WorldWideScience

Sample records for avulsions

  1. Complete Ureteral Avulsion

    Directory of Open Access Journals (Sweden)

    V. Gupta

    2005-01-01

    Full Text Available Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

  2. Nasal avulsion injuries.

    Science.gov (United States)

    Denneny, J C

    1987-11-01

    The nose is the most frequently traumatized portion of the human face. High-speed motor vehicle accidents and interpersonal violence commonly produce bony pyramid and septal damage and occasional minor soft-tissue damage. Major soft-tissue injuries are much less commonly encountered. Avulsion injuries of this type may involve skin only or the bony and cartilaginous framework as well. The severity of these injuries can range from total avulsion to minor skin loss and anywhere within the spectrum between. My experience is reviewed, management guidelines and options are detailed, and selected cases are presented.

  3. Nonoperatively treated infraglenoid tubercle avulsion

    Directory of Open Access Journals (Sweden)

    Renjit Issac

    2014-10-01

    Full Text Available 【Abstract】Infraglenoid tubercle avulsion fractures are extremely rare injuries. We report a 38-year-old male with glenoid cavity fracture and infraglenoid tubercle avulsion of the left shoulder following a fall from bike. He refused surgery and was treated nonoperatively. Follow-up radiography and CT at 18 months revealed a malunited infraglenoid tubercle with signs of early glenohumeral osteoarthritis. He did not have shoulder instability or pain and had a fair-good functional outcome. There are no previously published data on the anatomic outcome of nonoperatively treated displaced infraglenoid tubercle avulsion fractures based on CT. Key words: Tomography, X-ray computed; Infraglenoid tubercle; Avulsion

  4. Delayed replantation of avulsed teeth

    Directory of Open Access Journals (Sweden)

    Adil N

    2007-05-01

    Full Text Available Dental injuries are very common and their extent has been classified by Ellis. Avulsion of tooth is a grievous injury and ranges from 1-16% among the traumatic injuries, of which maxillary anterior are commonest. Reimplantation of avulsed teeth is a standard procedure. However, it has certain limitations. Most often their management is very challenging. In this case report we are presenting the management of maxillary incisors by replantation after 36 hrs in a 12 year old girl.

  5. Avulsion fractures of the scapula

    International Nuclear Information System (INIS)

    Heyse-Moore, G.H.; Stoker, D.J.

    1982-01-01

    Fractures of the scapula due to direct violence are relatively common. Wilber and Evans [18] reported 40 scapular fractures and reviewed the literature. All those injured has received direct trauma to the shoulder and they were able to divide their cases into two groups, based on anatomical location and functional results. Scapular fractures due to avulsion of the muscular attachments are uncommon and, as reports of these injuries in the literature are usually confined to single cases, no classification has been established which takes account of the anatomical sites at which these fractures occur and the mechanism of injury involved. In this paper the more common sites of avulsion injury of the scapula are described and illustrated by case reports. In several of these the skeletal injury resulted from muscle contraction against a resisted force on the upper limb during the course of an accident. This mechanism has been implicated in fractures of the coracoid and acromion, but is shown in this paper to contribute to other avulsion fractures. (orig.)

  6. Avulsion fractures of the scapula

    Energy Technology Data Exchange (ETDEWEB)

    Heyse-Moore, G.H.; Stoker, D.J.

    1982-11-01

    Fractures of the scapula due to direct violence are relatively common. Wilber and Evans (18) reported 40 scapular fractures and reviewed the literature. All those injured has received direct trauma to the shoulder and they were able to divide their cases into two groups, based on anatomical location and functional results. Scapular fractures due to avulsion of the muscular attachments are uncommon and, as reports of these injuries in the literature are usually confined to single cases, no classification has been established which takes account of the anatomical sites at which these fractures occur and the mechanism of injury involved. In this paper the more common sites of avulsion injury of the scapula are described and illustrated by case reports. In several of these the skeletal injury resulted from muscle contraction against a resisted force on the upper limb during the course of an accident. This mechanism has been implicated in fractures of the coracoid and acromion, but is shown in this paper to contribute to other avulsion fractures.

  7. First-Aid Algorithms in Dental Avulsion

    Science.gov (United States)

    Baginska, Joanna; Wilczynska-Borawska, Magdalena

    2012-01-01

    Almost one fourth of traumatic dental injuries occur at schools or in their surroundings. Prevalence of tooth avulsion varies from 0.5% to 16% of all cases of dental trauma. Children with dental avulsion may seek help from school nurses so they should be able to provide first-aid treatment. However, many studies showed that the general level of…

  8. Replantation of ring avulsion amputations

    Directory of Open Access Journals (Sweden)

    Sabapathy R

    2003-01-01

    Full Text Available Replantation of ring avulsion injuries is a challenge because of the long segment damage to the vessels and intrinsic damage caused to soft tissues at the proximal edge of the amputation. Eight patients with total ring avulsion amputations underwent microsurgical replantation in the period 1994 to 2002. Arterial repair was done by direct vessel suture in three patients, interposition vein grafts in two and cross anastomosis of the digital arteries in three patients. Venous anastomosis was carried out by mobilization and direct suture in seven patients and vessel transfer from the adjacent finger in one patient. Seven of the eight replantations were successful, while one patient had a partial failure. At a minimum follow-up of one year, these patients showed good functional and cosmetic recovery. All successful patients were happy with the outcome and none have requested for amputation, even those whose results were not functionally adequate. However, in addition to technical factors, it is important to evaluate the patient's motivation to undergo not only the long surgery, but also multiple secondary procedures and regular supervised physiotherapy. We also describe a simple method which prevents the soft tissues inside the degloved digit from becoming wrapped around the K wire during bony fixation, thus making one step of this technically challenging procedure a little easier.

  9. Optic Nerve Avulsion after Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Hacı Halil Karabulut

    2014-05-01

    Full Text Available Optic nerve avulsion is an uncommon presentation of ocular trauma with a poor prognosis. It can be seen as complete or partial form due to the form of trauma. We assessed the complete optic nerve avulsion in a 16-year-old female patient complaining of loss of vision in her left eye after a traffic accident. (Turk J Ophthalmol 2014; 44: 249-51

  10. Ureteral avulsion as a complication of ureteroscopy

    Directory of Open Access Journals (Sweden)

    J.M. Alapont

    2003-02-01

    Full Text Available PURPOSE: Report and review the literature on ureteral avulsion as a rare complication of ureteroscopy. MATERIALS AND METHODS: We analyzed 3 cases of ureteral avulsion in a series of 4,645 ureteroscopic procedures performed from January 1990 to December 2001. We especially report the different managements for this complication. RESULTS: Due to the different extent of the injury, each patient was treated in a particular way, including a patient managed by means of an endourological approach. CONCLUSIONS: When performing ureteroscopy or using Dormia baskets, one should always bear in mind the possibility of serious complications, including ureteral avulsion or perforation. The use of an extremely careful technique of ureteral insertion, the mandatory placement of a safety guidewire, and a working guidewire, all minimize the risk of untoward events.

  11. Ring Avulsion Injuries: A Systematic Review.

    Science.gov (United States)

    Bamba, Ravinder; Malhotra, Gautam; Bueno, Reuben A; Thayer, Wesley P; Shack, R Bruce

    2018-01-01

    Ring avulsion injuries can range from soft tissue injury to complete amputation. Grading systems have been developed to guide treatment, but there is controversy with high-grade injuries. Traditionally, advanced ring injuries have been treated with completion amputation, but there is evidence that severe ring injuries can be salvaged. The purpose of this systematic review was to pool the current published data on ring injuries. A systematic review of the English literature published from 1980 to 2015 in PubMed and MEDLINE databases was conducted to identify patients who underwent treatment for ring avulsion injuries. Twenty studies of ring avulsion injuries met the inclusion criteria. There were a total of 572 patients reported with ring avulsion injuries. The Urbaniak class breakdown was class I (54 patients), class II (204 patients), and class III (314 patients). The average total arc of motion (TAM) for patients with a class I injury was 201.25 (n = 40). The average 2-point discrimination was 5.6 (n = 10). The average TAM for patients with a class II injury undergoing microsurgical revascularization was 187.0 (n = 114), and the average 2-point discrimination was 8.3 (n = 40). The average TAM for patients with a class III injury undergoing microsurgical revascularization was 168.2 (n = 170), and the average 2-point discrimination was 10.5 (n = 97). Ring avulsion injuries are commonly classified with the Urbaniak class system. Outcomes are superior for class I and II injuries, and there are select class III injuries that can be treated with replantation. Shared decision making with patients is imperative to determine whether replantation is appropriate.

  12. Myelography for nerve root avulsion in birth palsy

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro (Osaka Univ. (Japan). Faculty of Medicine)

    1990-04-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.).

  13. Myelography for nerve root avulsion in birth palsy

    International Nuclear Information System (INIS)

    Hashimoto, Tsutomu; Mitomo, Masanori; Hirabuki, Norio; Miura, Takashi; Kawai, Ryuji; Imakita, Satoshi; Harada, Koshi; Nakamura, Hironobu; Kozuka, Takahiro

    1990-01-01

    Myelography and CT myelography (CMT) were reviewed in 18 cases of birth palsy with clinically suspected avulsion injury. Root-somatosensory evoked potential (root-SEP) was also reviewed for myelographic evaluation of the nerve root avolusion in birth palsy. Root-SEP is not induced in case of avulsed nerve roots, but is induced in case of both normal and incompletely avulsed roots. Myelography demonstrated 58 abnormal nerve roots in 18 cases (19 limbs); 45 (78%) complete and 13 (22%) incomplete nerve root avulsions. Each of complete and incomplete avulsions was defined as total absence and partial presence of rootlets on myelography, respectively. Traumatic meningoceles were detected at 46 roots (79%) on myelography and/or CTM; 35 roots on myelography and 45 roots on CTM. CTM could not detect only a very small meningocele at one root. At 11 roots CTM was superior to myelography in delineating a meningocele because CTM is sensitive to a poorly enhanced meningocele. CTM, however, could not diagnose nerve root avulsions so accurately as myelography, since myelography detected 12 (7 completely and 5 incompletely) avulsed roots without meningocele, whereas CTM could not delineate the nerve roots clearly. Thus, myelography is indispensable to evaluate nerve root avulsions without meningocele. Root-SEP was examined in 9 patients who underwent branchial plexus exploration. SEP was negative at 22/25 roots with complete avulsion and was positive at 7/7 roots with myelographically incomplete avulsion, regardless of presence or absence of any traumatic meningocele. Myelography and root-SEP correlated well at 29 (92%) out of 32 roots in evaluating complete and incomplete avulsion injuries. Myelography and root-SEP were not considered in 3 roots. Though myelography demonstrated complete avulsions with traumatic meningocele, SEP was positive in these three roots, which were interpreted as partially avulsed roots. (J.P.N.)

  14. Traumatic avulsion of extraocular muscles: case reports

    Directory of Open Access Journals (Sweden)

    Nilza Minguini

    2013-04-01

    Full Text Available We described the clinical, surgical details and results (motor and sensory of the retrieving procedure of traumatically avulsed muscles in three patients with no previous history of strabismus or diplopia seen in the Department of Ophthalmology, State University of Campinas, Brazil. The slipped muscle portion was reinserted at the original insertion and under the remaining stump, which was sutured over the reinserted muscle. For all three cases there was recovery of single binocular vision and stereopsis.

  15. [Avulsion of the Proximal Hamstring Insertion. Case Reports].

    Science.gov (United States)

    Mizera, R; Harcuba, R; Kratochvíl, J

    2016-01-01

    Proximal hamstring avulsion is an uncommon muscle injury with a lack of consensus on indications and the timing and technique of surgery. Poor clinical symptoms and difficulties in the diagnostic process can lead to a false diagnosis. The authors present three cases of proximal hamstring avulsion, two complete and one partial ruptures of the biceps femoris muscle. MRI and ultrasound scans were used for optimal treatment alignment. Acute surgery reconstruction (hamstring strength. Two interesting systematic reviews published on the treatment of proximal hamstring avulsion are discussed in the final part of the paper. Key words: hamstring, rupture, avulsion.

  16. Reimplantation of avulsed dry permanent teeth after three days: A ...

    African Journals Online (AJOL)

    2011-03-03

    Mar 3, 2011 ... Avulsion is a traumatic injury which results in loss of the tooth from the alveolus, while reimplantation is the technique of reinserting an avulsed tooth into the alveolus or tooth socket after its loss.[1,2,3,4] The success of reimplantation depends on many factors[5,6,7] among which are the time lapse before ...

  17. Avulsion fracture of the tibial tubercle associated with patellar ...

    African Journals Online (AJOL)

    We present a case of combined avulsion fracture of the tibial tubercle (AFTT) and avulsion of the patellar ligament in a 15-year-old boy. This injury was treated by open reduction and fixation of both lesions using staples with satisfactory results. This constellation of injury is rare but a high index of suspicion is needed when ...

  18. Case Report:Triceps Tendon Avulsion: A Rare Injury | Sharma ...

    African Journals Online (AJOL)

    Background: Triceps tendon avulsion is one of the rare tendinous injuries. Such injuries can easily be missed, and should be kept as a differential diagnosis in all patients who present with pain and swelling at the back of the elbow after a traumatic event. Case Details: We present a case of triceps tendon avulsion which ...

  19. Calcaneal insufficiency avulsion fractures in diabetic patients

    International Nuclear Information System (INIS)

    Kathol, M.H.; El-Khoury, G.Y.; Moore, T.E.; Marsh, J.L.

    1990-01-01

    This paper presents a calcaneal fracture pattern that appears to be unique to diabetic patients. Radiographs and clinical records of 58 patients with calcaneal fractures were evaluated, 18 were diabetic and 40 nondiabetic. All 18 diabetic patients were insulin dependent and had clinically evident peripheral neuropathy. Thirteen had juvenile-onset diabetes. The average time from the diagnosis of diabetes mellitus to insufficiency fracture was 21 years. Sixteen of the diabetic patients had no history of significant trauma, and 13 of them had insufficiency avulsion fractures limited to the posterior third of the calcaneus

  20. Tricuspid valve avulsion after blunt chest trauma.

    Science.gov (United States)

    Mehrotra, Deepak; Dalley, Paul; Mahon, Barry

    2012-01-01

    Blunt cardiac trauma causing tricuspid regurgitation is rare and is most often associated with traffic accidents. Falling from a height can also cause such injuries, resulting in hemodynamic compromise and arrhythmias. The signs of traumatic tricuspid regurgitation can appear early or be delayed, depending upon the severity of injury. We present the case of a 68-year-old woman who fell from a height onto rocks during a hike. She sustained blunt cardiac injury with complete tricuspid valve avulsion, and underwent successful repair. In addition, we review the relevant medical literature.

  1. Upstream and downstream controls of recent avulsions on the Taquari megafan, Pantanal, south-western Brazil

    NARCIS (Netherlands)

    Makaske, B.; Maathuis, B.H.P.; Padovani, C.R.; Stolker, C.; Mosselman, E.; Jongman, R.H.G.

    2012-01-01

    Avulsion, the natural relocation of a river, is a key process in the evolution of subaerial fans, river floodplains and deltas. The causes of avulsion are poorly understood, which is partly due to the scarcity of field studies of present avulsions. At present, two avulsions are occurring on the

  2. Treatment of avulsed teeth with Emdogain--a case report.

    Science.gov (United States)

    Caglar, Esber; Tanboga, Ilknur; Süsal, Seckin

    2005-02-01

    The present case report describes the reimplantation of avulsed teeth with the treatment of Emdogain. Case was avulsed right maxillary permanent central and lateral incisor in a 9-year-old girl suffering from a traumatic injury. After pretreatment of avulsed teeth, Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. Evaluation parameters included horizontal and vertical percussion sound and periapical radiographs. At 1-2-6-12-month follow-up period, the clinical and radiographic appearance of the teeth showed resolution of mobility and no signs of replacement resorbption.

  3. Storage Media For Avulsed Teeth: A Literature Review

    OpenAIRE

    Poi, Wilson Roberto; Sonoda, Celso Koogi; Martins, Christine Men; Melo, Moriel Evangelista; Pellizzer, Eduardo Pizza; Mendonça, Marcos Rogério de; Panzarini, Sônia Regina

    2013-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may con...

  4. Storage media for avulsed teeth: a literature review

    OpenAIRE

    Poi, Wilson Roberto [UNESP; Sonoda, Celso Koogi [UNESP; Men-Martins, Christine [UNESP; Melo, Moriel Evangelista [UNESP; Panzarini, Sônia Regina [UNESP

    2013-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries because it causes damageto several structures and results in the complete displacement of the tooth from its socketin the alveolar bone. The ideal situation is to replant an exarticulated tooth immediatelyafter avulsion because the extraoral time is a determinant factor for treatment successand for a good prognosis. However, it is not always possible. The success of replantationdepends on a number of factors that may contribu...

  5. Construction of avulsion potential zone model for Kulik River of Barind Tract, India and Bangladesh.

    Science.gov (United States)

    Sarkar, Debabrata; Pal, Swades

    2018-04-21

    Avulsion is a natural fluvial process but considered it as a hazard in the populated region due to the chance of immense failure of lives and properties. So, early warning indicates that the zone of avulsion can facilitate the people living there. About 317 numbers of local and regional historical imprints of channel cutoff along river Kulik claim the need of this work. The present study tried to identify avulsion potential zone (APZ) of Kulik river of Indo-Bangladesh using multi-parametric weighted combination approach. Analytic hierarchy approach (AHP) is applied for weighting the used parameters. Avulsion potential model clearly exhibits that 9.51-km stream segment of middle and lower catchment is highly susceptible for avulsion especially during sudden high discharge and earthquake incidents. There is also high chance of channel avulsion following the existing Paleo-avulsion courses and left channels. Hard points can also be erected alongside the main channel for resisting channel avulsion propensity.

  6. Human impact and avulsion: a long-standing relationship

    Science.gov (United States)

    Heyvaert, Vanessa M. A.; Walstra, Jan

    2015-04-01

    This study demonstrates that avulsions in Upper and Lower Khuzestan (Iran) are the result of interplay between human-induced and natural causes. The importance of human interference during all stages of river avulsion and the long-term consequences for alluvial fan development is proven. Avulsion can be defined as the diversion of flow from an existing channel onto the floodplain (or the fan surface), eventually resulting in a new channel belt (Allen, 1965). It represents the response of a river system to a wide range of autogenic factors, such as river meandering and vertical accretion, and allogenic controls, such as tectonics, climate change and sea-level change (Jones & Schumm, 1999). The framework used in this study is based on concepts introduced by Slingerland & Smith (2004), regarding avulsion style (i.e. through annexation, progradation or incision), and Makaske (2012), regarding the different phases in the process leading to avulsion (i.e. preconditioning, triggering and post-triggering)on megafans. This study primarily focusses on actions that directly affect river hydraulics, such as the construction and maintenance of dams, embankments, irrigation and diversion canals, the destruction of dams, channel modifications, etc. For several avulsion events, style and controlling factors are examined, and the ways by which human activities have interfered with the natural processes are highlighted. All case-studies are based on an integrated analysis of historical, archaeological, geomorphological and geological datasets. References: Allen, J.R.L., 1965. A review of the origin and characteristics of recent alluvial sediments. Sedimentology, 5, 89-91. Jones, L.S. & Schumm, S.A., 1999. Causes of avulsion: an overview, In: Smith, N.D. & Rogers, J. (Eds.), Fluvial Sedimentology VI, Blackwell Science, Oxford, UK, 171-178. Makaske, B., Maathuis, B.H.P., Padovani, C.R., Stolker, C., Mosselman, E. & Jongman, R.H.G., 2012. Upstream and downstream controls of recent

  7. Management of avulsed permanent maxillary central incisors during endotracheal intubation

    Directory of Open Access Journals (Sweden)

    Ritesh R Kalaskar

    2016-01-01

    Full Text Available Avulsion is serious injury that may encounter during endotracheal intubation and its management often presents a challenge. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. The present article describes the management of air-dried maxillary permanent incisors that have been avulsed due to direct laryngoscopy during the induction of general anesthesia for tonsillectomy procedure. The replanted maxillary central incisors had maintained its function and esthetic for 1 year after replantation. Children in a mixed dentition phase are high-risk group children for traumatic dental injury during laryngoscopy; therefore, Anesthetic Departments should have local protocols to refer patients for dental treatment postoperatively in the event of trauma.

  8. Avulsion and replantation of a primary incisor tooth.

    Science.gov (United States)

    Friedlander, Lara T; Chandler, Nicholas P; Drummond, Bernadette K

    2013-12-01

    Avulsion of a primary tooth is a serious dental trauma, and the guidelines of the International Association of Dental Traumatology and textbooks in paediatric dentistry do not recommend replantation. Such management can result in severe damage to the supporting structures, and together with avulsion itself is commonly associated with developmental disturbances of the permanent tooth. We report the case of replantation in a 9-month-old child with a successful outcome, in a unique situation where conditions were optimal and careful long-term follow up was possible. © 2012 John Wiley & Sons A/S.

  9. Sequential bilateral lesser trochanter avulsion fractures in an adolescent patient

    Science.gov (United States)

    Obi, Nnamdi Jonathan; Allman, Claire; Moore-Thompson, Elizabeth; Latimer, Mark David

    2014-01-01

    We report the rare case of a 15-year-old boy who sustained sequential bilateral lesser trochanter avulsion fractures over a 6-month period while playing football. No malignancy or associated metabolic bone disease was found. He subsequently made a full recovery with non-operative treatment. PMID:25422350

  10. Repair of gluteus medius muscle avulsion following transgluteal hip replacement

    NARCIS (Netherlands)

    Groot, Diederik; van Ooij, Andre; Haverkamp, Daniel; Morrenhof, Wim

    2011-01-01

    During a transgluteal approach to the hip joint the anterior part of the gluteus medius and minimus muscles are detached and subsequently reattached to the greater trochanter. Avulsion or rupture of these muscles may result in weak abduction, pain and/or instability. 15 patients with these symptoms

  11. Proximal Rectus Femoris Avulsion: Ultrasonic Diagnosis and Nonoperative Management.

    Science.gov (United States)

    Esser, Stephan; Jantz, David; Hurdle, Mark F; Taylor, Walter

    2015-07-01

    To present a case of ultrasonic diagnosis and nonoperative management of a complete proximal rectus femoris avulsion in a National Collegiate Athletic Association Division 1 soccer goalkeeper. While delivering a goal kick, a previously uninjured 24-year-old collegiate soccer goalkeeper had the sudden onset of right anterior thigh pain. He underwent rehabilitation with rapid resolution of his presenting pain but frequent intermittent recurrence of anterior thigh pain. After he was provided a definitive diagnosis with musculoskeletal ultrasound, he underwent an extended period of rehabilitation and eventually experienced complete recovery without recurrence. Rectus femoris avulsion, rectus femoris strain or partial tear, inguinal hernia, or acetabular labral tear. Operative and nonoperative options were discussed. In view of the player's recovery, nonoperative options were pursued with a good result. Complete proximal rectus femoris avulsions are rare. Our case contributes to the debate on whether elite-level kicking and running athletes can return to full on-field performance without surgery. Complete proximal rectus femoris avulsions can be treated effectively using nonoperative measures with good preservation of function even in the elite-level athlete. In addition, musculoskeletal ultrasound is an excellent tool for on-site evaluation and may help guide prognosis and management.

  12. Perineal anterior dislocation of the hip with avulsion fracture of ...

    African Journals Online (AJOL)

    Traumatic anterior dislocation of the hip is rare even in children. Very uncommon also is the perineal variant of the inferior type of anterior dislocation with concomitant avulsion fracture of the greater trochanter. We report such a case highlighting the peculiarity of its management. No similar case of triumvirate injury of the hip ...

  13. Replantation of avulsed primary teeth: a systematic review.

    Science.gov (United States)

    Martins-Júnior, Paulo Antônio; Franco, Felipe Augusto da Silva; de Barcelos, Ramon Valério; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia

    2014-03-01

    There is little evidence regarding the risks and benefits of replantation of avulsed primary teeth. The aim of this study was to perform a systematic review of the literature on the replantation of avulsed primary teeth, analysing the risks and benefits to help guide dentists regarding the best clinical decision-making in such cases. The Medline/Pubmed, LILACS, and SciELO databases were searched for articles published in English, Portuguese, German or Spanish on the replantation of avulsed primary teeth in dental journals dating from the inception of the databases through to May 2013. Among the 891 papers identified in the search, nineteen fulfilled the inclusion criteria. All 19 studies were case reports involving a total of 41 replanted primary teeth. No negative consequences to either the primary tooth or permanent successor were observed in 15 cases. Among the other 26 cases, there were negative consequences to only the replanted primary tooth in 16 cases, only the permanent successor in three cases and both the replanted primary tooth and permanent successor in seven cases. There is a lack of high-quality studies that can help guide clinicians regarding the best approach in cases of primary tooth avulsion. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Avulsion Fracture of the Calcaneal Tuberosity: Classification and Its Characteristics

    Science.gov (United States)

    Lee, Sang-Myung; Huh, Sung-Woo; Chung, Jin-Wha; Kim, Dong-Wook; Kim, Youn-Jun

    2012-01-01

    Background Not much is known regarding avulsion fractures of the calcaneal tuberosity. We propose a modified classification scheme that presents the four types of calcaneal avulsion fracture as described by surgical and magnetic resonance imaging (MRI) findings, and evaluation of their specific features. Methods Out of 764 cases of calcaneal fractures, we examined 20 cases (2.6%) that involved the tuberosity of the calcaneus. Each case was classified depending on the avulsed fracture patterns as follows; type I is a 'simple extra-articular avulsion' fracture, type II is the 'beak' fracture, type III is an infrabursal avulsion fracture from the middle third of the posterior tuberosity, and finally in type IV there is the 'beak', but a small triangular fragment is separated from the upper border of the tuberosity. We examined the features of each avulsed type according to several criteria including patient age, gender, anatomical variances of the Achilles tendon, the fibers involved and the mechanism of injury. Results The type I fracture (8/20 cases) was the most common and likely to occur in elderly women. However, in other types, they were more common in relatively younger male patients. Type I were usually caused due to an accidental trip causing a fall by the patient. However, the dominant cause of type II (5/20 cases) fractures a direct blow or hit directly to the bone. Type III (4/20 cases) and IV (3/20 cases) fractures were likely to occur due to falling. All fibers within the Achilles tendon are involved in both type I and II fractures. However, only the superficial fibers are involved in type III fractures, whereas the deep fibers are involved in type IV fractures. Conclusions The avulsion patterns of the calcaneal tuberosity fractures are the result of several factors including the bony density level, the mechanism of injury and the fibers of the Achilles tendon that transmit the force. Accurate diagnosis of type III and IV is dependant on MRI technology

  15. Natural products as storage media for avulsed tooth

    Directory of Open Access Journals (Sweden)

    Deepika Jain

    2015-01-01

    Full Text Available Avulsion of tooth is complete displacement of tooth out of its socket that results in mutilation of periodontal ligaments. The desirable treatment option is replantation of the tooth. However, unsuccessful replantation is a matter of great discontentment. Unsuccessful replantation is due to inappropriate management of the avulsed tooth. Protection of teeth from desiccation due to drying of the periodontal ligament tissue, by keeping it in storage media can improve the outcome of the treatment. This review paper focuses on the use of natural products as storage media for avulsed teeth. In vitro and in vivo research published during 1995-2014, allowing open access on National Center for Biotechnology Information (NCBI database and articles on EBSCO host (EBSCO-Elton B. Stephens Company were included. It was found that natural products such as milk, coconut water, propolis, green tea, red mulberry, Aloe vera, egg-white and pomegranate have shown ability to maintain viability of periodontal ligament cells of avulsed teeth. Few natural products such as coconut water and milk can be used in raw form, while other products such as green tea and red mulberry need processing. Ability to maintain periodontal cell viability for a longer time is warranted in cases of major accidents, where teeth can be replanted only after other major surgeries. Natural products have easy availability, greater efficacy and longer storage time as compared to Hank′s balanced salt solution which has been recommended by the International Association of Dental Traumatology as standard solution for storage of avulsed teeth. Natural products have shown good qualities in in vitro experiments; further in vivo studies are needed to evaluate their efficacy as storage media.

  16. Management of maxillary avulsed teeth: using lasers for canal sterilization.

    Science.gov (United States)

    Gupta, Indra; Gupta, Satyendra; Sonwane, Kishore; Damankar, Dilip

    2011-07-01

    Avulsion or exarticulation accounts for up to 16% of all traumatic injuries. It is most common in age group of 7 to 14 years. Following the loss of anterior teeth, the replacement is necessary to maintain esthetics, phonetics and avoid arch length discrepancy. Following replantation, postoperative care and management is done in several ways. This article reports replantation and use of laser for endodontic sterilization and healing in a 12-year-old boy. It is suggested that replantation of an avulsed tooth as soon as possible using appropriate splint and regular followup will show good prognosis. Laser offers itself as a good alternative to Ca(OH)₂ for root canal sterilization and improved periapical healing.

  17. Simultaneous bilateral tibal tubercle avulsion: A rare fracture

    Directory of Open Access Journals (Sweden)

    Hasan Metineren

    2013-12-01

    Full Text Available Tibial tuberosity avulsion is a rare fracture in adolescence.Due to the shear forces on the immature epiphysis. Thirteenyears old girl was admitted to the emergency departmentwith knee pain and tenderness in both knees afterjumping from a height of about one meter. İn examinationshe had tenderness and swelling over both tibial tuberosities.The patient could not do active knee extension. TypeIIA fracture on the left and type IIIA fracture on the rightknee were detected. For the patient’s fractures, closedreduction and fixation with 3 smooth Kirschner wires wasperformed. After immobilization in long-leg brace for threeweeks the brace was removed and she include in therehabilitation program. In this report, we discuss similarcases in the literature and the results of the treatment appliedto our patient.Key words: Tuberositas tibia, avulsion fracture, percutaneouspinning

  18. Anterior superior iliac spine avulsion in a young soccer player.

    Science.gov (United States)

    Bendeddouche, I; Jean-Luc, B B; Poiraudeau, S; Nys, A

    2010-11-01

    Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. Finger avulsion injuries: A report of four cases

    Directory of Open Access Journals (Sweden)

    Fejjal N

    2008-01-01

    Full Text Available Injury that occurs to a finger wearing a ring though rare can have grave consequences. It is a preventable injury which has a peculiar mode of trauma that is usually occupational. Injury ranges from simple contusion to degloving of soft tissues to traumatic amputation. We hereby report our experience of four cases of finger avulsion injuries due to a ring and discuss their variable clinical presentation and individualized management.

  20. Timing of pulp extirpation for replanted avulsed teeth.

    LENUS (Irish Health Repository)

    Stewart, Chris

    2009-01-01

    A search was performed (April 2004) across four databases, namely Ovid Medline, Cochrane Library, PubMed and Web of Science, relevant to the proposed PICO ( Patient or problem, Intervention, Comparison, Outcome) question: (P) for a replanted avulsed permanent tooth, (I) is early pulp extirpation within 10-14 days of replantation, (C) compared with delayed pulp extirpation, (O) associated an increased likelihood of successful periodontal healing after tooth replantation. Only articles published in the English language were considered.

  1. Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion

    OpenAIRE

    Galos, David K.; Konda, Sanjit R.; Kaplan, Daniel J.; Ryan, William E.; Alaia, Michael J.

    2016-01-01

    Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not pr...

  2. Atypical stress-avulsion fracture of the Lisfranc joint complex.

    LENUS (Irish Health Repository)

    O'Neill, Barry J

    2014-04-01

    Antiphospholipid syndrome and systemic erythematosus have been associated with metatarsal stress fractures. Stress fractures of the Lisfranc joint complex are uncommon injuries but have been reported to occur most frequently in ballet dancers. We present a case of an avulsion fracture of the Lisfranc joint complex that occurred spontaneously. We have reviewed the association between systemic conditions and metatarsal fractures and proposed a series of hypothetical pathological events that may have contributed to this unusual injury.

  3. Posterior labrocapsular periosteal sleeve avulsion complicating locked posterior shoulder dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Simons, P. [Department of Radiology, Onze Lieve Vrouwe Hospital, Aalst (Belgium)]|[Department of Radiology, Leiden University Medical Centre, Leiden (Netherlands); Joekes, E.; Bloem, J.L. [Department of Radiology, Leiden University Medical Centre, Leiden (Netherlands); Nelissen, R.G.H.H. [Department of Orthopaedic Surgery, Leiden University Medical Centre (Netherlands)

    1998-10-01

    This case presents the imaging features of a posterior shoulder dislocation complicated by a rare but surgically relevant lesion of the posterior labrum. Due to the attachment of the posterior capsule to the posterior portion of the labrum, which in itself is attached to the posterior scapular periosteum, stripping of the labrum by the posterior capsule resulted in a posterior labrocapsular periosteal sleeve avulsion. (orig.) With 4 figs., 5 refs.

  4. Control of Delta Avulsion by Downstream Sediment Sinks

    Science.gov (United States)

    Salter, Gerard; Paola, Chris; Voller, Vaughan R.

    2018-01-01

    Understanding how fluxes are partitioned at delta bifurcations is critical for predicting patterns of land loss and gain in deltas worldwide. Although the dynamics of river deltas are influenced from both upstream and downstream, previous studies of bifurcations have focused on upstream controls. Using a quasi-1-D bifurcation model, we show that flow switching in bifurcations is strongly influenced by downstream sediment sinks. We find that coupling between upstream and downstream feedbacks can lead to oscillations in water and sediment flux partitioning. The frequency and initial rate of growth/decay of the oscillations depend on both upstream and downstream conditions, with dimensionless bifurcate length and bypass fraction emerging as key downstream parameters. With a strong offshore sink, causing bypass in the bifurcate branches, we find that bifurcation dynamics become "frozen"; that is, the bifurcation settles on a permanent discharge ratio. In contrast, under depositional conditions, we identify three dynamical regimes: symmetric; soft avulsion, where both branches remain open but the dominant branch switches; and full avulsion. Finally, we show that differential subsidence alters these regimes, with the difference in average sediment supply to each branch exactly compensating for the difference in accommodation generation. Additionally, the model predicts that bifurcations with shorter branches are less asymmetric than bifurcations with longer branches, all else equal, providing a possible explanation for the difference between backwater length distributaries, which tend to be avulsive, and relatively stable mouth-bar-scale networks. We conclude that bifurcations are sensitive both quantitatively and qualitatively to downstream sinks.

  5. Tibial avulsion fracture of the posterior root of the medial meniscus in children

    DEFF Research Database (Denmark)

    Iversen, Jonas Vestergård; Krogsgaard, Michael Rindom

    2012-01-01

    Few reports have described avulsion fractures of the posterior root of the medial meniscus in skeletally immature patients. This lesion should not be overlooked as it damages the load absorptive (distributive) function of the meniscus, increasing the risk of cartilage degeneration. Two cases...... of displaced avulsion fractures of the posterior root of the medial meniscus in children are presented along with a concise report of the literature regarding avulsion fractures of the posterior root of the medial meniscus. Both avulsions were reattached arthroscopically by trans-tibial pull-out sutures...

  6. Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair

    Science.gov (United States)

    Wilson, Thomas J.; Spinner, Robert J.; Mohan, Rohith; Gibbs, Christopher M.; Krych, Aaron J.

    2017-01-01

    Background: Muscle bellies of the hamstring muscles are intimately associated with the sciatic nerve, putting the sciatic nerve at risk of injury associated with proximal hamstring avulsion. There are few data informing the magnitude of this risk, identifying risk factors for neurologic injury, or determining neurologic outcomes in patients with distal sciatic symptoms after surgery. Purpose: To characterize the frequency and nature of sciatic nerve injury and distal sciatic nerve–related symptoms after proximal hamstring avulsion and to characterize the influence of surgery on these symptoms. Study Design: Cohort study; Level of evidence, 3. Methods: This was a retrospective review of patients with proximal partial or complete hamstring avulsion. The outcome of interest was neurologic symptoms referable to the sciatic nerve distribution below the knee. Neurologic symptoms in operative patients were compared pre- and postoperatively. Results: The cohort consisted of 162 patients: 67 (41.4%) operative and 95 (58.6%) nonoperative. Sciatic nerve–related symptoms were present in 22 operative and 23 nonoperative patients, for a total of 45 (27.8%) patients (8 [4.9%] motor deficits, 11 [6.8%] sensory deficits, and 36 [22.2%] with neuropathic pain). Among the operative cohort, 3 of 3 (100.0%) patients showed improvement in their motor deficit postoperatively, 3 of 4 (75.0%) patients’ sensory symptoms improved, and 17 of 19 (89.5%) patients had improvement in pain. A new or worsening deficit occurred in 5 (7.5%) patients postoperatively (2 [3.1%] motor deficits, 1 [1.5%] sensory deficit, and 3 [4.5%] with new pain). Predictors of operative intervention included lower age (odds ratio [OR], 0.952; 95% CI, 0.921-0.982; P = .001) and complete avulsion (OR, 10.292; 95% CI, 2.526-72.232; P hamstring avulsion are underrecognized. Currently, neurologic symptoms are not considered when determining whether to pursue operative intervention. Given the high likelihood of

  7. Abduction in Proximal Hamstring Tendon Avulsion Injury Mechanism-A Report on 3 Athletes

    NARCIS (Netherlands)

    van der Made, Anne D.; Peters, Rolf W.; Verheul, Claire; Maas, Mario; Kerkhoffs, Gino M.

    2017-01-01

    Proximal hamstring tendon avulsions are typically sustained during forced hip hyperflexion combined with knee extension. We present 3 cases of athletes with a proximal hamstring tendon avulsion caused by an alternative injury mechanism that also involves a considerable hip abduction component

  8. Clinical analysis of 54 cases of large area soft tissue avulsion in the lower limb

    Directory of Open Access Journals (Sweden)

    Yu Chen

    2016-12-01

    Conclusion: Treatment choices for skin avulsion on the lower limb should be based on the viability of the avulsed skin flap and the location of the wound. Proper choice can not only reduce the economic burden caused by using VSD, but also shorten the long hospital stay due to repeated wound dressing change or second stage surgery.

  9. Bilateral avulsion fractures of the anterior superior iliac spines in sprinters

    Energy Technology Data Exchange (ETDEWEB)

    Khoury, M.B.; Kirks, D.R.; Martinez, S.; Apple, J.

    1985-01-01

    Three cases of bilateral pelvic avulsion fractures in adolescent sprinters are reviewed. An acute avulsion fracture of the anterior superior iliac spine (ASIS) occurred during active running in three teenaged sprinters. Radiography confirmed a healed fracture of the contralateral ASIS. The clinical features and radiologic appearances are characteristic. The pathophysiology of this type of unique pediatric fracture is discussed. Conservative treatment is successful.

  10. Avulsion of the tuberosity of the calcaneus, an unusual injurie: case ...

    African Journals Online (AJOL)

    Avulsion calcaneal tuberosity fracture is an uncommon but potentially serious condition. Recent studies on the epidemiology of these specific fractures have demonstrated that avulsed calcaneal fractures account for 1.3% of all calcaneal fractures.It is therefore understandable that little has been written about these fractures.

  11. [Treatment of calcaneal avulsion fractures with twinfix suture anchors fixation].

    Science.gov (United States)

    Zhao, Bin-xiu; Wang, Kun-zheng; Wang, Chun-sheng; Xie, Yue; Dai, Zhi-tang; Liu, Gang; Liu, Wei-dong

    2011-06-01

    For the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors. From July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon. Total average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor. The methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

  12. Coronary sinus and atrioventricular groove avulsion after motor vehicle crash

    Directory of Open Access Journals (Sweden)

    Bradley M Dennis

    2014-01-01

    Full Text Available Simultaneous cardiac and pericardial rupture from blunt chest trauma is a highly lethal combination with rarely reported survival. We report of a case of young patient with a right atrioventricular groove injury, pericardial rupture and a unique description of a coronary sinus avulsion following blunt chest trauma. Rapid recognition of this injury is crucial to patient survival, but traditional diagnostic adjuncts such as ultrasound, echocardiography and computed tomography are often unhelpful. Successful repair of these injuries requires high suspicion of injury, early cardiac surgery involvement of and possible even placement of the patient on cardiopulmonary bypass.

  13. Avulsed Nasoenteric Bridle System Magnet as an Intranasal Foreign Body.

    Science.gov (United States)

    Puricelli, Michael D; Newberry, Christopher Ian; Gov-Ari, Eliav

    2016-02-01

    Nasoenteric tubes provide short-term nutrition support to patients unable to take an adequate oral diet. Bridling systems may be used to secure tubes to guard against displacement. We present the first case of an avulsed magnet from a bridling system to raise awareness of this potential complication. The primary methods of securing a nasogastric tube are reviewed, and comparative assessment of the 3 main systems is presented. Diagnosis and management of nasal foreign bodies relevant to this case are reviewed and prevention/safety considerations discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

  14. Unravelling the evolution and avulsion mechanisms of debris-flow fans

    Science.gov (United States)

    de Haas, Tjalling; Densmore, Alex; Stoffel, Markus; Ballesteros-Cánovas, Juan; Suwa, Hiroshi; Imaizumi, Fumitoshi; Wasklewicz, Thad

    2017-04-01

    Debris flows are water-laden masses of soil and fragmented rock that rush down mountainsides and spill out onto valley floors and alluvial fans, where they can devastate people and property. Expansion of human population into mountainous regions and the effects of global warming have increased the hazardous effects of debris flows over the last decades. Debris-flow channel avulsions (channel shifts) are critical to debris-flow fan evolution and hazard mitigation, because avulsions distribute debris flows and associated hazards through space and time. However, both the long-term evolution of debris-flow fans and their avulsion process are poorly understood. We aim to unravel the spatio-temporal patterns of debris-flow fan evolution and their avulsion mechanisms and tendency. Here we present a combined analysis of laboratory experiments; field data (repeat topographic analyses and dendrogeomorphological and lichenometrical reconstructions from debris-flow fans in Japan, USA, Switserland and France) and numerical modelling, identifying the main drivers of avulsion on debris-flow fans and their associated spatio-temporal evolution. We show that there are two main processes driving avulsions on debris-flow fans operating at two distinct timescales. (1) Channel plugs locally block channels forcing subsequent flows to avulse and follow alternative flow paths. The frequent but stochastic nature of channel-plug formation leads to a partly unpredictable avulsion and spatial depositional patterns on timescales of a few events. (2) Nevertheless, over timescales of tens of events the average locus of debris-flow deposition is observed to gradually shift towards the topographically lower parts of a fan, highlighting the importance of topographic compensation in the avulsion process on debris-flow fans. We further show that the magnitude-frequency distribution of the debris flows feeding a fan strongly affects the spatio-temporal patterns of deposition. Our results have strong

  15. Channel Evolution Following Avulsion: an Example from the Yellow River Delta

    Science.gov (United States)

    Zheng, S.

    2017-12-01

    Long-term field observation of morphological adjustments of rivers following avulsions is lacked when studying the evolution of avulsive channel on deltas. Avulsion at the Yellow River Delta (YRD) is frequent with average lifespan of channels of only about a decade. The Qing-shui-gou channel, the recent lobe on the YRD, provides a rare opportunity for investigating channel evolution following artificial avulsion. The reasons for its longer lifespan also needs investigation of the channel evolution. In this study, we comprehensively analyzed the geomorphic adjustment of the channel based on filed survey data during 1976-2014. The evolution of the channel was impacted by anthropogenic activities, including artificial avulsion at the downstream channel reaches in 1996, alteration of runoff and sediment load through Water and Sediment Regulation Scheme (WSRS), construction of levees and dikes. Analysis on channel geometry showed that avulsions in 1976 and in 1996 both caused short-term (1 2 years) erosion at the upstream channel reaches. Following the avulsion in 1976, massive aggradation occurred at the channel reaches at the downstream of the avulsion point. A single-thread channel gradually formed, widened and enlarged as channel bed under-cut on the deposition material. As delta extended seaward and the longitudinal slope decreased with time, aggradation occurred and an alluvial ridge formed. The ratio of lateral slope to the longitudinal slope (i.e. gradient advantage) and the relative super-elevation of the channel were calculated to estimate the possibility of avulsion at the channel in the late 1990. Results showed that the slope ratio was greater than 20 locally and super-elevation near its critical value for avulsion. The fact, that natural avulsion did not occurred despite of high values of gradient advantage and super elevation, may indicate that they are not sufficient conditions for avulsion at highly human-controlled rivers, where channel boundaries are

  16. Clinical characteristics and treatment outcomes of patients undergoing nail avulsion surgery for dystrophic nails.

    Science.gov (United States)

    Lai, W Y; Tang, William Y M; Loo, Steven K F; Chan, Y

    2011-04-01

    To evaluate the clinical characteristics and treatment outcomes of patients undergoing surgical nail avulsion. Retrospective study. Two dermatology centres in Hong Kong. A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records. Age, gender, co-morbidities, disease duration, clinical features, histopathology and fungal culture of nail plate, nail bed specimen for fungal culture in appropriate cases, and postoperative outcome. The mean age of the patients at the time of nail avulsion was 54 (range, 27-86) years. The most frequent preoperative findings were thickened nails (23 specimens, 70%) and discolouration (20 specimens, 61%). Onychomycosis was the most common pre-consultative diagnosis (20 specimens, 61%). Prior to nail avulsion, topical or systemic treatment had been tried in more than half of the cases. Histopathology of the avulsed nails confirmed onychomycosis in 24 (73%) of specimens. The clinical cure rate was 88% and the mycologic cure rate was 100%. The procedure was well tolerated without significant complications. Relapse was only noted in three (9%) of the patients having nail avulsions. The time for full re-growth ranged from 5 to 10 months. Total nail avulsion is an effective management option for patients whose diagnosis of onychomycosis was doubtful, and constitutes a treatment armamentarium especially for patients with single or oligo-onychomycosis.

  17. Rehabilitation of avulsion fracture of the tibial tuberosity following Osgood-Schlatter disease.

    Science.gov (United States)

    Baltaci, G; Ozer, H; Tunay, V B

    2004-03-01

    A sixteen-year-old boy suffered from sharp pain in the knee during a jump while playing basketball. He had a positive history of Osgood Schlatter disease. Radiographic evaluation demonstrated an avulsion fracture of the tibial tuberosity Type III according to the classification of Watson-Jones. Rehabilitation after avulsion fracture of the tibial tuberosity is an important consideration for this relatively uncommon adolescent injury. In such avulsion fractures, landing on the ground with the knee fully extended after a jump is the most likely cause. This case report reviews the rehabilitation program, and selected functional outcome measures after rehabilitation are reported. The patient returned to sporting activity after 12 months.

  18. Avulsion Fracture and Myositis Ossificans in a Professional Teenage Dancer: A Case Report.

    Science.gov (United States)

    Tosun, Ozgur; Koralp, Muhabbet D; Tosun, Aliye; Celebi, Levent; Bulakbaşi, Nail

    2015-06-01

    Fractures of the transverse processes in the lumbar vertebrae occur as the result of major forces such as direct blunt trauma, violent lateral flexion-extension forces, avulsion of the psoas muscle, or Malgaigne fractures of the pelvis. Dancers make repeated and forceful hyperextension and flexions of the spine, which may cause fractures of the transverse processes of the lumbar vertebrae. Repeated trauma of muscles in dancers may cause avulsion fractures and myositis ossificans. Herein, we report MRI and CT findings of an avulsion from the right transverse process of the L2 and L3 vertebrae in a 16-year-old professional teenage dancer, who responded to conservative treatment.

  19. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F.

    2016-01-01

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury. (orig.)

  20. Brachialis periosteal avulsion injury: case report with magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Justin Chak Yiu; Lee, Ka Lok Ryan; Griffith, James F. [Prince of Wales Hospital, Department of Imaging and Interventional Radiology, Shatin, N.T (China)

    2016-11-15

    Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury. (orig.)

  1. Avulsion of the Lesser Trochanter Following a Shot Put Sport Session

    Directory of Open Access Journals (Sweden)

    Mohamed H. Grissa

    2017-03-01

    Full Text Available Avulsion of the lesser trochanter is an uncommon injury. In children and adolescents it usually occurs as a sports injury via traumatic avulsion of the psoas major tendon. In adults, isolated fractures of the lesser trochanter are most commonly pathological due to metastatic tumor invasion of the proximal femur. This case report documents how a 14-year-old boy, who presented with an avulsion of the lesser trochanter of the proximal femur following a seemingly atraumatic shot put session at a track and field event, was diagnosed and successfully treated with a conservative approach.

  2. Surgical Management of Rectus Femoris Avulsion Among Professional Soccer Players.

    Science.gov (United States)

    Sonnery-Cottet, Bertrand; Barbosa, Nuno Camelo; Tuteja, Sanesh; Gardon, Roland; Daggett, Matt; Monnot, Damien; Kajetanek, Charles; Thaunat, Mathieu

    2017-01-01

    Rectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity. The purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength. Case series; Level of evidence, 4. Our retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months. At 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides. The surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.

  3. Anterior superior iliac spine avulsion fracture presenting as meralgia paraesthetica in an adolescent sprinter.

    Science.gov (United States)

    Hsu, Chia-Yu; Wu, Chu-Ming; Lin, Shih-Wei; Cheng, Kui-Lin

    2014-02-01

    We report here a rare case of anterior superior iliac spine avulsion fracture that presented initially as meralgia paraesthetica. A 14-year-old male sprinter presented with anterior superior iliac spine avulsion fracture, which was not observed on initial plain radiograph of the hip, but was diagnosed by ultrasound. Both clinical presentations and electrophysiological studies indicated meralgia paraesthetica. The lateral femoral cutaneous nerve of the thigh was probably compressed by an inguinal haematoma resulting from sartorius muscle strain, which was detected on musculoskeletal ultrasound. Computed tomography of the pelvis confirmed anterior superior iliac spine avulsion fracture. Meralgia paraesthetica in adolescents can be due to anterior superior iliac spine avulsion fracture. Sonography is a valuable tool for screening for muscular haematoma and occult fractures, which may allow clinicians to diagnose the nature of the muscle injury, and thus guide the most appropriate therapeutic strategy.

  4. Prehospital emergency management of avulsed permanent teeth: Knowledge and attitude of schoolteachers

    Directory of Open Access Journals (Sweden)

    Harkiran Kaur

    2012-01-01

    Conclusions: Knowledge regarding emergency management of dental trauma is poor amongst schoolteachers. Therefore, we suggest that orientation to management of avulsed tooth be part of the teacher training education.

  5. The relationship between postpartum levator ani muscle avulsion and signs and symptoms of pelvic floor dysfunction

    NARCIS (Netherlands)

    Delft, K. van; Sultan, A.H.; Thakar, R.; Schwertner-Tiepelmann, N.; Kluivers, K.B.

    2014-01-01

    OBJECTIVE: To establish the relationship between postpartum levator ani muscle (LAM) avulsion and signs and/or symptoms of pelvic floor dysfunction (PFD). DESIGN: Observational longitudinal cohort study. SETTING: District General University Hospital, UK. POPULATION OR SAMPLE: Primigravida at 36

  6. Knowledge and attitude of some nigerian school teachers on the emergency management of avulsed permanent incisor.

    Science.gov (United States)

    Olatosi, O O; Iwuala, S O; Isiekwe, G I; Oredugba, F A; Adenaike, A S; Oluwo, A O

    2013-01-01

    Tooth avulsion has been known to be the most severe of all dental injuries. The immediate action taken at the accident site will determine the prognosis of the tooth. Replantation of an avulsed tooth is the treatment of choice. To assess the knowledge and attitude of primary and secondary (Basic educational) school teachers on the emergency management of avulsed permanent incisors. Twenty public and private basic educational schools were randomly selected from Lagos State. Descriptive cross-sectional study. A 23 item self administered questionnaire was distributed to teachers to determine their knowledge and attitude on the emergency management of avulsed permanent incisors. Data was analysed using SPSS (Statistical Package for Social Sciences), Version 21.0. The responses obtained were tabulated and expressed as frequency distributions and then computed in percentages. Chi-square was used to test the association between knowledge of the schools teachers regarding the emergency management of avulsed permanent incisors and their socio-demographic variables. Multivariate analysis was used to adjust for confounding variables. The level of significance was set at P ≤0.05. A total of 320 teachers answered the questionnaires. Most of the teachers were female (63.1%). Only (30.9%) had received first aid training which included emergency management of dental trauma. Forty- two percent (134) didn't know that an avulsed permanent tooth could be replanted. Twenty teachers (44.4%) would clean an avulsed tooth with toothbrush and toothpaste. A greater proportion of the respondents 130 (40.6%) would transport an avulsed tooth using a clean white handkerchief. The overall knowledge of the school teachers was poor (84%).There was a statistically significant association between the knowledge of the school teachers and the inclusion of emergency management of dental trauma in the first aid training of the teachers P=0.05. Predictors of teachers' level of knowledge of emergency

  7. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant

    OpenAIRE

    de Oliveira, Natalice Sousa; Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias; Pretti, Henrique

    2017-01-01

    The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic appr...

  8. Combined anterior and posterior cruciate ligaments avulsion from the tibial side in adult patient: case report

    Directory of Open Access Journals (Sweden)

    Marcos George de Souza Leao

    2013-12-01

    Full Text Available The authors describe a rare case of a 28-year-old male patient, victim of motorcycle crash, with direct impact on the right knee, who sustained a bicruciate ligament fracture avulsion from the tibial side, dislocated and with large dimensions, without associated ligamentary lesions; he has undergone surgical treatment - open reduction and internal fixation, of the avulsions, and the follow up was at least six months, presenting good outcome using the Tegner -Lysholm scale.

  9. Development of Repair Materials for Avulsive Combat-Type Maxillofacial Injuries.

    Science.gov (United States)

    1982-08-01

    crucible to a Petrie dish containing the - - ... 8 . ..... ... . ... •. remainder of the filler. The material is then kneaded by hand like bread dough to...AD7-ft43 936 DEVELOPMENT OF REPAIR MATERIALS FOR AVULSIVE ’ CONSAT- TYPE NAXILLOFACIAL INJURIESCU) DYMATECH R/D CO CAMBRIDGE MASS D L RISE ET AL. RUG...2 .. - . ’l ’:. . . . - . ... . Development of Repair Materials for Avulsive Combat- Type Maxillof actal Injuries I Annual and Final Report ~ D. L

  10. SIMULTANEOUS BILATERAL AVULSION FRACTURE OF THE TIBIAL TUBEROSITY IN A TEENAGER: CASE REPORT AND THERAPY USED.

    Science.gov (United States)

    E Albuquerque, Rodrigo Pires; Giordano, Vincenzo; Carvalho, Antônio Carlos Pires; Puell, Thiago; E Albuquerque, Maria Isabel Pires; do Amaral, Ney Pecegueiro

    2012-01-01

    Simultaneous bilateral avulsion fracture of the tibial tuberosity in teenagers is a rare lesion. We describe the first case in the literature, in a teenage girl who sustained a fall while jumping during a volleyball match. No predisposing factors were iden tified. The lesions were treated with open surgical reduction and internal fixation. The aim of the present study was to present a case of simultaneous bilateral avulsion fracture of the tibial tuberosity in a teenage girl and the therapy used.

  11. Primary school health teachers’ knowledge regarding the emergency treatment of avulsed permanent teeth in Hamadan

    OpenAIRE

    Arghavan Kamali; Amene Taghdisi Kashani; Masume Hydarpoor

    2016-01-01

    Background and Aims: Trauma to the teeth is a common problem that occurs in children. Avulsion is the one of the most complex dental damages that if be untreated can cause multiple problems. Since many of dental traumas happen in school and school health teachers have main role in children treatments, the aim of this study was to evaluate the primary school health teachers’ knowledge regarding the emergency treatment of avulsed permanent teeth. Materials and Methods: In this cross-s...

  12. Prehospital emergency management of avulsed permanent teeth: Knowledge and attitude of school teachers.

    Science.gov (United States)

    Kaur, Harkiran; Kaur, Supreet; Kaur, Hargundeep

    2012-01-01

    Tooth avulsion is one of the most serious dental emergencies in children. Often these injuries occur in school and, therefore, the knowledge of school teachers regarding the appropriate measures to be taken immediately after tooth avulsion is crucial to good prognosis. The purpose of the present study was to evaluate school teachers' knowledge and attitudes regarding immediate management of avulsed teeth in children. A total of 177 teachers from seven schools of Garhshankar town, Hoshiarpur District, Punjab, India, formed the sample of the study. A self-administered questionnaire consisting of 16 questions was used to assess the knowledge and attitudes of school teachers about tooth avulsion and its management. The chi-square test and one-way analysis of variance (ANOVA) were used for analysis. Pair-wise comparison was done using Tukey's honestly significant difference (HSD) test. P ≤ 0.05 was considered to be statistically significant. Markedly low knowledge levels were noted among the school teachers. The mean knowledge score was 5 (of a maximum possible score of 10). Only 0.6% of the teachers answered correctly that they would use milk as a transport medium. The number of correct responses was not affected by previous experience with tooth avulsion, sex, educational level, teaching experience, or teacher training. Overall, 85.9% of teachers showed a positive attitude towards this campaign. Knowledge regarding emergency management of dental trauma is poor amongst school teachers. Therefore, we suggest that orientation to management of avulsed tooth be part of the teacher training education.

  13. Sequential avulsions of the tibial tubercle in an adolescent basketball player.

    Science.gov (United States)

    Huang, Ying Chieh; Chao, Ying-Hao; Lien, Fang-Chieh

    2010-05-01

    Tibial tubercle avulsion is an uncommon fracture in physically active adolescents. Sequential avulsion of tibial tubercles is extremely rare. We reported a healthy, active 15-year-old boy who suffered from left tibial tubercle avulsion fracture during a basketball game. He received open reduction and internal fixation with two smooth Kirschner wires and a cannulated screw, with every effort to reduce the plate injury. Long-leg splint was used for protection followed by programmed rehabilitation. He recovered uneventfully and returned to his previous level of activity soon. Another avulsion fracture happened at the right tibial tubercle 3.5 months later when he was playing the basketball. From the encouragement of previous successful treatment, we provided him open reduction and fixation with two small-caliber screws. He recovered uneventfully and returned to his previous level of activity soon. No genu recurvatum or other deformity was happening in our case at the end of 2-year follow-up. No evidence of Osgood-Schlatter disease or osteogenesis imperfecta was found. Sequential avulsion fractures of tibial tubercles are rare. Good functional recovery can often be obtained like our case if we treat it well. To a physically active adolescent, we should never overstate the risk of sequential avulsion of the other leg to postpone the return to an active, functional life.

  14. DENTAL SPLINTS: TYPES AND TIME OF IMMOBILIZATION POST TOOTH AVULSION

    Directory of Open Access Journals (Sweden)

    Samuel Rodrigo de Andrade VERAS

    2017-12-01

    Full Text Available Avulsion is defined as the complete displacement of the tooth out of its socket with disruption of the fibers of periodontal ligament, remaining some of them adhered to the cementum and the rest to the alveolar bone. This condition is more frequent in young permanent teeth, because the root development is still incomplete. Splints are used to immobilize traumatized teeth that suffered damage in their structures of support, preventing their constant movement. The literature has shown that after replantation, it is necessary to use splints in order to immobilize the teeth during the initial period, which is essential for the repair of periodontal ligament; the use of semi-rigid splint is more indicated than the rigid one, and long periods of splinting showed that substitutive resorption or ankylosis is an expected complication. Thus, the aim of this review is to describe the different types of splints; their time of permanency, and its influence on the process of healing and reparation on the occurrence of substitutive resorption or ankylosis. It is very important to keep gathering knowledge about this content, since it has been proved that the approaches and the protocols keep changing over time.

  15. Primary School Teachers’ Knowledge Regarding Emergency Management of Avulsed Permanent Incisors

    Directory of Open Access Journals (Sweden)

    B. Touré

    2011-09-01

    Full Text Available Objective: The goal of this study was to evaluate primary school teachers' knowledge regarding emergency management of avulsed permanent incisors.Materials and Methods: The study was conducted in fifty randomly chosen primary schools from Casablanca, Morocco. All teachers of the selected schools were included in the study. The data were collected by self administered questionnaires. The questions focusedon the teachers' general characteristics, experience of avulsed teeth and the importance of emergency management. The data were analyzed using chi square test.Results: A total of 501 teachers, of which 23.6% were male and 75.4% were female, answered the questionnaire. The results showed that 44.5 % of the teachers had an experience of avulsed tooth at school, 82.82% of them knew the importance of emergency managementand 32.6% would look for a dentist for treatment of the cases. Only 15.8% would reimplant the tooth themselves. Regarding the storage media, 21.95% would keep the avulsed tooth in milk. There was no significant difference between gender and education level (p>0.05.Conclusion: This study shows school teachers' lack of knowledge regarding dental trauma and especially tooth avulsion. Therefore, the results indicated that educational programs are necessary for improvement in their level of knowledge.

  16. Continued Root Formation after Delayed Replantation of an Avulsed Immature Permanent Tooth

    Directory of Open Access Journals (Sweden)

    Nima Moradi Majd

    2014-01-01

    Full Text Available Introduction. Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident. Methods. A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avulsion, replantation was performed, and the tooth was splinted; but after two weeks the replanted tooth’s pulp was necrotic. Thus, endodontic treatment was performed and root canal was filled using a calcium hydroxide and iodoform paste (Metapex. Three months later, the intracanal medication was washed out and the canal was sealed using an apical plug of calcium enriched mixture (CEM cement. Results. 20 months after replantation the tooth was completely asymptomatic, with physiologic mobility. Also, continued root formation including an apical segment beyond the artificial apical plug was observed. Conclusion. Creation of an appropriate apical barrier following the disinfection of root canal system promoted continued root-end growth in a replanted immature permanent tooth.

  17. Radiographic and pathologic characterization of lateral palmar intercarpal ligament avulsion fractures in the horse.

    Science.gov (United States)

    Beinlich, Christopher P; Nixon, Alan J

    2004-01-01

    In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondral cystic lesions of the ulnar carpal bone included a variable-sized osseous opacity adjacent to the lucent concavity of the fracture bed and the consistent location within the palmar transition zone at the confluence of LPICL insertion and hyaline cartilage on the palmar surface of the ulnar carpal bone. All 26 horses having surgical removal of the fragments had arthroscopic confirmation that the fragment was within the LPICL. Histologic examination confirmed the fragments were fracture related rather than developmental or the result of dystrophic mineralization. Many of the fragments had attached remnants of a ligament. This study describes the radiographic, surgical, and histologic features in 37 horses which better characterize LPICL avulsion fracture in the carpus and provide differentiating features to assist in separating this syndrome from true osseous cyst-like lesions within the ulnar carpal bone.

  18. Knowledge of emergency management of avulsed teeth among a sample of Egyptian parents

    Directory of Open Access Journals (Sweden)

    Abeer M. Abdellatif

    2011-04-01

    Full Text Available Traumatic dental injuries (TDIs frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents’ knowledge of appropriate emergency measures. Therefore this study aimed at evaluating the knowledge level of a sample of Egyptian parents in the management of a case of tooth avulsion in a child. A total of 985 parents attending a Pediatric Dental Clinic formed the sample of the study. A questionnaire comprising 13 questions in simple Arabic language was used. The parents were categorized into two groups according to their education level. The tabulated data were statistically analyzed using the Chi-square test. Markedly low knowledge levels were noted in both groups. This was evidenced in replanting the avulsed primary teeth, brushing and using antiseptics to clean the roots, holding the root instead of the crown, dry storage of the avulsed permanent teeth, and neglect over time from most of the parents. However, 24.3% of group 1 and 15.6% of group 2 chose milk as a transport medium. Therefore, educational programs would be necessary to improve awareness of the immediate management of avulsed teeth.

  19. Laypeoples' preferred sources of health information on the emergency management of tooth avulsion.

    Science.gov (United States)

    Al-Sane, Mona; Bourisly, Nibal; Almulla, Taghreed; Andersson, Lars

    2011-12-01

    When planning nationwide information campaigns on the emergency management of tooth avulsion, the populations' preference to different modes of information delivery should be taken into consideration. We currently lack information on that. The aim of this study was, therefore, to assess laypeoples' preferred sources of information on the emergency management of tooth avulsion. This was a joint study undertaken by experts in media and experts in dental traumatology. Interview-assisted questionnaires were conducted on a sample of 579 adults from Kuwait. Subjects were asked to choose their three preferred sources of information on the emergency management of tooth avulsion. Subjects' responses and sociodemographic data were registered. The data were descriptively analyzed, and a chi-square test was used to assess the relation of the subjects' preferences to their registered demographics. The Internet, health care professionals, and TV were the three most preferred sources of information on the emergency management of tooth avulsion across all groups, regardless of the sociodemographic characteristics. Younger adults, singles and subjects with higher education significantly preferred the Internet. Older adults preferred TV. Family was a preferred source in geographic districts populated with extended families, while friends were a preferred source in geographic districts populated by expatriates. Younger people and those with higher education can be effectively targeted through the Internet, while it is more effective to target older people through TV. Information, on tooth avulsion management, given by health care professionals is preferred across all population segments. © 2011 John Wiley & Sons A/S.

  20. Knowledge regarding emergency management of avulsed teeth among elementary school teachers in Jaboatão dos Guararapes, Pernambuco, Brazil

    Directory of Open Access Journals (Sweden)

    A de Lima Ludgero

    2012-01-01

    Conclusions: A lack of technical information was observed among teachers regarding management of tooth avulsion. Educational campaigns at schools are necessary to modify the behavior of the teachers with regard to management of tooth avulsion. Further studies should be carried out for the assessment of teachers who have participated in educational campaigns to make the treatment of dental trauma a matter of public interest.

  1. Novel stress radiography technique for avulsion fracture of the lateral malleolus in children: a report of three cases.

    Science.gov (United States)

    Iwata, Y

    2016-04-01

    This study reports a novel stress radiography technique to evaluate an avulsion fracture at the lateral malleolus in children. Radiographs in the stress anteroposterior view or the Haraguchi calcaneofibular ligament or anterior tarofibular ligament (ATFL) projection could not detect any fracture; only manual inversion stress radiography in the Haraguchi ATFL projection could identify the avulsion fracture.

  2. Avulsion fracture of the posterior cruciate ligament in an uncommon location associated with distal injury to the patellar ligament

    Directory of Open Access Journals (Sweden)

    Rodrigo Pires e Albuquerque

    2015-12-01

    Full Text Available ABSTRACT Avulsion fractures of the posterior cruciate ligament in unusual locations are rare injuries. We report the first case in the literature of an avulsion fracture of the posterior cruciate ligament associated with distal injury to the patellar ligament. The aim of this study was to present a novel case, the therapy used and the clinical follow-up.

  3. Reimplantation of Accidentally Avulsed Permanent Maxillary Anterior Teeth in a 10-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Md Abdul Hannan Sheikh

    2017-09-01

    Full Text Available Accidental tooth avulsion is a grievous injury and common among the children. Management of avulsed tooth within alveolar socket by reimplantation becomes a challenge for the clinician due to extraoral time and media of transportation. Although the long-term prognosis of reimplantation is poor, the time during which the tooth remain within the arch will guide the development of alveolar bone completely. Moreover, reimplantation will maintain anatomical, functional and esthetic rehabilitation of the patient. In this case report, we present a case of accidental avulsion where teeth were gently rinsed of any debris and placed in normal saline during the examination and preparation of the reimplantation sockets. The teeth were then reimplanted, functionally splinted followed by endodontical treatment. After 12 months follow-up the periodontal space was healed perfectly without any resorption or ankylosis.

  4. The treatment of avulsion fractures of the tibial tuberosity in adolescent athletes.

    Science.gov (United States)

    Balmat, P; Vichard, P; Pem, R

    1990-05-01

    Avulsion fractures of the tibial tuberosity occur mainly during sport activities and are closely related to the strains exerted on the anterior tibial tuberosity by the extension complex of the thigh. A knowledge of the mechanical aspects of these avulsions may improve understanding of the mechanisms of such injuries. In such avulsion fractures, tensile forces due to the contraction of the quadriceps complex overcome the cohesive forces within the apophyseal cartilage. A 1-month cast immobilisation on an extended knee gives good results in the management of nondisplaced fractures. In minor displacements, such immobilisations follow closed external reductions. Open reductions and stable screw fixations precede a 3-week immobilisation for displaced fractures. Long term results are regularly good in well-managed cases.

  5. Functional outcome after repair of proximal hamstring avulsions.

    Science.gov (United States)

    Birmingham, Patrick; Muller, Mark; Wickiewicz, Thomas; Cavanaugh, John; Rodeo, Scott; Warren, Russell

    2011-10-05

    Rupture of the proximal origin of the hamstrings leads to pain, weakness, and a debilitating decrease in physical activity. Repair of these injuries should be based on the expectation that these deficits can be addressed. The goal of this study was to objectively evaluate the efficacy of repair of proximal hamstring avulsions. Thirty-four patients were identified retrospectively to have a complete rupture of the proximal origin of the hamstrings based on the presence of a bowstring sign and the results of magnetic resonance imaging (MRI).Patients were contacted for follow-up evaluation to fill out a subjective questionnaire, to undergo functional testing, and to undergo isokinetic testing on a Cybex dynamometer. Twenty-three patients were evaluated. There were nine acute and fourteen chronic repairs, and the average period of follow-up was 43.3 months. Twenty-one of twenty-three patients reported returning to activity at an average of 95% of their pre-injury activity level at an average of 9.8 months. Eighteen patients reported excellent results; four, good results; and one, fair results. Hamstring strength was an average of 93% and 90% of that in the uninvolved limb at 240° per second and 180° per second, respectively. The hamstrings-to-quadriceps ratio was 56% for 240° per second and 48% at 180° per second. Hamstring endurance was an average of 81% and 91% of the nonoperative limb at 240° per second and 180° per second, respectively. Postoperative quadriceps strength and endurance were positively correlated with return to pre-injury level of activity (r = 0.6, p hamstring tendon yields good subjective and objective functional results with minimal complications. Overall, patients are satisfied with surgical repair and experience return of functional activity with minimal postoperative weakness.

  6. Avulsive axillary artery injury in reverse total shoulder arthroplasty.

    Science.gov (United States)

    Wingert, Nathaniel C; Beck, John D; Harter, G Dean

    2014-01-01

    In addition to neurologic injuries such as peripheral nerve palsy, axillary vessel injury should be recognized as a possible complication of reverse total shoulder arthroplasty. Limb lengthening associated with Grammont-type reverse total shoulder arthroplasty places tension across the brachial plexus and axillary vessels and may contribute to observed injuries. The Grammont-type reverse total shoulder arthroplasty prosthesis reverses the shoulder ball and socket, shifts the shoulder center of rotation distal and medial, and lengthens the arm. This alteration of native anatomy converts shearing to compressive glenohumeral joint forces while augmenting and tensioning the deltoid lever arm. Joint stability is enhanced; shoulder elevation is enabled in the rotator cuff–deficient shoulder. Arm lengthening associated with reverse total shoulder arthroplasty places a longitudinal strain on the brachial plexus and axillary vessels. Peripheral nerve palsies and other neurologic complications of reverse total shoulder arthroplasty have been documented. The authors describe a patient with rotator cuff tear arthropathy and a history of radioulnar synostosis who underwent reverse total shoulder arthroplasty complicated by intraoperative injury to the axillary artery and postoperative radial, ulnar, and musculocutaneous nerve palsies. Following a seemingly unremarkable placement of reverse shoulder components, brisk arterial bleeding was encountered while approximating the incised subscapularis tendon in preparation for wound closure. Further exploration revealed an avulsive-type injury of the axillary artery. After an unsuccessful attempt at primary repair, a synthetic arterial bypass graft was placed. Reperfusion of the right upper extremity was achieved and has been maintained to date. Postoperative clinical examination and electromyographic studies confirmed ongoing radial, ulnar, and musculocutaneous neuropathies.

  7. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture

    OpenAIRE

    Hoogervorst, Paul; Gardeniers, J. W. M.; Moret-Wever, S.; van Kampen, A.

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good functional result following minimally invasive pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture. There are no previous reports of similar pseudo-arthrosis repairs, and other aut...

  8. Surgical reconstitution of a unilaterally avulsed symptomatic puborectalis muscle using autologous fascia lata.

    Science.gov (United States)

    Shobeiri, S Abbas; Chimpiri, A Rao; Allen, Ariel; Nihira, Mikio A; Quiroz, Lieschen H

    2009-08-01

    The puborectalis muscle is an important muscle for the maintenance of fecal continence. We present a novel surgical technique for repair of symptomatic avulsed puborectalis muscle. This woman presented with dyspareunia and fecal incontinence since the vaginal birth of her child 2 years before. The diagnosis of an avulsed right puborectalis was made by physical examination and confirmed by magnetic resonance imaging and three-dimensional ultrasonography. Fascia lata was harvested from the patient's thigh and used to reconstitute the missing portion of the puborectalis muscle. At 12 months postoperatively, the patient was continent of stool and relieved of dyspareunia. The patient's dyspareunia and fecal incontinence were alleviated by restoring normal anatomy.

  9. Replantation of an avulsed tooth with an extended extra oral period

    Directory of Open Access Journals (Sweden)

    Girish Kubasad

    2012-01-01

    Full Text Available In this study, we have reported a case of the replantation of a maxillary incisor with an extended extraoral period following a traumatic avulsion. After storage in normal saline, the root surface of the avulsed tooth was conditioned with citric acid and treated with a triple antibiotic solution. The tooth socket was filled with Emdogain before replantation. A 12 month, 18 month and a 5 year follow-up clinical examination revealed the patient to be asymptomatic, and the tooth was functional. The recall radiograph showed no evidence of renewed periradicular breakdown and apical root resorption.

  10. Anterior avulsion fracture of the tibial tuberosity in adolescents - Two case reports

    Directory of Open Access Journals (Sweden)

    Aleilimar Teixeira da Silva Júnior

    Full Text Available ABSTRACT The objective here was to report two rare cases of anterior avulsion fracture of the tibial tuberosity in adolescents. Case 1 was a 15-year-old male who became injured through landing on his left knee and presented limited extension. Case 2 was a 16-year-old basketball player who presented sudden pain in the right knee and functional incapacity, after a jump. Imaging examinations (radiographs and computed tomography showed anterior avulsion fractures of the tibial tuberosity. Surgical fixation was performed using screws and anchors, while avoiding growth plate injury. The cases evolved without lower-limb deformities.

  11. MR Imaging of Lumbar Root Avulsion: Report of Two Case Studies

    International Nuclear Information System (INIS)

    Lee, Jung Bin; Cha, Jang Gyu; Lee, Min Hee; Paik, Sang Hyun; Im, Soo Bin

    2011-01-01

    Lumbosacral nerve root avulsion is a rare disease entity that is usually associated with a fracture of the pelvic bone. We report on two cases to share our multimodal images and to introduce new magnetic resonance (MR) imaging findings. In one case (a pediatric patient), neither a history of pelvic ring fracture, nor a history of hip dislocation with characteristic MR myelography findings was evident. In the other case, secondary MR findings associated with lumbosacral nerve root avulsion were found that had not been introduced previously.

  12. Lumbar nerve root avulsions with secondary ipsilateral hip dysplasia in a child

    International Nuclear Information System (INIS)

    Polyzoidis, Konstandinos; Vranos, Georgios; Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I.; Sarmas, Ioannis

    2002-01-01

    We report on an 8-year-old child with avulsions of the left L3, L4 and L5 nerve roots and traumatic meningoceles that were not associated with lumbar spine or pelvic girdle fractures. The patient had a history of a road traffic accident. Plain radiographs of the pelvis revealed left hip dysplasia. The magnetic resonance imaging findings of the lumbar spine are illustrated. The pathogenesis of lumbar nerve root avulsions and their association with ipsilateral hip dysplasia are discussed. (orig.)

  13. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  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. Nuchal crest avulsion fracture in 2 horses : a cause of headshaking : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Voigt

    2009-05-01

    Full Text Available The medical records of 2 Thoroughbred horses that developed headshaking after blunt trauma to the occipital region are reviewed. The history, signalment, clinical signs, diagnostic methods, diagnosis and treatment were recorded in each case. Both horses displayed headshaking, while one horse repeatedly lifted its upper lip and pawed excessively at the ground. In both horses, diagnostic imaging of the occipital region revealed avulsion fragments of the nuchal crest and a nuchal desmitis in association with hyperfibrinogenaemia. The presence of an avulsion fragment of the nuchal crest with associated nuchal desmitis should be considered in horses presenting with headshaking and may respond favourably to conservative therapy.

  16. Microvascular replantation of avulsed tissue after a dog bite of the face

    African Journals Online (AJOL)

    Various authors have described successful microsurgical replantation of totally avulsed facial tissue. In a significant nwnber of cases difficulties were experienced with the venous anastomoses and/or venous drainage of the tissue. Many different methods were used to overcome the problem. Despite these difficulties, good ...

  17. Depositional record of an avulsive fluvial system controlled by peat compaction (Neogene, Most Basin, Czech Republic)

    Czech Academy of Sciences Publication Activity Database

    Rajchl, M.; Uličný, David

    2005-01-01

    Roč. 52, č. 3 (2005), s. 601-625 ISSN 0037-0746 R&D Projects: GA ČR GA205/01/0629 Institutional research plan: CEZ:AV0Z30120515 Keywords : avulsion * Eger Graben * fluvial channels Subject RIV: DB - Geology ; Mineralogy Impact factor: 1.876, year: 2005

  18. Pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture.

    NARCIS (Netherlands)

    Hoogervorst, P.; Gardeniers, J.W.M.; Moret-Wever, S.; Kampen, A. van

    2010-01-01

    A pseudo-arthrosis repair of a 4-year-old bony avulsion fracture of the PCL using a minimally invasive technique, screw fixation, and bone grafting is reported. The case presented seems to be rather unique due to the fragment size and the approach for pseudo-arthrosis repair. There was a good

  19. Displaced avulsion fractures of the posterior cruciate ligament: Treated by stellate steel plate fixation.

    Science.gov (United States)

    Li, Lijun; Tian, Wei

    2015-01-01

    The open reduction with internal fixation is an effective approach for treatment of avulsion fracture of posterior cruciate ligament. The previously used internal fixation materials including hollow screws, absorbable screw, tension bands and sutures have great defects such as insufficient fixation strength, susceptibility to re-fracture, etc. Stellate steel plate is novel material for internal fixation which has unique gear-like structure design. We used stellate steel plate for treatment of displaced avulsion fractures of posterior cruciate ligament in this study. 14 patients (9 men, 5 women; aged, 19-35 years; mean age, 28 years) with displaced avulsion fractures of the tibial insertion of the posterior cruciate ligament were retrospectively analyzed between June 2009 and June 2011. The mean duration from injury to the operation was 8.3 days (range 6-15 days). All the patients were treated with open reduction and internal fixation of a stellate steel plate (DePuy, Raynham, MA 02767, USA). The Lysholm-Tegner knee function score criteria were used to analyze results. The mean followup was 24.6 months (range 18-32 months). After 6 months, all the fractures healed and knee joint activity was normal, with no knee stiffness or instability. The Lysholm-Tegner scores were 97.1 ± 1.7 points at the final followup. Owing to its unique gear structure, the stellate steel plate design can effectively fix an avulsion fracture block and it is a simple operation with short postoperative rehabilitation time and firm fixation.

  20. Emdogain does not prevent progressive root resorption after replantation of avulsed teeth: a clinical study.

    Science.gov (United States)

    Schjøtt, M; Andreasen, J O

    2005-02-01

    Emdogain has been shown in clinical and experimental studies to promote regeneration of all periodontal tissues: cementum with anchoring fibres, a functional, periodontal ligament and alveolar bone in connection with treatment of marginal periodontitis. The intention of this study was to analyse whether this regenerative capacity upon the periodontal ligament also worked in a trauma situation where a significant number of PDL cells have been eliminated because of unphysiologic storage or actual damage during avulsion or replantation. Furthermore if ankylosis sites already established because of earlier replantation after avulsion could be surgical removed and application of Emdogain could revert the ankylosis stage to a normal PDL situation. The first treatment situation was tested in seven patients with a total of 16 avulsed teeth with varying time of extra oral storage. The teeth were extra-orally endodontically treated and the root and socket covered with Emdogain before replantation. All teeth demonstrated subsequent ankylosis, primarily diagnosed by a percussion test. The second treatment situation where an ankylosis was already established constituted of seven patients with a total of 11 teeth because of previous replantation after avulsion. These teeth were all extracted, the ankylosis sites removed and the root and socket treated with Emdogain. After 6 months all teeth showed recurrence of ankylosis. It is concluded that Emdogain was not able to prevent or cure ankylosis.

  1. The natural history of levator avulsion one year following childbirth: a prospective study

    NARCIS (Netherlands)

    Delft, K. van; Thakar, R.; Sultan, A.H.; Hout, J. in't; Kluivers, K.B.

    2015-01-01

    OBJECTIVE: To explore the natural history of levator avulsion in primipara 1 year postpartum and correlate this to pelvic floor dysfunction (PFD). DESIGN: Observational longitudinal cohort study. SETTING: District General University Hospital. POPULATION OR SAMPLE: Nullipara at 36 weeks of gestation,

  2. Conservative treatment of anterior inferior and superior avulsion fractures of spina iliaca in adolescent amateur footballer

    Directory of Open Access Journals (Sweden)

    Umut Hatay Gölge

    2015-06-01

    Full Text Available The anterior inferior iliac spine (AIIS and the anterior superior iliac spine (ASIS avulsion fracture is a rare injury of pelvis. It usually occurs during the sport activities especially in football while hitting the ball. It is commonly misdiagnosed so that a detailed history and physical examination have a great importance. We present two cases of AIIS and ASIS avulsion fracture. Both of the patients applied to outpatient clinics with hip pain and difficulty in walking. History revealed the complaints started after hitting the ball during the football match and hip movements were limited. The patients were fifteen and sixteen years and after physical examination and radiological evaluation, avulsion fracture of the AIIS and the ASIS were diagnosed. Patients were treated conservatively with non-steroidal anti-inflammatory drugs and limited weight bearing with crutches for a month. The patients were free of pain and had full range of hip movements after one month period. At the end of the second month patients returned to active sports. AIIS and ASIS avulsion fractures are more common in adolescent football players but clinicians sometimes fail to diagnose this rare injury. We emphasize the importance of the detailed history and clinical examination and direct radiography could be enough for the diagnosis.

  3. Traumatic partial avulsion of a single right subclavian artery from the aortic arch and definitive repair.

    Science.gov (United States)

    Kapetanakis, Emmanouil I; Sears-Rogan, Pamela; Young, Richard S; Kanda, Louis T; Ellis, Jennifer L

    2006-01-01

    Blunt injury to the right subclavian artery is a rare complication of severe deceleration trauma often associated with significant morbidity and mortality. We describe an atypical presentation in a patient who sustained a traumatic avulsion of his right subclavian artery arising off the aortic arch. An interposition graft was used to restore the continuity of the artery to the ascending thoracic aorta.

  4. Correlating signs and symptoms with pubovisceral muscle avulsions on magnetic resonance imaging

    NARCIS (Netherlands)

    Lammers, K.; Futterer, J.J.; Hout, J. in't; Prokop, M.; Vierhout, M.E.; Kluivers, K.B.

    2013-01-01

    OBJECTIVE: We sought to correlate signs and symptoms of pelvic organ prolapse (POP) with pubovisceral muscle avulsions on magnetic resonance imaging (MRI). STUDY DESIGN: In this retrospective cohort study of 189 women with recurrent POP or unexplained symptoms of pelvic floor dysfunction, we

  5. C8 cross transfer for the treatment of caudal brachial plexus avulsion in three dogs.

    Science.gov (United States)

    Moissonnier, Pierre; Carozzo, Claude; Thibaut, Jean-Laurent; Escriou, Catherine; Hidalgo, Antoine; Blot, Stéphane

    2017-01-01

    To evaluate the cervical nerve 8 cross-transfer technique (C8CT) as a part of surgical treatment of caudal brachial plexus avulsion (BPA) in the dog. Case series. Client-owned dogs suspected to have caudal BPA based on neurological examination and electrophysiological testing (n = 3). The distal stump of the surgically transected contralateral C8 ventral branch (donor) was bridged to the proximal stump of the avulsed C8 ventral branch (recipient) and secured with 9-0 polypropylene suture under an operating microscope. A carpal panarthrodesis was performed on the injured limb after C8CT. Surgical exploration confirmed avulsion of nerve roots C7, C8, and T1 in all cases. There was no evidence of an iatrogenic effect on the donor forelimb. Gradual improvement in function of the affected forelimb occurred in all dogs, with eventual recovery of voluntary elbow extension. Reinnervation was evident in EMG recordings 6 months postoperatively in all three dogs. Stimulation of the donor C8 ventral branch led to motor evoked potentials in the avulsed side triceps brachialis and radial carpus extensor muscles. Variable functional outcome was observed in the 3 dogs during clinical evaluation 3-4 years after surgery. Digital abrasion wounds, distal interphalangeal infectious arthritis, and self-mutilation necessitated distal phalanx amputation of digits 3 and 4 in 2 dogs. C8CT provided partial reconnection of the donor C8 ventral branch to the avulsed brachial plexus in the 3 dogs of this series. Reinnervation resulted in active elbow extension and promoted functional recovery in the affected limb. © 2017 The American College of Veterinary Surgeons.

  6. Avulsion Fracture of the Coracoid Process at the Coracoclavicular Ligament Insertion: A Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Takeshi Morioka

    2016-01-01

    Full Text Available Avulsion fracture at the site of attachment of the coracoid process of the coracoclavicular ligament (CCL is extremely rare. We presented three adult cases of this unusual avulsion fracture associated with other injuries. Case  1 was a 25-year-old right-handed male with a left distal clavicular fracture with an avulsion fracture of the coracoid attachment of the CCL; this case was treated surgically and achieved an excellent outcome. Case  2 was a 39-year-old right-handed male with dislocation of the left acromioclavicular joint with two avulsion fractures: one at the posteromedial surface of the coracoid process at the attachment of the conoid ligament and one at the inferior surface of the clavicle at the attachment site of the trapezoid ligament; this case was treated conservatively, and unfavorable symptoms such as dull pain at rest and sharp pain during some daily activities remained. Case  3 was a 41-year-old right-handed female with a right distal clavicular fracture with an avulsion fracture of the coracoid attachment of the conoid ligament; this case was treated conservatively, and the distal clavicular fracture became typical nonunion. These three cases corresponded to type I fractures according to Ogawa’s classification as the firm scapuloclavicular connection was destroyed and also to double disruption of the superior shoulder suspensory complex. We recommend surgical intervention when treating patients with this type of acute or subacute injury, especially in those engaging in heavy lifting or overhead work.

  7. A tuber calcanei avulsion fracture developed on the basis of idiopathic osteoporosis in a young male: a case report.

    Science.gov (United States)

    Terzi, R; Özer, T

    2015-09-01

    Calcaneus fractures constitute 1.2 % of all fractures. Tuber calcanei avulsion fractures constitute 1.3-2.7 % of calcaneus fractures. Osteoporosis, osteomalacia, and diabetes mellitus have been reported to increase the risk of development of these fractures. It has been reported that tuber calcanei avulsion fractures in elderly females might develop due to osteoporosis. As far as we know, no tuber calcanei avulsion fracture developing on the basis of osteoporosis without presence of a trauma has been reported in young males in the literature. In the current case report, a 41-year-old male patient who was admitted with complaints of pain in the left heel and diagnosed with calcaneal avulsion fracture that developed on the basis of idiopathic osteoporosis and who was treated with conservative methods was presented.

  8. PCL tibial avulsion with an associated medial meniscal tear in a child: a case report on diagnosis and management.

    LENUS (Irish Health Repository)

    2012-02-01

    Posterior cruciate ligament (PCL) injuries from tibial avulsions are rare in the paediatric setting. One would need a high index of suspicion as clinical examination may be difficult, especially in the early period. Magnetic resonance imaging is an excellent diagnostic modality for this condition and other associated injuries within the knee. We report a rare case in which the patient had a PCL avulsion off the tibial insertion site with an associated posterior horn medial meniscal tear off the posterior capsule. He was treated through open reduction and internal fixation of the avulsed fragment with suture repair of the meniscal tear. We emphasize the importance of diagnosing and managing associated intra-articular injuries when dealing with the rare condition of PCL tibial avulsion in the paediatric setting.

  9. The Brahmaputra River: a stratigraphic analysis of Holocene avulsion and fluvial valley reoccupation history

    Science.gov (United States)

    Hartzog, T. R.; Goodbred, S. L.

    2011-12-01

    The Brahmaputra River, one of the world's largest braided streams, is a major component of commerce, agriculture, and transportation in India and Bangladesh. Hence any significant change in course, morphology, or behavior would be likely to influence the regional culture and economy that relies on this major river system. The history of such changes is recorded in the stratigraphy deposited by the Brahmaputra River during the Holocene. Here we present stratigraphic analysis of sediment samples from the boring of 41 tube wells over a 120 km transect in the upper Bengal Basin of northern Bangladesh. The transect crosses both the modern fluvial valley and an abandoned fluvial valley about 60 km downstream of a major avulsion node. Although the modern Brahmaputra does not transport gravel, gravel strata are common below 20 m with fluvial sand deposits dominating most of the stratigraphy. Furthermore, the stratigraphy preserves very few floodplain mud strata below the modern floodplain mud cap. These preliminary findings will be assessed to determine their importance in defining past channel migration, avulsion frequency, and the reoccupation of abandoned fluvial valleys. Understanding the avulsion and valley reoccupation history of the Brahmaputra River is important to assess the risk involved with developing agriculture, business, and infrastructure on the banks of modern and abandoned channels. Based on the correlation of stratigraphy and digital surface elevation data, we hypothesize that the towns of Jamalpur and Sherpur in northern Bangladesh were once major ports on the Brahmaputra River even though they now lie on the banks of small underfit stream channels. If Jamalpur and Sherpur represent the outer extent of the Brahmaputra River braid-belt before the last major avulsion, these cities and any communities developed in the abandoned braid-belt assume a high risk of devastation if the next major avulsion reoccupies this fluvial valley. It is important to

  10. The usefulness of MR myelography for evaluation of nerve root avulsion in brachial plexus injury

    International Nuclear Information System (INIS)

    Nishiura, Yasumasa; Ochiai, Naoyuki; Miyauchi, Yukio; Niitsu, Mamoru

    2002-01-01

    Myelography has been the most popular and reliable method for evaluation of nerve root avulsion in brachial plexus injury. However, it is invasive because it requires the use of contrast medium, dural puncture and exposure to radiation. In addition, it has a fault. When a nerve rootlet is not filled with contrast medium, it is impossible to evaluate it. It has sometimes been a problem in the injury to upper roots. Recently, MRI also has been used for diagnosis of brachial plexus injury. But it was not until recently that it has had a high resolution to detect affected nerve rootlets. We have used MR myelography with high resolution for diagnosis of brachial plexus injury. The purpose of this study is to investigate the usefulness of it. MR myelography was preoperatively performed in 14 cases, consisting of 13 traumatic brachial plexus injuries and an obstetrical palsy. In them, 12 cases had root avulsion injuries and 2 cases had infraclavicular injuries. A 1.5 Tesla MR system (Philips) and a cervical coil were used. Coronal sections with 2 mm-overcontiguous thickness were obtained by heavily T2-weighted sequence fast spin echo (TR/TE=3000/450). The fat signal was suppressed by a presaturation inversion-pulse. The scanning time was about five minutes. The three-dimensional image was reconstructed by using maximum intensity projection (MIP) method. MIP images and individual coronal images were used for evaluation for root avulsion. In evaluation the shape of a nerve sleeve and nerve rootlets was compared on both sides. The abnormal shape of a nerve sleeve or the defect of nerve rootlets was diagnosed as root avulsion. The brachial plexus lesions were exposed operatively and examined with electrophysiologic methods (SEP and/or ESCP) in all cases. Operative findings were compared with MR myelography. Twenty-four roots had been diagnosed as normal and 46 roots had been diagnosed as root avulsion with MR myelography preoperatively. In the former only one root was

  11. MR Imaging findings of avulsion fracture of the tibial spine of the knee, focusing of cruciate ligament tear

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Won; Hong, Hoon Pyo; Ryu, Kyung Nam [Kyung Hee University Hospital, Seoul (Korea, Republic of); Jin, Wook [Gachon Medical School Gil Hospital, Incheon (Korea, Republic of)

    2003-04-01

    To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. Between March 1997 and May 2002, avulsion injury involving the ACL and PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. Among seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial teat. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, teats of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL.

  12. Concomitant Vesicouterine Rupture with Avulsion of Ureter: A Rare Complication of Vaginal Birth after Cesarean Section.

    Science.gov (United States)

    Sharma, Nalini; Thiek, J Lalnunnem; Sialo, Stephen; Ahanthem, Santa Singh

    2016-03-01

    Uterine rupture is the most serious and life threatening complication and occurs in 0.7-0.9% of vaginal birth after lower segment caesarean section. Cases of bladder rupture along with uterine rupture have been rarely reported and avulsion of ureter, required ureteric implantation is even rarer. This case report describe a very rare case of vesicouterine rupture with avulsion of ureter following vacuum assisted delivery in a grandmulti with previous lower segment cesarean section (LSCS). Haematuria is the most common presentation of bladder rupture. Antenatal counseling regarding this entity is recommended if woman opted for vaginal birth after cesarean section. Intrapartum and postpartum high index of suspicion are important in clinching the diagnosis.

  13. A tuber ischium avulsion fracture treated with modified subgluteal approach: a case report.

    Science.gov (United States)

    Saka, Gürsel; Küçükdurmaz, Fatih; Sağlam, Necdet; Akpınar, Fuat

    2012-01-01

    We report a 16-year-old soccer player with a displaced avulsion fracture of the ischial tuberosity sustained during a soccer match. Open reduction and internal fixation were performed using a longitudinal incision and subgluteal approach. The patient returned to sports 6 months following the operation and returned to his preoperative performance at the 16th month postoperative follow-up. Surgical treatment is often avoided for these types of fractures due to complications associated with the sciatic nerve and exposure difficulty. However, we believe that this incision is a safer alternative to existing methods, providing sufficient exposure and avoiding damage to the neurovascular structures. This article aims to review this alternative incision in the surgical treatment of avulsion fractures of the ischial tuberosity.

  14. Knowledge of emergency management of avulsed tooth among Japanese dental students

    Science.gov (United States)

    2014-01-01

    Background The management of the avulsion of deciduous and permanent teeth in children is well outlined in the guidelines of the International Association of Dental Traumatology and the American Academy of Pediatric Dentistry. However, little information is available about the level of knowledge in the management of dental trauma among undergraduate dental students in Japan. The objective of this study is to explore dental students’ level of educational knowledge in the management of avulsed teeth. Methods A three-part questionnaire was used to gather demographic data and evaluate the knowledge of students at Kyushu Dental University. Results Questionnaire data were collected from 121 (53 first-year, 68 sixth-year) students. Regarding the immediate emergency management of a case in which a 9-year-old girl had fallen down the stairs and lost a maxillary incisor but remained conscious, 55.9% of sixth year students and 28.3% of first-year students suggested the immediate transportation of the tooth to a dentist. The answer selected by the largest number (50.9%) of first-year respondents was “sideline the injured girl and get her to bite on a tissue paper for several hours”. In a case in which a boy had an avulsed tooth after falling down on a road, only 13.2% of first-year students suggested the transportation of the tooth in his mouth to the clinic. Most the largest number of respondents believed that the best way to transport an avulsed tooth to the dental clinic was to “wrap it in dry tissue paper”. Conclusions These results suggest that education in first aid for accidents that occur outside dental clinics or hospitals is insufficient. Japanese dentists and dental educations must immediately improve the utilization of the guidelines for dental trauma and the education of undergraduate students and patients in the management of dental trauma using an integrated approach. PMID:24712491

  15. Displaced avulsion fractures of the posterior cruciate ligament: Treated by stellate steel plate fixation

    Directory of Open Access Journals (Sweden)

    Lijun Li

    2015-01-01

    Full Text Available Background: The open reduction with internal fixation is an effective approach for treatment of avulsion fracture of posterior cruciate ligament. The previously used internal fixation materials including hollow screws, absorbable screw, tension bands and sutures have great defects such as insufficient fixation strength, susceptibility to re-fracture, etc. Stellate steel plate is novel material for internal fixation which has unique gear-like structure design. We used stellate steel plate for treatment of displaced avulsion fractures of posterior cruciate ligament in this study. Materials and Methods: 14 patients (9 men, 5 women; aged, 19-35 years; mean age, 28 years with displaced avulsion fractures of the tibial insertion of the posterior cruciate ligament were retrospectively analyzed between June 2009 and June 2011. The mean duration from injury to the operation was 8.3 days (range 6-15 days. All the patients were treated with open reduction and internal fixation of a stellate steel plate (DePuy, Raynham, MA 02767, USA. The Lysholm-Tegner knee function score criteria were used to analyze results. Results: The mean followup was 24.6 months (range 18-32 months. After 6 months, all the fractures healed and knee joint activity was normal, with no knee stiffness or instability. The Lysholm-Tegner scores were 97.1 ± 1.7 points at the final followup. Conclusion: Owing to its unique gear structure, the stellate steel plate design can effectively fix an avulsion fracture block and it is a simple operation with short postoperative rehabilitation time and firm fixation.

  16. Avulsed permanent incisors: knowledge and attitudes of primary school teachers with regard to emergency management.

    Science.gov (United States)

    Blakytny, C; Surbuts, C; Thomas, A; Hunter, M L

    2001-09-01

    This study was designed to examine the knowledge and attitudes of primary school teachers with regard to the emergency management of avulsed permanent incisors. Data were collected by self-administered questionnaire. The study was conducted in primary schools lying within a 2-mile radius of the University Dental Hospital, Cardiff. Sample and methods. A total of 388 teachers in 31 participating schools were asked to complete a questionnaire, which was subsequently collected by two of the authors (CS and AT). Two hundred and seventy-four teachers returned completed questionnaires, a response rate of 70.6%. One hundred and eighty-one respondents (60.1%) had received no advice about the emergency management of dental avulsion. Of the 133 teachers (48.5%) who possessed a first aid certificate, 39 (29.3%) had been given relevant advice as part of this training. Less than one-third of respondents (85 (31%)) cited an optimum extra-oral time of 30 min or less, with only 43 (15.7%) considering that this should be 10 min or less. However, 125 (45.6%) knew milk to be the best transport medium. Two hundred and four teachers (74.5%) stated that they would not be prepared to replant an avulsed tooth themselves, 133 (80%) basing this decision on lack of expertise and training. Two hundred and sixty-two teachers (95.6%) expressed a desire for further information. The majority of respondents possessed, at best, rudimentary knowledge of the emergency management of dental avulsion. Teachers, and other individuals who supervise children in schools, should receive simple instruction in dental first aid.

  17. AVULSION OF THE ISCHIAL TUBEROSITY IN A YOUNG SOCCER PLAYER: SIX YEARS FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    Ertan Okay

    2002-03-01

    Full Text Available In this case a seventeen-years-old male soccer player, who sustained an injury while playing football, diagnosed as ischial tuberosity avulsion was reported. Following six-months of a conservative rehabilitation program, the athlete returned to his sports' activities. Six years along he had no complaints and his athletic performance was not deteriorated. In this case report diagnosis, treatment and six-years follow-up results were discussed

  18. Avulsion of the ischial tuberosity in a young soccer player: six years follow-up.

    Science.gov (United States)

    Akova, Bedrettin; Okay, Ertan

    2002-03-01

    In this case a seventeen-years-old male soccer player, who sustained an injury while playing football, diagnosed as ischial tuberosity avulsion was reported. Following six-months of a conservative rehabilitation program, the athlete returned to his sports' activities. Six years along he had no complaints and his athletic performance was not deteriorated. In this case report diagnosis, treatment and six-years follow-up results were discussed.

  19. AVULSION OF THE ISCHIAL TUBEROSITY IN A YOUNG SOCCER PLAYER: SIX YEARS FOLLOW-UP

    OpenAIRE

    Ertan Okay; Bedrettin Akova

    2002-01-01

    In this case a seventeen-years-old male soccer player, who sustained an injury while playing football, diagnosed as ischial tuberosity avulsion was reported. Following six-months of a conservative rehabilitation program, the athlete returned to his sports’ activities. Six years along he had no complaints and his athletic performance was not deteriorated. In this case report diagnosis, treatment and six-years follow-up results were discussed.

  20. Modulation of the visceromotor reflex by a lumbosacral ventral root avulsion injury and repair in rats

    OpenAIRE

    Chang, Huiyi H.; Havton, Leif A.

    2012-01-01

    Increased abdominal muscle wall activity may be part of a visceromotor reflex (VMR) response to noxious stimulation of the bladder. However, information is sparse regarding the effects of cauda equina injuries on the VMR in experimental models. We studied the effects of a unilateral L6-S1 ventral root avulsion (VRA) injury and acute ventral root reimplantation (VRI) into the spinal cord on micturition reflexes and electromyographic activity of the abdominal wall in rats. Cystometrogram (CMG) ...

  1. Amputation of finger by horse bite with complete avulsion of both flexor tendons.

    Science.gov (United States)

    Koren, Lior; Stahl, Shalom; Rovitsky, Alexey; Peled, Eli

    2011-08-08

    Amputation of fingers with tendon avulsion occurs through a traction injury, and most occur through a ring avulsion mechanism. Usually the flexor digitorum profundus is torn out with the amputated finger. Replantation usually is recommended only when the amputation is distal to the flexor digitorum superficialis insertion. Animal bites are relatively common, with a decreasing order of frequency of dogs, cats, and humans. Horse bites are relatively infrequent but are associated with crush injuries and tissue loss when they occur. This article describes a 23-year-old man with amputation of his middle finger at the level of the proximal phalanx after being bitten by a horse. The amputated stump was avulsed with the middle finger flexor digitorum profundus and flexor digitorum superficialis torn from the muscle-tendon junction from approximately the middle of the forearm. The patient had no other injuries, and he was able to move his other 4 fingers with only mild pain. As the amputated digit was not suitable for replantation, the wound was irrigated and debrided. The edges of the phalanx were trimmed, and the edges of the wound were sutured. Tetanus toxoid and rabies vaccine were administered, along with intravenous amoxicillin and clavulanic acid. The patient was discharged from the hospital 2 days later, with no sign of infection of the wound or compartment syndrome of the forearm. This case demonstrates the weakest point in the myotendinous junction and emphasizes the importance of a careful physical examination in patients with a traumatic amputation. Copyright 2011, SLACK Incorporated.

  2. Pomegranate juice (punica granatum: a new storage medium for avulsed teeth.

    Directory of Open Access Journals (Sweden)

    Sara Tavassoli-Hojjati

    2014-04-01

    Full Text Available There is evidence indicating that pomegranate juice contains many of the essential properties necessary to retain cell viability and cell proliferation. These properties indicate that pomegranate juice is a suitable storage medium for avulsed teeth. However, this idea has not yet been tested. In this study, the capacity of pomegranate juice (PJ as a storage medium for retaining avulsed teeth was evaluated.PDL fibroblasts were obtained from healthy human premolars and cultured in Dulbecco's Modified Eagle's Medium (DMEM. Cultured cells were subjected to different concentrations of pomegranate juice (PJ, 1% Hank's balanced salt solution (HBSS and tap water for 1, 3, 6 and 24 hours. PDL cell viability was assessed by the neutral red uptake assay.The results indicated that 7.5% PJ was the most effective solution for maintaining PDL cell viability amongst all the experimental solution's and time intervals (P<0.05. The results also showed that 1% PJ was as effective as HBSS for maintaining PDL cell viability. The amount of cell viability increased with increasing concentration of PJ at all time intervals (P<0.001. This effect is suggestive of the proliferative potential of PJ solution.In conclusion, PJ can be recommended as a suitable transport medium for avulsed teeth.

  3. Dental luxation and avulsion injuries in Hong Kong primary school children.

    Science.gov (United States)

    Cho, S Y

    2015-08-01

    To identify the major causes and types of dental luxation and avulsion injuries, and their associated factors in primary school children in Hong Kong. Case series. School dental clinic, New Territories, Hong Kong. The dental records of children with a history of dental luxation and/or avulsion injury between November 2005 and October 2012 were reviewed. Objective clinical and radiographical findings at the time of injury and at follow-up examinations were recorded using a standardised form. Data analysis was carried out using the Chi squared test and multinomial logistic regression. A total of 220 children with 355 teeth of dental luxation or avulsion injury were recorded. Their age ranged from 6 to 14 years and the female-to-male ratio was 1:1.8. The peak occurrence was at the age of 9 years. Subluxation was the most common type of injury, followed by concussion. Maxillary central incisors were the most commonly affected teeth. The predominant cause was fall and most injuries occurred at school. Incisor relationship was registered in 199 cases: most of them were Class I. Comparison of the incisor relationship in study children and the general Chinese population in another study revealed a higher proportion of Class II and fewer Class III occlusions in the trauma group (PHong Kong primary school children are caused by fall. Boys are more commonly affected than girls, and a Class II incisor relationship is a significant risk factor.

  4. [What does the non-dentistry-trained person know about avulsion?].

    Science.gov (United States)

    Sterenborg, E M; van Hooft, M J; Frankenmolen, F W; Weerheijm, K L; Groen, H J

    1999-02-01

    The prognosis of an avulsed permanent incisor depends on a swift and correct emergency treatment. The chance of a favourable prognosis increases if the tooth is replanted as quickly as possible, preferably by the persons first present at the scene of the accident. Usually this person is a layman, therefore the aim of this study is to investigate the knowledge in this respect. To 48 schools and 15 swimming pools in Amsterdam, Arnhem and Nijmegen (the Netherlands), questionnaires were sent. Thirty-six schools and 15 swimming pools responded. Twenty-eight percent of the respondents had previous experience with an avulsion. Ten percent of the respondents would replant the incisor and 90% would store the incisor. Sixty-three percent would treat the tooth correctly. Respondents with previous experience had no more knowledge of the most effective treatment than persons without previous experience. Swimming instructors and physical health instructors knew significantly more about avulsion than teachers in primary schools. Since only 10% of the respondents would replant the incisor and 37% would handle this accident incorrectly, more information seems to be necessary.

  5. Concurrent patellar fracture and lateral collateral ligament avulsion as a result of trauma in three horses.

    Science.gov (United States)

    McLellan, Jonathan; Plevin, Sarah; Taylor, Elizabeth

    2012-05-15

    3 horses were evaluated because of lameness and swelling of the stifle joint subsequent to trauma. All horses had characteristic clinical signs of stifle joint pain and effusion. A medial patellar fracture and lateral collateral ligament avulsion fracture were visible ultrasonographically in each. Radiography, including standard as well as flexed lateromedial, cranioproximal-craniodistal oblique (skyline patellar), and laterally stressed caudocranial views, revealed similar findings. Arthroscopic surgery to remove the patellar fracture was attempted in 1 horse with severe desmitis of the lateral collateral ligament; it remained lame afterward. The other 2 horses, with less severe collateral ligament damage, were managed conservatively and returned to athletic use, despite the lack of surgical intervention to repair the patellar fractures. Special radiographic views were necessary for diagnosis of medial patellar fracture and lateral collateral ligament avulsion fracture in the 3 horses. Ultrasonographic findings pertaining to the collateral ligament may be prognostically important in such situations. The severity of a fracture involving ligament avulsion may be the limiting factor in horses with this combined injury, and this factor should be considered prior to attempting surgical correction of patellar fractures.

  6. Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion.

    Science.gov (United States)

    El Ashry, Saad R; El Gamal, Tarek A; Platt, Simon R

    Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula. Both patients had sustained a twisting injury to the ankle. The fractures failed to unite. The nonunion resulted in dysfunction of the anterior talofibular ligament with consequent chronic ankle instability. At the initial clinical assessment, magnetic resonance imaging was requested for both patients. In patient 1 (12 years old), the fracture was fixed with 2 headless screws and was immobilized in a plaster cast for 6 weeks. In patient 2 (9 years old), because of the small size of the avulsed fragment, fixation was not possible. A modified Gould-Broström procedure was undertaken, facilitating repair of the avulsed fragment using anchor sutures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Arthroscopically assisted reconstruction of triangular fibrocartilage complex foveal avulsion in the ulnar variance-positive patient.

    Science.gov (United States)

    Kim, ByungSung; Yoon, Hong-Kee; Nho, Jae-Hwi; Park, Kang Hee; Park, Sung-Yong; Yoon, Jun-Hee; Song, Hyun Seok

    2013-11-01

    Our aim was to evaluate the clinical results of patients treated by arthroscopically assisted reconstruction of foveal avulsion injury of the triangular fibrocartilage complex (TFCC) using a suture anchor. We retrospectively reviewed the results of 15 patients (11 men and 4 women; mean age, 30.5 years) who underwent surgical procedures for the treatment of TFCC foveal avulsion at our hospital. The patients were followed up for a mean of 29 months. The patients had TFCC foveal avulsion caused by sprains (n = 8), falls (n = 4), playing baseball (n = 2), and a motor vehicle accident (n = 1). All the patients underwent magnetic resonance imaging. Radiographs obtained to assess ulnar variance (UV), ulnar-dorsal subluxation, and function of the wrist based on grip power; Disabilities of the Arm, Shoulder and Hand score; and Mayo wrist score were examined for all patients both preoperatively and postoperatively. On preoperative magnetic resonance imaging, TFCC foveal avulsion was observed in 13 of 15 cases. The mean UV value based on preoperative simple radiographic findings was 1.7 ± 1.0 mm, and dorsal subluxation at the distal ulna improved from 2.9 ± 3.0 mm to 0.2 ± 0.9 mm (P = .017). In all cases the distal radioulnar joint instability disappeared postoperatively. Grip power (compared with the uninvolved limb) was 79.3% preoperatively and 82.9% postoperatively (P = .086). The Disabilities of the Arm, Shoulder and Hand scores were 28.4 points preoperatively and 16.6 points postoperatively (P = .061). The Mayo wrist scores were excellent in 10 cases, good in 2, and fair in 3, and the mean score improved significantly from 64 points preoperatively to 84 points postoperatively (P = .007). Arthroscopic-assisted suture anchor reattachment of the TFCC in patients with traumatic TFCC foveal avulsion can prevent or reduce distal radioulnar joint instability and reduce pain even in chronic cases with positive UV. Level IV, therapeutic case series. Copyright © 2013

  8. Pelvic floor morphometry and function in women with and without puborectalis avulsion in the early postpartum period.

    Science.gov (United States)

    Cyr, Marie-Pierre; Kruger, Jennifer; Wong, Vivien; Dumoulin, Chantale; Girard, Isabelle; Morin, Mélanie

    2017-03-01

    Pelvic floor muscles are subject to considerable stretching during vaginal birth. In 13-36% of women, stretching results in avulsion injury whereby the puborectalis muscle disconnects from its insertion points on the pubis bone. Until now, few studies have investigated the effect of this lesion on pelvic floor muscles in the early postpartum period. The primary aim of this study was to compare pelvic floor muscle morphometry and function in primiparous women with and without puborectalis avulsion in the early postpartum period. Our secondary objective was to compare the 2 groups for pelvic floor disorders and impact on quality of life. In all, 52 primiparous women diagnosed with (n = 22) or without (n = 30) puborectalis avulsion injury were assessed at 3 months postpartum. Pelvic floor muscle morphometry was evaluated with 3-/4-dimensional transperineal ultrasound at rest, maximal contraction, and Valsalva maneuver. Different parameters were measured in the midsagittal and axial planes: bladder neck position, levator plate angle, anorectal angle, and levator hiatus dimensions. The dynamometric speculum was used to assess pelvic floor muscle function including: passive properties (passive forces and stiffness) during dynamic stretches, maximal strength, speed of contraction, and endurance. Pelvic floor disorder-related symptoms (eg, urinary incontinence, vaginal and bowel symptoms) and impact on quality of life were evaluated with the International Consultation on Incontinence Questionnaire and the Pelvic Floor Impact Questionnaire-Short Form. Pelvic Organ Prolapse Quantification was also assessed. In comparison to women without avulsion, women with avulsion presented an enlarged hiatus area at rest, maximal contraction, and Valsalva maneuver (P ≤ .013) and all other ultrasound parameters were found to be significantly altered during maximal contraction (P ≤ .014). They showed lower passive forces at maximal and 20-mm vaginal apertures as well as lower

  9. Axillary artery injury after an anterior shoulder fracture dislocation and “periosteal sleeve avulsion of the rotator cuff” (SARC. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ash Chehata

    2017-04-01

    Full Text Available We present the rare complication of an axillary artery injury associated with an anterior dislocation of the humerus and what we believe to be the first reported periosteal sleeve avulsion of the entire rotator cuff (SARC. We review the literature and discuss the cause of this unusual injury pattern. Keywords: Axillary artery, Shoulder fracture dislocation, Periosteal sleeve avulsion, SARC

  10. Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report

    DEFF Research Database (Denmark)

    Sørensen, Jens Christian Hedemann; Meier, Kaare; Perinpam, Larshan

    Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report......Peripheral nerve stimulation (PNS) in the trapezius muscle region alleviate chronic neuropathic pain after lower brachial plexus root avulsion lesion: A case report...

  11. Knowledge and Attitude of Primary School Teachers toward Tooth Avulsion and Dental First Aid in Davangere City: A Cross-sectional Survey.

    Science.gov (United States)

    Prasanna, Sapna; Giriraju, Anjan; Narayan, Nagesh Lakshmi

    2011-01-01

    Traumatic dental injuries including avulsed tooth is a tragic and ignored problem among school children. As children spend much of their time in schools, school teachers form the group who commonly supervise the physical activity of the children, so awareness about avulsed tooth emergency management among school teachers is an important concept for long-term success and to prevent its future consequences. The purpose of this study was to assess the knowledge and attitude regarding tooth avulsion and dental first aid among primary school teachers in Davangere city. The study was performed by administering a self-designed questionnaire on a sample of 300 primary school teachers. Sixty-eight percent of the school teachers (government, semi-aided and aided schools) admitted the possibility of an avulsed tooth to be replanted and thirty-two percent had no idea on tooth replantation and only twenty-three percent of the teachers knew the procedures taken in cases of avulsed teeth. Seventy-seven percent of all teachers did not feel the possibility of tooth replantation. There is poor knowledge in the management of avulsed teeth among the school teachers of Davangere city. They do not feel capable of replanting an avulsed tooth. As one of the child supervisors, all the school teachers should have the basic knowledge to recognize oral emergencies and regarding conservation of avulsed teeth to prevent its consequences in the child's future.

  12. Clinical analysis of 54 cases of large area soft tissue avulsion in the lower limb.

    Science.gov (United States)

    Chen, Yu; Liu, Lei

    2016-12-01

    To assess the clinical curative effect of different treatment methods for large area avulsion injury in the lower limb. Between January 2010 and December 2013, 54 patients with large area avulsion injury in the lower limb were treated in the trauma center of our hospital, including 34 males and 20 females with a mean age of 35.7 years (range, 16-65 years). The injury mechanism was traffic accident in 44 cases, hitting by heavy objects in 8 cases, and fall from height in 2 cases, involving 31 thighs, 19 legs and 4 feet involved. The sizes of the avulsed wounds ranged from 10 cm ×15 cm to 50 cm ×30 cm. There were 16 cases combined with hemorrhagic shock, 5 with femoral fractures, and 7 with tibiofibula fractures. Averagely the patients were sent to our hospital within 3.5 h (range, 1.5-10 h) after injury. For the 54 patients, three different surgical strategies were performed based on the wound area and condition of the avulsed skin: in Group A, 24 patients were treated by debridement and preservation of subcutaneous vascular network ⁺ vertical mattress suture of full thickness skin flap ⁺ tube drainage; in Group B, 25 patients were treated by split-thickness skin flap meshing and grafting ⁺ vacuum sealing drainage (VSD); and in Group C, the other 5 patients were treated by debridement and VSD at stage I ⁺ reattachment of autologous reserved frozen split-thickness skin graft at stage II. All the 54 patients recovered and were discharged eventually, without any deaths or amputees. In each group, there were no statistical differences (all p > 0.05) among different injury sites in terms of survival rate and length of hospital stay, except for the infection rate, which was much higher (p =0.000) at the leg area than that at the thigh (32.54% ± 2.97% vs. 2.32% ± 2.34% in Group A and 50.00% ± 0.00% vs. 0 in Group C) or the foot (50.00% ± 0.00% vs. 0 in Group C). Moreover comparison of the three surgical methods showed a significant different (all p < 0

  13. Avulsion of the L4 spinous process: an unusual injury in a professional rugby player: case report.

    Science.gov (United States)

    Jones, Alwyn; Andrews, John; Shoaib, Amer; Lyons, Kath; Ahuja, Sashin; Howes, John; Davies, Paul

    2005-06-01

    A case of L4 spinous process avulsion following a hyperflexion injury treated with surgical excision. To show that single photon emission computerized tomography is essential for the diagnosis and that excision can provide a successful outcome. The avulsion resulted from a forced hyperflexion injury at the L4/5 area, where the interspinous ligament provides a high resistance to flexion. A 29-year-old international rugby football player injured his low back during a match. Plain radiography and magnetic resonance imaging did not reveal the injury. Single photon emission computerized tomography and computerized tomography showed the lesion. Initial conservative therapy failed to control the symptoms, and, therefore, late excision was performed with pain-free return to contact sports at 3 months. Few cases of interspinous process avulsions have been described, and, to our knowledge, this is the first reported case of rugby football player who had a successful outcome with late surgical excision.

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

    Directory of Open Access Journals (Sweden)

    Yoshihiro Onada

    2016-01-01

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

  15. Immediate self-replantation of an avulsed permanent mandibular incisor - a case report.

    Science.gov (United States)

    Emerich, Katarzyna; Czerwinska, Marta; Ordyniec-Kwasnica, Iwona

    2010-10-01

    Approximately 50% of children under the age of 15 years are subjected to various kinds of injuries in the orofacial region. In the permanent dentition, the most severe dental injury affects the surrounding alveolar bone structure and leads to loss of the tooth. The current literature emphasizes that the awareness of appropriate triage procedures following dental trauma is unsatisfactory and that delay in treatment is the single most influential factor affecting prognosis. This case report presents the immediate self-replantation of a right lateral mandibular incisor of a 12-year-old male patient following a traumatic avulsion. The same patient had earlier, aged 10 years, experienced a trauma leading to the loss of all four maxillary incisors. The missing incisors were replaced by a removable acrylic denture. Having the requisite experience from the earlier accident, the child performed on himself an immediate replantation of the tooth at the site of the accident. After avulsion, the tooth was not splinted timely nor was an endodontic procedure carried out and no antibiotics were prescribed. The first dental examination after the trauma was performed 6 months later and since then, radiographic follow-up has been introduced. One year after the trauma, following the late endodontic treatment performed 6 months after reimplantation, the tooth is asymptomatic and stable. Immediate self-replantation of an avulsed tooth is the best treatment choice, even without any other proceeding treatment. However, the healing process should be followed up to allow for the treatment of the early signs of pulpal necrosis and/or root resorption. © 2010 John Wiley & Sons A/S.

  16. The Avulsion Fracture of Tibial Tubercle in the Basis of Osgood-Schlatter Disease

    Directory of Open Access Journals (Sweden)

    Umut Gulacti

    2014-03-01

    Full Text Available    The avulsion fractures of tibial tubercle are seen very rare and usually occur during sports activities in adolescence boys. The injury mechanism often is sudden  and strong contraction of the quadriceps muscle. Rarely, it can be seen in Osgood- Schlatter disease (OSH with a simple trauma. In this case report, a 16 year-old male patient who admitted to emergency service because of knee pain with Ogden type IIB tibial tuberosity fracture in the basis OSH is discussed with literature.

  17. Investigation and management of an isolated complete distal avulsion of semitendinosus.

    Science.gov (United States)

    Ahmed, Idrees; Williams, Martin; Murray, James

    2018-04-17

    A 34-year-old male patient presented with right-sided posteromedial knee pain following an attempted tackle during a soccer match. MRI revealed that the semitendinosus (ST) tendon had completely avulsed from its distal insertion site. The patient was initially managed conservatively but eventually required surgery due to ongoing posteromedial knee pain. Surgical management was achieved through tenodesis of ST to gracilis. Postsurgery, the posteromedial knee pain had been alleviated, and following physiotherapy the patient regained a good range of motion. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. A new treatment for avulsion fracture of the calcaneus using an Ilizarov external fixator.

    Science.gov (United States)

    Takahashi, Masayasu; Noda, Mitsuaki; Saegusa, Yasuhiro

    2013-11-01

    In the treatment of avulsion fractures of the posterior calcaneal tuberosity, open reduction and internal fixation are prone to several complications. We describe a new treatment using an Ilizarov external fixator, which can minimise the complications and achieve sufficient stability of the displaced fragment. A 55-year-old woman sustained an avulsion fracture of the calcaneus. Examination revealed the development of bruising with extremely taut skin over the posterior prominence of the displaced bone. Radiographs demonstrated grossly proximal displacement of the tuberosity fragment. Surgery was exclusively percutaneous using an Ilizarov external fixator. The displaced fragment was adequately reduced and stabilised. Progressive weight bearing in the equinus position was initiated at the third week after surgery and the external fixator was removed at the seventh week. There was no skin necrosis or loss of reduction while the fixator was maintained. Postoperative follow-up for 2 years revealed full recovery. Major postoperative complications after conventional open reduction and internal fixation include skin necrosis, skin irritation by metal implants and re-displacement of the reduced fragment. Our method of using an external fixator may decrease the incidence of these three complications. Skin incision and the risk of skin necrosis are inevitable during internal fixation. On the other hand, the use of an external fixator reduces or eliminates skin necrosis, as it is applied percutaneously for reduction and stabilisation of the fragment. External fixation is mostly recommended in cases of poor vascularity or bruising. In addition, skin irritation can be avoided upon removal of the external fixator. Re-displacement occurs occasionally as a serious complication in lag screw fixation, particularly in cases with poor purchase of the osteoporotic bone. Tension band wiring and application of an Ilizarov external fixator in avulsion fractures of the calcaneus can

  19. Simultaneous bilateral tibial tubercle avulsion fracture in a male teenager: case report and literature review.

    Science.gov (United States)

    Nicolini, Alexandre P; Carvalho, Rogerio T; Ferretti, Mario; Cohen, Moises

    2018-01-01

    Tibial tuberosity avulsion fractures are injuries accounting for less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are very rare, with only 19 cases described in the literature. These types of fractures occur commonly in male teenagers during sport activities and are often associated with other orthopaedic disorders. We report the case of a male teenager with simultaneous bilateral tibial tubercle fractures, describe the evolution and treatment of this injury and review the literature on this subject. Case report.

  20. Primary school health teachers’ knowledge regarding the emergency treatment of avulsed permanent teeth in Hamadan

    Directory of Open Access Journals (Sweden)

    Arghavan Kamali

    2016-11-01

    T-test. Results: 81 Health teachers were studied and the ratio of knowledge score of all of health teachers to a maximum knowledge score was obtained to be 43/1%. There was no significant relationship between the school health teacher knowledge and their work experiences and age (P=0.23-0.6, respectively. Average of knowledge score of who were educated was more than who were not educated previously (P<0.001. Conclusion: Primary school health teachers' knowledge of dealing with Avulsion was not at a high level. Therefore, training on the dental trauma cases is quite essential for them.

  1. Bifocal osseous avulsion of the patellar tendon from the distal patella and tibial tuberosity in a child

    DEFF Research Database (Denmark)

    Lykke Hermansen, Lars; Gade Freund, Knud

    2016-01-01

    This case report describes a 12-year-old boy, who suffered an injury to the right knee in a skateboard accident. Radiographs and surgery confirmed the extremely rare bifocal avulsion fracture including the distal patellar pole and tibial tuberosity. Open reduction and internal fixation was accomp......This case report describes a 12-year-old boy, who suffered an injury to the right knee in a skateboard accident. Radiographs and surgery confirmed the extremely rare bifocal avulsion fracture including the distal patellar pole and tibial tuberosity. Open reduction and internal fixation...

  2. An avulsion fracture of the calcaneal tuberosity: delay of treatment causes the ‘Achilles heel’ of optimal recovery

    Science.gov (United States)

    Bosman, Willem-Maarten; Leijnen, Michiel; van den Bremer, Jephta; Ritchie, Ewan D

    2016-01-01

    A 72-year-old woman was diagnosed with an avulsion fracture of the tuberosity of the calcaneus. The fracture was planned for elective fixation 12 days after the accident. The planned open reduction and internal fixation was not possible due to a decubital wound on the Achilles heel as a result of pressure on the skin of the fractured tuberosity. Closed reduction and internal fixation was performed, leading to an acceptable outcome. Avulsion fractures of the tuberosity of the calcaneus are rare injuries, and delay in treatment should be avoided as it may lead to preventable complications. PMID:26759395

  3. Operative Fixation of an Anterior Inferior Iliac Spine Apophyseal Avulsion Fracture Nonunion in an Adolescent Soccer Player: A Case Report.

    Science.gov (United States)

    Carr, James B; Conte, Evan; Rajadhyaksha, Evan A; Laroche, Kevin A; Gwathmey, F Winston; Carson, Eric W

    2017-01-01

    A 14-year-old male competitive soccer player presented with a history of recurrent right hip pain for 18 months. He was diagnosed with an anterior inferior iliac spine (AIIS) apophyseal avulsion fracture nonunion with subspinal impingement, which was confirmed by radiographs, computed tomography, and magnetic resonance imaging. The patient underwent surgical fixation and subspinal decompression. He returned to competitive soccer 5 months postoperatively. AIIS apophyseal avulsion fractures occur in adolescent athletes and generally respond to nonoperative treatment. When such management is unsuccessful, surgical fixation can lead to resolution of pain with return of full function.

  4. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant.

    Science.gov (United States)

    de Oliveira, Natalice Sousa; Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias; Pretti, Henrique

    2017-01-01

    The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.

  5. Psychosocial outcomes and coping after complete avulsion traumatic brachial plexus injury.

    Science.gov (United States)

    Franzblau, Lauren; Chung, Kevin C

    2015-01-01

    To understand psychosocial outcomes, coping and adjustment after complete avulsion traumatic brachial plexus injury (BPI). We conducted a grounded theory analysis of 12 semi-structured patient interviews exploring psychosocial outcomes, augmented by quantitative evaluation of self-reported mental health and social functioning, body image and coping strategies obtained via three questionnaires (SF-36, Brief COPE and modified SWAP). Subjects' main sources of psychological stress were chronic pain, unemployment, decreased self-efficacy and social-emotional consequences of poor body image. One third of participants reported depression, half experienced anger and frustration and two-thirds were dissatisfied with the appearance of their affected limbs. Acceptance, active coping, planning and emotional support were the most frequently used coping strategies. Patients encounter high levels of physical and psychological stress after complete avulsion BPI and must find ways to cope to adjust to their injuries. They face similar challenges to patients with spinal cord injuries, for whom many models describing coping and adjustment exist. Similar models could facilitate more complete adjustment and rehabilitation of BPI patients and help to reduce the prevalence of negative stress responses, including anger and depression. Future patients would benefit from a multidisciplinary treatment program, involving medical and mental health services.

  6. Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?

    Directory of Open Access Journals (Sweden)

    Hamid Reza Niknejad

    2016-01-01

    Full Text Available Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings. Here, we describe a case of isolated traumatic injury to this structure and discuss the clinical outcome. A 64 year old polytrauma patient with a remarkable avulsion fracture at the site of the insertion of the ALL was admitted to our center. We evaluated the patient both clinical and radiological at admission, after 3 months and after 1 year. We clinically assessed the upper cervical rotational stability using the cervical flexion rotation test. We observed no rotational instability or any other clinical repercussions at the long term after an isolated ALL injury. This case shows that isolated traumatic damage to the ALL is possible. Unilateral damage to the ALL probably does not cause rotational instability of the craniocervical junction. In case a similar avulsion fracture is observed, we recommend performing a magnetic resonance imaging of the craniovertebral region to assess for any ligamentous lesions.

  7. Investigation of lay knowledge of the management of avulsed permanent incisors.

    Science.gov (United States)

    Hamilton, F A; Hill, F J; Mackie, I C

    1997-02-01

    The prognosis of replanted avulsed permanent incisors depends largely on prompt and appropriate emergency management. The aim of this study was to investigate lay knowledge and attitudes in this respect. Postal questionnaires were sent to all physical education teachers, school nurses and secretaries, attendants in swimming baths and leisure centres and to 220 parents of teenage children in a defined area of North West England. The overall questionnaire response rate was 86.9%. Knowledge of methods of dealing with this problem was generally inadequate in both parents and the other groups. Although 53.6% of respondents claimed to have received first aid training only 3.1% could remember dental injuries being included. There was evidence that dental health education in this field can be effective, since the highest mean knowledge score was found in the 11.5% of respondents who recalled receiving advice from sources such as posters, magazines and newspapers. More than 80% of the respondents stated that they would not want to replant an avulsed incisor themselves, the main reason being lack of knowledge and training. It is suggested that there is a need for potentially effective dental health education in relation to this problem.

  8. Core curriculum case illustration: [Stieda fracture (avulsion fracture of the medial femoral condyle)].

    Science.gov (United States)

    Fadl, Shaimaa Abdelhassib; Robinson, Jeffrey D

    2018-02-01

    This is the 30th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC . A Stieda fracture is an avulsion injury from the medial femoral condyle of the origin of the medial collateral ligament. The medial collateral ligament originates superiorly from the medial femoral condyle and has superficial and deep fibers. On radiographs, the avulsion fracture at or near the medial femoral condyle near the attachment site of the medial collateral ligament is usually characteristic. Isolated partial or complete MCL injuries can be treated nonoperatively with good outcomes. Reconstruction of the medial ligamentous structures of the knee is usually performed if there is persistent valgus laxity or anteromedial rotatory instability after nonoperative management.

  9. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant

    Science.gov (United States)

    Barbosa, Gabriella Lopes de Rezende; Lanza, Lincoln Dias

    2017-01-01

    The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents. PMID:29093976

  10. Incarceration of the medial collateral ligament in the intercondylar notch following proximal avulsion

    Energy Technology Data Exchange (ETDEWEB)

    Walton, Edward [Fiona Stanley Hospital, Department of Radiology, Perth, Western Australia (Australia); Williams, Martin [North Bristol NHS Trust, Department of Radiology, Bristol (United Kingdom); Robinson, James R. [Bristol Knee Group, Avon Orthopaedic Centre, Bristol (United Kingdom)

    2017-11-15

    Intra-articular entrapment of the medial collateral ligament (MCL) is a rare but recognised complication of traumatic injury to the posteromedial corner (PMC) of the knee. Considering the MCL is the most commonly injured ligament of the knee this complication is extremely rare with only a handful of cases describing MCL entrapment following distal avulsion of the MCL. We present the first known case of MCL entrapment following proximal avulsion of the MCL and posterior oblique ligament (POL) with the mid-substance of the MCL becoming entrapped in the joint, lying on the superior surface of the medial meniscus and extending up into the intercondylar notch. In addition, the medial patellar retinaculum was also entrapped in the medial aspect of the medial patellofemoral joint. MCL entrapment is best treated with expeditious surgical intervention and it is therefore crucial that the MRI findings are not overlooked. Details of the clinical assessment, MRI and operative findings are presented with a literature review of MCL entrapment. (orig.)

  11. Prosthetic Rehabilitation of Child Victim of Avulsion of Anterior Teeth with Orthodontic Mini-Implant

    Directory of Open Access Journals (Sweden)

    Natalice Sousa de Oliveira

    2017-01-01

    Full Text Available The treatment of choice in cases of avulsed permanent teeth is the immediate reimplantation. However, this conduct does not always work favorably, either by failures in the initial approach or by inappropriate interventions. In this sense, the aim of this study is to present an alternative prosthetic rehabilitation with the use of orthodontic mini-implants in the anterior region. This case reports a ten-year-old child with history of avulsion of superior central incisors. The therapeutic approach was planned to promote physiological teeth contacts and acceptable esthetics and phonetics. First, the occlusal-gingival insertion of two orthodontic mini-implants was performed in the alveolar ridge, and, immediately after that, two provisional crowns were attached to the implants. The interventions achieved satisfactory cosmetic and functional results. After one-year follow-up, the adjacent periodontal tissues remained without signs and/or symptoms of inflammation. The provisional crowns presented no mobility and fractures. During radiographic examination, a healthy bone tissue appearance was observed. The simplicity of mini-implant installation makes them a promising alternative for temporary prosthetic rehabilitation of patients undergoing growth and development. The technique provides positive aesthetic and functional results that may reflect on self-esteem and social inclusion of children and adolescents.

  12. Surgical treatment of avulsion fractures at the tibial insertion of the posterior cruciate ligament: functional result

    Directory of Open Access Journals (Sweden)

    Marcos Alexandre Barros

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To objectively and subjectively evaluate the functional result from before to after surgery among patients with a diagnosis of an isolated avulsion fracture of the posterior cruciate ligament who were treated surgically. METHOD: Five patients were evaluated by means of reviewing the medical files, applying the Lysholm questionnaire, physical examination and radiological examination. For the statistical analysis, a significance level of 0.10 and 95% confidence interval were used. RESULTS: According to the Lysholm criteria, all the patients were classified as poor (<64 points before the operation and evolved to a mean of 96 points six months after the operation. We observed that 100% of the posterior drawer cases became negative, taking values less than 5 mm to be negative. CONCLUSION: Surgical methods with stable fixation for treating avulsion fractures at the tibial insertion of the posterior cruciate ligament produce acceptable functional results from the surgical and radiological points of view, with a significance level of 0.042.

  13. Treatment of an avulsed maxillary permanent central incisor by autotransplantation of a primary canine tooth.

    Science.gov (United States)

    Sönmez, D; Dalci, K; Tunç, E Sen

    2008-07-01

    To present a case in which an avulsed permanent maxillary central incisor was replaced by autotransplantation of a primary canine tooth. The present case describes transplantation of a primary canine tooth into the space left by an avulsed permanent maxillary central incisor after a delay of several days. After root canal treatment, the primary canine tooth was extracted and placed into the prepared socket. To provide better adaptation of the donor tooth, the recipient alveolar site was remodeled using surgical burs. Semi-rigid splinting was maintained for 15 days. The crown of the primary canine was reshaped with composite resin and with an interim prosthesis, preventing movement of the lateral incisor tooth into the space of the transplanted canine. After 24-month follow-up the autotransplanted primary canine showed ankylosis but the tooth was in an acceptable state. The use of permanent tooth autotransplantation has been well documented. However a literature search revealed only one case report on the autotransplantation of primary teeth. Long term results of primary tooth autotransplantation are scarce but the procedure in this case report could be considered as a temporary space maintainer for the treatment of a patient with a lost permanent incisor under 10 years of age. Success of primary tooth autotransplantation may be affected by several factors, such as case selection, extra oral time, surgical and endodontic procedures.

  14. Surgical Treatment of Calcaneal Avulsion Fracture in Elderly Patients Using Cannulated Cancellous Screws and Titanium Wire.

    Science.gov (United States)

    Miyamura, Satoshi; Ota, Haruka; Okamoto, Michio; Namba, Jiro; Yamamoto, Koji

    2016-01-01

    Avulsion fractures of the calcaneus are relatively uncommon and are seen most frequently in elderly or osteoporotic patients. A surgical method that avoids displacement of the avulsed fragment after fixation has not been developed. We report the cases of 3 patients (a 73-year-old male, an 85-year-old male, and an 81-year-old female) treated by open reduction and internal fixation using titanium wire and cannulated cancellous screws. The posterior approach was used by way of a vertical midline incision. The fracture was fixed with 2 screws, and then a titanium wire was passed through the holes of the cannulated screws. A small incision on the lateral side of planter was added for the exit and return of the wire. The wire knot was bent inside the proximal Achilles tendon bursa in 2 patients and was directed to the plantar side in 1 to avoid irritation. Bony union was achieved without repeat displacement of the fragment in all 3 patients. Normal ankle function was restored, and the patients recovered the activities of daily living almost to the original level. Although an additional plantar incision is required, this surgical technique provides strong internal fixation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Simultaneous Bilateral Tibial Tubercle Avulsion Fracture in a case of Pre-Existing Osgood-Schlatter Disease (OSD).

    Science.gov (United States)

    Narayana Gowda, B S; Mohan Kumar, J

    2012-01-01

    Osgood-Schlatter disease (OSD) is a well known condition, characterized by pain over the tibial tubercle with subsequent tubercle prominence. Avulsion fracture following OSD is a rare complication. We report an unusual case of simultaneous bilateral tibial tubercle avulsion fracture in a 16 year old boy who was a known case of OSD. A 16 year old boy a known case of OSD presented to the outpatient department with history of jumping from the school compound wall (two feet height) while playing, followed by severe pain around anterior aspect of both knees and difficulty in walking. Radiographs showed bilateral tibial tubercle avulsion fracture. He was treated successfully with open reduction and internal fixation with tension band wiring. At the end of 22 months the patient was symptomatically relieved and both the tuberosities were united with the main bone. Even though bilateral Osgood-Schlatter disease (OSD) is a well known condition, one should always keep in mind the risk of tibial tubercle avulsion fractures while treating a case of OSD. Patient should be advised not to involve in strenuous activities till the disease subsides radiologically or till skeletal maturity.

  16. Successful return to high-level sports following early surgical repair of combined adductor complex and rectus abdominis avulsion.

    Science.gov (United States)

    Tansey, R J; Benjamin-Laing, H; Jassim, S; Liekens, K; Shankar, A; Haddad, F S

    2015-11-01

    Hip and groin injuries are common in athletes who take part in high level sports. Adductor muscle tendon injuries represent a small but important number of these injuries. Avulsion of the tendons attached to the symphysis pubis has previously been described: these can be managed both operatively and non-operatively. We describe an uncommon variant of this injury, namely complete avulsion of the adductor sleeve complex: this includes adductor longus, pectineus and rectus abdominis. We go on to describe a surgical technique which promotes a full return to the pre-injury level of sporting activity. Over a period of ten years, 15 high-level athletes with an MRI-confirmed acute adductor complex avulsion injury (six to 34 days old) underwent surgical repair. The operative procedure consisted of anatomical re-attachment of the avulsed tissues in each case and mesh reinforcement of the posterior inguinal wall in seven patients. All underwent a standardised rehabilitation programme, which was then individualised to be sport-specific. One patient developed a superficial wound infection, which was successfully treated with antibiotics. Of the 15 patients, four complained of transient local numbness which resolved in all cases. All patients (including seven elite athletes) returned to their previous level of participation in sport. ©2015 The British Editorial Society of Bone & Joint Surgery.

  17. Knowledge and awareness of first aid of avulsed tooth among physicians and nurses of hospital emergency department

    Directory of Open Access Journals (Sweden)

    Sudeep Sreepad Iyer

    2017-01-01

    Full Text Available Introduction: Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. Materials and Methods: A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department. Results: With 100% response rate, the data obtained was subjected to statistical analysis. Results showed lack of knowledge and confidence in both groups. About 66.7% (n = 100 nurses and 74.7% (n = 112 considered reimplantation of avulsed tooth. There was overbalanced confusion regarding storage/transport media and handling of avulsed tooth. Conclusion: The findings from the results suggested a definite inadequacy in knowledge, demanding need for appropriate training for delivering treatment with more predictability and better prognosis.

  18. Modified tension band wiring fixation for avulsion fractures of the calcaneus in osteoporotic bone: a review of three patients.

    Science.gov (United States)

    Nagura, Issei; Fujioka, Hiroyuki; Kurosaka, Masahiro; Mori, Hiroyuki; Mitani, Makoto; Ozaki, Akihiro; Fujii, Hideo; Nabeshima, Yuji

    2012-01-01

    Calcaneal avulsion fractures are not uncommon, and they are probably more likely in patients with osteoporosis. Closed manipulation for this type of fracture often fails to achieve acceptable reduction, and open reduction and internal fixation are usually required. However, open reduction and internal fixation with either a lag screw or Steinmann pins do not provide satisfactory fixation in patients with diabetes and elderly patients because of the presence of porotic bone. Levi described a tension band fixation system used to treat a calcaneal avulsion fracture using a simple technique performed with a transverse Kirschner wire through the os calcaneus, securing a figure-of-8 metal tension band wiring to the fragment. We report the successful treatment of 3 patients with calcaneal avulsion fractures using a modified tension band wiring technique, resulting in satisfactory recovery. Re-displacement of the fragment during the initial follow-up period was not reported, and bony union was achieved in all patients. We believe this technique is a useful surgical option for the treatment of calcaneal avulsion fractures. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Isolated avulsion of the biceps femoris insertion-injury patterns and treatment options: a case report and literature review.

    Science.gov (United States)

    Kusma, Matthias; Seil, R; Kohn, D

    2007-11-01

    Isolated avulsion of the biceps femoris tendon is a relatively rare condition. We report a case of a 43 year-old soccer player with a rupture of the biceps femoris tendon which occurred in a hyperextension of the knee. Based on this case, we discuss the literature referring to injury pattern and treatment.

  20. Acute avulsion fractures of the pelvis in adolescent competitive athletes: prevalence, location and sports distribution of 203 cases collected

    International Nuclear Information System (INIS)

    Rossi, F.; Dragoni, S.

    2001-01-01

    Objective. To describe the prevalence, location and sports distribution of pelvic avulsion fractures in adolescent competitive athletes. Design and patients. One thousand two hundred and thirty-eight radiographs of the pelvis taken for focal traumatic symptoms in athletes with an age range of 11-35 years over a period of 22 years were reviewed. Results. One hundred and ninety-eight adolescent athletes were affected by 203 avulsion fractures of the pelvic apophyses (five cases presented multiple locations). The localisation was the ischial tuberosity (IT) in 109 cases, anterior inferior iliac spine (AIIS) in 45 cases, anterior superior iliac spine (ASIS) in 39 cases, superior corner of pubic symphysis (SCPS) in 7 cases and iliac crest (IC) in 3 cases. Soccer (74 cases) and gymnastics (55 cases) were the sports with the highest number of avulsion fractures documented. Conclusions. Apophyseal avulsion fractures of the pelvis in adolescent competitive athletes are most common in soccer and gymnastics. The lesions are usually the consequence of sudden and forceful muscle-tendon contractions during sport activities. Plain radiographs, are determinant for the diagnosis. (orig.)

  1. Comparison of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion in the treatment of ingrown toenails.

    Science.gov (United States)

    Huang, Jia-Zhang; Zhang, Yi-Jun; Ma, Xin; Wang, Xu; Zhang, Chao; Chen, Li

    2015-01-01

    The present retrospective study compared the efficacy of wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion for the treatment of ingrown toenails (onychocryptosis). Two surgical methods were performed in 95 patients with a stage 2 or 3 ingrown toenail. Each patient was examined weekly until healing and then at 1, 6, and 12 months of follow-up. The outcomes measured were surgical duration, healing time, recurrence rate, the incidence of postoperative infection, and cosmetic appearance after surgery. Of the 95 patients (115 ingrown toenails) included in the present study, 39 (41.1%) underwent wedge resection (Winograd procedure) and 56 (59%), wedge resection plus complete nail plate avulsion. The mean surgical duration for wedge resection (Winograd procedure) and wedge resection plus complete nail plate avulsion was 14.9 ± 2.4 minutes and 15.1 ± 3.2 minutes, respectively (p = .73). The corresponding healing times were 2.8 ± 1.2 weeks and 2.7 ± 1.3 weeks (p = .70). Recurrence developed in 3 (3.2%) patients after wedge resection (Winograd procedure) and in 4 (4.2%) after wedge resection plus complete nail plate avulsion. In addition, postoperative infection occurred in 3 (3.2%) patients after wedge resection (Winograd procedure) and 2 (2.1%) after wedge resection plus complete nail plate avulsion. Both of the surgical procedures were practical and appropriate for the treatment of ingrown toenails, being simple and associated with low morbidity and a high success rate. However, cosmetically, wedge resection (Winograd procedure) would be the better choice because the nail plate remains intact. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Avulsion research using flume experiments and highly accurate and temporal-rich SfM datasets

    Science.gov (United States)

    Javernick, L.; Bertoldi, W.; Vitti, A.

    2017-12-01

    SfM's ability to produce high-quality, large-scale digital elevation models (DEMs) of complicated and rapidly evolving systems has made it a valuable technique for low-budget researchers and practitioners. While SfM has provided valuable datasets that capture single-flood event DEMs, there is an increasing scientific need to capture higher temporal resolution datasets that can quantify the evolutionary processes instead of pre- and post-flood snapshots. However, flood events' dangerous field conditions and image matching challenges (e.g. wind, rain) prevent quality SfM-image acquisition. Conversely, flume experiments offer opportunities to document flood events, but achieving consistent and accurate DEMs to detect subtle changes in dry and inundated areas remains a challenge for SfM (e.g. parabolic error signatures).This research aimed at investigating the impact of naturally occurring and manipulated avulsions on braided river morphology and on the encroachment of floodplain vegetation, using laboratory experiments. This required DEMs with millimeter accuracy and precision and at a temporal resolution to capture the processes. SfM was chosen as it offered the most practical method. Through redundant local network design and a meticulous ground control point (GCP) survey with a Leica Total Station in red laser configuration (reported 2 mm accuracy), the SfM residual errors compared to separate ground truthing data produced mean errors of 1.5 mm (accuracy) and standard deviations of 1.4 mm (precision) without parabolic error signatures. Lighting conditions in the flume were limited to uniform, oblique, and filtered LED strips, which removed glint and thus improved bed elevation mean errors to 4 mm, but errors were further reduced by means of an open source software for refraction correction. The obtained datasets have provided the ability to quantify how small flood events with avulsion can have similar morphologic and vegetation impacts as large flood events

  3. Modified dorsal root entry zone lesioning for intractable pain relief in patients with root avulsion injury.

    Science.gov (United States)

    Takai, Keisuke; Taniguchi, Makoto

    2017-08-01

    OBJECTIVE Dorsal root entry zone (DREZ) lesioning has been the most effective surgical treatment for the relief of intractable pain due to root avulsion injury, but residual pain and a decrease in pain relief in the follow-up period have been reported in 23%-70% of patients. Based on pain topography in the most recent studies on neuropathic pain, the authors modified the conventional DREZ lesioning procedure to improve clinical outcomes. The presumed rationale for this procedure is to eliminate the spontaneous discharges of neurons in the superficial spinal dorsal horn as well as wide dynamic range neurons in the deep spinal dorsal horn. METHODS Ten patients with avulsion-related pain underwent surgery between 2011 and 2015. The surgical procedure was described and postoperative pain relief was assessed as follows: excellent (residual pain never exceeded 3 on the visual analog scale [VAS] without medication), good (residual pain never exceeded 5 on the VAS with medication), and poor (residual pain was greater than 5 with medication). Specific perioperative complications were assessed. RESULTS The aim of this surgical procedure was to destroy the deeper layers of the posterior horn of spinal gray matter, which was in contrast to the procedures of Nashold and Sindou, which were to destroy the superficial layers. All patients achieved excellent (n = 7, pain relief without medication) or good (n = 3, pain relief with medication) pain relief postoperatively, and the recurrence of pain was not reported in any patients (median 29 months after surgery, range 12-64 months). Nine patients (90%) achieved complete pain relief (a score of 0 or 1 on the VAS) with or without medication. No surgical site complications such as infection or CSF leakage were noted. No motor deficit was observed in any patient. A sensory deficit was observed in 2 patients and disappeared within 1 month in 1 patient. New pain at the adjacent level of DREZ lesioning was observed in 3 patients and

  4. Arthroscopic Reduction and Fixation of Tibial Spine Avulsion Fractures by a Stainless Steel Wiring Technique.

    Science.gov (United States)

    Abdelhamid, Mohamed M; Bayoumy, Maysara Abdelhalim; Elkady, Hesham A; Abdelkawi, Ayman Farouk

    2017-12-01

    Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. In this study, we evaluate a new wiring technique for the treatment of these injuries. This technique involves fixation by stainless steel tension wires passed over the fractured spine and tied over a bone bridge. The advantages of this technique are that it aids in reduction, allows for compression of the tibial spine fragment anatomically in its fracture bed, provides stable fixation in difficult comminuted fractures, and allows for early mobilization and weight bearing because of the solid fixation.

  5. Temporary preservation of avulsed tooth in oral submucosal tissue: an experimental study in cat.

    Science.gov (United States)

    Jamalpour, Mohammad Reza; Soltanian, Ali Reza; Tootunchi, Amir Sasan; Roshanipaian, Milad

    2014-08-01

    The purpose of this study was to determine the ability of oral submucosal tissue to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL) cell viability of avulsed teeth. Thirty cats were divided into five groups. After extraction of three teeth in each cat, one tooth was put in the depth of cat's oral submucosal tissue and the other two teeth were put in Hanks' balanced salt solution (HBSS) and tap water. The teeth were removed after 8, 24, 48, 72, and 168 h from their mediums and sent for laboratory processing and counting of vital periodontal cells. Statistical analysis demonstrated that submucosal tissue kept PDL cells viable as good as HBSS. This animal study showed that the efficacy of oral submucosal tissue in maintaining the viability of human PDL cells is similar to that of HBSS. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Isolated Avulsion of the Common Hepatic Duct from Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2012-01-01

    Full Text Available Isolated extrahepatic biliary tract injury following blunt abdominal trauma is rare. The underlying pathogenic mechanisms remain obscure, but include shear and/or compression forces on the biliary system. Associated morbidity rates are high and largely the result of delays in diagnosis. Imaging modalities commonly employed for diagnosis include ultrasonography, computed tomography, nuclear medicine, and magnetic resonance imaging. Percutaneous and endoscopic techniques have been used both for diagnosis and treatment. Treatment options are dictated by the stability of the patient and the extent of bile duct and concomitant injuries. In this paper, we discuss a case of isolated avulsion of the hepatic duct confluence following blunt trauma that was successfully managed with Roux-en-Y hepaticojejunostomy. To our knowledge, this specific injury pattern has not been previously reported.

  7. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    Science.gov (United States)

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-03-11

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. 2016 BMJ Publishing Group Ltd.

  8. The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.

    LENUS (Irish Health Repository)

    Mohan, H

    2012-02-01

    Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.

  9. A Combinatorial Approach to Induce Sensory Axon Regeneration into the Dorsal Root Avulsed Spinal Cord

    DEFF Research Database (Denmark)

    Hoeber, Jan; Konig, Niclas; Trolle, Carl

    2017-01-01

    restores sensory functions. In this study, we elucidate mechanisms underlying stem cell-mediated ingrowth of sensory axons after dorsal root avulsion (DRA). We show that human spinal cord neural stem/progenitor cells (hscNSPC), and also, mesoporous silica particles loaded with growth factor mimetics (Meso......MIM), supported sensory axon regeneration. However, when hscNSPC and MesoMIM were combined, sensory axon regeneration failed. Morphological and tracing analysis showed that sensory axons grow through the newly established glial scar along “bridges” formed by migrating stem cells. Coimplantation of Meso......MIM prevented stem cell migration, “bridges” were not formed, and sensory axons failed to enter the spinal cord. MesoMIM applied alone supported sensory axons ingrowth, but without affecting glial scar formation. In vitro, the presence of MesoMIM significantly impaired migration of hscNSPC without affecting...

  10. Variability Matters: New Insights into Mechanics of River Avulsions on Deltas and Their Deposits

    Science.gov (United States)

    Ganti, V.

    2015-12-01

    River deltas are highly dynamic, often fan-shaped depositional systems that form when rivers drain into a standing body of water. They host over a half billion people and are currently under threat of drowning and destruction by relative sea-level rise, subsidence, and anthropogenic interference. Deltas often develop planform fan shapes through avulsions, whereby major river channel shifts occur via "channel jumping" about a spatial node, thus determining their fundamental length scale. Emerging theories suggest that the size of delta lobes is set by backwater hydrodynamics; however, these ideas are difficult to test on natural deltas, which evolve on centennial to millennial timescales. In this presentation, I will show results from the first laboratory delta built through successive deposition of lobes that maintain a constant size that scales with backwater hydrodynamics. The characteristic size of deltas emerges because of a preferential avulsion node that remains fixed spatially relative to the prograding shoreline, and is a consequence of multiple river floods that produce persistent morphodynamic river-bed adjustment within the backwater zone. Moreover, river floods cause erosion in the lowermost reaches of the alluvial river near their coastline, which may leave erosional boundaries in the sedimentary record that may appear similar to those previously interpreted to be a result of relative sea-level fall. I will discuss the implications of these findings in the context of sustainability management of deltas, decoding their stratigraphic record, and identifying ancient standing bodies of water on other planets such as Mars. Finally, I will place this delta study in a broader context of recent work that highlights the importance of understanding and quantifying variability in sedimentology and geomorphology.

  11. Posterior Humeral Avulsion of the Glenohumeral Ligament and Associated Injuries: Assessment Using Magnetic Resonance Imaging.

    Science.gov (United States)

    Rebolledo, Brian J; Nwachukwu, Benedict U; Konin, Gabrielle P; Coleman, Struan H; Potter, Hollis G; Warren, Russell F

    2015-12-01

    Lesions associated with posterior humeral avulsion of the glenohumeral ligament (HAGL) can lead to persistent symptoms related to posterior shoulder instability and can be commonly missed or delayed in diagnosis. To identify and characterize the MRI findings in patients with a posterior HAGL lesion. Case series; Level of evidence, 4. This retrospective case series included 27 patients (28 shoulders) identified by search through the senior authors' databases, with cross-reference to their institutional radiologic communication system for MRI review. Baseline patient demographic data were collected, including age and sex. All posterior HAGL lesions were identified on MRI and characterized as partial, complete, or floating lesions. All acute glenohumeral pathologic changes concurrent with the posterior HAGL were documented. Chondrolabral retroversion of the injured shoulder was measured on axial MRI. The average age of the identified cohort was 33.6 years (range, 15-81 years), and 23 patients were male (86%). Posterior HAGL injuries were found to be complete tears (71%), partial tears (25%), and floating lesions (4%); concomitant bony HAGL avulsion was found in 7% of injuries. Additional traumatic glenohumeral disorders occurred in 93% of cases. The most common concurrent injuries were reverse Hill-Sachs lesions (36%), anterior Bankart lesions (29%), and posterosuperior rotator cuff tears (25%). Notably, concomitant anterior labral or capsular injury was found in 50% of patients, signifying bidirectional disruption of the capsule. In addition, increased chondrolabral version was found in this cohort (10.2° ± 3.7° retroversion). This study depicts the high association of combined injury with posterior HAGL lesions and increased chondrolabral retroversion. Findings on MRI related to a posterior HAGL injury could potentially be masked by additional injury and may occur with mechanisms that also lead to anterior glenohumeral disorders. © 2015 The Author(s).

  12. Comparative Biomechanical Study on Contact Alterations After Lateral Meniscus Posterior Root Avulsion, Transosseous Reinsertion, and Total Meniscectomy.

    Science.gov (United States)

    Perez-Blanca, Ana; Espejo-Baena, Alejandro; Amat Trujillo, Daniel; Prado Nóvoa, María; Espejo-Reina, Alejandro; Quintero López, Clara; Ezquerro Juanco, Francisco

    2016-04-01

    To compare the effects of lateral meniscus posterior root avulsion left in situ, its repair, and meniscectomy on contact pressure distribution in both tibiofemoral compartments at different flexion angles. Eight cadaveric knees were tested under compressive 1000 N load for 4 lateral meniscus conditions (intact, posterior root avulsion, transosseous root repair, and total meniscectomy) at flexion angles 0°, 30°, 60°, and 90°. Contact area and pressure distribution were registered using K-scan pressure sensors inserted between menisci and tibial plateau. In the lateral compartment, root detachment decreased contact area (P = .017, 0° and 30°; P = .012, 60° and 90°) and increased mean (P = .012, all angles) and maximum (P = .025, 0° and 30°; P = .017, 60°; P = .012, 90°) pressures relative to intact condition. Repair restored all measured parameters close to intact at 0°, but effectiveness decreased with flexion angle, yielding no significant effect at 90°. Meniscectomy produced higher decreases than root avulsion in contact area (P = .012, 0° and 90°; P = .05, 30° and 60°) and increases in mean (P = .017, 0° and 30°; P = .018, 90°) and maximum pressure (P = .012, 0°; P = .036, 30°). In the medial compartment, lesion changed the contact area at high flexion angles only, while meniscectomy induced greater changes at all angles. Lateral meniscus posterior root avulsion generates significant alterations in contact area and pressures at lateral knee compartment for flexion angles between full extension and 90°. Meniscectomy causes greater disorders than the avulsion left in situ. Transosseous repair with a single suture restores these alterations to conditions close to intact at 0° and 30° but not at 60° and 90°. Altered contact mechanics after lateral meniscus posterior root avulsion might have degenerative consequences. Transosseous repair with one suture should be revised to effectively restore contact mechanics at high flexion angles

  13. Avulsion in inhabited deltas triggered by human-induced sea ingressions: a historical analogue from the first millennium AD in the Netherlands

    Science.gov (United States)

    Pierik, Harm Jan; Stouthamer, Esther; Schuring, Tim; Cohen, Kim

    2017-04-01

    The shifting of river channels (avulsion) has consequences for people living in deltas as it is a key process in the distribution of sediment and water and thus transport and resources. These avulsions have many causes which are either upstream or downstream induced, such as base level rise, flooding events, or levee superelevation. However, a so far unexplored decisive factor in determining avulsion success is the development of sea ingressions and the role of human activities in forming them. The landward expansions of tidal channels significantly reduce the distance to sea for a potential new river course. In this contribution we infer the role of sea ingressions from a historical case study from the first millennium AD of a multiple-staged avulsion in the Rhine-Meuse delta, the Netherlands. This avulsion resulted in a major reorganisation of the river channel network: it was the first avulsion which successfully crossed an extensive peat area that separated the rivers Rhine and Meuse, thereby distributing a major part of the Rhine discharge towards another tidal inlet. This tidal inlet expanded into the peat area and connected to an active crevasse splay. Archaeological evidence surrounding this ingression strongly suggests that its expansion was accelerated by human-induced soil subsidence related to peat land reclamation. This case study demonstrates that an increase in tidal influence in a low gradient delta plain is an important mechanism determining avulsion success. Considering major subsidence and sediment depletion problems that many deltas are nowadays facing, human-induced sea ingressions will presumably become increasingly important for successful avulsions.

  14. Novel avulsion pattern of the left principal bronchus with involvement of the carina and caudal thoracic trachea in a cat.

    Science.gov (United States)

    Schmierer, Philipp A; Schwarz, Andrea; Bass, Danielle A; Knell, Sebastian Christoph

    2014-08-01

    A 2-year-old, 4.5 kg, neutered male domestic shorthair cat was presented to the emergency service with dyspnoea, anorexia and apathetic behaviour. Thoracic radiographs showed typical signs for a thoracic trauma and a tracheal lesion in the region of the carina, consistent with pseudoairway formation. Computed tomography (CT) was performed in the conscious cat to avoid aggravation of air leakage associated with ventilation. The additional CT findings were consistent with a novel pattern of a traumatic avulsion of the left principal bronchus expanding into the carina and caudal thoracic trachea. Despite the complex avulsion pattern, successful treatment was achieved surgically by performing an end-to-end anastomosis via a fifth right intercostal lateral thoracotomy. The cat was ventilated with a feeding tube and jet ventilation throughout. The cat showed excellent recovery 6 months after surgery. © ISFM and AAFP 2013.

  15. Rehabilitation of Avulsed Teeth in Fractured Jaws via Bone Grafting and Implant Placement: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Anshul Jain

    2016-01-01

    Full Text Available The maxillofacial region is one of the most injury-prone areas during road traffic accidents, personal violence, falls and sports. Maxillofacial trauma can lead to breakage or avulsion of upper anterior teeth, which may cause significant aesthetic and functional problems. There are many treatment options available for rehabilitation including removable partial dentures, fixed partial dentures, crown and bridges and implant-supported prostheses.Herein, two cases are presented where implant placement was done for upper anterior teeth, which were traumatized or avulsed following maxillofacial trauma. Both patients demonstrated a history of maxillofacial trauma and had undergone open reduction and internal fixation. The first patient had a severe maxillary alveolar defect treated via autogenous bone grafting and a six-month period was given for proper integration of the bone graft. The second patient was a smoker with very poor oral hygiene and a deep bite. Thus, implant placement was not initially justified.

  16. Evaluation of Avulsion-Induced Neuropathology in Rat Spinal Cords with 18F-FDG Micro-PET/CT.

    Directory of Open Access Journals (Sweden)

    Ze-Min Ling

    Full Text Available Brachial plexus root avulsion (BPRA leads to dramatic motoneuron death and glial reactions in the corresponding spinal segments at the late stage of injury. To protect spinal motoneurons, assessment of the affected spinal segments should be done at an earlier stage of the injury. In this study, we employed 18F-FDG small-animal PET/CT to assess the severity of BPRA-induced cervical spinal cord injuries. Adult Sprague-Dawley rats were randomly treated and divided into three groups: Av+NS (brachial plexus root avulsion (Av treated with normal saline, Av+GM1 (treated with monosialoganglioside, and control. At time points of 3 day (d, 1 week (w, 2 w, 4 w and 8 w post-injury, 18F-FDG micro-PET/CT scans and neuropathology assessments of the injured spinal roots, as well as the spinal cord, were performed. The outcomes of the different treatments were compared. The results showed that BPRA induced local bleeding and typical Wallerian degeneration of the avulsed roots accompanied by 18F-FDG accumulations at the ipsilateral cervical intervertebral foramen. BPRA-induced astrocyte reactions and overexpression of neuronal nitric oxide synthase in the motoneurons correlated with higher 18F-FDG uptake in the ipsilateral cervical spinal cord during the first 2 w post-injury. The GM1 treatment reduced BPRA-induced astrocyte reactions and inhibited the de novo nNOS expressions in spinal motoneurons. The GM1 treatment also protected spinal motoneurons from avulsion within the first 4 w post-injury. The data from this study suggest that 18F-FDG PET/CT could be used to assess the severity of BPRA-induced primary and secondary injuries in the spinal cord. Furthermore, GM1 is an effective drug for reducing primary and secondary spinal cord injuries following BPRA.

  17. An evidence-based assessment of the clinical guidelines for replanted avulsed teeth. Part II: prescription of systemic antibiotics.

    Science.gov (United States)

    Hinckfuss, Susan Elisabeth; Messer, Louise Brearley

    2009-04-01

    Current clinical guidelines recommend prescribing systemic antibiotic therapy (SAT) for patients having an avulsed permanent tooth replanted. The principles of evidence-based dentistry can be used to assess whether this is the best approach based on currently-available evidence. The objective of this study was to use the principles of evidence-based dentistry to answer the PICO question: (P) for a replanted avulsed permanent tooth, (I) is prescribing SAT, (C) compared with not prescribing SAT, (O) associated with an increased likelihood of successful periodontal healing after tooth replantation? A literature search was performed across four internet databases (Ovid Medline, Cochrane Library, PubMed, ISI Web of Science), for relevant citations (n = 35 702). Limiting citations to those in English and removing duplicates produced a set of titles (n = 14 742) that were sieved according to evidence-based dentistry principles. Relevant titles were selected for abstract assessment (n = 782), identifying papers for examination (n = 74). Inclusion criteria were applied and three papers (326 total teeth) met the final criteria for meta-analysis. Meta-analyses found no statistically significant difference between prescribing or not prescribing antibiotics for acceptable periodontal healing without progressive root resorption (common odds ratio = 0.90, SE = 0.29, 95% confidence intervals = 0.51-1.58). The evidence for an association between prescribing SAT and an increased likelihood of acceptable periodontal healing outcome is inconclusive. This investigation of antibiotic use as defined in the clinical guidelines indicates there is inconclusive clinical evidence from studies of replanted avulsed human teeth to either contradict or support the guideline. Pending future research to the contrary, dentists are recommended to follow current guidelines in prescribing SAT when replanting avulsed teeth.

  18. Motor Recovery and Synaptic Preservation after Ventral Root Avulsion and Repair with a Fibrin Sealant Derived from Snake Venom

    Science.gov (United States)

    Barbizan, Roberta; Castro, Mateus V.; Rodrigues, Antônio C.; Barraviera, Benedito; Ferreira, Rui S.; Oliveira, Alexandre L. R.

    2013-01-01

    Background Ventral root avulsion is an experimental model of proximal axonal injury at the central/peripheral nervous system interface that results in paralysis and poor clinical outcome after restorative surgery. Root reimplantation may decrease neuronal degeneration in such cases. We describe the use of a snake venom-derived fibrin sealant during surgical reconnection of avulsed roots at the spinal cord surface. The present work investigates the effects of this fibrin sealant on functional recovery, neuronal survival, synaptic plasticity, and glial reaction in the spinal motoneuron microenvironment after ventral root reimplantation. Methodology/Principal Findings Female Lewis rats (7 weeks old) were subjected to VRA and root replantation. The animals were divided into two groups: 1) avulsion only and 2) replanted roots with fibrin sealant derived from snake venom. Post-surgical motor performance was evaluated using the CatWalk system twice a week for 12 weeks. The rats were sacrificed 12 weeks after surgery, and their lumbar intumescences were processed for motoneuron counting and immunohistochemistry (GFAP, Iba-1 and synaptophysin antisera). Array based qRT-PCR was used to evaluate gene regulation of several neurotrophic factors and receptors as well as inflammatory related molecules. The results indicated that the root reimplantation with fibrin sealant enhanced motor recovery, preserved the synaptic covering of the motoneurons and improved neuronal survival. The replanted group did not show significant changes in microglial response compared to VRA-only. However, the astroglial reaction was significantly reduced in this group. Conclusions/Significance In conclusion, the present data suggest that the repair of avulsed roots with snake venom fibrin glue at the exact point of detachment results in neuroprotection and preservation of the synaptic network at the microenvironment of the lesioned motoneurons. Also such procedure reduced the astroglial reaction and

  19. Motor recovery and synaptic preservation after ventral root avulsion and repair with a fibrin sealant derived from snake venom.

    Directory of Open Access Journals (Sweden)

    Roberta Barbizan

    Full Text Available BACKGROUND: Ventral root avulsion is an experimental model of proximal axonal injury at the central/peripheral nervous system interface that results in paralysis and poor clinical outcome after restorative surgery. Root reimplantation may decrease neuronal degeneration in such cases. We describe the use of a snake venom-derived fibrin sealant during surgical reconnection of avulsed roots at the spinal cord surface. The present work investigates the effects of this fibrin sealant on functional recovery, neuronal survival, synaptic plasticity, and glial reaction in the spinal motoneuron microenvironment after ventral root reimplantation. METHODOLOGY/PRINCIPAL FINDINGS: Female Lewis rats (7 weeks old were subjected to VRA and root replantation. The animals were divided into two groups: 1 avulsion only and 2 replanted roots with fibrin sealant derived from snake venom. Post-surgical motor performance was evaluated using the CatWalk system twice a week for 12 weeks. The rats were sacrificed 12 weeks after surgery, and their lumbar intumescences were processed for motoneuron counting and immunohistochemistry (GFAP, Iba-1 and synaptophysin antisera. Array based qRT-PCR was used to evaluate gene regulation of several neurotrophic factors and receptors as well as inflammatory related molecules. The results indicated that the root reimplantation with fibrin sealant enhanced motor recovery, preserved the synaptic covering of the motoneurons and improved neuronal survival. The replanted group did not show significant changes in microglial response compared to VRA-only. However, the astroglial reaction was significantly reduced in this group. CONCLUSIONS/SIGNIFICANCE: In conclusion, the present data suggest that the repair of avulsed roots with snake venom fibrin glue at the exact point of detachment results in neuroprotection and preservation of the synaptic network at the microenvironment of the lesioned motoneurons. Also such procedure reduced the

  20. Avulsion Fracture of the Calcaneus Treated With a Soft Anchor Bridge and Lag Screw Technique: A Report of Two Cases.

    Science.gov (United States)

    Yoshida, Kazushige; Kasama, Kentaro; Akahane, Tsutomu

    2016-01-01

    The displaced extra-articular avulsion fracture of the calcaneus has been classified as a Böhler type 1c calcaneal fracture, and most cases will require surgical repair. In the present report, we describe 2 patients in whom we performed the soft anchor bridge technique using single loaded suture anchors with lag screws for the repair of Böhler type 1c avulsion fractures of the calcaneus. In one of these patients, clinically relevant osteoporosis complicated the injury. In both cases, bone union was achieved, and by 1.5 months after surgery satisfactory recovery was observed. To our knowledge, the soft anchor bridge technique was first used for the treatment of rotator cuff tears, and the greatest merit of this technique is the ability to generate vertical compression force to the pulled out rotator cuff through the use of knotting sutures. In recent years, the soft anchor bridge technique using 4 suture anchors has also been used for fractures of the greater tuberosity of the humerus, an injury that poses operative difficulties similar to those encountered with an avulsion fracture of the calcaneus owing to the traction force of the rotator cuff and relative weakness of adjacent bone. The outcomes of our patients suggest that the soft anchor bridge technique combined with adjunct lag screws is useful in the fixation of avulsion fractures of the calcaneus. In addition, the result in the elderly patient indicates the possibility of using this technique for patients with osteoporosis. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period.

    Science.gov (United States)

    Marchiori, Erica Cristina; Santos, Saulo Ellery; Asprino, Luciana; de Moraes, Márcio; Moreira, Roger William Fernandes

    2013-06-01

    This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.

  2. Comparative study of surgical and conservative treatments for fifth metatarsal base avulsion fractures (type I) in young adults or athletes.

    Science.gov (United States)

    Wu, Gen-Bin; Li, Bing; Yang, Yun-Feng

    2018-01-01

    This study aimed to investigate the therapeutic effects and complications of minimally invasive surgery in treating displaced avulsion fractures (2-3 mm) of fifth metatarsal base zone I in young adults or athletes. Forty-six patients with displaced fifth metatarsal base avulsion fractures were assigned to operative and nonoperative groups by randomization. Patients in nonoperative group were immobilized with plaster, while patients in operative group were treated with closed reduction and fixation with a percutaneous screw. All patients were followed up for 14 months on average (ranging from 12 to 24 months). All cases got primary union except for three patients in nonoperative group with malunion and two with frequent mild to moderate plantar pain. The American Orthopaedic Foot and Ankle Society score was significantly better in operative group at 6 months after treatment ( p 0.05). The average time of full weight bearing and returning to work was significantly shorter in operative group than nonoperative group ( p athletes with displaced avulsion fractures of fifth metatarsal base zone I, closed reduction and percutaneous screw fixation provides anatomical stable fixation and early mobilization.

  3. Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Pavlidis Theodoros E

    2011-08-01

    Full Text Available Abstract Introduction Injury of the gallbladder after blunt abdominal trauma is an unusual finding; the reported incidence is less than 2%. Three groups of injuries are described: simple contusion, laceration, and avulsion, the last of which can be partial, complete, or total traumatic cholecystectomy. Case presentation A case of isolated complete avulsion of the gallbladder (near traumatic cholecystectomy from its hepatic bed in a 46-year-old Caucasian man without any other sign of injury is presented. The avulsion was due to blunt abdominal trauma after a car accident. The rarity of this injury and the stable condition of our patient at the initial presentation warrant a description. The diagnosis was made incidentally after a computed tomography scan, and our patient was treated successfully with ligation of the cystic duct and artery, removal of the gallbladder, coagulation of the bleeding points, and placement of a drain. Conclusions Early diagnosis of such injuries is quite difficult because abdominal signs are poor, non-specific, or even absent. Therefore, a computed tomography scan should be performed when the mechanism of injury is indicated.

  4. Integrating Delta Building Physics & Economics: Optimizing the Scale of Engineered Avulsions in the Mississippi River Delta

    Science.gov (United States)

    Kenney, M. A.; Mohrig, D.; Hobbs, B. F.; Parker, G.

    2011-12-01

    Land loss in the Mississippi River Delta caused by subsidence and erosion has resulted in habitat loss, interference with human activities, and increased exposure of New Orleans and other settled areas to storm surge risks. Prior to dam and levee building and oil and gas production in the 20th century, the long term rates of land building roughly balanced land loss through subsidence. Now, however, sediment is being deposited at dramatically lower rates in shallow areas in and adjacent to the Delta, with much of the remaining sediment borne by the Mississippi being lost to the deep areas of the Gulf of Mexico. A few projects have been built in order to divert sediment from the river to areas where land can be built, and many more are under consideration as part of State of Louisiana and Federal planning processes. Most are small scale, although there have been some proposals for large engineered avulsions that would divert a significant fraction of the remaining available sediment (W. Kim, et al. 2009, EOS). However, there is debate over whether small or large diversions are the economically optimally and socially most acceptable size of such land building projects. From an economic point of view, the optimal size involves tradeoffs between scale economies in civil work construction, the relationship between depth of diversion and sediment concentration in river water, effects on navigation, and possible diminishing returns to land building at a single location as the edge of built land progresses into deeper waters. Because land building efforts could potentially involve billions of dollars of investment, it is important to gain as much benefit as possible from those expenditures. We present the result of a general analysis of scale economies in land building from engineered avulsions. The analysis addresses the question: how many projects of what size should be built at what time in order to maximize the amount of land built by a particular time? The analysis

  5. A new evaluation system for early and successful conservative treatment for acute ischial tuberosity avulsion

    Directory of Open Access Journals (Sweden)

    Ceretti Marco

    2013-08-01

    Full Text Available 【Abstract】In this report we analyse a case of ischi-atic tuberosity avulsion. A 15-year-old patient who came to our first aid department two days after a football match ac-cident was treated conservatively and examined at month 1-4, 6 and 12. In order to examine patient condition, a new index was formulated: the inability score index (ISI, which is based on hip range of motion and scales for rest, walking, running pain and compared to other parameters such as oedema area, fragment diastasis evaluated by X-ray and CT accordingly. ISI defines the inability as severe, moderate and mild. It guides the rehabilitative program in the right way. In this case, the patient was able to run softly after 35 days and to go back to the full agonist activity after 4 months. At the end of treatment the patient referred to the complete pain remission, full range of motion recovery and a good fracture consolidation. After 1 year we discuss about thera-peutic strategies used and results obtained. Key words: Fractures, bone; Sports medicine; Reha-bilitation

  6. Plasma rich in growth factors to treat an articular cartilage avulsion: a case report.

    Science.gov (United States)

    Sánchez, Mikel; Azofra, Juan; Anitua, Eduardo; Andía, Isabel; Padilla, Sabino; Santisteban, Juanma; Mujika, Iñigo

    2003-10-01

    The application of an autologous plasma rich in growth factors is beneficial in restoring connective tissues, as shown by clinical evidence in oral surgery and more recently in arthroscopic anterior cruciate ligament reconstruction and two cases of ruptured Achilles tendon in professional athletes. This is attributed to the slow delivery of growth factors from harvested platelets that have been activated by endogenous thrombin promoted by the addition of calcium chloride. This case report describes a new application of this therapy in the arthroscopic treatment of a large, nontraumatic avulsion of articular cartilage in the knee of an adolescent soccer player. After arthroscopic reattachment of the large (>2 cm) loose chondral body in its crater in the medial femoral condyle, autologous plasma rich in growth factors was injected into the area between the crater and the fixed fragment. Despite the extremely poor prognosis of the case, complete articular cartilage healing was considerably accelerated, and the functional outcome was excellent, allowing a rapid resumption of symptom-free athletic activity. This technique opens new perspectives for human tissue regeneration.

  7. Thalamic deep brain stimulation for neuropathic pain after amputation or brachial plexus avulsion.

    Science.gov (United States)

    Pereira, Erlick A C; Boccard, Sandra G; Linhares, Paulo; Chamadoira, Clara; Rosas, Maria José; Abreu, Pedro; Rebelo, Virgínia; Vaz, Rui; Aziz, Tipu Z

    2013-09-01

    Fifteen hundred patients have received deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy over the last half-century, but few during the last decade. Deep brain stimulation for neuropathic pain has shown variable outcomes and gained consensus approval in Europe but not the US. This study prospectively evaluated the efficacy at 1 year of DBS for phantom limb pain after amputation, and deafferentation pain after brachial plexus avulsion (BPA), in a single-center case series. Patient-reported outcome measures were collated before and after surgery, using a visual analog scale (VAS) score, 36-Item Short-Form Health Survey (SF-36), Brief Pain Inventory (BPI), and University of Washington Neuropathic Pain Score (UWNPS). Twelve patients were treated over 29 months, receiving contralateral, ventroposterolateral sensory thalamic DBS. Five patients were amputees and 7 had BPAs, all from traumas. A postoperative trial of externalized DBS failed in 1 patient with BPA. Eleven patients proceeded to implantation and gained improvement in pain scores at 12 months. No surgical complications or stimulation side effects were noted. In the amputation group, after 12 months the mean VAS score improved by 90.0% ± 10.0% (p = 0.001), SF-36 by 57.5% ± 97.9% (p = 0.127), UWNPS by 80.4% ± 12.7% (p stimulation demonstrated efficacy at 1 year for chronic neuropathic pain after traumatic amputation and BPA. Clinical trials that retain patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.

  8. A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

    Directory of Open Access Journals (Sweden)

    Hyoseob Lim

    2014-03-01

    Full Text Available Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

  9. Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.

    Science.gov (United States)

    McIntosh, Mark S; Konzelmann, Jason; Smith, Jeffrey; Kalynych, Colleen J; Wears, Robert L; Schneider, Howard; Wylie, Todd; Kaminski, Anne; Matar-Joseph, Madeline

    2009-10-01

    The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. This was a randomized crossover study comparing 3 splinting techniques for managing a traumatically avulsed tooth (periodontal pack, wire, and bondable reinforcement ribbon) and 2 bandage techniques for managing a fractured tooth (calcium hydroxide paste and light-cured composite). After viewing a Just-in-Time training video, a convenience sample of emergency physicians performed the 5 stabilization techniques on dental models containing extracted teeth embedded in clay to simulate a segment of the human dentition. Data collected included time to complete each procedure, the evaluation of dentists about whether the procedure was performed satisfactorily or unsatisfactorily, and the ranking of dentists' and participants' preferred technique. Twenty-five emergency physicians participated in the study: 17 residents, 2 pediatric emergency medicine fellows, and 6 attending physicians. Reported median time, as well as minimum and maximum times to complete each splinting technique for an avulsed tooth, was as follows: periodontal pack 4.4 minutes (2.5 to 6.5 minutes), wire 8.6 minutes (5.8 to 12.9 minutes), and bondable reinforcement ribbon 8.9 minutes (5.6 to 15 minutes). Median time (and minimum and maximum times) to complete each protective bandaging technique for a fractured tooth was calcium hydroxide paste 4.6 minutes (3 to 9.6 minutes) and light-cured composite 7.1 minutes (5.5 to 14.1 minutes). When asked to choose a preferred splinting and bandaging technique according to the performance of the physicians, the dentists chose the bondable reinforcement ribbon 96% (24/25) and the light-cured composite 100% (25/25) of the time. Study participants had no measurable or agreeable preference for a particular splinting

  10. Long-term provisional anterior tooth replacement using fiber-reinforced composite and avulsed tooth crowns as pontics.

    Science.gov (United States)

    Yurdagüven, Haktan; Say, Esra Can; Güler, Nurhan

    2010-02-01

    The loss of anterior teeth due to trauma requires immediate attention for function and esthetics. While implant- supported or conventional fixed prostheses may be the treatments of choice for adults, relatively noninvasive and reversible provisional procedures for tooth replacement are necessary for adolescents. In recent years, developments in fiber and composite technology offer a conservative treatment approach to restore the anterior edentulous space as a fixed provisional tooth replacement. This case report presents the chairside procedures of anterior tooth replacement in an adolescent using the avulsed tooth crowns as pontics which were bonded to teeth on either side of the edentulous space and reinforced with a preimpregnated fiber.

  11. Research progress of dorsal root entry zone lesioning for the treatment of pain after brachial plexus avulsion

    Directory of Open Access Journals (Sweden)

    Qing-jun LIU

    2015-08-01

    Full Text Available Pain after brachial plexus avulsion (BPA is a clinically common drug-refractory neuropathic pain. Overactive spontaneous potential due to deafferentation in the neurons of spinal dorsal horn is the main pathogenesis of pain after BPA. Dorsal root entry zone (DREZ lesioning is one way that damages overactive spontaneous potential neurons in spinal dorsal horn through radio-frequency electrode or bipolar coagulation so as to achieve pain relief. Dorsal root entry zone lesioning is a safe and effective treatment approach for pain after BPA. DOI: 10.3969/j.issn.1672-6731.2015.08.014

  12. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings; Avulsao da espinha iliaca antero-inferior: espectro dos achados de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Joao Luiz [Hospital Santa Lucia, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica; Viana, Sergio Lopes; Mendonca, Jose Luiz Furtado de; Freitas, Flavia Mendes Oliveira; Lima, Gylse-Anne de Souza; Vila, Ana Fabiola da; Ribeiro, Nelmar [Clinica Radiologica Vila Rica, Brasilia, DF (Brazil). Dept. de Ressonancia Magnetica]. E-mail: radiolog@uol.com.br

    2005-07-15

    Avulsive injuries of the pelvic aphophyses are relatively common among 13-18 year old athletes, particularly among soccer players in Brazil. Diagnosis is made upon clinical and imaging findings. These lesions show three distinct phases: acute, repair and consolidation phases. Although acute and consolidation phases usually represent no diagnostic challenge, the repair phase may appear as an aggressive process on diagnostic images simulating neoplasic lesions. In this paper, the authors present the imaging findings of patients with avulsion of the anterior inferior iliac spine on plain radiographs, computerized tomography and magnetic resonance imaging, emphasizing the typical features of the three evolutive phases of these lesions. (author)

  13. Unusual Transalveolar and Transmuco-Gingival Root Avulsion of a Fractured Primary Central Incisor: A Case with an 8-Year Follow-Up

    OpenAIRE

    Ferr?s-Amat, E.; D?az-Mart?nez, C.; Herrera-Mart?nez, S.; Maura-Solivellas, I.; Ferr?s-Padr?, E.

    2015-01-01

    The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in...

  14. Dragon's Blood Sap (Croton Lechleri) As Storage Medium For Avulsed Teeth: In Vitro Study Of Cell Viability.

    Science.gov (United States)

    Martins, Christine Men; Hamanaka, Elizane Ferreira; Hoshida, Thayse Yumi; Sell, Ana Maria; Hidalgo, Mirian Marubayashi; Silveira, Catarina Soares; Poi, Wilson Roberto

    2016-01-01

    Tooth replantation success depends on the condition of cementum periodontal ligament after tooth avulsion; which is influenced by storage medium. The dragon's blood (Croton lechleri) sap has been suggested as a promising medium because it supports collagen formation and exhibits healing, anti-inflammatory and antimicrobial properties. Thus, the aim of this study was to evaluate the efficacy of dragon's blood sap as a storage medium for avulsed teeth through evaluation of functional and metabolic cell viability. This in vitro study compared the efficacy of different storage media to maintain the viability of human peripheral blood mononuclear and periodontal ligament cells. A 10% dragon's blood sap was tested while PBS was selected as its control. Ultra pasteurized whole milk was used for comparison as a commonly used storage medium. DMEM and distilled water were the positive and negative controls, respectively. The viability was assessed through trypan blue exclusion test and colorimetric MTT assay after 1, 3, 6, 10 and 24 h of incubation. The dragon's blood sap showed promising results due to its considerable maintenance of cell viability. For trypan blue test, the dragon's blood sap was similar to milk (psap showed better results than all storage media, even better than milk (psap was as effective as milk, the gold standard for storage medium. The experimental sap preserved the membrane of all cells and the functional viability of periodontal ligament cells.

  15. Complete avulsion of the adductor longus in a semi-professional football player: Rapid return to play with nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Vince W Lands

    2016-01-01

    Full Text Available The adductor longus has become recognized as one of the more commonly injured muscles in the medial compartment. Acute complete rupture injuries occurring at the proximal aspect of the muscle are less common. Limited data exist regarding management of the injuries in athletes required for return to play and functioning. The current data favors operative management; however, nonoperative treatment may be a viable option. Nonoperative management of avulsion injuries of the proximal adductor longus tendon may prove equal results to surgical repair in return to play and functioning. A semi-professional football player sustained a left groin injury while participating in the play. Due to continued pain, swelling, and suspicion of injury, a magnetic resonance imaging was performed diagnosing a complete tear of proximal adductor longus tendon. Physical examination, strength, and range of motion were recorded until the patient was able to function normally without strength deficit, the range of motion loss, and the return of speed. The player was treated nonoperatively and was eventually allowed to return to play. The time of return to play was 6 weeks. Strength deficit was not appreciated or loss of motion and player was able to return to baseline function. Nonoperative management of complete avulsion injuries of the proximal adductor longus tendon result in faster return to play than operative management even if significant retraction is present.

  16. Efficiency of Castor Oil as a Storage Medium for Avulsed Teeth in Maintaining the Viability of Periodontal Ligament Cells.

    Science.gov (United States)

    Nabavizadeh, Mohammadreza; Abbaszadegan, Abbas; Khodabakhsi, Afrooz; Ahzan, Shamseddin; Mehrabani, Davood

    2018-03-01

    Researchers always seek a new storage medium for avulsed teeth. Castor oil is a vegetable oil with several advantages such as antimicrobial and antioxidant properties, low toxicity, and glutathione preservation capability, low cost, and high availability. The purpose of this study was to evaluate and compare the capacity of castor oil as a new storage medium in preserving the viability of periodontal ligament (PDL) cells compared to Hank's balanced salt solution (HBSS) and milk. Forty freshly extracted human teeth were divided into 3 experimental and 2 control groups. The experimental teeth were stored dry for 30 min and then immersed for 45 min in one of the following media; castor oil, HBSS, and milk. The positive and negative control groups were exposed to 0 min and 2 h of dry time respectively with no immersion in any storage medium. The teeth were then treated with dispase grade II and collagenase and the number of viable PDL cells were counted. Data were analyzed using Kruskal- Wallis test. The percentage of viable cells treated with castor oil, HBSS and milk counted immediately after removal from these media were 46.93, 51.02 and 55.10 % respectively. The statistical analysis revealed that the value for castor oil was significantly lower than HBSS and milk ( p > 0.05). Within the parameters of this study, it appears that castor oil cannot be served as an ideal medium for storage of avulsed tooth. More investigations under in vivo conditions are required to justify the results of this study.

  17. The importance of sand in the formation of avulsion channels within experimental fans that develop from sediment mixtures of mud and sand

    Science.gov (United States)

    Iscen, N.; Strom, K.

    2017-12-01

    Autogenic channel migration and avulsion has long been recognized as important drivers of alluvial fan dynamics. In the literature, several field studies have documented that the presence and the amount of sand transport through a channel is important for channel incision in alluvial fans and deltas. In our experiments, we present the general autogenic avulsion cycle of experimental alluvial fans with mixtures of cohesive sediment and sand with a range of boundary conditions, and we detail the importance of mobile sand fraction in the development of channels that lead to avulsion. Experimental observations demonstrate that new channels form at topographically low regions within the floodplain providing that sand is transported to these topographic lows due to overbank flow or levee breaching. In addition to the sediment transported from upstream, erosion of a previous deposit and an ongoing backfilling nearby are observed as the possible sources of sand getting into the ghost channels. We explore whether the presence of sand is important for channel development because it increases abrasion of the channel or because it changes the roughness characteristics of the flow. We also examine the affect of sediment and water supply change on the newly described channelization process and link distinctive channel morphologies to different stages of described channel development and the avulsion process.

  18. [Ultrabraid SUTURE WITH FOOTPRINT RIVET FOR ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE IN ADOLESCENTS UNDER ARTHROSCOPY].

    Science.gov (United States)

    Liang, Jinying; Zheng, Jiapeng; Ll, Qiang; Zhong, Shuyu; Chen, Minzhen

    2015-06-01

    To investigate the clinical effects of the Ultrabraid suture with FOOTPRINT rivet by arthroscopic technique for the treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture. Between May 2011 and December 2013, 19 adolescent patients with ACL tibial eminence avulsion fracture were treated with arthroscopic reduction and fixation by Ultrabraid sutures with FOOTPRINT rivet. There were 13 males and 6 females with an average age of 15.8 years (range, 8-18 years). The left knees were involved in 10 cases and the right knees in 9 cases. The injury causes included traffic accident injury in 8 cases, sport injury in 6 cases, and sprain injury in 5 cases. Three patients had old fractures, and the others had fresh fractures. The results of Lachman test and anterior drawer test were both positive. The International Knee Documentation Committee (IKDC) subject score was 54.2 ± 4.0. Based on Meyers-McKeever classification, there were 3 cases of type II, 10 cases of type III, and 6 cases of type IV. The operation time was 50-60 minutes (mean, 55.2 minutes). X-ray film showed satisfactory fracture reduction at 1 day after operation. Primary healing of incision was obtained with no infection. Eighteen patients were followed up for 1-3 years (mean, 1.7 years). All fractures healed with smooth joint surface on the X-ray film at 3 months after operation. The results of Lachman test and anterior drawer test were both negative in 17 cases, and the results was negative for anterior drawer test and was weakly positive for Lachman test in 1 case. The IKDC subject score was significantly improved to 96.1 ± 2.1 at last follow-up (t = 34.600, P = 0.000). It could achieve early restoration of knee joint function to treat the ACL tibial eminence avulsion fracture by arthroscopic technique of the Ultrabraid suture with FOOTPRINT rivet because of satisfactory reduction, reliable fixation, small wound, and early rehabilitation.

  19. Geomorphology, facies architecture, and high-resolution, non-marine sequence stratigraphy in avulsion deposits, Cumberland Marshes, Saskatchewan

    Science.gov (United States)

    Farrell, K. M.

    2001-02-01

    This paper demonstrates field relationships between landforms, facies, and high-resolution sequences in avulsion deposits. It defines the building blocks of a prograding avulsion sequence from a high-resolution sequence stratigraphy perspective, proposes concepts in non-marine sequence stratigraphy and flood basin evolution, and defines the continental equivalent to a parasequence. The geomorphic features investigated include a distributary channel and its levee, the Stage I crevasse splay of Smith et al. (Sedimentology, vol. 36 (1989) 1), and the local backswamp. Levees and splays have been poorly studied in the past, and three-dimensional (3D) studies are rare. In this study, stratigraphy is defined from the finest scale upward and facies are mapped in 3D. Genetically related successions are identified by defining a hierarchy of bounding surfaces. The genesis, architecture, geometry, and connectivity of facies are explored in 3D. The approach used here reveals that avulsion deposits are comparable in process, landform, facies, bounding surfaces, and scale to interdistributary bayfill, i.e. delta lobe deposits. Even a simple Stage I splay is a complex landform, composed of several geomorphic components, several facies and many depositional events. As in bayfill, an alluvial ridge forms as the feeder crevasse and its levees advance basinward through their own distributary mouth bar deposits to form a Stage I splay. This produces a shoestring-shaped concentration of disconnected sandbodies that is flanked by wings of heterolithic strata, that join beneath the terminal mouth bar. The proposed results challenge current paradigms. Defining a crevasse splay as a discrete sandbody potentially ignores 70% of the landform's volume. An individual sandbody is likely only a small part of a crevasse splay complex. The thickest sandbody is a terminal, channel associated feature, not a sheet that thins in the direction of propagation. The three stage model of splay evolution

  20. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  1. Geomorphology, facies architecture, and high-resolution, non-marine sequence stratigraphy in avulsion deposits, Cumberland Marshes, Saskatchewan

    Science.gov (United States)

    Farrell, K.M.

    2001-01-01

    This paper demonstrates field relationships between landforms, facies, and high-resolution sequences in avulsion deposits. It defines the building blocks of a prograding avulsion sequence from a high-resolution sequence stratigraphy perspective, proposes concepts in non-marine sequence stratigraphy and flood basin evolution, and defines the continental equivalent to a parasequence. The geomorphic features investigated include a distributary channel and its levee, the Stage I crevasse splay of Smith et al. (Sedimentology, vol. 36 (1989) 1), and the local backswamp. Levees and splays have been poorly studied in the past, and three-dimensional (3D) studies are rare. In this study, stratigraphy is defined from the finest scale upward and facies are mapped in 3D. Genetically related successions are identified by defining a hierarchy of bounding surfaces. The genesis, architecture, geometry, and connectivity of facies are explored in 3D. The approach used here reveals that avulsion deposits are comparable in process, landform, facies, bounding surfaces, and scale to interdistributary bayfill, i.e. delta lobe deposits. Even a simple Stage I splay is a complex landform, composed of several geomorphic components, several facies and many depositional events. As in bayfill, an alluvial ridge forms as the feeder crevasse and its levees advance basinward through their own distributary mouth bar deposits to form a Stage I splay. This produces a shoestring-shaped concentration of disconnected sandbodies that is flanked by wings of heterolithic strata, that join beneath the terminal mouth bar. The proposed results challenge current paradigms. Defining a crevasse splay as a discrete sandbody potentially ignores 70% of the landform's volume. An individual sandbody is likely only a small part of a crevasse splay complex. The thickest sandbody is a terminal, channel associated feature, not a sheet that thins in the direction of propagation. The three stage model of splay evolution

  2. Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy.

    Science.gov (United States)

    Pohl, Yango; Filippi, Andreas; Kirschner, Horst

    2005-04-01

    The status of the periodontal ligament (PDL) and of the pulp are decisive for the healing of avulsed and replanted teeth. A tooth rescue box was developed and distributed to offer optimal storage conditions for avulsed teeth. The therapy comprised extraoral endodontic treatment and applications of medicaments to enhance periodontal healing. In this long-term clinical study the healing results following avulsion and replantation were investigated. Twenty-eight permanent teeth in 24 patients were evaluated. The extraoral storage media and periods varied considerably. Soon after avulsion six teeth were stored in a cell culture medium (tooth rescue box Dentosafe) for 1-53 h; the PDL was defined as not compromised. Sixteen teeth were stored in a non-physiologic situation temporarily, the PDL was considered as compromised. Six teeth were stored in non-physiologic conditions for longer periods; the condition of the PDL was defined as hopeless. On 14 teeth antiresorptive-regenerative therapy (ART) with the local application of glucocorticoids and enamel matrix derivative and the systemic administration of doxycyclin was used. In all teeth extraoral endodontic treatment by retrograde insertion of posts was performed. The mean observation period was 31.2 months (+/-24.1; 5.1-100.2; median: 23.8). All six teeth rescued physiologically healed with a functional PDL (functional healing, FH) irrespective of the storage period. Of eight teeth with a compromised PDL on which ART was used, three teeth healed with a functional PDL. All other teeth showed replacement resorption, in three teeth additionally infection-related resorption was recorded. The predominant influence on the healing results was the immediate physiologic rescue of avulsed teeth (chi-square, P = 0.0001). The use of ART seemed to support FH (chi-square, P = 0.0547) in teeth with a compromised PDL. No other factors (maturity of roots, crown fractures, gender, age, antibiotics) were related to healing. In a linear

  3. The brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer: a FDG-PET study

    International Nuclear Information System (INIS)

    Zuo, C.T.; Guan, Y.H.; Xu, W.D.; Zhao, J.; Sun, G.X.; Lin, X.T.

    2002-01-01

    Objectives: To study FDG-PET for imaging the brain plasticity in patients with brachial plexus root avulsion after contralateral C7 nerve-root transfer. Methods: One male patient with left brachial plexus root avulsion underwent a two-stage procedure (first phase: C7 root → ulnar nerve; second phase: ulnar nerve → recipient nerve) 4 years ago; Another with right brachial plexus root avulsion also underwent a two-stage procedure 3 years ago. First two patients underwent basic FDG-PET imaging, the next day FDG-PET scans were performed after initiative or passive limb movement. Using ROI and MPI tools to evaluate the images. The ratios of sensorimotor frontal cingulated Thalami to white matter were used as the semiquantitive index. Results: Whether brain plasticity had occurred was determined by whether the affected limb can perform initiative movement. The increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with left brachial plexus root avulsion were 40.1%, 37.9%, 48.3%, 31.9% after initiative movement, the right corresponding brain regions were 39.4%, 34.3%, 48.5%,35.4% respectively. However, the increases in glucose metabolism of left sensorimotor frontal cingulated Thalami in patient with right brachial plexus root avulsion were increased by 12.6%, 9.6%, 10.7%, 5.3% after passive movement, the right corresponding brain regions were respectively 17.9%, 12.9%, 15.4%, 10.1%. It was founded that the metabolism of bilateral sensorimotor frontal cingulated Thalami increased after initiative movement, while the metabolism of right sensorimotor frontal cingulated Thalami increased more obviously than that of the left brain regions when using MPI tool to substract the images before and after the affected limb movement. Conclusions: Sensorimotor frontal cingulated Thalami were necessary to the initiative movement. After being activated by movement, the metabolisms of plasticised brain regions increased obviously. However, the

  4. Avulsion of the left internal mammary artery graft after minimally invasive coronary surgery: fatal complication or medical error? A case report.

    Science.gov (United States)

    Viel, Guido; Balmaceda, Ute; Sperhake, Jan P

    2009-01-01

    Minimally invasive direct coronary artery bypass (MIDCAB) is performed through a left anterior mini-thoracotomy without the use of a cardiopulmonary bypass and offers greater potential for more rapid recovery, reduced pain and a decreased need for blood transfusion than conventional coronary artery bypass grafting. Few major complications of the MIDCAB procedure have been reported in the literature since the first intervention was performed in 1995, but the most serious one is avulsion of the left internal mammary artery (LIMA) graft near the site of anastomosis with the left anterior descending coronary artery. Forensic issues regarding the role of the surgeon in causing this life-threatening emergency condition have not been discussed. We report here the case of a 48-year-old man who died 18 days after a MIDCAB of massive thoracic bleeding due to the avulsion of the LIMA graft. We discuss the probable etiopathogenesis of this fatal complication from a forensic point of view.

  5. Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review.

    LENUS (Irish Health Repository)

    Hanley, C

    2012-02-01

    BACKGROUND: Avulsion fractures of the tibial tubercle are an unusual injury pattern generally occurring in the adolescent male during sporting activities. Bilateral simultaneous fractures are extremely rare. They are often associated with other underlying orthopaedic pathology. AIMS: We present a case of bilateral tibial tubercle avulsions occurring in a 15 year-old male hurler. We describe the management and necessary investigations required for this type of trauma and present a literature review on this rarely encountered injury. CONCLUSION: Although this type of atypical fracture pattern is associated with high energy trauma and other underlying pathology, we have shown that once treated, the patient can expect to make a prompt return to sporting activities with no significant long-term functional deficit.

  6. Avulsion Fractures at the Base of the 2nd Metacarpal Due to the Extensor Carpi Radialis Longus Tendon: A Case Report and Review of the Literature

    OpenAIRE

    Najefi, Ali; Jeyaseelan, Lucksmana; Patel, Anand; Kapoor, Akhil; Auplish, Sunil

    2016-01-01

    Introduction Simultaneous contraction of the extensor carpi radialis longus (ECRL) with forced hyperflexion of the wrist can result in avulsion of the tendon and its bony attachment at its insertion at the dorsum of the base of the second metacarpal. This is a rare and often unreported fracture pattern. Case Presentation We present a 31- year- old male who sustained a hyperflexion injury. He was managed surgically and had good pos...

  7. Locking compression plate distal ulna hook plate fixation versus intramedullary screw fixation for displaced avulsion fifth Metatarsal Base fractures: a comparative retrospective cohort study

    OpenAIRE

    Xie, Lin; Guo, Xin; Zhang, Shu-Jun; Fang, Zhen-Hua

    2017-01-01

    Background Intramedullary screw (IMS) fixation was wildly used in fifth metatarsal base fractures (FMBFs) and the results were satisfactory. However, in the comminuted osteoporosis or small displaced avulsion FMBFs, anatomical reduction and stable fixation could not be achieved with IMS. The Locking Compression Plate (LCP) distal ulna hook plate fixation was a novel alternative fixation method. The aim of this retrospective cohort study was to determine if LCP distal ulna hook plate fixation ...

  8. Evaluation of the long-shelf life honey milk As a storage media for preservation of avulsed teeth

    Directory of Open Access Journals (Sweden)

    Ali Nozari

    2013-09-01

    Full Text Available Introduction: Tooth avulsion is defined as the complete displacement of the tooth from its alveolar socket which causes damage to the periodontal ligament structure, cementum, alveolar bone, gingiva, and dental pulp. The purpose of this study was to determine the ability of long-shelf life honey milk to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL cell viability on avulsed teeth. Methods: PDL cells were obtained from premolars extracted for orthodontic purposes which were clinically healthy and had healthy gingiva (i.e. not inflamed.Then, 8×10³ cells were seeded in each well of 96-well plate. and Afterwards treated with long-shelf life milk and honey milk, Hank’s Balanced Salt Solution (HBSS and fresh milk. Different incubation periods were 1, 3, 6, and 9 hours. Dulbecco’s Modified Eagle Medium (DMEM and dry medium were considered as positive and negative control media, respectively. Cell viability was determined by using the MTT (Thiazolyl Blue Tetrazolium Bromide assay. Data were statistically analyzed with one-way anova, two-way anova and post hoc Scheffe tests. A level of p≤0.05 was accepted as statistically significant Results: The results indicate that all media performed significantly better in maintaining PDL cell viability than the negative control at all time periods. (p≤0.001 After 9 hours, Percentage of viable PDL cells in long-shelf life honey milk, long-shelf life milk and HBSS were 82±0.82, 75±8.13 and 87±2.78 respectively. Furthermore cells' viability in both long-shelf life honey milk and HBSS was significantly better than fresh milk medium (p=0.003. Moreover, the results of One-way ANOVA showed long-shelf life honey milk were more effective in preserving the PDL cell viability as well as HBSS after 9 hours. Conclusions: According to the study results, long-shelf life honey milk considered as appropriate storage media which are comparable to HBSS. These media are not only able

  9. Consequences of Avulsion Fracture of the Proximal Phalanx Caused by a Technical Failure of Hallux Valgus Surgery.

    Science.gov (United States)

    Park, Young Uk; Lee, Kyung Tai; Jegal, Hyuk; Kim, Ki Chun; Choo, Ho Sik; Kweon, Heon Ju

    2016-01-01

    Several cases of avulsion fracture of the proximal phalanx of the big toe during the lateral capsular release procedure were observed. However, these fractures have not been reported as a complication of hallux valgus surgery. The purpose of the present study was to report the proximal phalanx base fracture as an unrecognized complication and to evaluate the clinical and radiographic consequences of this complication. We retrospectively reviewed 225 feet that had undergone hallux valgus surgery involving proximal chevron osteotomy and distal soft tissue release from May 2009 to December 2012. Of these 225 feet (198 patients), 12 (5.3%) developed proximal phalanx base fracture postoperatively. These patients were assigned to the fracture group. The remaining patients were assigned to the nonfracture group. Patients were followed to observe whether the fractures united and whether degenerative changes developed at the first metatarsophalangeal joint because of this fracture. The mean follow-up period was 36 (range 12 to 72) months. All the subjects in the fracture and nonfracture groups underwent weightbearing anteroposterior and lateral radiographs of the foot at the initial presentation and final follow-up point. The 2 groups were compared with respect to the hallux valgus angle, intermetatarsal angle, range of motion, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes. No significant differences were found in age, follow-up period, hallux valgus angle, intermetatarsal angle, range of motion of the first metatarsophalangeal joint, American Orthopaedic Foot and Ankle Society score, satisfaction, and degenerative changes between the 2 groups. Ten (83.3%) of the 12 fractures healed, 2 (16.7% of the fractures, 0.89% of the operated feet) progressed to asymptomatic nonunion, and 3 (1.33%) developed first metatarsophalangeal joint degeneration. Avulsion fracture of the proximal phalanx of the big toe is an uncommon complication of

  10. Medium-Detail Delta Morphodynamic Modeling: Initial Experiments with Avulsion Behaviors, Sediment Delivery, Artificial Leeves, and Relative Sea Level Rise Rates

    Science.gov (United States)

    Ratliff, K. M.; Murray, A. B.; Hutton, E. W. H.; Piliouras, A.; Kim, W.

    2014-12-01

    Deltas and their flat, fertile lands have become the most densely populated places on earth, but, partly because of anthropogenic interactions with fluvial, coastal, and wetland processes, their inhabitants are increasingly susceptible to natural disasters. Humans have decreased sediment supply delivered to rivers and ultimately wetlands and the coast, causing accelerating subsidence. The natural course and processes of many rivers have been altered through channelization, artificial levees, and dams, which 'perch' the river above its floodplain. As the rate of relative sea-level rise (RSLR) increases, so will surface aggradation and channel backfilling, resulting in a fluvial system that is more vulnerable to flooding and frequent avulsions. To investigate the effects of increasing RSLR and anthropogenic manipulations on delta morphodynamics, we create new avulsion and floodplain modules to couple with the 3D mode of Sedflux (Hutton and Syvitski, 2008), a stratigraphic basin-filling model. We replace the probabilistic approach of channel avulsion previously used in the model with a module incorporating the steepest-decent methodology used in Jerolmack and Paola (2007), and a floodplain algorithm to deposit sediment on subaerial cells. Model experiments with Sedflux and the new modules address the effects on delta morphodynamics of varying rates of RSLR (affecting base-level), changes in sediment delivery (adjusting the upstream boundary conditions), and restriction of natural fluvial dynamics (inhibiting avulsions). The work presented here is the first step in a more expansive project to develop a new 3D eco-morphodynamic delta model system that will be based on further model couplings, including a vegetation module (that will affect fluvial and floodplain dynamics) and a coastline module (that will re-work the shoreline based on wave-driven alongshore sediment transport). The model system results will be tested and calibrated based on comparisons with

  11. Common Peroneal Nerve Palsy with Multiple-Ligament Knee Injury and Distal Avulsion of the Biceps Femoris Tendon

    Directory of Open Access Journals (Sweden)

    Takeshi Oshima

    2015-01-01

    Full Text Available A multiple-ligament knee injury that includes posterolateral corner (PLC disruption often causes palsy of the common peroneal nerve (CPN, which occurs in 44% of cases with PLC injury and biceps femoris tendon rupture or avulsion of the fibular head. Approximately half of these cases do not show functional recovery. This case report aims to present a criteria-based approach to the operation and postoperative management of CPN palsy that resulted from a multiple-ligament knee injury in a 22-year-old man that occurred during judo. We performed a two-staged surgery. The first stage was to repair the injuries to the PLC and biceps femoris. The second stage involved anterior cruciate ligament reconstruction. The outcomes were excellent, with a stable knee, excellent range of motion, and improvement in the palsy. The patient was able to return to judo competition 27 weeks after the injury. To the best of our knowledge, this is the first case report describing a return to sports following CPN palsy with multiple-ligament knee injury.

  12. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  13. Comparative evaluation of four transport media for maintaining cell viability in transportation of an avulsed tooth - An in vitro study.

    Science.gov (United States)

    Bharath, Makonahalli Jaganath; Sahadev, Chickmagravalli Krishnegowda; Ramachandra, Praveen Kumar Makonahalli; Rudranaik, Sandeep; George, Jijo; Thomas, Ashna

    2015-01-01

    The study was performed to compare and evaluate the efficacy of four experimental storage media (Hank's balanced salt solution, Ringer's lactate solution, tender coconut water, and green tea extract) for maintaining cell viability of human periodontal cells at different time intervals of 15 min 30 min, 60 min, and 90 min. Human periodontal cells were cultured and stored in the four media. After 15 min 30 min, 60 min, and 90 min, the different media were examined under optical microscope and viabilities analyzed using an optical calorimeter. Mean and standard deviation were estimated from the results that were statistically analyzed using one-way analysis of variance (ANOVA) to identify the significant groups. The results indicated that there was no difference in cell viability between the four media up to a period of 60 min, whereas green tea extract showed a lower cell viability after 90 min. Within the limitations of the present study, it appears that due to superior osmolality, cost effectiveness, and easier availability, Ringer's lactate, tender coconut water, and green tea extract can be used as alternate storage media for avulsed tooth.

  14. Variable scale channel avulsion history using fan architecture and stratigraphy, and sediment provenance of Sutlej-Yamuna fans in northwest Gangetic plains during Late Quaternary

    Science.gov (United States)

    Singh, Ajit; Gupta, Sanjeev; Sinha, Rajiv; Densmore, Alexander; Buylaert, Jan-Pieter; Carter, Andrew; Van-Dijk, Wout M.; Joshi, Suneel; Nayak, Nibedita; Mason, Philippa J.; Kumar, Dewashish; Mondal, Setbandhu; Murray, Andrew; Rai, Shiv P.; Shekhar, Shashank

    2016-04-01

    Channel avulsion during fan development controls distribution and deposition of channel sandbodies and hence alluvial architecture of a fan system. Variable scale spatio-temporal information of fluvial responses to past climate changes is stored in these channel sandbodies. Further these channel sandbodies form fluvial aquifers in alluvial fans and therefore understanding of alluvial architecture and stratigraphy of a fan is crucial for development of groundwater management strategies. In this study we used multiple approaches to map subsurface fluvial aquifer architecture and alluvial stratigraphy, and to estimate sediment provenance using U-Pb dating of detrital zircon grains of Sutlej-Yamuna fan system in northwest India. Satellite imagery based geomorphic mapping shows two large fan system with interfan area. The fan surfaces show presence of major and minor paleochannels. 2D resistivity tomography along several transects across fan surfaces shows distinct layers with contrasting resistivity values. These geo-electric facies corresponds to presence of channel sandbodies beneath surface signature of paleochannels and finer floodplain deposits useful to demarcate lateral extent of subsurface channel sandbodies. A more detailed subsurface stratigraphy using ~50m deep sediment cores and their luminescence ages from across fan surface shows presence of multi-storey sandbodies (MSB) separated by floodplain fines. Within the MSB, individual channel deposits are identified by presence of channel scour surfaces located at coarse sand overlying fine sand layer. Depositional ages of MSB's ranges from ~81 ka (late MIS5) to ~15 ka (MIS2) with major depositional break during MIS3 in parts of the fans. Sediment aggradation rate varies laterally across fan surface as well as vertically down the depth with an average rate of 0.54 mm/year. Fluvial channel persistence for studied time interval (about last 81 ka BP) shows major depositional breaks (and possible incision) at ~41 ka

  15. Selective plasticity of primary afferent innervation to the dorsal horn and autonomic nuclei following lumbosacral ventral root avulsion and reimplantation in long term studies.

    Science.gov (United States)

    Wu, Lisa; Wu, Jun; Chang, Huiyi H; Havton, Leif A

    2012-02-01

    Previous studies involving injuries to the nerves of the cauda equina and the conus medullaris have shown that lumbosacral ventral root avulsion in rat models results in denervation and dysfunction of the lower urinary tract, retrograde and progressive cell death of the axotomized motor and parasympathetic neurons, as well as the emergence of neuropathic pain. Root reimplantation has also been shown to ameliorate several of these responses, but experiments thus far have been limited to studying the effects of lesion and reimplantation local to the lumbosacral region. Here, we have expanded the region of investigation after lumbosacral ventral root avulsion and reimplantation to include the thoracolumbar sympathetic region of the spinal cord. Using a retrograde tracer injected into the major pelvic ganglion, we were able to define the levels of the spinal cord that contain sympathetic preganglionic neurons innervating the lower urinary tract. We have conducted studies on the effects of the lumbosacral ventral root avulsion and reimplantation models on the afferent innervation of the dorsal horn and autonomic nuclei at both thoracolumbar and lumbosacral levels through immunohistochemistry for the markers calcitonin gene-related peptide (CGRP) and vesicular glutamate transporter 1 (VGLUT1). Surprisingly, our experiments reveal a selective and significant decrease of CGRP-positive innervation in the dorsal horn at thoracolumbar levels that is partially restored with root reimplantation. However, no similar changes were detected at the lumbosacral levels despite the injury and repair targeting efferent neurons, and being performed at the lumbosacral levels. Despite the changes evident in the thoracolumbar dorsal horn, we find no changes in afferent innervation of the autonomic nuclei at either sympathetic or parasympathetic segmental levels by CGRP or VGLUT1. We conclude that even remote, efferent root injuries and repair procedures can have an effect on remote and non

  16. Assessment of knowledge and attitude before and after a health education program in East Madurai primary school teachers with regard to emergency management of avulsed teeth.

    Science.gov (United States)

    Taranath, M; Senaikarasi, R M; Manchanda, Kavita

    2017-01-01

    Children attend primary school from as early as 6 years to the mixed dentition stage of about 9 years and spend most of their time in school along with the teachers. School teachers are likely to be among the first to see a child immediately after an injury has occurred, and their knowledge regarding emergency procedures is critical to ensure good prognosis of the clinical treatment. The purpose of the study was to evaluate, by means of a questionnaire, the primary school teacher's knowledge and attitude with regard to emergency management of traumatized avulsed teeth and to test the effectiveness of a health education tool. A total of 214 primary school teachers from 24 government schools, in and around East Madurai Panchayat, participated in a 3-month long study. Baseline data were collected using a pretested questionnaire in the 1st month. Based on that data, a health educational tool was prepared. The final assessment was made using the same questionnaire in the 3rd month. Baseline data and final data were compared using Z-test. The knowledge level of 70.83% of primary school teachers was in the very good category after the health education tool, which was initially nil. Similarly, the attitude level also raised drastically with 0.90% initially in the very good category, and after the health education tool, it was 41.20%. From this study, the importance of the need for the steps to increase the knowledge about the emergency management of avulsion is clearly understood. Thus, the main implication of the study is that a health educational tool regarding the emergency management of avulsion is necessary for the primary school teachers during their teacher training program.

  17. Assessment of knowledge and attitude before and after a health education program in East Madurai primary school teachers with regard to emergency management of avulsed teeth

    Directory of Open Access Journals (Sweden)

    M Taranath

    2017-01-01

    Full Text Available Introduction: Children attend primary school from as early as 6 years to the mixed dentition stage of about 9 years and spend most of their time in school along with the teachers. School teachers are likely to be among the first to see a child immediately after an injury has occurred, and their knowledge regarding emergency procedures is critical to ensure good prognosis of the clinical treatment. Purpose: The purpose of the study was to evaluate, by means of a questionnaire, the primary school teacher's knowledge and attitude with regard to emergency management of traumatized avulsed teeth and to test the effectiveness of a health education tool. Methodology: A total of 214 primary school teachers from 24 government schools, in and around East Madurai Panchayat, participated in a 3-month long study. Baseline data were collected using a pretested questionnaire in the 1st month. Based on that data, a health educational tool was prepared. The final assessment was made using the same questionnaire in the 3rd month. Baseline data and final data were compared using Z-test. Results: The knowledge level of 70.83% of primary school teachers was in the very good category after the health education tool, which was initially nil. Similarly, the attitude level also raised drastically with 0.90% initially in the very good category, and after the health education tool, it was 41.20%. Conclusion: From this study, the importance of the need for the steps to increase the knowledge about the emergency management of avulsion is clearly understood. Thus, the main implication of the study is that a health educational tool regarding the emergency management of avulsion is necessary for the primary school teachers during their teacher training program.

  18. [Decoronation management of the replacement resorption after delayed replantation of avulsed teeth-case report with 4-year follow-up].

    Science.gov (United States)

    Ruizhen, Fang; Siyi, Li; Lei, Gao; Li'an, Wu

    2017-12-01

    Replacement resorption is the most frequent complication after delayed replantation of avulsed teeth. The resorption can interfere with the development of the alveolar ridge and lead to tilt of the adjacent teeth in growing patients. However, there is no means of arresting or reversing the process. Recently decoronation is recommended by International Assocaition of Dental Traumatology as the optimal choice to manage it. This paper demonstrates the procedure and effectiveness of the decoronation by literature review and a case report with 4-year follow-up.

  19. Spontaneous bilateral avulsion fracture of the tuberositas tibiae in a New Zealand White rabbit - a counterpart to Osgood-Schlatter disease in humans?

    Science.gov (United States)

    Nehrbass, D; Arens, D; Zeiter, S

    2015-02-01

    The first reported case describing a spontaneous bilateral avulsion fracture of the tuberositas tibiae in a New Zealand White rabbit is presented. So far in animals, this condition has been only described in dogs and horses. In humans, this condition is also called Osgood-Schlatter disease (OSD) or syndrome, traction apophysitis of the tibial tubercle (ATT) or patellar tendon enthesopathy of the tibial tuberosity respectively. It is mainly seen in young adolescents coinciding with periods of growth spurts. In humans, its pathogenesis is believed to be caused by repetitive tendon/muscle strain at the insertion of the patellar tendon to the immature tibial tuberosity, which has its own secondary ossification center. Morphologically this case is characterized by bilateral chronic avulsion with incomplete separation of the tuberositas tibae, and proximal dislocation of the patella (patella alta). Despite these marked pathological changes, the animal was clinically without findings. Nevertheless, this case emphasizes the need for thorough clinical and radiological examination of rabbits intended for preclinical research studies prior to study begin, especially in orthopedic research. Copyright © 2014 Elsevier GmbH. All rights reserved.

  20. Unusual Transalveolar and Transmuco-Gingival Root Avulsion of a Fractured Primary Central Incisor: A Case with an 8-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    E. Ferrés-Amat

    2015-01-01

    Full Text Available The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor’s crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition.

  1. Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie [The 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Xicheng Qu, Beijing (China); Wang, Shufeng; Xue, Yunhao; Li, Wenjun [The 4th Medical College of Peking University, Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing (China)

    2017-03-15

    The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

  2. A Middle to Late Holocene avulsion history of the Euphrates river: a case study from Tell ed-Dēr, Iraq, Lower Mesopotamia

    Science.gov (United States)

    An Heyvaert, Vanessa Mary; Baeteman, Cecile

    2008-12-01

    Geoarchaeological research was performed to reconstruct the floodplain history in the surroundings of two ancient Mesopotamian cities: Tell ed-Dēr and Sippar. The mapping of the floodplain is based on facies analyses of the sedimentary succession of 225 hand-operated boreholes. The archaeological sites Tell ed-Dēr and Sippar are closely linked to a palaeochannelbelt of the Euphrates, located in the western part of the study area. Channel activity started at least in ca 3100 BC/5050 cal BP, until ca 1400-1000 BC/3350-2950 cal BP. The channel belt was part of an avulsion driven multiple Euphrates channel network that gradually became abandoned from the second half of the 2nd millennium BC. A second mapped Euphrates, Tigris or Joint Euphrates -Tigris palaeochannel belt became abandoned well before 3100 BC. Examples of natural processes as well as human interactions triggering avulsion are given. Moreover, textual, archaeological and geological data show clearly that flood-control techniques and the construction of large-scale dikes seemed to be a common practice.

  3. Unusual Transalveolar and Transmuco-Gingival Root Avulsion of a Fractured Primary Central Incisor: A Case with an 8-Year Follow-Up

    Science.gov (United States)

    Ferrés-Amat, E.; Díaz-Martínez, C.; Herrera-Martínez, S.; Maura-Solivellas, I.; Ferrés-Padró, E.

    2015-01-01

    The purpose of this unique case report is to describe a very unusual dentoalveolar fracture associated with avulsion of the near-complete root. A 3-year-old male patient came for consultation after a dentoalveolar trauma with a “fragment that looks like canine” found in his mouth by his mother. This boy suffered root fracture of the upper primary central right incisor, accompanied by transalveolar and transmuco-gingival avulsion of the tooth root fragment, leaving the crown in its position in the dental arch. Clinical and radiological examinations were performed in order to follow up the case: 15 days, one month, and three months after trauma, the crown had a slight mobility without other clinical or radiological signs. After six months, the upper primary central right incisor's crown was exfoliated. Open bite due to the persistence of the pacifier habit favored the crown retention in the mouth. This case emphasizes the importance of primary diagnosis and follow-up of trauma cases. To the best of our knowledge, this kind of dental injury has not been previously described in the literature nor in the current Dental Trauma guidelines for the management of traumatic dental injuries in the primary dentition. PMID:25793129

  4. Avulsion processes at the terminus of low-gradient semi-arid fluvial systems: Lessons from the Río Colorado, Altiplano endorheic basin, Bolivia

    Science.gov (United States)

    Donselaar, M. E.; Cuevas Gozalo, M. C.; Moyano, S.

    2013-01-01

    The Río Colorado dryland river system in the southeast of the endorheic Altiplano Basin (Bolivia) terminates on a very flat coastal plain at the edge of the Salar de Uyuni, the world's largest salt pan with an area of ca. 12,500 km2. Since the Pleistocene the basin has experienced several lake expansion and contraction cycles in response to wetter and drier climate periods, respectively. At present the basin is in a dry climate period which results in a lake level lowstand and progradation of fluvial systems such as the Río Colorado onto the former lake bottom. The present field study of the terminus of the Río Colorado shows that the river experiences a gradual downstream decrease of bankfull width and depth. This bankfull decrease is caused by the combined effects of: (1) extremely low gradient of the lake bottom and, hence, loss of flow energy, and (2) downstream transmission losses due to high evaporation potential and river water percolation through the channel floor. Peak water discharge in seasonal, short-duration rain periods causes massive overbank flooding and floodplain inundation. On satellite images the morphology of the river terminus has a divergent pattern and resembles a network of coeval sinuous distributary channels. However, field observations show that only one channel is active at low flow stage, and at high-flow stage an abandoned, partially infilled channel may be active as well. The active channel at its termination splits into narrow and shallow anastomosing streams before its demise on the lacustrine coastal plain. The rest of the channels which form the divergent network are older sediment-filled abandoned sinuous river courses with multiple random avulsion points. These channel deposits, together with extensive amalgamated crevasse-splay deposits, form an intricate network of fluvial sand deposits. Successive stages of progressively deeper crevasse-channel incision into the floodplain are the result of waning-stage return flow of

  5. Aircast walking boot and below-knee walking cast for avulsion fractures of the base of the fifth metatarsal: a comparative cohort study.

    Science.gov (United States)

    Shahid, Mohammad Kamran; Punwar, Shahid; Boulind, Caroline; Bannister, Gordon

    2013-01-01

    Acute avulsion fractures of the base of the fifth metatarsal are common and are treated in a variety of ways. The aims of this study were to compare pain, functional outcome, and time taken off work after treatment with a walking boot or a short-leg cast. Of 39 patients with acute avulsion fractures of the base of the fifth metatarsal, 23 were treated with a short-leg cast and 16 with a walking boot, according to the preference of the consultant present at outpatient clinic. Functional outcome was assessed by the Visual Analogue Scale Foot and Ankle Questionnaire (VAS FA), pain, and other complaints on presentation and at 3, 6, 9, and 12 weeks after injury. The VAS FA scores were compared between the 2 groups by a paired Student t test. The mean time to return to the level of pain and function before injury was approximately 9 weeks after treatment in the walking boot group and 12 weeks with a short-leg cast. Patients with walking boots reported less pain between 3 and 12 weeks than did those with short-leg casts after 6 (P = .06), 9 (P = .020), and 12 weeks (P = .33). Function was significantly better with Aircast walking boots after 3 (P = .006), 6 (P = .002), and 9 weeks (P = .002) but not after 12 weeks (P = .09). Patients returned to their preinjury level of driving after 6 weeks with walking boots and 12 weeks with short-leg casts (P = .006). Employed patients took a mean of 35.8 days off work (range, 28-42 days), fewer with boots (31.5 days) than with short-leg casts (39.2 days). The walking boot was better treatment than a short-leg cast for avulsion fractures of the base of the fifth metatarsal. Patients had an improved combined level of pain and function 3 weeks earlier, at 9 weeks post injury, when managed in a walking boot. Level II, prospective comparative series.

  6. triceps tendon avulsion

    African Journals Online (AJOL)

    GB

    2014-01-01

    Jan 1, 2014 ... trauma. Systemic causes such as chronic renal failure, steriod use, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, osteogensis imperfecta and local causes like local steriod injection, olecranon bursitis and attritional changes due to degenerative arthritis are associated with tendon weakening.

  7. Successful Nonoperative Management of HAGL (Humeral Avulsion of Glenohumeral Ligament) Lesion With Concurrent Axillary Nerve Injury in an Active-Duty US Navy SEAL.

    Science.gov (United States)

    Ernat, Justin J; Bottoni, Craig R; Rowles, Douglas J

    2016-01-01

    Humeral avulsion of the glenohumeral ligament (HAGL) is a lesion that has been recognized as a cause of recurrent shoulder instability. To our knowledge there are no reports of successful return to full function in young, competitive athletes or return to manual labor following nonoperative management of a HAGL lesion. A 26-year-old Navy SEAL was diagnosed with a HAGL injury, and associated traction injury of the axillary nerve as well as a partial tear of the rotator cuff. Operative intervention was recommended; however, due to issues with training and with inability to properly rehab with the axillary nerve injury, surgical plans were delayed. Interestingly, the patient demonstrated both clinical and radiographic magnetic resonance imaging healing of his lesion over an 18-month period. At 18 months the patient had returned to full active duty without pain or instability as a Navy SEAL.

  8. Avulsion Fractures at the Base of the 2(nd) Metacarpal Due to the Extensor Carpi Radialis Longus Tendon: A Case Report and Review of the Literature.

    Science.gov (United States)

    Najefi, Ali; Jeyaseelan, Lucksmana; Patel, Anand; Kapoor, Akhil; Auplish, Sunil

    2016-03-01

    Simultaneous contraction of the extensor carpi radialis longus (ECRL) with forced hyperflexion of the wrist can result in avulsion of the tendon and its bony attachment at its insertion at the dorsum of the base of the second metacarpal. This is a rare and often unreported fracture pattern. We present a 31- year- old male who sustained a hyperflexion injury. He was managed surgically and had good post-operative outcomes. A literature search revealed 16 papers covering 18 cases of similar injuries. 12 were initially managed surgically and 6 were managed conservatively. Of the open reductions and internal fixations, 11 (92%) were successful and patients made a full recovery. Conservative management was unsuccessful in 4 cases; one patient required surgery for metacarpal boss, one patient had retraction of the tendon at one week follow up and another had weak flexion of the wrist. We recommend open reduction and internal fixation for these injuries. It may allow a faster recovery and therefore allow an earlier return to work and activity.

  9. Ancient lakes, Pleistocene climates and river avulsions structure the phylogeography of a large but little-known rock scorpion from the Mojave and Sonoran deserts

    Science.gov (United States)

    Graham, Matthew R.; Wood, Dustin A.; Henault, Jonathan A.; Valois, Zachary J.; Cushing, Paula E.

    2017-01-01

    Recent syntheses of phylogeographical data from terrestrial animals in the Mojave and Sonoran deserts have revealed a complex history of geologic and climatic vicariance events. We studied the phylogeography of Smeringurus vachoni to see how vicariance events may have impacted a large, endemic rock scorpion. Additionally, we used the phylogeographical data to examine the validity of two subspecies of S. vachoni that were described using unconventional morphological characters. Phylogenetic, network and SAMOVA analyses indicate that S. vachoni consists of 11 clades mostly endemic to isolated desert mountain ranges. Molecular clock estimates suggest that clades diversified between the Miocene and early Pleistocene. Species distribution models predict a contraction of suitable habitat during the last glacial maximum. Landscape interpolations and Migrate-n analyses highlight areas of gene flow across the Colorado River. Smeringurus vachoni does not comprise two subspecies. Instead, the species represents at least 11 mitochondrial clades that probably diversified by vicariance associated with Pleistocene climate changes and formation of ancient lakes along the Colorado River corridor. Gene flow appears to have occurred from west to east across the Colorado River during periodic river avulsions.

  10. Fratura avulsão do planalto tibial medial (Segond reverso Avulsion fracture of the medial tibial plateau (reverse Segond injury

    Directory of Open Access Journals (Sweden)

    Fabio Janson Angelini

    2007-01-01

    Full Text Available Descreve-se neste artigo um padrão de lesão descrito na literatura apenas duas vezes, num total de quatro casos, denominado Segond reverso por apresentar achados clínicos e radiológicos exatamente opostos aos da clássica lesão de Segond. Semelhantemente aos casos previamente descritos, apresentou fratura avulsão do planalto tibial medial, na inserção do ligamento colateral medial profundo, associada a lesão do ligamento cruzado posterior. Assim como em um dos casos prévios, foi constatada lesão do ligamento cruzado anterior. Entretanto, diferiu dos anteriormente relatados por não apresentar lesão do menisco medial.This article reports an injury pattern described only twice in literature, totaling four cases, and referred to as reverse Segond injury for its clinical and radiological findings are precisely opposite to those observed in the classical Segond injury. Similarly to the previously described cases, our case reported avulsion fracture of the medial tibial plateau at the insertion of the deep tibial collateral ligament, associated to posterior cruciate ligament injury. Similarly to one of the previous cases, anterior cruciate ligament injury was found in our case, although it differs from the previous ones because it does not show medial meniscal injury.

  11. Avulsão traumática do nervo óptico por projétil de arma de fogo de grosso calibre: relato de caso Traumatic optic nerve avulsion by high caliber bullet: case report

    Directory of Open Access Journals (Sweden)

    Rogério de Almeida Tárcia

    2006-06-01

    Full Text Available A avulsão traumática do nervo óptico ocorre mais comumente devido a traumas contusos óculo-orbitários. A avulsão do mesmo por projétil de arma de fogo de grosso calibre é causa excepcional desta lesão e deve ser pensada no manejo dos pacientes vítimas de lesões por arma de fogo na região cefálica. O presente trabalho descreve o primeiro caso documentado desta singular lesão ao nervo óptico e tece comentários sobre as diversas outras causas relatadas, mecanismos fisiopatológicos, histologia e condutas.Traumatic optic nerve avulsion occurs most commonly after blunt ocular trauma. Optic nerve avulsion by high caliber bullet is exceptional and must be thought of in the management of those patients victims of gunshot wounds to the globe and orbit. The present paper reports the first documented case of this singular condition of optic nerve injury and comments on several other related causes, pathophysiology mechanisms, histology and management.

  12. Nerve Wrapping of the Sciatic Nerve With Acellular Dermal Matrix in Chronic Complete Proximal Hamstring Ruptures and Ischial Apophyseal Avulsion Fractures

    Science.gov (United States)

    Haus, Brian M.; Arora, Danny; Upton, Joseph; Micheli, Lyle J.

    2016-01-01

    Background: Patients with chronic injuries of the proximal hamstring can develop significant impairment because of weakness of the hamstring muscles, sciatic nerve compression from scar formation, or myositis ossificans. Purpose: To describe the surgical outcomes of patients with chronic injury of the proximal hamstrings who were treated with hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Study Design: Retrospective case series; Level of evidence, 4. Methods: Fifteen consecutive patients with a diagnosis of chronic complete proximal hamstring rupture or chronic ischial tuberosity apophyseal avulsion fracture (mean age, 39.67 years; range, 14-69 years) were treated with proximal hamstring repair and sciatic neurolysis supplemented with nerve wrapping with acellular dermal matrix. Nine patients had preoperative sciatica, and 6 did not. Retrospective chart review recorded clinical outcomes measured by the degree of pain relief, the rate of return to activities, and associated postoperative complications. Results: All 15 patients were followed in the postoperative period for an average of 16.6 months. Postoperatively, there were 4 cases of transient sciatic nerve neurapraxia. Four patients (26%) required postoperative betamethasone sodium phosphate (Celestone Soluspan) injectable suspension USP 6 mg/mL. Among the 9 patients with preoperative sciatica, 6 (66%) had a good or excellent outcome and were able to return to their respective activities/sports; 3 (33%) had persistent chronic pain. One of these had persistent sciatic neuropathy that required 2 surgical reexplorations and scar excision after development of recurrent extraneural scar formation. Among the 6 without preoperative sciatica, 100% had a good or excellent outcomes and 83% returned to their respective activities/sports. Better outcomes were observed in younger patients, as the 3 cases of persistent chronic sciatic pain were in patients older than 45

  13. Avulsão do plexo braquial em cães -1: aspectos clínicos e neurológicos Brachial plexus avulsion in dogs -1: clinical and neurological aspects

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available A avulsão do plexo braquial é afecção de ordem traumática relativamente comum, ocasionando paralisia grave do membro torácico. É freqüentemente confundida com paralisia do nervo radial, havendo controvérsias sobre o tratamento. O objetivo deste trabalho foi: avaliar clinica e neurologicamente cães com avulsão do plexo braquial, demonstrando os aspectos significativos para o diagnóstico desta afecção. Observou-se predominância de cães sem raça definida, fêmea, com menos de três anos de idade, sendo o atropelamento a etiologia principal. As alterações clinicam/neurológicas mais freqüentes foram: paralisia flácida, ausência do reflexo dopanículo, ausência dos reflexos tricipital, bicipital e extensor do carpo radial, atrofia dos músculos tríceps, bíceps, supra-espinhal, infra-espinhal e extensores do carpo, anestesia cutânea abaixo do nível do cotovelo e abrasão/ulceração em face dorsal da mão. A associação destes resultados com os aspectos da histologia e da eletroneuroestimulação (relatados na parte 2 e 3 deste trabalho, respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.Brachial plexus avulsion is a relatively common affection, causing serious paralysis of the thoracic limb. It is often misdiagnosed as radial paralysis and there are controversies about the treatment. The main purposes of this work were: to evaluate clinically and neurologically dogs with brachial plexus avulsion and to demonstrate the relevant aspects in the diagnosis of this affection. Predominantly mixed breed dogs, females under three years of age were observed, and the brachial plexus avulsion was mainly a result of road accidents. The more frequent clinical and neurological signs were: flacid paralysis, loss of the panniculus, triceps, biceps and extensor carpi radial muscle reflexes, atrophy of the muscles triceps, biceps, extensor carpi radial, supraspinatus and infraespinatus

  14. Reimplantes nas amputações por mecanismo de avulsão: táticas e técnicas para o sucesso Limb replantation after avulsion injuries: techniques and tactics for success

    Directory of Open Access Journals (Sweden)

    Renata Gregorio Paulos

    2012-01-01

    Full Text Available OBJETIVOS: Avaliação retrospectiva criteriosa de casos de reimplantes após amputação por avulsão. Avaliação de técnicas e táticas utilizadas que determinaram evolução satisfatória e bom resultado funcional. METÓDOS: Foram avaliados, retrospectivamente, prontuários de 43 pacientes que tiveram membros amputados por mecanismo de avulsão e reimplantados nos últimos 21 anos. RESULTADOS: A maior parte dos casos envolvia homens adultos jovens. A localização de amputação mais frequente foi do polegar. As técnicas e táticas cirúrgicas utilizadas isoladas ou conjuntamente incluem: enxertos de nervo, enxertos vasculares (veia ou artéria, transposição de feixe vascular digital, encurtamento do membro e reimplante heterotópico. A técnica mais frequentemente utilizada foi o emprego de enxertos venosos. A taxa de sobrevida dos reimplantes foi alta (93%, assim como a satisfação dos pacientes. CONCLUSÃO: Os reimplantes por mecanismo de avulsão dependem do correto diagnóstico de viabilidade anatômica e utilização de técnicas e táticas cirúrgicas apropriadas para cada caso. A experiência da equipe cirúrgica e estrutura hospitalar adequada são fundamentais para obtenção de bons resultados. Existem poucos relatos na literatura sobre indicação, tática, técnicas e resultados de procedimentos de reimplantes em amputações por avulsão. Acreditamos que a avaliação retrospectiva desta série de casos possa trazer novas informações e contribuições no atendimento desta situação de alta complexidade. Nível de evidência IV, Série de casos.OBJECTIVES: Retrospective evaluation of cases of limb replantation after avulsion injuries. Evaluation of the techniques and tactics used, that contributed to success and good functional results. METHODS: Forty-three patients' records were assessed. All the cases had been submitted to limb replantation after avulsion injuries. RESULTS: The majority of the cases were young men. The

  15. Tratamento ortodôntico em pacientes com dentes reimplantados após avulsão traumática: relato de caso Orthodontic treatment in patients with reimplanted teeth after traumatic avulsion: a case report

    Directory of Open Access Journals (Sweden)

    Simone Requião Thá Rocha

    2010-08-01

    Full Text Available INTRODUÇÃO: a alta prevalência de indivíduos com traumatismo dentário prévio ao tratamento ortodôntico justifica os cuidados a serem observados antes e durante o tratamento, considerando todas as implicações do movimento ortodôntico sobre os dentes traumatizados. Entre as lesões traumáticas dentárias, a avulsão com posterior reimplantação do dente é a que apresenta maior risco de complicações - como necrose pulpar, reabsorção radicular e anquilose -, sendo também a que inspira maiores cuidados pelo ortodontista. OBJETIVO: este trabalho busca, através do relato de um caso clínico, analisar as implicações do reimplante dentário após avulsão traumática, em pacientes que requerem tratamento ortodôntico. CONCLUSÕES: a movimentação ortodôntica de um dente reimplantado, após sua avulsão traumática, é possível desde que não ocorra qualquer sinal de anormalidade. Porém, dentes que sofrem anquilose não são passíveis de movimentação ortodôntica, mas devem ser preservados como mantenedores de espaço, até a reabsorção total da raiz, desde que não apresentem infraposição severa. Ocorrendo infraposição severa do dente anquilosado, é indicada a amputação da coroa e o sepultamento da raiz, como meio de favorecer a manutenção do osso alveolar na região, pois ocorrerá reabsorção por substituição da raiz sepultada, como ocorreu no caso clínico apresentado.INTRODUCTION: The high prevalence of individuals with dental trauma prior to orthodontic treatment justifies the precautions that should be followed before and during treatment, considering all possible effects of orthodontic movement on traumatized teeth. Among the major traumatic dental injuries, avulsion with subsequent tooth reimplantation entails a higher than average risk of complications, such as pulp necrosis, root resorption and ankylosis. Therefore, it gives orthodontists several reasons for concern. OBJECTIVE: This case report sought

  16. Perforación de intestino delgado por arrancamiento de adherencias intraabdominales a causa de caída accidental Perforarion of the small intestine by avulsion of intraabdominal adherences caused by an accidental fall

    Directory of Open Access Journals (Sweden)

    Ernesto Hernández

    2007-12-01

    Full Text Available Se presenta el caso de una paciente de 76 años que sufrió una contusión abdominal provocada por una caída de sus pies. Es atendida por un cuadro de dolor abdominal, el cual se intensificó durante el período de observación. Se realizó punción abdominal y su resultado fue positivo. Se practicó laparotomía exploradora de urgencia, en la que se encontró una perforación de yeyuno producida por arrancamiento de adherencias intraabdominales.The case of a 76-year-old patient that had an abdominal contusion caused by a fall from her feet was presented. She received attention due to a picture of abdominal pain that intensified during the observation period. An abdominal puncture that yielded positive was performed. She underwent an emergency exploratory laparotomy, where it was found a jejunum perforation produced by avulsion of intraabdominal adherences.

  17. Changes in Expressions of Major Histocompatibility Complex Class I, Paired-Immunoglobulin-Like Receptor B, and Cluster of Differentiation 3ζ in Motor Cortical Representations of the Brachial Plexus After Avulsion in Rats.

    Science.gov (United States)

    Zhang, Jie; Chen, Liang; Gu, Yu-Dong

    2017-10-01

    Major histocompatibility complex class I (MHCI), paired-immunoglobulin-like receptor B (PirB), and cluster of differentiation 3ζ (CD3ζ) negatively regulate neuronal plasticity in developing and adult brains. The aim of this study was to evaluate expressive changes of these factors in motor cortical representations of the brachial plexus (MCRBP) after total brachial plexus root avulsion (tBPRA). A total of 45 rats were randomly and equally divided into 3 groups for evaluating mRNA and protein expression levels of MHCI, PirB, and CD3ζ: 7 days, 3 months, and control. In the 7-day and 3-month groups, expressions were examined at 7 days and 3 months, respectively, after left tBPRA. In the control group, the brachial plexus was uninjured. Three rats from each group were used for examining expressions of MHCI, PirB, and CD3ζ proteins by immunofluorescence labeling, 6 rats for quantification of MHCI, PirB, and CD3ζ mRNAs by real-time quantitative polymerase chain reaction, and the remaining 6 animals for quantification of MHCI, PirB, and CD3ζ proteins by Western blotting. In the original MCRBP, mRNA and protein expression levels of MHCI, PirB, and CD3ζ were down-regulated 7 days postinjury compared with control (P  0.05). Recovery of protein expressions were initiated from near the border region of the original MCRBP. MHCI, PirB, and CD3ζ may participate in motor cortical reorganization after tBPRA. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Tricuspid Valve Avulsion after Blunt Chest Trauma

    OpenAIRE

    Mehrotra, Deepak; Dalley, Paul; Mahon, Barry

    2012-01-01

    Blunt cardiac trauma causing tricuspid regurgitation is rare and is most often associated with traffic accidents. Falling from a height can also cause such injuries, resulting in hemodynamic compromise and arrhythmias. The signs of traumatic tricuspid regurgitation can appear early or be delayed, depending upon the severity of injury. We present the case of a 68-year-old woman who fell from a height onto rocks during a hike. She sustained blunt cardiac injury with complete tricuspid valve avu...

  19. Tratamento cirúrgico da fratura-avulsão da inserção tibial do L.C.P. do joelho: experiência de 21 casos Surgical treatment of avulsion fractures of the knee PCL tibial insertion: experience with 21 cases

    Directory of Open Access Journals (Sweden)

    Sérgio Rocha Piedade

    2007-01-01

    Full Text Available Avaliamos 21 pacientes, sendo 16 pacientes do sexo masculino e 5 do feminino, com idade média de 30 anos, foram submetidos à tratamento cirúrgico da fratura-avulsão do LCP. Em 57% dos casos a lesão foi secundária a acidente motociclístico e 19% a acidente automobilístico. Em 72% dos casos foi identificada uma lesão na face anterior do joelho. O tratamento cirúrgico consistiu na abordagem posterior do joelho e fixação do fragmento ósseo com parafuso e arruela em 18 casos; e amarrilhas trans-ósseas em 3 casos, onde o fragmento ósseo era muito pequeno. Em 91% dos casos, a cirurgia foi realizada dentro dos primeiros 15 dias apos a lesão. Os pacientes foram avaliados objetivamente (teste de gaveta posterior e subjetivamente (Escala de Lysholm, apos um seguimento pós-operatório mínimo de 12 meses. A análise estatística não mostrou diferença significativa, ao nível de 5%, entre as avaliações objetiva e subjetiva. A ausência de lesão ligamentar periférica pode ter contribuído para que os resultados clínicos pós-operatórios tenham avaliação subjetiva satisfatória; entretanto, a presença de uma posteriorização tibial residual sugere que a fratura-avulsão do ligamento cruzado posterior deve ser abordada não como uma lesão óssea pura, mas sim, como uma lesão ósteo-ligamentar.We assessed 21 patients (16 males and 5 females, with mean age of 30 years who underwent surgical treatment for PCL avulsion fracture. In 57% of the cases, injuries were secondary to motorcycle accidents and 19% resulted from car accidents. Injuries on knee's anterior surface were detected in 72% of the cases. The surgical procedure involved posterior approach and bone fragment fixation using nut and screw in 18 cases, the trans-bone suture loop fixation in 3 cases with small bone fragments. In 91% of the cases, surgery was performed within the first two weeks following injury. The patients were objectively (posterior drawer test and

  20. Viabilidade das células mononucleares de sangue periférico humano em diferentes meios de estocagem de dentes avulsionados - DOI: 10.4025/actascihealthsci.v25i1.2301 Human peripheral blood mononuclear cells viability in differents storage media for avulsed teeth - DOI: 10.4025/actascihealthsci.v25i1.2301

    Directory of Open Access Journals (Sweden)

    Carlos Marcelo Lopes

    2003-04-01

    Full Text Available This study aims to compare the viability of the human mononuclear cells for 24 hours at 20ºC in different storage media for avulsed teeth: distillated water, type C pasteurized milk, whole ultra-pasteurized milk, saliva, physiologic solution, and McCoy culture cells medium. At times 0, 30min, 1h, 3h, 6h, 10h and 24h was extracted sample and analyzed for the exclusion with Trypan blue method. The pH of each storage medium was also measured. The tests indicated that all media performed better than water (p Neste estudo comparou-se a viabilidade de células mononucleares humanas mantidas durante 24 horas, a 20ºC, em diferentes meios de estocagem para dentes avulsionados: água destilada, leite pasteurizado tipo C, leite ultrapasteurizado integral, saliva, solução fisiológica e meio de cultura celular McCoy. Nos tempos 0, 30min, 1h, 3h, 6h, 10h e 24h foram coletadas amostras e analisadas pelo método de exclusão com azul de Tripan. Também foi medido o pH de cada meio de estocagem. Os testes indicaram que todos os meios tiveram melhor desempenho que a água (p < 0,05. A partir de 3h, os dois tipos de leite e o McCoy mostraram viabilidade estatisticamente melhor (p < 0,05 que a saliva e a solução fisiológica. Não houve diferença entre os leites, não sendo possível realizar a leitura de 24h devido ao depósito de material biológico. Os leites, saliva e McCoy apresentaram pH compatível com a proliferação celular. Os resultados sugerem que o meio de cultura McCoy e o leite são efetivos para estocagem de dentes avulsionados por possibilitarem a manutenção da viabilidade celular.

  1. Fraturas com arrancamento do anel apofisário ("limbus" póstero-superior da vértebra L5, associado com hérnia discal pré-marginal em atletas Avulsion fractures of apophysial ring ("limbus" posterior superior of the L5 vertebra, associated to pre-marginal hernia in athletes

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2002-03-01

    Full Text Available O aumento de adolescentes praticando esportes de forma cada vez mais competitiva tem causado o aumento de lesões relacionadas à prática desportiva. A dor lombar é uma queixa freqüente entre os atletas, geralmente relacionada a contraturas da musculatura paravertebral e fraturas ( espondilólise devido ao excesso de treinamento e aplicação de técnicas incorretas. Porém, outras etiologias podem causar a dor lombar, como processos infecciosos, tumorais e fraturas. As fraturas com arrancamento do anel apofisário são lesões incomuns e raramente ocorrem na região póstero-superior da vértebra L5. Os relatos da literatura mostram que o local mais acometido é a região póstero-inferior da vértebra L4. Apresentamos dois casos de atletas jovens com esta incomum lesão. O objetivo deste trabalho é discutir a possível etiologia, os melhores métodos para o diagnóstico e possíveis formas de tratamento desta patologia.The number of sport related injuries has raised as the increasing number of adolescents practicing competitive sports. Lumbar pain is a frequent complaint among young athletes. It is usually related to the contracture of paravertebral muscles and fractures (spondylolysis caused by excessive practicing and incorrect techniques. However, other etiologies can cause lumbar pain, such as infectious processes, tumor and fractures. Avulsion fractures of the apophysial ring are uncommon lesions which rarely happen in the posterior superior area of the L5 vertebra. The literature shows that the most susceptible place to injuries is the posterior inferior area of the L4 vertebra. This paper presents two cases of young athletes with this unusual lesion. The objective of this work is to discuss the possible etiology and the best diagnostic and treatment procedures for this pathology.

  2. Transplantation of premolars as an approach for replacing avulsed teeth

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Schwartz, Ole; Kofoed, Thomas

    2009-01-01

    . Secondly the tooth precipitates growth of the alveolar procces and allows treatment to be performed at an early age (10-12 years) where the trauma incidence is at its maximum. Finally transplanted teeth can be moved orthodontically. These characteristics make implant solutions appealing in a number...... of situations. The procedure consist in selecting a premolar in a optimal root development stage which is approximately three fourths root formation where optimal pulp and periodontal ligament healing can be achieved in more than 90 percent of the cases. The tooth is later after slight crown remodeling restored...

  3. Humeral avulsion of the glenohumeral ligament: The J sign

    African Journals Online (AJOL)

    2014-12-05

    Dec 5, 2014 ... The musculotendinous structures of the rotator cuff and almost all the shoulder muscles maintain the stability of ... Magnetic resonance imaging (MRI) is essential in preoperative detection of a HAGL lesion. The 15° ... sequence showed the typical J sign caused by contrast leaking between the humerus and.

  4. Avulsion of subscapularis muscle tendon leading to recurrent ...

    African Journals Online (AJOL)

    to iule out a Hill-Sachs lesion. The biceps tendon was freed from its bicipital groove ... Football. Rugby. Lawn tennis. Road traffic accidents. Grand ma1 epilepsy. TOTAL. Discussion ilpparently subscapularis tendon tears are not a common cause of anterior clislocation of the shoulder. I have seen only 15 patients with this.

  5. recurrent traumatic posterior hip dislocation in labral avulsion

    African Journals Online (AJOL)

    2003; 54(3):520-529. 5. Dameron, T.B Jr. Bucket-handle tear of acetabular labrum accompanying posterior dislocation of the hip. J Bone Joint Surg Am. 1959; 41(1): 131-134. 6. Lieberman, J.R., Altchek, D.W. and Salvati,. E.A. Recurrent dislocation of a hip with a labral lesion: treatment with a modified Bankart-type repair.

  6. Transplantation of premolars as an approach for replacing avulsed teeth

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Schwartz, Ole; Kofoed, Thomas

    2009-01-01

    Autotransplantation of premolars to the anterior region subsequent to tooth loss represent a unique treatment method that has a number of advantages in comparison with other tooth substitution methods. A tooth transplant has a bone inducing capacity implying that lost labial bone is regenerated. ...

  7. Humeral avulsion of the glenohumeral ligament of the shoulder

    African Journals Online (AJOL)

    impo

    Skeletal Radiol 2001;30:661-6. 5. Habermeyer P, Gleyze P, Rickert M. Evolution of lesions of the labrum-lig- ament complex in posttraumatic anterior shoulder instability: a prospective study. J Shoulder Elbow Surg 1999;8:66-74. 6. Hintermann B, Gachter A. Arthroscopic findings after shoulder dislocation. Am J Sports Med ...

  8. Hypergravity effects on normal and avulsed developing avian radii

    Science.gov (United States)

    Negulesco, J. A.; Clark, D. L.

    1976-01-01

    Rhode Island red female chicks were subjected to complete closed fracture of the right radius at 2 weeks post-hatching. The animals were allowed to heal for 1 week at either earth-gravity or 2-G-hypergravity state with control and estrogen-injected groups. Intact and fractured radial length, weight, average epiphysial-diaphysial diameters, and length, width, and weight of healing fracture callus were measured. Daily 2000 IU estrogen administration for 7 d increased intact radial length. Estrogen augments the effects of the 2-G state by inhibiting growth and depleting the mass of both intact and fractured radii and by decreasing the average distal epiphysial diameter of fractured bones. Animals exposed to the hypergravity state without hormonal treatment showed decreased fractured radial length, weight, and smaller proximal epiphysial diameters. The measurable parameters of the fracture callus (width, length, and weight) were depressed by the hypergravity state regardless of whether the animal was untreated or supplemented with estrogen.

  9. Mallet fingers with bone avulsion and DIP joint subluxation.

    Science.gov (United States)

    Wada, T; Oda, T

    2015-01-01

    One-third of all mallet fingers are associated with a fracture. Mallet fractures associated with large fracture fragments may result in volar subluxation of the distal phalanx. The management of mallet fractures varies based on injury pattern and surgeon preference. These treatment options include splinting regimens, closed reduction and percutaneous pinning and open reduction and internal fixation. Although numerous surgical techniques have been described, there is little clear consensus on operative treatment. Moreover, there is insufficient evidence to support operative over nonoperative treatment for mallet fractures. © The Author(s) 2014.

  10. Fracture-avulsion de l'epine iliaque anterosuperieure: a propos d'un ...

    African Journals Online (AJOL)

    Journal de la Recherche Scientifique de l'Université de Lomé. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 18, No 4 (2016) >. Log in or Register to get access to full text downloads.

  11. Effect of the barrage and embankments on flooding and channel avulsion case study Koshi River, Nepal

    NARCIS (Netherlands)

    Devkota, L.; Crosato, A.; Giri, S.

    2012-01-01

    Humans have utilized water resources for millennia by modifying natural river courses and such interventions have greatly influenced not only river flows and sediment fluxes, but also the overall river morphology. Situated in the Nepal's eastern Ganges region, the braided Koshi River is unique among

  12. Revised palaeogeographical reconstruction and avulsion history of the Holocene Rhine-Meuse delta, The Netherlands

    NARCIS (Netherlands)

    Stouthamer, E.; Cohen, K.M.; Hoek, W.Z.; Pierik, H.J.; Taal, L.J.; Hijma, M.P.; Bos, I.J.

    2013-01-01

    In the Holocene Rhine-Meuse delta, the geography, architecture, and chronology of the channel belts and their flood basins is known in exceptional high detail. This is due to a long history of intensive geological, geomorphological, and archeological research by various universities

  13. A rare and an unusually delayed presentation of orbital actinomycosis following avulsion injury of the scalp

    Directory of Open Access Journals (Sweden)

    Hegde Vidya

    2010-01-01

    Full Text Available We report a rare case of orbital swelling presenting one year after head trauma. An initial fine needle aspiration cytology revealed it to be an infected organizing hematoma. However, broad-spectrum antibiotics did not resolve the infection and the orbital lesion continued to grow in size, as evaluated by magnetic resonance imaging. Incisional biopsies were done, which were reported as orbital actinomycosis. Patient has responded well to treatment with penicillin. This case is of interest due to the delayed presentation of an orbital complication of head trauma and the rare infection with actinomyces. It also highlights the importance of using appropriate antibiotics, as well as the need for long-term treatment.

  14. [Spontaneous avulsion of the tibial tuberosity following Osgood-Schlatter disease].

    Science.gov (United States)

    Bang, J; Broeng, L

    1995-05-22

    Two cases of spontaneous fracture and dislocation of the tibial tuberosity in boys (15 and 19 years of age), who had both suffered from Osgood-Schlatter disease are described. The treatment and prognosis are discussed.

  15. Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent.

    Directory of Open Access Journals (Sweden)

    Ruban Raj Joshi

    2014-12-01

    years (SD=2.3. Fifteen (75% dominant elbows were injured in our study and 12(60% elbows had an associated elbow dislocation. On examination in operating room post anaesthesia, all of the elbow injuries revealed some degree of valgus instability. All of our patients(n=20 showed good to excellent results in the MAYO elbow performance score (MEPS. Radiographically, union was achieved in all cases. Three patients developed postoperative ulnar nerve neuropraxia, all recovered at time of final follow up. One patient developed mild lateral heterotrophic ossification but did not require any additional surgical intervention. Conclusion: Our results suggest that open reduction internal fixation of displaced medial epicondyle fractures leads to satisfactory motion and function. A valgus stress test in operating room can reveal the true nature of joint instability that can warrant operative stabilization of medial epicondylar injuries.

  16. Late repair of simultaneous bilateral distal biceps brachii tendon avulsion with fascia lata graft.

    Science.gov (United States)

    Bayat, A; Neumann, L; Wallace, W A

    1999-08-01

    A 50 year old rock climber sustained a bilateral rupture of the distal biceps brachii tendons. He retained some flexion power in both arms but minimal supination, being weaker on the non-dominant right side. As the patient presented late, with retraction and shortening of the biceps muscle bellies, reconstruction was carried out using fascia lata grafts on both sides. Because of residual weakness on the left (dominant) side, three further surgical procedures had to be carried out to correct for elongation of the graft. A functionally satisfactory outcome, comparable with that on the right side, was eventually obtained. In summary, bilateral fascia lata grafts to bridge the gap between the retracted biceps bellies and the radial tuberosities were successful in restoring function and flexion power to the elbow. Despite being the stronger side, the dominant arm did not respond as well to the initial surgery. This may be due to overuse of this arm after the operation.

  17. Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures

    International Nuclear Information System (INIS)

    Nachtrab, O.; Cassar-Pullicino, V.N.; Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J.

    2012-01-01

    MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits.

  18. Avulsion of the distal tibial shaft in aircraft crashes: a pathological feature of extreme decelerative injury.

    Science.gov (United States)

    Byard, Roger W; Tsokos, Michael

    2006-12-01

    A pilot and his passenger were killed on impact with the ground when their light aircraft crashed. Both deaths were caused by extensive injuries involving severe craniocerebral, skeletal, soft tissue, and organ trauma. In both victims, the legs were shortened, with stripping of muscle and soft tissues from the shafts of the lower limb long bones. In addition, fragments of distal tibial shaft had been forced through the soles of the victims' shoes. This sign indicated a fall from height and showed that the direction of the decelerative forces had been along the axis of the legs and that the force of impact was severe enough to cause fracturing of the lower limb bones, with subsequent extrusion of bone fragments downwards through the shoes. When present, this observation represents another feature at autopsy that can add to the understanding of the circumstances of a fatal air crash and the position of the victims immediately prior to impact.

  19. Avulsion fractrues of the pelvis | Naudé | South African Journal of ...

    African Journals Online (AJOL)

    South African Journal of Sports Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 2 (2003) >. Log in or Register to get access to full text downloads.

  20. Oral Trauma and Tooth Avulsion Following Explosion of E-Cigarette.

    Science.gov (United States)

    Rogér, James M; Abayon, Maricelle; Elad, Sharon; Kolokythas, Antonia

    2016-06-01

    Electronic cigarettes (E-cigarettes), or personal vaporizers, were introduced in 2003 and have been available in the United States since 2007. In addition to the health and safety concerns of the aerosol delivery of nicotine through E-cigarettes, during the past 8 years, reports of explosions and fires caused by the E-cigarette devices have led the US Fire Administration to evaluate the safety of these devices. These explosions have been observed frequently enough that the US Department of Transportation has recently banned E-cigarette devices in checked baggage aboard airplanes. This report contributes to existing knowledge about the hazards related to E-cigarettes by describing oral hard and soft tissue injuries from an E-cigarette explosion. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Proximal avulsion fracture of the long head of the triceps brachii muscle

    OpenAIRE

    Vansevenant, M.; Vanhoenacker, F.M.; Wauters, T.

    2014-01-01

    A 27-year-old male and indoor soccer goalkeeper presented at the private practice of the orthopaedic surgeon with pain in the posterior right shoulder. Two months previously, he felt sudden pain and loss of function in his shoulder when throwing a ball, more specifically during ball release. After 6 weeks of rest, there was almost complete recovery. He started playing indoor soccer again and fell on his right shoulder with relapse of the pain. He never experienced dislocation of the shoulder....

  2. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation

    Directory of Open Access Journals (Sweden)

    Lee WXP

    2015-07-01

    Full Text Available The optimal treatment for thoracolumbar fractures (TLF without neurological deficit remains controversial. Majority of the systematic reviews and meta-analyses have evaluated open operative approaches but have yet to compare the outcomes of minimally invasive percutaneous pedicle fixation (MIPPF versus non-operative treatment. A retrospective cohort study was performed to compare clinical and radiological outcomes between MIPPF and conservative groups for TLF AO Type A1 to Type B2 during a 2-year follow-up period. Pre-operative plain and CT films were evaluated and decision made for short segment (non-fusion MIPPF. Patients who refused operation were treated conservatively with three months of body cast, brace, or corset. MIPPF group showed earlier Visual Analog Score (VAS improvement at six months post-injury (0 vs 6.0- p0.050. MIPPF as a method of internal bracing can be pursued in the treatment of TLF, with larger future cohorts and RCTs being called for to support and explore new findings.

  3. Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 14-Year-Old Athlete with Vitamin-D Deficiency

    Directory of Open Access Journals (Sweden)

    Ziad Harb

    2015-01-01

    Full Text Available Fractures involving the proximal tibial epiphysis are rare and form 0.5% of all epiphyseal injuries. The specific anatomical and developmental features of the proximal tibial epiphysis make it vulnerable to unique patterns of fractures. Vitamin-D plays a vital role in bone homeostasis and its deficiency has an impact on fracture risk and healing. We present the first ever reported case of simultaneous bilateral proximal tibial physeal fractures in an athlete with vitamin-D deficiency. Treatment consisted of plaster immobilisation, and the patient made a full recovery and returned to preinjury level of activities. We report this case for its uniqueness and as an educational review of the importance of the developmental anatomy of the proximal tibia. We review the literature and discuss how the stages of the growing physis determine the type of fracture sustained.

  4. Effect of suture material on gap formation and failure in type 1 FDP avulsion repairs in a cadaver model.

    Science.gov (United States)

    Schreuder, F B; Scougall, P J; Puchert, E; Vizesi, F; Walsh, W R

    2006-06-01

    An in vitro cyclical testing simulating a passive mobilisation protocol was used to compare repair of flexor digitorum profundus tendon with modified-Bunnell two-strand pullout technique using a monofilament (Prolene), braided polyester (Ethibond) and a synthetic polyfilament ensheathed by caprolactan (Supramid) sutures. Eighteen fresh-frozen cadaveric fingers were randomly divided into three repair groups (n = 6); modified-Bunnell technique with 3/0 Prolene, Ethibond or Supramid. After repair, specimens were cyclically loaded from 2 to 15N at 5N/s, for a total of 500 cycles. Gap formation at the tendon-bone interface was assessed every 100 cycles. Samples were tested to failure at the completion of 500 cycles. All sutures held in all specimens during cyclic testing. The gap formation after 500 cycles was greatest with Prolene suture (6.8 mm, SD 1.2) followed by Supramid suture (4.0 mm, SD 1.1) and Ethibond suture (1.7 mm, SD 1.7) (P failure load (52.7 N, SD 5.5) as compared to Prolene (37.6N, SD 4.7) (P = 0.001) but not compared to Ethibond (44.9 N, SD 7.1). The failure loads between Prolene and Ethibond did not differ (P = 0.130). Gap formation with Ethibond was significantly lower compared to Supramid and Prolene. The four strand nature of the Supramid repair was superior to Prolene but did not differ compared to Ethibond with respect to failure load. Prolene is the least favourable suture when considering gap formation and failure load, while Ethibond is the most favourable.

  5. Segond fracture: an MR evaluation of 146 patients with emphasis on the avulsed bone fragment and what attaches to it

    Energy Technology Data Exchange (ETDEWEB)

    Flores, Dyan V.; Smitaman, Edward; Huang, Brady K.; Resnick, Donald L. [University of California San Diego Medical Center, Department of Radiology, San Diego, CA (United States)

    2016-12-15

    To re-evaluate the Segond fragment emphasizing those structures that attach to the fragment in patients with reported acute/subacute anterior cruciate ligament (ACL) injuries, and to clarify the nomenclature used to describe these structures. A search of databases of knee MR examinations over 4.5 years with reported ACL tears yielded 19,726 studies. Using strict exclusion criteria, a total of 146 MR studies with acute/subacute ACL tears were re-assessed with respect to the Segond fragment's size, shape, orientation, location, displacement, attaching soft tissue structures, and associated osseous and/or soft tissue injuries. Segond fractures were present in 1.25 % of reported acute/subacute ACL tears. The fragment measured 11.9 x 7.3 x 3.27 mm, being thin, ovoid, vertically oriented, situated anterolaterally along the proximal tibial epiphysis, posterior to Gerdy's tubercle and inferior to the lateral tibial plateau, and displaced up to 6 mm laterally. The attached structures were the meniscotibial component of the mid-third lateral capsular ligament (mt-MTLCL) in 58.9 %, both the mt-MTLCL and the posterior fibers of the ITB (pf-ITB) in 35.6 %, and the pf-ITB in 5.48 % of cases. In no case was there an additional attaching structure that did not meet criteria for the mt-MTLCL or the pf-ITB. The mt-MTLCL most commonly attaches to the Segond fragment, but the pf-ITB can also attach to this fragment. In no case was there an additional attaching structure that did not meet criteria for the mt-MTLCL or the pf-ITB. (orig.)

  6. Respuesta del ligamento periodontal a la avulsión dental. Reporte de caso / Periodontal Ligament Response to Dental Avulsion. Case Report

    OpenAIRE

    Solórzano Santos, Raúl; Universidad de Cartagena. Cartagena, Colombia; Díaz-Caballero, Antonio José; Universidad de Cartagena. Cartagena, Colombia; Covo Morales, Eduardo; Universidad de Cartagena, Cartagena, Colombia

    2017-01-01

    RESUMEN. Antecedentes: La avulsión es un tipo de lesión traumática poco frecuente en la dentición permanente. La reabsorción radicular externa es un evento común posterior al reimplante de un diente avulsionado. Objetivo: Reportar un caso de trauma de dos dientes reimplantados, en el que se obtuvieron resultados satisfactorios con 26 semanas de seguimiento. Reporte del caso: Manejo clínico de paciente de sexo masculino de 8 años de edad que se presenta a la clínica del Postgrado de Endodoncia...

  7. Isolated HAGL lesion after arthroscopic Bankart repair in a professional soccer player.

    Science.gov (United States)

    Celik, Haluk; Seckin, Mustafa Faik; Kara, Adnan; Akman, Senol

    2017-05-01

    Post-traumatic anterior shoulder instability commonly occurs following an avulsion of capsulolabral complex from glenoid (Bankart lesion) or rarely after humeral avulsion of the glenohumeral ligaments (HAGL lesion). Arthroscopic Bankart repair offers high success rates of healing. However, trauma following the treatment may cause implant failure or re-avulsion of the treated tissue. We aim to present the diagnosis and treatment of an isolated HAGL lesion in a professional soccer player who had previously undergone arthroscopic Bankart repair.

  8. 348 Pain Control by Coaptation Procedure C3 and C4 Anterior Rami to Brachial Plexus.

    Science.gov (United States)

    Yamada, Shokei; Lonser, Russell R; Won, Daniel J; Tsao, Bryan E

    2016-08-01

    Previously, the authors presented the coaptation of C3 and C4 primary rami to one of brachial plexus trunks to regain function from cervical root avulsion-caused paralysis. The purpose of this presentation is 2-fold: (1) discuss specific surgical techniques and (2) discuss control or prevention of intractable pain associated with root avulsion. (1) The surgical procedure consists of exposure of C3 and C4 anterior rami coaptation to the upper trunk (Erb-Duchenne) or lower trunk (Klumpke), with sural nerve bridge graft, and additionally intercostal nerve coaptation to median and ulnar nerves for flail arm. (2) Of 30 total patients, 23 patients presented with Erb-Duchenne palsy due to C5 and C6 root avulsion, 3 presented with Klumpke palsy due to C8 and T1 avulsion, and 4 presented with C5 through T1 avulsion (a flail arm). These patients are divided into 2 groups according to pain control: Group 1 patients were operated on within 3 months after avulsion, group 2 was treated surgically later than 3 months postinjury. (1) The surgical procedure consists of exposure of C3 and C4 anterior rami coaptation to the upper trunk (Erb-Duchenne) or lower trunk (Klumpke), with sural nerve bridge graft, and additionally intercostal nerve coaptation to median and ulnar nerves for flail arm. (2) Of 30 patients, 23 patients presented with Erb-Duchenne palsy due to C5 and C6 root avulsion, 3 presented with Klumpke palsy due to C8 and T1 avulsion, and 4 presented with C5 through T1 avulsion (a flail arm). These patients are divided into 2 groups according to pain control: Group 1 patients were operated on within 3 months after avulsion; group 2 was treated surgically later than 3 months post injury. Coaptation procedures are effective to control arm and hand pain associated with nerve root avulsion.

  9. A retrospective study of traumatic injuries to teeth at a Nigerian ...

    African Journals Online (AJOL)

    Enamel‑dentine fracture was the most common type of injury, seen in 73 (38.6%) of the traumatized teeth, 5 were avulsed and 20 posterior teeth had cuspal fracture. All the cases of avulsion and most (83.3%) of root fracture presented within 1 week of injury while teeth that presented late had pulpal necrosis. 22% of the ...

  10. Dental exarticulation

    African Journals Online (AJOL)

    2014-06-23

    Jun 23, 2014 ... are damaged following avulsion and healing is believed to depend on extraoral dry time, stage of root‑end formation, and extra‑alveolar handling.[2,3] Experimental studies have indicated that despite immediate replantation of the avulsed tooth, pulpal reactions may vary from apposition of the tertiary dentin ...

  11. Accuracy of a Computer Assisted Program for ’Classic’ Presentations of Dental Pain

    Science.gov (United States)

    1989-04-11

    Fractured facial bones Irreversible pulpitis Internal derangement of the TMJ Localized alveolar osteitis Maxillary sinusitis Myofascial pain/muscle...alveolar bone Fractured mandible Fractured maxilla Fractured facial bones Irreversible pulpitis Internal derangement of the TMJ Localized...Reversible pulpitis Root fracture Total avulsion, good candidate for replant Total avulsion, poor candidate for replant STUDY ONE Method Nineteen

  12. Accidental Peno-Scrotal Degloving Injuries in a Child A Case Report ...

    African Journals Online (AJOL)

    This case illustrates degloving injury of the penis and avulsion of the scrotum in a young boy while operating a roller type machine used in palm trees plantation. The penis was primarily regloved and avulsed skin primarily repaired. A good cosmetic outcome was observed from this treatment. This case also illustrates the

  13. Proximal hamstring reconstruction using semitendinosus and gracilis autograft: a novel technique.

    Science.gov (United States)

    Muellner, Thomas; Kumar, Sandeep; Singla, Amit

    2017-01-01

    The complete proximal hamstring avulsion is relatively uncommon injury and predominantly occurs in young athletes but causes significant functional impairment. In chronic cases, the muscle mass is so much retracted that primary repair is not possible. A surgical technique for reconstruction of chronic proximal hamstring avulsion using contralateral semitendinosus and gracilis autograft is described in this case report. V.

  14. Images in medicine

    African Journals Online (AJOL)

    abp

    2016-03-25

    Mar 25, 2016 ... Avulsion calcaneal tuberosity fracture is an uncommon but potentially serious condition. Recent studies on the epidemiology of these specific fractures have demonstrated that avulsed calcaneal fractures account for 1.3% of all calcaneal fractures.It is therefore understandable that little has been written ...

  15. Protocolo de manejo de diente permanente avulsionado para el servicio de salud oral de la Fundación Hospital La Misericordia y la Facultad de Odontología de la Universidad Nacional de Colombia, sede Bogotá (2011) / Protocol for Treatment of Avulsed [...

    OpenAIRE

    Jordán Mariño, Freddy; Universidad Nacional de Colombia, sede Bogotá; Sossa Rojas, Henry; Universidad Nacional de Colombia, Bogotá, Colombia; Estrada Montoya, John Harold; Universidad Nacional de Colombia, Bogotá, Colombia

    2012-01-01

    Objetivo: la presente guía se elaboró con el fin de actualizar y complementar la guía de manejo de trauma dentoalveolar de la Fundación Hospital de la Misericordia y la Facultad de Odontología de la Universidad Nacional de Colombia. Métodos: se realizó una búsqueda de literatura internacional en diferentes bases de datos y se analizaron los protocolos más recientes y con mejores resultados en cuanto a la disminución de la aparición y al progreso de la reabsorción radicular por remplazo, princ...

  16. Anastomosing Rivers are Disequilibrium Patterns

    NARCIS (Netherlands)

    Lavooi, E.; Haas, de T.; Kleinhans, M.G.; Makaske, B.; Smith, D.G.

    2010-01-01

    Anastomosing rivers have multiple interconnected channels that enclose floodbasins. Various theories have been proposed to explain this pattern, including an increased discharge conveyance and sediment transport capacity of multiple channels, or, alternatively, a tendency to avulse due to upstream

  17. Evaluating competing hypotheses for the origin and dynamics of river anastomosis

    NARCIS (Netherlands)

    Kleinhans, M.G.; Haas, T. de; Lavooi, E.; Makaske, B.

    2012-01-01

    Anastomosing rivers have multiple interconnected channels that enclose flood basins. Various theories potentially explain this pattern, including an increased discharge conveyance and sediment transport capacity of multiple channels, deltaic branching, avulsion forced by base-level rise, or a

  18. Confirmation of a theory: reconstruction of an alluvial plain development in a flume experiment

    Czech Academy of Sciences Publication Activity Database

    Bertalan, L.; Tóth, C. A.; Szabó, G.; Nagy, G.; Kuda, František; Szabó, S.

    2016-01-01

    Roč. 70, č. 3 (2016), s. 271-285 ISSN 0014-0015 Institutional support: RVO:68145535 Keywords : fluvial geomorphology * flume experiment * avulsion Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 0.923, year: 2016

  19. Medical Department, United States Army. Wound Ballistics for World War II.

    Science.gov (United States)

    1962-01-01

    tooth , both premolars, and the first molar were avulsed . A penetrating wound, 2.5 x 3.5 cm., entered the posterior left side of the chest through a...expla- nation for this unusual condition was that aircraft ammunition may have been salvaged from grounded planes and air force depots and used when... avulsion of the leg. A tourniquet was applied to the leg, 350 WOUND BALLISTICS plasma was given, and the patient was removed from the lines within an

  20. Traumatic degloving lesion of penile and scrotal skin

    Directory of Open Access Journals (Sweden)

    Luiz A. Zanettini

    2005-06-01

    Full Text Available Avulsions of penile and scrotal skin are uncommon events and are caused mainly by accidents with industrial machines and agricultural machine belts. We report the case of a 30-year old patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the cavernous bodies, spongy body, and testes due to an industrial machine accident. Reconstruction was performed in steps, achieving a satisfactory esthetic result, normal voiding and reestablished sexual function.

  1. Radiological case

    Directory of Open Access Journals (Sweden)

    Filipe Macedo

    2016-03-01

    Full Text Available We present a case of a 15-year-old boy with sudden onset of left hip pain while playing football. The x-ray revealed an avulsion injury of the anterior inferior iliac spine. The anterior inferior iliac spine is one of the places in the pelvis where avulsion injuries can occur and is due to forceful contractions of the rectus femoris muscle.

  2. A different trauma, a different fracture

    Directory of Open Access Journals (Sweden)

    Ü. Kaldırım

    2013-12-01

    Discussion and conclusion: The epiphyses and the apophyses are the weakest part of all the skeletal system. In these regions, avulsion fractures may occur with sudden and severe spasm of the muscles. Avulsion fractures of SIAS are mostly treated conservatively unless there is more than 2 cm fragment separated and non-union case in which case surgery is recommended. This type of injuries can be easily overlooked or misdiagnosed due to history of trauma free. It may also effects

  3. Neuroprotective Drug for Nerve Trauma Revealed Using Artificial Intelligence

    OpenAIRE

    Romeo-Guitart, David; Forés, Joaquim; Herrando-Grabulosa, Mireia; Valls, Raquel; Leiva-Rodríguez, Tatiana; Galea, Elena; González-Pérez, Francisco; Navarro, Xavier; Petegnief, Valerie; Bosch, Assumpció; Coma, Mireia; Mas, José Manuel; Casas, Caty

    2018-01-01

    Here we used a systems biology approach and artificial intelligence to identify a neuroprotective agent for the treatment of peripheral nerve root avulsion. Based on accumulated knowledge of the neurodegenerative and neuroprotective processes that occur in motoneurons after root avulsion, we built up protein networks and converted them into mathematical models. Unbiased proteomic data from our preclinical models were used for machine learning algorithms and for restrictions to be imposed on m...

  4. Degloving injury to the penis

    Directory of Open Access Journals (Sweden)

    Satsangi Bhaskar

    2010-01-01

    Full Text Available A case of reconstruction after penile skin avulsion is described in an eight-year-old boy. Penile coverage was gained by use of the avulsed skin flap itself, without a graft or local tissue flap. The procedure avoids any valuable time delay; thus, enhancing the chances to obtain adequate flap viability, avoids patient discomfort caused by perineal expansion, gives a satisfactory cosmetic appearance, and taking into account his age, avoids future psychosomatic and psychosexual problems.

  5. Degloving injury to the penis.

    Science.gov (United States)

    Mathur, Raj K; Lahoti, Brajesh K; Aggarwal, Gaurav; Satsangi, Bhaskar

    2010-01-01

    A case of reconstruction after penile skin avulsion is described in an eight-year-old boy. Penile coverage was gained by use of the avulsed skin flap itself, without a graft or local tissue flap. The procedure avoids any valuable time delay; thus, enhancing the chances to obtain adequate flap viability, avoids patient discomfort caused by perineal expansion, gives a satisfactory cosmetic appearance, and taking into account his age, avoids future psychosomatic and psychosexual problems.

  6. Degloving injury to the penis

    OpenAIRE

    Satsangi Bhaskar; Lahoti Brajesh; Aggarwal Gaurav; Mathur Raj

    2010-01-01

    A case of reconstruction after penile skin avulsion is described in an eight-year-old boy. Penile coverage was gained by use of the avulsed skin flap itself, without a graft or local tissue flap. The procedure avoids any valuable time delay; thus, enhancing the chances to obtain adequate flap viability, avoids patient discomfort caused by perineal expansion, gives a satisfactory cosmetic appearance, and taking into account his age, avoids future psychosomatic and psychosexual problems.

  7. Conhecimento de mães sobre os procedimentos de emergência nos casos de avulsão dentária

    OpenAIRE

    Albuquerque, Yasmin Etienne [UNESP; Rosell, Fernanda Lopez [UNESP; Tagliaferro, Elaine Pereira da Silva [UNESP; Silva, Silvio Rocha Corrêa da [UNESP

    2014-01-01

    Introduction: Despite tooth avulsion following trauma being relatively common in children, the available studies show that adults have limited knowledge about it. Aim: The purpose of this study was to assess, by a questionnaire, the mothers’ general knowledge about the immediate management of tooth avulsion. Material and method: This descriptive study was carried out on a convenient sample of mothers (n= 65) who participated of the “Pastoral da Criança”, from Araraquara, SP, Brazil. The quest...

  8. Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis

    OpenAIRE

    Gutmacher, Zvi; Peled, Eli; Norman, Doron; Lin, Shaul

    2017-01-01

    Aim: Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other t...

  9. [Treatment of dental accidents and associated alveolar fractures].

    Science.gov (United States)

    Teerijoki-Oksa, Tuija; Karjalainen, Sára; Soukka, Tero

    2010-01-01

    Diagnosis of dental accidents is based on patient history, clinical examination and imaging. A completely avulsed tooth should immediately be reimplanted, and a dislodged tooth urgently repositioned to the original position. Avulsed primary teeth will never be reimplanted, and primary teeth of children under three years are not repositioned. Furthermore, fractures of the alveolar process and various soft tissue injuries but not dental fractures require urgent treatment. All dental accident patients should be referred to dental consultation for further examinations and treatment.

  10. New Insights About Large-Scale Delta Morphodynamics from a Coupled Model of Fluvial-Coastal Processes

    Science.gov (United States)

    Murray, A. B.; Ratliff, K. M.; Hutton, E.

    2017-12-01

    We use a newly developed delta model to explore the combined effects of sea-level rise (SLR) and variable wave influence on delta morphology, avulsion behavior, and autogenic sediment flux variability. Using the Community Surface Dynamics Modeling System framework and tools, we couple the River Avulsion and Floodplain Evolution Model (RAFEM) to the Coastline Evolution Model (CEM). RAFEM models the fluvial processes, including river profile evolution, floodplain deposition, and avulsions. CEM uses gradients in alongshore sediment transport to distribute the fluvial sediment along the coastline. A suite of recent experiments using the coupled model and the Dakota software toolkit lead to several new insights: 1) A preferential avulsion location (which scales with the backwater length) can arise for geometric reasons that are independent of the recently suggested importance of alternation between flood and inter-flood periods. 2) The angular distribution of waves, as well as the wave height, affect the avulsion timescale. Previous work suggested that the time between avulsions will increase with greater wave influence, and we find that this is true for an angular mix of waves that tends to smooth a fairly straight coastline (coastline diffusion), where river mouth progradation is slowed and avulsions are delayed. However, if the angular distribution of waves leads to locally smooth shorelines but large amplitude coastline features (anti-diffusive coastline evolution), then avulsion timescales are barely affected, even when wave influence is high. 3) Increasing SLR rates are expected to cause more frequent avulsions, and it does in laboratory deltas. Unexpectedly, we find that this is not the case for the river-dominated deltas in our coupled model, in which SLR-related transgression effectively decreases progradation, offsetting base-level-rise effects. This finding raises potentially important questions about the geometric differences between prototypical and

  11. Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases.

    Science.gov (United States)

    von Pfeil, Dirsko J F; Glassman, Mathieu; Ropski, Meaghan

    2017-07-20

    To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures. Clinical data of 14 dogs and three cats were included. The "spiking" technique was described. Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures. Surgery times ranged from eight to 54 minutes. The "spiking" technique was successfully applied in six tibial tuberosity avulsion fracture cases. Return to function was at a mean (± standard deviation) of 1.9 (± 1.6) weeks. Long-term (>12 months; n = 17) follow-up was available at a mean of 40.6 (± 13.4) months. Major complications consisted of skin irritation from a pin (distal tibia / fibula physeal fracture case; 8 weeks post-PTPFR), and a bilateral grade II medial patella luxation (tibial tuberosity avulsion fracture case; 1.5 years post-PTPFR). One case developed a mild tibial tuberosity avulsion fracture re-avulsion. All conditions in these three cases were not of clinical concern at follow-up and final outcome was graded as good in these and excellent in the other 14 cases. Percutaneous tibial physeal fracture repair can be considered as a technique to treat tibial physeal fractures. The "spiking" technique was successfully applied in six dogs. A larger, prospective case series is indicated to provide additional clinical information.

  12. [Long-term efficacy of tubularized peritoneal free grafts as ureteral mucosal substitutes in dogs].

    Science.gov (United States)

    Jing, Yi-Feng; Xia, Shu-Jie; Li, Du-Jian; Guo, Wen-Huan; Xu, Yao-Ting

    2011-02-15

    To investigate the long-term efficacy of ureteral reconstruction with tubularized peritoneal free grafts for the treatment of avulsion of ureteral mucosa in animal models. The model of avulsion of ureteral mucosa was established in 12 adult dogs. Then they were divided into Group A (n = 6, length of avulsed mucosa at 4 cm) and Group B (n = 6, length of avulsed mucosa at 6 cm). And the tubularized peritoneal free grafts and ureteral stents were implanted into the injured ureters. The curative effect was observed by intravenous urethrogram (IVU) and histological examination at Week 24 post-operation. Severe stenosis was observed by IVU in 1 dogs in Groups A and B respectively. In the remaining 10 dogs, IVU showed normal size and morphology of kidneys. There was no hydronephrosis. And no obvious stricture of ureteral part was observed for mucosa substitutes made of peritoneal free grafts. In all 10 dogs without stenosis of both groups, peritoneal membrane was replaced by integrated transitional epithelium. And there was no obvious stricture. Collagen fibers were arranged parallel to mucosal surface. For avulsion of ureteral mucosa under 6 cm, reconstruction with tubularized peritoneal free grafts as mucosa substitutes is an effective method. And its long-term efficacy is satisfactory.

  13. Medial and lateral segond fractures in a skeletally immature patient: a radiographic marker for the multiply injured knee.

    Science.gov (United States)

    Kwon, Oh Soo; Park, Min Jung; Tjoumakaris, Fotios P

    2011-11-09

    Marginal fractures of the medial tibial plateau have been reported in the literature as a secondary type of Segond fracture. Some reports described this entity in the setting of combined injuries such as root avulsions of the medial meniscus, complete disruption of the posterior cruciate ligament (PCL), partial tear of the anterior cruciate ligament (ACL), and tears of the medial meniscus and medial collateral ligament. It has been postulated that medial marginal fractures are secondary to compression of the medial aspect of the femoral condyle and tibial plateau with a corresponding posterolateral corner injury. However, this mechanism of injury may not always be as straightforward.This article presents a case of an alternate injury pattern in a skeletally immature patient. A 16-year-old boy sustained a varus force and twisting injury to his knee, resulting in radiographic evidence of multiple avulsion fractures of the knee, including a fibular epiphyseal avulsion fracture and medial and lateral Segond fractures. Usually, the avulsion fractures serve as markers for significant ligamentous injuries in adult patients, but our patient had minimal injury to the PCL, ACL, and posterolateral corner. Further physical examination and imaging studies revealed an anterior horn root avulsion, meniscocapsular separation, and anterior cortical rim fracture. A combination of imaging modalities helped us further characterize the injury pattern to devise the optimal surgical plan, especially the fixation of the anterior cortical fracture of the tibia. Copyright 2011, SLACK Incorporated.

  14. Evaluation of the hamstring muscle complex following acute injury

    Energy Technology Data Exchange (ETDEWEB)

    Koulouris, George; Connell, David [Department of Radiology, St Francis X Cabrini, Wattletree Rd, 3144, Malvern, Victoria (Australia)

    2003-10-01

    To evaluate the imaging findings following acute hamstring injury. We retrospectively reviewed the imaging findings of hamstring muscle complex (HMC) strain in 170 patients referred to our institution over a 3-year period. A total of 179 injuries to the HMC were demonstrated in 170 patients (154 male, 16 female, mean age 28.2 years). The mean duration of symptoms was 4.7 days (range 1-10 days). MR imaging was performed in 97 cases and sonography in 102 cases (both modalities were performed in 20 examinations). Attention was directed to the frequency of muscle involvement, the location of the injury within the muscle-tendon unit, the extent of the injury and discriminating avulsion from muscle injury. Twenty-one patients had proximal tendon injury, with sixteen avulsions and five partial tears. Sixteen of these patients had surgical confirmation of hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps femoris alone) and all were reliably diagnosed with MR imaging (16/16), but less so with sonography (7/12). Four distal tendon avulsions were also observed (three semitendinosus, one biceps femoris). With respect to muscle injury, the biceps femoris was most commonly injured (124/154). Semimembranosus was an uncommon muscle injury (21/154) and semitendinosus rare (9/154). Imaging can discriminate a hamstring tendon avulsion from musculotendinous strain and helps identify which patients necessitate surgical management as opposed to conservative treatment. (orig.)

  15. Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong.

    Science.gov (United States)

    Chan, A W; Wong, T K; Cheung, G S

    2001-04-01

    The purpose of this study was to investigate the knowledge of a group of physical education (PE) teachers about the emergency management of dental trauma in Hong Kong. A postal questionnaire was sent to PE teachers in 100 randomly selected secondary schools in Hong Kong. A total of 166 teachers from 65 schools responded. Results show that a majority of the respondents have received formal teaching training (98.8%). While all but one teacher had received formal first aid training, only eight of them recalled that they had received advice on the management of dental trauma. Concerning the management of tooth fracture, 118 respondents (71.1%) gave an appropriate answer. In contrast, only 29 teachers (17.5%) were able to indicate the appropriate management for an avulsed tooth. Over 60% (102) of the respondents indicated it was "very urgent" to seek professional assistance if a permanent tooth has been avulsed, but they had little knowledge of the correct procedures for replanting or transporting avulsed teeth. Only 15 respondents (9%) pointed out that milk was the medium of choice for transporting avulsed teeth. Finally, over 90% (157) of respondents indicated that they had never received advice on the emergency procedures for the management of dental avulsion. The present study showed that the level of lay knowledge of management of dental injuries in a selection of PE teachers in Hong Kong is inadequate and educational campaigns are necessary to improve their emergency management of dental injuries.

  16. Imaging the infrapatellar tendon in the elite athlete

    International Nuclear Information System (INIS)

    Peace, K.A.L.; Lee, J.C.; Healy, J.

    2006-01-01

    Extensor mechanism injuries constitute a major cause of anterior knee pain in the elite athlete. Sonography and magnetic resonance imaging (MRI) are the imaging methods of choice when assessing the infrapatellar tendon. A comprehensive imaging review of infrapatellar tendon normal anatomy, tendinopathy, and partial/full-thickness tendon tears is provided. The value of imaging the infrapatellar tendon in clinical practice, including whether sonography can predict symptoms in asymptomatic athletes, is discussed. Acute avulsion fractures, including periosteal sleeve avulsion, and chronic avulsion injuries, including Sinding-Larsen-Johansson and Osgood-Schlatter syndromes, are shown. Mimics of infrapatellar tendon pathology, including infrapatellar plica injury, patellar tendon-lateral femoral condyle friction syndrome, and Hoffa's syndrome, are illustrated

  17. Imaging the infrapatellar tendon in the elite athlete

    Energy Technology Data Exchange (ETDEWEB)

    Peace, K.A.L. [Department of Radiology, Chelsea and Westminster Hospital, London (United Kingdom)]. E-mail: kalpeace@hotmail.com; Lee, J.C. [Department of Radiology, Chelsea and Westminster Hospital, London (United Kingdom); Healy, J. [Department of Radiology, Chelsea and Westminster Hospital, London (United Kingdom)

    2006-07-15

    Extensor mechanism injuries constitute a major cause of anterior knee pain in the elite athlete. Sonography and magnetic resonance imaging (MRI) are the imaging methods of choice when assessing the infrapatellar tendon. A comprehensive imaging review of infrapatellar tendon normal anatomy, tendinopathy, and partial/full-thickness tendon tears is provided. The value of imaging the infrapatellar tendon in clinical practice, including whether sonography can predict symptoms in asymptomatic athletes, is discussed. Acute avulsion fractures, including periosteal sleeve avulsion, and chronic avulsion injuries, including Sinding-Larsen-Johansson and Osgood-Schlatter syndromes, are shown. Mimics of infrapatellar tendon pathology, including infrapatellar plica injury, patellar tendon-lateral femoral condyle friction syndrome, and Hoffa's syndrome, are illustrated.

  18. Lithium Enhances Axonal Regeneration in Peripheral Nerve by Inhibiting Glycogen Synthase Kinase 3β Activation

    Directory of Open Access Journals (Sweden)

    Huanxing Su

    2014-01-01

    Full Text Available Brachial plexus injury often involves traumatic root avulsion resulting in permanent paralysis of the innervated muscles. The lack of sufficient regeneration from spinal motoneurons to the peripheral nerve (PN is considered to be one of the major causes of the unsatisfactory outcome of various surgical interventions for repair of the devastating injury. The present study was undertaken to investigate potential inhibitory signals which influence axonal regeneration after root avulsion injury. The results of the study showed that root avulsion triggered GSK-3β activation in the injured motoneurons and remaining axons in the ventral funiculus. Systemic application of a clinical dose of lithium suppressed activated GSK-3β in the lesioned spinal cord to the normal level and induced extensive axonal regeneration into replanted ventral roots. Our study suggests that GSK-3β activity is involved in negative regulation for axonal elongation and regeneration and lithium, the specific GSK-3β inhibitor, enhances motoneuron regeneration from CNS to PNS.

  19. Tridimensional sonographic anatomical changes on pelvic floor muscle according to the type of delivery.

    Science.gov (United States)

    Cassadó Garriga, Jordi; Pessarrodona Isern, Antoni; Espuña Pons, Montserrat; Durán Retamal, Montserrat; Felgueroso Fabregas, Anna; Rodriguez-Carballeira, Monica

    2011-08-01

    The aim of the study was to evaluate the association of avulsion and postnatal hiatal dimensions with delivery mode. These anatomical changes on pelvic floor muscle may be assessed by 3-4D ultrasonography. This is a prospective observational study that included 164 women: 20 nulliparous, 20 primigravid, and 124 postpartum women (62 at 1 month, 62 at 9 months postpartum). We performed an introital 3-4D ultrasonography to assess levator ani muscle's integrity, levator hiatal area at rest, on Valsalva, and on contraction. Levator ani avulsion was diagnosed in 59.5% of forceps deliveries. There were no statistically significant differences in postnatal hiatal dimensions between normal vaginal deliveries at 9 months postpartum and nulligravid. Levator hiatal area was significantly higher after forceps delivery. Low incidence of levator avulsion takes place in normal vaginal deliveries. However, forceps delivery is the riskiest type of delivery for pelvic floor pathology and its recovery.

  20. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries

    DEFF Research Database (Denmark)

    Andersson, Lars; Andreasen, Jens O; Day, Peter

    2012-01-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature...... were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth....

  1. Use of a hypogastric flap and split-thickness skin grafting for a degloving injury of the penis and scrotum: A different approach

    Directory of Open Access Journals (Sweden)

    Selvan S

    2009-01-01

    Full Text Available Penile and scrotal skin avulsions are not common events and are caused usually by accidents with industrial machines or agricultural machines. We report a case of a 27-year-old newly married thin-built patient with avulsion and traumatic degloving of the penile and scrotal skin, with exposure of the corpora cavernosa and copus spongiosum of penis and testes as his loose clothes got entangled in a paddy harvesting machine accidently. Reconstruction was performed using a hypogastric flap and split skin graft, achieving a satisfactory aesthetic result and sexual functions.

  2. Traumatic Degloving of Penoscrotal Skin: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    R. Yegane

    2014-05-01

    Full Text Available Skin avulsions of male genitals are a rare traumatic plastic surgery and urologic emergency. This kind of trauma occur mainly because of accidents with industrial machines or agricultural machine belts. In this paper we reported two patients with traumatic avulsion of penile and scrotal skin. These patients wound were covered with split thickness skin graft after two weeks. We recommend for using a split thickness skin graft to cover the penis and scrotal degloved area because of this operation has minimal invasiveness and rapid healing.

  3. Delayed Reimplantation: A Case Report

    OpenAIRE

    Harris, Anoop; Reshmi, J; George, Sageena; Issac, Jyothi Sumi

    2014-01-01

    A 12-year-old boy reported to the clinic with a history of trauma, whereas playing 1 day before. On examination it was noted that the patient had an avulsed tooth in relation to 11, Class III fracture in relation to 12 and Class II fracture in relation to 21. The avulsed tooth was brought by the patient wrapped in a newspaper. Although the tooth was in highly unfavorable storage condition, it was decided to reimplant the teeth since the patient was young and to relieve him from psychological,...

  4. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 2

    DEFF Research Database (Denmark)

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A

    2014-01-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and gr...

  5. Download this PDF file

    African Journals Online (AJOL)

    user

    The loss of the protective skin barrier such as in burns or avulsion injury accompanying the penetrating trauma and the presence of micro-organisms peculiar to the hospital environment ... such as knife or stab wounds, low energy such as handguns, and high ... Bullets have an available kinetic energy of. 15003000 joules ...

  6. JMBR VOLUME 14 NO 1 - JUNE 2015.cdr- CORRESPONDENCE.cdr

    African Journals Online (AJOL)

    FinePrint

    2015-06-01

    Jun 1, 2015 ... implantation should be adopted . Re- implantation of an avulsed tooth preferably should be done in order to minimize extra-alveolar time and to keep the periodontal cells viable for healing. 25 and a possible pulp revascularization, only 16% of the respondents knew that the best emergency treatment for an ...

  7. Author Details

    African Journals Online (AJOL)

    Oberholzer, PJ. Vol 18, No 2 (2014) - Articles Humeral avulsion of the glenohumeral ligament: The J sign. Abstract PDF · Vol 18, No 2 (2014) - Articles Complete rupture of the long head of the biceps tendon and the distal biceps tendon. Abstract PDF. ISSN: 2078-6778. AJOL African Journals Online. HOW TO USE AJOL.

  8. TRAUMATIC INJURIES TO THE TEETII OF CHILDREN

    African Journals Online (AJOL)

    periodontal or root fracture;. 4. Direction: intrusion, extrusion or avulsion ... fall against an object, or a fall from a bicycle. The main aetiological ... where the injury occured? The place of acci- dent indicates if preventive measures against tetanus are required;. - how the injury occured? The direction of the blow may indicate a ...

  9. J_'-9_7__ Degloving injuries and flap viability assesstnent

    African Journals Online (AJOL)

    necessitated euthanasia and reassessment of the trial protocol. Flap viability assessment in both groups was made clinically, histologically and by planirnerry. RG.3. Flap raised and partially de-epithelialised using wire bristle dermabrader. series.IO Approximately 50% of the avulsed flap was dis- carded and a maximum of ...

  10. Are primary care physicians equipped enough to act as first ...

    African Journals Online (AJOL)

    Background: Prompt and appropriate management of dental trauma has been shown to significantly improve the prognosis of the resulting injuries in numerous cases. Frequently it is other health professionals that provide emergency care following traumatic dental injuries including tooth avulsion. The objective of this study ...

  11. Dental exarticulation | Yadav | Nigerian Journal of Clinical Practice

    African Journals Online (AJOL)

    Immediate replantation of the tooth allows for immediate restoration of esthetics and phonetics. This case report presents the management of an avulsed mature tooth in a young boy, with a two‑year follow‑up, which had been preserved in milk after around 15-20 minutes of injury and transplanted after two ours at a dental ...

  12. Radiology of posterior lumbar apophyseal ring fractures: Report of 13 cases

    Energy Technology Data Exchange (ETDEWEB)

    Dietemann, J.L.; Beaujeux, R.; Wackenheim, A.; Runge, M.; Bonneville, J.F.; Badoz, A.; Dosch, J.C.

    1988-08-01

    The authors report radiological findings in 13 cases of avulsion of the posterior lumbar apophyseal ring. The lesion affected young adults in 10 cases and adolescents in 3 cases. The lesion involved the inferior endplate of L4 in 11, and of L5 in 2 patients. 6 patients presented with unilateral sciatica, 3 with bilateral sciatica, and 4 with low back pain. Acute spinal trauma was evident only in 2 adolescents. Radiological recognition of the lesion was possible on plain films in 9 cases. CT demonstrates association of avulsion of the posterior vertebral apophyseal ring and herniated disc in all cases. Avulsion of the posterior apophyseal ring has to be differentiated from posterior longitudinal ligament, annulus, or herniated disc calcifications, as well as from posterior degenerative ridge osteophytes. Controversy about physiopathology of the lesion remains: Weakness of the apophyseal ring during childhood and in patients with Scheuermann's disease may explain avulsion of the apophyseal ring in association with median disc herniation.

  13. MR arthrography of elbow: evaluation of the ulnar collateral ligament of elbow

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Katsunuki [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Masatomi, Takashi [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Ochi, Takahiro [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Ishida, Takeshi [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Hori, Shinichi [Department of Radiology, Izumisano Municipal Hospital, Osaka (Japan); Ikezoe, Junpei [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Nakamura, Hironobu [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan)

    1996-10-01

    Objective. The purpose of this study was to evaluate ulnar collateral ligament (UCL) injury of the elbow in throwing athletes by MRI and MR arthrography. Design. Ten elbows of throwing athletes were examined on both plain MRI and MR saline arthrography and the injuries subsequently surgically proven. Spin-echo (SE) T1-weighted and fast SE T2-weighted coronal images were obtained. Results. The UCL was unclear in all ten cases on T1-weighted MRI. In five cases an avulsion fracture was also found on T1-weighted MRI. On T2-weighted MRI, abnormal high-intensity areas were identified in or around the UCL. On T2-weighted MR arthrography images, extracapsular high-intensity areas, which represent extracapsular leakage, were found in four of five cases with avulsion fracture. At surgery, all these four cases showed avulsion fractures with instability; the other case had a fracture but it was stable and adherent to the humerus. On T2-weighted MR arthrography images, an extracapsular high-intensity area was found in one of the five cases without avulsion fracture. At surgery this patient had a complete tear of the UCL itself. Conclusion. MR arthrography provided additional information for evaluating the degree of UCL injury. (orig.). With 5 figs., 1 tab.

  14. Horse Bite Injury to the Lip – A Case Report | Donkor | African ...

    African Journals Online (AJOL)

    Patient and method: A 12-year-old boy sustained a full-thickness avulsion injury to the lower lip following a bite by a horse. The lip was reconstructed at Komfo Anokye Teaching Hospital, Kumasi, Ghana, within 48 hours of injury under general anaesthesia , using a local flap. The patient had a full course of Amoxicillin and ...

  15. Fast-tracked Rehabilitation and Return to Sport of an Elite Rugby Player with a Complicated Posterolateral Corner Injury and Associated Peroneal Paralysis

    NARCIS (Netherlands)

    Paget, L. D. A.; Kuijer, P. P. F. M.; Maas, M.; Kerkhoffs, G. M. M. J.

    2017-01-01

    Acute posterolateral corner injuries of the knee with associated hamstring avulsions and peroneal paralysis are rare in rugby. Regain of motor function following a complete paralysis is documented to be 38%. To our knowledge, only one case describes return to preinjury level of competitive sport

  16. Late Quaternary dynamics of a South African floodplain wetland and the implications for assessing recent human impacts

    Science.gov (United States)

    Tooth, S.; Rodnight, H.; McCarthy, T. S.; Duller, G. A. T.; Grundling, A. T.

    2009-05-01

    Knowledge of the long-term geomorphological dynamics of wetlands is limited, so currently there is an inadequate scientific basis for assessing anthropogenically induced changes and for developing conservation, remediation, and/or sustainable management guidelines for these fragile ecosystems. Along the upper Klip River, eastern South Africa, geomorphological and sedimentological investigations, geochronology, and remote sensing have been used to establish the late Quaternary dynamics of some internationally important floodplain wetlands, thus providing a reference condition against which to assess the extent of recent human impacts. Optically stimulated luminescence dating reveals that the wetlands have developed over at least the last 30 ky as a result of slow meander migration (jams, and the artificial excavation of a 1.2-km-long channel section across the wetlands have initiated an ongoing avulsion that is characterised by failure (gradual abandonment) of the main channel and rapid incision of a headcutting channel. Compared to the pre-settlement condition, little change in lateral migration activity has occurred, but this avulsion provides a clear example of anthropogenically accelerated change, occurring only ~ 1 ky after the last natural avulsion and in a part of the wetlands where avulsions have not occurred previously. Subsequent human interventions have included installing weirs in an attempt to control the resulting erosion and promote reflooding, but ongoing maintenance has been required. In areas that were not glaciated during the Quaternary, many other floodplain wetlands may be of similar antiquity, but the Klip River illustrates their sensitivity to direct and indirect human impacts.

  17. Sinding-Larsen-Johansson syndrome | Kuehnast | South African ...

    African Journals Online (AJOL)

    A spectrum of entities is involved in injury to the inferior aspect of the patella and the proximal patella tendon, including Sinding-Larsen- Johansson syndrome, patellar sleeve avulsion and jumper's knee. The patellar tendon is usually only a few centimetres long, arising from the inferior patella and inserting distally into the ...

  18. Cervico-Cephalic Arthroplasty with Peroperative Fractures: Analysis ...

    African Journals Online (AJOL)

    Austin Moore prosthesis have been implanted in all the patients. From the records, we documented the type of fracture, specific treatment, local evolution and the patient's outcome. Results: we observed two great trochanter fractures, one calcar fracture (fissure), one small trochanter avulsion, and two metaphysis fractures.

  19. Horse Bite Injury to the Lip – A Case Report | Donkor | African ...

    African Journals Online (AJOL)

    Background: Bite injuries to the face are commonly caused by pets and humans. Bite injury by horse is uncommon. A case of horse bite injury and its management is reported. Patient and method: A 12-year-old boy sustained a full-thickness avulsion injury to the lower lip following a bite by a horse. The lip was reconstructed ...

  20. Journal of Medicine and Biomedical Research - Vol 14, No 1 (2015)

    African Journals Online (AJOL)

    Knowledge and attitudes of final year medical students to first aid management of traumatic tooth avulsion: A cross-sectional survey · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Joan Emien Enabulele, Julie Omole Omo, 54 - 63 ...

  1. bite ofthe face

    African Journals Online (AJOL)

    1992-12-09

    Dec 9, 1992 ... and the return of sensation and function of the orbicularis oris muscle were obtained. SAfrMedJ1994; 84: 37-39. Case report. A 46-year-old WOIDart ... injury (1 hour of warm and 5 hours of cold ischaemia time). The replantation was performed under general anaesthesia. The avulsed tissue was rinsed in ...

  2. A retrospective study of traumatic injuries to teeth at a Nigerian ...

    African Journals Online (AJOL)

    All the cases of avulsion and most (83.3%) of root fracture presented within 1 week of injury while teeth that presented late had pulpal necrosis. 22% of the patients presented within 1 week of injury while 13.7% came after 10 years. Conclusion: There was late patients' presentation with average duration of trauma before ...

  3. Degloved foot sole successfully reconstructed with split thickness skin grafts

    NARCIS (Netherlands)

    Janssens, Loes; Holtslag, Herman R.; Schellekens, Pascal P A; Leenen, Luke P H

    2015-01-01

    Introduction The current opinion is that split thickness skin grafts are not suitable to reconstruct a degloved foot sole. The tissue is too fragile to carry full bodyweight; and therefore, stress lesions frequently occur. The treatment of choice is the reuse of the avulsed skin whenever possible,

  4. Pediatric maxillofacial injuries at a Nigerian teaching hospital: A ...

    African Journals Online (AJOL)

    Animal related injury and violence accounted equally for 3.8%. Soft tissue injuries in the form of abrasion, laceration and avulsion accounted for 70.0% of cases. Other anatomical sites included the mandible (16.3%), dento-alveolar fractures(12.5%), and midface (1.3%). Conclusion: Road traffic accident and falls still ...

  5. Contralateral C7 nerve transfer - Our experiences over past 25 years.

    Science.gov (United States)

    Zhang, Cheng-Gang; Gu, Yu-Dong

    2011-11-23

    Contralateral C7 nerve transfer has been used in treating brachial plexus avulsion injury since 1986. During the past two and half decades, much has been achieved, yet more needs to be explored. In this review article, the indications, technical details, outcome and pitfalls of this technique are summarized.

  6. Contralateral C7 nerve transfer - Our experiences over past 25 years

    OpenAIRE

    Zhang, Cheng-Gang; Gu, Yu-Dong

    2011-01-01

    Abstract Contralateral C7 nerve transfer has been used in treating brachial plexus avulsion injury since 1986. During the past two and half decades, much has been achieved, yet more needs to be explored. In this review article, the indications, technical details, outcome and pitfalls of this technique are summarized.

  7. Contralateral C7 nerve transfer - Our experiences over past 25 years

    Directory of Open Access Journals (Sweden)

    Zhang Cheng-Gang

    2011-11-01

    Full Text Available Abstract Contralateral C7 nerve transfer has been used in treating brachial plexus avulsion injury since 1986. During the past two and half decades, much has been achieved, yet more needs to be explored. In this review article, the indications, technical details, outcome and pitfalls of this technique are summarized.

  8. Knowledge and attitudes of final year medical students to first aid ...

    African Journals Online (AJOL)

    This was a descriptive cross-sectional study aimed at assessing the knowledge of final year medical students at the University of Benin regarding emergency management of traumatic tooth avulsion. Data collected were information on demographics, knowledge and practice regarding emergency management of traumatic ...

  9. Vulval defect after pelvic trauma and its repair with reverse TRAM flap

    African Journals Online (AJOL)

    Introduction: In trauma, a vulval defect may result from avulsion injury or develops after a wound infection with or without necrosis in the event of infected heamatoma formation. Patient: We present a case report of a patient who had a vulval defect following pelvic trauma and its subsequent successful repair with a reversed ...

  10. Craton-derived alluvium as a major sediment source in the Himalayan Foreland Basin of India

    DEFF Research Database (Denmark)

    Sinha, R.; Kettanah, Y.; Gibling, M.R.

    2009-01-01

    foreland basin may reflect avulsion of orogenic rivers along the craton margin, in addition to dynamic transverse drainage systems from the Himalaya that pushed the axial drainage to the basin's feather edge. The wide spread of cratonic sediment would have been enhanced by slow subsidence in the distal...

  11. Annals of African Surgery January 2012 16.12.2012.indd

    African Journals Online (AJOL)

    andrew

    penis with skin avulsed starting just distal to the base of the penis. [fig 1] There was gross edema of the skin and surrounding tissues and impending infection. The scrotum was intact. The penile bodies and urethra were also intact, and were covered by bright red tissues with prominent blood vessels. He was passing urine ...

  12. MANAGING SCALP DEFECTS IN SUB-SAHARAN AFRICA J. N. ...

    African Journals Online (AJOL)

    hi-tech

    2004-02-01

    Feb 1, 2004 ... reconstruction to restore contour and skull integrity remains secondary to adequate wound closure. ... produce partial thickness losses in the subgaleal layer(1). Small avulsion injuries of that nature can be ... Full thickness defects, involving loss of all layers, including pericranium, are more difficult to ...

  13. Pattern of Assault-induced Oral and Maxillofacial Injuries in Ado ...

    African Journals Online (AJOL)

    Obimakinde, et al.: Oral and maxillofacial injuries due to assault in Ado-Ekiti, Nigeria. 90. Nigerian Journal of Surgery. Jul-Dec 2012 | Volume 18 | Issue 2. Table 2: Etiology and pattern of injury. Etiology. Soft tissue. Dentoalveolar#. Mandibular#. Tooth avulsion. Nasal#. Student unrest. 3. 1. 1. 1. 0. Domestic violence. 4. 3. 0.

  14. ONYCHOMYCOSIS OF THE FEET—Treatment with Griseofulvin

    Science.gov (United States)

    Reisner, Ronald M.; Homer, Richard S.; Newcomer, Victor D.; Sternberg, Thomas H.

    1960-01-01

    Griseofulvin, a new orally administered antifungal antibiotic which has proved to be effective for the treatment of a wide variety of superficial fungus infections of man, was used in the treatment of 51 patients with infections of the toenails due to T. rubrum. Thirty-four of the patients were treated with griseofulvin alone and seven were treated with griseofulvin combined with surgical avulsion of all involved toenails. The remaining ten had bilateral infections, and avulsion was done on one foot but not the other before griseofulvin therapy was begun. Of 34 patients who were treated with griseofulvin alone, few had complete cure even after prolonged treatment. Some nails showed improvement for a time, then no further gain; some showed no improvement; some showed resistant wedges of infection which penetrated proximally toward the posterior nail fold. In the instances of surgical avulsion, clinically normal nails regrew during griseofulvin therapy. This simple procedure, with thorough removal of all underlying keratinous debris, apparently did away with foci of possible reinfection. The results of the study indicated that surgical avulsion of the toenails in combination with griseofulvin therapy is an effective and practical method of treating onychomycosis of the toenails due to T. rubrum. ImagesFigure 1.Figure 2. PMID:13740670

  15. Civilian Firearm and blast injuries of the Hand in Lagos, Nigeria ...

    African Journals Online (AJOL)

    The firearm injuries occurred during armed robbery attacks (80.1%), while majority(82.7%) of the blast injuries followed firework accidents during New year celebrations. The commonest pattern of injuries were soft tissue lacerations and avulsions. Others such as amputations, fractures, tendon and nerve disruptions ...

  16. Geomorphic processes affecting meadow ecosystems [chapter 3

    Science.gov (United States)

    Jerry R. Miller; Dru Germanoski; Mark L. Lord

    2011-01-01

    Three geomorphic processes are of primary concern with respect to the current and future state of wet meadow ecosystems: channel incision, avulsion (the abrupt movement of the channel to a new location on the valley floor), and gully formation. Gully formation often is accompanied by upvalley headcut migration and a phenomenon referred to as "groundwater sapping...

  17. Prevalence and risk factors of low back pain among undergraduate ...

    African Journals Online (AJOL)

    2015-03-09

    Mar 9, 2015 ... package, version 11.5 (SPSS, Inc., Chicago, IL, USA). The chi-square test was used to test associations between. LBP and other categorical variables (sex, ..... Shepard NP, Westrick RB, Owens BD, Johnson MR. Bony avulsion injury of the pectoralis major in a 19 year-old male judo athlete: a case report.

  18. Automatic detection of buried channel deposits from dense laser altimetry data

    NARCIS (Netherlands)

    Possel, B.M.J.; Lindenbergh, R.C.; Storms, J.E.A.

    2010-01-01

    The formation of the current Rhine-Meuse delta mainly took place during the last 12 000 years. Consecutive avulsions, i.e. sudden changes in the course of river channels, resulted in a complicated pattern of sandy channel deposits, surrounded by peat and clay. Knowledge of this pattern is not only

  19. Late Holocene lowland fluvial archives and geoarchaeology : Utrecht's case study of Rhine river abandonment under Roman and Medieval settlement

    NARCIS (Netherlands)

    van Dinter, M.; Cohen, K.M.; Hoek, W.Z.; Stouthamer, E.; Jansma, E.; Middelkoop, H.

    2017-01-01

    Fluvial lowlands have become attractive human settling areas all around the world over the last few millennia. Because rivers kept changing their course and networks due to avulsion, the sedimentary sequences in these areas are archives of both fluvial geomorphological and archaeological

  20. Dental trauma management awareness among primary school teachers in the Emirate of Ajman, United Arab Emirates.

    Science.gov (United States)

    Hashim, R

    2011-06-01

    To assess, by means of self-administered structured questionnaire, the level of knowledge of primary schools teachers in Ajman with regards to the immediate emergency management of dental trauma. The questionnaire was sent to teachers in randomly selected primary schools in Ajman. A total of 161 teachers responded (response rate 84.4%). The questionnaire surveyed teachers' background, knowledge and management of tooth fracture, avulsion, and also investigated teachers' attitudes and self-assessed knowledge. Ninety-one percent of the teachers were females, 51.6% in their thirties and 61.5% had university qualification. Fifty teachers had received formal first aid training, and only thirteen of them recalled that they had received training on the management of dental trauma. Concerning the management of tooth fracture, 138 respondents (85.8%) gave the appropriate management for fractured tooth. One hundred twenty-one (75%) of the respondents indicated that is very urgent to seek professional assistance if a permanent tooth is avulsed, but they had little knowledge on the correct media for transporting the avulsed tooth. Most teaches were unsatisfied with their level of knowledge for dental trauma and the majority were interested in having further education on the topic. The findings revealed that the level of knowledge of management of dental trauma (especially tooth avulsion) among school teachers in Ajman is inadequate, and education campaigns are necessary to improve their emergency management of dental injuries.

  1. Degloving injury to the penis | Mathur | African Journal of Paediatric ...

    African Journals Online (AJOL)

    The procedure avoids any valuable time delay; thus, enhancing the chances to obtain adequate flap viability, avoids patient discomfort caused by perineal expansion, gives a satisfactory cosmetic appearance, and taking into account his age, avoids future psychosomatic and psychosexual problems. Key words: Avulsion ...

  2. Incisor reduction: a provisional aesthetic technique for traumatised teeth.

    LENUS (Irish Health Repository)

    Darby, L J

    2010-12-11

    Patients in the mixed dentition who have suffered severe extrusion or avulsion injuries often present with difficult treatment decisions, especially when the initial emergency care has been compromised. Here we describe a well-tolerated, aesthetically acceptable and conservative method for treating such patients until a definitive treatment plan is possible.

  3. Dynamic assessment of Capparis spinosa buds on survival of ...

    African Journals Online (AJOL)

    2014-11-05

    Nov 5, 2014 ... Background: Tooth avulsion is the most severe type of traumatic dental injuries and it results in the complete displacement of the tooth out of its socket in alveolar bone. Reimplantation of the tooth is considered to be a best treatment modality due to its biological and psychological advantages. Its prognosis ...

  4. Browse Title Index

    African Journals Online (AJOL)

    Items 101 - 150 of 159 ... Vol 9, No 2 (2010), Pre-Induction and Intrapartum Correlates of Successful Induction Of Labour Using Oxytocin and Misoprostol in Abakaliki, Nigeria, Abstract. JA Obuna ... Vol 9, No 2 (2010), Re implantation of an Avulsed Maxillary Permanent Central Incisor in an Eight-Year-Old Girl – Case Report.

  5. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries. 2

    DEFF Research Database (Denmark)

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A

    2014-01-01

    were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth. The Hebrew Edition is part...

  6. Traumatic dental injuries and their management among children ...

    African Journals Online (AJOL)

    Subluxation and Extrusion were the least sustained types of dental injury (2.0%) and there was no case with a tooth avulsion. The most frequently offered treatment of injured teeth was either crown build-up, root canal treatment or splinting. Only 20% of all teeth were extracted. Conclusion: From this study it is concluded that ...

  7. East African Orthopaedic Journal - Vol 11, No 1 (2017)

    African Journals Online (AJOL)

    A comparison of accuracy of clinical tests and MRI in the diagnosis of meniscal and anterior cruciate ligament injuries · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL ... Recurrent traumatic posterior hip dislocation in labral avulsion: case report · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  8. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap

    Science.gov (United States)

    Denadai, Rafael; Raposo-Amaral, Cassio Eduardo; Marques, Frederico Figueiredo; Raposo-Amaral, Cesar Augusto

    2015-01-01

    The temporoparietal fascia flap has been extensively used in craniofacial reconstructions. However, its use for eyebrow reconstruction has been sporadically reported. We describe a successfully repaired hair-bearing temporoparietal fascia flap after traumatic avulsion of eyebrow. Temporoparietal fascia flap is a versatile tool and should be considered as a therapeutic option by all plastic surgeons. PMID:25993077

  9. Multi-detector CT assessment of traumatic renal lesions

    African Journals Online (AJOL)

    Mohamed Samir Shaaban

    2015-07-10

    Jul 10, 2015 ... had avulsed segmental artery with active bleeding and underwent total nephrectomy. Figure 2. Fifty-five year old female patient who sustained blunt trauma in a road traffic accident. (A) Axial CECT nephrographic phase,. (B) axial delayed phase showing multiple bilateral pre-existing simple cortical cysts ...

  10. Isolated gallbladder rupture following blunt abdominal trauma

    African Journals Online (AJOL)

    2011-11-03

    Nov 3, 2011 ... Road traffic accidents. (RTA) that are on the increase are now the primary causes of .... motor vehicular incidents from road traffic accidents[2,4] followed by significant falls[1,3,4,6] and direct kicks or blows ... torn from the liver bed but with intact cystic duct and artery; and total avulsion also termed “traumatic ...

  11. Reduced functional connectivity within the primary motor cortex of patients with brachial plexus injury

    NARCIS (Netherlands)

    Fraiman, D.; Miranda, M.F.; Erthal, F.; Buur, P.F.; Elschot, M.; Souza, L.; Rombouts, S.A.; Schimmelpenninck, C.A.; Norris, D.G.; Malessy, M.J.; Galves, A.; Vargas, C.D.

    2016-01-01

    This study aims at the effects of traumatic brachial plexus lesion with root avulsions (BPA) upon the organization of the primary motor cortex (M1). Nine right-handed patients with a right BPA in whom an intercostal to musculocutaneous (ICN-MC) nerve transfer was performed had post-operative resting

  12. Digging for Lost Rivers in Thailand: Locating and Dating Paleochannels in the Chiang Mai Intermontane Basin

    Science.gov (United States)

    Teo, Elisha A.; Ziegler, Alan D.; Wasson, Robert J.; Morthekai, Paulramasamy

    2017-04-01

    The drainage of the Chiang Mai basin has a dynamic but largely forgotten history. In the late 1980s, an ancient lost city was excavated near the Ping River in Chiang Mai, Thailand. Archaeologists had unearthed Wiang Kum Kam, the former royal capital of the Lanna Civilisation founded in 1286 CE. Former investigations revealed that flood sediments buried the capital and remnants of an abandoned river channel were discovered beneath the surface. This concurs with historical descriptions of the Ping River being on the eastern bank of the capital, despite being presently located on the western bank. The paleochannel drained 500 years ago after diverting west of the ancient city. This switch, an avulsion, coincided with a large flood, which could have triggered and/or caused the avulsion. Local oral histories also recount other Ping avulsions across the basin, but these were not documented. Some of these paleochannels residually remain as unusually sinuous irrigation canals, with historically suggestive names such as the Old Ping and the Small Ping Rivers. Here, the geomorphological evolution of the Ping River is investigated, as a future avulsion in this extensively populated area would be catastrophic. Evidence shows that the drainage of the Chiang Mai basin evolved from a braided system, to an avulsing anastomosing system, to a primarily single channel system. Two-dimensional electrical resistivity tomography and augering detected a large continuous body of fluvial sand 4 m below the surface, across the 10 km distance between the Ping and Kuang Rivers. This sand continues to the depth of at least 30 m and is typical of a braided system. Further augering along paleochannels revealed buried levees that protrude from the braided river deposits to near the surface, separated by fine floodplain sediments. This may have formed as the braided system evolved into an anastomosing system, where distinct channels stabilised and floodplain deposits could develop between channels

  13. Emergency management of dental trauma: knowledge of Hong Kong primary and secondary school teachers.

    Science.gov (United States)

    Young, Cecilia; Wong, K Y; Cheung, L K

    2012-10-01

    OBJECTIVES. To investigate the level of knowledge about emergency management of dental trauma among Hong Kong primary and secondary school teachers. DESIGN. Questionnaire survey. SETTING. A teachers' union that unites 90% of teachers in Hong Kong. PARTICIPANTS. Randomly selected primary and secondary school teachers. RESULTS. Only 32.8% of respondents correctly stated that a person sustaining dental trauma should go to dentists directly. In all, 73.1% of teachers correctly stated that a dental trauma patient should go for treatment immediately. Only 32.5% knew that a fractured tooth should be put in liquid. Even fewer (23.2%) realised that the displaced tooth should be repositioned back to the original position. Relatively more respondents (74.7%) understood that an avulsed baby tooth should not be put back. Disappointingly, only 16.3% of teachers knew that an avulsed permanent tooth should be replanted. Furthermore, only 29.6% of teachers thought that they were able to distinguish between deciduous teeth and permanent teeth, whilst 20.4% correctly identified at least one of the appropriate mediums: milk, physiological saline or saliva, for storing an avulsed tooth. Teachers who previously received first-aid training with dental content or acquired dental injury information from other sources, scored significantly higher than teachers without such training or acquired information. CONCLUSION. The knowledge on emergency management of dental trauma among primary and secondary school teachers in Hong Kong is insufficient, particularly on the handling of permanent tooth avulsion and the appropriate storage medium for avulsed teeth. Receipt of first-aid training with dental contents and acquisition of dental injury information from other sources were positively correlated with knowledge in managing dental trauma.

  14. Injury of anterior cruciate ligament with associated bony lesions: MR image

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soon; Oh, Yeon Hee; Lee, Chang Wook [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Yong Min [Chungbuk Univ. College of Medicine, Chongju (Korea, Republic of); Lee, Hyeon Kyeong; Kim, Seung Hyeon; Lee, Sung Woo [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-05-01

    To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. Complete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37%), and combined bony lesion in 14 (52%). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23%) of partial ACL tears;combined bony lesion was seen in four such cases(31%). There were eight cases of avulsion fracture;the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6);the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear.

  15. Alveolar Bone Fracture: Pathognomonic Sign for Clinical Diagnosis.

    Science.gov (United States)

    Gutmacher, Zvi; Peled, Eli; Norman, Doron; Lin, Shaul

    2017-01-01

    Dental injuries, especially luxation and avulsion, are common. Dental trauma can cause alveolar bone fracture that can lead to tooth loss and malocclusion. Single tooth alveolar bone fractures are difficult to identify unless it protrudes through the overlying mucosa and can be visualized. Pain, malocclusion, and tooth mobility provide signs of suspected alveolar bone fractures. Integrity of the proximate alveolar bone should be examined for fractures where avulsion, luxation, or other tooth trauma is detected. Any suggestion of alveolar fractures should be further investigated with an appropriate radiograph. This case report shows a pathognomonic sign that detects and diagnosis single tooth alveolar bone fractures, i.e. , a localized hematoma crossing the attached gingiva from the free gingival margin to the vestibular mucosa. This should serve as a warning for localized alveolar bone fracture. A visualized hematoma and gentle, careful palpation may help detect covered fractures when the overlying mucosa is not perforated.

  16. Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures.

    Science.gov (United States)

    Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao

    2008-09-01

    We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.

  17. Dental trauma management by New York City school nurses.

    Science.gov (United States)

    Choi, David; Badner, Victor M; Yeroshalmi, Farhad; Margulis, Keith S; Dougherty, Nancy J; Kreiner-Litt, Geri

    2012-01-01

    The purpose of this study was to assess the knowledge and ability of school nurses in NYC to manage and properly treat traumatic dental injuries. A survey questionnaire was sent to 160 randomly selected public schools and 40 randomly selected private schools in New York City. The questionnaire consisted of 24 multipart questions regarding background, personal experience, and knowledge of dental trauma. Seventy-four percent (74%) of the nurses rated their confidence in handling dental trauma in the middle range on a scale from 1 to 10. Sixty-two percent (62%) of nurses knew liquid was the optimal transportation method of an avulsed tooth; however, 52% of participants responded incorrectly that it was not appropriate to replant an avulsed permanent tooth. Ninety percent of nurses surveyed were interested in receiving further education in the management of dental trauma. This survey indicates that a gap of knowledge exists in the ability of school nurses to handle dental trauma.

  18. Fatal injuries of the brain stem and/or upper cervical spinal cord in traffic accidents: nine autopsy cases.

    Science.gov (United States)

    Kondo, T; Saito, K; Nishigami, J; Ohshima, T

    1995-01-01

    Nine forensic autopsy cases were studied. All had injuries of the brain stem and/or upper cervical spinal cord due to traffic accidents. Among the nine subjects, eight were pedestrians and one was a left, front seat occupant of a vehicle. Examination of these 9 cases revealed that three had ponto-medullary avulsion, two had medullary avulsion and the other four had laceration of the upper cervical spinal cord. Atlanto-occipital dislocation was observed in five cases, and a ring fracture around the foramen magnum in the other two cases. Intraventricular haemorrhage, probably due to tears of the choroid plexus caused by hyperextension or hyperflexion of the head, was found in seven cases. In just one of these seven cases, both of the lateral ventricles were filled with dark red haemocoagulum. Hyperextension is considered to occur more commonly in road trauma cases where the victim is alcoholically intoxicated.

  19. Neuroprotective Drug for Nerve Trauma Revealed Using Artificial Intelligence.

    Science.gov (United States)

    Romeo-Guitart, David; Forés, Joaquim; Herrando-Grabulosa, Mireia; Valls, Raquel; Leiva-Rodríguez, Tatiana; Galea, Elena; González-Pérez, Francisco; Navarro, Xavier; Petegnief, Valerie; Bosch, Assumpció; Coma, Mireia; Mas, José Manuel; Casas, Caty

    2018-01-30

    Here we used a systems biology approach and artificial intelligence to identify a neuroprotective agent for the treatment of peripheral nerve root avulsion. Based on accumulated knowledge of the neurodegenerative and neuroprotective processes that occur in motoneurons after root avulsion, we built up protein networks and converted them into mathematical models. Unbiased proteomic data from our preclinical models were used for machine learning algorithms and for restrictions to be imposed on mathematical solutions. Solutions allowed us to identify combinations of repurposed drugs as potential neuroprotective agents and we validated them in our preclinical models. The best one, NeuroHeal, neuroprotected motoneurons, exerted anti-inflammatory properties and promoted functional locomotor recovery. NeuroHeal endorsed the activation of Sirtuin 1, which was essential for its neuroprotective effect. These results support the value of network-centric approaches for drug discovery and demonstrate the efficacy of NeuroHeal as adjuvant treatment with surgical repair for nervous system trauma.

  20. The role of the reversed oblique radiograph in trauma of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Geyskens, W.; Brys, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Janzing, H. [Dept. of Traumatology, University Hospitals, Leuven (Belgium)

    2000-03-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  1. An unusual case of a serious blunt injury of the eye

    Directory of Open Access Journals (Sweden)

    Jovanović Miloš

    2009-01-01

    Full Text Available Introduction. Optic nerve avulsion is a serious injury of the eye. The objective of the paper was to present the peculiarity of the eye injury caused by a penetrating orbital wound with foreign body being retained in the orbit. Case report. A 15-year-old boy who sustained injury by chain link is presented. While he was turning the chain round in his hand, the last link broke off, piercing the lower lid, penetrated the left orbital cavity and remained behind the eyeball at the top of orbit. While passing towards the top of the orbit, the foreign body caused a blunt injury of the eyeball and avulsion of the ocular nerve. The accurate localization of the foreign body was verified by X-ray and CT imaging. The foreign body was removed through the entry wound. The eye injury resulted in amaurosis. Conclusion. This injury was one of those that could have been prevented.

  2. The role of the reversed oblique radiograph in trauma of the foot and ankle

    International Nuclear Information System (INIS)

    Geusens, E.; Geyskens, W.; Brys, P.; Janzing, H.

    2000-01-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  3. APLIKASI KOMPOSIT RESIN UNTUK PENATALAKSANAAN KEGOYANGAN GIGI AKIBAT TRAUMA

    Directory of Open Access Journals (Sweden)

    Venita Venita

    2015-08-01

    Full Text Available Injuries to the teeth range from minor coronal fractures to total avulsion. If the injuries cause totl avulsion or luxation, there will be varying levels of injuries to the periodontal ligament, alveolus and microvascular supply. Management of the injured teeth ranges from inspection and treatment which includes stabilization by splinting. Usually splinting is accomplished by a segment of arch bar. Due to the ebsence of arch bar appliances, dentists often referred patients to an oral surgeon. It would cost extra time, for an immediate action to help the patients. This paper is a case report of a traumatized tooth which has been successfully stabilized with acid etched wire-composite. The use of composite resin is considered as a quick and an easy solution for dental trauma therapy.

  4. MR imaging of posterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobuyuki [Tsukuba Univ., Ibaraki (Japan). Hospital; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

    2001-07-01

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  5. Frog Appliance- An Innovative Treatment Option for the Replacement of Missing Teeth in An Epileptic Child

    Science.gov (United States)

    Goyal, Anita; Reddy, Hanumanth; Sajjnar, Arun B; Jain, Sonal

    2015-01-01

    Epilepsy is a chronic neurological disease which may result in various oro-facial injuries among which fracture of crown and avulsion of tooth are commonly reported. Challenges come in growing epileptic children where fixed prosthesis could not be delivered and it demands a fixed semi-permanent prosthesis that needs strength along with esthetics. The present paper reports an innovative appliance which has fulfilled fore mentioned criteria; with the appliance named-frog appliance. PMID:26155578

  6. Post-traumatic Raynaud's phenomenon following volar plate injury.

    Science.gov (United States)

    Chodakiewitz, Yosef G; Daniels, Alan H; Kamal, Robin N; Weiss, Arnold-Peter C

    2014-04-01

    Post-traumatic Raynaud's phenomenon following non-penetrating or non-repetitive injury is rare. We report a case of Raynaud's phenomenon occurring in a single digit 3 months following volar plate avulsion injury. Daily episodes of painless pallor of the digit occurred for 1 month upon any exposure to cold, resolving with warm water therapy. Symptoms resolved after the initiation of hand therapy, splinting, and range-of- motion exercises.

  7. Electroacupuncture attenuates neuropathic pain after brachial plexus injury

    OpenAIRE

    Zhang, Shenyu; Tang, Hailiang; Zhou, Junming; Gu, Yudong

    2014-01-01

    Electroacupuncture has traditionally been used to treat pain, but its effect on pain following brachial plexus injury is still unknown. In this study, rat models of an avulsion injury to the left brachial plexus root (associated with upper-limb chronic neuropathic pain) were given electroacupuncture stimulation at bilateral Quchi (LI11), Hegu (LI04), Zusanli (ST36) and Yanglingquan (GB34). After electroacupuncture therapy, chronic neuropathic pain in the rats’ upper limbs was significantly at...

  8. Traumatic tracheal diverticulum corrected with resection and anastomosis during one-lung ventilation and total intravenous anesthesia in a cat.

    Science.gov (United States)

    Sayre, Rebecca S; Lepiz, Mauricio; Wall, Corey; Thieman-Mankin, Kelley; Dobbin, Jennifer

    2016-11-01

    This report describes the clinical findings and diagnostic images of a traumatic intrathoracic tracheal avulsion with a tracheal diverticulum in a cat. Furthermore, a complete description of the tracheal resection and anastomosis using one-lung ventilation (OLV) with total and partial intravenous anesthesia is made. A 3-year-old neutered male domestic shorthair cat weighing 6.8 kg was presented to the University Teaching Hospital for evaluation of increased respiratory noise 3 months following unknown trauma. Approximately 12 weeks prior to presentation, the cat had been seen by the primary care veterinarian for respiratory distress. At that time, the cat had undergone a tracheal ballooning procedure for a distal tracheal stricture diagnosed by tracheoscopy. The tracheal ballooning had provided only temporary relief. At presentation to our institution, the cat had increased respiratory effort with harsh upper airway noise auscultated during thoracic examination. The remainder of the physical examination was normal. Diagnostics included a tracheoscopy and a thoracic computed tomographic examination. The cat was diagnosed with tracheal avulsion, pseudotrachea with a tracheal diverticulum, and stenosis of the avulsed tracheal ends. Surgical correction of the tracheal stricture via a thoracotomy was performed using OLV with total and partial intravenous anesthesia. The cat recovered uneventfully and at last follow-up was active and doing well. This case report describes OLV using standard anesthesia equipment that is available at most private practices. Furthermore, this case describes the computed tomographic images of the intrathoracic tracheal avulsion and offers a positive outcome for tracheal resection and anastomosis. © Veterinary Emergency and Critical Care Society 2015.

  9. The adductor magnus "mini-hamstring": MRI appearance and potential pitfalls.

    Science.gov (United States)

    Broski, Stephen M; Murthy, Naveen S; Krych, Aaron J; Obey, Mitchel R; Collins, Mark S

    2016-02-01

    To examine the anatomic MRI characteristics of the adductor magnus mini hamstring (AMMH) and explore its involvement in cases of hamstring avulsion. An IRB-approved retrospective review of patients undergoing "hamstring protocol" MRI between March 2009 and June 2014 was performed. Two musculoskeletal radiologists recorded multiple AMMH anatomic characteristics and involvement in cases of hamstring avulsion. Seventy-six AMMHs were analyzed in 66 patients [35 females and 31 males, mean age 49.3 ± 15.2 years (range 17-81)]. Eleven percent of AMMHs were poorly visualized, 51 % visualized, and 37 % well visualized. Seven percent demonstrated round, 73 % ovoid, and 21 % flat/lenticular tendon morphologies. Most (88 %) demonstrated typical origins. Average cross-sectional area (CSA) was 22.4 ± 10.6 mm² (range 6-56), diameter was 7.2 ± 2.5 mm (range 2.9-15), medial distance from the semimembranosus tendon was 7.5 ± 2.5 mm (range 3-14), and tendon length was 6.8 ± 3.3 cm (range 1.2-14.1). There was no gender difference in AMMH anatomic measurements or correlation between age and CSA or diameter. Of 17 complete hamstring avulsion cases, the AMMH was intact in 13, partially torn in 3, and completely torn in 1. The AMMH is a constant finding with variable anatomic characteristics. It is visualized or well visualized by MRI in 88 % of cases and is a sizable tendon located in close proximity to the semimembranosus tendon. Because it is uncommonly completely torn (6 %) in cases of complete hamstring avulsion, radiologists should be aware of its presence and appearance to avoid diagnostic confusion.

  10. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    OpenAIRE

    Kazufumi Tachi; Masanori Mori; Reiko Tsukuura; Rintaro Hirai

    2018-01-01

    Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the...

  11. Radiologic findings in lesions of the ligamentum bifurcatum of the midfoot

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, S.; Agnholt, J.; Christensen, H.

    1987-02-01

    In a consecutive study of 106 patients presenting with a history of ankle sprain, 40.5% showed clinical signs of damage to the ligamentum bifurcatum. Eighteen of these patients showed 20 radiologic signs related to a lesion of this ligament; these signs included avulsions from the points of insertion and laxity in the lateral part of the transverse tarsal joint. The supplementary radiographs revealing these signs are demonstrated, and a more differentiated radiologic handling of the patient with ankle sprain is suggested.

  12. The adductor magnus ''mini-hamstring'': MRI appearance and potential pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Broski, Stephen M.; Murthy, Naveen S.; Collins, Mark S. [Department of Radiology, Mayo Clinic, Rochester, MN (United States); Krych, Aaron J. [Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN (United States); Obey, Mitchel R. [Mayo School of Graduate Medical Education, Rochester, MN (United States)

    2016-02-15

    To examine the anatomic MRI characteristics of the adductor magnus mini hamstring (AMMH) and explore its involvement in cases of hamstring avulsion. An IRB-approved retrospective review of patients undergoing ''hamstring protocol'' MRI between March 2009 and June 2014 was performed. Two musculoskeletal radiologists recorded multiple AMMH anatomic characteristics and involvement in cases of hamstring avulsion. Seventy-six AMMHs were analyzed in 66 patients [35 females and 31 males, mean age 49.3 ± 15.2 years (range 17-81)]. Eleven percent of AMMHs were poorly visualized, 51 % visualized, and 37 % well visualized. Seven percent demonstrated round, 73 % ovoid, and 21 % flat/lenticular tendon morphologies. Most (88 %) demonstrated typical origins. Average cross-sectional area (CSA) was 22.4 ± 10.6 mm{sup 2} (range 6-56), diameter was 7.2 ± 2.5 mm (range 2.9-15), medial distance from the semimembranosus tendon was 7.5 ± 2.5 mm (range 3-14), and tendon length was 6.8 ± 3.3 cm (range 1.2-14.1). There was no gender difference in AMMH anatomic measurements or correlation between age and CSA or diameter. Of 17 complete hamstring avulsion cases, the AMMH was intact in 13, partially torn in 3, and completely torn in 1. The AMMH is a constant finding with variable anatomic characteristics. It is visualized or well visualized by MRI in 88 % of cases and is a sizable tendon located in close proximity to the semimembranosus tendon. Because it is uncommonly completely torn (6 %) in cases of complete hamstring avulsion, radiologists should be aware of its presence and appearance to avoid diagnostic confusion. (orig.)

  13. Advances in the treatment of varicose veins: ambulatory phlebectomy, foam sclerotherapy, endovascular laser, and radiofrequency closure.

    Science.gov (United States)

    Sadick, Neil S

    2006-01-01

    Dermatologists have played a key role in the advancement and development of new safe, noninvasive technologies that are utilized in the treatment of both cosmetic telangiectasias and larger varicose veins of medical significance. As presented in this article, major advances in sclerosing solutions, hook avulsion techniques, and endovascular RF and laser procedures have revolutionized the world of phlebology. This medical sector continues to evolve through its relevance to the ever-expanding aesthetic and aging population.

  14. Traumatic hemipelvectomy (amputae: Report of one case

    Directory of Open Access Journals (Sweden)

    Errol U. Hutagalung

    2001-09-01

    Full Text Available Traumatic hemipelvectomy (amputae is a catastrophic injury resulting front violent shearing forces which avulsed the lower limb at the level sacroiliac joint and symphisis pubis. Patients surviving traumatic hemipelvectomy are rare. One case of a 25 months old girl surviving traumatic hemipelvectomy, is presented. This is the first case reported from Indonesia. (Med J Indones 2001; 10: 169-73Keywords: Colostomy, skin graft, traffic accident

  15. Value of ultrasonography in assessment of recent injury of anterior talofi bular ligament in children

    Directory of Open Access Journals (Sweden)

    Joanna Szczepaniak

    2015-09-01

    Full Text Available Introduction: Sprained ankle is a very common injury in children. Proper treatment of ligament injuries enables full recovery. X-ray and US examinations are commonly available diagnostic methods. Material and methods: Two hundred and six children (113 girls and 93 boys, mean age 10.6 with recent ankle joint sprain (up to 7 days of injury were subject to a retrospective analysis. All patients underwent an X-ray and US examination of the ankle joint within 7 days of injury. In 19 patients, anterior talofi bular ligament reconstruction was conducted. Results: X-ray failed to visualize a pathology in 129 children (63%; in 24 patients (12%, avulsion fracture of the lateral malleolus was found, and in 36 cases (17%, effusion in the talocrural joint was detected. Ultrasonography failed to visualize a pathology in 19 children (9%; in 60 patients (29%, it showed avulsion fracture of the lateral malleolus involving the attachment of the anterior talofi bular ligament (ATFL; in 34 cases (17%, complete ATFL tear was detected, and in 51 patients (25%, partial ATFL injury was found. Other injuries constituted 19%. The surgeries conducted to repair the anterior talofi bular ligament (19 confi rmed the US/X-ray diagnoses in 100% of cases. Avulsion ATFL injury, i.e. the one that involves the ligament attachment site, is usually found in younger children (median: 8 years of age. Complete ATFL tears (not involving the attachment site concern older children (median: 14 years of age. Conclusions: Since X-ray is of limited value in diagnosing ankle joint pathologies in recent sprain injuries in children, soft tissue imaging, i.e. ultrasonography, is the basic examination to assess the ligament complex. Avulsion fractures, which involve the ATFL attachment site and are usually found in younger children, are a consequence of the incomplete ossifi cation and require urgent diagnosis and orthopedic consultation.

  16. Patterns of Hamstring Muscle Tears in the General Population: A Systematic Review.

    Science.gov (United States)

    Kuske, Barbara; Hamilton, David F; Pattle, Sam B; Simpson, A Hamish R W

    2016-01-01

    Hamstring tears are well recognised in the sporting population. Little is known about these injuries in the general population. Evaluating the rates, patterns and risk factors of non-sporting hamstring tears, compared to sporting related hamstring tears. MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (1989-2015). Studies reporting patients with a grade 2 or 3 hamstring muscle tear, identified clinically, confirmed by MRI imaging or direct visualisation during surgical exploration. 144 sets of linked data were extracted for analysis. Most injuries were in males (81.3%), where mean age at injury was lower (30.2, 95% CI 29.1-31.3) than in females (35.4, 95% CI 32.4-38.4) p = 0.06. Key differences were found in the proportion of non-sporting injuries in patients under and over the age 40 (p = 0.001). The proportion of non-sporting injuries was significantly higher in females compared to males (25.9% female non-sporting injuries, versus 8.5% male; p = 0.02). Avulsions were more frequently reported in non-sporting activities (70.5%). The proportion of such injuries was notably higher in females, though this failed to meet significance (p = 0.124). Grouped by age category a bimodal distribution was noted, with the proportion of avulsions greater in younger (age 40) (p = 0.008). 86.8% of patients returned to pre-injury activity levels with a similar frequency across all study variables; age, activity (sporting vs non-sporting) and injury type (avulsion vs tear). This review highlights a proportion of adults suffering grade 2 or 3 hamstring injuries from activities other than the classic sports trauma. The majority of these non-sporting injuries were avulsion injuries that clustered in older female and skeletally immature patients suggesting a potential link to bone mineral density.

  17. Anatomy of the Adductor Magnus Origin

    OpenAIRE

    Obey, Mitchel R.; Broski, Stephen M.; Spinner, Robert J.; Collins, Mark S.; Krych, Aaron J.

    2016-01-01

    Background: The adductor magnus (AM) has historically been a potential source of confusion in patients with suspected proximal hamstring avulsion injuries. Purpose: To investigate the anatomic characteristics of the AM, including its osseous origin, anatomic dimensions, and relationship to the proximal hamstring tendons. Study Design: Descriptive laboratory study. Methods: Dissection of the AM origin was performed in 11 (8 cadavers) fresh-frozen hip-to-foot cadaveric hemipelvis specimens. The...

  18. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    OpenAIRE

    Guan-Yang Song; Jin Zhang; Xu Li; Yue Li; Hua Feng

    2014-01-01

    Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root...

  19. Tooth loss treatment in the anterior region: Autotransplantation of premolars and cryopreservation

    OpenAIRE

    Hans Ulrik Paulsen; Jens Ove Andreasen; Ole Schwartz

    2016-01-01

    Avulsed and lost anterior teeth are common in young people. Using autotransplantation, it is possible to move problems in dental arches to regions where they are easier to solve orthodontically. Transplantation of premolars with three-quarter root formation or full root formation with wide open apical foramina provides the best prognosis for long-term survival. This article describes the use of autotransplantation and orthodontic treatment, together with cryopreservation, in connection with c...

  20. Does Emdogain work?

    Science.gov (United States)

    Kenny, David J

    2009-01-01

    Emdogain has been available commercially for just over a decade. It is used currently in clinical practice of periodontics and has been investigated in four clinical outcome studies of replanted teeth. This review covers the origin and concepts behind the use of this amelogenin derivative, the unique conditions associated with an avulsed tooth, and the laboratory and clinical characteristics of this material. Emdogain continues to be an experimental material for replantation applications.

  1. Regeneration of Surgically Excised Segments of Dog Esophagus using Biodegradable PLA Hollow Organ Grafts,

    Science.gov (United States)

    1980-06-01

    7 AG 396 ARMY INST OF DENTAL RESEARCH WASHINGTON DC FIG 6/5 REGENERATION OF SURGICALLY EXCISED SEGMENTS OF DOG ESOPHAGUS US-ETC(W) U15 G’OE UN8 N F...which will yield effective long-term functional results. The current therapy for repair and replacement of the diseased or avulsed esophagus is by the...C biodegradable polymeric implant constructed from the polymers and copolymers of polylactic acid (PLA) and polyglycolic acid (PGA) to replace an

  2. Prolonged Second Stage of Labor and Levator Ani Muscle Injuries

    OpenAIRE

    Marsoosi, Vajihe; Jamal, Ashraf; Eslamian, Laleh; Oveisi, Sonia; Abotorabi, Shokohossadat

    2014-01-01

    Objective: To determine the effect of pregnancy and vaginal delivery on the pelvic floor and levatorani morphology and function. Methods: Design. Cross-sectional study. Setting. Tertiary care teaching hospital. Population. 75 primigravid women were recruited for assessment at 6 weeks postpartum compared with 25 nulliparous women. Hiatal morphology and levator ani muscle avulsion were assessed by 4-dimensional translabial ultrasound examination. The volume achievement obtained by ultrasound wa...

  3. Extraordinary sediment delivery and rapid geomorphic response following the 2008–2009 eruption of Chaitén Volcano, Chile

    Science.gov (United States)

    Major, Jon J.; Bertin, Daniel; Pierson, Thomas C.; Amigo, Alvaro; Iroume, Andres; Ulloa, Hector; Castro, Jonathan M.

    2016-01-01

    The 10 day explosive phase of the 2008–2009 eruption of Chaitén volcano, Chile, draped adjacent watersheds with a few cm to >1 m of tephra. Subsequent lava-dome collapses generated pyroclastic flows that delivered additional sediment. During the waning phase of explosive activity, modest rainfall triggered an extraordinary sediment flush which swiftly aggraded multiple channels by many meters. Ten kilometer from the volcano, Chaitén River channel aggraded 7 m and the river avulsed through a coastal town. That aggradation and delta growth below the abandoned and avulsed channels allow estimates of postdisturbance traction-load transport rate. On the basis of preeruption bathymetry and remotely sensed measurements of delta-surface growth, we derived a time series of delta volume. The initial flush from 11 to 14 May 2008 deposited 0.5–1.5 × 106 m3 of sediment at the mouth of Chaitén River. By 26 May, after channel avulsion, a second delta amassed about 2 × 106 m3 of sediment; by late 2011 it amassed about 11 × 106 m3. Accumulated sediment consists of low-density vesicular pumice and lithic rhyolite sand. Rates of channel aggradation and delta growth, channel width, and an assumed deposit bulk density of 1100–1500 kg m−3 indicate mean traction-load transport rate just before and shortly after avulsion (∼14–15 May) was very high, possibly as great as several tens of kg s−1 m−1. From October 2008 to December 2011, mean traction-load transport rate declined from about 7 to 0.4 kg−1 m−1. Despite extraordinary sediment delivery, disturbed channels recovered rapidly (a few years).

  4. Selected Topical Agents Used in Traditional Chinese Medicine in the Treatment of Minor Injuries- A Review

    OpenAIRE

    Leung, Ping-chung; Ko, Erik Chun-hay; Siu, Wing-sum; Pang, Ellie Suet-yee; Lau, Clara Bik-san

    2016-01-01

    Topical medicinal patches have been popular for the treatment of minor injuries like sprains and avulsions. Other inflammatory conditions like chronic musculo-tendinous pain and or fasciitis are also taken care of by local ointments or rubs. In the oriental communities, medicinal herbs frequently form the major components of the patches. In spite of the lack of scientific evidence of efficacy, the popularity of such traditional application persists for centuries. In this era of evidence-based...

  5. Selected topical agents used in Traditional Chinese Medicine in the treatment of minor injuries- a review

    OpenAIRE

    Ping Chung eLEUNG; Ping Chung eLEUNG; Ping Chung eLEUNG; Sammy Wing-sum eSIU; Chun Hay eKo; Clara Bik-san eLau; Clara Bik-san eLau

    2016-01-01

    Topical medicinal patches have been popular for the treatment of minor injuries like sprains and avulsions. Other inflammatory conditions like chronic musculo-tendinous pain and or fasciitis are also taken care of by local ointments or rubs. In the oriental communities, medicinal herbs frequently form the major components of the patches.In spite of the lack of scientific evidence of efficacy, the popularity of such traditional application persists for centuries.In this era of evidence-based c...

  6. Combined hyperextension and supination of the elbow joint induces lateral ligament lesions. An experimental study of the pathoanatomy and kinematics in elbow ligament injuries

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    ) during forced valgus, external and internal rotation, respectively, but not during forced varus. The hyperextension trauma produced three lesions: (1) anterior capsule rupture, (2) avulsion of the proximal insertion of both the medial and the lateral collateral ligaments, and (3) occasional single...... rupture of the lateral collateral ligament. The lesions indicate that combined hyperextension and supination represent a possible mechanism leading to 'handball goalie's elbow'....

  7. Rescue Surgery 19 Years after Composite Root and Hemiarch Replacement

    Directory of Open Access Journals (Sweden)

    Konstantin von Aspern

    2013-01-01

    Full Text Available A 59-year-old male patient with Marfan's syndrome was referred to our clinic due to acute chest pain. His medical history contains complex surgery for type A aortic dissection 19 years ago including composite root replacement using a mechanical aortic valve. Immediate computed tomography indicated perforation at the distal ascending aortic anastomosis plus complete avulsion of both coronary ostia. The patient underwent successful rescue surgery with ascending aortic and arch replacement using a modified Cabrol technique.

  8. Unusual Variant of the Nutcracker Fracture of the Calcaneus and Tarsal Navicular

    OpenAIRE

    Gajendran, Varun K.; Yoo, Brad J.; Hunter, John C.

    2008-01-01

    A 62-year-old woman with severe seizure disorder presented with right ankle and foot pain after being found down, presumably following a seizure recurrence. Imaging showed an acute comminuted fracture of the anterolateral aspect of the right calcaneus, as well as an acute avulsion fracture of the right navicular tuberosity at the site of insertion of the tibialis posterior tendon. This fracture pattern suggests forced abduction of the midfoot or forefoot with severe compression of the lateral...

  9. To Compare the Effects of Storage Solutions 0.05% Thymol vs. 6% Sodium Hypochlorite vs. Hank’s Balanced Salt Solution on the Flexural Strength of Dentin Bars

    Science.gov (United States)

    2016-05-20

    generalized to teeth in vivo. If extracted teeth are to be treated as valid proxies of teeth in vivo, it is critical to understand the effect of...as Young’s modulus and yield stress. (Aydin B, 2015) For in vitro measures such as flexural strength to be considered valid proxies of in vivo...The solution is commonly used to preserve periodontal ligament cells on a tooth that has been avulsed from the patient’s mouth (Aydin, 2015). The

  10. Magnetic Resonance Imaging of Nonneoplastic Musculoskeletal Pathologies in the Pelvis.

    Science.gov (United States)

    Alapati, Sindhura; Wadhwa, Vibhor; Komarraju, Aparna; Guidry, Carey; Pandey, Tarun

    2017-06-01

    Musculoskeletal pathologies in the pelvis encompass a wide variety of lesions including femoroacetabular impingement, athletic pubalgia, ischiofemoral impingement, and apophyseal avulsion injuries. Magnetic resonance imaging is the noninvasive imaging modality of choice for the diagnosis and management of these lesions. In this article, the authors discuss the nonneoplastic musculoskeletal lesions in the pelvis, with illustrations and relevant case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Varicose vein surgery using a pneumatic tourniquet: reduced blood loss and improved cosmesis.

    OpenAIRE

    Thompson, J. F.; Royle, G. T.; Farrands, P. A.; Najmaldin, A.; Clifford, P. C.; Webster, J. H.

    1990-01-01

    A prospective controlled randomised study has been performed of 100 consecutive patients undergoing varicose vein surgery. One group underwent saphenofemoral flush ligation and multiple lower leg avulsions with the leg exsanguinated with a Rhys-Davies cuff, and ischaemia maintained with a pneumatic tourniquet. The other group underwent identical surgery but with a 30 degree head down tilt only. Blood loss was significantly less (13.5 +/- 12 ml vs 133 +/- 78 ml; P less than 0.01) and postopera...

  12. Anam Cara, St Canice's Road, Glasnevin, Dublin 11.

    LENUS (Irish Health Repository)

    O'Neill, Barry J

    2014-04-01

    Antiphospholipid syndrome and systemic erythematosus have been associated with metatarsal stress fractures. Stress fractures of the Lisfranc joint complex are uncommon injuries but have been reported to occur most frequently in ballet dancers. We present a case of an avulsion fracture of the Lisfranc joint complex that occurred spontaneously. We have reviewed the association between systemic conditions and metatarsal fractures and proposed a series of hypothetical pathological events that may have contributed to this unusual injury.

  13. Ligament-induced sacral fractures of the pelvis are possible.

    Science.gov (United States)

    Steinke, Hanno; Hammer, Niels; Lingslebe, Uwe; Höch, Andreas; Klink, Thomas; Böhme, Jörg

    2014-07-01

    Pelvic ring stability is maintained passively by both the osseous and the ligamentous apparatus. Therapeutic approaches focus mainly on fracture patterns, so ligaments are often neglected. When they rupture along with the bone after pelvic ring fractures, disrupting stability, ligaments need to be considered during reconstruction and rehabilitation. Our aim was to determine the influence of ligaments on open-book injury using two experimental models with body donors. Mechanisms of bone avulsion related to open-book injury were investigated. Open-book injuries were induced in human pelves and subsequently investigated by anatomical dissection and endoscopy. The findings were compared to CT and MRI scans of open-book injuries. Relevant structures were further analyzed using plastinated cross-sections of the posterior pelvic ring. A fragment of the distal sacrum was observed, related to open-book injury. Two ligaments were found to be responsible for this avulsion phenomenon: the caudal portion of the anterior sacroiliac ligament and another ligament running along the ventral surface of the third sacral vertebra. The sacral fragment remained attached to the coxal bone by this second ligament after open-book injury. These results were validated using plastination and the structures were identified. Pelvic ligaments are probably involved in sacral avulsion caused by lateral traction. Therefore, ligaments should to be taken into account in diagnosis of open-book injury and subsequent therapy. Copyright © 2014 Wiley Periodicals, Inc.

  14. Microsurgical replantation of a small segment of thumb volar skin.

    Science.gov (United States)

    Akyürek, Mustafa; Safak, Tunç

    2004-06-01

    This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

  15. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Directory of Open Access Journals (Sweden)

    Marília Pacífico Lucisano

    2016-01-01

    Full Text Available The aim of this paper is to present the clinical and radiological outcome of the treatment involving a delayed tooth replantation after an avulsed immature permanent incisor, with a follow-up of 1 year and 6 months. An 8-year-old boy was referred after dental trauma that occurred on the previous day. The permanent maxillary right central incisor (tooth 11 had been avulsed. The tooth was hand-held during endodontic therapy and an intracanal medication application with calcium hydroxide-based paste was performed. An apical plug with mineral trioxide aggregate (MTA was introduced into the apical portion of the canal. When the avulsed tooth was replanted with digital pressure, a blood clot had formed within the socket, which moved the MTA apical plug about 2 mm inside of the root canal. These procedures developed apical revascularization, which promoted a successful endodontic outcome, evidenced by apical closure, slight increase in root length, and absence of signs of external root resorption, during a follow-up of 1 year and 6 months.

  16. Simple replantation protocol to avoid ankylosis in teeth intended for orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Yuli Nugraeni

    2009-03-01

    Full Text Available Background: Dento-alveolar trauma resulted from accidents involving the oral regions mostly affect the upper central incisors. Overjet that is beyond 5 mm and incompetent lip also contribute to increase the risk. Several literatures had already discussed different methods of replantation of avulsed teeth. However, it was not meant for further orthodontic treatment. Purpose: The objective of this review is to propose a simple replantation protocol of avulsed teeth which also prevent from ankylosis. Reviews: Protruded teeth usually need orthodontic treatment; therefore, an appropriate management should be done to avoid the development of ankylosis. Ankylosis of the periodontal ligament (PDL becomes a problem in orthodontic tooth movement in repositioned or replanted teeth. In addition, ankylosed teeth also more susceptible to root resorption. Actually, it was caused by the endodontic treatment. In particular, severely protruded or unoccluded teeth are hypofunctional, therefore have narrow PDL, thus it may facilitate to ankylosis development. Ideal management protocol such as the use of root canal sealer i.e. mineral trioxide aggregate (MTA; the using of Emdogain, and resilient wiring or semi-rigid fixation with brackets has become a solution in avulsed teeth arranged for orthodontic treatment. Nevertheless, the presence of oral surgeon, endodontist and orthodontist in the same time, and also ideal preparations after an accident was difficult to achieve. Conclusion: Considering that reducing the ongoing PDL inflammation with intracanal medicaments and maintaining the functional force during mastication is possible; it is concluded that this simple replantation protocol is likely.

  17. Isolated Subscapularis Tendon Tear in a Skeletally Immature Soccer Player.

    Science.gov (United States)

    Avanzi, Paolo; Dei Giudici, Luca; Giovarruscio, Roberto; Gigante, Antonio; Zorzi, Claudio

    2018-03-01

    Subscapularis injury in adolescents, usually associated to an avulsion fracture of the lesser humeral tuberosity, accounts for less than 2% of all fractures of the proximal humerus. Isolated tears of the subscapularis tendon without a history of dislocation and associated avulsion fractures are an even rarer occurrence, and treatment is controversial. This article describes a rare case of a 12-year-old suffering from an isolated subscapularis tear and discusses its management. The patient was evaluated at presentation, and at 1 to 2.5 months after he underwent a cuff tear arthroscopic repair with a single "all suture" anchor loaded with two wires, active/passive range of motion (A/PROM), Constant-Murley score, and American Shoulder and Elbow Surgeons (ASES) score were noted. Patient reported an excellent outcome, recovered the whole ROM, was pain free, and returned to the previous level of activity. Isolated avulsion of the subscapularis tendon requires a high index of suspicion for a proper diagnosis as early treatment is required for a good recovery. Arthroscopy reserves more advantages in proper hands, restoring the previous levels of function and activity. An increase in attention for this condition is mandatory in a society where many adolescents are getting more and more active in high levels of sport activities.

  18. Axillary nerve neurotization with the anterior deltopectoral approach in brachial plexus injuries.

    Science.gov (United States)

    Jerome, J Terrence Jose; Rajmohan, Bennet

    2012-09-01

    Combined neurotization of both axillary and suprascapular nerves in shoulder reanimation has been widely accepted in brachial plexus injuries, and the functional outcome is much superior to single nerve transfer. This study describes the surgical anatomy for axillary nerve relative to the available donor nerves and emphasize the salient technical aspects of anterior deltopectoral approach in brachial plexus injuries. Fifteen patients with brachial plexus injury who had axillary nerve neurotizations were evaluated. Five patients had complete avulsion, 9 patients had C5, six patients had brachial plexus injury pattern, and one patient had combined axillary and suprascapular nerve injury. The long head of triceps branch was the donor in C5,6 injuries; nerve to brachialis in combined nerve injury and intercostals for C5-T1 avulsion injuries. All these donors were identified through the anterior approach, and the nerve transfer was done. The recovery of deltoid was found excellent (M5) in C5,6 brachial plexus injuries with an average of 134.4° abduction at follow up of average 34.6 months. The shoulder recovery was good with 130° abduction in a case of combined axillary and suprascapular nerve injury. The deltoid recovery was good (M3) in C5-T1 avulsion injuries patients with an average of 64° shoulder abduction at follow up of 35 months. We believe that anterior approach is simple and easy for all axillary nerve transfers in brachial plexus injuries. Copyright © 2012 Wiley Periodicals, Inc.

  19. Awareness of emergency management of dental trauma

    Directory of Open Access Journals (Sweden)

    Ritu Namdev

    2014-01-01

    Full Text Available Aim: Traumatic dental injuries frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents′ knowledge of appropriate emergency measures. This study is aimed at evaluating the awareness level of a sample of Indian (Rohtak, Haryana parents in the management of dental trauma. Materials and Methods: A total of 1500 parents were surveyed using a self-administered structured questionnaire. The questionnaire was divided into three parts. The tabulated data were statistically analyzed using the Chi-square test. Result: This study indicated a low level of knowledge regarding tooth avulsion and replantation procedures to be followed in emergency. The residing area and age of parent did not affect the knowledge and awareness of parents. Moreover, well-educated parents also had very little or no information about dental trauma first-aid. The lack of significance in correct answers between those with and without such experience indicated that past experience did not seem to have increase the knowledge of the correct emergency procedures. Very little or no information about tooth avulsion and replantation had been given to most of them. Conclusion: Dental injury prevention and management should be recognized as a major public health issue and adequate resources to be allocated for research in this area. Educational programs to improve the knowledge and awareness among the parents have to be implemented.

  20. The relationship of dental visits to parental knowledge of management of dental trauma.

    Science.gov (United States)

    Vergotine, Rodney J; Koerber, Anne

    2010-01-01

    The purposes of this study were to: (1) determine the level of parental knowledge regarding initial trauma management; and (2) assess which factors could influence that level of knowledge. A self-administered questionnaire was given to parents of patients that attended 1 of 2 dental clinics. The questionnaire consisted of 3 parts and assessed patient and parental demographics and knowledge of dental trauma management. Four hundred sixty-seven questionnaires were completed. Most patients had Medicaid insurance (79%). Most parents would seek care from a dentist (71% broken tooth; 62% avulsed tooth). Only 31% knew that avulsed permanent teeth could be placed back into the socket, and only 25% of parents chose milk as a transport medium for avulsed teeth. A mere 3% of parents answered all 5 trauma management questions correctly, and 10% had no correct responses. The number of correct responses was not affected by clinic location, history of previous trauma, sex, education, or insurance status. Parents of recalled patients had more correct responses (PKnowledge of dental trauma management was poor. The fact that parents of recalled patients were somewhat more knowledgeable suggests that the dental visit can be an effective vehicle for education. The management of dental trauma should be part of the dental health education provided at dental visits.

  1. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    Science.gov (United States)

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352.

  2. What would happen if the Mississippi River changed its course to the Atchafalaya?

    Science.gov (United States)

    Xu, Y. J.

    2017-12-01

    The Mississippi River Delta faces an uncertain future as sea level keeps rising while the land continues to subside. In its latest Master Plan draft of 2017, the Louisiana Coastal Protection and Restoration Authority has outlined a $50 billion investment for 120 projects designed to build and maintain coastal Louisiana. These projects are all developed under the assumption that the Mississippi River (MR) would remain on its current course, which is artificially maintained through a control structure built in 1963 (also known as the Old River Control Structure, or ORCS) after it was realized that the river attempted to change its course back to its old river channel - the Atchafalaya River (AR). Since the ORCS is in operation of controlling only about 25% of the MR flow into the AR, little attention has been paid to the importance of possible riverbed changes downstream the avulsion node on the MR course switch. As one of the largest alluvial river in the world, the MR avulsed every 1,000-1,500 years in the past. Alluvial rivers avulse when two conditions are met: a sufficient in-channel aggradation and a major flood. In our ongoing study on sediment transport and channel morphology of the lower Mississippi River, we found that the first 30-mile reach downstream the ORCS has been experiencing rapid bed aggradation and channel narrowing in the past three decades. A mega flood could be a triggering point to overpower the man-made ORCS and allow the river abandon its current channel - the MR main stem. This is not a desirable path; however, nature has its own mechanism of choosing river flows, which do not bow to our expectation. The Missisippi River's flow is projected to increase in the future as global temperature continues to rise and hydrologic cycle intensifies. Additionally, rapid urbanization in the river basin will create conditions that foster the emergence of mega floods. It would be impractical to spend considerable resources for a river delta without

  3. Long-term interactions between man and the fluvial environment - case of the Diyala alluvial fan, Iraq

    Science.gov (United States)

    Heyvaert, Vanessa M. A.; Walstra, Jan; Mortier, Clément

    2014-05-01

    The Mesopotamian alluvial plain is dominated by large aggradading river systems (the Euphrates, Tigris and their tributaries), which are prone to avulsions. An avulsion can be defined as the diversion of flow from an existing channel onto the floodplain, eventually resulting in a new channel belt. Early civilizations depended on the position of rivers for their economic survival and hence the impact of channel shifts could be devastating (Wilkinson 2003; Morozova 2005; Heyvaert & Baeteman 2008). Research in the Iranian deltaic part of the Mesopotamian plain has demonstrated that deliberate human action (such as the construction of irrigation canals and dams) triggered or obstructed the alluvial processes leading to an avulsion on fluvial megafans (during preconditioning, triggering and post-triggering stages) (Walstra et al. 2010; Heyvaert et al. 2012, Heyvaert et al.2013). Thus, there is ample evidence that the present-day alluvial landscapes in the region are the result of complex interactions between natural and anthropogenic processes. Here we present a reconstruction of the Late Holocene evolution of the Diyala alluvial fan (one of the main tributaries of the Tigris in Iraq), with particular attention to the relations between alluvial fan development, changes in channel pattern, the construction of irrigation networks and the rise and collapse of societies through historic times. The work largely draws on the use of remote sensing and GIS techniques for geomorphological mapping, and previously published archaeological field data (Adams 1965). By linking archaeological sites of known age with traces of ancient irrigation networks we were able to establish a chronological framework of alluvial activity of the Diyala alluvial fan. Our results demonstrate that centralized and technologically advanced societies were able to maintain a rapidly aggradading distibutary channel system, supplying water and sediment across the entire alluvial fan. As a consequence

  4. Evaluation of the topical effect of alendronate on the root surface of extracted and replanted teeth. Microscopic analysis on rats' teeth.

    Science.gov (United States)

    Lustosa-Pereira, Adriana; Garcia, Roberto Brandão; de Moraes, Ivaldo Gomes; Bernardineli, Norberti; Bramante, Clovis Monteiro; Bortoluzzi, Eduardo Antunes

    2006-02-01

    The treatment of choice for tooth avulsion is replantation. The ideal replantation should be realized as quickly as possible, or at least, the avulsed tooth should be kept in an adequate solution to preserve the periodontal ligament attached to the root. If that is not possible, treatment of the radicular surface should be done in order to prevent radicular resorption. The purpose of this study was to test sodium alendronate as a substance for topical treatment of the radicular surface of avulsed teeth in an attempt to prevent the occurrence of dental resorptions. Fifty-four rat maxillary right central incisors were extracted and replanted. Group I--extra-alveolar dry period of 15 min, intracanal dressing with calcium hydroxide (CALEN, S.S. White, Artigos Dentários LTDA, Rio de Janeiro, Brazil) and replantation; Groups II and III - extra-alveolar dry periods of 30 and 60 min, respectively, immersion in 1% sodium hypochlorite for 30 min for removal of the periodontal ligament, washing in saline solution for 5 min, and treatment of the radicular surface with 3.2 mg/l sodium alendronate solution for 10 min. Intracanal dressing with calcium hydroxide and replantation followed. At 15, 60, and 90 days post-reimplantation, the animals were killed and the samples obtained and processed for microscopic analysis. The results indicated that sodium alendronate was able to reduce the incidence of radicular resorption, but not of dental ankylosis. No significant differences were observed regarding variations in the extra-alveolar periods among the groups.

  5. Stratigraphy and paleohydrology of delta channel deposits, Jezero crater, Mars

    Science.gov (United States)

    Goudge, Timothy A.; Mohrig, David; Cardenas, Benjamin T.; Hughes, Cory M.; Fassett, Caleb I.

    2018-02-01

    The Jezero crater open-basin lake contains two well-exposed fluvial sedimentary deposits formed early in martian history. Here, we examine the geometry and architecture of the Jezero western delta fluvial stratigraphy using high-resolution orbital images and digital elevation models (DEMs). The goal of this analysis is to reconstruct the evolution of the delta and associated shoreline position. The delta outcrop contains three distinct classes of fluvial stratigraphy that we interpret, from oldest to youngest, as: (1) point bar strata deposited by repeated flood events in meandering channels; (2) inverted channel-filling deposits formed by avulsive distributary channels; and (3) a valley that incises the deposit. We use DEMs to quantify the geometry of the channel deposits and estimate flow depths of ∼7 m for the meandering channels and ∼2 m for the avulsive distributary channels. Using these estimates, we employ a novel approach for assessing paleohydrology of the formative channels in relative terms. This analysis indicates that the shift from meandering to avulsive distributary channels was associated with an approximately four-fold decrease in the water to sediment discharge ratio. We use observations of the fluvial stratigraphy and channel paleohydrology to propose a model for the evolution of the Jezero western delta. The delta stratigraphy records lake level rise and shoreline transgression associated with approximately continuous filling of the basin, followed by outlet breaching, and eventual erosion of the delta. Our results imply a martian surface environment during the period of delta formation that supplied sufficient surface runoff to fill the Jezero basin without major drops in lake level, but also with discrete flooding events at non-orbital (e.g., annual to decadal) timescales.

  6. The rivers of civilization

    Science.gov (United States)

    Macklin, Mark G.; Lewin, John

    2015-04-01

    The hydromorphic regimes that underpinned Old World river-based civilizations are reviewed in light of recent research. Notable Holocene climatic changes varied from region to region, whilst the dynamics of floodplain environments were equally diverse, with river channel changes significantly affecting human settlement. There were longer-term trends in Holocene hydroclimate and multi-centennial length 'flood-rich' and 'flood-poor' episodes. These impacted on five identified flooding and settlement scenarios: (i) alluvial fans and aprons; (ii) laterally mobile rivers; (iii) rivers with well-developed levees and flood basins; (iv) river systems characterised by avulsions and floodouts; and (v) large river-fed wetlands. This gave a range of changes that were either more or less regular or incremental from year-to-year (and thus potentially manageable) or catastrophic. The latter might be sudden during a flood event or a few seasons (acute), or over longer periods extending over many decades or even centuries (chronic). The geomorphic and environmental impacts of these events on riparian societies were very often irreversible. Contrasts are made between allogenic and autogenic mechanism for imposing environmental stress on riverine communities and a distinction is made between channel avulsion and contraction responses. Floods, droughts and river channel changes can precondition as well as trigger environmental crises and societal collapse. The Nile system currently offers the best set of independently dated Holocene fluvial and archaeological records, and the contrasted effects of changing hydromorphological regimes on floodwater farming are examined. The persistence of civilizations depended essentially on the societies that maintained them, but they were also understandably resilient in some environments (Pharaonic Egypt in the Egyptian Nile), appear to have had more limited windows of opportunity in others (the Kerma Kingdom in the Nubian Nile), or required

  7. Fingertip replantation: determinants of survival.

    Science.gov (United States)

    Li, Jing; Guo, Zheng; Zhu, Qingsheng; Lei, Wei; Han, Yisheng; Li, Mingquan; Wang, Zhen

    2008-09-01

    The purpose of this study was to determine the risk factors for an unsuccessful replanted fingertip. Two hundred eleven complete fingertip amputations in 211 patients who underwent replantation surgery between August of 1990 and March of 2006 were included in this study. The patients' age, gender, smoking history, digit position, dominant hand, amputation level, injury mechanism, platelet count, ischemia time, preservation method of the amputated part, anesthesia, number of arteries repaired, venous drainage, use of vein grafting, neurorrhaphy, bone shortening, and smoking after operation were tested for their impact on fingertip survival. One hundred seventy-two of 211 patients (81.5 percent) had a successful replantation. Univariate analysis showed crush or avulsion injury, high platelet count, and inappropriate preservation of the amputated part in saline solution or ethanol to be associated with a high incidence of replantation failure. Twenty-two of 54 patients (41 percent) who had a crush or avulsion trauma had failed replantation. Logistic regression analysis identified injury mechanism, platelet count, smoking after operation, preservation method of the amputated part, and the use of vein grafting as statistically significant predictive factors for success or failure. Injury mechanism, platelet count, smoking after operation, preservation method of amputated part, and the use of vein grafting were found to be the main predictors for the survival of the replanted fingertip. Applying external bleeding in zone 1 and venous drainage through the medullary cavity in zone 2 or venous anastomosis combined with vein grafting rather than venous anastomosis alone were strongly recommended in the fingertip replantation of crush or avulsion injury.

  8. Quantifying and Validating Rapid Floodplain Geomorphic Evolution, a Monitoring and Modelling Case Study

    Science.gov (United States)

    Scott, R.; Entwistle, N. S.

    2017-12-01

    Gravel bed rivers and their associated wider systems present an ideal subject for development and improvement of rapid monitoring tools, with features dynamic enough to evolve within relatively short-term timescales. For detecting and quantifying topographical evolution, UAV based remote sensing has manifested as a reliable, low cost, and accurate means of topographic data collection. Here we present some validated methodologies for detection of geomorphic change at resolutions down to 0.05 m, building on the work of Wheaton et al. (2009) and Milan et al. (2007), to generate mesh based and pointcloud comparison data to produce a reliable picture of topographic evolution. Results are presented for the River Glen, Northumberland, UK. Recent channel avulsion and floodplain interaction, resulting in damage to flood defence structures make this site a particularly suitable case for application of geomorphic change detection methods, with the UAV platform at its centre. We compare multi-temporal, high-resolution point clouds derived from SfM processing, cross referenced with aerial LiDAR data, over a 1.5 km reach of the watercourse. Changes detected included bank erosion, bar and splay deposition, vegetation stripping and incipient channel avulsion. Utilisation of the topographic data for numerical modelling, carried out using CAESAR-Lisflood predicted the avulsion of the main channel, resulting in erosion of and potentially complete circumvention of original channel and flood levees. A subsequent UAV survey highlighted topographic change and reconfiguration of the local sedimentary conveyor as we predicted with preliminary modelling. The combined monitoring and modelling approach has allowed probable future geomorphic configurations to be predicted permitting more informed implementation of channel and floodplain management strategies.png" class="documentimage" >

  9. [Hand injuries in mountain sports].

    Science.gov (United States)

    Prommersberger, K-J; Mühldorfer-Fodor, M; Kalb, K

    2015-06-01

    Apart from clean cut finger amputations, every kind of hand injury can be seen in mountain and winter sports but only skier's thumb and injuries of the pulley system in sport climbers are seen in a greater number of cases. Nevertheless, these two common injuries as well as the rare frostbite of the fingers are often underdiagnosed or overdiagnosed as well as undertreated or overtreated. This paper describes the diagnostics and treatment of skier's thumb, injuries of the pulley system in sport climbers and frostbite of the fingers. Before checking the metacarpophalangeal (MP) joint of the thumb for stability, radiographs should be taken to exclude a bony avulsion of the ulnar collateral ligament in skier's thumb. If there is no bony ligament avulsion further diagnostic procedures, e.g. ultrasound, are recommended to prove or exclude a Stener lesion, which is an absolute indication for operative treatment together with a dislocated bony ligament avulsion. To quantify the severity of a lesion of the pulley system ultrasound and magnetic resonance imaging (MRI) are needed. Most lesions of the pulley system can be treated conservatively. Only multiple pulley ruptures or isolated ruptures associated with a lesion of the lumbrical muscles or collateral ligaments require operative treatment. As long as there is no infection amputation should be done as late as possible in frostbite of the fingers because the extent of the frostbite can rarely be correctly estimated. Most cases of skier's thumb as well as lesions of the pulley system can be treated non-operatively but precise diagnostics are needed.

  10. Modeling of failure mode in knee ligaments depending on the strain rate

    Directory of Open Access Journals (Sweden)

    Hyman William

    2002-01-01

    Full Text Available Abstract Background The failure mechanism of the knee ligament (bone-ligament-bone complex at different strain rates is an important subject in the biomechanics of the knee. This study reviews and summarizes the literature describing ligament injury as a function of stain rate, which has been published during the last 30 years. Methods Three modes of injury are presented as a function of strain rate, and they are used to analyze the published cases. The number of avulsions is larger than that of ligament tearing in mode I. There is no significant difference between the number of avulsions and ligament tearing in mode II. Ligament tearing happens more frequently than avulsion in mode III. Results When the strain rate increases, the order of mode is mode I, II, III, I, and II. Analytical models of ligament behavior as a function of strain rate are also presented and used to provide an integrated framework for describing all of the failure regimes. In addition, this study showed the failure mechanisms with different specimens, ages, and strain rates. Conclusion There have been several a numbers of studies of ligament failure under various conditions including widely varying strain rates. One issue in these studies is whether ligament failure occurs mid-ligament or at the bone attachment point, with assertions that this is a function of the strain rate. However, over the range of strain rates and other conditions reported, there has appeared to be discrepancies in the conclusions on the effect of strain rate. The analysis and model presented here provides a unifying assessment of the previous disparities, emphasizing the differential effect of strain rate on the relative strengths of the ligament and the attachment.

  11. Displaced articular calcaneus fractures: classification and fracture scores: a preliminary study.

    Science.gov (United States)

    Harnroongroj, Thos; Chuckpaiwong, Bavornrit; Angthong, Chayanin; Nanakorn, Pongtep; Sudjai, Narumol; Harnroongroj, Thossart

    2012-03-01

    To review and group configurations of displaced articular calcaneal fracture advantaged for classification and radiographic fracture scores. Between 2002 and 2011, medical records and radiographs of patients who sustained acute displaced articular calcaneal fractures were reviewed. The calcanealfracture configurations were grouped as avulsion, bending, burst, or combination. Radiographic displaced articular calcaneal fracture score was designed to include Bohler and Gissane angles, degrees of posterior subtalar joint line parallel, degrees of varus, and burst. The calcaneal fracture score was modified as power of the fracture response to treatment (PFRT). Prevalence of the fracture types, pre- and post-reduction fracture scores including PFRT were studied and statistically analyzed. Sixty-four patients had 77 acute displaced articular calcaneal fractures. The classification consisted of type I avulsion, type II compression bending, type III compression burst, type IV avulsion burst, and type V bending burst. Type IV is the most common. The radiographic calcaneal fracture scores were 10 points. Pre-, post-reduction calcaneal fracture scores and PFRTof type I, II, III, IV, and V were 4.17 (0.41), 0 and 1 (0), 4.63 (2.13), 0.50 (0.93) and 0.84 (0.35), 6.94 (2.05), 3.18 (1.38) and 0.50 (0.27), 8.03 (1.12), 3.03 (2.42) and 0.62 (0.30), and 7.22 (2.11), 3.00 (2.50) and 0.59 (0.29) respectively. Statistical analysis showed significant difference (p fracture scores contained 10 points and were used for determining complexity of the fractures. PFRT was used for evaluating efficacy of fracture treatment.

  12. Evaluation of the hamstring muscles after injury

    International Nuclear Information System (INIS)

    Koulouris, G.; Connell, D.; Burke, F.; Young, D.

    2002-01-01

    Full text: The aim of this study was to describe the imaging findings following acute hamstring injury. We retrospectively reviewed the imaging findings of 224 examinations in 208 patients (192 male, 16 female, mean age 28.2 years). MR imaging was performed in 102 cases and sonography in 156 cases (both modalities were performed in 34 examinations). The mean duration of symptoms was 4.7 days (range 1-10 days). Attention was directed to the frequency of muscle movement, the location of the injury within the musculotendinous unit, the extent of the injury and discriminating avulsion from musculotendinous injury. Sixteen patients underwent surgery. The biceps femoris was the most common muscle injured (150/224). Sixteen patients with surgical confirmation of a hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps alone) were reliably diagnosed with MR imaging (16/16), but less so with ultrasound (7/12). Eighty-six patients (86/150) had injuries of the musculotendinous junction of biceps, 51/150 myofascial injuries and 13/150 muscle belly alone. Proximal injuries of the biceps were more common that the distal. Sixty-eight patients had injuries of semitendinosus and eight patients semimebranosus.The semitendinosus muscle was more often injured in the distal half of the muscle (42/68) as was semimebranosus (7/8). Three patients had a distal rupture of semitendinosus muscle with retraction. Haematoma was a common finding (170/224) and often tracked around the myofascial layer.This was felt to be a reliable sign for hamstring injury. Discriminating a hamstring tendon avulsion from myotendinous strain is important as these patients necessitate surgical management as opposed to conservative treatment. MR imaging is the preferred modality in the investigation of hamstring muscle and tendon injury. Ultrasound has a complimentary role and may be used to monitor hamstring tendon injuries prior to return to competitive sport. Copyright (2002) Blackwell Science Pty

  13. Assessment of pelvic floor by three-dimensional-ultrasound in primiparous women according to delivery mode: initial experience from a single reference service in Brazil.

    Science.gov (United States)

    Araujo Júnior, Edward; de Freitas, Rogério Caixeta Moraes; Di Bella, Zsuzsanna Ilona Katalin de Jármy; Alexandre, Sandra Maria; Nakamura, Mary Uchiyama; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

    2013-03-01

    To evaluate changes to the pelvic floor of primiparous women with different delivery modes, using three-dimensional ultrasound. A prospective cross-sectional study on 35 primiparae divided into groups according to the delivery mode: elective cesarean delivery (n=10), vaginal delivery (n=16), and forceps delivery (n=9). Three-dimensional ultrasound on the pelvic floor was performed on the second postpartum day with the patient in a resting position. A convex volumetric transducer (RAB4-8L) was used, in contact with the large labia, with the patient in the gynecological position. Biometric measurements of the urogenital hiatus were taken in the axial plane on images in the rendering mode, in order to assess the area, anteroposterior and transverse diameters, average thickness, and avulsion of the levator ani muscle. Differences between groups were evaluated by determining the mean differences and their respective 95% confidence intervals. The proportions of levator ani muscle avulsion were compared between elective cesarean section and vaginal birth using Fisher's exact test. The mean areas of the urogenital hiatus in the cases of vaginal and forceps deliveries were 17.0 and 20.1 cm(2), respectively, versus 12.4 cm(2) in the Control Group (elective cesarean). Avulsion of the levator ani muscle was observed in women who underwent vaginal delivery (3/25), however there was no statistically significant difference between cesarean section and vaginal delivery groups (p=0.5). Transperineal three-dimensional ultrasound was useful for assessing the pelvic floor of primiparous women, by allowing pelvic morphological changes to be differentiated according to the delivery mode.

  14. Fluvial response to active extension: evidence from 3D seismic data from the Frio Formation (Oligo-Miocene) of the Texas Gulf of Mexico Coast, USA

    Energy Technology Data Exchange (ETDEWEB)

    J.R. Maynard [ExxonMobil Upstream Research Company, Houston, TX (United States)

    2006-06-15

    Tectonic deformation of the land surface is known to influence the gradient, water and sediment discharge and the grain-size of modern fluvial systems. Any change in these variables alters the equilibrium of a fluvial system, potentially causing a change in channel morphology. 3D seismic data from the Tertiary (Miocene) age, Upper Frio Formation, Kelsey Field, South Texas, in the US are used to examine changing fluvial channel morphology through time during a period of active growth of a rollover anticline in the hanging wall of a normal fault (the Vicksburg Fault). The studied interval varies between 22 and 47 m thick, and spans several hundred thousand years. It consists of an alternation of fluvial sandstones, overbank mudstones and coal. Seismic extractions show the evolution of sinuous fluvial channels during a phase of growth fault activity. Prior to growth, a single sinuous channel is imaged. During growth, the fluvial system became decapitated by a developing rollover anticline, and a highly sinuous drainage network formed, with frequent avulsion events, headward propagation of streams and related stream capture. Increased channel sinuosity was spatially associated with increased avulsion frequency in the area down dip to the east of the rollover anticline, more than 10 km from the active fault. More than 25 m of relative accommodation developed on the flank of the growing rollover anticline compared with on the crest. The increased channel sinuosity is interpreted as reflecting an increase in longitudinal valley slope analogous to observations made in flume experiments and modern river systems. The increase in avulsion frequency is attributed to increased aggradation as the rivers adjusted back to equilibrium grade following the increase in slope.

  15. Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Josephine; Trudell, Debra; Resnick, Donald L. [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Papakonstantinou, Olympia [Department of Radiology, Veterans Affairs Medical Center, University of California, San Diego, CA (United States); Department of Radiology/MRI Unit, University Hospital of Heraklion (Greece); Brookenthal, Keith R. [Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA (United States)

    2003-11-01

    The ''arcuate sign'' is considered a pathognomonic sign for injuries of the posterolateral (PL) corner of the knee. The purpose of our study was to identify different patterns of injury to the fibular head that may associate with injuries to specific ligaments and tendons of the PL corner of the knee. The anatomic relations between the insertions of fibular collateral ligament (FCL), biceps femoris tendon (BFT), popliteofibular ligament (PFL), and arcuate ligament in normal cadaveric knees were also investigated. Magnetic resonance imaging was performed in two cadaveric knees which subsequently were dissected. Radiopaque markers were placed upon the fibular insertions of the FCL, BFT, PFL, and arcuate ligament in the dissected knees, and knee radiographs were then obtained. Twelve patients with radiographic or MR imaging evidence of isolated injury to the PL corner of the knee were retrospectively reviewed, with regard to avulsion fractures and marrow edema in the fibular head and the integrity of the ligaments of the PL corner of the knee. The PFL and arcuate ligament were seen to attach directly to the posterior and medial aspect of the styloid process of the fibular head. The FCL and BFT attached as a conjoined structure on the lateral aspect of the fibular head lateral, anterior and inferior to the attachment site of the PFL and arcuate ligament. Injury to the arcuate ligament or PFL was diagnosed in 8 patients who presented with a small avulsion fracture of the styloid process of the fibula (n=2), bone marrow edema in the medial aspect of the fibular head (n=3), or both (n=3). In 4 patients with injury to the conjoined tendon or FCL, a larger avulsion fragment and more diffuse proximal fibular edema were seen. Radiographic and MR imaging findings in injuries of the posterolateral corner of the knee may suggest injury to specific structures inserting in the fibular head. (orig.)

  16. Novel Spiked-Washer Repair Is Biomechanically Superior to Suture and Bone Tunnels for Arcuate Fracture Repair.

    Science.gov (United States)

    Vojdani, Saman; Fernandez, Laviel; Jiao, Jian; Enders, Tyler; Ortiz, Steven; Lin, Liangjun; Qin, Yi-Xian; Komatsu, David E; Penna, James; Ruotolo, Charles J

    2017-03-01

    Injuries to the posterolateral corner of the knee can lead to chronic degenerative changes, external rotation instability, and varus instability if not repaired adequately. A proximal fibula avulsion fracture, referred to as an arcuate fracture, has been described in the literature, but a definitive repair technique has yet to be described. The objective of this study was to present a novel arcuate fracture repair technique, using a spiked-washer with an intramedullary screw, and to compare its biomechanical integrity to a previously described suture and bone tunnel method. Ten fresh-frozen cadaveric knees underwent a proximal fibula osteotomy to simulate a proximal fibula avulsion fracture. The lateral knee capsule and posterior cruciate ligament were also sectioned to create maximal varus instability. Five fibulas were repaired using a novel spiked-washer technique and the other 5 were repaired using the suture and bone tunnel method. The repaired knees were subjected to a monotonic varus load using a mechanical testing system instrument until failure of the repair or associated posterolateral corner structures. Compared with the suture repair group, the spiked-washer repair group demonstrated a 100% increase in stiffness, 100% increase in yield, 110% increase in failure force, and 108% increase in energy to failure. The spiked-washer technique offers superior quasi-static biomechanical performance compared with suture repair with bone tunnels for arcuate fractures of the proximal fibula. Further clinical investigation of this technique is warranted and the results of this testing may lead to improved outcomes and patient satisfaction for proximal fibula avulsion fractures.

  17. Preventing erosion at pipeline crossings of watercourses

    International Nuclear Information System (INIS)

    Sawatsky, L.; Arnold, G.

    1997-01-01

    Watercourses are naturally vulnerable to erosion but the risk is particularly acute after sub-soil and armour materials have been disturbed by trenching and backfilling during construction. Various types of erosion (river scour, river bed, river channel bed and river bank ) and the progressive removal of pipeline cover resulting from erosion were discussed. Methods of estimating the risk of progressive erosion, river avulsions and beaver dam scour, and methods of mitigating erosion at pipeline crossings such as deep burial, proper siting, conventional armouring, and a combination of bank toe protection, and upper bank vegetation cover, were described

  18. Morphodynamics and Sediment Transport on the Huanghe (Yellow River) Delta: Work in Progress

    Science.gov (United States)

    Kineke, G. C.; Calson, B.; Chadwick, A. J.; Chen, L.; Hobbs, B. F.; Kumpf, L. L.; Lamb, M. P.; Ma, H.; Moodie, A. J.; Mullane, M.; Naito, K.; Nittrouer, J. A.; Parker, G.

    2017-12-01

    Deltas are perhaps the most dynamic of coastal landforms with competing processes that deliver and disperse sediment. As part of the NSF Coastal SEES program, an interdisciplinary team of scientists from the US and China are investigating processes that link river and coastal sediment transport responsible for morphodynamic change of the Huanghe delta- an excellent study site due to its high sediment load and long history of natural and engineered avulsions, that is, abrupt shifts in the river course. A fundamental component of the study is a better understanding of sediment transport physics in a river system that transports mostly silt. Through theory and data analysis, we find that fine-grained rivers fail to develop full scale dunes, which results in faster water flow and substantially larger sediment fluxes as compared to sandy rivers (e.g. the Mississippi River). We also have developed new models for sediment-size dependent entrainment that are needed to make longer term predictions of river sedimentation patterns. On the delta front, we are monitoring the high sediment flux to the coast, which results in steep foresets and ideal conditions for off-shore sediment delivery via gravity flows. These constraints on sediment transport are being used to develop new theory for where and when rivers avulse - including the effects of variable flood discharge, sediment supply, and sea level rise -and how deltas ultimately grow through repeated cycles of lobe development. Flume experiments and field observations are being used to test these models, both in the main channel of the Huanghe and in channels abandoned after historic avulsions. Abandoned channels and floodplains are now dominated by coastal sediment transport through a combination of wave resuspension and tidal transport, settling lag and reverse estuarine circulation. Finally, the field and laboratory tested numerical models are being used as inputs to define a cost curve for efficient avulsion management of

  19. Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease.

    Science.gov (United States)

    Hirano, Atsushi; Fukubayashi, Toru; Ishii, Tomoo; Ochiai, Naoyuki

    2002-06-01

    The purpose of this study was to clarify the nature of Osgood-Schlatter disease (OSD) using MR images. Thirty boys (40 knees) with OSD diagnosed by clinical symptoms and signs were investigated with MRI. Longitudinal evaluation was undertaken in 22 patients and the mean follow-up was 1.5+/-0.9 years. MR examinations were performed at least every 6 months in most cases. When a patient's symptoms changed, MRI was repeated and in cases where the initial MR examination showed an early or progressive stage of OSD, MRI was undertaken every month where possible. All MR examinations were performed in the sagittal plane with a 0.2 T imager. MR images were classified into five stages as follows: normal, early, progressive, terminal and healing. The stage of 11 knees (28%) did not change during the course of the study and 21 knees (53%) showed a change of at least one stage. Eight knees (20%) did not have follow-up MR studies. The initial MR examination was normal in nine knees. Eight knees were at the early stage at presentation. MR images showed edema-like changes around the tibial tuberosity. Ten knees were classified as in the progressive stage at the initial presentation and six knees were classified in this group during progression on follow-up MRI. MR images showed partial avulsion of the secondary ossification center, which was seen to be being pulled proximally. Eleven knees were at the terminal stage on presentation, where the avulsed parts of the secondary ossification center had become completely separated. Two knees were classified as in the healing stage at presentation and 19 knees progressed to the healing stage from the normal, early and progressive stages. The MR images showed the separated part that did not create the ossicle had recovered by osseous healing. On the other hand, radiographs of the early stage appeared almost normal, and in the progressive stage could not show the avulsed parts. We clarified the progress of OSD with MRI. The process of OSD

  20. Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease

    International Nuclear Information System (INIS)

    Hirano, Atsushi; Ishii, Tomoo; Ochiai, Naoyuki

    2002-01-01

    Objective. The purpose of this study was to clarify the nature of Osgood-Schlatter disease (OSD) using MR images.Design. Thirty boys (40 knees) with OSD diagnosed by clinical symptoms and signs were investigated with MRI. Longitudinal evaluation was undertaken in 22 patients and the mean follow-up was 1.5±0.9 years. MR examinations were performed at least every 6 months in most cases. When a patient's symptoms changed, MRI was repeated and in cases where the initial MR examination showed an early or progressive stage of OSD, MRI was undertaken every month where possible. All MR examinations were performed in the sagittal plane with a 0.2 T imager.Results. MR images were classified into five stages as follows: normal, early, progressive, terminal and healing. The stage of 11 knees (28%) did not change during the course of the study and 21 knees (53%) showed a change of at least one stage. Eight knees (20%) did not have follow-up MR studies. The initial MR examination was normal in nine knees. Eight knees were at the early stage at presentation. MR images showed edema-like changes around the tibial tuberosity. Ten knees were classified as in the progressive stage at the initial presentation and six knees were classified in this group during progression on follow-up MRI. MR images showed partial avulsion of the secondary ossification center, which was seen to be being pulled proximally. Eleven knees were at the terminal stage on presentation, where the avulsed parts of the secondary ossification center had become completely separated. Two knees were classified as in the healing stage at presentation and 19 knees progressed to the healing stage from the normal, early and progressive stages. The MR images showed the separated part that did not create the ossicle had recovered by osseous healing. On the other hand, radiographs of the early stage appeared almost normal, and in the progressive stage could not show the avulsed parts.Conclusions. We clarified the progress

  1. Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Atsushi; Ishii, Tomoo; Ochiai, Naoyuki [Tsukuba Univ., Sakura, Ibaraki (Japan). Inst. of Clinical Medicine; Fukubayashi, Toru [Department of Life Sciences, University of Tokyo (Japan)

    2002-06-01

    Objective. The purpose of this study was to clarify the nature of Osgood-Schlatter disease (OSD) using MR images.Design. Thirty boys (40 knees) with OSD diagnosed by clinical symptoms and signs were investigated with MRI. Longitudinal evaluation was undertaken in 22 patients and the mean follow-up was 1.5{+-}0.9 years. MR examinations were performed at least every 6 months in most cases. When a patient's symptoms changed, MRI was repeated and in cases where the initial MR examination showed an early or progressive stage of OSD, MRI was undertaken every month where possible. All MR examinations were performed in the sagittal plane with a 0.2 T imager.Results. MR images were classified into five stages as follows: normal, early, progressive, terminal and healing. The stage of 11 knees (28%) did not change during the course of the study and 21 knees (53%) showed a change of at least one stage. Eight knees (20%) did not have follow-up MR studies. The initial MR examination was normal in nine knees. Eight knees were at the early stage at presentation. MR images showed edema-like changes around the tibial tuberosity. Ten knees were classified as in the progressive stage at the initial presentation and six knees were classified in this group during progression on follow-up MRI. MR images showed partial avulsion of the secondary ossification center, which was seen to be being pulled proximally. Eleven knees were at the terminal stage on presentation, where the avulsed parts of the secondary ossification center had become completely separated. Two knees were classified as in the healing stage at presentation and 19 knees progressed to the healing stage from the normal, early and progressive stages. The MR images showed the separated part that did not create the ossicle had recovered by osseous healing. On the other hand, radiographs of the early stage appeared almost normal, and in the progressive stage could not show the avulsed parts.Conclusions. We clarified the

  2. Slipped vertebral epiphysis (report of 2 cases

    Directory of Open Access Journals (Sweden)

    Majid Reza Farrokhi

    2009-02-01

    Full Text Available

    • Avulsion or fracture of posterior ring apophysis of lumbar vertebra is an uncommon cause of radicular low back pain in pediatric age group, adolescents and athletes. This lesion is one of differential diagnosis of disc herniation. We reported two teenage boys with sever low back pain and sciatica during soccer play that ultimately treated with diagnosis of lipped vertebral apophysis.
    • KEY WORDS: Ring Apophysis, vertebral fracture, sciatica, low back pain, disc herniation.

  3. A new understanding of oral and dental disorders of the equine incisor and canine teeth.

    Science.gov (United States)

    Earley, Edward; Rawlinson, Jennifer T

    2013-08-01

    This article discusses the classification systems for dental fractures and how the assessment affects treatment options. Diagonal incisor malocclusion is discussed in relation to skull asymmetry and how this commonly relates to premolar and molar occlusion. Oral and radiographic assessment of incisive bone fracture and incisor avulsion is reviewed for determining treatment options. A summary of incisor and canine resorption and hypercementosis is presented. Clinical presentations, staging, and classifications of tooth resorption as well as canine odontoplasty are discussed. Excessive plaque and calculus formation on lower canines leading to periodontal disease and abscess is examined. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Diseases of the tendons and tendon sheaths.

    Science.gov (United States)

    Steiner, Adrian; Anderson, David E; Desrochers, André

    2014-03-01

    Contracted flexor tendon leading to flexural deformity is a common congenital defect in cattle. Arthrogryposis is a congenital syndrome of persistent joint contracture that occurs frequently in Europe as a consequence of Schmallenberg virus infection of the dam. Spastic paresis has a hereditary component, and affected cattle should not be used for breeding purposes. The most common tendon avulsion involves the deep digital flexor tendon. Tendon disruptions may be successfully managed by tenorrhaphy and external coaptation or by external coaptation alone. Medical management alone is unlikely to be effective for purulent tenosynovitis. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Transverse posterior element fractures associated with torsion

    International Nuclear Information System (INIS)

    Abel, M.S.

    1989-01-01

    Six examples of a previously undescribed class of transverse vertebral element fractures are presented. These fractures differ from Chance and Smith fractures and their variants in the following respects: (1) the etiology is torsion and not flexion; (2) there is neither distraction of posterior ring fragments nor posterior ligament tears; (3) in contrast to Chance and Smith fractures, extension of the fracture into the vertebral body is absent or minimal; (4) the transverse process of the lumbar vertebra is avulsed at its base with a vertical fracture, not split horizontally. These fractures occur in cervical, lumbar, and sacral vertebrae in normal or compromised areas of the spine. (orig.)

  6. Tectonic Uplift and Fan Delta Incision along the Conway Coast, NZ

    Science.gov (United States)

    Burtt, D. G.; Bassett, K. N.

    2015-12-01

    The Conway Coast features a unique confluence of fan deltas, terrace uplift, and transpressional faulting. Thrust faults have caused the uplift of the Hawkeswood Range which provides sediment sources for local Gilbert-type fan deltas uplifting to form terraces. Sediments are characterized by steeply dipping foreset beds, horizontal topset beds and tangential bottomset beds. These fan deltas tend to form on steep basin margins often associated with extensional faulting. However, the Conway coast is dominated by thrust faulting. The Rafa terrace, dated between 52.4±4.5 and 79.0±3.5 ka with Optically Stimulated Luminescence, is exposed in cliff faces on the beach. Local creek channels deposited the fan deltas and later incised older deposits to reveal a three-dimensional perspective of the fan delta. This perspective is vital to the recreation of the fan delta position and channel avulsion, leading to a better understanding of the role of uplift superimposed by sea level change in the formation of the terraces. Forty-three photographs were stitched together to form an extensive photomosaic. The types of sediments, significant structures and relationships between adjacent beds were noted and analyzed. Correlations between the sedimentary architecture and sea level change were made using a sea level curve of the South Pacific over the last 140 ka. The incision of mud by gravel producing large flame structures suggests that there was a drop in sea level and a subsequent progradation of the fan delta. Based on the sea level curve, this drop occurred between ~66-79 ka. Higher in the fan delta, a fining-upward sequence points to a rise in sea level. This correlates with a rise on the sea level curve between ~52-63 ka. Upsection there is another coarsening-upward sequence of 5-10 m thick beds suggesting a fall in sea level before the uplift and incision of the terrace and the subsequent formation of the Ngaroma terrace. Due to their lateral extent, the gravels seem to

  7. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    Directory of Open Access Journals (Sweden)

    Guan-Yang Song

    2014-07-01

    Full Text Available Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root functions and to review the available treatment options for posterior meniscal root lesion.

  8. Tooth loss treatment in the anterior region: Autotransplantation of premolars and cryopreservation

    Directory of Open Access Journals (Sweden)

    Hans Ulrik Paulsen

    2016-01-01

    Full Text Available Avulsed and lost anterior teeth are common in young people. Using autotransplantation, it is possible to move problems in dental arches to regions where they are easier to solve orthodontically. Transplantation of premolars with three-quarter root formation or full root formation with wide open apical foramina provides the best prognosis for long-term survival. This article describes the use of autotransplantation and orthodontic treatment, together with cryopreservation, in connection with complicated trauma in the anterior region of an 8-year-old female child.

  9. Tooth loss treatment in the anterior region: autotransplantation of premolars and cryopreservation.

    Science.gov (United States)

    Paulsen, Hans Ulrik; Andreasen, Jens Ove; Schwartz, Ole

    2006-01-01

    Avulsed and lost anterior teeth are common in young people. Using autotransplantation, it is possible to move problems in dental arches to regions where they are more easy to solve orthodontically. Transplantation of premolars with three-quarter root formation or full root formation with wide-open apical foramina provides the best prognosis for long-term survival. This article describes the use of autotransplantation and orthodontic treatment, together with cryopreservation, in connection with complicated trauma in the anterior region of an 8-year-old girl.

  10. Dental injuries: "first aid" knowledge of Southampton teachers of physical education.

    Science.gov (United States)

    Newman, L J; Crawford, P J

    1991-12-01

    A total of 66 teachers of physical education within the Southampton telephone area responded to a postal questionnaire related to their knowledge of the first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave an appropriate answer. In a second case study relating to avulsion (loss) of a permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and the accuracy of their responses. There is a need for further information in this area.

  11. Evaluation and treatment of jersey finger and pulley injuries in athletes.

    Science.gov (United States)

    Freilich, Aaron M

    2015-01-01

    The flexor tendon system in the finger is complex and can be difficult to treat. Closed injuries to the flexor tendon or pulley system are not uncommon in high-level athletes. Their treatment can be complicated by in-season play, position, and the number of people involved in the patient's care. Injuries can be misdiagnosed as "sprains" or unreported by some athletes at the time of injury. Some of these injuries, especially flexor tendon avulsions, require prompt recognition and appropriate treatment to prevent permanent disability to the hand and finger. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Lacustrine-fluvial interactions in Australia's Riverine Plains

    Science.gov (United States)

    Kemp, Justine; Pietsch, Timothy; Gontz, Allen; Olley, Jon

    2017-06-01

    Climatic forcing of fluvial systems has been a pre-occupation of geomorphological studies in Australia since the 1940s. In the Riverine Plain, southeastern Australia, the stable tectonic setting and absence of glaciation have combined to produce sediment loads that are amongst the lowest in the world. Surficial sediments and landforms exceed 140,000 yr in age, and geomorphological change recorded in the fluvial, fluvio-lacustrine and aeolian features have provided a well-studied record of Quaternary environmental change over the last glacial cycle. The region includes the Willandra Lakes, whose distinctive lunette lakes preserve a history of water-level variations and ecological change that is the cornerstone of Australian Quaternary chronostratigraphy. The lunette sediments also contain an ancient record of human occupation that includes the earliest human fossils yet found on the Australian continent. To date, the lake-level and palaeochannel records in the Lachlan-Willandra system have not been fully integrated, making it difficult to establish the regional significance of hydrological change. Here, we compare the Willandra Lakes environmental record with the morphology and location of fluvial systems in the lower Lachlan. An ancient channel belt of the Lachlan, Willandra Creek, acted as the main feeder channel to Willandra Lakes before channel avulsion caused the lakes to dry out in the late Pleistocene. Electromagnetic surveys, geomorphological and sedimentary evidence are used to reconstruct the evolution of the first new channel belt following the avulsion. Single grain optical dating of floodplain sediments indicates that sedimentation in the new Middle Billabong Palaeochannel had commenced before 18.4 ± 1.1 ka. A second avulsion shifted its upper reaches to the location of the present Lachlan River by 16.2 ± 0.9 ka. The timing of these events is consistent with palaeohydrological records reconstructed from Willandra Lakes and with the record of

  13. Radiology of sport injuries of pelvic apophyses

    International Nuclear Information System (INIS)

    Heuck, F.

    1983-01-01

    Pelvic apophyses are places of insertion of strong muscles and tendons and are therefore places of least resistance at the end of skeletal growth. Avulsions and disruptions of pelvic apophyses can be caused by overstrain during different kinds of sport activity. Typical radiological findings in 8 different cases of ruptures of apophyses, osteochondropathies, and resulting conditions of sport injuries are demonstrated. The difficulties of correct diagnosis and different diagnosis are pointed out. The significance of hormonal impairment of ossification for development and stress factor of pelvic apophyses is exposed. Questions of treatment and follow-up studies are discussed. (orig.)

  14. Scapulothoracic Dissociation: A Rare Variant: A Case Report

    Directory of Open Access Journals (Sweden)

    Rajat Jangir

    2014-07-01

    Full Text Available Scapulothoracic dissociation is a rare injury involving separation of scapula from the thorax along with the upper extremity. Majority of the patients have concomitant neurovascular injury and the prognosis is uniformly poor in such cases. We present a case of scapulothoracic dissociation with comminuted fracture of scapula and acromioclavicular joint disruption without neurovascular deficit. There were associated avulsion fractures of the spinous processes of vertebrae (T3-T5. Such presentation is rare in an already rare scapulothoracic dissociation injury. A discussion regarding the probable mechanism of injury, management and prognosis is presented.

  15. Debates to personal conclusion in peripheral nerve injury and reconstruction: A 30-year experience at Chang Gung Memorial Hospital

    Science.gov (United States)

    Chuang, David Chwei-Chin

    2016-01-01

    Significant progress has been achieved in the science and management of peripheral nerve injuries over the past 40 years. Yet there are many questions and few answers. The author, with 30 years of experience in treating them at the Chang Gung Memorial Hospital, addresses debates on various issues with personal conclusions. These include: (1) Degree of peripheral nerve injury, (2) Timing of nerve repair, (3)Technique of nerve repair, (4) Level of brachial plexus injury,(5) Level of radial nerve injury,(6) Traction avulsion amputation of major limb, (7) Proximal Vs distal nerve transfers in brachial plexus injuries and (8) Post paralysis facial synkinesis. PMID:27833273

  16. Periosteal osteoblastoma of the distal femur

    Energy Technology Data Exchange (ETDEWEB)

    Nakatani, Tetsuya; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Hitora, Toshiaki; Kawamoto, Teruya; Nagira, Keiko; Yoshiya, Shinichi; Kurosaka, Masahiro [Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe (Japan); Fujita, Ikuo; Matsumoto, Keiji [Department of Orthopaedic Surgery, Hyogo Medical Center for Adults, Akashi, Hyogo (Japan)

    2004-02-01

    Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors. (orig.)

  17. Periosteal osteoblastoma of the distal femur

    International Nuclear Information System (INIS)

    Nakatani, Tetsuya; Yamamoto, Tetsuji; Akisue, Toshihiro; Marui, Takashi; Hitora, Toshiaki; Kawamoto, Teruya; Nagira, Keiko; Yoshiya, Shinichi; Kurosaka, Masahiro; Fujita, Ikuo; Matsumoto, Keiji

    2004-01-01

    Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors. (orig.)

  18. Painful/unstable shoulder

    International Nuclear Information System (INIS)

    Saez, F.; Negueruela, J.; Martin, J.C.; Elizagaray, E.; Pena, J.M.; Merino, A.

    1991-01-01

    This paper reports on the diagnostic performance of CT-arthrography of the painful/unstable shoulder that was evaluated in more than 300 patients. We have encountered a great variety of painful shoulder pathology, including impingement syndrome, cuff tear arthropathy, lesions of the long head of the biceps tendon, calcifying tendinitis, adhesive capsulitis, dead arm syndrome, and degenerative joint disease. Lesions related to instability include cases of capsular avulsions, disruption of the glenohumeral ligaments, labral pathology, glenoid fractures, Hill-Sachs lesions, and changes in glenoid angulation. CT-arthrography is an accurate exploration for both unstable and painful shoulders

  19. Three-Dimensional CT Findings of Os Calcaneus Secundarius Mimicking a Fracture

    OpenAIRE

    Mehmet Deniz Bulut; Alpaslan Yavuz; Aydın Bora; Mehmet Ata Gökalp; Sercan Özkaçmaz; Abdussamet Batur

    2014-01-01

    Os calcaneus secundarius is one of several accessory ossicles of the foot that have been identified as normal variants of skeletal development. It may cause ankle pain and may mimic an avulsion fracture of the anterior calcaneal process. A twenty-year-old male was admitted to our institution with right ankle pain following an inversion injury. An axial CT image of the patient’s right ankle revealed a shape with smooth and sharp margins, identified as a well-corticated bone fragment in the sub...

  20. Onychocryptosis.

    Science.gov (United States)

    DeLauro, Nicole M; DeLauro, Thomas M

    2004-10-01

    Onychocryptosis is prevalent globally and most often the result of self-attempts at curing the condition in its earliest stages. Its clinical presentation is often confused with a number of osseous and soft tissue abnormalities, some of which have great import to a patient's overall welfare. Treatment consists of local and systemic care, including nail avulsion. Recurrences are reduced when some form of matricectomy is used. Matricectomy techniques vary and must be selected on the basis of caregiver and patient preference. Although the chemical matricectomy is popular, care must be exercised in selecting patients for its use.

  1. Management of Traumatized Permanent Incisors. Revascularization and Delayed Replantation.

    Science.gov (United States)

    Gharechahi, Maryam; Shojaeian, Shiva

    2016-01-01

    This article reports a clinical case of a 9-year-old boy with a traumatic injury to the maxillary central incisors 24 hours after a fall in his schoolyard. The upper left central incisor was avulsed and was kept in saliva for four hours from the moment of trauma until its replantation. The right one was necrotized after one month. We describe successful revascularization treatment of right necrotic immature upper incisor and delayed replantation of left one. After 18 months, radiolucent lesions in the periapical areas of both maxillary central incisors had healed, and root apex development was noted with thickening of the walls in tooth #8.

  2. Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

    Science.gov (United States)

    Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

    2017-02-01

    Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

  3. Tunica vaginalis hydrocele of reposited testis

    Directory of Open Access Journals (Sweden)

    Tiwari Manish

    2009-01-01

    Full Text Available Tunica vaginalis hydrocele (TVH is a relatively common entity. The procedure of testicular reposition in a subcutaneous pouch following severe scrotal avulsion injury is also a standard line of care. Though, the occurrence of TVH in such a reposited testis is extremely rare clinical presentation. We herein report a case of 55-year male patient who presented with swelling over medial aspect of left upper thigh which was diagnosed as TVH of reposited testis on detailed assessment. The patient was managed on the usual lines of management protocols of TVH with successful outcome.

  4. Naturally occurring genetic variability in expression of Gsta4 is associated with differential survival of axotomized rat motoneurons

    DEFF Research Database (Denmark)

    Mikael, Ström; Al Nimer, Faiez; Lindblom, Rickard

    2012-01-01

    such naturally occurring strain differences is a powerful approach, also known as forward genetics, to gain knowledge of mechanisms relevant for complex diseases, like injury-induced neurodegeneration. Overlapping congenic rat strains were used to fine map a gene region on rat chromosome eight previously shown...... to regulate motoneuron survival after ventral root avulsion. The smallest genetic fragment, R5, contains 35 genes and displays a highly significant regulatory effect on motoneuron survival. Furthermore, expression profiling in a F2(DAxPVG) intercross demonstrates one single cis-regulated gene within the R5...

  5. Twin Valve Caval Stent for Functional Replacement of Incompetent Tricuspid Valve: A Feasibility Animal Study

    International Nuclear Information System (INIS)

    Sochman, Jan; Peregrin, Jan H.; Pavcnik, Dusan; Uchida, Barry T.; Timmermans, Hans A.; Shimohira, Masashi; Choi, Young Ho; Keller, Frederick S.; Rösch, Josef

    2011-01-01

    Objective: To evaluate feasibility of a twin valve caval stent (TVCS) for functional replacement of an incompetent tricuspid valve (TV) in an acute animal study. Methods: One swine and three sheep were used in the study. TVCS placement was tested in a swine with a normal TV. TVCS function was tested in three sheep with TV regurgitation created by papillary muscle avulsion. Cardiac angiograms and pressure measurements were used to evaluate TVCS function. Two sheep were studied after fluid overload. Results: TVCS was percutaneously placed properly at the central portions of the superior vena cava (SVC) and inferior vena cava (IVC) in the swine. Papillary muscle avulsion in three sheep caused significant tricuspid regurgitation with massive reflux into the right atrium (RA) and partial reflux into the SVC and IVC. TVCS placement eliminated reflux into the SVC and IVC. After fluid overload, there was enlargement of the right ventricle and RA and significant increase in right ventricle, RA, SVC, and IVC pressures, but no reflux into the IVC and SVC. Conclusion: The results of this feasibility study justify detailed evaluation of TVCS insertion for functional chronic replacement of incompetent TV.

  6. An earth systems approach to understanding the tectonic and cultural landscapes of linked marine embayments: Avon-Heathcote Estuary (Ihutai) and Lake Ellesmere (Waihora), New Zealand

    Science.gov (United States)

    McFadgen, Bruce G.; Goff, James R.

    2005-03-01

    An earth systems study of the Avon-Heathcote Estuary (Ihutai), New Zealand, shows that tectonic activity has a marked direct and indirect control upon its geomorphology and human settlement in the area. We discuss the Late Holocene history of the embayment in relation to large earthquakes and their after-effects. Of particular note is the rapid fluvial transfer of sand to the coast causing dune formation and a more delayed pulse of coarser sediment causing channel avulsion of the Waimakariri River. While dune system development seems to occur soon after tectonic activity, river channel avulsion, spit/barrier formation and ongoing geomorphological changes may well relate to periods of tectonic activity that occurred 100-200 years previously. The interaction between these two sediment delivery systems causes significant, and often rapid, changes to coastal geomorphology and ecosystems that have serious implications for human populations living at or near the coast. We show a more region-wide picture of the direct and indirect effects of tectonic activity, by comparing two embayments that represent coastal points of entry at opposite ends of the Waimakariri River floodplain: the Avon-Heathcote Estuary (Ihutai) and Lake Ellesmere (Waihora).

  7. Alluvial plain dynamics and human occupation in SW Amazonia during the Holocene: A paleosol-based reconstruction

    Science.gov (United States)

    Lombardo, Umberto; Rodrigues, Leonor; Veit, Heinz

    2018-01-01

    The present study reconstructs Holocene fluvial dynamics in the southern Amazonian foreland basin through the analysis of 36 stratigraphic profiles taken along a 300 km long transect across the Llanos de Moxos (LM), in the Bolivian Amazon. Based on 50 radiocarbon ages from paleosols intercalated with fluvial sediments, the most important changes in floodplain dynamics on a millennial scale are reconstructed and the links between pre-Columbian cultural processes and environmental change in the region explored. Results show that the frequency of river avulsions and crevasses, as inferred from the number and age of the cored paleosols, is stable from 8k cal. yrs BP to 4k cal. yrs BP and increases significantly from 4k to 2k cal. yrs BP, following the strengthening of el Niño/la Niña cycle and an increase in average precipitation. Fluvial activity then decreases and reaches its minimum after 2k cal BP. A comparison between the stratigraphic record and the archaeological record shows a match between periods of landscape stability in SW Amazonia (low river activity) and periods of pre-Columbian human occupation. The first Amazonians lived in the LM until 4k yrs. BP, when an abrupt increase in the frequency of river avulsions and crevasses forced the abandonment of the region. After two thousand years of archaeological hiatus, which matches the period of highest river activity in the region, agriculturists reoccupied the Bolivian Amazon.

  8. Dental trauma: knowledge and attitudes of community health workers.

    Science.gov (United States)

    Costa, Fábio Wildson Gurgel; de Oliveira, Elaine Helena; Bezerra, Marcelo Ferraro; Nogueira, Alexandre Simões; Soares, Eduardo Costa Studart; Pereira, Karuza Maria Alves

    2014-09-01

    The international literature emphasizes the importance of evaluating the knowledge of different groups such as teachers, students, dentists, physicians, parents, and athletes regarding dental injuries. In Brazil, community health workers are professionals who can reach a wide variety of people and who have a marked influence on prevention and health promotion strategies. The objective of this study was to investigate the knowledge and attitudes of community health workers regarding dental trauma. A questionnaire consisting of 19 questions divided into 3 parts was applied: demographic characteristics, knowledge, and attitudes. Data from 206 respondents were analyzed using descriptive statistics and logistic regression models. Approximately 28% of the participants reported to have been called to assist individuals with dental trauma. Only 42 subjects had received education on dental injuries, with 34 of them being instructed by a dentist. In cases of tooth avulsion, only 1.9% of the health workers reported that they would search for the tooth and reimplant it. The most frequently indicated storage media for avulsed teeth were nonphysiological media (69.42%). The educational level of the community health workers somehow influenced their knowledge (P Educational programs for this group are needed to improve the management of traumatic dental injuries.

  9. Morphodynamics of the Final 500 Kilometers of the Mississippi River

    Science.gov (United States)

    Wang, B.; Xu, Y. J.

    2017-12-01

    Channel dynamics of alluvial rivers in their lower reaches can strongly influence deltaic development. In this study, we analyzed over 6,000 single-beam cross-sectional measurements surveyed in 1992, 2004, and 2013 in the last 500-km reach of the highly engineered Mississippi River, a.k.a. the lowermost Mississippi River (LmMR), starting from the river's Gulf outlet to its avulsion into the Atchafalaya River. We applied Inverse Distance Weighted interpolation to downscale the survey records into 10 x 10 m Digital Elevation Models. We assessed riverbed deformation from bank to bank and quantified georeferenced changes in riverbed sediment volume and mass. We intended to test the hypothesis that the lower reach of a large alluvial river can function as a conduit for sediment transport under the current engineering focus of navigation safety and flood control. Our analysis shows that in the past two decades, nearly 70% of the riverine sand is trapped within the LmMR, and that continuous riverbed aggradation occurred below the Mississippi-Atchafalaya diversion, presenting favorable backwater conditions for avulsion. Backwater effects have mainly controlled riverbed deformation in the LmMR, while flow reduction may have also contributed to channel aggradation in the uppermost and lowermost reaches. The study reveals the considerable complexity of geomorphic responses of a large alluvial river to human interventions, strongly suggesting that future river engineering and management need also to focus on strategies that will improve sediment transport to the downstream river delta.

  10. A CASE REPORT OF RETROPHARYNGEAL PASSAGE OF ENDOTRACHEAL TUBE WHILE ATTEMPTING BLIND NASAL INTUBATION - A RARE COMPLICATION

    Directory of Open Access Journals (Sweden)

    Harinath

    2015-06-01

    Full Text Available Nasal route of intubation is commonly used for surgical procedures involving Head and Neck, Patients with intra - oral pathology, structural abnormalities, trismus, cervical spine instability, cervical spine disease and OSA. The intubation may be aided by direct laryngoscopy, flexible fibreoptic laryngoscopy or by blind technique. The classical tec hnique of blind nasal intubation requires a spontaneously breathing patient and uses breath sounds to guide placement. Most common complication associated with this technique is epistaxis. Other rare complications include - Inferior turbinate avulsion, mid dle turbinate/nasal polyp/tumour avulsion, Bacteraemia, Retropharyngeal mucosa dissection/laceration. Here we present to you a case of fracture mandible posted for ORIF for which blind nasal intubation was planned. While attempting the intubation the endot racheal tube coursed behind the retropharyngeal mucosa for a short distance before entering the trachea. Post - operatively the patient was put on Ryle’s tube feeding for 3 days followed by orals. The track healed spontaneously and the recovery was uneventfu l.

  11. [Scabies of the nail unit in an infant].

    Science.gov (United States)

    Finon, A; Desoubeaux, G; Nadal, M; Georgescou, G; Baran, R; Maruani, A

    2017-05-01

    There are no guidelines regarding the management of scabies in infants and recurrence is common at this age. We report the case of an infant with subungual hyperkeratosis and ungual lesions subsequent to classic scabies. A 7-month-girl, treated 6 weeks earlier with esdepallethrin for scabies, consulted for acquired lesions on 3 toe nails. These nails were thickened and displayed subungual hyperkeratosis. Physical examination of the skin, the finger nails and mucous membranes was otherwise normal. Fungal analyses were negative, but direct microscopic examination revealed numerous larvae of Sarcoptes scabiei as well as ovular debris. The child was treated with urea 40% to obtain chemical avulsion of the nails, and with topical esdepallethrin and a quarter tablet of ivermectin orally; there was no follow-up of the child. Ungual scabies has already been reported in crusted scabies and very rarely in classic scabies. Subungual and ungual locations of S. scabiei may constitute a source of reinfestation with scabies in infants. Treatment is not well defined and currently involves chemical avulsion of the nails and the application of topical antiscabies treatment. Copyright © 2016. Published by Elsevier Masson SAS.

  12. Unilateral traumatic oculomotor nerve paralysis

    International Nuclear Information System (INIS)

    Asari, Syoji; Satoh, Toru; Yamamoto, Yuji

    1982-01-01

    The present authors report a case of unilateral traumatic oculomotor nerve paralysis which shows interesting CT findings which suggest its mechanism. A 60-year-old woman was admitted to our hospital with a cerebral concussion soon after a traffic accident. A CT scan was performed soon after admission. A high-density spot was noted at the medial aspect of the left cerebral peduncle, where the oculomotor nerve emerged from the midbrain, and an irregular, slender, high-density area was delineated in the right dorsolateral surface of the midbrain. Although the right hemiparesis had already improved by the next morning, the function of the left oculomotor nerve has been completely disturbed for the three months since the injury. In our case, it is speculated that an avulsion of the left oculomotor nerve rootlet occurred at the time of impact as the mechanism of the oculomotor nerve paralysis. A CT taken soon after the head injury showed a high-density spot; this was considered to be a hemorrhage occurring because of the avulsion of the nerve rootlet at the medial surface of the cerebral peduncle. (J.P.N.)

  13. Does Osgood-Schlatter disease exist in the dog?

    Science.gov (United States)

    von Pfeil, D J F; Decamp, C E; Diegel, K L; Gholve, P A; Probst, C W; Dejardin, L M

    2009-01-01

    Osgood-Schlatter disease (OSD) is a condition affecting human adolescents in which there is partial separation of bone fragments from the tibial tuberosity at the site of insertion of the patellar ligament to the tibial tuberosity. Tensile trauma seems to be the most likely aetiology. Clinical signs in people consist of swelling and pain at the proximal part of the tibial tuberosity and around the distal end of patellar ligament. Radiographs frequently show small ossicles at the patellar ligament insertion. Conservative treatment is usually curative. The term OSD has also been used for the canine patient. However, radiographs of these patients typically show an enlarged radiolucent line at the apophyseal plate of the tibial tuberosity. This finding is consistent with a mild avulsion fracture of the canine tibial tuberosity. Based on the radiographic differences between the two species, it seems more appropriate to use the term OSD only for people. The purpose of this paper is to review the literature on OSD in people and the reports of injuries to the proximal tibial tuberosity in dogs. In addition, a new classification system for tibial tuberosity avulsion injuries in the immature dog is proposed, with an algorithm for management of this injury.

  14. Osgood-Schlatter lesion: fracture or tendinitis? Scintigraphic, CT, and MR imaging features.

    Science.gov (United States)

    Rosenberg, Z S; Kawelblum, M; Cheung, Y Y; Beltran, J; Lehman, W B; Grant, A D

    1992-12-01

    To determine whether the Osgood-Schlatter lesion (OS) is produced by avulsion fracture or injury to the patellar tendon, all images obtained in 28 cases of OS in 20 patients (16 scintigrams, 34 computed tomographic [CT] scans, and 27 magnetic resonance [MR] images) were retrospectively analyzed. In 21 cases, imaging was performed before and after treatment; in 20 cases, relief from pain was complete at the time of repeat examination. In all patients (100%), abnormal size of the tendon, decreased attenuation, and increase in signal intensity were compatible with the CT and MR imaging appearance of tendinitis. Distended deep infrapatellar bursa was a frequent finding, particularly on MR studies. These abnormalities had partially disappeared at follow-up examination. An ossicle was seen in only nine of 28 cases (32%); in three of seven cases with follow-up, the ossicle remained nonunited to the tibial tuberosity on follow-up studies despite relief from symptoms. This implies that healing of fracture is not essential for relief from symptoms. These results strengthen the argument that in most cases of OS, insult to the tendon and associated soft tissues, rather than avulsion fracture, causes OS.

  15. Successful microsurgical lip replantation: Monitoring venous congestion by blood glucose measurements in the replanted lip

    Directory of Open Access Journals (Sweden)

    Kazufumi Tachi

    2018-03-01

    Full Text Available Replantation of an amputated lip using microvascular anastomosis is the best option for restoration of the defect. However, the amputated region often lacks veins with appropriate diameters for microvascular anastomoses and typically necessitates both postoperative exsanguination using medicinal leeches and a blood transfusion. We present a case of the successful replantation of an avulsed lip in which postoperative congestion was evaluated objectively by measuring blood glucose levels in the replanted region. The patient presented to our hospital with an upper lip avulsion that was caused by a dog bite. The lip was replanted by the microvascular anastomoses of one artery and two veins using interposed vein grafts. The replanted lip showed signs of congestion on postoperative day one; exsanguination using medicinal leeches was attempted, while blood glucose levels were measured every three hours. Critical congestion, which did not occur in this patient, was defined as a blood glucose level lower than 40 mg/dL. Lip replantation was successful without any complications in this patient.

  16. Finger replantation: surgical technique and indications.

    Science.gov (United States)

    Barbary, S; Dap, F; Dautel, G

    2013-12-01

    In this article, we discuss the surgical technique of finger replantation in detail, distinguishing particularities of technique in cases of thumb amputation, children fingertip replantation, ring finger avulsion, and very distal replantations. We emphasize the principles of bone shortening, the spare part concept, the special importance of nerve sutures and the use of vein graft in case of avulsion or crushing. However, even if finger replantation is now a routine procedure, a clear distinction should be made between revascularization and functional success. The indications for finger replantation are then detailed in the second part of this paper. The absolute indications for replantation are thumb, multiple fingers, transmetacarpal or hand, and any upper extremity amputation in a child whatever the level. Fingertip amputations distal to the insertion of the Flexor digitorum superficialis (FDS) are also a good indication. Other cases are more controversial because of the poor functional outcome, especially for the index finger, which is often functionally excluded. Copyright © 2013. Published by Elsevier SAS.

  17. Does the design of mini slings anchoring systems really matter? A biomechanical comparison between Mini Arc™ and Ophira™.

    Science.gov (United States)

    Santos-Souza, R; Rodrigues-Palma, P C; Goulart-Fernandes-Dias, F; Teixeira-Siniscalchi, R; Zanettini-Riccetto, C L

    2016-11-01

    Currently, a sling implant is the standard treatment for stress urinary incontinence in women. To be effective, they require an adequate anchoring system. The aim of this study is compare biomechanical features of fixation systems of two mini slings models available on the market (Ophira™ and Mini Arc™) through a tensile test. Anchoring devices of each sling were surgically implanted in abdominal wall of 15 rats divided into three groups of five animals which were arranged according to the date of post implant euthanasia on 7, 14 and 30 days. Abdominal walls of rats were extracted on bloc containing the anchoring system and were submitted to a tensile strength test to measure the maximum load and elongation until device avulsion from the tissue. The results were compared using Student test t and a 5% cut off was considered significant. The Ophira™ mini sling fixation system demanded a greater maximum load and developed a longer stretch for avulsion from the implanted site at all moments evaluated (p value less than 0.05). There were significant differences in fixation patterns of the anchoring systems, which were exclusively related to their designs. The Ophira™ mini sling fixation device provided better fixation to the abdominal wall of rats compared to the Mini Arc™ device, even in the late post implant period. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. The middle layer of lumbar fascia and attachments to lumbar transverse processes: implications for segmental control and fracture

    Science.gov (United States)

    Urquhart, Donna M.; Story, Ian H.; Fahrer, Marius; Briggs, Christopher A.

    2007-01-01

    The anatomy of the middle layer of lumbar fascia (MLF) is of biomechanical interest and potential clinical relevance, yet it has been inconsistently described. Avulsion fractures of the lumbar transverse processes (LxTP’s) are traditionally attributed to traction from psoas major or quadratus lumborum (QL), rather than transversus abdominis (TrA) acting via the MLF. This attachment is also absent from many biomechanical models of segmental control. The aims of this study were to document: (1) the morphology and attachments of the MLF and (2) the attachments of psoas and QL to the LxTP’s. Eighteen embalmed cadavers were dissected, measuring the thickness, fibre angle and width of the MLF and documenting the attachments of MLF, psoas and QL. The MLF was thicker at the level of the LxTP’s than between them (mean 0.62: 0.40 mm). Psoas attached to the anteromedial surface of each process and QL and TrA to its lateral border; QL at its upper and lower corners and TrA (via the MLF) to its tip. In three cadavers, tension applied to the MLF fractured a transverse process. The MLF has a substantial and thickened attachment to the tips of the LxTP’s which supports the involvement of TrA in lumbar segmental control and/ or avulsion fracture of the LxTP’s. PMID:17924150

  19. [Biomechanic considerations in wrist prostheses].

    Science.gov (United States)

    Kapandji, A I

    1992-01-01

    At the present time, in disorders of the wrist, avulsion of the first carpal row is the most commonly used technique as a last resort. However, there are many wrist prostheses, which are reviewed here. Roughly, they belong to two families: the three axis prostheses (spherical) that cannot transmit to the hand the pronation supination torque, because of their geometrical characteristics, and the two axis prostheses (universal joint) that are able to transmit this movement. The characteristics of future prostheses must include: based on the "universal joint" principle, occupy minimum space, isometric, maintain tendon tension, an axis identical to the true axis of the wrist, to maintain the hand in line with the forearm, fixed without cement but, not shortened with time, possibilities of mechanical flexibility immediately and lastingly stable, to be easily replaced modularly. This ideal prosthesis will certainly exist one day and will take the place of the first carpal row avulsion. In the meantime, this technique will still have a long use.

  20. Assessment of Elementary School Teachers’ Level of Knowledge and Attitude regarding Traumatic Dental Injuries in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Manal A. Awad

    2017-01-01

    Full Text Available Introduction. In this cross-sectional study, the level of knowledge and attitude of elementary school teachers regarding traumatic dental injuries (TDI were assessed. Materials and Methods. A questionnaire was distributed to 330 elementary school teachers in 30 randomly selected schools in the Emirates of Sharjah and Dubai. The questionnaire collected information on participants’ demographic characteristics, first aid training, and attitude about emergency management of TDI. Results. 292 teachers (88% completed the questionnaires; of these, 95% were females, and 50% of the participants had first aid training. Knowledge about tooth avulsion was inadequate, and first aid training was not associated with correct responses to management of avulsed teeth (p>0.05. A significantly higher percentage of younger teachers (p<0.05 expressed the need for future education on TDI management. A significantly higher percentage of participants who had an educational position (95% indicated that they did not have enough knowledge regarding TDI compared to physical education teachers (79% and administrators (87% (p<0.05. Conclusions. Elementary school teachers in the UAE have a low level of knowledge regarding the management of dental trauma. Educational programs that address TDI are needed and could improve the elementary school teachers’ level of knowledge in emergency management of TDI.

  1. Three phase bone scan in sports injuries

    International Nuclear Information System (INIS)

    Chauhan, M.S.; Chowhan, M.

    2007-01-01

    Full text: Sports injuries are common in individual who participate in sports and exercise related activities. In majority of sports related injuries such as stress fracture, periosteitits, acute stress reaction of bone, the radiological investigations are usually normal in early stages. These injuries can lead to serious complications if not detected early and managed properly. This study was jointly carried out in premier medical institutes. All patients were referred from premier sports institute of the country and also by orthopedic surgeons. All patients were subjected for relevant radiological investigations and 3 phase bone scan. Total number of cases included in this study was 70 (N=70) among which bone scan was positive for stress fracture in 45 patients and shin splint was detected in 15 patients and avulsion injury seen in 3 patients. However, only one patient showed features of avulsion injury in X ray and in 1 patient X-ray was inconclusive. Conclusion:-The study shows that 3 phase bone scan is the most sensitive and relatively an inexpensive study. Bone scan has the ability for early detection of sports injuries and provide physiological information and evaluate multiple sites in single examination.SPECT study will help in the diagnostic specificity. (author)

  2. Hamstring injuries: update article

    Directory of Open Access Journals (Sweden)

    Lucio Ernlund

    Full Text Available ABSTRACT Hamstring (HS muscle injuries are the most common injury in sports. They are correlated to long rehabilitations and have a great tendency to recur. The HS consist of the long head of the biceps femoris, semitendinosus, and semimembranosus. The patient's clinical presentation depends on the characteristics of the lesion, which may vary from strain to avulsions of the proximal insertion. The most recognized risk factor is a previous injury. Magnetic resonance imaging is the method of choice for the injury diagnosis and classification. Many classification systems have been proposed; the current classifications aim to describe the injury and correlate it to the prognosis. The treatment is conservative, with the use of anti-inflammatory drugs in the acute phase followed by a muscle rehabilitation program. Proximal avulsions have shown better results with surgical repair. When the patient is pain free, shows recovery of strength and muscle flexibility, and can perform the sport's movements, he/she is able to return to play. Prevention programs based on eccentric strengthening of the muscles have been indicated both to prevent the initial injury as well as preventing recurrence.

  3. Simultaneous intercostal nerve transfers to deltoid and triceps muscle through the posterior approach.

    Science.gov (United States)

    Malungpaishrope, Kanchai; Leechavengvongs, Somsak; Witoonchart, Kiat; Uerpairojkit, Chairoj; Boonyalapa, Artit; Janesaksrisakul, Disorn

    2012-04-01

    This study reports the results of restoring the deltoid and triceps functions in patients with C5, C6, and C7 root avulsion injuries by simultaneously transferring 4 intercostal nerves to the anterior axillary nerve and the nerve to the long head of the triceps through the posterior approach. Nine patients with C5, C6, and C7 root avulsion injuries underwent spinal accessory nerve transfer to the suprascapular nerve combined with transfer of the third and fourth intercostal nerves to the anterior axillary nerve for shoulder reconstruction. Simultaneous transfer of the fifth and sixth intercostal nerves to the radial nerve branch of the triceps was done to restore elbow extension. For shoulder function, 8 patients had M4 recovery and 1 patient had M2 recovery. Average shoulder abduction and external rotation were 69° and 42°, respectively. For elbow extension, 3 patients achieved M3 recovery, 5 patients had M2 recovery, and 1 patient had M1 recovery. Reconstruction of 2 muscles with intercostal nerves is possible when both muscles act synergistically, such as shoulder abduction and elbow extension. Two intercostal nerves are adequate to transfer for deltoid reconstruction but not enough for elbow extension against gravity. Therapeutic IV. Copyright © 2012. Published by Elsevier Inc.

  4. Knowledge, attitude, and practice of elementary school teachers toward emergency management of dental trauma in Sirmaur District, Himachal Pradesh: A questionnaire study

    Directory of Open Access Journals (Sweden)

    Abhishek Kumar

    2017-01-01

    Full Text Available Background: Traumatic dental injuries (TDIs are widespread in the population and are a serious dental public health problem among children. Dental trauma may cause both functional and esthetic problems, with possible impacts on the patient's quality of life. Aim: The aim of the study is to assess the knowledge, attitude, and practice of elementary school teachers regarding dental trauma and its management. Materials and Methods: A questionnaire study consisting of 12 closed-ended questions were used to interview 150 elementary school teachers who participated in this study. The questions assessed the knowledge and attitude of teachers toward their student's dental trauma and its management. Statistical analysis was performed using Statistical Packages of Social Sciences (SPSS version 17.0. Results: Among 150 teachers, 54% had dealt with trauma to their students, 91.3% school teachers said that they would save the avulsed tooth, 64% had heard about reimplantation of tooth, and 37% school teachers stated that they would not carry the tooth in any media reflecting their lack of knowledge regarding management of avulsed tooth. Conclusion: As many teachers have a low level of knowledge regarding dental trauma, there is a need for greater awareness to improve knowledge and attitude of teachers related to the emergency management of TDIs in children by organizing educative and motivational programs.

  5. Tracing the Anthropocene in the Rhine-Meuse delta

    Science.gov (United States)

    Middelkoop, Hans; van der Perk, Marcel; Cohen, Kim M.; Stouthamer, Esther; Hoek, Wim Z.; Kleinhans, Maarten G.; Erkens, Gilles; Jansma, Esther

    2014-05-01

    The Holocene Rhine-Meuse delta developed during the past ~8000 yr under a first rapid and later decreasing sea level rise in a back-barrier area along the North Sea. After about 3500 yr BP, natural delta evolution became increasingly influenced by humans, with different types of imprints: increased discharge and sediment load associated with deforestation in the hinterland affecting channel geometry and deposition; artificial avulsion; large-scale peat excavation; reclamation and drainage of flood basins resulting in compaction and oxidation of peat; river embankment preventing delta-wide overbank deposition and finalizing avulsion; channelization, changing channel belt geometry and causing shifts in sediment deposition within the delta. After the onset of the industrial revolution, contaminants have been deposited along with the river sediment on the embanked floodplains and in the estuary. The extremely well-documented human-affected evolution of the delta provides a unique opportunity to demonstrate how the Anthropocene can manifest itself in such an environment. We give an overview of human-affected processes in the Rhine-Meuse delta and discuss their effect on fluvial architecture, morphology and sediment composition, and how these may remain preserved within the delta sedimentary record.

  6. Mitoses and microorganisms in the periodontal membrane after storage in milk or saliva.

    Science.gov (United States)

    Lindskog, S; Blomlöf, L; Hammarström, L

    1983-12-01

    Milk and saliva were tested in vitro as potential storage media for avulsed teeth. Developing monkey teeth were extracted and stored in milk or saliva for periods ranging from 1 to 6 h. The osmolality, pH, conductivity and number of viable bacteria in the media were determined after predetermined intervals during the storage periods. After the storage periods the teeth were either prepared for scanning electron microscopy or cultured for 24 h in Eagle's medium supplemented with 3H-thymidine. In the scanning electron microscope numerous adherent bacteria were seen covering the periodontal membrane after storage in saliva but none were found after storage in milk. The cultured teeth were sectioned and evaluated with autoradiography. Superficial parts of the periodontal membrane were rapidly injured by storage in saliva while the epithelial root sheath and the apical pulpal cells were affected at a later stage. Cells neighboring the cementoblasts incorporated 3H-thymidine after 6 h storage in milk but not after storage in saliva for the same length of time. It was concluded that the low osmolality in combination with bacteria which adhered to the periodontal membrane made saliva less suited than milk for long time storage of avulsed teeth. Furthermore, a viable layer of cells close to the root surface seemed to be a prerequisite for a successful healing without root resorption after replantation.

  7. Replantation of permanent incisors in children using Emdogain.

    Science.gov (United States)

    Barrett, Edward J; Kenny, David J; Tenenbaum, Howard C; Sigal, Michael J; Johnston, Douglas H

    2005-10-01

    The aim of this study was to determine whether application of an enamel matrix protein derivative, Emdogain (Biora AB Malmo, Sweden) to the root surface of avulsed permanent incisors would improve postreplantation outcomes in a pediatric population. Between June 1999 and May 2002, 25 avulsed permanent maxillary incisors (22 centrals and three laterals) were treated with Emdogain and followed for up to 32 months, mean duration 20.6 months (range: 6.9-32.5 months). Mean patient age at the time of treatment was 12.0 years (range: 7.7-17.6 years) and mean extra-alveolar duration was 185 min (range: 100-300 min). At the end of their follow-up each of the replanted incisors demonstrated radiographic evidence of replacement root resorption and clinical evidence of ankylosis. None of the replanted teeth were affected by inflammatory root resorption and there was no evidence of infection. When compared with the control samples from Barrett and Kenny (Endod Dent Traumatol 1997;15:269-72.) and Andersson et al. (Endod Dent Traumatol 1989;5:38-47.) this sample treated with the Emdogain protocol demonstrated significantly less root resorption than either of the control samples (anova, P Emdogain protocol did not produce periodontal regeneration, it did eliminate inflammatory resorption and infection and led to significantly less root resorption compared with the two historical controls.

  8. Nonsurgical Clinical Management of Periapical Lesions Using Calcium Hydroxide-Iodoform-Silicon-Oil Paste

    Directory of Open Access Journals (Sweden)

    Qusai Al Khasawnah

    2018-01-01

    Full Text Available Background. The study aim is to avoid tooth extraction by nonsurgical treatment of periapical lesion. It assesses healing progress in response to calcium hydroxide-iodoform-silicon oil paste (CHISP. Numeric Pain Rating Scale was used to validate the approach. Furthermore, CHISP was used to treat cystic lesions secondary to posttraumatic avulsion of permanent teeth. Materials and Methods. Over 200 patients with radicular cysts were treated with CHISP through the root canal. Radiographs were used to verify lesion size and position, ensure correct delivery to the site, and monitor the progress of bone healing in the lesion area. Ten males and 10 females were randomly selected for statistical assessment. Results. No severe pain, complications, or failure in cyst healing was reported. Complete healing was achieved in an average of 75 days. Furthermore, healing of radicular cyst secondary to posttraumatic tooth avulsion was successful. Conclusion. CHISP indicated an antiseptic effect, which enhanced and shortened healing time of periapical lesions. The less invasive procedure avoids tooth extraction and reduces bone resorption. Cyst management with CHISP can remedy failed root canal treatments. The results show a bone regenerative capacity of CHISP suggested in first rapid phase and a second slow phase.

  9. Predicting the planform configuration of the braided Toklat River, AK with a suite of rule-based models

    Science.gov (United States)

    Podolak, Charles J.

    2013-01-01

    An ensemble of rule-based models was constructed to assess possible future braided river planform configurations for the Toklat River in Denali National Park and Preserve, Alaska. This approach combined an analysis of large-scale influences on stability with several reduced-complexity models to produce the predictions at a practical level for managers concerned about the persistence of bank erosion while acknowledging the great uncertainty in any landscape prediction. First, a model of confluence angles reproduced observed angles of a major confluence, but showed limited susceptibility to a major rearrangement of the channel planform downstream. Second, a probabilistic map of channel locations was created with a two-parameter channel avulsion model. The predicted channel belt location was concentrated in the same area as the current channel belt. Finally, a suite of valley-scale channel and braid plain characteristics were extracted from a light detection and ranging (LiDAR)-derived surface. The characteristics demonstrated large-scale stabilizing topographic influences on channel planform. The combination of independent analyses increased confidence in the conclusion that the Toklat River braided planform is a dynamically stable system due to large and persistent valley-scale influences, and that a range of avulsive perturbations are likely to result in a relatively unchanged planform configuration in the short term.

  10. Arthroscopic Treatment of a Displaced Nonunion of the Anterior Inferior Iliac Spine Causing Extra-articular Impingement.

    Science.gov (United States)

    Shibahara, Motoi; Ohnishi, Yasuo; Honda, Eisaburo; Matsuda, Dean K; Uchida, Soshi

    2017-07-01

    This report describes a case of nonunion of an anterior inferior iliac spine (AIIS) apophyseal avulsion fracture with resultant subspine impingement combined with symptomatic femoroacetabular impingement (FAI). A 16-year-old male soccer player presented with a 6-month history of right groin pain exacerbated by kicking and running. The patient was diagnosed with a displaced nonunion of the AIIS apophysis avulsion fracture causing secondary extra-articular impingement beyond cam-type FAI by physical examination and radiological findings. The authors performed arthroscopic AIIS decompression, with concurrent FAI correction and labral repair and capsular closure. At 4 months after surgery, a radiograph and a computed tomography scan showed complete bony union of the AIIS apophyseal nonunion. Modified Harris Hip Sore and Nonarthritic Hip Score improved from 74.8 and 61, respectively, to 100 for both at final follow-up. The effectiveness of arthroscopic decompression of the AIIS as part of a comprehensive minimally invasive surgery including FAI correction and labral repair resulted in complete union of the AIIS and pain-free return to sport and bony union. [Orthopedics. 2017; 40(4):e725-e728.]. Copyright 2017, SLACK Incorporated.

  11. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    Science.gov (United States)

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.

  12. Traumatic cervical root injury: Diagnostic value of MR imaging

    International Nuclear Information System (INIS)

    Lee, Seon Kyu; Chang, Kee Hyun; Han, Moon Hee; Kim, Ho Chul; Kim, Jea Seung; Cha, Sang Hoon

    1993-01-01

    Although superior soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelography has been the imaging modality of choice in evaluation cervical root injury. We assessed the role of MRI and compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR imagings of cervical root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patients). MR findings were compared with myelography and surgical results. In 29 roots (8 patients), which were confirmed by myelography or exploration, the MR findings were focal extradural CSF collections (pseudomeningocele) in 21/29 (72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickening of dura in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to T1-weighted and protein-density- weighted images for delineation root avulsion. The sensitivity and specificity of MRI were 72.7% and 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of MRI and myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the modality of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensitivity. MRI, however, may obviate the myelography with some technical refinements

  13. Survival of Dental Pulp Stem Cells: The effect of Soymilk and Milk

    Directory of Open Access Journals (Sweden)

    Fatemeh Sholehvar

    2015-11-01

    Full Text Available Background & Objectives: Dental pulp stem cells (DPSCs are alternate source of mesenchymal stem cells. Subsequent to tooth avulsion and fracture, DPSCs can play a prominent role in tissue regeneration. This study was conducted to evaluate the effect of soymilk and milk on survival of dental pulp stem cells. Materials & Methods: DPSCs were isolated from 16 freshly extracted incisors of 5 rabbits. The 3rd passage was seeded in 24 well plates, and after 3 days, soymilk, cow milk, HBSS, and distilled water were replaced with culture media. After 45 minutes, 1.5, 3, and 6 hours, the viability of DPSCs were investigated. Mesenchymal nature of stem cells was investigated by RT-PCR. The cell viability was determined by Trypan blue exclusion. Karyotyping was done to evaluate the cytogenetic stability of cells.  Results: The viability of DPSCs in all media were significantly more than distilled water at all intervals. After 6 h, the viability of DPSCs in soymilk, cow milk, and HBSS were 100,000±0.00, 100,000±0.00, and 74.74±5.70, respectively. After 6 h, both soymilk and cow milk maintained cells significantly better than HBSS. Conclusion: Like cow milk, soymilk is a suitable alternative transfer media for avulsed and broken teeth that can increase the survival of DPSCs.   

  14. Systemic Administration of Propentofylline, Ibudilast, and (+)-Naltrexone Each Reverses Mechanical Allodynia in a Novel Rat Model of Central Neuropathic Pain

    Science.gov (United States)

    Ellis, Amanda; Wieseler, Julie; Favret, Jacob; Johnson, Kirk W.; Rice, Kenner C.; Maier, Steven F.; Falci, Scott; Watkins, Linda R.

    2014-01-01

    Central neuropathic pain (CNP) is a debilitating consequence of central nervous system (CNS) damage for which current treatments are ineffective. To explore mechanisms underlying CNP, we developed a rat model involving T13/L1 dorsal root avulsion. The resultant dorsal horn damage creates bilateral below-level (L4-6) mechanical allodynia. This allodynia, termed spinal neuropathic avulsion pain (SNAP), occurs in the absence of confounding paralysis. To characterize this model, we undertook a series of studies aimed at defining whether SNAP could be reversed by any of 3 putative glial activation inhibitors, each with distinct mechanisms of action. Indeed, the phosphodiesterase inhibitor propentofylline, the macrophage migration inhibitory factor (MIF) inhibitor ibudilast, and the toll-like receptor 4 (TLR4) antagonist (+)-naltrexone each reversed below-level allodynia bilaterally. Strikingly, none of these impacted SNAP upon first administration but required 1–2 wk of daily administration before pain reversal was obtained. Given reversal of CNP by each of these glial modulatory agents, these results suggest that glia contribute to the maintenance of such pain and enduring release of MIF and endogenous agonists of TLR4 is important for sustaining CNP. The markedly delayed efficacy of all 3 glial modulatory drugs may prove instructive for interpretation of apparent drug failures after shorter dosing regimens. PMID:24412802

  15. Two Extension Block Kirschner Wires’ Technique for Bony Mallet Thumb

    Directory of Open Access Journals (Sweden)

    Yutaka Mifune

    2016-01-01

    Full Text Available Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires’ technique under digital block anesthesia. At 4 months postoperatively, the patient had achieved excellent results according to Crawford’s evaluation criteria and had no difficulties in working or playing basketball. Various conservative and operative treatment strategies have been reported for management of mallet thumb. We chose the two extension block Kirschner wires’ technique to minimize invasion of the extensor mechanism and nail bed and to stabilize the large fracture fragment.

  16. The POLPSA lesion: MR imaging findings with arthroscopic correlation in patients with posterior instability

    International Nuclear Information System (INIS)

    Yu, Joseph S.; Ashman, Carol J.; Jones, Grant

    2002-01-01

    Objective. To evaluate the features of the posterior labrocapsular periosteal sleeve avulsion (POLPSA) lesion on MR imaging in athletes with posterior shoulder instability.Design and patients. Six male athletes (age range 19-43 years) with avulsion of the posterior glenoid periosteum were identified on MR imaging. There were four football players, one wrestler, and one competitive weightlifter. The weightlifter had a bilateral condition so that seven shoulders were evaluated. MR imaging was performed with a 1.5 T magnet utilizing conventional and fat-saturated fast spin-echo coronal oblique and sagittal oblique sequences and a 3D-GRE transaxial sequence. Surgical correlation was available in all shoulders.Results. All patients presented with pain and a joint effusion. The size of the periosteal sleeve and redundant joint recess was variable. Fibrous proliferation was noted arthroscopically in four shoulders beneath the sleeve. Although the posterior labrum was detached in all studies, only one labrum had a tear while two showed marked degeneration.Conclusion. The POLPSA lesion is an abnormality that can be associated with posterior instability. It differs from a reverse Bankart lesion because the periosteum, although detached, remains intact with the posterior capsule and detached posterior labrum. This lesion may represent an acute form of a Bennett lesion. (orig.)

  17. Differential expression of the capsaicin receptor TRPV1 and related novel receptors TRPV3, TRPV4 and TRPM8 in normal human tissues and changes in traumatic and diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Bountra Chas

    2007-05-01

    Full Text Available Abstract Background Transient receptor potential (TRP receptors expressed by primary sensory neurons mediate thermosensitivity, and may play a role in sensory pathophysiology. We previously reported that human dorsal root ganglion (DRG sensory neurons co-expressed TRPV1 and TRPV3, and that these were increased in injured human DRG. Related receptors TRPV4, activated by warmth and eicosanoids, and TRPM8, activated by cool and menthol, have been characterised in pre-clinical models. However, the role of TRPs in common clinical sensory neuropathies needs to be established. Methods We have studied TRPV1, TRPV3, TRPV4, and TRPM8 in nerves (n = 14 and skin from patients with nerve injury, avulsed dorsal root ganglia (DRG (n = 11, injured spinal nerve roots (n = 9, diabetic neuropathy skin (n = 8, non-diabetic neuropathic nerve biopsies (n = 6, their respective control tissues, and human post mortem spinal cord, using immunohistological methods. Results TRPV1 and TRPV3 were significantly increased in injured brachial plexus nerves, and TRPV1 in hypersensitive skin after nerve repair, whilst TRPV4 was unchanged. TRPM8 was detected in a few medium diameter DRG neurons, and was unchanged in DRG after avulsion injury, but was reduced in axons and myelin in injured nerves. In diabetic neuropathy skin, TRPV1 expressing sub- and intra-epidermal fibres were decreased, as was expression in surviving fibres. TRPV1 was also decreased in non-diabetic neuropathic nerves. Immunoreactivity for TRPV3 was detected in basal keratinocytes, with a significant decrease of TRPV3 in diabetic skin. TRPV1-immunoreactive nerves were present in injured dorsal spinal roots and dorsal horn of control spinal cord, but not in ventral roots, while TRPV3 and TRPV4 were detected in spinal cord motor neurons. Conclusion The accumulation of TRPV1 and TRPV3 in peripheral nerves after injury, in spared axons, matches our previously reported changes in avulsed DRG. Reduction of TRPV1 levels

  18. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Beumer, Annechien; Moonen, Adrianus F.C.M. [Amphia Hospital, Department of Orthopaedics, Breda (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Biostatistics, Rotterdam (Netherlands)

    2012-02-15

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement ({kappa}) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes ({kappa} 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique

  19. Histopathological evaluation of the effects of variable extraoral dry times and enamel matrix proteins (enamel matrix derivatives) application on replanted dogs' teeth.

    Science.gov (United States)

    Barbizam, Joao V B; Massarwa, Rasha; da Silva, Lea Assed Bezerra; da Silva, Raquel Assed Bezerra; Nelson-Filho, Paulo; Consolaro, Alberto; Cohenca, Nestor

    2015-02-01

    The extra-alveolar dry period and storage medium in which the tooth was kept prior to replantation remain the critical factors affecting the survival and regeneration of the damaged periodontium. When the replantation is delayed, replacement root resorption is the most common complication following replantation of an avulsed tooth. The aim of this histological study was to evaluate the periodontal healing of replanted dogs' teeth after 20 min (short) and 60 min (long) extraoral dry time with and without the application of enamel matrix proteins. Eighty mature premolar roots (40 teeth) maxillary and mandibular premolars were extracted, the root canals were accessed, instrumented, and filled using a lateral condensation technique, and the access cavity was restored with amalgam. Each root was randomly assigned to one of experimental groups: Groups I and II: Roots were replanted after an extraoral dry time of 20 min. In group II, Emdogain(®) (Biora, Malmo, Sweden) was applied directly to the external root surface with complete coverage. Groups III and IV: Roots were replanted after an extraoral dry time of 60 min. In group IV, Emdogain(®) was applied to the whole external root surface before replantation. Roots that replanted within a total extraoral dry time of 10 min were used as negative controls, while those replanted after 90 min of extraoral dry time were assigned as positive controls. After 4 months, the dogs were euthanized, and the maxillary and mandibular processes were processed for histology and microscopically evaluated. Statistical analysis showed no significant differences (P = 0.1075) among the experimental groups. The results of this study show that 20 min of extraoral dry time is as detrimental to the PDL cells as 60 or 90 min of extraoral dry time, with avulsed dogs' teeth, even when replanted with an inductive material such as EMD. This study provides strong evidence in relation to the threshold of the extraoral dry time of avulsed teeth

  20. Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury

    Energy Technology Data Exchange (ETDEWEB)

    Medina, L.S. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Miami Children' s Hospital, Department of Radiology, Miami, FL (United States); Yaylali, Ilker [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); Zurakowski, David [Harvard Medical School, Boston Children' s Hospital, Boston, MA (United States); Ruiz, Jennifer; Altman, Nolan R. [Miami Children' s Hospital, Division of Neuroradiology, Department of Radiology, Brain Institute, Health Outcomes, Policy, and Economics (HOPE) Center, Miami, FL (United States); Grossman, John A.I. [Miami Children' s Hospital, Brachial Plexus and Peripheral Nerve Surgery Program, Miami, FL (United States); New York University, Hospital for Joint Disease, New York, NY (United States)

    2006-12-15

    Detailed evaluation of a brachial plexus birth injury is important for treatment planning. To determine the diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury. Included in the study were 31 children with perinatal brachial plexus injury who underwent surgical intervention. All patients had cervical and brachial plexus MRI. The standard of reference was the combination of intraoperative (1) surgical evaluation and (2) electrophysiological studies (motor evoked potentials, MEP, and somatosensory evoked potentials, SSEP), and (3) the evaluation of histopathological neuronal loss. MRI findings of cord lesion, pseudomeningocele, and post-traumatic neuroma were correlated with the standard of reference. Diagnostic performance characteristics including sensitivity and specificity were determined. From June 2001 to March 2004, 31 children (mean age 7.3 months, standard deviation 1.6 months, range 4.8-12.1 months; 19 male, 12 female) with a brachial plexus birth injury who underwent surgical intervention were enrolled. Sensitivity and specificity of an MRI finding of post-traumatic neuroma were 97% (30/31) and 100% (31/31), respectively, using the contralateral normal brachial plexus as the control. However, MRI could not determine the exact anatomic area (i.e. trunk or division) of the post-traumatic brachial plexus neuroma injury. Sensitivity and specificity for an MRI finding of pseudomeningocele in determining exiting nerve injury were 50% and 100%, respectively, using MEP, and 44% and 80%, respectively, using SSEP as the standard of reference. MRI in infants could not image well the exiting nerve roots to determine consistently the presence or absence of definite avulsion. In children younger than 18 months with brachial plexus injury, the MRI finding of pseudomeningocele has a low sensitivity and a high specificity for nerve root avulsion. MRI and MR myelography cannot image well the exiting nerve roots to determine

  1. Historical perspectives on channel pattern in the Clark Fork River, Montana and implications for post-dam removal restoration

    Science.gov (United States)

    Woelfle-Erskine, C. A.; Wilcox, A. C.

    2009-12-01

    Active restoration approaches such as channel reconstruction have moved beyond the realm of small streams and are being applied to larger rivers. Uncertainties arising from limited knowledge, fluvial and ecosystem variability, and contaminants are especially significant in restoration of large rivers, where project costs and the social, infrastructural, and ecological costs of failure are high. We use the case of Milltown Dam removal on the Clark Fork River, Montana and subsequent channel reconstruction in the former reservoir to examine the use of historical research and uncertainty analysis in river restoration. At a cost of approximately $120 million, the Milltown Dam removal involves the mechanical removal of approximately 2 million cubic meters of sediments contaminated by upstream mining, followed by restoration of the former reservoir reach in which a single-thread meandering channel is being constructed. Historical maps, surveys, photographs, and accounts suggest a conceptual model of a multi-thread, anastomosing river in the reach targeted for channel reconstruction, upstream of the confluence of the Clark Fork and Blackfoot Rivers. We supplemented historical research with analysis of aerial photographs, topographic data, and USGS stage-discharge measurements in a lotic but reservoir-influenced reach of the Clark Fork River within our study area to estimate avulsion frequency (0.8 avulsions/year over a 70-year period) and average rates of lateral migration and aggradation. These were used to calculate the mobility number, a dimensionless relationship between channel filling and lateral migration timescales that can be used to predict whether a river’s planform is single or multi-threaded. The mobility number within our study reach ranged from 0.6 (multi-thread channel) to 1.7 (transitional channel). We predict that, in the absence of active channel reconstruction, the post-dam channel pattern would evolve to one that alternates between single and multi

  2. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    International Nuclear Information System (INIS)

    Hermans, John J.; Ginai, Abida Z.; Beumer, Annechien; Moonen, Adrianus F.C.M.; Hop, Wim C.J.

    2012-01-01

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement (κ) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes (κ 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique MRI plane were

  3. Megafans of the Northern Kalahari Basin

    Science.gov (United States)

    Wilkinson, M. J.; Miller, R. McG.; Eckardt, F.; Kreslavsky, M. A.

    2016-01-01

    We identify eleven megafans (partial cones of fluvial sediment, >80 km radius) in the northern Kalahari Basin, using several criteria based on VIS and IR remotely sensed data and SRTM-based surface morphology reconstructions. Two other features meet fewer criteria of the form which we class as possible megafans. The northern Kalahari megafans are located in a 1700 km arc around the southern and eastern flanks of the Angola's Bié Plateau, from northern Namibia through northwest Botswana to western Zambia. Three lie in the Owambo subbasin centered on the Etosha Pan, three in the relatively small Okavango rift depression, and five in the Upper Zambezi basin. The population includes the well-known Okavango megafan (150 km), Namibia's Cubango megafan, the largest megafan in the region (350 km long), and the largest nested group (the five major contiguous megafans on the west slopes of the upper Zambezi Valley). We use new, SRTM-based topographic roughness data to discriminate various depositional surfaces within the flat N. Kalahari landscapes. We introduce the concepts of divide megafans, derived megafans, and fan-margin rivers. Conclusions. (i) Eleven megafan cones total an area of 190,000 sq km. (ii) Different controls on megafan size operate in the three component basins: in the Okavango rift structural controls become the prime constraint on megafan length by controlling basin dimensions. Megafans in the other les constricted basins appear to conform to classic relationships fan area, slope, and feeder-basin area. (iii) Active fans occupy the Okavango rift depression with one in the Owambo basin. The rest of the population are relict but recently active fans (surfaces are relict with respect to activity by the feeder river). (iv) Avulsive behavior of the formative river-axiomatic for the evolution of megafans-has resulted in repeated rearrangements of regional drainage, with likely effects in the study area well back into the Neogene. Divide megafans comprise the

  4. Treatment of inflammatory root resorption using mineral trioxide aggregate: A case report

    Directory of Open Access Journals (Sweden)

    Roohollah Sharifi

    2014-01-01

    Full Text Available Introduction: This report presents a case to show inflammatory root resorption can be successfully treated by using mineral trioxide aggregate (MTA. Case Report: A central maxillary incisor of an eight-year-old boy was avulsed associated with crown fracture secondary to a fall. The tooth was stored in ice. Early attempts at pulpal revascularization of the replanted tooth proved unsuccessful. To stop inflammatory root resorption, long-term calcium hydroxide therapy was employed. Despite the use of calcium hydroxide, resorption continued. Subsequent to the failure of that treatment, MTA was used as a root canal filling material. At 20-month follow-up, the tooth was asymptomatic and had clinical signs of ankylosis but external inflammatory root resorption had stopped. Discussion: MTA may be considered as an alternative option for the treatment of continuous external inflammatory root resorption.

  5. Tips for splinting traumatised teeth

    LENUS (Irish Health Repository)

    Leith, Rona

    2017-11-01

    A splint is required when teeth are mobile or need to be repositioned following a traumatic injury. The aim of splinting is to stabilise the injured tooth and maintain its position throughout the splinting period, improve function and provide comfort. Current best practice guidelines from the International Association for Dental Traumatology (IADT) recommend splinting for luxated, avulsed, root fractured and traumatically loosened permanent teeth.1,2 Splinting of primary teeth is usually not feasible. In general, the prognosis of a traumatised tooth is determined by the type of injury rather than the type of splint.3 However, correct splinting is important to maximise healing of the soft and hard tissues, and prevent further injury.1

  6. Tips for splinting traumatised teeth

    LENUS (Irish Health Repository)

    Leith, Rona

    2017-10-01

    A splint is required when teeth are mobile or need to be repositioned following a traumatic injury. The aim of splinting is to stabilise the injured tooth and maintain its position throughout the splinting period, improve function and provide comfort. Current best practice guidelines from the International Association for Dental Traumatology (IADT) recommend splinting for luxated, avulsed, root fractured and traumatically loosened permanent teeth.1,2 Splinting of primary teeth is usually not feasible. In general, the prognosis of a traumatised tooth is determined by the type of injury rather than the type of splint.3 However, correct splinting is important to maximise healing of the soft and hard tissues, and prevent further injury.1-6

  7. Sonography and MRI of latissimus dorsi strain injury in four elite athletes

    Energy Technology Data Exchange (ETDEWEB)

    Pedret, Carles [Unitat Medicina Esportiva Consorci Sanitari del Garraf, Barcelona (Spain); Centre Diagnostic per Imatge de Tarragona, Tarragona (Spain); Balius, Ramon [Generalitat of Catalonia, Sports Catalan Council, Catalonia (Spain); Idoate, Fernando [Clinica San Miguel, Department of Radiology, Pamplona (Spain)

    2011-05-15

    The objective of this study was to describe the MR and sonographic findings in latissimus dorsi (LD) muscle strain in athletes, and to review the most common injuries described in the literature, most of which are humeral avulsions. Four injuries and two reinjuries of the myotendinous junction of the LD were followed from the day of injury until the return to play. Sonography (US) and MR imaging were performed in each case to confirm the diagnosis and to monitor the healing process. All cases had acute and isolated pain in the back of the shoulder while performing an eccentric maneuver of the arm and the shoulder. US and MR images demonstrated that injuries were located in the middle and cranial portion of the latissimus dorsi surrounding the myotendinous junction. After rehabilitation, all players played at high level again. Isolated lesions of LD are very rare. They can be demonstrated by US and MR images. (orig.)

  8. Tendon rupture as an adverse effect of rasagiline.

    Science.gov (United States)

    Lefaucheur, Romain; Fetter, Damien; Gaillon, Gaëlle; Borden, Alaina; Maltête, David

    2014-01-01

    A 66-year-old woman with advanced Parkinson disease (PD) was referred to our center for an adjustment of her antiparkinsonian medication. To reduce daily off-time, we introduced rasagiline 1 mg/d. Three days after starting this new treatment, she presented with intense arthralgia that symmetrically affected the shoulders, hands, and hips without myalgia. Ten days later, while walking, she experienced acute pain on the inner side of her right thigh, with the absence of any trauma. Findings of ultrasonography confirming the diagnosis of partial avulsion of the right harmstrings. Rasagiline was stopped immediately, and the arthralgia disappeared within 48 hours and did not recur. To our knowledge, this is the first reported case of a spontaneous tendon rupture possibly caused by rasagiline. Our observation emphasizes that, although often well tolerated, rasagiline may cause muscle and joint complications that could increase disability in patients with PD.

  9. Traumatic sacral pseudomeningocele with spina bifida occulta.

    Science.gov (United States)

    Banno, Tomohiro; Ohishi, Tsuyoshi; Suzuki, Daisuke; Honda, Yosuke; Kobayashi, Sho; Matsuyama, Yukihiro

    2012-01-01

    Pseudomeningocele arises after spinal fracture and nerve root avulsion or after complications of spine surgery. However, traumatic pseudomeningocele with spina bifida occulta is rare. In this report, a traumatic pseudomeningocele in a patient with spina bifida occulta that required surgical treatment is documented. This 37-year-old man presented to the authors' hospital with headache and a fluctuant mass in the center of his buttocks. A CT scan with myelography and MR imaging of the sacral region revealed a large subcutaneous area of fluid retention communicating with the intradural space through a defect of the S-2 lamina. Because 3 months of conservative treatment was unsuccessful, a free fat graft was placed with fibrin glue to seal the closure of the defect, followed by 1 week of CSF drainage. This is the first report on traumatic pseudomeningocele with spina bifida occulta successfully treated in this manner.

  10. The Paleoecology of Vegetation on Pennsylvanian Basin Margins

    DEFF Research Database (Denmark)

    Bashforth, Arden Roy

    deposits are capped by log accumulations, many of which are overlain by abandoned channel mudstones.  It is proposed that flood sediment buildup and log jam development prompted avulsion and channel abandonment, thus providing some of the earliest evidence for the effects of large woody debris on fluvial...... settings.  Such landscapes were characterized by steep gradients and high-energy regimes due to their proximity to uplands, and the prevalence of coarse-grained sediment enhanced soil drainage and hindered peat accumulation. To help resolve the full spectrum of vegetation cover in tropical Euramerica......, megafloral assemblages were documented from strata that accumulated on disturbance-prone fluvial tracts within or adjacent to Pennsylvanian mountain belts.  Taphonomic indicators and multivariate analyses reveal that riparian vegetation comprised a collage of monospecific to low-diversity communities...

  11. Contradictions in the treatment of traumatic dental injuries and ways to proceed in dental trauma research

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Andreasen, Francis

    2010-01-01

    that short-term splinting with a semi-rigid splint appears to optimize fracture healing. In tooth avulsion with subsequent replantation, cleansing of the root surface for contamination and systemic antibiotics has been considered essential for pulp and periodontal healing. These treatment concepts have been...... dentition. Accepted treatment philosophy is dentin coverage (dental liner and/or dentin bonded restoration) to prevent bacteria penetration into the pulp. Today there is, apart from deep proximal fractures, no evidence that this treatment is necessary to protect the pulp. In case of luxation injuries......, the accepted treatment principles appear to be anatomically correct repositioning, stabilization with a splint and sometimes antibiotic coverage. In clinical studies, these principles could not be proven to optimize either periodontal or pulpal healing, the explanation possibly being that both reposition...

  12. [Posterior radiocarpal fracture-dislocation (eight case reports)].

    Science.gov (United States)

    Lahtaoui, A; el Bardouni, A; Ismael, F; Jellali, T; Bahri, A; el Yaacoubi, M; el Manouar, M

    2002-07-01

    The Authors report a retrospective series of eight cases of posterior radiocarpal fracture-dislocation. Average age of patients was 32 years (23/54), with a male predominance (7 men and a woman). Injury was often due to a fall on the hand in extension from an elevated place (5/8). The wrist in back of fork is the characteristic deformity. Diagnosis was confirmed by AP and lateral views of the wrist. Radial styloïd fracture, posterior dislocation of the carpus and posterior rim avulsion were constant. Ulnar styloïd fracture was present in half of the cases and distal radio-ulnar dislocation in two cases. Four patients were treated conservatively and four surgically. Whatever the treatment choice, results are satisfactory at a short follow-up. The two patients presenting a distal radio-ulnar dislocation resulted in a bad result.

  13. Editorial Commentary: Renaissance of Primary Anterior Cruciate Ligament Repair: Is History Repeating Itself?

    Science.gov (United States)

    Hohmann, Erik

    2016-12-01

    In a comparative Level III study, Achtnich et al. compared suture anchor repair of acute proximal anterior cruciate ligament avulsion tears with single-bundle anterior cruciate ligament reconstruction with the quadrupled semitendinosus tendon. Short-term follow-up at a mean of 28 months showed that the between-group differences were not different. These results are encouraging but not different from other published series 25+ years ago. Only time will tell whether the long-term outcomes are identical and whether these techniques will also die a slow death. Hopefully history is not repeating itself. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. Emergency Department Visits for Hand and Finger Injuries Associated with the Use of Log Splitters.

    Science.gov (United States)

    Hammig, Bart; Jones, Ches

    2017-04-26

    The purpose of this study was to examine patients treated in an emergency department (ED) for injuries related to the use of log splitters. Data were obtained from the National Electronic Injury Surveillance System for the years 2011-2014. National estimates of ED visits for injuries associated with the use of log splitters were obtained, and descriptive epidemiological characteristics are presented. An estimated 37,000 ED visits for injuries related to the use of log splitters occurred during the study period. The majority of injuries occurred to the hand, with lacerations, fractures/avulsions, and amputations being the most common. The findings indicate that injuries from log splitters constitute a serious public health problem. Efforts to reduce injuries are discussed in accordance with the inherent challenges of detailing the circumstances surrounding these injuries. Copyright© by the American Society of Agricultural Engineers.

  15. Effects of non-surgical factors on digital replantation survival rate: a meta-analysis.

    Science.gov (United States)

    Ma, Z; Guo, F; Qi, J; Xiang, W; Zhang, J

    2016-02-01

    This study aimed to evaluate the risk factors affecting survival rate of digital replantation by a meta-analysis. A computer retrieval of MEDLINE, OVID, EMBASE, and CNKI databases was conducted to identify citations for digital replantation with digit or finger or thumb or digital or fingertip and replantation as keywords. RevMan 5.2 software was used to calculate the pooled odds ratios. In total, there were 4678 amputated digits in 2641 patients. Gender and ischemia time had no significant influence on the survival rate of amputation replantation (P > 0.05). Age, injured hand, injury type, zone, and the method of preservation the amputated digit significantly influence the survival rate of digital replantation (P < 0.05). Children, right hand, crush, or avulsion and little finger are the risk factors that adversely affect the outcome. Level 5*. © The Author(s) 2015.

  16. Fingertip replantations: importance of venous anastomosis and the clinical results.

    Science.gov (United States)

    Hasuo, Takaaki; Nishi, Genzaburo; Tsuchiya, Daiji; Otsuka, Takanobu

    2009-01-01

    Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

  17. Contradictions in the treatment of traumatic dental injuries and ways to proceed in dental trauma research

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva Fejerskov; Andreasen, Francis

    2010-01-01

    Almost all treatment procedures used for dental traumas are still today not evidence-based, a fact, which makes it difficult to analyse the long-term outcome of healing and its relationship to treatment. Crown fractures with extensive dentin exposure represent a dominant injury in the permanent...... dentition. Accepted treatment philosophy is dentin coverage (dental liner and/or dentin bonded restoration) to prevent bacteria penetration into the pulp. Today there is, apart from deep proximal fractures, no evidence that this treatment is necessary to protect the pulp. In case of luxation injuries...... that short-term splinting with a semi-rigid splint appears to optimize fracture healing. In tooth avulsion with subsequent replantation, cleansing of the root surface for contamination and systemic antibiotics has been considered essential for pulp and periodontal healing. These treatment concepts have been...

  18. Hand reconstruction using heterotopic replantation of amputated index and little fingers

    Directory of Open Access Journals (Sweden)

    ZHANG Gong-lin

    2012-02-01

    Full Text Available 【Abstract】In cases of severe segmental injury across the hand and wrist, but one or other fingers are still in peak condition, the fingers can be selected for replantation at the forearm bones to restore pinch function. Here we reported an unusual case with a severe crush-avulsion amputated injury to the right hand caused by a machine accident. We conducted hand reconstruction using heterotopic replantation of the amputated index and little fingers. During 19 months follow-up, the bone union healed well with satisfactory outcome. The interphalangeal and metacarpophalangeal joint of the fingers after the heterotopic replantation had a good holding activity. This is a worthwhile procedure and the patient is satisfied with the result. The major disadvantage of this method is the poor appearance of the reconstructed fingers. Key words: Amputation traumatic; Hand injuries; Replantation; Transplantation heterotopic

  19. Difficulty in Clinical Evaluation of Radial Nerve Injury due to Multiple Trauma to the Humerus, Wrist, and Hand

    Directory of Open Access Journals (Sweden)

    Balik Mehmet Sabri

    2014-01-01

    Full Text Available Radial nerve damage is frequently encountered in humeral fractures. The radial nerve is primarily damaged when the humerus gets fractured, while secondary damage maybe due to post-traumatic manipulations and surgical exploration. High impact traumatic nerve injury, serious neuropathic pain, lack of response to therapeutic interventions, and indifference to the Tinel test are indications for surgical intervention. Since most humeral fracture-induced low impact radial nerve injuries resolve spontaneously, conservative therapy is preferred. We present a patient with humeral fracture-associated radial nerve injury, accompanied with digital amputation and flexor tendon avulsion on the same arm. These injuries required immediate surgery, thus rendering the clinical evaluation of the radial nerve impossible. We would like to highlight and discuss the inherent difficulties associated with multiple trauma of the upper arm.

  20. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

    International Nuclear Information System (INIS)

    Beltran, Javier; Jbara, Marlena; Maimon, Ron; Matityahu, Amir; Hwang, Ki; Padron, Mario; Mota, Javier; Beltran, Luis; Sundaram, Murali

    2003-01-01

    To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples. The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis. (orig.)