: the author's technique of hydrokinesitherapy with application hydrokinesimechanotherapy device in the program of physical rehabilitation which provides optimum conditions for...

  18. Obstetrical brachial plexus injuries: a MRI diagnostic approach

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the utility of Magnetic Resonance (MR) imaging in the evaluation of the obstetric injuries of the brachial plexus. Material and methods: 23 patients with semiology of brachial plexus palsy have been evaluated with high field MR. Patients were evaluated with a brain coil in axial, oblique coronal and sagittal planes with T1, T2 and STIR sequences. Results: In four patients (17%) the study was normal. In 19 patients (83%) we got pathological findings (pseudomeningoceles, neuromas, tumour and arachnoid cyst). Conclusion: The MR is a non-invasive method that permits to determinate the site and range of the brachial plexus damage, allowing to plan therapy. (author)

  19. 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...

  20. Predicting Functional Recovery after Acute Ankle Sprain

    OpenAIRE

    Sean R O'Connor; Bleakley, Chris M; Tully, Mark A; McDonough, Suzanne M

    2013-01-01

    INTRODUCTION:Ankle sprains are among the most common acute musculoskeletal conditions presenting to primary care. Their clinical course is variable but there are limited recommendations on prognostic factors. Our primary aim was to identify clinical predictors of short and medium term functional recovery after ankle sprain.METHODS:A secondary analysis of data from adult participants (N = 85) with an acute ankle sprain, enrolled in a randomized controlled trial was undertaken. The predictive v...

  1. How to Stretch Your Ankle After a Sprain

    Science.gov (United States)

    ... Ankle After A Sprain How to Stretch Your Ankle After A Sprain Page Content You should perform the following stretches ... Consider these home exercises when recuperating from an ankle sprain. Perform them twice per day. While seated, bring ...

  2. Total Ankle Arthroplasty: An Imaging Overview

    Science.gov (United States)

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  3. Surgical treatment of the arthritic varus ankle.

    Science.gov (United States)

    Easley, Mark E

    2012-12-01

    Within the past several years, the arthritic varus ankle has been addressed extensively in Foot and Ankle Clinics, with numerous excellent reviews by particularly knowledgeable authors. To support these outstanding contributions, this article provides a practical approach to this challenging constellation of foot and ankle abnormalities. Varus ankle arthritis exists on a continuum that prompts the treating surgeon to be familiar with a spectrum of surgical solutions, including joint-sparing realignment, arthroplasty, and arthrodesis. Each of these treatment options is addressed with several expanded case examples and supports the management approaches with the available pertinent literature. PMID:23158376

  4. Evidence-based treatment for ankle injuries: a clinical perspective

    OpenAIRE

    Lin, Chung-Wei Christine; Hiller, Claire E; de Bie, Rob A.

    2010-01-01

    The most common ankle injuries are ankle sprain and ankle fracture. This review discusses treatments for ankle sprain (including the management of the acute sprain and chronic instability) and ankle fracture, using evidence from recent systematic reviews and randomized controlled trials. After ankle sprain, there is evidence for the use of functional support and non-steroidal anti-inflammatory drugs. There is weak evidence suggesting that the use of manual therapy may lead to positive short-t...

  5. Neural-mechanical feedback control scheme generates physiological ankle torque fluctuation during quiet stance.

    Science.gov (United States)

    Vette, Albert H; Masani, Kei; Nakazawa, Kimitaka; Popovic, Milos R

    2010-02-01

    We have recently demonstrated in simulations and experiments that a proportional and derivative (PD) feedback controller can regulate the active ankle torque during quiet stance and stabilize the body despite a long sensory-motor time delay. The purpose of the present study was to: 1) model the active and passive ankle torque mechanisms and identify their contributions to the total ankle torque during standing and 2) investigate whether a neural-mechanical control scheme that implements the PD controller as the neural controller can successfully generate the total ankle torque as observed in healthy individuals during quiet stance. Fourteen young subjects were asked to stand still on a force platform to acquire data for model optimization and validation. During two trials of 30 s each, the fluctuation of the body angle, the electromyogram of the right soleus muscle, and the ankle torque were recorded. Using these data, the parameters of: 1) the active and passive torque mechanisms (Model I) and 2) the PD controller within the neural-mechanical control scheme (Model II) were optimized to achieve potential matching between the measured and predicted ankle torque. The performance of the two models was finally validated with a new set of data. Our results indicate that not only the passive, but also the active ankle torque mechanism contributes significantly to the total ankle torque and, hence, to body stabilization during quiet stance. In addition, we conclude that the proposed neural-mechanical control scheme successfully mimics the physiological control strategy during quiet stance and that a PD controller is a legitimate model for the strategy that the central nervous system applies to regulate the active ankle torque in spite of a long sensory-motor time delay. PMID:20071280

  6. Joint denervation and neuroma surgery as joint-preserving therapy for ankle pain.

    Science.gov (United States)

    Gohritz, Andreas; Dellon, A Lee; Kalbermatten, Daniel; Fulco, Ilario; Tremp, Mathias; Schaefer, Dirk J

    2013-09-01

    Partial joint denervation or surgical neuroma therapy are alternative concepts to treat pain around the ankle joint that preserve joint function and relieve pain by interrupting neural pathways that transmit pain impulses from the joint to the brain. This review article summarizes the indication, anatomic background, operative techniques, and clinical results of joint denervation or neuroma surgery, which, although rarely reported and used, may provide a valuable alternative treatment in selected patients with neurogenous problems around the ankle. PMID:24008220

  7. Electrodiagnosis in traumatic brachial plexus injury

    Directory of Open Access Journals (Sweden)

    K A Mansukhani

    2013-01-01

    Full Text Available Electrodiagnosis (EDX is a useful test to accurately localize the site, determine the extent, identify the predominant pathophysiology, and objectively quantify the severity of brachial plexopathies. It can also be used to examine muscles not easily assessed clinically and recognize minimal defects. Post-operatively and on follow up studies, it is important for early detection of re-innervation. It can be used intra-operatively to assess conduction across a neuroma, which would help the surgeon to decide further course of action. Localization of the site of the lesion can be very challenging as there may be multiple sites of involvement and hence the electroneuromyographic evaluation must be adequate. The unaffected limb also needs to be examined for comparison. The final impression must be co-related with the type and severity of injury.

  8. Brachial access technique for aortoiliac stenting revisited

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report a modified technique to perform iliac artery stenting through the brachial artery access. A 6F Brite tip sheath (Cordis, Jonhson & Jonhson Medical, Miami Lakes, FL, USA) is inserted into either brachial artery and a standard 4F Judkins Right diagnostic catheter was inserted over a 260 cm 0.038" Terumo Stiff wire (Terumo Corp, Tokyo, Japan) through the sheath. The catheter is navigated down to the aortic bifurcation, and after selecting the common iliac artery ostium, the wire is navigated through the lesion and advanced to the ipsilateral superficial femoral arteries. The catheter should be then moved forward over the wires beyond the lesion and the Terumo guidewire is replaced by two 0.038" 260 cm Supracor wires (Boston Scientific Corporation, San Jose, CA, USA). In order to facilitate advancement of the stent without risk of dislodgement as well as to check the position with low contrast dose injection, a 6 F (or 7F if large stent is selected) 90cm Shuttle Flexor introducer long sheath (Cook Group, Bloomington, IN, USA) should be advanced over the Supracor wire until it reaches the common iliac artery ostium. A road-map technique can be used to check the ostium position in order to properly deploy the selected stent. This technique promises to be safe and effective offering more support than guiding catheter technique; moreover it reduces the stress on the arterial vessel at the subclavian site and enables a stiff balloon or stent catheter to be advanced even through a very elongated and calcified aorta without the risk of stent dislodgement.

  9. HIGH BIFURCATION OF THE BRACHIAL ARTERY - A COMMON VARIANT

    Directory of Open Access Journals (Sweden)

    Sesi

    2015-10-01

    Full Text Available 28 cadavers were dissected for variations in the bifurcation of brachial artery bilaterally {n=56} at the department of anatomy, Rangaraya Medical College, Kakinada, A.P. from 2010 to 2015 . Found variations during routine dissections for first year MBBS students. The findings have thrown light on the common as well as rare variants in the anatomy of brachial artery bifurcation and the course of radial and ulnar arteries in current study

  10. Can Local Anesthesia Prevent the Injury of Brachial Plexus?

    OpenAIRE

    Alaattin Ozturk

    2014-01-01

    Schwannomas (neurilemmomas) are benign tumors arising from peripheral nerve sheaths. They can be seen all over the body, but approximately half of the cases occur in the head and neck region. The schwannoma arising from brachial plexus is a rare cause of neck masses. They are rarely diagnosed preoperatively. The risk of nerve damage after excision is high under general anesthesia. In this article, a case of brachial plexus schwannoma was presented and the excision with local anesthesia was sh...

  11. Management of Intrathoracic Benign Schwannomas of the Brachial Plexus

    OpenAIRE

    Alessandro Bandiera; Giampiero Negri; Giulio Melloni; Carlo Mandelli; Simonetta Gerevini; Angelo Carretta; Paola Ciriaco; Armando Puglisi; Piero Zannini

    2014-01-01

    Primary tumours of the brachial plexus are rare entities. They usually present as extrathoracic masses located in the supraclavicular region. This report describes two cases of benign schwannomas arising from the brachial plexus with an intrathoracic growth. In the first case the tumour was completely intrathoracic and it was hardly removed through a standard posterolateral thoracotomy. In the second case the tumour presented as a cervicomediastinal lesion and it was resected through a one-st...

  12. Schwannoma of the brachial plexus presenting as a cystic swelling

    OpenAIRE

    Somayaji, K. S. G.; Rajeshwari, A.; Gangadhara, K. S.

    2004-01-01

    Schwannomas are benign nerve sheath tumours. A small percentage of these tumours arise from the brachial plexus. Cystic degeneration and hemorrhagic necrosis can occur in these tumours in up to 40% of the cases. Detailed preoperative evaluation and careful dissection during surgery will avoid post operative neurological complications. We report a case of schwannoma of the brachial plexus presenting as a cystic neck swelling which was successfully managed by us.

  13. Brachial plexus variations in its formation and main branches

    OpenAIRE

    Valéria Paula Sassoli Fazan; André de Souza Amadeu; Adilson L. Caleffi; Omar Andrade Rodrigues Filho

    2003-01-01

    PURPOSE: The brachial plexus has a complex anatomical structure since its origin in the neck throughout its course in the axillary region. It also has close relationship to important anatomic structures what makes it an easy target of a sort of variations and provides its clinical and surgical importance. The aims of the present study were to describe the brachial plexus anatomical variations in origin and respective branches, and to correlate these variations with sex, color of the subjects ...

  14. Morphological description of the brachial plexus in ocelot (Leopardus pardalis)

    OpenAIRE

    Kylma Lorena Saldanha Chagas; Lara Cochete Moura Fé; Luiza Correa Pereira; Érika Branco; Ana Rita de Lima

    2014-01-01

    The brachial plexus is formed by the ventral roots of the spinal nerves, which unite to form the nerve trunks. It is usually formed by contributions of the last three cervical nerves and the first two thoracic nerves. Due to the scarcity of information on neuroanatomy, this study aimed to determine the macroscopic morphology of the brachial plexus of the ocelot (Leopardus pardalis). In this work, we used two ocelot specimens from the area of the Paragominas Bauxite Mine, P...

  15. Technical note: the humeral canal approach to the brachial plexus.

    OpenAIRE

    Frizelle, H. P.

    1998-01-01

    Many variations to the axillary approach to the brachial plexus have been described. However, the success rate varies depending on the approach used and on the definition of success. Recent work describes a new approach to regional anaesthesia of the upper limb at the humeral/brachial canal using selective stimulation of the major nerves. This report outlines initial experience with this block, describing the technique and results in 50 patients undergoing hand and forearm surgery. All patien...

  16. Interscalene brachial plexus blocks in the management of shoulder dislocations.

    OpenAIRE

    Underhill, T J; Wan, A; Morrice, M

    1989-01-01

    Interscalene brachial plexus block is a simple and effective alternative to intravenous benzodiazepines or general anaesthesia for manipulation of the dislocated shoulder. Thirty interscalene brachial plexus blocks were performed on 29 patients with dislocations of the shoulder to provide regional anaesthesia for reduction. Pain was abolished by 14 out of the 30 blocks performed, improved by 13 and unchanged by three. Muscle relaxation (MRC grade 3 or less) occurred in 21 patients. In 26 case...

  17. Do ankle braces provide similar effects on ankle biomechanical variables in subjects with and without chronic ankle instability during landing?

    Institute of Scientific and Technical Information of China (English)

    Songning; Zhang; Michael; Wortley; Julia; Freedman; Silvernail; Daniel; Carson; Maxime; R.Paquette

    2012-01-01

    <正>Purpose:The purpose of this study was to examine effects of a sport version of a semi-rigid ankle brace(ElementTM) and a soft ankle brace (ASO) on ankle biomechanics and ground reaction forces(GRFs) during a drop landing activity in subjects with chronic ankle instability(CAD compared to healthy subjects with no history of CAI. Methods:Ten healthy subjects and 10 subjects who had multiple ankle sprains participated in the study as the control and unstable subjects, respectively.The CAI subjects were age,body mass index and gender matched with the control subjects.The arch index and ankle functions of the subjects were measured in a subject screening session.During the biomechanical test session,participants performed five trials of drop landing from 0.6 m,wearing no brace(NB).Element? brace and ASO brace.Simultaneous recording of three-dimensional kinematic(240 Hz) and GRF(1200 Hz) data were performed. Results:The CAI subjects had lower ankle functional survey scores.The arch index and deformity results showed greater arch deformity of ElementTM against a static load than in NB and ASO due to greater initial arch position held by the brace.CAI participants had greater eversion velocity than healthy controls.The ASO brace reduced the first peak vertical GRF whereas ElementTM increased 2nd peak vertical GRF. ElementTMbrace reduced eversion range of motion(ROM) and peak eversion velocity compared to NB and ASO.In addition,ElementTM reduced dorsiflexion ROM and increased peak plantarflexion moment compared to NB and ASO. Conclusion:Results of static arch measurements and dynamic ankle motion suggest that the restrictions offered by both braces are in part due to more dorsiflexed ankle positions at contact,and higher initial arch position and stiffer ankle for ElementTM.

  18. Redefining prosthetic ankle mechanics: non-anthropomorphic ankle design.

    Science.gov (United States)

    LaPrè, Andrew K; Sup, Frank

    2013-06-01

    The moment transferred at the residual limb socket interface of transtibial amputees can be a limiting factor of the comfort and activity level of lower limb amputees. The high pressures seen can be a significant source of pain, as well as result in deep tissue damage. The compensation of the sound limbs causes an asymmetrical gait which can be a contributor of early onset osteoarthritis in the sound limbs. It has been shown that the moment transferred with conventional passive prostheses can be lowered in magnitude by aligning the tibia with ground reaction forces, but this limits the effectiveness of the device. With recent powered prosthetics designed to mimic the missing limb, power can be injected into the gait cycle, but can also be limited by this pressure threshold. This paper shows the results of calculations that suggest that altering the prosthetic ankle mechanism can reduce the socket interface moments by as much as 50%. This supports the development of an active non-anthropomorphic ankle prosthesis which reduces socket interface moments while still injecting substantial power levels into the gait cycle. PMID:24187257

  19. Traumatic injuries of brachial plexus: present methods of surgical treatment Part II. Treatment policy for brachial plexus injuries

    OpenAIRE

    M. L. Novikov; T. E. Torno

    2015-01-01

    The task of this paper is to familiarize practicing neurologists, neurosurgeons, traumatologists, and orthopedists with the current principles of diagnosis and treatment of different brachial plexus (BP) injuries. Part I describes the anatomy of BP in detail, considers the main mechanisms of its injuries, and gives their current classification (Nervno-Myshechnye Bolezni (Neuromuscular Diseases) 2012;4:19–27).Part II presents the author's approach to treatment of brachial plexus injuries accor...

  20. Chinese Massage Therapy for Ankle Injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Ming-xia; LI Nian-qun; HUANG Guo-qi

    2003-01-01

    Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises. Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%. Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint.

  1. Computed tomography in complex fractures of the ankle joint

    International Nuclear Information System (INIS)

    Diagnostic value of conventional roentgen technique and computed tomography is proofed by examination of 50 patients with sprain fractures of the ankle joint. The dimension of destruction of the distal tibial joint surface is better documented by CT than by other radiological techniques. Additional informations like multifragmentation of the distal tibia or evaluation of reposition impedigment are found more frequently by CT. Therefore indication and planning of the traumatherapy can be assessed better by the traumatologist. (orig.)

  2. Computed tomography in complex fractures of the ankle joint

    Energy Technology Data Exchange (ETDEWEB)

    Friedburg, H.; Wimmer, B.; Hendrich, V.; Riede, U.N.

    1983-09-01

    Diagnostic value of conventional roentgen technique and computed tomography is proofed by examination of 50 patients with sprain fractures of the ankle joint. The dimension of destruction of the distal tibial joint surface is better documented by CT than by other radiological techniques. Additional informations like multiframentation of the distal tibia or evaluation of reposition impediment are found more frequently by CT. Therefore indication and planning of the traumatherapy can be assessed better by the traumatologist.

  3. The initial effects of a Mulligan's mobilization with movement technique on dorsiflexion and pain in subacute ankle sprains.

    Science.gov (United States)

    Collins, Natalie; Teys, Pamela; Vicenzino, Bill

    2004-05-01

    Physiotherapists frequently use manipulative therapy techniques to treat dysfunction and pain resulting from ankle sprain. This study investigated whether a Mulligan's mobilization with movement (MWM) technique improves talocrural dorsiflexion, a major impairment following ankle sprain, and relieves pain in subacute populations. Fourteen subjects with subacute grade II lateral ankle sprains served as their own control in a repeated measures, double-blind randomized controlled trial that measured the initial effects of the MWM treatment on weight bearing dorsiflexion and pressure and thermal pain threshold. The subacute ankle sprain group studied displayed deficits in dorsiflexion and local pressure pain threshold in the symptomatic ankle. Significant improvements in dorsiflexion occurred initially post-MWM ( F(2,26) = 7.82, P = 0.002 ), but no significant changes in pressure or thermal pain threshold were observed after the treatment condition. Results indicate that the MWM treatment for ankle dorsiflexion has a mechanical rather than hypoalgesic effect in subacute ankle sprains. The mechanism by which this occurs requires investigation if we are to better understand the role of manipulative therapy in ankle sprain management. PMID:15040966

  4. The role of ankle bracing for prevention of ankle sprain injuries.

    Science.gov (United States)

    Gross, Michael T; Liu, Hsin-Yi

    2003-10-01

    Lateral ankle sprains are one of the most common injuries incurred in recreational and competitive athletics. These injuries have a significant impact in terms of cost, athletic participation, and activities of daily living. Prophylactic ankle braces are often used to reduce the risk of injury recurrence when individuals return to athletic participation. The purpose of this clinical commentary is to review the literature and provide our own experience relative to the use of prophylactic ankle bracing. Relatively high incidence rates of ankle sprain injury have been reported for basketball and soccer athletes, military trainees, and individuals with a previous history of ankle sprain injury. Semirigid and laced ankle braces have significantly reduced the incidence of initial and recurrent ankle sprain injuries in athletic and military samples. With few exceptions, these braces do not appear to affect functional performance adversely. The prophylactic use of semirigid ankle braces appears warranted to reduce the incidence of initial and, in particular, recurrent ankle sprain injuries for individuals who participate in activities that have the highest risk for these injuries. Additional research is needed to evaluate the many new braces that are available and in use and their influence on the incidence of ankle sprain injury and functional performance. PMID:14620786

  5. Surgical outcomes following nerve transfers in upper brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    Bhandari P

    2009-01-01

    Full Text Available Background: Brachial plexus injuries represent devastating injuries with a poor prognosis. Neurolysis, nerve repair, nerve grafts, nerve transfer, functioning free-muscle transfer and pedicle muscle transfer are the main surgical procedures for treating these injuries. Among these, nerve transfer or neurotization is mainly indicated in root avulsion injury. Materials and Methods: We analysed the results of various neurotization techniques in 20 patients (age group 20-41 years, mean 25.7 years in terms of denervation time, recovery time and functional results. The inclusion criteria for the study included irreparable injuries to the upper roots of brachial plexus (C5, C6 and C7 roots in various combinations, surgery within 10 months of injury and a minimum follow-up period of 18 months. The average denervation period was 4.2 months. Shoulder functions were restored by transfer of spinal accessory nerve to suprascapular nerve (19 patients, and phrenic nerve to suprascapular nerve (1 patient. In 11 patients, axillary nerve was also neurotized using different donors - radial nerve branch to the long head triceps (7 patients, intercostal nerves (2 patients, and phrenic nerve with nerve graft (2 patients. Elbow flexion was restored by transfer of ulnar nerve motor fascicle to the motor branch of biceps (4 patients, both ulnar and median nerve motor fascicles to the biceps and brachialis motor nerves (10 patients, spinal accessory nerve to musculocutaneous nerve with an intervening sural nerve graft (1 patient, intercostal nerves (3rd, 4th and 5th to musculocutaneous nerve (4 patients and phrenic nerve to musculocutaneous nerve with an intervening graft (1 patient. Results: Motor and sensory recovery was assessed according to Medical Research Council (MRC Scoring system. In shoulder abduction, five patients scored M4 and three patients M3+. Fair results were obtained in remaining 12 patients. The achieved abduction averaged 95 degrees (range, 50 - 170

  6. Vascular surgical society of great britain and ireland: immunoglobulin A antibodies against chlamydia pneumoniae are associated with expansion of small abdominal aortic aneurysms and declining ankle blood pressure

    DEFF Research Database (Denmark)

    Lindholt, Jes S.; Vammen; Henneberg;

    1999-01-01

    or greater, were significant independent predictors of AAA expansion adjusted for age, smoking, initial AAA size, steroid treatment, diastolic blood pressure, pulmonary function and other plasma factors. The ankle blood pressure index (ABI) of the IgA-seropositive men decreased 11 per cent, while the...... ABI decreased by 5 per cent among IgA-seronegative men (P < 0.05). The significant difference persisted after adjusting for age, smoking, initial systolic ankle blood pressure, initial brachial systolic or diastolic blood pressure, but disappeared after adjusting for low-density lipoprotein (LDL....... Some 139 men (aged 65-73 years) with a 3.0-4.9-cm AAA were followed prospectively for 1-3 (mean 2.7) years. Initially, an interview and examination was performed, and blood samples were taken. RESULTS: Some 62 per cent (53-71 per cent) had an immunoglobulin (Ig) A level of 40 or more, or an IgG level...

  7. EFFECTS OF FATIGUE & GENDER ON PERONEAL REFLEXES AFTER ANKLE INVERSION

    OpenAIRE

    Wilson, Erin Lawall

    2005-01-01

    An estimated 23,000 ankle injuries occur every day in the U.S. Ankle sprains account for 85% of all ankle injuries and inversion ankle sprains account for 85% of all ankle sprains. There is growing evidence that suggests gender and fatigue may increase the risk for inversion ankle sprains. Investigating the effects of fatigue and gender on peroneal reflex response after ankle inversion may help explain the differences in sprain rates with fatigue and gender. Therefore, the purpose of this stu...

  8. Pharyngeal-cervical-brachial variant of Guillain-Barre syndrome.

    Science.gov (United States)

    Wakerley, Benjamin R; Yuki, Nobuhiro

    2014-03-01

    The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome is defined by rapidly progressive oropharyngeal and cervicobrachial weakness associated with areflexia in the upper limbs. Serial nerve conduction studies suggest that PCB represents a localised subtype of Guillain-Barré syndrome characterised by axonal rather than demyelinating neuropathy. Many neurologists are unfamiliar with PCB, which is often misdiagnosed as brainstem stroke, myasthenia gravis or botulism. The presence of additional ophthalmoplegia and ataxia indicates overlap with Fisher syndrome. Half of patients with PCB carry IgG anti-GT1a antibodies which often cross-react with GQ1b, whereas most patients with Fisher syndrome carry IgG anti-GQ1b antibodies which always cross-react with GT1a. Significant overlap between the clinical and serological profiles of these patients supports the view that PCB and Fisher syndrome form a continuous spectrum. In this review, we highlight the clinical features of PCB and outline new diagnostic criteria. PMID:23804237

  9. Conversion of ankle autofusion to total ankle replacement using the Salto XT revision prosthesis.

    Science.gov (United States)

    Williamson, Emilie R C; Demetracopoulos, Constantine A; Ellis, Scott J

    2016-09-01

    Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered. We describe the clinical and radiographic outcomes achieved in this case. At 12 months post-operatively the patient reported significant reduction of pain, increased FAOS scores and had increased ankle range of motion. PMID:27502236

  10. Foot and Ankle Injuries in Runners.

    Science.gov (United States)

    Tenforde, Adam S; Yin, Amy; Hunt, Kenneth J

    2016-02-01

    Foot and ankle injuries account for nearly one-third of running injuries. Achilles tendinopathy, plantar fasciopathy, and ankle sprains are 3 of the most common types of injuries sustained during training. Other common injuries include other tendinopathies of the foot and ankle, bone stress injuries, nerve conditions including neuromas, and joint disease including osteoarthritis. This review provides an evidence-based framework for the evaluation and optimal management of these conditions to ensure safe return to running participation and reduce risk for future injury. PMID:26616180

  11. Novel Axillary Approach for Brachial Plexus in Robotic Surgery: A Cadaveric Experiment

    OpenAIRE

    Cihangir Tetik; Metin Uzun

    2014-01-01

    Brachial plexus surgery using the da Vinci surgical robot is a new procedure. Although the supraclavicular approach is a well known described and used procedure for robotic surgery, axillary approach was unknown for brachial plexus surgery. A cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery. Our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outl...

  12. Granular Cell Tumor of Brachial Plexus Mimicking Nerve Sheath Tumor: A Case Report

    OpenAIRE

    Kim, Young-Im; Lee, Chul-kyu; Cho, Ki Hong; Kim, Sang-Hyun

    2012-01-01

    Primary tumors of the brachial plexus region are rare and granular cell tumors arising from the brachial plexus region is an extremely rare disease. We present a case of granular cell tumor arising from of the brachial plexus which appeared to be a usual presentation of nerve sheath tumor before the pathological confirmation. We report a granular cell tumor of the brachial plexus with literature review. Total resection is important for good clinical outcome and prognosis in the treatment of g...

  13. Idiopathic brachial neuritis in a child: A case report and review of the literature

    OpenAIRE

    Shikha Jain; Girish Chandra Bhatt; Nirendra Rai; Bhavna Dhingra Bhan

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association wit...

  14. New approaches in imaging of the brachial plexus

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, M.I. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland)], E-mail: maria.i.vargas@hcuge.ch; Viallon, M. [Department of Radiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Nguyen, D. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Beaulieu, J.Y. [Unit of Hand Surgery, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Delavelle, J. [Department of Neuroradiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland); Becker, M. [Unit of Head and Neck Radiology, Geneva University Hospital and University of Geneva, Geneva (Switzerland)

    2010-05-15

    Imaging plays an essential role for the detection and analysis of pathologic conditions of the brachial plexus. Currently, several new techniques are used in addition to conventional 2D MR sequences to study the brachial plexus: the 3D STIR SPACE sequence, 3D heavily T2w MR myelography sequences (balanced SSFP = CISS 3D, True FISP 3D, bFFE and FIESTA), and the diffusion-weighted (DW) neurography sequence with fiber tracking reconstruction (tractography). The 3D STIR sequence offers complete anatomical coverage of the brachial plexus and the ability to slice through the volume helps to analyze fiber course modification and structure alteration. It allows precise assessment of distortion, compression and interruption of postganglionic nerve fibers thanks to the capability of performing maximum intensity projections (MIP) and multiplanar reconstructions (MPRs). The CISS 3D, b-SSFP sequences allow good visualization of nerve roots within the spinal canal and may be used for MR myelography in traumatic plexus injuries. The DW neurography sequence with tractography is still a work in progress, able to demonstrate nerves tracts, their structure alteration or deformation due to pathologic processes surrounding or located along the postganglionic brachial plexus. It may become a precious tool for the understanding of the underlying molecular pathophysiologic mechanisms in diseases affecting the brachial plexus and may play a role for surgical planning procedures in the near future.

  15. New approaches in imaging of the brachial plexus

    International Nuclear Information System (INIS)

    Imaging plays an essential role for the detection and analysis of pathologic conditions of the brachial plexus. Currently, several new techniques are used in addition to conventional 2D MR sequences to study the brachial plexus: the 3D STIR SPACE sequence, 3D heavily T2w MR myelography sequences (balanced SSFP = CISS 3D, True FISP 3D, bFFE and FIESTA), and the diffusion-weighted (DW) neurography sequence with fiber tracking reconstruction (tractography). The 3D STIR sequence offers complete anatomical coverage of the brachial plexus and the ability to slice through the volume helps to analyze fiber course modification and structure alteration. It allows precise assessment of distortion, compression and interruption of postganglionic nerve fibers thanks to the capability of performing maximum intensity projections (MIP) and multiplanar reconstructions (MPRs). The CISS 3D, b-SSFP sequences allow good visualization of nerve roots within the spinal canal and may be used for MR myelography in traumatic plexus injuries. The DW neurography sequence with tractography is still a work in progress, able to demonstrate nerves tracts, their structure alteration or deformation due to pathologic processes surrounding or located along the postganglionic brachial plexus. It may become a precious tool for the understanding of the underlying molecular pathophysiologic mechanisms in diseases affecting the brachial plexus and may play a role for surgical planning procedures in the near future.

  16. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability

    OpenAIRE

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-01-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In...

  17. Clinical Value of the Ottawa Ankle Rules for Diagnosis of Fractures in Acute Ankle Injuries

    OpenAIRE

    Xin Wang; Shi-min Chang; Guang-rong Yu; Zhi-tao Rao

    2013-01-01

    BACKGROUND: The Ottawa ankle rules (OAR) are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OAR have been proven that their application reduces unnecessary radiography. They have nearly perfect sensitivity for identifying clinically significant ankle fractures. OBJECTIVES: The purpose of this study was to assess the applicability of the OAR in China, to examine their accuracy for the diagnosis of fractures in patients with a...

  18. Primary ankle arthrodesis for neglected open weber B ankle fracture dislocation.

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described.

  19. Developing A mobile App for the Rehabilitation of Ankle Sprains

    Directory of Open Access Journals (Sweden)

    Suzanne McDonough

    2015-10-01

    to implement, and video and voice over content was completed. The following strategies were identified to incorporate into the app: modelling of behaviour; monitoring and receiving feedback related to individual behaviour, monitoring and receiving feedback related to the outcome of individual behaviour; and receiving reminders. ReApp 2 received a mean SUS score of 86, which is considerably above the average of 69.69 reported in Bangor et al.’s (2008 review of 2324 surveys from 206 studies. The technical experts indicated that the usability of ReApp 2 was considered to be “excellent” (SUS score over 85.58 by 60% of participants, and “good” by the remaining 40% (SUS score over 72.75. Clinicians agreed or strongly agreed that the clinical content within the app was evidence based (n=3, that the clinical content within the app was suitable for ankle rehabilitation (n=4 and that they would recommend the app to a patient presenting with ankle sprain (n=3. Conclusions: The SUS scores received from the technical evaluation in this project are considerably above average, indicating the excellent-good usability of the app. Clinicians rated the app as evidence based and 50% of clinicians would recommend the app in its current format to patients with ankle sprain.

  20. Prognostic value of thumb pain sensation in birth brachial plexopathy

    Directory of Open Access Journals (Sweden)

    Carlos O. Heise

    2012-08-01

    Full Text Available OBJECTIVE: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. METHODS: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6. The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. RESULTS: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. CONCLUSION: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.

  1. Reversible brachial plexopathy following primary radiation therapy for breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Salner, A.L.; Botnick, L.E.; Herzog, A.G.; Goldstein, M.A.; Harris, J.R.; Levene, M.B.; Hellman, S.

    Reversible brachial plexopathy has occurred in very low incidence in patients with breast carcinoma treated definitively with radiation therapy. Of 565 patients treated between January 1968 and December 1979 with moderate doses of supervoltage radiation therapy (average axillary dose of 5000 rad in 5 weeks), eight patients (1.4%) developed the characteristic symptoms at a median time of 4.5 months after radiation therapy. This syndrome consists of paresthesias in all patients, with weakness and pain less commonly seen. The symptom complex differs from other previously described brachial plexus syndromes, including paralytic brachial neuritis, radiation-induced injury, and carcinoma. A possible relationship to adjuvant chemotherapy exists, though the etiology is not well-understood. The cases described demonstrate temporal clustering. Resolution is always seen.

  2. Lichen simplex chronicus on the ankle (image)

    Science.gov (United States)

    Lichen simplex chronicus on the ankle: Lichen simplex chronicus is also known as neurodermatitis. A minor itch may encourage scratching which increases the irritation, leading to more scratching. This ultimately results ...

  3. A novel dynamic ankle-supinating device.

    Science.gov (United States)

    Gutierrez, Gregory M; Kaminski, Thomas

    2010-02-01

    Lateral ankle sprains (LAS) are among the most common joint injuries, and although most are resolved with conservative treatment, others develop chronic ankle instability (AI). Considerable attention has been directed toward understanding the underlying causes of this pathology; however, little is known concerning the neuromuscular mechanisms behind AI. A biomechanical analysis of the landing phase of a drop jump onto a device that simulates the mechanism of a LAS may give insight into the dynamic restraint mechanisms of the ankle by individuals with AI. Furthermore, work evaluating subjects who have a history of at least one lateral ankle sprain, yet did not develop AI, may help elucidate compensatory mechanisms following a LAS event. Identifying proper neuromuscular control strategies is crucial in reducing the incidence of AI. PMID:20147765

  4. Osteoarthritis of the Foot and Ankle

    Science.gov (United States)

    ... joint. Diagnosis In diagnosing osteoarthritis, the foot and ankle surgeon will examine the foot thoroughly, looking for swelling in the joint, limited mobility, and pain with movement. In some cases, deformity ...

  5. Postoperative MR study of the ankle

    International Nuclear Information System (INIS)

    20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress X-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress X-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exsudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR. (orig.)

  6. What Is a Foot and Ankle Surgeon?

    Science.gov (United States)

    ... school, the foot and ankle surgeon enters a postgraduate residency in podiatric medicine and surgery approved by ... disorders and injuries that affect people of all ages. They are uniquely qualified to detect the early ...

  7. Permanent upper trunk plexopathy after interscalene brachial plexus block.

    Science.gov (United States)

    Avellanet, Merce; Sala-Blanch, Xavier; Rodrigo, Lidia; Gonzalez-Viejo, Miguel A

    2016-02-01

    Interscalene brachial plexus block (IBPB) has been widely used in shoulder surgical procedures. The incidence of postoperative neural injury has been estimated to be as high as 3 %. We report a long-term neurologic deficit after a nerve stimulator assisted brachial plexus block. A 55 year-old male, with right shoulder impingement syndrome was scheduled for elective surgery. The patient was given an oral dose of 10 mg of diazepam prior to the nerve stimulator assisted brachial plexus block. The patient immediately complained, as soon as the needle was placed in the interscalene area, of a sharp pain in his right arm and he was sedated further. Twenty-four hours later, the patient complained of severe shoulder and arm pain that required an increased dose of analgesics. Severe peri-scapular atrophy developed over the following days. Electromyography studies revealed an upper trunk plexus injury with severe denervation of the supraspinatus, infraspinatus and deltoid muscles together with a moderate denervation of the biceps brachii muscle. Chest X-rays showed a diaphragmatic palsy which was not present post operatively. Pulmonary function tests were also affected. Phrenic nerve paralysis was still present 18 months after the block as was dysfunction of the brachial plexus resulting in an inability to perform flexion, abduction and external rotation of the right shoulder. Severe brachial plexopathy was probably due to a local anesthetic having been administrated through the perineurium and into the nerve fascicles. Severe brachial plexopathy is an uncommon but catastrophic complication of IBPB. We propose a clinical algorithm using ultrasound guidance during nerve blocks as a safer technique of regional anesthesia. PMID:25744163

  8. Postoperative infection in the foot and ankle.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-07-01

    Our discussion highlights the commonly performed surgical procedures in the foot and ankle and reviews the various imaging modalities available for the detection of infection with graphic examples to better enable radiologists to approach the radiological evaluation of postoperative infection in the foot and ankle. Discrimination between infectious and noninfectious inflammation remains a diagnostic challenge usually needing a combination of clinical assessment, laboratory investigations, and imaging studies to increase diagnostic accuracy.

  9. Is balance impaired by recurrent sprained ankle?

    OpenAIRE

    Isakov, E; Mizrahi, J.

    1997-01-01

    OBJECTIVE: To evaluate uninjured and recurrent sprained ankles during single leg standing, both with and without visual input, and the contribution of related proprioceptive feedback in this event. METHODS: A force measuring system was used for monitoring reaction forces in the anteroposterior and mediolateral directions during single leg standing. Differences between selected variables obtained in the uninjured and sprained ankles were analysed using two way analysis of variance. RESULTS: Fo...

  10. Variations of the ventral rami of the brachial plexus.

    OpenAIRE

    Lee, H. Y.; Chung, I. H.; Sir, W. S.; Kang, H S; Lee, H.S.; Ko, J S; Lee, M. S.; Park, S. S.

    1992-01-01

    We studied the variations in the ventral rami of 152 brachial plexuses in 77 Korean adults. Brachial plexus were composed mostly of the fifth, sixth, seventh and eighth cervical nerves and the first thoracic nerve (77.0%). In 21.7% of the cases examined, the fourth, fifth, sixth, seventh and eighth cervical and the first thoracic nerves contributed to the plexus. A plexus composed of the fourth, fifth, sixth, seventh and eighth cervical and the first and second thoracic nerves, and a plexus c...

  11. Pediatric Stinger Syndrome: Acute Brachial Plexopathy After Minor Trauma.

    Science.gov (United States)

    Quong, Whitney L; Hynes, Sally L; Arneja, Jugpal S

    2015-11-01

    The "stinger" or "burner" is a form of transient brachial plexopathy termed for its characteristic knife-like pain extending from the neck to the fingertips. Muscle weakness and paresthesia are oftentimes associated symptoms and are similarly temporary. Commonly observed in athletes of contact sports, the stinger results from high force trauma causing either traction/direct compression to the brachial plexus or extension/compression of the cervical nerve roots. We describe a pediatric case of a stinger in a 14-year-old boy, which was caused by a relatively low force trauma accident. Our management strategy and recommendations are discussed. PMID:26893985

  12. DOES BRACHIAL ARTERY FMD PROVIDE A BIOASSAY FOR NITRIC OXIDE?

    OpenAIRE

    Wray, D. Walter; Witman, Melissa A. H.; Ives, Stephen J.; McDaniel, John; Trinity, Joel D.; Conklin, Jamie D.; Supiano, Mark A.; Richardson, Russell S.

    2013-01-01

    This study sought to better define the role of nitric oxide (NO) in brachial artery flow-mediated vasodilation (FMD) in young, healthy humans. Brachial artery blood velocity and diameter were determined (ultrasound Doppler) in eight volunteers (26 ± 1 yrs) before and after 5-min forearm circulatory occlusion with and without intra-arterial infusion of the endothelial nitric oxide synthase (eNOS) inhibitor L-NMMA (0.48 mg/dl/min). Control (CON) and L-NMMA trials were performed with the occlusi...

  13. Ankle flexibility and injury patterns in dancers.

    Science.gov (United States)

    Wiesler, E R; Hunter, D M; Martin, D F; Curl, W W; Hoen, H

    1996-01-01

    Lower-extremity injuries are common among dancers and cause significant absences from rehearsals and performances. For this study of lower-extremity injuries in 101 ballet and 47 modern dance students, injuries requiring medical attention sustained over 1 academic year were associated with the following data obtained at the beginning of the school year: ankle flexibility, sex, dance discipline, previous injury, body mass index, and years of training. Eighty-three of the 148 students (age range, 12 to 28 years) reported prior lower-limb injuries, the most common being ankle sprains (28% of all dancers). Previous leg injuries correlated significantly with lower dorsiflexion measurements and with more new injuries. Female students had greater ankle and first metatarsophalangeal flexibility. Modern dancers had greater ankle inversion. Ninety-four students sustained 177 injuries during the study, including 75 sprains or strains and 71 cases of tendinitis. Thirty-nine percent (N = 69) were ankle injuries; 18% (N = 33) were knee injuries; 23% (N = 40) were foot injuries; and 20% (N = 35) were either hip or thigh injuries. Sixty-seven percent (N = 78) of the injured students were ballet dancers. Age, years of training, body mass index, sex, and ankle range of motion measurement had no predictive value for injury; previous injury and dance discipline both correlated with increased risk of injury. PMID:8947396

  14. [Brachial plexus. Long lasting neurological deficit following interscalene blockade of the brachial plexus].

    Science.gov (United States)

    Funk, W; Angerer, M; Sauer, K; Altmeppen, J

    2000-07-01

    An interscalene block of the brachial plexus was combined with general anaesthesia for repair of a complex chronic lesion of the shoulder. The localisation of the plexus with electro-stimulation and the injection of Bupivacain 0.5% were accomplished easily and without painful sensations. 48 hours later the block was still partially present. Paraesthesia and a sensory and motor innervation deficit affected mainly the dorsal fascicle, but also areas innervated by the median and lateral fascicles. The deficit did not completely disappear for 18 month. The cause could have been due to direct traumatisation during blockade or operation, toxic action of the injected substance (Bupivacain 0.5%, 30 ml), distension of the plexus, a cervical syndrome or an aseptic plexitis, although a definite determination is not possible. However, the pattern of the lesion and the lack of pain during localisation of the plexus and injection favour traumatisation during the acromioplasty. PMID:10969388

  15. Interrater and intrarater reliability of photoplethysmography for measuring toe blood pressure and toe-brachial index in people with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Scanlon Christopher

    2012-06-01

    Full Text Available Abstract Background A reliable tool to measure arterial flow to the feet in people with diabetes is required given that they are particularly prone to peripheral arterial disease. Traditionally, the ankle brachial index (ABI has been used to measure arterial circulation, but its application is limited due to calcification of larger arteries. More recently, toe pressure and the toe brachial index (TBI has been suggested as superior to ABI measurements because they assess smaller digital arteries less prone to arterial calcification. However, reliability studies for the clinical use of photoplethysmography (PPG in people with diabetes are lacking. Methods Sixty people with diabetes mellitus (35 males and 25 females, mean age 59.6 yrs consented to take part in the study. The majority (92% had type 2 diabetes and 8% had type 1 diabetes. Forty-three percent were diagnosed as having peripheral neuropathy when tested using a biothesiometer and 15% were current smokers (10 – 40/day. A podiatrist and a diabetes educator measured toe and brachial blood pressure independently and in a random order using PPG. These measurements were repeated again seven days later, and subsequently analysed with intraclass correlation coefficients (ICC, 95% confidence intervals (CI and standard error of measurement (SEM. Results The intrarater reliability of measuring toe pressures was excellent (ICC3,1 =0.78-0.79, SEM 8 mmHg and interrater reliability was also excellent (ICC2,2 = 0.93, SEM 4 mmHg. The intrarater reliability for measuring brachial pressures was generally poor (ICC3,1 = 0.40 – 0.42, SEM 19 mmHg and interrater reliability was fair-good (ICC2,2. 0.65, SEM 14 mmHg. The TBI intrarater reliability was fair-good (ICC3,1 = 0.51-0.72, SEM 0.08, whilst the interrater reliability of TBI was excellent (ICC2,2 = 0.85, SEM 0.07. Conclusions Based on these results, interrater and intrarater reliability of PPG is excellent for measuring toe

  16. Prospective study of ankle and foot fractures in elderly women

    Directory of Open Access Journals (Sweden)

    Yadagiri Surender Rao

    2015-01-01

    Full Text Available The epidemiology of ankle fractures in old people is changing as time passes on. The incidence of ankle fractures increases with advancing age. The study conducted was among a rural popula-tion which comprised of 68 women (32 women with ankle fractures & 36 women with foot fractures. Patients studied were in the age group more than 50 years. The study highlights the etiological & risk factors for fractures of ankle & foot. The commonest ankle fracture was the lateral malleolar fracture & the commonest foot fracture was the 5th Metatarsal fracture. Diabetes is a risk factor which increases the occurrence of ankle and foot injuries.

  17. Arthrography, talar tilt and surgical findings after inversion trauma of the ankle

    International Nuclear Information System (INIS)

    Both inversion stress examination under general anesthesia and arthrography are sensitive indicators of lateral ankle ligament pathology (91%, 96% resp.). Arthrography is significantly superior to inversion stress examination done under local anesthesia (96%, 70% resp.). Peroneus tendon sheath filling is always pathological, but although this does not always indicate calcaneo-fibular ligament rupture, such rupture cannot be excluded in its absence. Talar tilt difference cannot be correlated with the extent of ligamentous rupture and therefore inversion stress examination, while providing valuable additional information, must be regarded as a secondary technique to ankle arthrography. (orig.)

  18. Clinical value of the Ottawa ankle rules for diagnosis of fractures in acute ankle injuries.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available BACKGROUND: The Ottawa ankle rules (OAR are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OAR have been proven that their application reduces unnecessary radiography. They have nearly perfect sensitivity for identifying clinically significant ankle fractures. OBJECTIVES: The purpose of this study was to assess the applicability of the OAR in China, to examine their accuracy for the diagnosis of fractures in patients with acute ankle sprains, and to assess their clinical utility for the detection of occult fractures. METHODS: In this prospective study, patients with acute ankle injuries were enrolled during a 6-month period. The eligible patients were examined by emergency orthopedic specialists using the OAR, and then underwent ankle radiography. The results of examination using the OAR were compared with the radiographic results to assess the accuracy of the OAR for ankle fractures. Patients with OAR results highly suggestive of fracture, but no evidence of a fracture on radiographs, were advised to undergo 3-dimensional computed tomography (3D-CT. RESULTS: 183 patients with ankle injuries were enrolled in the study and 63 of these injuries involved fractures. The pooled sensitivity, specificity, positive predictive value and negative predictive value of the OAR for detection of fractures of the ankle were 96.8%, 45.8%, 48.4% and 96.5%, respectively. Our results suggest that clinical application of the OAR could decrease unnecessary radiographs by 31.1%. Of the 21 patients with positive OAR results and negative radiographic findings who underwent 3D-CT examination, five had occult fractures of the lateral malleolus. CONCLUSIONS: The OAR are applicable in the Chinese population, and have high sensitivity and modest specificity for the diagnosis of fractures associated with acute ankle injury. They may detect some occult fractures of the malleoli that are not visible on

  19. Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

    OpenAIRE

    Rosenbaum D; Rodriguez-Carranza S; Laroche P; Bruckert E; Giral P; Girerd X

    2012-01-01

    David Rosenbaum1,2, Sandra Rodriguez-Carranza1,3, Patrick Laroche4, Eric Bruckert1,2, Philippe Giral1,2, Xavier Girerd1,21Unité de Prévention Cardiovasculaire, Service d'Endocrinologie-Métabolisme, Assistance Publique/Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière – Université Pierre et Marie Curie, 2Dyslipoproteinemia and Atherosclerosis Research Unit, National Institute for Healt...

  20. Acute injury of the ankle joint; Akutes Trauma des Sprunggelenks

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Univ. Klinik fuer Radiodiagnostik, Abt. fuer Osteologie und Besondere Klinische Einrichtung Magnet Resonanz, AKH, Wien (Austria)]|[Ludwig-Boltzmann-Institut fuer Radiologisch-Physikalische Tumordiagnostik, Vienna (Austria)

    1999-01-01

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments. In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic. (orig.) [Deutsch] Die Diagnose einer lateralen Bandverletzung beim frischen Sprunggelenkstrauma fusst auf der Anamnese, der klinischen Untersuchung und klinischen Stresstests. Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung fuer den Wert der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesonders fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 -30 reicht. Die MRT wird zur Zeit bei dieser Indikation nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenksbaende erlaubt. Bei knoecherner Sprunggelenksverletzungen ist die Verwendung des konventionellen Roentgen die etablierte Methode und meist

  1. Brachial versus central blood pressure and vascular stiffness

    DEFF Research Database (Denmark)

    Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie

    2010-01-01

    Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...

  2. Axillary Brachial Plexus Blockade for the Reflex Sympathetic Dystrophy Syndrome.

    Science.gov (United States)

    Ribbers, G. M.; Geurts, A. C. H.; Rijken, R. A. J.; Kerkkamp, H. E. M.

    1997-01-01

    Reflex sympathetic dystrophy syndrome (RSD) is a neurogenic pain syndrome characterized by pain, vasomotor and dystrophic changes, and often motor impairments. This study evaluated the effectiveness of brachial plexus blockade with local anaesthetic drugs as a treatment for this condition. Three patients responded well; three did not. (DB)

  3. Imaging diagnosis of neurogenic tumors of the brachial plexus

    International Nuclear Information System (INIS)

    To analyse the imaging characteristics of neurogenic tumors in the brachial plexus, six cases of neurogenic tumors of the brachial plexus were reported pathologically proved as schwannoma in 4 and neurofibroma in 2 cases. The plain films demonstrated the mass at the apex of lung in 3 cases, enlargement of cervical intervertebral foremen in 1. CT scan revealed that the average diameter of the masses was 4 cm, with spindle shape in 4, dumb-bell shape in 2 cases. The averaged CT value was similar to that of muscle on plain scan. The density of the tumor was higher than that of muscle and lower than that of vessels after contrast enhancement. On MRI T1W image, the masses were all hyperintense. Three schwannoma presented high signal intensity similar to CSF. The lesion demonstrated moderate enhancement after contrast administration in 1 case. Based on the location of the mass and its imaging features, diagnosis of neurogenic tumor of the brachial plexus could possibly be established before operation. MRI imaging is the imaging modality of choice in displaying the anatomy and the lesion of brachial plexus

  4. Morphological description of the brachial plexus in ocelot (Leopardus pardalis

    Directory of Open Access Journals (Sweden)

    Kylma Lorena Saldanha Chagas

    2014-06-01

    Full Text Available The brachial plexus is formed by the ventral roots of the spinal nerves, which unite to form the nerve trunks. It is usually formed by contributions of the last three cervical nerves and the first two thoracic nerves. Due to the scarcity of information on neuroanatomy, this study aimed to determine the macroscopic morphology of the brachial plexus of the ocelot (Leopardus pardalis. In this work, we used two ocelot specimens from the area of the Paragominas Bauxite Mine, PA, Brazil/Empresa Terra LTDA, with permission from SEMA – BP Nos. 455/2009 and 522/2009. The animals were donated to the Research Laboratory of Animal Morphology (LaPMA, Federal Rural University of Amazonia (UFRA, after they were accidentally run over. They were fixed by intramuscular injection of 10% formaldehyde. After fixation, the animals were dissected, allowing visualization of the thoracic nerves, as well as the identification of the ventral rami of the cervical and thoracic spinal nerves forming the brachial plexus. The brachial plexus was found to be formed by four trunks, which originated the ventral branches of cervical spinal nerves C6, C7 and C8 and the first thoracic (T1. These trunks gave rise to the suprascapular, subscapular, musculocutaneous, axillary, radial, median, ulnar, thoracodorsal and lateral thoracic nerves.

  5. Treatment for idiopathic and hereditary neuralgic amyotrophy (brachial neuritis) (Review)

    NARCIS (Netherlands)

    Alfen, N. van; Engelen, B.G.M. van; Hughes, R.A.

    2009-01-01

    BACKGROUND: Neuralgic amyotrophy (also know as Parsonage-Turner syndrome or brachial plexus neuritis) is a distinct peripheral nervous system disorder characterised by episodes (attacks) of extreme neuropathic pain and rapid multifocal weakness and atrophy in the upper limbs. Neuralgic amyotrophy ha

  6. Brachial plexus neuropathy - A long-term outcome study

    NARCIS (Netherlands)

    Geertzen, JHB; Groothoff, JW; Nicolai, JP; Rietman, JS

    2000-01-01

    This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patients. The mean follow up was 8 years. Nine patients complained of persistent pain and muscle weakness, four had continuing problems with various activities of daily living and 11 had trouble with some hou

  7. Brachial plexus birth palsy: Management during the first year of life.

    Science.gov (United States)

    Abid, A

    2016-02-01

    Brachial plexus birth palsy (BPBP) is defined as an injury to any nerve root of the brachial plexus during difficult delivery. BPBP is relatively rare; its incidence has remained constant over the last few decades, mostly due to unpredictable risk factors, such as shoulder dystocia. Both diagnosis and assessment of spontaneous recovery is based on clinical examination. Electromyography is difficult to interpret in the newborn and is therefore not meaningful. MRI of the cervical spine requires sedation or general anesthesia. Searching for a pre-ganglion tear prior to surgery is indicted. Prognosis depends on the level of the injury (pre- or post-ganglion), size and severity of the post-ganglion tears, speed of recovery, and quality of initial management. Although spontaneous recovery is frequent, some children suffer various degrees of sequelae, up to complete loss of function of the affected upper limb. Recent publications have improved general knowledge and indications for surgery. However, some aspects, such as indication and timing of nerve repair continue to be debated. PMID:26774906

  8. Analysis of the Effects of Normal Walking on Ankle Joint Contact Characteristics After Acute Inversion Ankle Sprain.

    Science.gov (United States)

    Bae, Ji Yong; Park, Kyung Soon; Seon, Jong Keun; Jeon, Insu

    2015-12-01

    To show the causal relationship between normal walking after various lateral ankle ligament (LAL) injuries caused by acute inversion ankle sprains and alterations in ankle joint contact characteristics, finite element simulations of normal walking were carried out using an intact ankle joint model and LAL injury models. A walking experiment using a volunteer with a normal ankle joint was performed to obtain the boundary conditions for the simulations and to support the appropriateness of the simulation results. Contact pressure and strain on the talus articular cartilage and anteroposterior and mediolateral translations of the talus were calculated. Ankles with ruptured anterior talofibular ligaments (ATFLs) had a higher likelihood of experiencing increased ankle joint contact pressures, strains and translations than ATFL-deficient ankles. In particular, ankles with ruptured ATFL + calcaneofibular ligaments and all ruptured ankles had a similar likelihood as the ATFL-ruptured ankles. The push off stance phase was the most likely situation for increased ankle joint contact pressures, strains and translations in LAL-injured ankles. PMID:26077988

  9. Radiographic Evaluation of the Ankle Mortise

    Directory of Open Access Journals (Sweden)

    Hamid Mirbagheri

    2010-05-01

    Full Text Available The ankle joint is the most frequently injured joint in adults. Decisions on management are usually based on clinical examination and interpretation of the x-rays. Stability of the ankle mortise relies on the configuration of the osseous structures and the ligaments. A basic radiographic examination consists of a mortise-view and a lateral view. Some add the AP-view. The Mortise view is an AP-view with 15-25 degrees endorotation of the foot. "nThe view clearly demonstrates both lateral and medial joint spaces. On a true AP-view the talus overlaps a portion of the lateral malleolus obscuring the lateral aspect of the ankle joint. However, the AP-view will give you an extra view on both malleoli from a different angle. The lateral radiograph of the ankle should include the base of the fifth metatarsal because of the frequency of fractures at this side that clinically mimic a fracture of the ankle.

  10. Sprained Ankle Could Pose Longer-Term Harms to Health

    Science.gov (United States)

    ... them said they had sustained some kind of ankle injury at some point in their lives. Those who' ... taken more seriously, the researchers said. "In isolation, ankle injuries are seen as relatively benign and inconsequential injuries," ...

  11. How to sprain your ankle - a biomechanical case report of an inversion trauma.

    Science.gov (United States)

    Gehring, D; Wissler, S; Mornieux, G; Gollhofer, A

    2013-01-01

    In order to develop preventive measures against lateral ankle sprains, it is essential to have a detailed understanding of the injury mechanism. Under laboratory experimental conditions the examination of the joint load has to be restricted with clear margins of safety. However, in the present case one athlete sprained his ankle while performing a run-and-cut movement during a biomechanical research experiment. 3D kinematics, kinetics, and muscle activity of the lower limb were recorded and compared to 16 previously performed trials. Motion patterns of global pelvis orientation, hip flexion, and knee flexion in the sprain trail deviated from the reference trials already early in the preparatory phase before ground contact. During ground contact, the ankle was rapidly plantar flexed (up to 1240°/s), inverted (up to 1290°/s) and internally rotated (up to 580°/s) reaching its maximum displacement within the first 150 ms after heel strike. Rapid neuromuscular activation bursts of the m. tibialis anterior and the m. peroneus longus started 40-45 ms after ground contact and overshot the activation profile of the reference trials with peak activation at 62 ms and 74 ms respectively. Therefore, it may be suggested that neuromuscular reflexes played an important role in joint control during the critical phase of excessive ankle displacement. The results of this case report clearly indicate that (a) upper leg mechanics, (b) pre-landing adjustments, and (c) neuromuscular contribution have to be considered in the mechanism of lateral ankle sprains. PMID:23078945

  12. The prevention of ankle sprains in sports. A systematic review of the literature.

    Science.gov (United States)

    Thacker, S B; Stroup, D F; Branche, C M; Gilchrist, J; Goodman, R A; Weitman, E A

    1999-01-01

    To assess the published evidence on the effectiveness of various approaches to the prevention of ankle sprains in athletes, we used textbooks, journals, and experts in the field of sports medicine to identify citations. We identified 113 studies reporting the risk of ankle sprains in sports, methods to provide support, the effect of these interventions on performance, and comparison of prevention efforts. The most common risk factor for ankle sprain in sports is history of a previous sprain. Ten citations of studies involving athletes in basketball, football, soccer, or volleyball compared alternative methods of prevention. Methods tested included wrapping the ankle with tape or cloth, orthoses, high-top shoes, or some combination of these methods. Most studies indicate that appropriately applied braces, tape, or orthoses do not adversely affect performance. Based on our review, we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those athletes suffering a moderate or severe sprain should wear an appropriate orthosis for at least 6 months. Both coaches and players must assume responsibility for prevention of injuries in sports. Methodologic limitations of published studies suggested several areas for future research. PMID:10569362

  13. Isolated posterior high ankle sprain: a report of three cases.

    Science.gov (United States)

    Botchu, Rajesh; Allen, Patricia; Rennie, Winston J

    2013-12-01

    High ankle sprains are difficult to diagnose and account for 10% of all ankle sprains. A high index of suspicion is essential for diagnosis. High ankle sprains are managed symptomatically, with prolonged rehabilitation. The posterior inferior tibiofibular ligament is the strongest syndesmotic ligament; isolated injury of it is rare. We present 3 cases of isolated posterior high ankle sprain and discuss the relevant anatomy, mechanism of injury, and management. PMID:24366808

  14. The Effects of Kinesio™ Taping on Proprioception at the Ankle

    OpenAIRE

    Mark DeBeliso; Ross Vaughn; Jeff Lien; McChesney, John W.; Travis Halseth

    2004-01-01

    An experiment was designed to determine if KinesioTM taping the anterior and lateral portion of the ankle would enhance ankle proprioception compared to the untaped ankle. 30 subjects, 15 men, 15 women, ages 18-30 participated in this study. Exclusion criteria: Ankle injury < 6 months prior to testing, significant ligament laxity as determined through clinical evaluation by an ATC, or any severe foot abnormality. Experiment utilized a single group, pretest and posttest. Plantar flexion and in...

  15. Development and Reliability of the Ankle Instability Instrument

    OpenAIRE

    Docherty, Carrie L; Gansneder, Bruce M; Arnold, Brent L; Hurwitz, Shepard R.

    2006-01-01

    Context: Functional ankle instability has been defined in a variety of ways. Factors that are frequently used in this definition include a history of a severe ankle sprain, a history of multiple ankle sprains, and a recurrent feeling of instability or “giving way.” With all the variations in defining functional ankle instability, it becomes increasingly important to develop a more consistent framework for assessing this instability.

  16. Anterolateralni utesnitveni sindrom gležnja: Ankle impingement syndrome:

    OpenAIRE

    Frangež, Igor; Senekovič, Vladimir; Žnidaršič, Marta

    2011-01-01

    lnversion injuries of the ankle are common and most are managed adequately by functional treatment. A significant number will, however, remain symptomatic. Ankle impingement syndrome is clinicaly evident as pain, which is elicited by full range of motion in ankle joint because of the mechanical impidgement in the joint. Ankle impingement can result from trauma, infection, inflammation or from degenerative process. The impingement syndrome can be anterolateral, anteromedial, posterior, made of...

  17. Validation of the Ottawa ankle rules in children.

    OpenAIRE

    Libetta, C; Burke, D; Brennan, P; Yassa, J

    1999-01-01

    OBJECTIVE: To assess whether the Ottawa ankle rules can be used to accurately predict which children with ankle and midfoot injuries need radiography. METHODS: Prospective study with historical control group of all children aged 1-15 years presenting to Sheffield Children's Hospital accident and emergency department with blunt ankle and/or midfoot injuries during two five month periods before and after implementation of the Ottawa ankle rules. RESULTS: In the study group 432 out of 761 (56.76...

  18. RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprain.

    Science.gov (United States)

    Stecco, Antonio; Stecco, Carla; Macchi, Veronica; Porzionato, Andrea; Ferraro, Claudio; Masiero, Stefano; De Caro, Raffaele

    2011-12-01

    Recent studies reveal the role of the ankle retinacula in proprioception and functional stability of the ankle, but there is no clear evidence of their role in the outcomes of ankle sprain. 25 patients with outcomes of ankle sprain were evaluated by MRI to analyze possible damage to the ankle retinacula. Patients with damage were subdivided into two groups: group A comprised cases with ankle retinacula damage only, and group B those also with anterior talofibular ligament rupture or bone marrow edema. Both groups were examined by VAS, CRTA and static posturography and underwent three treatments of deep connective tissue massage (Fascial Manipulation technique). All evaluations were repeated after the end of treatment and at 1, 3 and 6 months. At MRI, alteration of at least one of the ankle retinacula was evident in 21 subjects, and a further lesion was also identified in 7 subjects. After treatment, VAS and CRTA evaluations showed a statistically significant decrease in values with respect to those before treatment (p stabilometric platform results. No significant difference was found between groups A and B. The initial benefit was generally maintained at follow-up. The alteration of retinacula at MRI clearly corresponds to the proprioceptive damage revealed by static posturography and clinical examination. Treatment focused on the retinacula may improve clinical outcomes and stabilometric data. PMID:21305286

  19. Search the Foot and Ankle: Interactive Foot Diagram

    Science.gov (United States)

    ... of the Fifth Metatarsal » Ganglion Cyst » Lisfranc Injuries » Posterior Tibial Tendon Dysfunction (PTTD) » Tarsal Coalition » Ankle Fractures » Ankle Sprain » Chronic Ankle Instability » Equinus » Gout » Posterior Tibial Tendon Dysfunction (PTTD) » Talar Dome Lesion » Bunions (Hallux ...

  20. Bone scanning a useful addition in the diagnosis of ankle joint trauma

    International Nuclear Information System (INIS)

    A retrospective study of the indication in 169 scintigraphic examinations of the ankle joint was made. Usually joints respond to trauma with a generalized increase of the concentration of the radiopharmaceutical. By using a highly performed technique the focal hot spot caused by the fracture can be seen in the bone scan. The focal accumulation of the radioactive material must not correspond to a bone fracture in any case. The ligamentous avulsion of a bone chip and/or the periosteum can yield the same image but it cannot be diagnosed by radiographic techniques. Initially the routine radiograph and even the tomograph often are interpreted as normal or equivocal. In these cases of ankle trauma bone scanning completes the clinical evaluation. Although bone scanning is very important in the diagnosis of any traumatic lesion of the ankle joints it cannot replace the conventional X-ray technique. (orig.)

  1. Serum Calcium Level is Associated with Brachial-ankle Pulse Wave Velocity in Middle-aged and Elderly Chinese

    Institute of Scientific and Technical Information of China (English)

    DENG Xin Ru; BI Yu Fang; LU Jie Li; ZHANG Yin Fei; WANG Tian Ge; XU Bai Hui; SUN Ji Chao; ZHAO Lie Bin; XU Min; CHEN Yu Hong; WANG Wei Qing

    2014-01-01

    Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was³1 752.5 cm/s (the upper quartile) either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level (P Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.

  2. Evaluation of Asymptomatic Peripheral Arterial Disease by Ankle-brachial Index in Patients with Concomitant Coronary Arterial Disease

    Directory of Open Access Journals (Sweden)

    Hosein Vakili

    2012-12-01

    Full Text Available Background: Peripheral arterial disease is associated with adverse cardiovascular outcomes. As such, it is found that screening for peripheral arterial disease (PAD improves risk assessment. Thus, intensive risk factor modification and medical treatment in these patients are necessary. Objectives: The purpose of this study was to determine the prevalence of asymptomatic peripheral arterial disease in patients with concomitant coronary arterial disease. Methods: Asymptomatic peripheral arterial disease was investigated in 400 patients (60% males, 40% females, aged 59.7± 11.3 with a documented coronary arterial disease. Results: Among patients with documented CAD, 12% had asymptomatic PAD with the ABI ratio of less than 0.9. Conclusions: It is advisable to screen for PAD not only as a disease but also as a risk assessment method for atherosclerosis.

  3. Ankle Brachial Index Compared With Different Lipid Ratios to Predict Coronary Events in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Zinat Nadia Hatmi

    2014-02-01

    Multivariable adjusted relations revealed that HDL-C and #8804;34 Mg/dl significantly increased the risk of future UA, HDL-C and #8804;53 Mg/dl and sedentary life style increased the risk of MI. CONCLUSION: Multivariate adjusted relationships revealed that HDL-C and #8804;34 Mg/dl was a strong predictor of unstable angina pectoris after 15 months of follow up period. HDL-C and #8804;53 Mg/dl and physical inactivity were associated with increased risk of MI after 15 months. Of the lipid ratios the strongest predictors for developing future MI and unstable angina were TC/HDL-C and LDL-C/HDL-C. [TAF Prev Med Bull 2014; 13(1.000: 29-36

  4. Combined Total Ankle Arthroplasty With Posterior Tibial Tendon Transfer for End-Stage Cavovarus Deformity.

    Science.gov (United States)

    Schuberth, John M; Bowlby, Melinda A; Christensen, Jeffrey C

    2016-01-01

    Posterior tibial tendon transfer has been described to reduce and balance the cavovarus deformity in those patients who receive a total ankle replacement for end-stage arthritis. In this article, we discuss the indications and provide a detailed description of the technique for this powerful procedure. Case examples that demonstrate the utility of the procedure are provided. PMID:27095088

  5. Brachial plexopathy after chemoradiotherapy for head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Platteaux, Nele; Dirix, Piet; Nuyts, Sandra [Dept. of Radiation Oncology, Leuvens Kankerinstituut (LKI), Univ. Hospitals Leuven, Campus Gasthuisberg (Belgium); Hermans, Robert [Dept. of Radiology, Leuvens Kankerinstituut (LKI), Univ. Hospitals Leuven, Campus Gasthuisberg (Belgium)

    2010-09-15

    Purpose: To evaluate late brachial plexopathy after primary chemoradiotherapy for locally advanced head and neck squamous cell carcinoma. Patients and Methods: Consecutive 43 disease-free patients were evaluated by a specifically developed 26-item questionnaire. Retrospectively, the brachial plexus was delineated and the dose-volume histograms were calculated. Results: After a median follow-up of 24 months, no radiation-induced brachial plexopathy was reported in these 43 patients. Conclusion: No radiation-induced brachial plexopathy was seen in the patient group, although 72.1% of the brachial plexuses received doses > 60 Gy. These findings should prompt further prospective studies and also stress the importance of trying to keep the doses to the brachial plexus as low as possible while covering the target volumes well. (orig.)

  6. An anatomical study of double brachial arteries – a case report

    Directory of Open Access Journals (Sweden)

    Krstonosic B

    2010-02-01

    Full Text Available Superficial brachial artery is one of the major variations of the arterial pattern in the upper limb. During routine anatomical dissection in our department, we observed a case of unilateral double brachial artery in a formalin-fixed female cadaver.Left axillary artery entered into the anterior region of the arm, where it branched into two brachial arteries – the superficial brachial artery (SBA, which was longer, tortuous and with a smaller caliber, and the brachial artery (BA, which was placed deep and medially. In the cubital fossa, covered with an aponeurosis of the biceps brachii muscle, both brachial arteries were connected with an anastomotic vessel. Under this anastomotic branch, in the forearm, SBA continued as the radial artery, whereas BA continued as the ulnar artery.Variations of the arterial pattern in the upper limb are undoubtedly of interest to the anatomists as well as to the clinicians.

  7. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry treatment following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion

    International Nuclear Information System (INIS)

    Objective: To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry procedure following unsuccessful subintimal angioplasty for the treatment of arterial occlusion below the ankle. Methods: TDP or TPD retrograde intraluminal re-entry angioplasty was carried out in 8 diseased limbs of 8 diabetic patients (5 males and 3 females, aged 62∼81 years with a mean age of 75±8 years), who were accompanied with chronic below-the-ankle arterial occlusive disease, after the standard transtibial subintimal angioplasty had failed. Both before and after the procedure the clinical symptoms, dorsal or plantar arterial pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the degree of pain relief, the healing of the wound, the salvage of the diseased limb and the restenosis occurrence of the target vessels were evaluated. Results: Of the total 8 patients, TDP or TPD retrograde intraluminal re-entry angioplasty was successfully performed in 5(62.5%). After the treatment the foot pain was markedly relieved, the median pulse volume scores and ankle-brachial indexes were increased from 0.60±0.55 and 0.32±0.20 before the procedure to 2.40±0.55 and 0.75±0.12 after the procedure, respectively (P<0.01 for both). At the end of the follow-up lasting for twelve months, the visual analogue scale was apparently improved, the scores decreased from preoperative 7.40±1.14 to 2.20±1.48 (P=0.002). Of two cases with intractable skin ulcer, the skin lesion was completely healed in one and was significantly decreased in size in another. No amputation surgery was needed in all successfully treated patients. Magnetic resonance angiography revealed that one target vessel developed re-stenosis. Conclusion: TDP and TDP retrograde intraluminal re-entry techniques are clinically feasible and effective for the

  8. A surgical ankle sprain pain model in the rat: Effects of morphine and indomethacin

    OpenAIRE

    Young Kim, Hee; Wang, Jigong; Chung, Kyungsoon; Mo Chung, Jin

    2008-01-01

    Ankle sprain is a frequent injury in humans that results in pain, swelling and difficulty in walking on the affected ankle. Currently a suitable animal model resembling human ankle sprain is lacking. Here, we describe an animal ankle sprain model induced by ankle ligament injury (ALI) in rats. Cutting combinations of the lateral ankle ligament complex produced pain, edema and difficulty of weight bearing, thereby mimicking severe (grade III) ankle sprain in humans. Analgesic compounds, morphi...

  9. Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton

    OpenAIRE

    Kao, Pei-Chun; Lewis, Cara L.; Ferris, Daniel P.

    2009-01-01

    To guide development of robotic lower limb exoskeletons, it is necessary to understand how humans adapt to powered assistance. The purposes of this study were to quantify joint moments while healthy subjects adapted to a robotic ankle exoskeleton and to determine if the period of motor adaptation is dependent on the magnitude of robotic assistance. The pneumatically-powered ankle exoskeleton provided plantar flexor torque controlled by the wearer’s soleus electromyography (EMG). Eleven naïve ...

  10. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    OpenAIRE

    Fu, Guo; Qin, Bengang; Jiang, Li; Huang, Xijun; Lu, Qinsen; Zhang, Dechun; Liu, Xiaolin; Zhu, Jiakai; Zheng, Jianwen; Li, Xuejia; Gu, Liqiang

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a subcutaneous injection...

  11. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    OpenAIRE

    Jimmy Thomas

    2014-01-01

    This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasin...

  12. A comparison of infraclavicular and supraclavicular approaches to the brachial plexus using neurostimulation

    OpenAIRE

    Yang, Chun Woo; Kwon, Hee Uk; Cho, Choon-Kyu; Jung, Sung Mee; Kang, Po-Soon; Park, Eun-Su; Heo, Youn Moo; Shinn, Helen Ki

    2010-01-01

    Background A prospective, double blind study was performed to compare the clinical effect of vertical infraclavicular and supraclavicular brachial plexus block using a nerve stimulator for upper limb surgery. Methods One hundred patients receiving upper limb surgery under infraclavicular or supraclavicular brachial plexus block were enrolled in this study. The infraclavicular brachial plexus block was performed using the vertical technique with 30 ml of 0.5% ropivacaine. The supraclavicular b...

  13. Delayed rupture of a pseudoaneurysm in the brachial artery of a burn reconstruction patient

    OpenAIRE

    Lee, Jun Yong; Kim, Hyeri; Kwon, Ho; Jung, Sung-No

    2013-01-01

    A brachial artery pseudoaneurysm is a rare but serious condition that can be limb threatening. A number of reports have found that it may be the result of damage to the blood vessels around the brachial artery, either directly or indirectly, due to trauma or systemic diseases. We present our experience of delayed pseudoaneurysm rupture of the brachial artery in a rehabilitation patient with burns of the upper extremity who underwent fasciotomy and musculocutaneous flap coverage. We also provi...

  14. Technical note: the humeral canal approach to the brachial plexus.

    LENUS (Irish Health Repository)

    Frizelle, H P

    2012-02-03

    Many variations to the axillary approach to the brachial plexus have been described. However, the success rate varies depending on the approach used and on the definition of success. Recent work describes a new approach to regional anaesthesia of the upper limb at the humeral\\/brachial canal using selective stimulation of the major nerves. This report outlines initial experience with this block, describing the technique and results in 50 patients undergoing hand and forearm surgery. All patients were assessed for completeness of motor and sensory block. The overall success rate was 90 percent. Motor block was present in 80 percent of patients. Completion of the block was necessary in 5 patients. Two patients required general anaesthesia. The preponderance of ulnar deficiencies agrees with previously published data on this technique. No complications were described. Initial experience confirms the high success rate described using the Dupre technique. This technically straightforward approach with minimal complications can be recommended for regional anaesthesia of the upper limb.

  15. MR evaluation of the brachial plexus: Optimal imaging technique

    International Nuclear Information System (INIS)

    The authors compared four different reception coils, different degrees of T1 and T2 weighting, and different imaging planes for ability to depict normal brachial plexus anatomy at 1.5 T in 67 subjects. The use of loop gap resonators (axial opposed and butterfly) resulted in better resolution but a more limited field of view than did use of a rectangular surface coil (placed transversely behind the base of the neck) and the body coil. T1 and spin-density coronal images showed normal anatomy of the roots, trunks, and cords in a high proportion of cases. Double-echo (spin-density and T2-weighted) coronal imaging performed with a transversely oriented rectangular coil may be the best technique for imaging all three portions of the brachial plexus in the neck, retroclavicular, and axillary regions

  16. Brachial plexus lesions in patients with cancer: 100 cases

    International Nuclear Information System (INIS)

    In patients with cancer, brachial plexus signs are usually caused by tumor infiltration or injury from radiation therapy (RT). We analyzed 100 cases of brachial plexopathy to determine which clinical criteria helped differentiate tumor from radiation injury. Seventy-eight patients had tumor and 22 had radiation injury. Severe pain occurred in 80% of tumor patients but in only 19% of patients with radiation injury. The lower trunk was involved in 72% of the tumors. Seventy-eight percent of the radiation injuries affected the upper plexus (C5-6). Horner syndrome was more common in tumor, and lymphedema in radiation injury. The time from RT to onset of plexus symptoms, and the dose of RT, also differed

  17. [Ankle sprain during a volleyball game].

    Science.gov (United States)

    Boersma, Anton R; Munzebrock, Arvid V E

    2015-01-01

    A 27-year old woman was admitted to the emergency room after her left ankle rolled inward during a volleyball game. On physical examination a bony prominence on the lateral side of the left foot was noticeable, without neurovascular injury. An X-ray (anterior-posterior view) showed a subtalar dislocation without associated fractures. PMID:26420145

  18. Injury of the ankle joint ligaments

    International Nuclear Information System (INIS)

    The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination and clinical stress tests. If the clinical stress test is positive, stress radiography can be performed. There is, however, no consensus about the usefulness of stress radiography in acute ankle sprain, and in particular about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to 30 . Today, magnetic resonance imaging (MRI) is not used in this area, although it does allow controlled positioning of the foot and defined section visualization of injured lateral collateral ankle ligaments. In acute and chronic sinus tarsi injuries, MRI forms the established basis for diagnostic imaging, and can provide a definitive answer in most cases. MRI is also the method of choice for chronic posttraumatic pain with anterolateral impingement after rupture of the anterior talofibular ligament. Generally, for the evaluation of acute ankle injuries, MRI has developed to be the most important second-step procedure when projection radiology is non-diagnostic. (orig.)

  19. Evaluation of brachial plexus injury by CT myelography

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of CT myelography (CTM) in brachial plexus injury. Methods: Twenty-seven patients with brachial plexus injury were examined by using cervical CTM with spiral scan and bone reconstruction algorithm. CT images were reviewed by the senior radiologists, who determined if the nerve root avulsion was presented. The criteria of diagnosing nerve root avulsion were loss of normal nerve root appearance in the Isovist filled thecal sac in consecutive CTM slices plus companion signs. The sensitivity, specificity, and accuracy of CTM in diagnosing nerve root injuries were calculated with operation findings and follow-up results as gold standard. Results: Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in consecutive CTM slices. Indirect signs included: (1) Pseudomeningocele bulge: The leak of Isovist into nerve root sheath, and extended into foramina; (2) Arachnoid cyst: displacement of spinal cord; (3) Dissymmetry of subarachnoid cavity: deformity of thecal sac, partially lack of Isovist into arachnoid space; (4) Non-integrity of dural cap sule wall: one side of cap sule cavity was obstructed. Part of the surface of spinal cord was exposed. Brachial plexus injury could be diagnosed by direct sign with one of the indirect signs. Of the 27 patients (128 nerve roots), 91 nerve root avulsions were found on CTM, and 37 was found normal. Compared with operation findings, 84 were true positive, 7 false positive, 34 true negative, and 3 false negative. Based on these results, the sensitivity, specificity, and accuracy were 96.6%, 82.9%, and 92.2%, respectively. Conclusion: CTM is accurate in detecting nerve root avulsion of brachial plexus. (authors)

  20. Delayed presentation of a traumatic brachial artery pseudoaneurysm.

    LENUS (Irish Health Repository)

    Forde, James C

    2009-09-01

    Delayed presentation of a brachial artery pseudoaneurysm following penetrating trauma is infrequently reported. We report the case of a 23-year-old male who presented three months following a penetrating trauma to his antecubital fossa with a sudden exacerbation of swelling and tenderness of his elbow. Doppler ultrasound and computed tomography arteriography confirmed the presence of a large pseudoaneurysm. Surgical reconstruction was performed using the long saphenous vein as an interposition vein graft, restoring normal arterial circulation.

  1. “Huge Axillary Mass - Neurofibroma Brachial Plexus”

    OpenAIRE

    Mehta, Dharmendra; Mehta, D. D.; Shaam, M. B.; Yadav, J. K.

    2011-01-01

    Axillary swelling arising from soft tissue is not uncommon. Lipoma, Lymphadenopathy due to Kochs or Lymphoma are commonest swellings seen but firm to hard non tender mass arising from maninges of Brachial plexus is not so common. Usually these masses are benign but one may come across malignant tumour. Twenty-three year male presented with mass in anterior chest wall & arm pit having no other specific complaints, was diagnosed as Spindle cell tumour on FNAC & excision biopsy turned out to be ...

  2. The Relationship between Multiple Health Behaviours and Brachial Artery Reactivity

    OpenAIRE

    Gordon, Jennifer L.; Lavoie, Kim L; André Arsenault; Bernard Meloche; Blaine Ditto; Campbell, Tavis S.; Simon L Bacon

    2012-01-01

    Background. The effects of smoking, alcohol consumption, obesity, and a sedentary lifestyle on endothelial function (EF) have only been examined separately. The relative contributions of these behaviours on EF have therefore not been compared. Purpose. To compare the relative associations between these four risk factors and brachial artery reactivity in the same sample. Methods. 328 patients referred for single-photon emission computed tomography (SPECT) exercise stress tests completed a nucl...

  3. Trapezius transfer to treat flail shoulder after brachial plexus palsy

    Directory of Open Access Journals (Sweden)

    Diaz Humberto

    2007-01-01

    Full Text Available Abstract Background After severe brachial palsy involving the shoulder, many different muscle transfers have been advocated to restore movement and stability of the shoulder. Paralysis of the deltoid and supraspinatus muscles can be treated by transfer of the trapezius. Methods We treated 10 patients, 8 males and 2 females, by transfer of the trapezius to the proximal humerus. In 6 patients the C5 and C6 roots had been injuried; in one C5, C6 and C7 roots; and 3 there were complete brachial plexus injuries. Eight of the 10 had had neurosurgical repairs before muscle transfer. Their average age was 28.3 years (range 17 to 41, the mean delay between injury and transfer was 3.1 years (range 14 months to 6.3 years and the average follow-up was 17.5 months (range 6 to 52, reporting the clinical and radiological results. Evaluation included physical and radiographic examinations. A modification of Mayer's transfer of the trapezius muscle was performed. The principal goal of this work was to evaluate the results of the trapezius transfer for flail shoulder after brachial plexus injury. Results All 10 patients had improved function with a decrease in instability of the shoulder. The average gain in shoulder abduction was 46.2°; the gain in shoulder flexion average 37.4°. All patients had stable shoulder (no subluxation of the humeral head on radiographs. Conclusion Trapezius transfer for a flail shoulder after brachial plexus palsy can provide satisfactory function and stability.

  4. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    Directory of Open Access Journals (Sweden)

    Jimmy Thomas

    2014-01-01

    Full Text Available This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed.

  5. Novel Axillary Approach for Brachial Plexus in Robotic Surgery: A Cadaveric Experiment

    Directory of Open Access Journals (Sweden)

    Cihangir Tetik

    2014-01-01

    Full Text Available Brachial plexus surgery using the da Vinci surgical robot is a new procedure. Although the supraclavicular approach is a well known described and used procedure for robotic surgery, axillary approach was unknown for brachial plexus surgery. A cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery. Our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outlet syndrome. However, we emphasize that new instruments should be designed and further studies are needed to evaluate in vivo results.

  6. Idiopathic brachial neuritis in a child: A case report and review of the literature.

    Science.gov (United States)

    Jain, Shikha; Bhatt, Girish Chandra; Rai, Nirendra; Bhan, Bhavna Dhingra

    2014-01-01

    Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2½-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies. PMID:25624937

  7. Idiopathic brachial neuritis in a child: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Shikha Jain

    2014-01-01

    Full Text Available Brachial neuritis is a rare disease in children, affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. We report a case of idiopathic brachial plexus neuritis in a 2³-year-old female child admitted with acute respiratory distress and given antibiotic therapy following which she developed weakness of the left hand. She was diagnosed as a case of idiopathic brachial plexus neuritis and was given supportive care. Although, the association with antibiotic therapy in this case could be incidental, indeed it is intriguing and requires further studies.

  8. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm

    Directory of Open Access Journals (Sweden)

    Hans Polzer

    2012-01-01

    Full Text Available Acute ankle injuries are among the most common injuries in emergency departments. However, a standardized examination and an evidence-based treatment are missing. Therefore, aim of this study was to systematically search the current literature, classify the evidence and develop an algorithm for diagnosis and treatment of acute ankle injuries. We systematically searched PubMed and the Cochrane Database for randomized controlled trials, meta-analysis, systematic reviews, or if applicable observational studies and classified them according to their level of evidence. According to the currently available literature, the following recommendations are given. The Ottawa Ankle/Foot Rule should be applied in order to rule out fractures, Physical examination is sufficient for diagnosing injuries to the lateral ligament complex. Classification into stable and unstable injuries is applicable and of clinical importance. The squeeze-, crossed leg- and external rotation test are indicative for injuries of the syndesmosis. Magnetic resonance imaging is recommended to verify such injuries. Stable ankle sprains have a good prognosis, while for unstable ankle sprains conservative treatment is at least as effective as operative treatment without carrying possible complications. Early functional treatment leads to the fastest recovery and the least rate of re-injury. Supervised rehabilitation reduces residual symptoms and re-injuries. Taken these recommendations into account, we here present an applicable and evidence-based step by step decision pathway for the diagnosis and treatment of acute ankle injuries, which can be implemented in any emergency department or doctor’s practice. It provides quality assurance for the patient and confidence for the attending physician.

  9. Bone stress injury of the ankle in professional ballet dancers seen on MRI

    Directory of Open Access Journals (Sweden)

    Besser Marcus P

    2008-03-01

    Full Text Available Abstract Background Ballet Dancers have been shown to have a relatively high incidence of stress fractures of the foot and ankle. It was our objective to examine MR imaging patterns of bone marrow edema (BME in the ankles of high performance professional ballet dancers, to evaluate clinical relevance. Methods MR Imaging was performed on 12 ankles of 11 active professional ballet dancers (6 female, 5 male; mean age 24 years, range 19 to 32. Individuals were imaged on a 0.2 T or 1.5 T MRI units. Images were evaluated by two musculoskeletal radiologists and one orthopaedic surgeon in consensus for location and pattern of bone marrow edema. In order to control for recognized sources of bone marrow edema, images were also reviewed for presence of osseous, ligamentous, tendinous and cartilage injuries. Statistical analysis was performed to assess the strength of the correlation between bone marrow edema and ankle pain. Results Bone marrow edema was seen only in the talus, and was a common finding, observed in nine of the twelve ankles imaged (75% and was associated with pain in all cases. On fluid-sensitive sequences, bone marrow edema was ill-defined and centered in the talar neck or body, although in three cases it extended to the talar dome. No apparent gender predilection was noted. No occult stress fracture could be diagnosed. A moderately strong correlation (phi = 0.77, p= 0.0054 was found between edema and pain in the study population. Conclusion Bone marrow edema seems to be a specific MRI finding in the talus of professional ballet dancers, likely related to biomechanical stress reactions, due to their frequently performed unique maneuvers. Clinically, this condition may indicate a sign of a bone stress injury of the ankle.

  10. Cervical myelographic findings of brachial plexus injury by trauma

    International Nuclear Information System (INIS)

    Authors reviewed 50 cases of cervical myelography during 4 years and 5 months, from February, 1985 to July, 1989 at Department of Radiography, Wonkwang University Hospital to analyse myelographic findings of traumatic brachial plexus injury with symptoms and signs and to discuss literature. The results were as follows: 1. Brachial plexus injury was predominant in male and the incidence was 50% in 3rd decade of the males. 2. Among the 50 patients, 11 were the peripheral type, which had symptoms but normal findings in cervical myelography and 39 were the central type, which were definitely abnormal findings in cervical myelography. 3. Cervical myelographic findings in the central type were divided into 5 groups. (all 39 cases) a. Obliteration of nerve root filling defect 39(cases) b. Pseudomeningocele. 32(cases) c. Narrowing of ipsilateral subarachnoid space 31(cases) d. Diverticulum. 4 (cases) e. Tracking of dye down the axillary sheath 1 (cases) 4. The most large numbers of pseudomeningoceles in cervical myelography were shown for two and in each case, the most multiple developing numbers of pseudomeningoceles were identified for four, that happened in one case. 5. In brachial plexus injury, there were two the most large involving numbers among the nerve roots, and in each involving nerve root, C7 was most common

  11. Continuous shoulder analgesia via an indwelling axillary brachial plexus catheter.

    Science.gov (United States)

    Reuben, S S; Steinberg, R B

    2000-09-01

    Continuous interscalene brachial plexus blockade can provide anesthesia and analgesia in the shoulder region. Difficulty accessing the interscalene space and premature displacement of interscalene catheters may preclude their use in certain situations. We present two case reports in which a catheter was advanced from the axilla along the brachial plexus sheath to the interscalene space to provide continuous cervicobrachial plexus analgesia. In the first case report, previous neck surgery made the anatomic landmarks for performing an interscalene block very difficult. An epidural catheter was advanced from the axillary brachial plexus sheath to the interscalene space under fluoroscopic guidance. This technique provided both intraoperative analgesia for shoulder surgery as well as 24-hour postoperative analgesia by an infusion of 0.125% bupivacaine. In the second case report, a catheter was inserted in a similar fashion from the axillary to the interscalene space to provide 14 days of continuous analgesia in the management of complex regional pain syndrome. We have found that this technique allows us to secure the catheter more easily than with the traditional interscalene approach and thus prevents premature dislodgment. This approach may be a suitable alternative when either an interscalene or an infraclavicular catheter may not be inserted. PMID:11090734

  12. Neurolysis and myocutaneous flap for radiation induced brachial plexus neuropathy

    International Nuclear Information System (INIS)

    Surgical treatment for radiation induced brachial plexus neuropathy is difficult. We followed 9 patients of radiation induced brachial plexus neuropathy who were surgically treated with neurolysis and myocutaneous flap coverage. Their ages ranged from 29 to 72 years old. Their diagnoses were breast cancer in 6 patients, lingual cancer in 1, thyroid cancer in 1 and malignant lymphoma in 1. Total dose of radiation ranged from 44 to 240 Gy. Interval from radiation therapy to our surgery ranged from 1 to 18 years (mean 6.7 years). Chief complaints were dysesthesia in 9 patients, motor weakness in 7 patients and dullach in scar formation of radiated skin in 7 patients. Preoperative neural functions were slight palsy in 1, moderate palsy in 5 and complete palsy in 3. In surgical treatment, neurolysis of the brachial plexus was done and it was covered by latissimus dorsi myocutaneous flap. We evaluated about dysesthesia and motor recovery after treatment for neuropathy. Follow up periods ranged from 1 to 11 years (average in 5 years). Dysesthesia improved in 6 patients and got worse in 3 patients. Motor weakness recovered in only 2 patients and got worse in 7 patients. From our results, intolerable dysesthesia which was first complaint of these patients improved. But motor function had not recovered. Our treatment was thought to be effective for extraneural factor like an compression neuropathy by scar formation and poor vascularity. But it was not effective for intraneural damage by radiation therapy. (author)

  13. Neurolysis and myocutaneous flap for radiation induced brachial plexus neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Hirachi, Kazuhiko; Minami, Akio; Kato, Hiroyuki; Nishio, Yasuhiko [Hokkaido Univ., Sapporo (Japan). School of Medicine; Ohnishi, Nobuki

    1998-11-01

    Surgical treatment for radiation induced brachial plexus neuropathy is difficult. We followed 9 patients of radiation induced brachial plexus neuropathy who were surgically treated with neurolysis and myocutaneous flap coverage. Their ages ranged from 29 to 72 years old. Their diagnoses were breast cancer in 6 patients, lingual cancer in 1, thyroid cancer in 1 and malignant lymphoma in 1. Total dose of radiation ranged from 44 to 240 Gy. Interval from radiation therapy to our surgery ranged from 1 to 18 years (mean 6.7 years). Chief complaints were dysesthesia in 9 patients, motor weakness in 7 patients and dullach in scar formation of radiated skin in 7 patients. Preoperative neural functions were slight palsy in 1, moderate palsy in 5 and complete palsy in 3. In surgical treatment, neurolysis of the brachial plexus was done and it was covered by latissimus dorsi myocutaneous flap. We evaluated about dysesthesia and motor recovery after treatment for neuropathy. Follow up periods ranged from 1 to 11 years (average in 5 years). Dysesthesia improved in 6 patients and got worse in 3 patients. Motor weakness recovered in only 2 patients and got worse in 7 patients. From our results, intolerable dysesthesia which was first complaint of these patients improved. But motor function had not recovered. Our treatment was thought to be effective for extraneural factor like an compression neuropathy by scar formation and poor vascularity. But it was not effective for intraneural damage by radiation therapy. (author)

  14. Correspondence in relation to the case report "Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note." published in May issue of Journal of Brachial Plexus and Peripheral Nerve Injury

    OpenAIRE

    Bhakta Pradipta

    2008-01-01

    Abstract Comment on 'Capnography as an aid in localizing the phrenic nerve in brachial plexus surgery. Technical note' Bhagat H, Agarwal A, Sharma MS Journal of Brachial Plexus and Peripheral Nerve Injury 2008, 3:14 (22 May 2008)

  15. A Systematic Review on the Treatment of Acute Ankle Sprain Brace versus Other Functional Treatment Types

    NARCIS (Netherlands)

    E. Kemler; I. van de Port; F. Backx; C.N. van Dijk

    2011-01-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of ta

  16. Acute and chronic lateral ankle instability in the athlete.

    Science.gov (United States)

    Chan, Keith W; Ding, Bryan C; Mroczek, Kenneth J

    2011-01-01

    Ankle sprain injuries are the most common injury sustained during sporting activities. Three-quarters of ankle injuries involve the lateral ligamentous complex, comprised of the anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). The most common mechanism of injury in lateral ankle sprains occurs with forced plantar flexion and inversion of the ankle as the body's center of gravity rolls over the ankle. The ATFL followed by the CFL are the most commonly injured ligaments. Eighty percent of acute ankle sprains make a full recovery with conservative management, while 20% of acute ankle sprains develop mechanical or functional instability, resulting in chronic ankle instability. Treatment of acute ankle sprains generally can be successfully managed with a short period of immobilization that is followed by functional rehabilitation. Patients with chronic ankle instability who fail functional rehabilitation are best treated with a Brostrom-Gould anatomic repair or, in those patients with poor tissue quality or undergoing revision surgery, an anatomic reconstruction. PMID:21332435

  17. Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability.

    Science.gov (United States)

    Kim, Ki-Jong; Jun, Hyun-Ju; Heo, Myoung

    2015-11-01

    [Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost. PMID:26696703

  18. 3 T MR tomography of the brachial plexus: Structural and microstructural evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Mallouhi, Ammar, E-mail: Ammar.Mallouhi@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Marik, Wolfgang, E-mail: Wolfgang.Marik@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Prayer, Daniela, E-mail: Daniela.Prayer@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kainberger, Franz, E-mail: Franz.Kainberger@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Bodner, Gerd, E-mail: Gerd.Bodner@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kasprian, Gregor, E-mail: Gregor.Kasprian@meduniwien.ac.at [Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2012-09-15

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus.

  19. 3 T MR tomography of the brachial plexus: Structural and microstructural evaluation

    International Nuclear Information System (INIS)

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus

  20. 3T MR tomography of the brachial plexus: structural and microstructural evaluation.

    Science.gov (United States)

    Mallouhi, Ammar; Marik, Wolfgang; Prayer, Daniela; Kainberger, Franz; Bodner, Gerd; Kasprian, Gregor

    2012-09-01

    Magnetic resonance (MR) neurography comprises an evolving group of techniques with the potential to allow optimal noninvasive evaluation of many abnormalities of the brachial plexus. MR neurography is clinically useful in the evaluation of suspected brachial plexus traumatic injuries, intrinsic and extrinsic tumors, and post-radiogenic inflammation, and can be particularly beneficial in pediatric patients with obstetric trauma to the brachial plexus. The most common MR neurographic techniques for displaying the brachial plexus can be divided into two categories: structural MR neurography; and microstructural MR neurography. Structural MR neurography uses mainly the STIR sequence to image the nerves of the brachial plexus, can be performed in 2D or 3D mode, and the 2D sequence can be repeated in different planes. Microstructural MR neurography depends on the diffusion tensor imaging that provides quantitative information about the degree and direction of water diffusion within the nerves of the brachial plexus, as well as on tractography to visualize the white matter tracts and to characterize their integrity. The successful evaluation of the brachial plexus requires the implementation of appropriate techniques and familiarity with the pathologies that might involve the brachial plexus. PMID:21763092

  1. Disturbed function of the brachial plexus after irradiation for a malignant disease

    International Nuclear Information System (INIS)

    In reference to the case history of a woman aged 26 years in whom approx. 7 years after irradiation for Hodgkin's disease, lesions of the upper roots of the brachial plexus (Erb-Duchenne type) developed, the differential diagnosis is discussed of brachial plexus lesions in the presence of a recurrent malignant disease or as the consequence of irradiation. (Auth.)

  2. Pleural effusion and atelectasis during continuous interscalene brachial plexus block -A case report-

    OpenAIRE

    Yang, Chun Woo; Jung, Sung Mee; Cho, Choon Kyu; Kwon, Hee Uk; Kang, Po Soon; Lim, Young Su; Oh, Jin Young; Yi, Jin Woong

    2010-01-01

    An interscalene brachial plexus block is an effective means of providing anesthesia-analgesia for shoulder surgery. However, it has a multitude of potential side effects such as phrenic nerve block. We report a case of a patient who developed atelectasis of the lung, and pleural effusion manifested as chest discomfort during a continuous interscalene brachial plexus block for postoperative analgesia.

  3. On the cause of brachial plexus neuropathy after radiation therapy of patients with mamma carcinoma

    International Nuclear Information System (INIS)

    Radiation therapy is often considered as cause of brachial plexus neuropathy in patients with mamma carcinoma. One case (in which metastases could be established as specific cause) is used as specific example for the possible differential diagnosis of brachial plexus neuropathy. (orig.)

  4. Pictorial essay: Role of magnetic resonance imaging in evaluation of brachial plexus pathologies

    OpenAIRE

    Malini Lawande; Patkar, Deepak P; Sona Pungavkar

    2012-01-01

    Brachial plexopathies, traumatic and nontraumatic, often present with vague symptoms. Clinical examination and electrophysiological studies are useful but may not localize the lesion accurately. Magnetic resonance imaging (MRI) with its multiplanar imaging capability and soft tissue contrast resolution plays an important role in evaluation of the abnormal brachial plexus.

  5. Schwannoma of the brachial plexus; report of two cases involving the C7 root

    OpenAIRE

    Rashid, Mamoon; Salahuddin, Omer; Yousaf, Shumaila; Qazi, Uzair A; Yousaf, Kanwal

    2013-01-01

    Brachial plexus schwannomas are rare tumors. They are benign nerve sheath tumors and only about 5% of Schwannoma arise from the brachial plexus. They pose a great challenge to surgeons due to their rare occurrence and complex anatomical location. We present two cases who presented with a supraclavicular swelling, that were proven to be schwannoma on histopathology.

  6. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Guo Fu; Xuejia Li; Liqiang Gu; Bengang Qin; Li Jiang; Xijun Huang; Qinsen Lu; Dechun Zhang; Xiaolin Liu; Jiakai Zhu; Jianwen Zheng

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a sub-cutaneous injection in the neck) to observe changes in erectile function. Rats subjected to simple brachial plexus root avulsion or those subjected to brachial plexus root avulsion combined with spinal cord injury had signiifcantly fewer erections than those subjected to the sham operation. Expression of neuronal nitric oxide synthase did not change in brachial plexus root avulsion rats. However, neuronal nitric oxide synthase expression was signiifcantly decreased in brachial plexus root avulsion + spinal cord injury rats. These ifndings suggest that a decrease in neuronal nitric oxide synthase expression in the penis may play a role in erectile dysfunction caused by the combi-nation of brachial plexus root avulsion and spinal cord injury.

  7. Modulation of ankle stiffness during postural sway.

    Science.gov (United States)

    Lang, Christopher B; Kearney, Robert E

    2014-01-01

    Ankle stiffness is a nonlinear, time-varying system which contributes to the control of human upright stance. This study sought to examine the nature of the contribution of stiffness to postural control by determining how intrinsic and reflex stiffnesses varied with sway. Subjects were instructed to stand quietly on a bilateral electro-hydraulic actuator while perturbations were applied about the ankle. Subjects performed three types of trials: normal stance, forward lean, and backward lean. Position, torque, and EMGs from the tibialis anterior and triceps surae were recorded. Background torque, intrinsic stiffness and reflex stiffness were calculated for each perturbation. Intrinsic and reflex stiffnesses were heavily modulated by postural sway. Moreover, they were modulated in a complimentary manner; intrinsic stiffness was lowest when reflex gain was highest, and vice versa. These findings suggest that intrinsic stiffness is modulated simultaneously with reflex stiffness to optimize the control of balance. PMID:25570884

  8. MR arthrography of the ankle joint

    International Nuclear Information System (INIS)

    Due to its superior soft tissue contrast conventional MRI is the imaging method of choice in the evaluation of ankle joint disorders. Conventional MR imaging can accurately demonstrate normal or acutely injured ligaments; however, in subacute and chronic injury joint fluid necessary for delineation of injured ligaments is absent and MR arthrography should be performed. MR arthrography uses the intraarticular injection of contrast material to distend the joint, yielding improved discrimination of intraarticular structures. This joint distension with MR arthrography is also helpful in the staging of osteochondritis dissecans, since in cases of unstable lesions tracking of contrast material into the interface can be more easily demonstrated. Finally, high contrast and joint distension by MR arthrography improves the detection of intraarticular loose bodies, which often require surgery. MR artrography, although invasive, may provide additional information in various ankle joint disorders. (orig.)

  9. [Advances on biomechanics and kinematics of sprain of ankle joint].

    Science.gov (United States)

    Zhao, Yong; Wang, Gang

    2015-04-01

    Ankle sprains are orthopedic clinical common disease, accounting for joint ligament sprain of the first place. If treatment is not timely or appropriate, the joint pain and instability maybe develop, and even bone arthritis maybe develop. The mechanism of injury of ankle joint, anatomical basis has been fully study at present, and the diagnostic problem is very clear. Along with the development of science and technology, biological modeling and three-dimensional finite element, three-dimensional motion capture system,digital technology study, electromyographic signal study were used for the basic research of sprain of ankle. Biomechanical and kinematic study of ankle sprain has received adequate attention, combined with the mechanism research of ankle sprain,and to explore the the biomechanics and kinematics research progress of the sprain of ankle joint. PMID:26072625

  10. Diagnosis of ligament injuries in the superior ankle joint

    International Nuclear Information System (INIS)

    Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscel splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. (orig.)

  11. Diagnostic dilemmas in foot and ankle injuries

    Energy Technology Data Exchange (ETDEWEB)

    Keene, J.S.; Lange, R.H.

    1986-07-11

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required.

  12. Osteoarthritis after osteosynthesis of ankle injuries

    International Nuclear Information System (INIS)

    98 patients were clinically and radiographically examined 2 to 9 years following the osteosynthesis of ankle fractures. The rate of secondary osteoarthritis was 70% including 40% of minor, 17% of medium and 13% of serious changes. Depending on the injured structures the frequency of posttraumatic osteoarthritis varies. Medium and serious radiology changes cause obvious dysfunction in 56% and 62% respectively. Joints free of Osteoarthritis one year after the injury will not develop secondary osteoarthritis later. (orig.)

  13. Diagnostic dilemmas in foot and ankle injuries

    International Nuclear Information System (INIS)

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required

  14. Optimal management of ankle syndesmosis injuries

    OpenAIRE

    Porter DA; Jaggers RR; Barnes AF; Rund AM

    2014-01-01

    David A Porter, Ryan R Jaggers, Adam Fitzgerald Barnes, Angela M Rund Methodist Sports Medicine/The Orthopedic Specialists, Indianapolis, IN, USA Abstract: Syndesmosis injuries occur when there is a disruption of the distal attachment of the tibia and fibula. These injuries occur commonly (up to 18% of ankle sprains), and the incidence increases in the setting of athletic activity. Recognition of these injuries is key to preventing long-term morbidity. Diagnosis and treatment of these injuri...

  15. The management of soft tissue ankle injuries.

    OpenAIRE

    Crean, D.

    1981-01-01

    The anatomy of the ankle, and the types of sporting injuries that occur in this joint, are described. Traditional treatment of soft tissue injuries involves immobilisation, and the value of this is questioned. An alternative treatment strategy is described, and involves immobilisation and compression for twenty-four hours, followed by rapid mobilisation using a balance board. This alternative strategy can bring about full functional mobility in 94% of patients within 14 days.

  16. Evaluation of brachial plexus with MR echo planar imaging: initial experience

    International Nuclear Information System (INIS)

    Objective: To determine the optimal sequences and scan parameters of Brachial Plexus MRI. Methods: Eighteen volunteers were underwent conventional MRI and echo planar imaging scanning. The images acquired were compared with the standard anatomical pictures. Results: Ventral rami, ganglion, trunks, cords and some peripheral nerves of brachial plexus were demonstrated very well by echo planar imaging with the post-processing techniques such as MIP, thin slice MIP and MPR. In 18/18 cases the postganglions on both sides and 17/18 cases the preganglions of brachial plexus on both sides could be visualized in EPI pre-processed and post-processed images. Conclusion: Echo planar imaging is an effective technique of accurately displaying brachial plexus and adjacent structures. It has potential value in the diagnosis and treatment of brachial plexus diseases. It is also a potential technique to demonstrate other peripheral nerves accurately. (authors)

  17. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

    International Nuclear Information System (INIS)

    AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS

  18. MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

    Energy Technology Data Exchange (ETDEWEB)

    Peace, K.A.L. E-mail: kalpeace@hotmail.com; Hillier, J.C.; Hulme, A.; Healy, J.C

    2004-11-01

    AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.

  19. MR imaging of the ankle: Normal variants

    International Nuclear Information System (INIS)

    Thirty asymptomatic ankles were studied with high-resolution surface coil MR imaging. The thirty ankles were reviewed for identification or normal structures. The MR appearance of the deltoid and posterior to talo-fibular ligaments, peroneous brevis and longus tendons, and posterior aspect of the tibial-talar joint demonstrated several normal variants not previously described. These should not be misinterpreted as pathologic processes. The specific findings included (1) cortical irregularity of the posterior tibial-talar joint in 27 of 30 cases which should not be mistaken for osteonecrois; (2) normal posterior talo-fibular ligament with irregular and frayed inhomogeneity, which represents a normal variant in seven of ten cases; and (3) fluid in the shared peroneal tendons sheath which may be confused for a longitudinal tendon tear in three of 30 cases. Ankle imaging with the use of MR is still a relatively new procedure. Further investigation is needed to better define normal anatomy as well as normal variants. The authors described several structures that normally present with variable MR imaging appearances. This is clinically significant in order to maintain a high sensitivity and specificity in MR imaging interpretation

  20. Forces predicted at the ankle during running.

    Science.gov (United States)

    Burdett, R G

    1982-01-01

    A biomechanical model of the ankle joint was developed and was used to predict the forces at the ankle during the stance phase of running. Measurements from five cadavers were averaged to obtain insertion points and directions of pull of equivalent tendons with respect to the assumed center of the ankle joint. A minimum joint force solution was obtained by assuming that only two equivalent muscle groups could exert force at one time. Three subjects ran at 4.47 m/s across a force platform that recorded the external forces and moments acting on the foot. Cinematography was used to measure the foot and leg positions during stance. Peak resultant joint forces ranging from 9.0 to 13.3 times body weight and peak Achilles tendon forces ranging from 5.3 to 10.0 times body weight were predicted. Small variations in some cases resulted in large differences in predicted forces. The highest tendon forces predicted exceeded those reported to cause damage to cadaver tendons in other studies. PMID:7132650

  1. Kinesthesia Is Not Affected by Functional Ankle Instability Status.

    Science.gov (United States)

    Hubbard, Tricia J; Kaminski, Thomas W

    2002-12-01

    OBJECTIVE: To determine whether subjects with functional ankle instability suffered kinesthetic deficits in the injured ankle compared with the healthy ankle and to examine the effect of prophylactic ankle bracing on kinesthesia in uninjured and functionally unstable ankles. DESIGN AND SETTING: We tested subjects over 4 consecutive days in a climate-controlled athletic training/sports medicine laboratory setting. A single-group time-series design enabled all subjects to serve as their own controls. A different bracing condition was tested on each of those occasions. SUBJECTS: Sixteen subjects (8 men, 8 women; age = 21.6 +/- 1.7 years; mass = 73.5 +/- 15.0 kg; height = 172.9 +/- 8.8 cm) with unilateral functional ankle instability participated in this study. MEASUREMENTS: Kinesthetic threshold-to-detection of passive motion (TTDPM) measurements were obtained during passive inversion and eversion movements (0.5 degrees.s(-1)) under 4 different bracing or taping conditions (unbraced, Swede-O Ankle Lok, Aircast Air-Stirrup, and tape). RESULTS: We analyzed the data using a 3-factor analysis of variance with repeated measures on the ankle and motion factors. Threshold-to-detection of passive motion scores in the unbraced condition were significantly better than the TTDPM scores in any of the other 3 test conditions. No significant differences were seen in TTDPM scores between the 2 ankles under any of the 4 conditions. CONCLUSIONS: Threshold-to-detection of passive motion scores did not differ in uninjured ankles and those with functional instability; however, bracing with either the Ankle Lok or Air-Stirrup decreased the ability to detect passive motion when compared with the no-tape (unbraced) condition. Further research is needed to determine the exact contributions of taping and bracing on ankle joint kinesthesia. PMID:12937571

  2. Kinematics and kinetics of an accidental lateral ankle sprain

    OpenAIRE

    Kristianslund, Eirik; Bahr, Roald; Krosshaug, Tron

    2011-01-01

    Ankle sprains are common during sporting activities and can have serious consequences. Understanding of injury mechanisms is essential to prevent injuries, but only two previous studies have provided detailed descriptions of the kinematics of lateral ankle sprains and measures of kinetics are missing. In the present study a female handball player accidentally sprained her ankle during sidestep cutting in a motion analysis laboratory. Kinematics and kinetics were calculated from 240 Hz recordi...

  3. Alteration in global motor strategy following lateral ankle sprain

    OpenAIRE

    Bastien, Maude; Moffet, Hélène; Bouyer, Laurent J; Perron, Marc; Hébert, Luc J; Leblond, Jean

    2014-01-01

    Background Lateral ankle sprain (LAS) has often been considered an injury leading to localized joint impairments affecting the musculoskeletal system. Persistent chronic ankle instability and bilateral alterations in motor control after a first ankle sprain episode suggest that the origin of relapses might be a maladaptive reorganization of central motor commands. The objectives of this study were (1) to compare the quality of motor control through motor strategy variables of two groups (with...

  4. Experimental and computational analysis of composite ankle-foot orthosis

    OpenAIRE

    Dequan Zou, DSc; Tao He, MS; Michael Dailey, MBA, CO; Kirk E. Smith, BS; Matthew J. Silva, PhD; David R. Sinacore, PhD, PT; Michael J. Mueller, PhD, PT; Mary K. Hastings, DPT, MSCI

    2015-01-01

    Carbon fiber (CF) ankle-foot orthoses (AFOs) can improve gait by increasing ankle plantar-flexor power and improving plantar-flexor ankle joint moment and energy efficiency compared with posterior leaf spring AFOs made of thermoplastic. However, fabricating a CF AFO to optimize the performance of the individual user may require multiple AFOs and expensive fabrication costs. Finite element analysis (FEA) models were developed to predict the mechanical behavior of AFOs in this study. Three AFOs...

  5. Neuropathic midfoot deformity: associations with ankle and subtalar joint motion

    OpenAIRE

    Sinacore, David R; Gutekunst, David J; Hastings, Mary K.; Strube, Michael J; Bohnert, Kathryn L.; Prior, Fred W.; Johnson, Jeffrey E

    2013-01-01

    Background Neuropathic deformities impair foot and ankle joint mobility, often leading to abnormal stresses and impact forces. The purpose of our study was to determine differences in radiographic measures of hind foot alignment and ankle joint and subtalar joint motion in participants with and without neuropathic midfoot deformities and to determine the relationships between radiographic measures of hind foot alignment to ankle and subtalar joint motion in participants with and without neuro...

  6. Review of common and unusual causes of lateral ankle pain

    International Nuclear Information System (INIS)

    Lateral ankle pain is a common clinical presentation having several important causes, including lateral ligament injury, peroneal tendon injury, sinus tarsi syndrome, and nerve entrapments. However, other causes should be kept in mind in patients with unusual patterns of pain or intractable symptoms. We present a review of common and some unusual causes of lateral ankle pain including a review of post-operative imaging findings following surgery for lateral ankle ligament and peroneal tendon injuries. (orig.)

  7. Influence on ankle taping on dynamic balance performance

    OpenAIRE

    Kenny, Ian; Wu, Can; McEvoy, Johnson

    2011-01-01

    peer-reviewed This research aimed to investigate the effect of ankle taping on dynamic balance performance. Eighteen recreational athletes without any previous ankle sprain history performed six star excursion balance tests on each leg; randomly three trials with taped ankles and three trials without. A three-layer modified closed-basket inelastic taping technique was used. Normalised (by leg length) reaching distance was measured. It was found 1.Movement direction significantl...

  8. Review of ankle inversion sprain simulators in the biomechanics laboratory

    OpenAIRE

    Sophia Chui-Wai Ha; Daniel Tik-Pui Fong; Kai-Ming Chan

    2015-01-01

    Ankle inversion ligamentous sprain is one of the most common sports injuries. The most direct way is to investigate real injury incidents, but it is unethical and impossible to replicate on test participants. Simulators including tilt platforms, trapdoors, and fulcrum devices were designed to mimic ankle inversion movements in laboratories. Inversion angle was the only element considered in early designs; however, an ankle sprain is composed of inversion and plantarflexion in clinical observa...

  9. Understanding acute ankle ligamentous sprain injury in sports

    OpenAIRE

    Fong Daniel TP; Chan Yue-Yan; Mok Kam-Ming; Yung Patrick SH; Chan Kai-Ming

    2009-01-01

    Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprai...

  10. Systematic review of chronic ankle instability in children

    OpenAIRE

    Mandarakas, Melissa; Pourkazemi, Fereshteh; Sman, Amy; Burns, Joshua; Hiller, Claire E

    2014-01-01

    Background Chronic ankle instability (CAI) is a disabling condition often encountered after ankle injury. Three main components of CAI exist; perceived instability; mechanical instability (increased ankle ligament laxity); and recurrent sprain. Literature evaluating CAI has been heavily focused on adults, with little attention to CAI in children. Hence, the objective of this study was to systematically review the prevalence of CAI in children. Methods Studies were retrieved from major databas...

  11. The Anatomic Pattern of Injuries in Acute Inversion Ankle Sprains

    OpenAIRE

    Khor, Yuet Peng; Tan, Ken Jin

    2013-01-01

    Background: There are little data on the incidence and patterns of injuries seen on magnetic resonance imaging (MRI) in acute inversion ankle sprains. This study may help in the understanding of the pathomechanics, natural history, and outcomes of this common injury. Study Design: Case series; Level of evidence, 4. Methods: From June 2011 to June 2013, a total of 64 consecutive patients had MRI of the ankle performed for acute inversion injury to the ankle. All injuries/pathologies reported w...

  12. Neuromuscular control and rehabilitation of the unstable ankle

    OpenAIRE

    Hung, You-jou

    2015-01-01

    Lateral ankle sprain is a common orthopedic injury with a very high recurrence rate in athletes. After decades of research, it is still unclear what contributes to the high recurrence rate of ankle sprain, and what is the most effective intervention to reduce the incident of initial and recurrent injuries. In addition, clinicians often implement balance training as part of the rehabilitation protocol in hopes of enhancing the neuromuscular control and proprioception of the ankle joint. Howeve...

  13. Review of common and unusual causes of lateral ankle pain

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Surabhi [Nuffield Orthopaedic Centre NHS Trust, Musculoskeletal Radiology, Oxford (United Kingdom); McNally, Eugene [Nuffield Orthopaedic Centre NHS Trust, Musculoskeletal Radiology, Oxford (United Kingdom); Nuffield Orthopaedic Centre and University of Oxford, Musculoskeletal Radiology, Oxford (United Kingdom)

    2011-11-15

    Lateral ankle pain is a common clinical presentation having several important causes, including lateral ligament injury, peroneal tendon injury, sinus tarsi syndrome, and nerve entrapments. However, other causes should be kept in mind in patients with unusual patterns of pain or intractable symptoms. We present a review of common and some unusual causes of lateral ankle pain including a review of post-operative imaging findings following surgery for lateral ankle ligament and peroneal tendon injuries. (orig.)

  14. Limiting the use of routine radiography for acute ankle injuries.

    OpenAIRE

    Cockshott, W P; Jenkin, J. K.; Pui, M.

    1983-01-01

    In the diagnosis of ankle injuries routine radiography is often productive. An international survey of the average number of radiographs made of injured ankles suggested that two projections are adequate to detect fractures. This was confirmed in a prospective study of 242 patients coming to a hospital emergency department with recent ankle injuries. All the fractures could be identified on an anteroposterior or a lateral projection, although some were more obvious on an oblique view. As well...

  15. Rehabilitation of Ankle and Foot Injuries in Athletes

    OpenAIRE

    Chinn, Lisa; Hertel, Jay

    2010-01-01

    Foot and ankle injuries are extremely common among athletes and other physically active individuals. Rehabilitation programs that emphasize the use of therapeutic exercise to restore joint range of motion, muscle strength, neuromuscular coordination, and gait mechanics have been shown to have clinical success for patients suffering various foot and ankle pathologies. Rehabilitation programs are discussed for ankle sprains, plantar fasciitis, Achilles tendonitis, and turf toe.

  16. Differences in Men's and Women's Mean Ankle Ligamentous Laxity

    OpenAIRE

    Wilkerson, Ricky D; Mason, Melanie A

    2000-01-01

    The incidence of ligamentous ankle injuries is known to be one of the most common athletic injuries that exists. Recently, there has been a great deal of interest regarding the increased risk of female ligamentous injury, such as the anterior cruciate ligament, lateral ankle sprains and others. The purpose of this study is to evaluate whether or not normal lateral ankle ligamentous laxity is similar in male and female athletes. This study selects 22 male and 27 female college athletes who hav...

  17. MRI in acute ligamentous injuries of the ankle.

    Science.gov (United States)

    Martella, Ilenia; Azzali, Emanuele; Milanese, Gianluca; Praticò, Francesco Emanuele; Ruggirello, Margherita; Trunfio, Vincenzo; Parziale, Raffaele; Corrado, Michele; Della Casa, Giovanni; Capasso, Raffaella; De Filippo, Massimo

    2016-01-01

    Ankle sprains are the most common lower limb injuries and affect more frequently young athletes; imaging is needed for an accurate diagnosis of such traumatic injuries. The purpose of this review is to analyse the magnetic resonance (MR) findings of both normal and pathological ankle's ligaments; indeed, MRI is the gold standard for the diagnosis of acute traumatic injuries and is useful for differentiation of the causes of ankle instability as well as for pre-operative planning. PMID:27467862

  18. Syndesmotic Malreduction after Ankle ORIF; Is Radiography Sufficient?

    OpenAIRE

    Alireza Manafi Rasi; Gholamhossein Kazemian; Mohamad M Omidian; Ali Nemati

    2013-01-01

      Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF) in patients with ankle fractures.   Methods: ...

  19. Benign and malignant tumors of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Singer, Adam D.; Datir, Abhijit; Langley, Travis [Emory University Hospital, Department of Radiology, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Tresley, Jonathan [University of Wisconsin, Department of Radiology, Madison, WI (United States); Clifford, Paul D.; Jose, Jean; Subhawong, Ty K. [University of Miami, Department of Radiology, Miami, FL (United States)

    2016-03-15

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  20. Benign and malignant tumors of the foot and ankle

    International Nuclear Information System (INIS)

    Pain and focal masses in the foot and ankle are frequently encountered and often initiate a workup including imaging. It is important to differentiate benign lesions from aggressive benign or malignant lesions. In this review, multiple examples of osseous and soft tissue tumors of the foot and ankle will be presented. Additionally, the compartmental anatomy of the foot and ankle will be discussed in terms of its relevance for percutaneous biopsy planning and eventual surgery. Finally, a general overview of the surgical management of benign, benign aggressive and malignant tumors of the foot and ankle will be discussed. (orig.)

  1. 改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的研究%Modified Brostrom precedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains

    Institute of Scientific and Technical Information of China (English)

    陈冬; 姚建华; 黄炎; 伍罕

    2015-01-01

    Objective To investigate the therapeutic effect of modified Brostrom procedure combined with ankle arthroscopy for chronic ankle instability derived from ankle sprains. Methods A total of 23 cases of chronic ankle instability derived from ankle sprain were investigated. The modified Brostrom procedure combined with ankle arthroscopy were used for treatment. AOFAS score were respectively evaluated before surger-y and three months and one year after treatment. Results Ankle arthroscopy found varying degrees of synovial hyperplasia in all patients and carti-lage damage in 18 patients(mainly Ⅱ ~ Ⅲ degree). After one year of surgery,AOFAS score was significantly improved. Conclusion Short -term postoperative follow - up indicates the combination of modified Brostrom procedure and ankle arthroscopy exhibits good treatment effect and better recovery of ankle function in chronic ankle instability patients.%目的:探讨改良 Brostrom 法联合踝关节镜治疗踝关节扭伤致慢性踝关节不稳的临床效果。方法选择踝关节扭伤治疗后发展为慢性踝关节不稳的患者共23例,采用改良的 Brostrom 法联合踝关节镜进行治疗,AOFAS 评分评价患者术前、术后3个月、术后1年时的治疗效果。结果踝关节镜检查发现患者均存在不同程度滑膜增生,其中发生软骨损伤18例,Ⅱ~Ⅲ度损伤为主。术后1年患者 AOFAS 分项及总分均显著高于术前。结论采用改良 Brostrom术式结合踝关节镜治疗踝关节扭伤致慢性踝关节不稳可获得较好的治疗效果,术后短期随访踝关节功能恢复较好。

  2. Postirradiation lesions of the brachial plexus. Results of surgical treatment

    International Nuclear Information System (INIS)

    In a series of 103 cases of postirradiation lesions of the brachial plexus operated on between 1978 and 1986--of which 60 patients have been reviewed with a follow up from 2 to 9 years--the surgical results are analyzed according to an anatomic classification, a clinical classification, and the surgical procedures. We conclude that the radiation plexitis should be treated surgically and at the earliest possible time after the onset of paresthesias. Also, the surgical procedure which gives the best results is neurolysis with pedicled omentoplasty

  3. Boston Children's Hospital approach to brachial plexus birth palsy.

    Science.gov (United States)

    Vuillermin, Carley; Bauer, Andrea S

    2016-07-01

    The treatment of infants with brachial plexus birth palsy (BPBP) continues to be a focus at Boston Children's Hospital. Over the last 15 years, there have been many developments in the treatment of infants with BPBP. Some of the greatest changes have emerged through technical advances such as the advent of distal nerve transfers to allow targeted reinnervation as well as through research to understand the pathoanatomical changes that lead to glenohumeral dysplasia and how this dysplasia can be remodeled. This review will discuss our current practice of evaluation of the infant with BPBP, techniques for microsurgical reconstruction, and prevention and treatment of secondary glenohumeral dysplasia. PMID:27137763

  4. Comparison of penile brachial index and penile arteriography

    International Nuclear Information System (INIS)

    Thirty patients complaining of erectile dysfunction were evaluated by measurement of the penile brachial index and arteriography. The PBIs were measured in five healthy controls. Half of the patients were studied in a vascular laboratory and the other half in a radiology-urology erectile dysfunction clinic. A poor correlation was found between PBI and arteriographic findings. No statistical difference was observed between the correlation coefficients for the two laboratory sites. Factors responsible for accurate and inaccurate assessments are discussed, and the process by which PBI measurements are obtained and their relationship to the physiology of erections is explained

  5. Differences in brachial and femoral artery responses to prolonged sitting

    OpenAIRE

    Thosar, Saurabh S.; Bielko, Sylvanna L.; Wiggins, Chad C.; Wallace, Janet P

    2014-01-01

    Introduction It is unknown if there are limb differences in vascular function during prolonged sitting. Purpose This study was designed to test whether the effects of prolonged sitting on brachial artery (BA) and the superficial femoral artery (SFA) are similar. Methods Twelve men (24.2 ± 4 yrs.) participated in a 3 hr prolonged sitting trial (SIT). SFA and BA flow mediated dilation (FMD) and respective flow patterns were measured at baseline, 1 hr, 2 hr and 3 hr. Results By a one-way ANOVA t...

  6. Ankle mechanics during sidestep cutting implicates need for 2-degrees of freedom powered ankle-foot prostheses

    OpenAIRE

    Evandro M. Ficanha; Mohammad Rastgaar, PhD; Kenton R. Kaufman, PhD

    2015-01-01

    The ankle joint of currently available powered prostheses is capable of controlling one degree of freedom (DOF), focusing on improved mobility in the sagittal plane. To increase agility, the requirements of turning in prosthesis design need to be considered. Ankle kinematics and kinetics were studied during sidestep cutting and straight walking. There were no significant differences between the ankle sagittal plane mechanics when comparing sidestep cutting and straight walking; however, signi...

  7. Is End-Stage Ankle Arthrosis Best Managed with Total Ankle Replacement or Arthrodesis? A Systematic Review

    OpenAIRE

    Jordan, Robert W.; Chahal, Gurdip S.; Anna Chapman

    2014-01-01

    Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must ...

  8. Hemodynamic Changes in the Brachial Artery Induced by Acupuncture Stimulation on the Lower Limbs: A Single-Blind Randomized Controlled Trial

    OpenAIRE

    Masashi Watanabe; Shin Takayama; Atsushi Hirano; Takashi Seki; Nobuo Yaegashi

    2012-01-01

    Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups...

  9. Comparison of Different Edge Detections and Noise Reduction on Ultrasound Images of Carotid and Brachial Arteries Using a Speckle Reducing Anisotropic Diffusion Filter

    OpenAIRE

    Rafati, Mehravar; Arabfard, Masoud; Rafati-Rahimzadeh, Mehrdad

    2014-01-01

    Background: Common carotid artery (CCA) ultrasound with measurement of intima-media thickness (IMT) is a safe and noninvasive technique for assessing subclinical atherosclerosis and determining cardiovascular risks. Moreover, the pattern of wall thickening in the brachial artery (BA) is rather diffuse compared to the carotid artery and may be a more sensitive indicator of long-term systemic exposure to risk factors. Therefore noninvasive evaluation of mechanical parameters changes of both art...

  10. An Acute Lateral Ankle Sprain Significantly Decreases Physical Activity across the Lifespan

    Directory of Open Access Journals (Sweden)

    Tricia Hubbard-Turner, Erik A. Wikstrom, Sophie Guderian, Michael J. Turner

    2015-09-01

    Full Text Available We do not know the impact an ankle sprain has on physical activity levels across the lifespan. With the negative consequences of physical inactivity well established, understanding the effect of an ankle sprain on this outcome is critical. The objective of this study was to measure physical activity across the lifespan after a single ankle sprain in an animal model. Thirty male mice (CBA/J were randomly placed into one of three groups: the transected calcaneofibular ligament (CFL group, the transected anterior talofibular ligament (ATFL/CFL group, and a SHAM group. Three days after surgery, all of the mice were individually housed in a cage containing a solid surface running wheel. Physical activity levels were recorded and averaged every week across the mouse’s lifespan. The SHAM mice ran significantly more distance each day compared to the remaining two running groups (post hoc p = 0.011. Daily duration was different between the three running groups (p = 0.048. The SHAM mice ran significantly more minutes each day compared to the remaining two running groups (post hoc p=0.046 while the ATFL/CFL mice ran significantly less minutes each day (post hoc p = 0.028 compared to both the SHAM and CFL only group. The SHAM mice ran at a faster daily speed versus the remaining two groups of mice (post hoc p = 0.019 and the ATFL/CFL mice ran significantly slower each day compared to the SHAM and CFL group (post hoc p = 0.005. The results of this study indicate that a single ankle sprain significantly decreases physical activity across the lifespan in mice. This decrease in physical activity can potentially lead to the development of numerous chronic diseases. An ankle sprain thus has the potential to lead to significant long term health risks if not treated appropriately.

  11. Enhanced balance associated with coordination training with stochastic resonance stimulation in subjects with functional ankle instability: an experimental trial

    Directory of Open Access Journals (Sweden)

    Brown Cathleen N

    2007-12-01

    Full Text Available Abstract Background Ankle sprains are common injuries that often lead to functional ankle instability (FAI, which is a pathology defined by sensations of instability at the ankle and recurrent ankle sprain injury. Poor postural stability has been associated with FAI, and sports medicine clinicians rehabilitate balance deficits to prevent ankle sprains. Subsensory electrical noise known as stochastic resonance (SR stimulation has been used in conjunction with coordination training to improve dynamic postural instabilities associated with FAI. However, unlike static postural deficits, dynamic impairments have not been indicative of ankle sprain injury. Therefore, the purpose of this study was to examine the effects of coordination training with or without SR stimulation on static postural stability. Improving postural instabilities associated with FAI has implications for increasing ankle joint stability and decreasing recurrent ankle sprains. Methods This study was conducted in a research laboratory. Thirty subjects with FAI were randomly assigned to either a: 1 conventional coordination training group (CCT; 2 SR stimulation coordination training group (SCT; or 3 control group. Training groups performed coordination exercises for six weeks. The SCT group received SR stimulation during training, while the CCT group only performed coordination training. Single leg postural stability was measured after the completion of balance training. Static postural stability was quantified on a force plate using anterior/posterior (A/P and medial/lateral (M/L center-of-pressure velocity (COPvel, M/L COP standard deviation (COPsd, M/L COP maximum excursion (COPmax, and COP area (COParea. Results Treatment effects comparing posttest to pretest COP measures were highest for the SCT group. At posttest, the SCT group had reduced A/P COPvel (2.3 ± 0.4 cm/s vs. 2.7 ± 0.6 cm/s, M/L COPvel (2.6 ± 0.5 cm/s vs. 2.9 ± 0.5 cm/s, M/L COPsd (0.63 ± 0.12 cm vs. 0.73 ± 0

  12. USE OF DEXMEDETOMIDINE ALONG WITH BUPIVACAINE FOR BRACHIAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Rachana Gandhi

    2012-02-01

    Full Text Available Introduction: Supraclavicular brachial plexus block provides safe, effective, low cost anaesthesia with good postoperative analgesia. This study was conducted to compare the postoperative analgesic efficacy and safety of dexmedetomidine for brachial plexus blockade along with bupivacaine. Methodology: This prospective double blind study was conducted on 70 patients of age 18 to 60 years posted for various upper limb surgeries and randomly allocated into two equal groups of 35 each. Control group-C received injection bupivacaine (0.25% 38 milliliter plus 2 milliliter normal saline, dexmedetomidine group-D received injection bupivacaine (0.25% 38 milliliter plus dexmedetomidine 30 microgram (2 milliliter. Assessment of motor and sensory blockade, pulse, systolic blood pressure, respiration and side effects were noted every 5 minutes for first 30 minute and every 10 minute till end of surgery. Duration of analgesia and incidence of various complications following the procedure were observed. Results: It was observed that in control group onset of motor and sensory blockade was faster. Where as, dexmedetomidine group have better hemodynamic stability and greater postoperative analgesia. Only two cases of bradycardia and two cases of hypotension were noticed in dexmedetomidine group-D. [National J of Med Res 2012; 2(1.000: 67-69

  13. Our experience on brachial plexus blockade in upper extremity surgery

    Directory of Open Access Journals (Sweden)

    Ömer Uslukaya

    2012-03-01

    Full Text Available Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effects

  14. Lower extremity function during gait in participants with first time acute lateral ankle sprain compared to controls.

    Science.gov (United States)

    Doherty, Cailbhe; Bleakley, Chris; Hertel, Jay; Caulfield, Brian; Ryan, John; Delahunt, Eamonn

    2015-02-01

    Laboratory analyses of chronic ankle instability populations during gait have elucidated a number of anomalous movement patterns. No current research exists analysing these movement patterns in a group in the acute phase of lateral ankle sprain (LAS) injury. It is possible that participants with an acute LAS display movement patterns continuous with their chronically impaired counterparts. Sixty eight participants with acute LAS and nineteen non-injured participants completed five gait trials. 3D lower extremity temporal kinematic and kinetic data were collected from 200 ms pre- to 200 ms post-heel strike (period 1) and from 200 ms pre- to 200 ms post-toe off (period 2). During period 1, the LAS group displayed increased knee flexion with increased net extensor pattern at the knee joint, increased ankle inversion with a greater inversion moment, and reduced ankle plantar flexion, compared to the non-injured control group. During period 2, the LAS group displayed decreased hip extension with a decrease in the flexor moment at the hip, and decreased ankle plantar flexion with a decrease in the net plantar flexion moment, compared to the non-injured control group. These results indicate that participants with acute LAS display coordination strategies which may play a role in the onset of chronicity or recovery. PMID:25443172

  15. The assessment of the range of normal values of lower limb perfusion indicators at rest stress with the own radio isotopic method and program

    International Nuclear Information System (INIS)

    Introduction: In this study, we took on the trial to elaborate the radioisotopic method and program allowing for defining the range of normal values of muscle perfusion. Aim: Elaborating the method and program allowing for half quantitative evaluation and defining the range of normal values of lower limbs perfusion indicators at rest and stress allowing for their clinical application. Material and Methods: 74 patients, age 21-45 without the lower limbs muscle perfusion disturbances. Basic tests biochemical blood tests, USG-Doppler, ankle-brachial, pulsation and resistance indexes and maximal blood flow in the lower limbs. Perfusion scintigraphy (Tc99m MIBI) of rest and stress. Data analysis with the own ALLP program. Results: Basic and biochemical examination and USG Doppler didn't show any deviation from the norm. The range of normal values of the lower limbs perfusion indexes was defined: calves: at rest - 5,28-8.02, at stress - 4.29-6.32; thighs, at rest - 4.54-7.08 and at stress - 4.00-5.66. Conclusions: The elaborated radioisotopes method and program allow for half quantitative assessment of lower limb perfusion at rest and stress. Established normal ranges of lower limb perfusion values at rest and stress allow for clinical assessment of perfusion in healthy patients and diagnostics of dysfunctions of muscle perfusion. They also monitor the effects in conservative and operative treatment and other factors that influence muscle perfusion. (author)

  16. Kinematics of ankle taping after a training session.

    Science.gov (United States)

    Meana, M; Alegre, L M; Elvira, J L L; Aguado, X

    2008-01-01

    This study aimed to test the effectiveness of ankle taping on the limitation of forced supination during a change of direction, as well as the losses of effectiveness after a 30-minute training session. Fifteen young men with no ankle injury volunteered for the study. The static and dynamic ranges of movement (ROM) were measured before and after a training session. The dynamic measurements were recorded using high-speed 3D photogrammetry. The differences between static and dynamic measures of ankle supination and plantar flexion were significant. The losses of effectiveness during supination and ankle plantar flexion restriction were 42.3 % and 47.6 %, respectively. Ankle taping was effective in restricting the maximal static ROMs before a training session, but the effectiveness decreased after 30 min of training. The present study shows the necessity of performing dynamic ROM analysis of sports techniques involved in the ankle sprain mechanism in order to determine the degree of tape restriction after a training session, because there were differences between static and dynamic ankle ROMs. The lack of effects on the restriction of the dynamic plantar flexion would bring into question the necessity of ankle taping in subjects without previous injuries. PMID:17614032

  17. Relationship between stress ankle radiographs and injured ligaments on MRI

    International Nuclear Information System (INIS)

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  18. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    International Nuclear Information System (INIS)

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  19. Rehabilitation of the Ankle After Acute Sprain or Chronic Instability

    OpenAIRE

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Objective: To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice.

  20. THE EFFECTS OF KINESIO TAPING ON PROPRIOCEPTION AT THE ANKLE

    Directory of Open Access Journals (Sweden)

    Mark DeBeliso

    2004-03-01

    Full Text Available An experiment was designed to determine if KinesioTM taping the anterior and lateral portion of the ankle would enhance ankle proprioception compared to the untaped ankle. 30 subjects, 15 men, 15 women, ages 18-30 participated in this study. Exclusion criteria: Ankle injury < 6 months prior to testing, significant ligament laxity as determined through clinical evaluation by an ATC, or any severe foot abnormality. Experiment utilized a single group, pretest and posttest. Plantar flexion and inversion with 20° of plantar flexion reproduction of joint position sense (RJPS was determined using an ankle RJPS apparatus. Subjects were barefooted, blindfolded, and equipped with headphones playing white noise to eliminate auditory cues. Subjects had five trials in both plantar flexion and inversion with 20° plantar flexion before and after application of the KinesioTM tape to the anterior/lateral portion of the ankle. Constant error and absolute error were determined from the difference between the target angle and the trial angle produced by the subject. The treatment group (KinesioTM taped subjects showed no change in constant and absolute error for ankle RJPS in plantar flexion and 20º of plantar flexion with inversion when compared to the untaped results using the same motions. The application of KinesioTM tape does not appear to enhance proprioception (in terms of RJPS in healthy individuals as determined by our measures of RJPS at the ankle in the motions of plantar flexion and 20º of plantar flexion with inversion.

  1. Relationship between stress ankle radiographs and injured ligaments on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyoung Min; Chung, Chin Youb; Chung, Myung Ki; Won, Sung Hun; Lee, Seung Yeol; Park, Moon Seok [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Kyungki (Korea, Republic of); Kwon, Soon-Sun [Seoul National University Bundang Hospital, Biomedical Research Institute, Kyungki (Korea, Republic of)

    2013-11-15

    This study was performed to investigate the relationship between the injured lateral ankle ligaments on MRI and stress ankle radiographs. Two hundred and twenty-nine consecutive patients (mean age 35.5 years, SD 14.6 years; 136 males and 93 females) that underwent ankle stress radiographs and MRI for lateral ankle instability were included. Tibiotalar tilt angle and anterior translation of talus were measured on stress ankle radiographs. Degree of lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular) and deltoid ligament injuries were evaluated and scored as intact (0), partial injury (1), and complete injury (2) on MR images. Effusion of ankle joint was also recorded. The effects of gender, age, injuries of ligaments, and ankle joint effusion on stress radiographs were statistically analyzed. Gender (p = 0.010), age (p = 0.020), and anterior talofibular ligament (ATFL) injury (p < 0.001) were the factors significantly affecting tibiotalar tilt angle. Posterior talofibular ligament (PTFL) injury (p = 0.014) was found to be the only significant factor affecting the anterior translation on the anterior drawer radiographs. ATFL injury and PTFL injury on MRI significantly affected tibiotalar tilt angle and anterior drawer on stress radiographs. Other factors, such as age and gender, need to be considered in evaluating radiographic lateral ankle instability. (orig.)

  2. Magnetic resonance imaging findings in anterolateral impingement of the ankle

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, L.K. III.; Cooperman, A.E. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Helms, C.A. [Department of Radiology, Duke University Medical Center, Durham, NC (United States); Duke University Medical Center, Durham, NC (United States); Speer, K.P. [Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC (United States)

    2000-01-01

    Objective. To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle.Design and patients. Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings correlated with the results of arthroscopy. Three additional patients with clinically suspected ALI of the ankle were also included. Ankle MR imaging studies from 20 control patients in whom ALI was not suspected clinically were examined for similar findings to the patient group.Results. MR imaging findings in the patients with ALI included a soft tissue signal mass in the anterolateral gutter of the ankle in 12 of 12 (100%) cases, corresponding to the synovial hypertrophy and soft tissue mass found at arthroscopy in the nine patients who underwent arthroscopy. Disruption, attenuation, or marked thickening of the anterior talofibular ligament was seen in all cases. Additional findings included signs of synovial hypertrophy elsewhere in the tibiotalar joint in seven of 12 patients (58%) and bony and cartilaginous injuries to the tibiotalar joint in five of 12 (42%). None of the control patients demonstrated MR imaging evidence of a soft tissue mass in the anterolateral gutter.Conclusions. ALI of the ankle is a common cause for chronic lateral ankle pain. It has been well described in the orthopedic literature but its imaging findings have not been clearly elucidated. The MR imaging findings, along with the appropriate clinical history, can be used to direct arthroscopic examination and subsequent debridement. (orig.)

  3. Foot and ankle injuries in child and adolescent athletes

    OpenAIRE

    Yildirim, Yakup; Esemenli, Tanil

    2004-01-01

    Foot and ankle injuries are most commonly encountered in athletes. Of these, pediatric and adolescent injuries have unique characteristics because of the distinct growth potentials and their consequences specific to this age group. In this article, foot and ankle injuries in child and adolescent athletes are reviewed in the light of the literature.

  4. Rehabilitation of the Ankle after Acute Sprain or Chronic Instability.

    Science.gov (United States)

    Mattacola, Carl G.; Dwyer, Maureen K.

    2002-01-01

    Outlines rehabilitation concepts applicable to acute and chronic ankle injury, providing evidence for current techniques used in ankle rehabilitation and describing a functional rehabilitation program that progresses from basic to advanced, while taking into account empirical data from the literature and clinical practice. The article notes that…

  5. Triplane ankle fracture with deltoid ligament tear and syndesmotic disruption

    OpenAIRE

    Cummings, Robert Jay

    2008-01-01

    In patients with immature skeletons, ligamentous injuries rarely accompany ankle fractures. In this article, we report about deltoid ligament tears and syndesmotic disruptions accompanying triplane ankle fractures in two children, and make recommendations as to the evaluation and treatment of children with such injuries.

  6. Acute lateral ankle sprains: from functional treatment to prevention

    NARCIS (Netherlands)

    Kemler, H.J.

    2015-01-01

    Ankle sprains are common in daily life and often considered to be minor injuries. The objective in this thesis was to provide more evidence on the burden and optimal management of ankle sprains in terms of the magnitude of the problem, the prognostic consequences and ways to improve treatment and p

  7. Understanding acute ankle ligamentous sprain injury in sports

    Directory of Open Access Journals (Sweden)

    Fong Daniel TP

    2009-07-01

    Full Text Available Abstract This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms. Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms. The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative

  8. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

    Future robotic exploration of near-Earth asteroids and the vertical and inverted rock walls of lava caves and cliff faces on Mars and other planetary bodies would require a method of gripping their rocky surfaces to allow mobility without gravitational assistance. In order to successfully navigate this terrain and drill for samples, the grippers must be able to produce anchoring forces in excess of 100 N. Additionally, the grippers must be able to support the inertial forces of a moving robot, as well gravitational forces for demonstrations on Earth. One possible solution would be to use microspine arrays to anchor to rock surfaces and provide the necessary load-bearing abilities for robotic exploration of asteroids. Microspine arrays comprise dozens of small steel hooks supported on individual suspensions. When these arrays are dragged along a rock surface, the steel hooks engage with asperities and holes on the surface. The suspensions allow for individual hooks to engage with asperities while the remaining hooks continue to drag along the surface. This ensures that the maximum possible number of hooks engage with the surface, thereby increasing the load-bearing abilities of the gripper. Using the microspine array grippers described above as the end-effectors of a robot would allow it to traverse terrain previously unreachable by traditional wheeled robots. Furthermore, microspine-gripping robots that can perch on cliffs or rocky walls could enable a new class of persistent surveillance devices for military applications. In order to interface these microspine grippers with a legged robot, an ankle is needed that can robotically actuate the gripper, as well as allow it to conform to the large-scale irregularities in the rock. The anchor serves three main purposes: deploy and release the anchor, conform to roughness or misalignment with the surface, and cancel out any moments about the anchor that could cause unintentional detachment. The ankle design contains a

  9. Clinical assessment and management of ankle sprains.

    Science.gov (United States)

    Myrick, Karen M

    2014-01-01

    Ankle sprains are a common occurrence and are frequently either undertreated or overtreated. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the United States alone, this is an orthopaedic injury that providers should be acutely aware of and successfully able to evaluate and treat. This clinical feature will provide a thorough review of the mechanism of injury, the history and physical examination, and the classification and management of these injuries. Clinical red flags are discussed. PMID:25233201

  10. Obstetrical brachial plexus palsy: Can excision of upper trunk neuroma and nerve grafting improve function in babies with adequate elbow flexion at nine months of age?

    Science.gov (United States)

    Argenta, Anne E; Brooker, Jack; MacIssac, Zoe; Natali, Megan; Greene, Stephanie; Stanger, Meg; Grunwaldt, Lorelei

    2016-05-01

    Accepted indications for exploration in obstetrical brachial plexus palsy (OBPP) vary by center. Most agree that full elbow flexion against gravity at nine months of age implies high chance of spontaneous recovery and thus excludes a baby from surgical intervention. However, there are certain movements of the shoulder and forearm that may not be used frequently by the infant, but are extremely important functionally as they grow. These movements are difficult to assess in a baby and may lead to some clinicians to recommend conservative treatment, when this cohort of infants may in fact benefit substantially from surgery. A retrospective review was conducted on all infants managed surgically at the Brachial Plexus Center of a major children's hospital from 2009 to 2014. Further analysis identified five patients who had near-normal AMS scores for elbow flexion but who had weakness of shoulder abduction, flexion, external rotation, and/or forearm supination. In contrast to standard conservative management, this cohort underwent exploration, C5-6 neuroma excision, and sural nerve grafting. Data analysis was performed on this group to look for overall improvement in function. During an average follow-up period of 29 months, all patients made substantial gains in motor function of the shoulder and forearm, without loss of elbow flexion or extension, or worsening of overall outcome. In select infants with brachial plexus injuries but near-normal AMS scores for elbow flexion, surgical intervention may be indicated to achieve the best functional outcome. PMID:26806089

  11. Dose Constraints to Prevent Radiation-Induced Brachial Plexopathy in Patients Treated for Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: As the recommended radiation dose for non-small-cell lung cancer (NSCLC) increases, meeting dose constraints for critical structures like the brachial plexus becomes increasingly challenging, particularly for tumors in the superior sulcus. In this retrospective analysis, we compared dose-volume histogram information with the incidence of plexopathy to establish the maximum dose tolerated by the brachial plexus. Methods and Materials: We identified 90 patients with NSCLC treated with definitive chemoradiation from March 2007 through September 2010, who had received >55 Gy to the brachial plexus. We used a multiatlas segmentation method combined with deformable image registration to delineate the brachial plexus on the original planning CT scans and scored plexopathy according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median radiation dose to the brachial plexus was 70 Gy (range, 56–87.5 Gy; 1.5–2.5 Gy/fraction). At a median follow-up time of 14.0 months, 14 patients (16%) had brachial plexopathy (8 patients [9%] had Grade 1, and 6 patients [7%] had Grade ≥2); median time to symptom onset was 6.5 months (range, 1.4–37.4 months). On multivariate analysis, receipt of a median brachial plexus dose of >69 Gy (odds ratio [OR] 10.091; 95% confidence interval [CI], 1.512–67.331; p = 0.005), a maximum dose of >75 Gy to 2 cm3 of the brachial plexus (OR, 4.909; 95% CI, 0.966–24.952; p = 0.038), and the presence of plexopathy before irradiation (OR, 4.722; 95% CI, 1.267–17.606; p = 0.021) were independent predictors of brachial plexopathy. Conclusions: For lung cancers near the apical region, brachial plexopathy is a major concern for high-dose radiation therapy. We developed a computer-assisted image segmentation method that allows us to rapidly and consistently contour the brachial plexus and establish the dose limits to minimize the risk of brachial plexopathy. Our results could be used as a guideline in future

  12. Incidence of early posterior shoulder dislocation in brachial plexus birth palsy

    OpenAIRE

    Düppe Henrik; Backman Clas; Thornqvist Catharina; Andersson Charlotte; Erichs Kristina; Dahlin Lars B; Lindqvist Pelle; Forslund Marianne

    2007-01-01

    Abstract Background Posterior dislocation of the shoulder in brachial plexus birth palsy during the first year of life is rare but the incidence increases with age. The aim was to calculate the incidence of these lesions in children below one year of age. Methods The incidence of brachial plexus birth lesion and occurrence of posterior shoulder dislocation was calculated based on a prospective follow up of all brachial plexus patients at an age below one in Malmö municipality, Sweden, 2000–20...

  13. Dose Constraints to Prevent Radiation-Induced Brachial Plexopathy in Patients Treated for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Amini, Arya [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); University of California Irvine School of Medicine, Irvine, California (United States); Yang Jinzhong; Williamson, Ryan [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); McBurney, Michelle L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Erasmus, Jeremy [Department of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K.; Karhade, Mandar; Komaki, Ritsuko; Liao, Zhongxing; Gomez, Daniel; Cox, James [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Dong, Lei [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2012-03-01

    Purpose: As the recommended radiation dose for non-small-cell lung cancer (NSCLC) increases, meeting dose constraints for critical structures like the brachial plexus becomes increasingly challenging, particularly for tumors in the superior sulcus. In this retrospective analysis, we compared dose-volume histogram information with the incidence of plexopathy to establish the maximum dose tolerated by the brachial plexus. Methods and Materials: We identified 90 patients with NSCLC treated with definitive chemoradiation from March 2007 through September 2010, who had received >55 Gy to the brachial plexus. We used a multiatlas segmentation method combined with deformable image registration to delineate the brachial plexus on the original planning CT scans and scored plexopathy according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median radiation dose to the brachial plexus was 70 Gy (range, 56-87.5 Gy; 1.5-2.5 Gy/fraction). At a median follow-up time of 14.0 months, 14 patients (16%) had brachial plexopathy (8 patients [9%] had Grade 1, and 6 patients [7%] had Grade {>=}2); median time to symptom onset was 6.5 months (range, 1.4-37.4 months). On multivariate analysis, receipt of a median brachial plexus dose of >69 Gy (odds ratio [OR] 10.091; 95% confidence interval [CI], 1.512-67.331; p = 0.005), a maximum dose of >75 Gy to 2 cm{sup 3} of the brachial plexus (OR, 4.909; 95% CI, 0.966-24.952; p = 0.038), and the presence of plexopathy before irradiation (OR, 4.722; 95% CI, 1.267-17.606; p = 0.021) were independent predictors of brachial plexopathy. Conclusions: For lung cancers near the apical region, brachial plexopathy is a major concern for high-dose radiation therapy. We developed a computer-assisted image segmentation method that allows us to rapidly and consistently contour the brachial plexus and establish the dose limits to minimize the risk of brachial plexopathy. Our results could be used as a guideline in future prospective

  14. Avulsion of the brachial plexus in a great horned owl (Bubo virginaus)

    Science.gov (United States)

    Moore, M.P.; Stauber, E.; Thomas, N.J.

    1989-01-01

    Avulsion of the brachial plexus was documented in a Great Horned Owl (Bubo virginianus). A fractured scapula was also present. Cause of these injuries was not known but was thought to be due to trauma. Differentiation of musculoskeletal injury from peripheral nerve damage can be difficult in raptors. Use of electromyography and motor nerve conduction velocity was helpful in demonstrating peripheral nerve involvement. A brachial plexus avulsion was suspected on the basis of clinical signs, presence of electromyographic abnormalities in all muscles supplied by the nerves of the brachial plexus and absence of median-ulnar motor nerve conduction velocities.

  15. Schwannoma of the brachial plexus: cross-sectional imaging diagnosis using CT, sonography, and MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rettenbacher, Thomas; Soegner, Peter; Springer, Peter; Nedden, Dieter zur [Department of Radiology II, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Fiegl, Michael [Department of Internal Medicine, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria); Hussl, Heribert [Department of Plastic and Reconstructive Surgery, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck (Austria)

    2003-08-01

    Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed. (orig.)

  16. Schwannoma of the brachial plexus: cross-sectional imaging diagnosis using CT, sonography, and MR imaging

    International Nuclear Information System (INIS)

    Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed. (orig.)

  17. Distinction between neoplastic and radiation-induced brachial plexopathy, with emphasis on the role of EMG

    International Nuclear Information System (INIS)

    The results of clinical, radiologic, and electrophysiologic studies are retrospectively reviewed for 55 patients with neoplastic and 35 patients with radiation-induced brachial plexopathy. The presence or absence of pain as the presenting symptom, temporal profile of the illness, presence of a discrete mass on CT of the plexus, and presence of myokymic discharges on EMG contributed significantly to the prediction of the underlying cause of the brachial plexopathy. The distribution of weakness and the results of nerve conduction studies were of no help in distinguishing neoplastic from radiation-induced brachial plexopathy

  18. MRI of injuries of the lateral ankle ligaments

    International Nuclear Information System (INIS)

    The most frequent sport injury of the ankle is located in the lateral ankle ligaments. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and stress radiography, allowing a fair diagnosis for the daily routine. For the direct visualization and precise diagnosis of the lateral ankle ligaments MRI provides the best answer. MRI is used with controlled positioning of the foot, correct angulation of sequenzes, and distinct analysis of MR findings. Sinus tarsi ligaments and ligaments of the distal syndesmosis should be included to the report. In selected patients MRI allows the best evaluation of the extent of the lateral ankle ligaments. MRI is the method of choice for combined osteochondral injuries and soft tissue lesions too. (orig.)

  19. The ankle joint - value of different radiological examinations especially in external ligament injuries

    International Nuclear Information System (INIS)

    For a correct radiological positioning of the ankle joint the bimalleolar line is helpful as well for the A.P.-view as for the lateral view. For the examination of external ligament lacerations Radiography with functional test is not always sufficient. After critical comparison of functional radiographs, clinical symptoms and case history arthrography is necessary in certain cases to come to a final conclusion. Indications for arthrography are stated and explained. (orig.)

  20. Ankle Fracture Surgery on a Pregnant Patient Complicated by Intraoperative Emergency Caesarian Section

    OpenAIRE

    Allen Coopersmith; Ramesh Gidumal; Ran Schwarzkopf; Gross, Steven C.

    2013-01-01

    We report the case of a woman in the third trimester of pregnancy who sustained an ankle fracture dislocation that could not be adequately closed reduced. After discussions with the patient, her obstetrician, and the anesthesiologists, she was indicated for surgical fixation. A heart tone monitor was used to assess fetal health during the procedure. During surgical incision, the fetus went into distress, and an emergency caesarian section was performed. After delivery of the infant and abdomi...

  1. Neurinoma del plexo braquial simulando metastasis de adenocarcinoma de mama Schwannoma of the brachial plexus resembling a breast adenocarcinoma metastasis

    Directory of Open Access Journals (Sweden)

    Gregorio Rodríguez Boto

    2011-10-01

    function. Histological findings indicated a schwannoma thus ruling out the presence of metastasis. The postoperative development was uneventful and six years after surgery, the patient is to date tumour-free. To the best of our knowledge, this is the first report of a brachial plexus schwannoma arising from the ulnar branch. Intraoperative electrophysiological monitoring is essential for a good surgical outcome.

  2. Syndesmosis and lateral ankle sprains in the National Football League.

    Science.gov (United States)

    Osbahr, Daryl C; Drakos, Mark C; O'Loughlin, Padhraig F; Lyman, Stephen; Barnes, Ronnie P; Kennedy, John G; Warren, Russell F

    2013-11-01

    Syndesmosis sprains in the National Football League (NFL) can be a persistent source of disability, especially compared with lateral ankle injuries. This study evaluated syndesmosis and lateral ankle sprains in NFL players to allow for better identification and management of these injuries. Syndesmosis and lateral ankle sprains from a single NFL team database were reviewed over a 15-year period, and 32 NFL team physicians completed a questionnaire detailing their management approach. A comparative analysis was performed analyzing several variables, including diagnosis, treatment methods, and time lost from sports participation. Thirty-six syndesmosis and 53 lateral ankle sprains occurred in the cohort of NFL players. The injury mechanism typically resulted from direct impact in the syndesmosis and torsion in the lateral ankle sprain group (P=.034). All players were managed nonoperatively. The mean time lost from participation was 15.4 days in the syndesmosis and 6.5 days in the lateral ankle sprain groups (P⩽.001). National Football League team physicians varied treatment for syndesmosis sprains depending on the category of diastasis but recommended nonoperative management for lateral ankle sprains. Syndesmosis sprains in the NFL can be a source of significant disability compared with lateral ankle sprains. Successful return to play with nonoperative management is frequently achieved for syndesmosis and lateral ankle sprains depending on injury severity. With modern treatment algorithms for syndesmosis sprains, more aggressive nonoperative treatment is advocated. Although the current study shows that syndesmosis injuries require longer rehabilitation periods when compared with lateral ankle sprains, the time lost from participation may not be as prolonged as previously reported. PMID:24200441

  3. Comparing Arc-shaped Feet and Rigid Ankles with Flat Feet and Compliant Ankles for a Dynamic Walker

    DEFF Research Database (Denmark)

    Kuhlemann, Ilyas; Matthias Braun, Jan; Wörgötter, Florentin;

    2014-01-01

    In this paper we show that exchanging curved feet and rigid ankles by at feet and compliant ankles improves the range of gait parameters for a bipedal dynamic walker. The new lower legs were designed such that they t to the old set-up, allowing for a direct and quantitative comparison. The dynami...

  4. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  5. The foot and ankle of Australopithecus sediba.

    Science.gov (United States)

    Zipfel, Bernhard; DeSilva, Jeremy M; Kidd, Robert S; Carlson, Kristian J; Churchill, Steven E; Berger, Lee R

    2011-09-01

    A well-preserved and articulated partial foot and ankle of Australopithecus sediba, including an associated complete adult distal tibia, talus, and calcaneus, have been discovered at the Malapa site, South Africa, and reported in direct association with the female paratype Malapa Hominin 2. These fossils reveal a mosaic of primitive and derived features that are distinct from those seen in other hominins. The ankle (talocrural) joint is mostly humanlike in form and inferred function, and there is some evidence for a humanlike arch and Achilles tendon. However, Au. sediba is apelike in possessing a more gracile calcaneal body and a more robust medial malleolus than expected. These observations suggest, if present models of foot function are correct, that Au. sediba may have practiced a unique form of bipedalism and some degree of arboreality. Given the combination of features in the Au. sediba foot, as well as comparisons between Au. sediba and older hominins, homoplasy is implied in the acquisition of bipedal adaptations in the hominin foot. PMID:21903807

  6. Brachial plexus injury in adults: Diagnosis and surgical treatment strategies

    Directory of Open Access Journals (Sweden)

    Mukund R Thatte

    2013-01-01

    Full Text Available Adult post traumatic Brachial plexus injury is unfortunately a rather common injury in young adults. In India the most common scenario is of a young man injured in a motorcycle accident. Exact incidence figures are not available but of the injuries presenting to us about 90% invole the above combination This article reviews peer-reviewed publications including clinical papers, review articles and Meta analysis of the subject. In addition, the authors′ experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Results have been discussed and analysed to get an idea of factors influencing final recovery. It appears that time from injury and number of roots involved are most crucial.

  7. Temporal pattern of pulse wave velocity during brachial hyperemia reactivity

    International Nuclear Information System (INIS)

    Endothelial function can be assessed non-invasively with ultrasound, analyzing the change of brachial diameter in response to transient forearm ischemia. We propose a new technique based in the same principle, but analyzing a continuous recording of carotid-radial pulse wave velocity (PWV) instead of diameter. PWV was measured on 10 healthy subjects of 22±2 years before and after 5 minutes forearm occlusion. After 59 ± 31 seconds of cuff release PWV decreased 21 ± 9% compared to baseline, reestablishing the same after 533 ± 65 seconds. There were no significant changes observed in blood pressure. When repeating the study one hour later in 5 subjects, we obtained a coefficient of repeatability of 4.8%. In conclusion, through analysis of beat to beat carotid-radial PWV it was possible to characterize the temporal profiles and analyze the acute changes in response to a reactive hyperemia. The results show that the technique has a high sensitivity and repeatability.

  8. Temporal pattern of pulse wave velocity during brachial hyperemia reactivity

    Science.gov (United States)

    Graf, S.; Valero, M. J.; Craiem, D.; Torrado, J.; Farro, I.; Zócalo, Y.; Valls, G.; Bía, D.; Armentano, R. L.

    2011-09-01

    Endothelial function can be assessed non-invasively with ultrasound, analyzing the change of brachial diameter in response to transient forearm ischemia. We propose a new technique based in the same principle, but analyzing a continuous recording of carotid-radial pulse wave velocity (PWV) instead of diameter. PWV was measured on 10 healthy subjects of 22±2 years before and after 5 minutes forearm occlusion. After 59 ± 31 seconds of cuff release PWV decreased 21 ± 9% compared to baseline, reestablishing the same after 533 ± 65 seconds. There were no significant changes observed in blood pressure. When repeating the study one hour later in 5 subjects, we obtained a coefficient of repeatability of 4.8%. In conclusion, through analysis of beat to beat carotid-radial PWV it was possible to characterize the temporal profiles and analyze the acute changes in response to a reactive hyperemia. The results show that the technique has a high sensitivity and repeatability.

  9. Supraclavicular Brachial Plexus Block for Arteriovenous Hemodialysis Access Procedures.

    Science.gov (United States)

    Hull, Jeffrey; Heath, Jean; Bishop, Wendy

    2016-05-01

    Ultrasound-guided supraclavicular brachial plexus block using 1% and 2% lidocaine in 21 procedures is reported. Average procedure time was 5.1 minutes (± 1.2 min; range, 2-8 min). Average time of onset and duration were 4.8 minutes (± 3.7 min; range, 0-10 min) and 77.9 minutes (± 26.7 min; range, 44-133 min), respectively, for sensory block and 8.4 minutes (± 5.7 min; range, 3-23 min) and 99 minutes (± 40.5 min; range, 45-171 min), respectively, for motor block. The pain scale assessment averaged 0.4 (± 1.1; range, 0-4). There were no complications. PMID:27106648

  10. Iatogenic pseudoaneurysm of the brachial artery in a child

    International Nuclear Information System (INIS)

    Arterial aneurysms are rarely encountered in children. When they are, the existence of an underlying disease or a history of previous infection or trauma should be suspected since the majority them are acquired. Pseudo aneurysms or false aneurysms are a consequence of the rupture of the arterial wall after accidental injury or a iatrogenic lesion. We present a case of a pseudoaneurysm of the brachial artery secondary to repeated attempts at venipuncture in a 3-month-old infant. We show the plain radiography and duplex Doppler color Doppler ultrasound findings which, in the clinical context of the patient, were sufficient for diagnosis, making it unnecessary to perform arteriography prior to surgical treatment. (Author) 9 refs

  11. Restoration and protection of brachial plexus injur y:hot topics in the last decade

    Institute of Scientific and Technical Information of China (English)

    Kaizhi Zhang; Zheng Lv; Jun Liu; He Zhu; Rui Li

    2014-01-01

    Brachial plexus injury is frequently induced by injuries, accidents or birth trauma. Upper limb function may be partially or totally lost after injury, or left permanently disabled. With the de-velopment of various medical technologies, different types of interventions are used, but their effectiveness is wide ranging. Many repair methods have phasic characteristics, i.e., repairs are done in different phases. This study explored research progress and hot topic methods for pro-tection after brachial plexus injury, by analyzing 1,797 articles concerning the repair of brachial plexus injuries, published between 2004 and 2013 and indexed by the Science Citation Index database. Results revealed that there are many methods used to repair brachial plexus injury, and their effects are varied. Intervention methods include nerve transfer surgery, electrical stimula-tion, cell transplantation, neurotrophic factor therapy and drug treatment. Therapeutic methods in this ifeld change according to the hot topic of research.

  12. Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2011-04-01

    We sought to compare the incidence and antecedents of neonatal brachial plexus injury (BPI) in 2 different 5-year epochs a decade apart following the introduction of specific staff training in the management of shoulder dystocia.

  13. MRI of the brachial plexus and its region: anatomy and pathology

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) of the brachial plexus and its region has become the imaging modality of choice, due to its multiplanar capabilities and inherent contrast differences between the brachial plexus, related vessels, and surrounding fat. A total of 41 patients with clinically suspected brachial plexus pathology or tumors in its region were studied. A normal anatomy was found in 12 patients. Pathologic entities included: traumatic nerve-root avulsion (n = 2), hematoma (n = 1), postoperative changes after scalenotomy (n = 2), primary tumor of the brachial plexus (n = 2), primary (n = 8) and metastatic (n = 1) tumors in the superior sulcus, primary (n = 5) and metastatic (n = 4) tumors in the axillary, supra- or infraclavicular region, and changes after nodal dissection and radiation therapy for breast carcinoma (n = 5; 1 patient also had had a prior scalenotomy). There was a positive correlation with surgery in 11 patients, and a negative correlation in 1 patient. (orig.)

  14. MRI of the brachial plexus and its region: anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Wouter van Es, H. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Witkamp, T.D. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Feldberg, M.A.M. [Dept. of Radiology, University Hospital, Utrecht (Netherlands)

    1995-08-01

    Magnetic resonance imaging (MRI) of the brachial plexus and its region has become the imaging modality of choice, due to its multiplanar capabilities and inherent contrast differences between the brachial plexus, related vessels, and surrounding fat. A total of 41 patients with clinically suspected brachial plexus pathology or tumors in its region were studied. A normal anatomy was found in 12 patients. Pathologic entities included: traumatic nerve-root avulsion (n = 2), hematoma (n = 1), postoperative changes after scalenotomy (n = 2), primary tumor of the brachial plexus (n = 2), primary (n = 8) and metastatic (n = 1) tumors in the superior sulcus, primary (n = 5) and metastatic (n = 4) tumors in the axillary, supra- or infraclavicular region, and changes after nodal dissection and radiation therapy for breast carcinoma (n = 5; 1 patient also had had a prior scalenotomy). There was a positive correlation with surgery in 11 patients, and a negative correlation in 1 patient. (orig.)

  15. Combination of Interscalene Brachial and Superficial Cervical Plexus Block for Fracture Clavicle Surgery

    OpenAIRE

    Anirban Pal; Nidhi Dawar; Rajarsree Biswas; Chaitali Biswas

    2011-01-01

    We report a case of interscalene brachial plexus block supplemented with superficial cervical plexus block in a patient with dilated cardiomyopathy with ejection fraction of 24% scheduled for surgery of fracture mid-shaft of clavicle.

  16. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia

    International Nuclear Information System (INIS)

    Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication

  17. Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report.

    Science.gov (United States)

    Seo, Yu Jung; Lee, Yu Jin; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

    2014-08-01

    Brachial plexus neuritis is reportedly caused by various factors; however, it has not been described in association with Streptococcus agalactiae. This is a case report of a patient diagnosed with brachial plexus neuritis associated with pyogenic arthritis of the shoulder. A 57-year-old man visited the hospital complaining of sudden weakness and painful swelling of the left arm. The diagnosis was pyogenic arthritis of the left shoulder, and the patient was treated with open irrigation and debridement accompanied by intravenous antibiotic therapy. S. agalactiae was isolated from a wound culture, and an electrodiagnostic study showed brachial plexopathy involving the left upper and middle trunk. Nine weeks after onset, muscle strength improved in most of the affected muscles, and an electrodiagnostic study showed signs of reinnervation. In conclusion, S. agalactiae infection can lead to various complications including brachial plexus neuritis. PMID:25229037

  18. Upright MRI of glenohumeral dysplasia following obstetric brachial plexus injury.

    Science.gov (United States)

    Nath, Rahul K; Paizi, Melia; Melcher, Sonya E; Farina, Kim L

    2007-11-01

    The purpose of this study was to evaluate the role of upright magnetic resonance imaging (MRI) shoulder scanning in the diagnosis of glenohumeral deformity following obstetric brachial plexus injury (OBPI). Eighty-nine children (ages 0.4 to 17.9 years) with OBPI who have medial rotation contracture and reduced passive and active lateral rotation of the shoulder were evaluated via upright MRI of the affected glenohumeral joint. Qualitative impressions of glenoid form were recorded, and quantitative measurements were made of glenoid version and posterior subluxation. Glenoid version of the affected shoulder averaged -16.8 +/- 11.0 degrees (range, -55 degrees to 1 degrees ), and percentage of the humeral head anterior to the glenoid fossa (PHHA) averaged 32.6 +/- 16.5% (range, -17.8% to 52.4%). The glenoid form was normal in 43 children, convex in 19 children and biconcave in 27 children. Standard MRI protocols were used to obtain bilateral images from 14 of these patients. Among the patients with bilateral MR images, glenoid version and PHHA were significantly different between the involved and uninvolved shoulders (P<.000). Glenoid version in the involved shoulder averaged -19.0 +/- 13.1 degrees (range, -52 degrees to -3 degrees ), and PHHA averaged 29.7 +/- 18.4% (range, -16.2% to 48.7%). In the uninvolved shoulder, the average glenoid version and PHHA were -5.2 +/- 3.7 degrees (range, -12 degrees to -1 degrees ) and 47.7 +/- 3.0% (range, 43% to 54%), respectively. The relative beneficial aspects of upright MRI include lack of need for sedation, low claustrophobic potential and, most important, natural, gravity-influenced position, enabling the surgeon to visualize the true preoperative picture of the shoulder. It is an effective tool for demonstrating glenohumeral abnormalities resulting from brachial plexus injury worthy of surgical exploration. PMID:17448618

  19. Radiation-induced brachial plexus neuropathy in breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, N.K.; Pfeiffer, P.; Mondrup, K.; Rose, C. (Odense Univ. Hospital (Denmark). Dept. of Neurology Odense Univ. Hospital (Denmark). Dept. of Clinical Neurophysiology Odense Univ. Hospital (Denmark). Dept. of Oncology R)

    1990-01-01

    The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy for antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-35%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy. (orig.).

  20. Radiation-induced brachial plexus neuropathy in breast cancer patients

    International Nuclear Information System (INIS)

    The incidence and latency period of radiation-induced brachial plexopathy (RBP) were assessed in 79 breast cancer patients by a neurological follow-up examination at least 60 months (range 67-130 months) after the primary treatment. All patients were treated primarily with simple mastectomy, axillary nodal sampling and radiotherapy (RT). Postoperatively, pre- and postmenopausal patients were randomly allocated chemotherapy for antiestrogen treatment. All patients were recurrence-free at time of examination. Clinically, 35% (25-47%) of the patients had RBP; 19% (11-29%) had definite RBP, i.e. were physically disabled, and 16% (9-26%) had probable RBP. Fifty percent (31-69%) had affection of the entire plexus, 18% (7-35%) of the upper trunk only, and 4% (1-18%) of the lower trunk. In 28% (14-48%) of cases assessment of a definite level was not possible. RBP was more common after radiotherapy and chemotherapy (42%) than after radiotherapy alone (26%) but the difference was not statistically significant (p = 0.10). The incidence of definite RBP was significantly higher in the younger age group (p = 0.02). This could be due to more extensive axillary surgery but also to the fact that chemotherapy was given to most premenopausal patients. In most patients with RBP the symptoms began during or immediately after radiotherapy, and were thus without significant latency. Chemotherapy might enhance the radiation-induced effect on nerve tissue, thus diminishing the latency period. Lymphedema was present in 22% (14-32%), especially in the older patients, and not associated with the development of RBP. In conclusion, the damaging effect of RT on peripheral nerve tissue was documented. Since no successful treatment is available, restricted use of RT to the brachial plexus is warranted, especially when administered concomitantly with cytotoxic therapy. (orig.)