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Sample records for avulsions

  1. Chronic avulsive injuries of childhood

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    Donnelly, L.F.; Helms, C.A. [Dept. of Radiology, Duke Univ. Medical Center, Durham, NC (United States); Bisset, G.S. III [Dept. of Radiology, Duke Univ. Medical Center, Durham, NC (United States)]|[Department of Pediatrics, Duke University Medical Center, Durham, NC (United States); Squire, D.L. [Department of Pediatrics, Duke University Medical Center, Durham, NC (United States)

    1999-03-01

    Children and adolescents are prone to avulsive injuries related to a combination of their propensity for great strength, ability to sustain extreme levels of activity, and immature growing apophyses. Appropriate interpretation of imaging studies showing chronic avulsive injuries is essential so that the irregularity and periostitis that can be associated with chronic avulsions is not misinterpreted as probable malignancy. This article reviews the chronic avulsive injuries of childhood. (orig.) With 12 figs., 8 refs.

  2. Nonoperatively treated infraglenoid tubercle avulsion

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    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

  3. Delayed replantation of avulsed teeth

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    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.

  4. Iliotibial band avulsion fracture: a case report with differential diagnosis.

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    Fay, Kristin; Mannem, Rajeev; Baynes, Keith; Sarin, Dhruv; DuBois, Melissa

    2016-02-01

    Avulsion injuries of the knee are common sequelae of significant trauma given the number of ligamentous and tendinous insertions around the joint. Commonly discussed avulsion fractures of the lateral knee include the Segond fracture of the lateral tibial plateau and the arcuate complex avulsion fracture of the fibular styloid process. A less common avulsion fracture is the iliotibial (IT) band avulsion fracture involving the anterolateral corner of the tibia (Gerdy's tubercle). It is crucial to identify IT band avulsion fractures because of the frequent associated internal derangements of the knee. This case report describes the imaging of an acute IT band avulsion fracture and compares these findings with other lateral knee avulsion fractures.

  5. First-Aid Algorithms in Dental Avulsion

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    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…

  6. Replantation of ring avulsion amputations

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    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.

  7. Dental Trauma: An inside to Avulsion Teeth

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    Mendes PhD, Beatriz

    2015-01-01

    Several studies shows that a wide range from 3-16% of dentoalveolar traumatic injuries result in avulsion. The ideal treatment for avulsion would be the reimplantation of the tooth. Thus, it is recommended to replant the tooth as quickly as possible. However, immediate repositioning of teeth is not always possible, so the choice of a suitable storage medium for maintenance of Periodontal Ligament cell viability is of extreme importance for the success of replantation. At the present article a...

  8. Optic Nerve Avulsion after Blunt Trauma

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    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

  9. Traumatic avulsion of extraocular muscles: case reports

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    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.

  10. MRI of radiographically occult ischial apophyseal avulsions

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    Meyers, Arthur B. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Children' s Hospital of Wisconsin, Milwaukee, WI (United States); Laor, Tal; Zbojniewicz, Andrew M.; Anton, Christopher G. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States)

    2012-11-15

    Acute avulsions of unossified ischial apophyses in children may go undetected on radiography. Therapy includes rest and rehabilitation; however, substantial displacement may require surgery. Our purpose is to illustrate the utility of MRI in the detection of these radiographically occult injuries in skeletally immature children. This retrospective study of more than 5 years included children with ischial avulsions who were evaluated with both radiography and MRI within 3 weeks of acute injury. Initially, radiographs were reviewed to identify those children with unossified ischial apophyses. Subsequently, their MRI examinations were assessed for physeal disruption, bone/soft tissue edema, periosteal/perichondrial elevation and disruption. Initial and follow-up radiographs (if available) were reviewed. Patient age, symptoms and offending activity were determined from clinical records. Five children met inclusion criteria. All initial radiographs were normal. MRI showed: edema (n = 5), periosteal elevation (n = 4), periosteal/perichondrial disruption (n = 4), >5.5 mm displacement (n = 0). Follow-up radiographs in two children (2 and 2.5 months from MRI) showed osseous ischial irregularity. The apophyses remained unossified. Acute unossified ischial apophyseal avulsions in children may be radiographically undetected. In the setting of correlative clinical symptoms, MRI can be used to identify these injuries and to help direct appropriate therapy. (orig.)

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

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    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 midd

  12. Complex Perineal Trauma with Anorectal Avulsion

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    Adelina Maria Cruceru

    2016-01-01

    Full Text Available Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed. After 12 hours in the Intensive Care Unit, the abdominal ultrasonography revealed free peritoneal fluid. We decided emergency laparotomy, and massive hemoperitoneum due to intraperitoneal rupture of pelvic hematoma was confirmed. Pelvic packing controlled the ongoing diffuse bleeding. After 48 hours, the relaparotomy with packs removal and loop sigmoid colostomy was performed. The postoperative course was progressive favorable, with discharge after 70 days and colostomy closure after four months, with no long-term complications. Conclusions. Severe perineal injuries are associated with significant morbidity and mortality. Their management in high volume centers, with experience in colorectal and trauma surgery, allocating significant human and material resources, decreases the early mortality and long-term complications, offering the best quality of life for patients.

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

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    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.

  14. Avulsion cycles and their stratigraphic signature on an experimental backwater-controlled delta

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    Ganti, Vamsi; Chadwick, Austin J.; Hassenruck-Gudipati, Hima J.; Lamb, Michael P.

    2016-09-01

    River deltas grow in large part through repeated cycles of lobe construction and channel avulsion. Understanding avulsion cycles is important for coastal restoration and ecology, land management, and flood hazard mitigation. Emerging theories suggest that river avulsions on lowland deltas are controlled by backwater hydrodynamics; however, our knowledge of backwater-controlled avulsion cycles is limited. Here we present results from an experimental delta that evolved under persistent backwater hydrodynamics achieved through variable flood discharges, shallow bed slopes, and subcritical flows. The experimental avulsion cycles consisted of an initial phase of avulsion setup, an avulsion trigger, selection of a new flow path, and abandonment of the parent channel. Avulsions were triggered during the largest floods (78% of avulsions) after the channel was filled by a fraction (0.3 ± 0.13) of its characteristic flow depth at the avulsion site, which occurred in the upstream part of the backwater zone. The new flow path following avulsion was consistently one of the shortest paths to the shoreline, and channel abandonment occurred through temporal decline in water flow and sediment delivery to the parent channel. Experimental synthetic stratigraphy indicates that bed thicknesses were maximum at the avulsion sites, consistent with our morphologic measurements of avulsion setup and the idea that there is a record of avulsion locations and thresholds in sedimentary rocks. Finally, we discuss the implications of our findings within the context of sustainable management of deltas, their stratigraphic record, and predicting avulsions on deltas.

  15. Functional reconstruction following brachial plexus root avulsion

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    Guixin Sun; Cunyi Fan; Yudong Gu

    2007-01-01

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

  16. Multidisciplinary Treatment Options of Tooth Avulsion Considering Different Therapy Concepts

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    Kostka, Eckehard; Meissner, Simon; Finke, Christian H; Mandirola, Manlio; Preissner, Saskia

    2014-01-01

    Background: Avulsion of permanent front teeth is a rare accident, mostly affecting children between seven and nine years of age. Replanted and splinted, these teeth often develop inflammation, severe resorption or ankylosis affecting alveolar bone development and have to be extracted sooner or later. Objectives: The purpose of this study was to evaluate different therapy concepts to create a structured concept for the treatment of avulsions. Results: Based on existing therapy concepts, a concept for different initial conditions (dry time, age, growth, tooth, hard and soft tissues) was developed and is presented here. Conclusion: A great deal of research has been performed during recent years and guidelines for the management of avulsions have been published. With the help of this literature it is possible to identify the best treatment procedure for each tooth. Clinical Relevance: The prognosis of avulsed teeth can be improved by considering evidence-based therapy concepts. Resorption, ankylosis and tooth loss could be minimized. PMID:25352922

  17. DISTAL TRICEPS AVULSION: A CASE REPORT

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    Ramkumar Reddy

    2015-05-01

    Full Text Available Triceps rupture is an uncommon injury. Fracture of olecranon or a dislocation / fracture is most often common injury for similar mechanism of fall. It is commonly associated with anabolic steroid use, weight lifting, and direct laceration. Risk factors include local steroid injection, olecranon bursitis, and hyperparathyroidism. Distal triceps rupture is usually caused by a fall on an outstretched hand. Eccentric loading of a contracting triceps has been implicated. Initial diagnosis may be difficult because a palpable defect is not always present. Pain and swelling may limit the ability to evaluate strength and elbow range of motion. Although plain radiographs are helpful in ruling out other elbow pathology, MRI is used to confirm the diagnosis, classify the injury, and plan management. Incomplete tears with active elbow extension against resistance are managed non - surgically. Surgical repair is indicated in active persons with complete tears and for incomplete tears with concomitant loss of strength. Good to excellent results have been reported with surgical repair in triceps, even for chronic tears. BACKGROUND: Distal triceps tendon avulsions occur very infrequently, and the diagnosis is often missed when the injury is acute. The literature provides little guidance regarding treatment or the outcome of these injuries. The goal of this report was to report our experience with the diagnosis, timing and technique of surgical treatment, and outcome of treatment of distal triceps tendon rupture.

  18. Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance

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    Babak Sanei

    2010-05-01

    Full Text Available The knee is an intricate joint with numerous tendinous, ligamentous, and meniscal attachments, which make it particularly vulnerable to complex injuries after trauma. A variety of avulsion fractures of the knee can occur, including Segond and reverse Segond fractures; avulsions of the anterior and posterior cruciate ligaments; arcuate complex avulsion; iliotibial band avulsion; avulsions of the biceps femoris, semimembranous, and quadriceps tendons; Sinding-Larsen-Johansson syndrome; and Osgood- Schlatter disease. These fractures often have a subtle appearance at conventional radiography, which is typically the first imaging modality performed in these cases. Advanced imaging modalities, particularly magnetic resonance imaging, are helpful and can provide valuable additional information for adequately defining the extent of damage. The onus is on the radiologist to identify the pattern of injury and to understand the substantial underlying damage that it frequently represents. Conveying this information to the referring clinician is crucial and represents the first step toward additional evaluation and probable orthopedic referral. By recognizing the significance of these injuries at initial presentation, radiologists can facilitate appropriate patient work-up and prevent the chronic morbidity associated with delayed treatment.

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

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    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.

  20. Iliac Crest Avulsion Fracture in a Young Sprinter.

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    Casabianca, L; Rousseau, R; Loriaut, P; Massein, A; Mirouse, G; Gerometta, A; Khiami, F

    2015-01-01

    Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

  1. Iliac Crest Avulsion Fracture in a Young Sprinter

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    L. Casabianca

    2015-01-01

    Full Text Available Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

  2. Traumatic Cervical Nerve Root Avulsion with Pseudomeningocele Formation

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    Haider, Ali S; Watson, Ian T; Sulhan, Suraj; Arrey, Eliel N; Khan, Umair; Nguyen, Phu; Layton, Kennith F

    2017-01-01

    Cervical nerve root avulsion is a well-documented result of motor vehicle collision (MVC), especially when occurring at high velocities. These avulsions are commonly traction injuries of nerve roots that may be accompanied by a tear in the meninges through the vertebral foramina with associated collections of cerebrospinal fluid (CSF), thereby resulting in a pseudomeningocele. We present a case of a 19-year-old male who experienced an MVC and was brought to the emergency department (ED) with right arm paralysis and other injuries. A neurological examination demonstrated intact sensation but 0/5 muscle strength in the right upper extremity. A magnetic resonance imaging (MRI) of the spinal cord demonstrated massive epidural hematomas extending the length of the cervical spine caudally from C2. An MRI of the right brachial plexus showed C3-C7 anterior horn cell edema and associated traumatic nerve root avulsion with pseudomeningoceles on the right from C5-C8. The development of spinal cord hematoma with these injuries has rarely been documented in the literature and the multiple level avulsion described here with extensive hematoma is a rare clinical presentation. A literature review was conducted to determine the diagnostic requirements, treatment strategies, and complications of such an injury. Our patient received conservative treatment of the right brachial plexus injury and was transferred to an inpatient rehabilitation facility 13 days later.  PMID:28352498

  3. Displaced anterior cruciate ligament avulsion fractures: Arthroscopic staple fixation

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    S R Sundararajan

    2011-01-01

    Full Text Available Background: Anterior cruciate ligament (ACL avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic fixation. The aim of our study was to assess the clinical and radiological results of arthroscopic staple fixation in the management of ACL avulsion fractures. Materials and Methods: Twenty-two patients (17 males and 5 females who underwent arthroscopic staple fixation for displaced ACL avulsion fractures were analysed. The mean age was 32.2 years (15-55 years with a mean followup of 21 months (6-36 months. All patients were assessed clinically by calculating their Lysholm and International Knee Documentation Committee (IKDC scores and the radiological union was assessed in the followup radiographs. Results: The mean Lysholm score was 95.4(83-100 and the mean IKDC score was 91.1(77-100 at the final followup. In 20 patients anterior drawer′s test was negative at the end of final followup while two patients had grade I laxity. Associated knee injuries were found in seven cases. The final outcome was not greatly influenced by the presence of associated injuries when treated simultaneously. At final followup all the patients were able to return to their pre-injury occupation Conclusion: Arthroscopic staple fixation is a safe and reliable method for producing clinical and radiological outcome in displaced ACL avulsion fractures.

  4. DENTAL CARE FOR CHILDREN AFTER REPLANTATION OF AVULSED PERMANENT INCISORS

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    Rossitza Kabaktchieva

    2016-12-01

    Full Text Available The diagnosis avulsion of permanent tooth/teeth is an emergency situation which has special requirements in respect of proper storage of the avulsed tooth, the need of urgent medical/dental care, time past till replantation and splinting, the need for endodontic treatment and long term follow up period. Those clinical actions depend on three groups: parents/people who are with the child in the moment when trauma happens and give the first aid; dental specialist- surgeon who replants the tooth/teeth; dental specialist- endodontist who takes care of the endodontic treatment and the long period after treatment for follow up and observation of the replanted teeth. The aim of the paper is to present the dental postoperative care in a couple of cases of children with trauma and replanted avulsed permanent incisors. Material and methods: We present four clinical cases of children who get 6 permanent upper incisors replanted. Replantation is made by the oral surgeon. Treatment and observation after replantation are made by dental specialists of pediatric dentistry and conservative dentistry. All 4 cases get 3 years follow up period. Results: After replantation of 2 central incisors with complete root development (first clinical case the left one has developed a resorption of the root but the right one is in a stable condition. Replantation of 3 teeth with incomplete root development (second and third clinical cases where the patients refer to specialized surgical care less than 60 minutes after injury and store the teeth in different ways lead to different clinical results. In the case of avulsed upper right incisor (second case, it is stored in milk and we observe revascularization followed by partial root canal obliteration. The tooth is scheduled for endodontic treatment. In the case of upper central incisors, both kept dry till replantation in the alveolus filled up with substitute bone, we observe fast root resorption which going to lead to early

  5. Preconditioning crush increases the survival rate of motor neurons after spinal root avulsion

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    Lin Li; Yizhi Zuo; Jianwen He

    2014-01-01

    In a previous study, heat shock protein 27 was persistently upregulated in ventral motor neurons following nerve root avulsion or crush. Here, we examined whether the upregulation of heat shock protein 27 would increase the survival rate of motor neurons. Rats were divided into two groups:an avulsion-only group (avulsion of the L4 lumbar nerve root only) and a crush-avulsion group (the L4 lumbar nerve root was crushed 1 week prior to the avulsion). Immunofluores-cent staining revealed that the survival rate of motor neurons was significantly greater in the crush-avulsion group than in the avulsion-only group, and this difference remained for at least 5 weeks after avulsion. The higher neuronal survival rate may be explained by the upregulation of heat shock protein 27 expression in motor neurons in the crush-avulsion group. Further-more, preconditioning crush greatly attenuated the expression of nitric oxide synthase in the motor neurons. Our ifndings indicate that the neuroprotective action of preconditioning crush is mediated through the upregulation of heat shock protein 27 expression and the attenuation of neuronal nitric oxide synthase upregulation following avulsion.

  6. Osseous femoral avulsion of the anterior cruciate ligament origin in an adult

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    Samir H. Shah, MD

    2015-01-01

    Full Text Available Injuries of the anterior cruciate ligament are commonly encountered in clinical practice, and occur in a wide variety of settings, from sports-related injuries to polytrauma. Tears of the anterior cruciate ligament supersede osseous avulsion in the adult demographic; however, in the pediatric population, osseous avulsion reflects the most frequent injury. When osseous avulsion of the anterior cruciate ligament occurs in children or adults, the injury typically occurs at the level of the tibial eminence. Conversely, osseous avulsion injuries from the femur are rare, with all cases reported in the literature occurring in the skeletally immature. We report a case of a 47-year-old woman who suffered an osseous avulsion of her anterior cruciate ligament from her lateral femoral condyle. To our knowledge, this reflects the first reported case of femoral osseous avulsion of the anterior cruciate ligament origin in an adult.

  7. Simultaneous bilateral tibal tubercle avulsion: A rare fracture

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    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

  8. Neglected lesser tuberosity avulsion in an adolescent elite gymnast.

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    Paxinos, Odysseas; Karavasili, Alexandra; Manolarakis, Manolis; Paxinos, Thrasivoulos; Papavasiliou, Athanasios

    2014-07-01

    We report the case of a 16-year-old elite gymnast who presented with recurring pain in the left shoulder after training. The athlete recalled an injury to the shoulder 2 years ago. Clinically a localized tenderness to the anterior shoulder and loss of strength and range of motion was noted. Imaging investigation suggested a neglected lesser tuberosity avulsion. The athlete was treated with open excision of the deformed tuberosity and direct repair of the subscapularis to the humeral head. Following a careful postoperative rehabilitation protocol the athlete was able to return to unrestricted gymnastics after 6 months. After surgery the athlete followed a intense rehabilitation program that allowed him to return to sports at 6 months. At 5-years follow-up, the athlete was asymptomatic and competing at an international level. Avulsion fractures of the lesser tuberosity are extremely rare injuries with significant shoulder disability if left untreated. Anatomic repair can yield excellent results, even in neglected cases.

  9. Management of a complex dentoalveolar trauma with multiple avulsions: a case report.

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    Sheroan, Marianne Mills; Roberts, Michael W

    2004-08-01

    Treatment of permanent tooth avulsions in an adolescent poses significant difficulties for the dental clinician. This case report gives details about the treatment of a complex dentoalveolar trauma involving multiple avulsions of primary molars, permanent incisors, permanent molars, and premolar toothbuds. Immediate treatment of the injury and short-term esthetic replacement of the dentition is described. A brief review of current research relative to the treatment of permanent tooth avulsions is provided.

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

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    Harkiran Kaur; Supreet Kaur; Hargundeep Kaur

    2012-01-01

    Context: Tooth avulsion is one of the most serious dental emergencies in children. Often these injuries occur in school and, therefore, the knowledge of schoolteachers regarding the appropriate measures to be taken immediately after tooth avulsion is crucial to good prognosis. Aims: The purpose of the present study was to evaluate schoolteachers′ knowledge and attitudes regarding immediate management of avulsed teeth in children. Materials and Methods: A total of 177 teachers from sev...

  11. Physical Education Teachers’ Knowledge Assessment on Reimplant-Avulsion

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    Ana Flávia GRANVILLE-GARCIA

    2007-03-01

    Full Text Available Objective: To assess the knowledge on reimplant-avulsion of Physical Education Teachers’ in the city of Caruaru (PE. Methods: The study was carried on in the city of Caruaru, Pernambuco (BR, and the participants were 79 professionals who were interviewed through a standard questionnaire containing 11 questions related to dental avulsion as well as to the procedures to be followed in such cases.  Results: Only 20.3% of teachers knew what dental traumas are, but none of them had studied the subject during their undergraduate course.  It was explained to participants what a dental avulsion was and 44.3% of them answered that they had already seen this kind of trauma in their classes.  All professionals said they would give children a handkerchief or a towel for them to bite in order to control bleeding. 19% of the participants would not know what to do and 81% would wash the tooth in water. Most of them (86.1% recognized the importance of an immediate treatment; all of them said they would wrap the tooth in a paper napkin until the child was assisted; and 26.6% said they would suggest an analgesic for the pain.  Conclusion: Teachers did not show any knowledge of the emergency procedures that should be taken in a case of dental avulsion. The inclusion of such procedures in the programs of physical education courses and the availability of preventive educational programs is needed in order to increase the chances of a successful dental reimplant.

  12. Direct Repair without Augmentation of Patellar Tendon Avulsion following TKA

    Directory of Open Access Journals (Sweden)

    Ravi Mittal

    2015-01-01

    Full Text Available Complications involving the extensor mechanism after TKA are potentially disastrous. We are reporting a case of patellar tendon rupture from tibial tuberosity following total knee arthroplasty. We managed it by direct repair with fiberwire using Krackow suture technique without augmentation. Our long term result has been very encouraging. Our method is a safe and better method of management of patellar tendon avulsion following TKA when it happens without any tissue loss.

  13. Direct Repair without Augmentation of Patellar Tendon Avulsion following TKA

    OpenAIRE

    2015-01-01

    Complications involving the extensor mechanism after TKA are potentially disastrous. We are reporting a case of patellar tendon rupture from tibial tuberosity following total knee arthroplasty. We managed it by direct repair with fiberwire using Krackow suture technique without augmentation. Our long term result has been very encouraging. Our method is a safe and better method of management of patellar tendon avulsion following TKA when it happens without any tissue loss.

  14. 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.

  15. 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.

  16. Venous arterialization for the treatment of large-area foot skin retrograde avulsion.

    Science.gov (United States)

    Xiao, Wan-an; Jiang, Jia-xi; Tian, Feng; Li, Xiao-chuan; Tian, Li-jie

    2013-08-01

    Between 2009 and 2011, three patients with large-area foot skin retrograde avulsion (more than 1% of the body surface area) underwent venous arterialization. Anastomosis of the artery in the wound surface with the vein in the skin flap and an appropriate number of venous end-to-end anastomoses were performed. The skin flaps survived in all 3 patients. Six months postoperatively, the flap elasticity and appearance were close to that of normal skin, and foot function was better without scar contracture. When venous arterialization is used to treat foot avulsion, the following points should be noted. Surgical indications include no fresh bleeding from the wound edge of the avulsed skin after debridement, more complete avulsed skin, and superficial veins that do not completely separate from the avulsed skin. Venous arterialization is not suitable to avulsion with fresh bleeding, avulsed skin in small fragments, and avulsion with a subcutaneous venous network embolism. During debridement, the subcutaneous venous network should be protected to avoid exposing the vein stems outside the fat layer. If the avulsion is less than 1% of the body surface area, arterial-venous anastomosis can provide adequate blood supply. Venous-venous anastomosis is performed as much as possible to enhance venous return and decrease microcirculatory pressure, which is conducive to the establishment of effective blood circulation.

  17. Clinical and neurobiological advances in promoting regeneration of the ventral root avulsion lesion

    NARCIS (Netherlands)

    Eggers, R.; Tannemaat, Martijn R; De Winter, F.; Malessy, Martijn J A; Verhaagen, J.

    2016-01-01

    Root avulsions due to traction to the brachial plexus causes complete and permanent loss of function. Until fairly recent, such lesions were considered impossible to repair. Here we review clinical repair strategies and current progress in experimental ventral root avulsion lesions. The current gold

  18. 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.

  19. Traumatic avulsion of the tricuspid valve after gas bottle explosion

    Directory of Open Access Journals (Sweden)

    Francesca Tedoldi

    2016-06-01

    Full Text Available We present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea. Blunt chest trauma caused by explosives leading to valvular dysfunction has not been reported in the literature so far. It is remarkable that the patient not only survived this trauma, but had been managing his chronic heart failure well without medication for over 20 years. Learning points: • Thorough clinical and physical examination remains the key to identifying patients with relevant valvulopathies. • With good acoustic windows, TTE is superior to TEE in visualizing the right heart. • Traumatic avulsion of valve apparatus is a rare but potentially life-threatening complication of blunt chest trauma and must be actively sought for. Transthoracic echocardiography remains the method of choice in these patients.

  20. Treatment of Skin Avulsion Injuries with Basic Fibroblast Growth Factor

    Directory of Open Access Journals (Sweden)

    Hajime Matsumine, MD, PhD

    2015-04-01

    Full Text Available Summary: This report describes favorable outcomes in 9 patients with skin avulsion injuries of the extremities who underwent full-thickness skin grafting and basic fibroblast growth factor (bFGF application. Following removal of contaminated subcutaneous fat tissue on the inside of skin, the avulsed skin was processed into a full-thickness skin graft, with as much of the skin used as possible irrespective of damage. Several drainage holes (5–10 mm in diameter were made on the graft for drainage from the graft bed and to prevent seroma and hematoma formation. Genetically recombinant human bFGF was sprayed at a dose of 1 μg/cm2 onto the graft bed, which was then covered with the graft and sutured. Pressure immobilization with ointment gauzes and elastic bandages was administered for 1 week postoperatively, and the surface of the skin grafts that did not take was scraped away, preserving the revascularized dermal component on the debrided raw surface as much as possible. bFGF was sprayed again onto the debrided surface to promote epithelialization. Wound closure was achieved in all cases with conservative therapy. The surgical procedure was effective in preventing postoperative ulcer formation and scar contracture and resulted in wound healing with the formation of good-quality, flexible scars.

  1. Traumatic avulsion of the tricuspid valve after gas bottle explosion

    Science.gov (United States)

    Krisper, Maximilian; Köhncke, Clemens; Pieske, Burkert

    2016-01-01

    Summary We present a very rare example of chronic right heart failure caused by torrent tricuspid regurgitation. Massive right heart dilatation and severe tricuspid regurgitation due to avulsion of the tricuspid valve apparatus occurred as a result of a blunt chest trauma following the explosion of a gas bottle 20 years before admission, when the patient was a young man in Vietnam. After this incident, the patient went through a phase of severe illness, which can retrospectively be identified as an acute right heart decompensation with malaise, ankle edema, and dyspnea. Blunt chest trauma caused by explosives leading to valvular dysfunction has not been reported in the literature so far. It is remarkable that the patient not only survived this trauma, but had been managing his chronic heart failure well without medication for over 20 years. Learning points Thorough clinical and physical examination remains the key to identifying patients with relevant valvulopathies.With good acoustic windows, TTE is superior to TEE in visualizing the right heart.Traumatic avulsion of valve apparatus is a rare but potentially life-threatening complication of blunt chest trauma and must be actively sought for. Transthoracic echocardiography remains the method of choice in these patients. PMID:27249554

  2. The bony partial articular surface tendon avulsion lesion: an arthroscopic technique for fixation of the partially avulsed greater tuberosity fracture.

    Science.gov (United States)

    Bhatia, Deepak N; de Beer, Joe F; van Rooyen, Karin S

    2007-07-01

    The partial articular surface tendon avulsion (PASTA) is a common lesion that involves the supraspinatus tendon in most cases. We present an arthroscopic fixation technique for a previously undescribed lesion that may be considered a variant of the PASTA. The lesion involves a partial avulsion of the greater tuberosity with an intact deep insertion of the supraspinatus tendon into the fractured bone fragment and an intact superficial insertion of the supraspinatus into the unavulsed lateral aspect of the greater tuberosity: a "bony PASTA" lesion. The surgical technique involves the use of a 70 degree arthroscope to provide an "end-on" view of the pathology. A superior-medial transmuscular portal is used for anchor insertion and suture management; the portal avoids damage to the intact tendinous insertion of the supraspinatus, which can occur during transtendon anchor/screw insertion. Abduction of the arm to 50 degrees, after creation of the portal and passage of the cannula, permits an optimal "deadman" angle of anchor placement. An angled suture grasper is used to retrieve the 4 suture strands from the double-loaded suture anchor through the intact superficial and deep supraspinatus tendon fibers along the length of the fracture; these are tied as 2 mattress sutures over the tendon fibers in the subacromial space by use of sliding-locking knots. Adequacy of reduction is confirmed by intra-articular arthroscopic observation during movement of the extremity through its complete range of motion.

  3. River avulsions in the presence of tectonic tilting, and the Ganges-Brahmaputra Delta

    Science.gov (United States)

    Reitz, M. D.; Steckler, M. S.; Paola, C.; Goodbred, S. L.; Petter, A. L.; Pickering, J.; Williams, L. A.

    2013-12-01

    In Bangladesh, the set of active rivers of the Ganges-Brahmaputra Delta overlie a landscape that is being continually modified by tectonics. The response of rivers to a surface being altered by tectonic tilting or other causes of spatially variable subsidence is generally understood to be a preferred path direction toward regions of higher subsidence. Quantifying the magnitude of the effect of variable subsidence on the timescale and path direction of channel avulsion remains, however, an open question. Recent experimental work has suggested an equilibrium-slope explanation for the timescale and conditions for avulsion, which provides a way forward on understanding how varied subsidence conditions would affect the avulsion process. Here we adapt this model for avulsion to the context of variable subsidence, developing a new framework to quantify its effect on channel avulsions. We find that variable subsidence results in two effects: differing timescales between avulsions on different parts of the delta, and differing frequencies of avulsion to these locations. Regions of higher subsidence both draw avulsions more frequently, and result in longer channel residence times in these locations. We also describe the effect of incision or aggradation due to sea level changes within this framework: incisional events lengthen avulsion timescales everywhere on the delta, while periods of sea-level rise drive the timescales back toward their minimum values. Finally, we apply this theory to the Ganges-Brahmaputra Delta, where we use a map of regional variable subsidence that we derived from GPS and published stratigraphic data, to predict the variation in avulsion timescale and frequency for the Brahmaputra River due to this variable subsidence. We make estimates for two different tectonic history interpretations, and for the cases with or without the estimated incision from the most recent sea-level fall. Comparison between our predictions and our stratigraphy

  4. 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.)

  5. 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

    Background: 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. Purpose/Hypothesis: 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. Study Design: Case series; Level of evidence, 4. Methods: 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. Results: 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. Conclusion: 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

  6. Repair of multiple cervical root avulsion with sural nerve graft.

    Science.gov (United States)

    Hsu, Sanford P C; Shih, Yang-Hsin; Huang, Ming-Chao; Chuang, Tien-Yow; Huang, Wen-Cheng; Wu, Hsiu-Mei; Lin, Pei-Hsin; Lee, Liang-Shong; Cheng, Henrich

    2004-09-01

    To obtain easier access to avulsed roots in the intradural space for patients suffering cervical root avulsion, the authors of this study developed a novel repair method. This involves using nerve grafts to bridge corresponding segments of the spinal cord and the trunk or cord level of the plexus, respectively, in two surgical stages. All eight patients admitted to this study received pre- and post-operative workups of electrophysiological evaluations and muscle power grading through Medical Research Council (MRC) scores. The degrees of impairment were also graded according to a modified version of Dumitru's and Wilbourn's scale (mild = 1; moderate = 2; severe = 3). The preoperative versus post-operative differences in the severity of the injuries and in the grading of the target muscle power were calculated according to the Wilcoxon signed-rank test. The preoperative degree of the severity of the injuries, as measured by electromyography (EMG), was 3.00 +/- 0.00 (mean +/- S.D.). The post-operative result was 2.125 +/- 0.641. Significant change took place after repair (P = 0.0313). Moreover, although little improvement was observed in the triceps, brachioradialis (BR), extensor carpi radialis (ECR), flexor digitorum profundus (FDP) and intrinsic hand muscles, the MRC grading showed significant yet not prominent motor recovery in the deltoid and biceps brachii (both P = 0.0313). We were impressed that the initial significant statistical results of differences in pre- and post-operative severity of the injuries and muscle power grading, demonstrated that regeneration does occur with this repair strategy.

  7. Inferior mesenteric artery branch avulsion from blunt trauma--CT findings. Case report.

    Science.gov (United States)

    Olson, M; Posniak, H; Gomes, G

    1992-01-01

    Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.

  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. Displaced avulsion of the ischial apophysis: a hamstring injury requiring internal fixation.

    Science.gov (United States)

    Servant, C T; Jones, C B

    1998-09-01

    A case is reported of an adolescent sprinter who was chronically disabled by pain after non-operative management for an acute hamstring injury. He had sustained an avulsion fracture of the ischial apophysis with displacement of 2.5 cm. Avulsion fractures of the ischial apophysis with displacement of 2 cm or more are unusual, but they frequently result in a symptomatic non-union, and early diagnosis, open reduction, and internal fixation is to be encouraged.

  10. Surgical Management of a Completely Avulsed Adductor Longus Muscle in a Professional Equestrian Rider

    Directory of Open Access Journals (Sweden)

    Conal Quah

    2014-01-01

    Full Text Available Avulsion injuries of the adductor longus muscle tendon are rare and a challenge to manage especially in athletes. There has been little published literature on the outcome of conservative and operative treatment for these injuries. We report the first case of an acute adductor longus avulsion injury which was surgically repaired in a professional equestrian rider. Return to full preinjury function was achieved at 3 months with surgical repair using 3 suture anchors.

  11. Valproic acid protects neurons and promotes neuronal regeneration after brachial plexus avulsion****

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Dianxiu Wu; Rui Li; Xiaojuan Zhu; Shusen Cui

    2013-01-01

    Valproic acid has been shown to exert neuroprotective effects and promote neurite outgrowth in several peripheral nerve injury models. However, whether valproic acid can exert its beneficial effect on neurons after brachial plexus avulsion injury is currently unknown. In this study, brachial plexus root avulsion models, established in Wistar rats, were administered daily with valproic acid dis-solved in drinking water (300 mg/kg) or normal water. On days 1, 2, 3, 7, 14 and 28 after avulsion injury, tissues of the C 5-T 1 spinal cord segments of the avulsion injured side were harvested to in-vestigate the expression of Bcl-2, c-Jun and growth associated protein 43 by real-time PCR and western blot assay. Results showed that valproic acid significantly increased the expression of Bcl-2 and growth associated protein 43, and reduced the c-Jun expression after brachial plexus avulsion. Our findings indicate that valproic acid can protect neurons in the spinal cord and enhance neuronal regeneration fol owing brachial plexus root avulsion.

  12. Clinical and neurobiological advances in promoting regeneration of the ventral root avulsion lesion.

    Science.gov (United States)

    Eggers, Ruben; Tannemaat, Martijn R; De Winter, Fred; Malessy, Martijn J A; Verhaagen, Joost

    2016-02-01

    Root avulsions due to traction to the brachial plexus causes complete and permanent loss of function. Until fairly recent, such lesions were considered impossible to repair. Here we review clinical repair strategies and current progress in experimental ventral root avulsion lesions. The current gold standard in patients with a root avulsion is nerve transfer, whereas reimplantation of the avulsed root into the spinal cord has been performed in a limited number of cases. These neurosurgical repair strategies have significant benefit for the patient but functional recovery remains incomplete. Developing new ways to improve the functional outcome of neurosurgical repair is therefore essential. In the laboratory, the molecular and cellular changes following ventral root avulsion and the efficacy of intervention strategies have been studied at the level of spinal motoneurons, the ventral spinal root and peripheral nerve, and the skeletal muscle. We present an overview of cell-based pharmacological and neurotrophic factor treatment approaches that have been applied in combination with surgical reimplantation. These interventions all demonstrate neuroprotective effects on avulsed motoneurons, often accompanied with various degrees of axonal regeneration. However, effects on survival are usually transient and robust axon regeneration over long distances has as yet not been achieved. Key future areas of research include finding ways to further extend the post-lesion survival period of motoneurons, the identification of neuron-intrinsic factors which can promote persistent and long-distance axon regeneration, and finally prolonging the pro-regenerative state of Schwann cells in the distal nerve.

  13. 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.

  14. 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.

  15. 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.

  16. Central incisor loss after delayed replantation following avulsion: a contemporary restorative and adjunctive orthodontic management approach.

    Science.gov (United States)

    Savi, Andrea; Turillazzi, Oliviero; Cocconi, Renato; Bonanini, Mauro; Pizzi, Silvia; Manfredi, Maddalena

    2012-04-01

    Delayed replantation of an avulsed tooth may result in rapid root resorption or, more frequently, dental ankylosis with subsequent bone substitution. If this process develop slowly, it is possible to observe that tooth loss is characterized by a well conserved alveolus with regard to bone preservation, particularly in vertical dimension. This clinical case reports a dental trauma of a central incisor in a young boy characterized by tooth avulsion and its delayed replantation. After 10 years, dental ankylosis of the incisor was recorded and the patient underwent a prosthetic-orthodontic rehabilitation using CAD-CAM technology and no-prep veneers.

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

    OpenAIRE

    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...

  18. 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.

  19. 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.

  20. Idiopathic odontoma formation following avulsion of immature permanent incisors: two case reports.

    Science.gov (United States)

    Motokawa, W; Braham, R L; Taniguchi, K

    1990-01-01

    From the findings of Case 1 and those cases reviewed in the literature it would appear that overfilling a canal with gutta percha prevents continued root formation after reimplantation of the tooth. The canal should be underfilled, therefore, if gutta percha is used as the obturating medium. Consequently, the authors recommend that calcium hydroxide be used as the root canal filling material of choice after reimplanting immature permanent teeth subsequent to traumatic avulsion. Since, however, calcium hydroxide paste tends to be resorbed, periodic refilling of the canal with the paste is required. Case 2 emphasizes the importance of periodic postoperative radiographic evaluation for several years after traumatic avulsion of immature permanent teeth.

  1. 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.

  2. Knowledge of Saudi parents toward the emergency management of avulsed permanent teeth: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Nadiya Mosfer S AlGhamdi

    2016-01-01

    Full Text Available Introduction: Traumatic dentoalveolar injuries are frequent in children, affecting teeth, their supporting structures, and adjacent soft tissues. Parents are among the first people to deal with tooth avulsion among children at home or at play. This study, therefore, aimed to examine parental knowledge and attitudes about avulsed permanent teeth and their emergency treatment in children. Materials and Methods: A cross-sectional study was carried out with 274 parents of children receiving care at KKU College of Dentistry, Abha. Informed consent was obtained after explaining the nature of the study and data were collected using a self-administered questionnaire. Data were entered in MS Excel Sheet, and descriptive statistics were obtained. Results: Sixty-one percent of the parents reported dental trauma at home or school. 67.2% were not aware of the steps to be taken in tooth avulsion. The percentage for the source of information for avulsed tooth was a dentist (38.8% and the internet (34.5%. 73.8% were unaware of the fact that permanent avulsed tooth can be replanted. 56.3% parents said that they would discard the knocked out tooth. Regarding knowledge about traumatic dental injuries 43.9% said it is imperative to know about it. Conclusion: This survey reflected the lack of awareness and adequate knowledge regarding the avulsed tooth. There is an imperative need for educating the parents regarding management of avulsed tooth permanent tooth.

  3. Knowledge and attitude of parents with regard to avulsed permanent tooth of their children and their emergency management-Chennai

    Directory of Open Access Journals (Sweden)

    Tee Jing Loo

    2014-01-01

    Full Text Available Background: Dental avulsion is defined as the complete displacement of tooth out of socket along with severed periodontal ligament with or without fracture of the alveolar bone. Reimplantation of the avulsed tooth is considered as a best treatment modality due to its biological and psychological advantages. The viability of periodontal ligament cell on the root surface determines the prognosis of reimplanted tooth. The knowledge of parents regarding important steps to be taken immediately after dental avulsion is considered crucial for success of the treatment. Aim: The study was conducted to evaluate the knowledge and attitude of parents in Chennai with regard to avulsed permanent tooth of their children and their emergency management using a questionnaire. Materials and Methods: The study included 529 parents who accompanied their children, aged between 6 years and 12 years, to the Department of Pedodontics, Saveetha Dental College and Hospitals. Chi-square test was done to evaluate the association between the results and the genders, educational level, and geographical status of the respondents. Results: The study revealed even though 90.7% of parents knew that saving an avulsed permanent tooth is important, but almost one third of the population thought ice water was the best media to transport an avulsed teeth. Conclusion: There is an imperative need for educating the parents regarding management of avulsed tooth for which 87.9% showed interest.

  4. A retrospective study of 92 avulsed primary teeth in 69 children assisted at a dental urgency service

    Directory of Open Access Journals (Sweden)

    Orlando Aguirre Guedes

    2013-01-01

    Full Text Available The purpose of this study was to evaluate the epidemiological aspects associated with avulsion of primary teeth. The sample consisted of 92 avulsed teeth of 69 patients seen at the dental urgency service of the Dental School of the Federal University of Goiás, Brazil, from 1998 to 2005. The data obtained from the records included children’s gender and age, causes of tooth avulsion, daily and monthly distribution, type and number of avulsed teeth and the treatment procedures. Frequency distribution and the chi-square test were calculated. The level of significance was set at 5% for all analyses. The highest incidence was found among boys (52.17% aged 4 years (31.88%. The main etiologic factors were falls (82.61% and traffic accidents (5.80%. Most cases occurred during weekdays (82.61%, from March to June (autumn; n=28; 40.58% and from September to December (spring; n=18; 26.09%. Most avulsed teeth were maxillary central incisors (68.48%, followed by maxillary lateral incisors (22.83%. The most frequent treatments were analysis of clinical history and clinical exam (64 teeth; 69.57% and space maintainer (18 teeth; 19.57%. The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. There was a high number of avulsed primary teeth in boys aged less than 4 years and caused by falls.

  5. 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.

  6. Migration and differentiation of neural progenitor cells after recurrent laryngeal nerve avulsion in rats.

    Directory of Open Access Journals (Sweden)

    Wan Zhao

    Full Text Available To investigate migration and differentiation of neural progenitor cells (NPCs from the ependymal layer to the nucleus ambiguus (NA after recurrent laryngeal nerve (RLN avulsion. All of the animals received a CM-DiI injection in the left lateral ventricle. Forty-five adult rats were subjected to a left RLN avulsion injury, and nine rats were used as controls. 5-Bromo-2-deoxyuridine (BrdU was injected intraperitoneally. Immunohistochemical analyses were performed in the brain stems at different time points after RLN injury. After RLN avulsion, the CM-DiI+ NPCs from the ependymal layer migrated to the lesioned NA. CM-DiI+/GFAP+ astrocytes, CM-DiI+/DCX+ neuroblasts and CM-DiI+/NeuN+ neurons were observed in the migratory stream. However, the ipsilateral NA included only CM-DiI+ astrocytes, not newborn neurons. After RLN avulsion, the NPCs in the ependymal layer of the 4th ventricle or central canal attempt to restore the damaged NA. We first confirm that the migratory stream includes both neurons and glia differentiated from the NPCs. However, only differentiated astrocytes are successfully incorporated into the NA. The presence of both cell types in the migratory process may play a role in repairing RLN injuries.

  7. Migration and differentiation of neural progenitor cells after recurrent laryngeal nerve avulsion in rats.

    Science.gov (United States)

    Zhao, Wan; Xu, Wen

    2014-01-01

    To investigate migration and differentiation of neural progenitor cells (NPCs) from the ependymal layer to the nucleus ambiguus (NA) after recurrent laryngeal nerve (RLN) avulsion. All of the animals received a CM-DiI injection in the left lateral ventricle. Forty-five adult rats were subjected to a left RLN avulsion injury, and nine rats were used as controls. 5-Bromo-2-deoxyuridine (BrdU) was injected intraperitoneally. Immunohistochemical analyses were performed in the brain stems at different time points after RLN injury. After RLN avulsion, the CM-DiI+ NPCs from the ependymal layer migrated to the lesioned NA. CM-DiI+/GFAP+ astrocytes, CM-DiI+/DCX+ neuroblasts and CM-DiI+/NeuN+ neurons were observed in the migratory stream. However, the ipsilateral NA included only CM-DiI+ astrocytes, not newborn neurons. After RLN avulsion, the NPCs in the ependymal layer of the 4th ventricle or central canal attempt to restore the damaged NA. We first confirm that the migratory stream includes both neurons and glia differentiated from the NPCs. However, only differentiated astrocytes are successfully incorporated into the NA. The presence of both cell types in the migratory process may play a role in repairing RLN injuries.

  8. 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 functi

  9. 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 reviewe

  10. Possible Complications of Ureteroscopy in Modern Endourological Era: Two-Point or “Scabbard” Avulsion

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    Andrius Gaizauskas

    2014-01-01

    Full Text Available Indication has led ureteroscopy to be a worldwide technique, with the expected appearance of multiple types of complications. Severe complications are possible including ureteral perforation or avulsion. Ureteral avulsion has been described as an upper urinary tract injury related to the action of blunt trauma, especially from traffic accidents, being the mechanism of injury, the result of an acute deceleration/acceleration movement. With the advent of endourology, that term is also applied to the extensive degloving injury resulting from a mechanism of stretching of the ureter that eventually breaks at the most weakened site, or ureteral avulsion is referred to as a discontinuation of the full thickness of the ureter. The paper presents a case report and literature review of the two-point or “scabbard” avulsion. The loss of long segment of the upper ureter, when end-to-end anastomosis is not technically feasible, presents a challenge to the urological surgeon. In the era of small calibre ureteroscopes these complications, due to growing incidence of renal stones will become more and more actual. Our message to other urologists is to know such a complication, to know the ways of treatment, and to analyse ureteroscopic signs, when to stop or pay attention.

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

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    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.

  12. Avulsions, channel evolution and floodplain sedimentation rates of the anastomosing upper Columbia River, British Columbia, Canada

    NARCIS (Netherlands)

    Makaske, B.; Smith, D.G.; Berendsen, H.J.A.

    2002-01-01

    Ages of channels of the anastomosing upper Columbia River, south-eastern British Columbia, Canada, were investigated in a cross-valley transect by C-14 dating of subsurface floodplain organic material from beneath levees. The avulsion history within the transect was deduced from these data, and morp

  13. Evaluation of sixth grade primary schoolchildren's knowledge about avulsion and dental reimplantation.

    Science.gov (United States)

    Castilho, Lithiene Ribeiro; Sundefeld, Maria Lucia Marçal Mazza; de Andrade, Dalton Francisco; Panzarini, Sônia Regina; Poi, Wilson Roberto

    2009-08-01

    Dental trauma, particularly tooth avulsion, is a frequent cause of tooth loss in children, adolescents, and young adults. The avulsed tooth should be immediately reimplanted in its alveolus. This procedure can be performed by anyone at the accident site and not only by dental surgeons. Therefore, the purpose of this study is to evaluate the knowledge of sixth graders of the city of Araçatuba, SP, about dental avulsion and tooth reimplantation through a structured and standardized survey. Our sample consisted of 778 students. The data collected was processed using the program EPIINFO 2000. Most students were around 12 years of age and 94.5% related to practice some kind of sports. Results demonstrated that the possibility of tooth reimplantation after dental avulsion is not acknowledged among these students and dental traumatism was associated to caries, toothache, and use of orthodontic appliances. Only 18.9% of the students associated dental traumatism to an impact trauma; 3.6% would store the tooth in milk, and 3.1% believed the tooth could be reimplanted by anyone present at the accident site. In summary, the results show an overall the lack of knowledge about dental traumatism and highlight the need of special programs designed to educate school-aged students about emergency procedures to handle cases of dental traumatisms.

  14. Timescales, mechanisms, and controls of incisional avulsions in floodplain wetlands: Insights from the Tshwane River, semiarid South Africa

    Science.gov (United States)

    Larkin, Zacchary T.; Tooth, Stephen; Ralph, Timothy J.; Duller, Geoff A. T.; McCarthy, Terence; Keen-Zebert, Amanda; Humphries, Marc S.

    2017-04-01

    Avulsion (relocation of a river course to a new position) typically is assumed to occur more frequently in rivers with faster sedimentation rates, yet supporting field data are limited and the influence of sedimentation rate on avulsion style remains unclear. Using analysis of historical aerial photographs, optically stimulated luminescence dating of fluvial sediments, and field observations, we document three avulsions that have occurred in the last 650 years along the lower reaches of the semiarid Tshwane River in northern South Africa. Study of the modern river and abandoned reaches reveals that a downstream decrease in discharge and stream power leads to reduced channel size and declining sediment transport capacity. Bank erosion drives an increase in channel sinuosity, leading to a decline in local channel slope, and to a further decrease in discharge and sediment transport. Local sedimentation rates > 10 mm a- 1 occur within and adjacent to the channel, so over time levees and an alluvial ridge develop. The resulting increase in cross-floodplain gradient primes a reach for avulsion by promoting erosion of a new channel on the floodplain, which enlarges and extends by knickpoint retreat during periods of overbank flow. Ultimately, the new channel diverts the discharge and bedload sediment from the older, topographically higher channel, which is then abandoned. Our findings support the assumption that avulsion frequency and sedimentation rate are positively correlated, and we demonstrate that incisional avulsions can occur in settings with relatively rapid net vertical aggradation. The late Holocene avulsions on the semiarid Tshwane River have been driven by intrinsic (autogenic) processes during meander belt development, but comparison with the avulsion chronology along a river in subhumid South Africa highlights the need for additional investigations into the influence of hydroclimatic setting on the propensity for avulsion.

  15. 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.

  16. 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

  17. Nontraumatic avulsion of the lesser trochanter: A pathognomonic sign of metastatic disease

    Energy Technology Data Exchange (ETDEWEB)

    Phillips, C.D.; Pope, T.L. Jr.; Jones, J.E.; Keats, T.E.; MacMillan, R.H. III

    1988-03-01

    Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy.

  18. Log jams and flood sediment buildup caused channel avulsion in the Pennsylvanian of Atlantic Canada

    DEFF Research Database (Denmark)

    Gibling, Martin R; Bashforth, Arden Roy; Falcon-Lang, Howard J;

    2010-01-01

    Accumulations of logs and flood sediment frequently block modern channels and may trigger avulsion, but these effects are difficult to demonstrate for the ancient record. Braided-fluvial channels in the Pennsylvanian South Bar Formation of Atlantic Canada contain sandstone successions up to 6 m...... are interpreted as stable ‘‘transport log jams’’ formed during floods, although some may have been ‘‘unstable jams’’ stranded on bars during peak-flow recession. Associated with the logs are extrabasinal gravel and intraclasts of mudstone and coal, which suggest that floods in sediment-choked channels undercut...... in some modern rivers. In two instances, a radical change in paleoflow between pre- and post-abandonment channels is consistent with an interpretation that log jams and flood sediment buildup promoted channel-belt avulsion. Although large trees had evolved by Middle to Late Devonian times, it is unlikely...

  19. Simultaneous bilateral avulsion fractures of the anterior superior iliac spines in an adolescent sprinter.

    Science.gov (United States)

    Boyce, Stephen H; Quigley, Michael A

    2009-01-01

    A 16-year-old boy presented to the emergency department with sudden onset of bilateral hip pain while performing in a 100 m sprint race. Examination revealed diffuse swelling and tenderness at both anterior superior iliac spines (ASIS). Pelvic x ray revealed bilateral displaced avulsion fractures of the ASIS at the origin of the sartorius muscle. He was managed conservatively with analgesia and bed rest with both hips held partially flexed at approximately 60°. Further x rays showed good healing and no further displacement of the avulsed fragments. Following physiotherapy he had a full range of hip movements at 6 weeks post-injury. He was able to return to full activity by 18 weeks post-injury.

  20. Analysis of 261 avulsed permanent teeth of patients treated in a dental urgency service

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    Orlando Aguirre Guedes

    2015-01-01

    Full Text Available Objective: The aim of this study was to evaluate the epidemiological aspects and clinical factors associated with avulsion of permanent teeth. Materials and Methods: The sample consisted of 261 avulsed teeth of 170 patients seen in the Dental School of the Federal University of Goiαs, Brazil, from 2000 to 2008. Result: The highest incidence was found among boys (71.18% aged 6-15 years (61.18%. The main etiologic factors were falls (51.76% and traffic accidents (29.41%. Most cases occurred in autumn (March to June; 31.18% and winter (June to September; 27.65%. Most avulsed teeth were the maxillary central incisor (62.45%, followed by the maxillary lateral incisor (21.46%. A high proportion (67.23% of injured teeth had a completely formed root apex. Replantation was used to treat 119 teeth (45.59% in 86 patients. Most replantations were delayed (89.08%. Thirty-eight teeth (31.93% were stored in dry media. Periodontal healing was found in 41 teeth (34.45%, inflammatory root resorption, in 44 (36.97% and replacement root resorption, in 22 (18.49%. The most frequent treatments for replanted teeth were endodontic treatment and temporary filling of the root canal with calcium hydroxide (58.92% and endodontic treatment and definitive root canal filling (26.89%. Conclusion: The epidemiological and clinical aspects of tooth avulsion in this study were similar to those reported in other studies. The number of replantation was low, the number of teeth stored in non-physiological conditions was high, and replantation was often delayed.

  1. Management of Hard Tissue Avulsive Wounds and Management of Orofacial Fractures.

    Science.gov (United States)

    2014-09-26

    phosphate has a destructive transformation from a to a form with the alpha form having a lower density. This conversion begins approximately at 2050°F and...SUPPLEMENTARY NOTES I9. KEY WORDS (Continue on reverse side it necessary mnd Identify by block numb.,) Bioceramics Maxillofacial Tricalcium Phosphate ...Ceramic Implants Avulsive Wounds Calcium Phosphates Biomaterials Porous Ceramics Prosthetic Materials Biodegradable Ceramics Implant Materials

  2. Degeneration of primary afferent terminals following brachial plexus extensive avulsion injury in rats

    OpenAIRE

    Muñetón-Gómez, Vilma; Taylor, Julian S.; Averill, Sharon; Priestley, John V.; Nieto-Sampedro, Manuel

    2004-01-01

    Important breakthroughs in the understanding regeneration failure in an injured CNS have been made by studies of primary afferent neurons. Dorsal rhizotomy has provided an experimental model of brachial plexus (BP) avulsion. This is an injury in which the central branches of primary afferents are disrupted at their point of entry into the spinal cord, bringing motor and sensory dysfunction to the upper limbs. In the present work, the central axonal organization of primary afferents was examin...

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

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    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.

  4. Pomegranate Juice (Punica Granatum): A New Storage Medium for Avulsed Teeth

    Science.gov (United States)

    Tavassoli-Hojjati, Sara; Aliasghar, Elham; Babaki, Fatemeh Ahmadian; Emadi, Fatemeh; Parsa, Maliheh; Tavajohi, Shohreh; Ahmadyar, Maryam; Ostad, Seyed Nasser

    2014-01-01

    Objective 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. Materials and Methods: 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. Results: 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. Conclusion: In conclusion, PJ can be recommended as a suitable transport medium for avulsed teeth. PMID:24910699

  5. 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...

  6. 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.

  7. Tectonic and climatic controls on historical landscape modifications: The avulsion of the lower Cecina River (Tuscany, central Italy)

    Science.gov (United States)

    Benvenuti, Marco; Bonini, Marco; Moratti, Giovanna; Ricci, Marianna; Tanini, Chiara

    2008-08-01

    Integration of geomorphology, stratigraphy, sedimentology and morphotectonics in the analysis of the lower Cecina River reach, coastal Tuscany, reveals an undocumented historical channel avulsion. Geomorphological evidence and radiocarbon dating support that, from the Last Glacial Maximum until the end of the 16th century, the Cecina River flowed north of the present course and formed a well-developed cuspate delta. Two concurrent factors, active tectonics as a preparing factor and discharge regime as an activation factor, are thus inferred to have favored the avulsion of Cecina River. Fragmentary archaeological and historical records indicate that the late Holocene Cecina River plain was virtually unpopulated until the latest 16th century. This seems the main reason why high-magnitude hydrological events and prominent river channel avulsions were not reported in historical chronicles. From this perspective, geomorphological data may provide important knowledge and understanding of recent dynamics of environmental change when historical record is lacking or missing.

  8. 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.

  9. 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.

  10. Return of function after spinal cord implantation of avulsed spinal nerve roots.

    Science.gov (United States)

    Carlstedt, T; Grane, P; Hallin, R G; Norén, G

    1995-11-18

    Avulsion of nerve roots from the spinal cord is widely regarded as an untreatable injury. However, a series of experiments in animals has shown that, if continuity is restored between spinal cord and ventral roots, axons from spinal motor neurons can regrow into the peripheral nerves with recovery of motor function. These observations were applied in the treatment of a man with avulsion of the 6th cervical (C6) to 1st thoracic roots due to brachial plexus injury. Two ventral roots were implanted into the spinal cord through slits in the pia mater, C6 directly and C7 via sural nerve grafts. Voluntary activity in proximal arm muscles was detected electromyographically after nine months and clinically after one year. After three years the patient had voluntary activity (with some co-contraction) in the deltoid, biceps, and triceps muscles. To determine whether the improvement was due to spontaneous recovery from C5, the C5 root was blocked pharmacologically, and the results indicated that the repaired roots were contributing substantially to motor function. Repair of spinal nerve roots deserves further exploration in management of brachial plexus injury.

  11. The Use of Aloe Vera Extract as a Novel Storage Media for the Avulsed Tooth

    Directory of Open Access Journals (Sweden)

    Samaneh Badakhsh

    2014-07-01

    Full Text Available Background: Tooth avulsion is one of the most severe dental traumas which most often occur in children. When immediate replantation is not possible, storage in a proper media may lead to a prolonged survival rate. Aloe Vera is a cactus like plant with green, tapered leaves that are filled with a transparent viscous gel. This medicinal plant has significant anti-inflammatory, antioxidant, antibacterial and antifungal effects. The purpose of this study was to assess the effectiveness of different concentrations of Aloe Vera extract compared to DMEM (cell culture medium and egg white. Methods: The periodontal ligament (PDL cells were cultured and certain number of cells were treated with Aloe Vera extract (in four different concentrations, egg white and culture media for 1, 3, 6, and 9 hours. Cell viability was determined by using the (3-[4, 5-dimethylthiazolyl-2]-2, 5-diphenyltetrazolium bromide assay. Moreover, One-way ANOVA and post hoc (LSD test were used for analyzing the study groups. Results: The results indicate that culture media and Aloe Vera extract (10, 30, and 50% concentration were statistically similar and significantly preserved more PDL cells compared to other experimental storage media. Conclusion: Aloe Vera 10, 30, and 50% may be recommended as a suitable storage media for avulsed teeth.

  12. Effect of propolis on survival of periodontal ligament cells: new storage media for avulsed teeth.

    Science.gov (United States)

    Ozan, Fatih; Polat, Zübeyde Akin; Er, Kürsat; Ozan, Ulkü; Değer, Orhan

    2007-05-01

    Propolis is a multifunctional material used by bees in the construction and maintenance of their hives. Propolis possesses several biologic activities such as anti-inflammatory, antibacterial, antioxidant, antifungal, antiviral, and tissue regenerative, among others. The purpose of this study was to determine the ability of propolis to serve as a temporary storage medium for the maintenance of periodontal ligament (PDL) cell viability of avulsed teeth. PDL cells were obtained from healthy third molars and cultured in Dulbecco's Modified Eagles Medium (DMEM). Cultures were subjected to 10% propolis solution, 20% propolis solution, long-shelf life light milk with lower fat content (milk), Hank's Balanced Salt Solution, tap water as the negative control, and DMEM as the positive control. Tissue culture plates were incubated with experimental media at 37 degrees C for 1, 3, 6, 12, or 24 hours. PDL cell viability was assessed by trypan blue exclusion. Statistical analysis of the data was accomplished by using one-way analysis of variance complemented by the Tukey test. The level of significance was 5% (ppropolis was a more effective storage medium than other groups. In conclusion, propolis can be recommended as a suitable transport medium for avulsed teeth.

  13. 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.

  14. Efficacy of a comprehensive dental education program regarding management of avulsed permanent teeth as a valid indicator of increased success rate of treatment of avulsion in a North Indian population

    Directory of Open Access Journals (Sweden)

    Navneet Grewal

    2015-01-01

    Full Text Available Aims: To assess whether educating the parents, teachers, and intermediate school children of Amritsar city about the emergency management of tooth avulsion was an effective method of increasing success rate of treatment of avulsion. Subjects and Methods: Self-administered questionnaires were prepared for 200 parents, teachers, and for intermediate school children to assess baseline knowledge. Sociodemographic distribution of the targeted group was carried out applying Kuppuswamy scale. Two months later, flip cards and posters were distributed to the selected sample followed by a reinforcement session conducted after 1 month in the form of slide presentations on dental trauma. After 3 months, reassessment performance was distributed to the same participants for reassessing any change in baseline knowledge. Further analysis of knowledge, attitude, and practices were carried out after 6 months. The scores based on Likert scale ranging 0-3 were obtained and put to statistical analysis to analyze efficacy of this program 12 months from baseline data. Results and Conclusion: Wilcoxon signed ranked test was applied to nonparametric data to study the knowledge before and after education was carried out. There was a significant change in the knowledge level of children, teachers, and parents after the campaign and teachers showed more positive change in the practice of emergency management of tooth avulsion, endorsing the fact that comprehensive dental education programs targeting school teachers and children can change the perspective of individuals toward treatment needs for dental trauma involving avulsion.

  15. The Effect of Root Coating with Titanium on Prevention of Root Resorption in Avulsed Teeth: An Animal Study

    Science.gov (United States)

    Heydari, Azar; Tahmasbi, Soodeh; Badiee, Mohammadreza; Izadi, SeyedSadra; Mashhadi Abbas, Fatemeh; Mokhtari, Sepideh

    2016-01-01

    Introduction: Tooth avulsion is a real dental emergency. If immediate replantation is not performed, the avulsed tooth may be lost due to inflammatory or replacement resorption. This animal study aimed to evaluate the bone response to the titanium coating of the root surface as an artificial barrier, and prevention of resorption of avulsed teeth. Methods and Materials: This experimental study was conducted on four male dogs. The dogs were randomly divided into two groups for assessment at two and eight weeks. Four teeth were extracted in each animal. The root surfaces of the test group were coated with a titanium layer using the Electron Beam Deposition system. After 24 h, replantation of the teeth was performed. Two animals were sacrificed after two weeks and the remaining dogs were killed after eight weeks. The presence of inflammation, inflammatory resorption, replacement resorption, periodontal regeneration, periapical granuloma and ankylosis were evaluated through histological analyses. Results: Inflammatory root resorption was not present in any tooth except one tooth in the coated group after eight weeks. Replacement resorption was noted just in three of the non-coated teeth after two weeks and two teeth after eight weeks. The McNemar's test revealed that the frequency of replacement resorption in the non-coated group was significantly higher than the coated group (P=0.031). Conclusion: Based on the results of this study, it seems that coating the root surfaces of avulsed teeth with titanium may control the replacement root resorption. PMID:27790261

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

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, F.; Dragoni, S. [Sports Science Inst., Rome (Italy)

    2001-03-01

    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.)

  17. Isolated avulsion fracture of lesser tuberosity of the humerus: Review of the literature and report of two cases

    Directory of Open Access Journals (Sweden)

    Bilgehan Tosun

    2011-01-01

    Full Text Available Two cases of acute isolated avulsion fracture of the lesser tuberosity of the humerus and their short-term outcome are presented with a review of previously reported cases. Open reduction and internal fixation was performed. Outcomes were excellent, and the patients regained their normal pain-free shoulder function 3 months after the operation. This was a Level IV study.

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

    Science.gov (United States)

    Hermansen, Lars L; Freund, Knud G

    2016-03-01

    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 accomplished, and 4-month follow-up demonstrated a good outcome.

  19. Humeral avulsion of the anterior shoulder stabilizing structures after anterior shoulder dislocation: demonstration by MRI and MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Tirman, P.F.J. [San Francisco Magnetic Resonance Center, San Francisco, CA (United States); Steinbach, L.S. [Department of Radiology, University of California, San Francisco, CA (United States); Feller, J.F. [Department of Veterans Affairs, David Grant USAF Medical Center, Travis Air Force Base, CA (United States); Stauffer, A.E. [Radiologic Imaging Associates, Mission Viejo, CA (United States)

    1996-11-01

    Objective. To demonstrate the MRI findings of an anterior shoulder capsular avulsion from the humerus, with or without subscapularis rupture, after anterior dislocation or severe abduction external rotation injury. Design and patients. We retrospectively reviewed the MRI and MR arthrographic examinations of seven patients who were identified at surgery with avulsion of the anterior shoulder stabilizers from the humerus. MRI was correlated with clinical history and surgical results. Results. MRI findings included: inhomogeneity or frank disruption of the anterior capsule at the humeral insertion (all), fluid intensity anterior to the shoulder (six patients), tear of the subscapularis tendon (six patients), dislocation of the biceps tendon (four patients), and a Hill-Sachs deformity (four patients). MR arthrography additionally found extravasation of contrast through the capsular defect (two patients). Conclusions. Our findings suggest that MRI is helpful for diagnosing humeral avulsion of the anterior glenohumeral capsule, especially when a tear of the subscapularis tendon insertion is present. MR arthrography may be of benefit for diagnosing capsular avulsion without associated subscapularis tendon abnormality. (orig.). With 4 figs.

  20. 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.

  1. Toenail Avulsion

    OpenAIRE

    Thornington, Martyn J.

    1983-01-01

    Ingrown toenails are commonly seen in family practice, and are treated conservatively. If this does not resolve the condition, lateral wedge resection and permanent, partial nail bed ablation are necessary. Recurrence can be prevented by chemical cautery with 10% sodium hydroxide. Betadine packing reduces infection.

  2. Avulsion of posterior primary teeth and space maintaining appliance: case report.

    Science.gov (United States)

    Rocha, M J; Cardoso, M; de Oliveira, J

    2000-01-01

    A four-year-old child was presented to the Pediatric Dentistry Clinic of the Federal University, 21 days after an incident in which canine first and second primary molar teeth were avulsed, due to a trauma to the face. This was confirmed on radiological examination. The clinical examinations showed that tissues were normal. A removable space-maintaining dental-mucosa supported appliance was made in acrylic resin to replace the three missing teeth. After a period of eight months, the tissues were preserved, the device is helping the child to eat, to speak, and preserving the appearance of the patient. Radiograph examinations have shown that the first molar tooth and canine, first pre molar and second pre molar teeth are erupting normally. Trauma in primary dentition can cause psychological, morphological and functional problems. In the presented case the treatment was planned to recuperate the function and to avoid problems from the premature loss of primary teeth.

  3. Treatment of inflammatory external root resorption resulting from dental avulsion and pulp necrosis: clinical case report.

    Science.gov (United States)

    Cunha, Rodrigo Sanches; Abe, Flavia Casale; Araujo, Roberta Aranha; Fregnani, Eduardo Rodrigues; Bueno, Carlos Eduardo da Silveiro

    2011-01-01

    The aim of this case report was to present a treatment for severe inflammatory external root resorption. The condition developed due to the patient's neglect to seek adequate treatment following replantation of an avulsed maxillary left central incisor. Following diagnosis, treatment consisted of conventional endodontic therapy with calcium hydroxide dressings and definitive filling of the root canal after the resorption was controlled radiographically. A 24-month follow-up showed that the resorption process had stabilized and the patient was free of symptoms. Successful tooth replantation requires following the indicated therapy effectively. Nevertheless, when an inflammatory external root resorption occurs, adequate endodontic treatment to remove the necrotic content and bacteria is required, as is the use of calcium hydroxide dressings.

  4. Replantation of an Avulsed Central Incisor after Long Extra- Alveolar Period. (Case Report

    Directory of Open Access Journals (Sweden)

    Seraj B

    2000-05-01

    Full Text Available A case involving the replantation of an avulsed incisor after long extra-oral period (8 days is reported. After cleaning the root surface, the tooth was soaked in fluoride gel for 20 minutes and root canal therapy was performed extraorally. The tooth was stabilized by wire and composite for six weeks. The patient has been periodically recalled and the tooth monitored for 36 months after replantation. Only minor external surface resorption was observed in the periapical area on the rodiograph, which was taken immediately before removal of the splint and the rate of subsequent replacement resorption has been acceptable. It should be considered that and extended extraoral period is not an absolute contraindication to replantation. Teeth replanted after long extra- alveolar periods can function for a long period of time and thus postpone prosthetic treatment.

  5. Replantation of an avulsive amputation of a foot after recovering the foot from the sea.

    Science.gov (United States)

    Yüksel, F; Karacaoğlu, E; Ulkür, E; Güler, M M

    2000-04-01

    A foot avulsion case, with the dismembered body part submerged in sea water for 1 hour, is presented. This report is unique in that it is the first to document the reattachment of a body part that had been submerged in sea water. It was not known how salt-water exposure would affect wound management. Differences in osmolarity and bacterial flora between the sea water and foot tissues have not caused any problems, and the patient has not suffered any vascular or infectious complications after replantation. Neurotization of the plantar surface by the tibial nerve, which was stripped off during amputation and replaced in its original traces, was the most critical part of convalescence. After management of such an interesting case, we conclude that exposure to sea water of the dismembered part should not be a contraindication for replantation surgery.

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

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    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. Class IIA ring avulsion injuries: an absolute indication for microvascular repair.

    Science.gov (United States)

    Nissenbaum, M

    1984-11-01

    The class II ring avulsion category, includes those patients in whom only digital arteries are damaged but all other structures are intact and functional (here labeled class IIA). Current literature suggests this is a rare lesion. Seven patients with this specific injury in whom the affected digits were nonviable are reported. Four of the seven were misdiagnosed on initial emergency room evaluation. Two did not seek additional medical attention and the condition progressed to necrosis and amputation. The other two, who sought additional treatment because of progressive ischemia, and three additional patients who were correctly diagnosed on initial examination underwent simple digital arterial repair. All digits operated on survived and demonstrated near normal function. Since failure to operate results in digital loss, this is an absolute indication for microvascular repair.

  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. Proximal rectus femoris avulsion in an elite, olympic-level sprinter.

    Science.gov (United States)

    Langer, Phillip R; Selesnick, Harlan

    2010-11-01

    Quadriceps injuries, ranging from simple strains to disabling muscle ruptures, are common athletic injuries. The rectus femoris is the most commonly injure portion of the quadriceps musculature. This article is, to our knowledge, the first report of a proximal rectus femoris avulsion in an elite, Olympic-level 100-meter sprinter, acutely managed with surgical repair. Several key factors must be considered and carefully assessed when determining the appropriate course of management (ie, deciding between operative and nonoperative treatment): amount of distal retraction of the tendon, severity of associated soft-tissue trauma, physical examination, and postoperative goals (eg, return to elite-level competitive sports involving running or kicking vs resuming basic activities of daily living). We believe that these factors in our elite, high-performance athlete dictated an operative course of management.

  10. Reimplantation combined with transplantation of transgenic neural stem cells for treatment of brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    CHEN Lei; LU Lai-jin; MENG Xiao-ting; CHEN Dong; ZHANG Zhi-xin; YANG Fan

    2008-01-01

    Objective: To explore a new method to treat brachial plexus root avulsion experimentally by reimplantation combined with transplantation of neural stem cells (NSCs) modified by neurotrophin-3 gene (NT-3).Methods: The total RNA was extracted from neonatal rat striatum and the NT-3 cDNA was obtained by reverse transcription and amplified by polymerase chain reaction.The NT-3 gene was transferred into NSCs via the pLEGFP-Cl,an expression plasmid vectors.The untransfected NSCs,the pLEGFP-Cl treated NSCs,and the pLEGFP-Cl-NT-3 treated NSCs were transplanted into corresponding spinal cord segment with brachial plexus root avulsion.The survival,differentiation,and migration of the transplanted cells were determined under confoeal laser scanning microscope or by immunohistochemistry method.The nerve regeneration was evaluated by gross observation,electrophysiologieal examination and reverse horseradish peroxidase tracing.Results: The NT-3 gene was successfully amplified and transferred into neural stem cells via the plasmid vectors.The transplanted cells survived,differentiated,and migrated and NT-3 was expressed within the spinal cord.The animals regained some muscle strength which was less than 3-degree muscular strength according to the British Medical Research Council (BMRC) evaluating system.The resuits of electrophysiological examination and reverse horseradish peroxidase tracing were superior in the pLEGFP-Cl-NT-3 group to the NSCs untransfected group orthe pLEGFP-Cl group.Conclusion: Transplantation of NSCs modified by NT-3gene combined with reimplantantion is a relatively effective way to treat brachial plexus root avuision experimentally.It still need further study to improve the results.

  11. Surgical options in the management of cystic duct avulsion during laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Mirsharifi Rasoul

    2008-06-01

    Full Text Available Abstract Background Avulsion of cystic duct during laparoscopic cholecystectomy (LC is not a common intraoperative complication, but may be encountered by any laparoscopic surgeon. Surgeons are rarely familiar with management of this condition. Methods Patients with gall stone related problems who were scheduled for LC at the minimal invasive surgery unit of a tertiary referral hospital during a 5 years period (April 2002–April 2007 were prospectively enrolled. Results 12 cases were identified (incidence: 1.15%. All 12 patients had gallbladder inflammation. Five patients had acute and seven patients had chronic cholecystitis. The avulsed cystic duct (ACD was managed by clipping in 4, intracorporeal suturing in 3, converting to open surgery with suture ligation in 2, and lonely external drainage in 3 patients. Bile leakage had ceased within 3 days in 2, 14 days in one, and 20 days in the other patient. Bile volume increased gradually in one of the patients, which stopped only after endoscopic sphincterotomy (ES at 25th postoperative day. No major late complication or mortality occurred. Conclusion ACD during LC is a rare complication. Almost all standard methods of treatment yield to successful outcomes with low morbidity. According to the situation, ACD may be successfully managed laparoscopically. Available cystic stump remnant was clipped. Intracorporeal suture ligation was performed when short length of stump precluded clipping. Deeply retracted cystic duct with active bile leak led to conversion to open surgery. With minimal or no bile leak at ACD stump, closed tube drainage of sub-hepatic area was attempted. Persistent bile leak was assumed to be controlled by ES, successfully accomplished in one patient.

  12. 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.

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

    Science.gov (United States)

    Baliga, Shridhar

    2015-01-01

    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. PMID:26877745

  14. 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.

  15. Crevassing and capture by floodplain drains as a cause of partial avulsion and anastomosis (lower Rio Pastaza, Peru)

    Science.gov (United States)

    Bernal, Carolina; Christophoul, Frédéric; Darrozes, José; Laraque, Alain; Bourrel, Luc; Soula, Jean-Claude; Guyot, Jean-Loup; Baby, Patrice

    2013-07-01

    Avulsion is the main process at the origin of anastomosing rivers. This study illustrates 3 examples of avulsions resulting from crevasse splays evolving in anastomosed channels along the Rio Pastaza, a tropical humid river sourced in the Ecuadorian Andean Cordillera and flowing into the Amazonian foreland. The Lower Pastaza flows in an alluvial plain, with no tectonic influence and an average monthly rainfall equally distributed throughout the year. Based on the analysis of satellite image recorded over the period 1977-2008, three cases have been studied. The first one began in 1990 with crevassing of natural levees of the right bank of the Pastaza main channel and the formation of a small channel linking up with a pre-existing tributary to this main channel. A splay formed at the confluence beheaded the tributary which became an anabranch of the main river. Downstream, two other avulsions developed from crevasse splays on a low gradient floodplain. In both cases, capture of one of the distributary channels flowing on the splay by a pre-existing drain of the floodplain and consecutive headward erosion arrives to disconnect the other drains and capture their flow into a single-thread channel. As this channel rejoins the Pastaza main channel downstream, this process gives rise to the larger-scale anastomosing system which characterizes the lower reach of the Rio Pastaza.

  16. Posteromedial approach of gastrocnemius for reduction and internal fixation of avulsed tibial attachment of posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; LI Ming-quan

    2006-01-01

    Objective:To introduce a posteromedial approach through the medial border of the medial head of gastrocnemius for reduction and reattachment of bony avulsion of the posterior cruciate ligament (PCL) from the tibia.Methods: Eleven patients with avulsed tibial attachment of the PCL underwent an operative reduction and internal fixation through the posteromedial approach of the gastrocnemius in our department from February 1998 to March 2000. The skin incision was reversed L-shaped along the medial border of the medial head of the gastrocnemius and the posterior capsule was exposed by dissecting the medial border and lateral retraction, avoiding the damage of the popliteal neurovascular structures. After that, the posterior capsule was vertically dissected a little medially to the posterior intercondylar sulcus and just on the posterior medial tibial eminence positioned by finger palpation. Then the PCL and its tibial attachment were easily accessible. In the delayed cases, PCL peripheral releasing was necessary to overcome the ligament retraction and to refresh the fracture bed for optimal reduction and bony healing. At last, one or two biodegradable screws were used to fix the avulsed bone segment and 30° flexion knee plaster cast immobilization was regularly applied after the wound was closed. The evaluation included X-ray, posterior sag sign and posterior drawer test compared with the contralateral side. The functional assessment of the low limbs was not available because of concomitant injuries.Results: The posteromedial approach of the gastrocnemius used in repair of tibial attachment avulsed injury of the PCL could provide benefit of clear anatomical exposure, few blood loss (20 ml on average), no need for detachment or reattachment of any structure. The patients were followed up for 11 months on an average (ranging from 6 months to 2 years ). It demonstrated that bony healing was achieved within 4-6 weeks in cases of fresh injury and 7-9 weeks in cases of

  17. The significance of avulsion phenomena in the alluvial filling configuration of a mountain stream: Venero Claro (Central Spain)

    Science.gov (United States)

    Ruiz-Villanueva, V.; Díez-Herrero, A.; Bodoque, J. M.; Fernández-García, P.; Ballesteros, J. A.

    2009-04-01

    In the dynamics and evolution of large river floodplains, alluvial fans and debris cones, avulsion phenomena have been considered very important. However, traditionally, in mountain streams, avulsion phenomena have been underestimated because they are not very frequent, and usually they are restricted to little chute cut-off. Nevertheless, there are mountainous areas where the valley bottom gets wider, and the alluvial filling works like an elongated debris cone. The Cabrera Stream in the Venero Claro reach (Spanish Central System) is one of these special areas. In this case, avulsion phenomena took place triggered by flash floods, and they were usually associated with hyperconcentrated flows, which exceeded the upper level of levees and banks, redefining the sedimentary architecture of the alluvial filling. In this study, an analysis of geomorphologic and sedymentological evolution of the alluvial filling in Venero Claro have been carried out. On this way, cartography made from the 19th Century until ninety ages were compared, and a stereoscopic analysis of aerial photographs and digital ortoimages were applied. Furthermore, the sedimentary filling was studied applying classic sedimentological techniques, such as a description and interpretation of sedimentary structures and facies analysis at field. As a result of the geomorphologic evolution analysis, a straightforward evolution model is proposed. This model enhances the relevant importance of the avulsion phenomena in the geomorphologic configuration of the Cabrera Stream in the Venero Claro reach. From the river pattern point of view, the avulsion phenomena originate capture processes in the main stream and its tributaries. As a result of these processes, the drainage network pattern changes successively from dendritic to sub-parallel. On other hand, from the sedimentologic point of view, the stratigraphy is composed of channel facies (debris flow facies and fluvial-torrential gravelbars) and back

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

    Science.gov (United States)

    Chang, Huiyi H; Havton, Leif A

    2012-09-01

    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) and electromyography (EMG) of the abdominal external oblique muscle (EOM) were performed. All rats demonstrated EMG activity of the EOM associated with reflex bladder contractions. At 1 wk after VRA and VRI, the duration of the EOM EMG activity associated with reflex voiding was significantly prolonged compared with age-matched sham rats. However, at 3 wk postoperatively, the duration of the EOM responses remained increased in the VRA series but had normalized in the VRI group. The EOM EMG duration was normalized for both VRA and VRI groups at 8-12 wk postoperatively. CMG recordings show increased contraction duration at 1 and 3 wk postoperatively for the VRA series, whereas the contraction duration was only increased at 1 wk postoperatively for the VRI series. Our studies suggest that a unilateral lumbosacral VRA injury results in a prolonged VMR to bladder filling using a physiological saline solution. An acute root replantation decreased the VMR induced by VRA injury and provides earlier sensory recovery.

  19. Child Abuse Mimic: Avulsion Injury in a Child With Penoscrotal Webbing.

    Science.gov (United States)

    Deutsch, Stephanie Anne; Long, Christopher J; Srinivasan, Arun K; Wood, Joanne N

    2017-04-01

    Sexual abuse of children is prevalent in today's society. In 2012, approximately 686,000 children (9.2 per 1000) in the United States were determined to be victims of substantiated child abuse and neglect, according to national data compiled by child protective service agencies; victimization rates were highest for children younger than 1 year. Nearly 9.3% of maltreated children were victims of sexual abuse, this finding was reported by US Department of Health and Human Services (http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment). Previous research has shown that as many as 1 in 3 girls and 1 in 7 boys will be sexually abused during childhood (Child Abuse Negl. 2003;27:1205-1222). Although sexual abuse seems to be less common in boys than girls, this may be partly due to underdiagnosis and underreporting of sexual abuse in boys (Arch Dis Child. 2007;92:328-331). Clinicians should therefore consider the possibility of sexual abuse when boys present with genital injuries, because failing to recognize and diagnose sexual abuse can pose an ongoing safety risk to a child. However, an erroneous diagnosis of sexual abuse can have equally hazardous repercussions, including removal of a child from their caregivers or prosecution of an innocent individual. A number of medical conditions can mimic child sexual abuse injuries, including anal fissures, failure of midline fusion, perianal streptococcal dermatitis, and straddle injury (J Pediatr Health Care. 2009;23:283-288 and Acta Paediatr. 2011;100:590-593). The following case involves a 5-week-old male infant who presented to the pediatric emergency department with an avulsion injury to his penis concerning for sexual abuse. He was ultimately diagnosed with a relatively rare anatomic variant of the genitalia and determined to have sustained an accidental injury whose appearance mimicked abuse.

  20. Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: a 4-year follow-up.

    Science.gov (United States)

    Senes, Andrea Melo; Sakai, Vivien T; Oliveira, Thais Marchini; Machado, Maria Aparecida A M; Santos, Carlos F; Marzola, Clóvis

    2008-03-01

    Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

  1. Horizontal intra-articular patellar dislocation resulting in quadriceps avulsion and medial patellofemoral ligament tear: a case report.

    Science.gov (United States)

    Kramer, Dennis E; Simoni, Michael K

    2013-07-01

    Intra-articular patellar dislocations are rare. We present a 13-year-old boy who sustained a complete horizontal intra-articular patellar dislocation following blunt trauma to the flexed knee. Closed reduction was unsuccessful and open reduction indicated a repairable quadriceps avulsion and medial patellofemoral ligament tear. He is the youngest patient to sustain a quadriceps rupture and the only patient to sustain a medial patellofemoral ligament tear to date. His flexed knee and the horizontally positioned patella (seen on lateral radiograph) were indicative of a complete rotational injury with extensor mechanism involvement. Open reduction allowed for the repair of both injuries and a favorable outcome.

  2. 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.

  3. The effect of severing a normal S1 nerve root to use for reconstruction of an avulsed contralateral lumbosacral plexus: a pilot study.

    Science.gov (United States)

    Zhu, L; F Zhang; Yang, D; Chen, A

    2015-03-01

    The aim of this study was to evaluate the feasibility of using the intact S1 nerve root as a donor nerve to repair an avulsion of the contralateral lumbosacral plexus. Two cohorts of patients were recruited. In cohort 1, the L4-S4 nerve roots of 15 patients with a unilateral fracture of the sacrum and sacral nerve injury were stimulated during surgery to establish the precise functional distribution of the S1 nerve root and its proportional contribution to individual muscles. In cohort 2, the contralateral uninjured S1 nerve root of six patients with a unilateral lumbosacral plexus avulsion was transected extradurally and used with a 25 cm segment of the common peroneal nerve from the injured leg to reconstruct the avulsed plexus. The results from cohort 1 showed that the innervation of S1 in each muscle can be compensated for by L4, L5, S2 and S3. Numbness in the toes and a reduction in strength were found after surgery in cohort 2, but these symptoms gradually disappeared and strength recovered. The results of electrophysiological studies of the donor limb were generally normal. Severing the S1 nerve root does not appear to damage the healthy limb as far as clinical assessment and electrophysiological testing can determine. Consequently, the S1 nerve can be considered to be a suitable donor nerve for reconstruction of an avulsed contralateral lumbosacral plexus.

  4. Does the prevalence of levator ani muscle avulsion differ when assessed using tomographic ultrasound imaging at rest vs on maximum pelvic floor muscle contraction?

    NARCIS (Netherlands)

    Delft, K. van; Thakar, R.; Sultan, A.H.; Kluivers, K.B.

    2015-01-01

    OBJECTIVE: It has been suggested that transperineal ultrasound images obtained during maximum pelvic floor muscle contraction improve the diagnosis of levator ani muscle (LAM) avulsion by comparison with those obtained at rest. The objective of this study was to establish, using transperineal tomogr

  5. 恒牙全脱位再植的研究现状%Present Studies of Replantation of Avulsed Permanent Teeth

    Institute of Scientific and Technical Information of China (English)

    钱瀚宇; 丁允鹏

    2015-01-01

    Permanent teeth are prone to avulsion by trauma.Replantation is the preferred treatment for avulsed perma-nent teeth, and the ideal prognosis of replantation is to achieve functional healing of periodontal ligament. If the avulsed teeth are immature, revascularization of the dental pulp is expected. The duration of extra-alveolar time, preservation of the root and storage media of the tooth, all of which determine the prognosis for dental replantation, but the current prognosis is not satisfactory. Present studies of replantation of avulsed permanent teeth were reviewed in the present paper.%恒牙外伤常导致牙齿全脱位,再植术是恒牙全脱位的首选治疗方法. 理想的预后是实现牙周功能性愈合,若牙根尖未完全封闭,尚有牙髓再生的可能. 恒牙再植术的预后与很多因素有关,如牙齿脱离牙槽窝的时间、牙根的保存以及牙齿的储存介质等,目前临床治疗效果尚不理想. 本文就恒牙全脱位再植的研究现状作一综述.

  6. Large-scale avulsion of the late Quaternary Sutlej river in the NW Indo-Gangetic foreland basin

    Science.gov (United States)

    Singh, Ajit; Gupta, Sanjeev; Sinha, Rajiv; Carter, Andrew; Thomsen, Kristina J.; Mark, Darren F.; Buylaert, Jan-Pieter; Mason, Philippa J.; Murray, Andrew S.; Jain, Mayank; Paul, Debajyoti

    2015-04-01

    River avulsions are important processes in the spatial evolution of river systems in tectonically active sedimentary basins as they govern large-scale patterns of sediment routing. However, the pattern and timing of avulsions in large river systems are poorly documented and not well understood. Here we document late Quaternary paleo-river channel changes in the Indo-Gangetic basin of northwest India. Using a combination of satellite remote sensing and detailed sediment coring, we analyse the large-scale planform geometry, and detailed sedimentary and stratigraphic nature of a major fluvial sedimentary deposit in the shallow subsurface. This sediment body records aggradation of multiple fluvial channel fills. Satellite remote sensing analysis indicates the trace of the buried channel complex and demonstrates that it exists in region of the Himalayan foreland where no major rivers are currently present. Thus it records the former drainage pathway of a major river, which has since been diverted. We use optically stimulated luminescence dating techniques to develop an age model for the stratigraphic succession and hence constrain the timing of river channel existence and diversion. Provenance analysis based on U-Pb dating of detrital zircons and detrital mica Ar-Ar ages indicate sediment sources in the Higher Himalayan Crystalline and Lesser Himalayan Crystalline Series indicating that this paleo-river channel system formed a major perennial river derived from the main body of the Himalaya. Specifically we are able to fingerprint bedrock sources in the catchment of the present-day Sutlej river indicating that the paleo-fluvial system represents the former course of the Sutlej river prior to a major nodal avulsion to its present day course. Our results indicate that on geologically relatively short time-scales, we observe dramatic along strike shifts in the location of major Himalayan rivers. Our sediment records when combined with high-resolution dating and

  7. 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.

  8. 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

  9. A rare case of bicondylar Hoffa fracture associated with ipsilateral tibial spine avulsion and extensor mechanism disruption

    Institute of Scientific and Technical Information of China (English)

    Kamal Bali; Aditya Krishna Mootha; Vibhu Krishnan; Vishal Kumar; Saurabh Rawall

    2011-01-01

    Intra-articular coronal fractures (Hoffas fractures) of distal femur are rare. Although bicondylar involvement in these fractures has been reported in the literature in association with high velocity traumata, the occurrence of these fractures involving extensor mechanism rupture and avulsion of ipsilateral tibial spine is extremely rare. To our acquaintance, such a fracture pattern has not yet been reported in the literature so far. In this article, we report one such case and discuss the importance of early diagnosis and prompt internal fixation in the management of such cases. We believe that these rare combinations of injuries should be treated aggressively by early open reduction and anatomic rigid internal fixation in order toachieve good recovery of function.

  10. 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.

  11. Improved C3-4 transfer for treatment of root avulsion of the brachial plexus upper trunk Animal experiments and clinical application

    Institute of Scientific and Technical Information of China (English)

    Lin Zou; Xuecheng Cao; Jing Li; Lifeng Liu; Pingshan Wang; Jinfang Cai

    2012-01-01

    Experimental rats with root avulsion of the brachial plexus upper trunk were treated with the improved C3-4 transfer for neurotization of C5-6. Results showed that Terzis grooming test scores were significantly increased at 6 months after treatment, the latency of C5-6 motor evoked potential was gradually shortened, and the amplitude was gradually increased. The rate of C3 instead of C5 and the C4 + phrenic nerve instead of C6 myelinated nerve fibers crossing through the anastomotic stoma was approximately 80%. Myelinated nerve fibers were arranged loosely but the thickness of the myelin sheath was similar to that of the healthy side. In clinical applications,39 patients with root avulsion of the brachial plexus upper trunk were followed for 6 months to 4.5 years after treatment using the improved C3 instead of C5 nerve root transfer and C4 nerve root and phrenic nerve instead of C6 nerve root transfer. Results showed that the strength of the brachial biceps and deltoid muscles recovered to level III-IV, scapular muscle to level III-IV, latissimus dorsi and pectoralis major muscles to above level III, and the brachial triceps muscle to level 0-III. Results showed that the improved C3-4 transfer for root avulsion of the brachial plexus upper trunk in animal models is similar to clinical findings and that C3-4 and the phrenic nerve transfer for neurotization of C5-6 can innervate the avulsed brachial plexus upper trunk and promote the recovery of nerve function in the upper extremity.

  12. ESTABLISHMENT ON ANIMAL MODEL OF SKIN AVULSION INJURY%皮肤撕脱伤实验动物模型建立与实验的报告

    Institute of Scientific and Technical Information of China (English)

    李向东; 鲁开化; 郭树忠; 高政慧

    2001-01-01

    through estabilshing animal model of skin avulsion injury in pigs. Methods: A 12cm × 14cm random avulsed flap was created in hind leg of pig by mimicking the mechanism of causing avalsion injury and by applying the avulsion-injury-created machine and made post-injury tissue pathology. Results: There were injuries at different levels in skin, dermis tissue and vessels. Subcutaneous separated from muscle. Throm bosis and hemorrhage could be found in some vessels. Conclusion: Skin avulsion injury created in hind leg of pigs is similar with one caused by traffic accident.%目的:了解撕脱伤后组织坏死机理和治疗方法。方法:在猪后肢应用皮肤撕脱伤模型机建立皮肤撕脱伤模型,形成12cm×4cm的撕脱皮瓣,撕脱组织行病理学检查。结果:皮肤、皮下组织以及血管受到不同程度损伤,皮下组织与肌肉分离,血细胞渗出,血管内形成广泛微血栓。结论:在猪后肢形成的皮肤撕脱伤模型与交通事故所致的皮肤撕脱伤相似,可以做为临床皮肤撕脱伤实验研究的模型。

  13. Replantation of avulsed permanent teeth:an analysis of 32 cases%外伤脱位牙再植后的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    张月云; 徐龙博

    2011-01-01

    AIM: To analyze the factors influencing the effects of tooth replantation of avulsed permanent teeth.METHODS : Twenty-six children with 32 avulsed permantent teeth were enrolled in this study.The avulsed permantent teeth were replantated in the Department of Pediatric Dentistry, Jining Stomatology Hospital, in the years between 2004 and 2008.The patients were followed up regularly for 2 to 3 years.RESULTS : During the follow-up period, periodontal ligament healing was observed in 4/32, replacement resorption in 23/32, inflammatory resorption in 3/32 and odontoptosis in 2/32 teeth.The success rate of replatation was 84.37%.CONCLUSION: The replantation of young permanent teeth showed a higher success rate.The success of replantation was related to ex vivo time,storage medium and root development stage of the avulsed teeth.%目的:研究探讨影响再植牙临床疗效的相关因素.方法:对2004-2008到我院儿童牙病科就诊的26例8~14岁患儿32个外伤牙进行常规再植,术后定期复查,观察时间2~3年.结果:观察期内,32个外伤恒牙中牙周膜愈合4个,替代性吸收23个,炎症性吸收3个,松动脱落2个.成功率为84.37%.结论:年轻恒牙再植后的成功率较高,但与脱位牙离体时间、保存方式及牙根的发育程度等因素有密切关系.

  14. Effects of C8 ventral root avulsion or transection on spinal alpha motoneurons in adult rats A qualitative light and electron microscopic study

    Institute of Scientific and Technical Information of China (English)

    Khulood M.AL-Khater; Bassem Y.Sheikh

    2008-01-01

    BACKGROUND:Nerve root avulsion is a frequent finding in patients with brachial plexus injury following road traffic accidents or as a result of severe arm traction during complicated deliveries.This injury constitutes a challenging clinical and surgical problem.The orphological characteristics of motoneurons after nerve root avulsion deserve further analysis.OBJECTIVE:To study the different morphological changes of u -motoneurons under light and electron microscopy after C8 spinal ventral rootlets avulsion and transection at various stages.DESIGN:Controlled animal study.SETTING:Department of Anatomy,King Faisal University.MATERIALS:The experiment was carried out at the Department of Anatomy,College of Medicine,King Faisal University between January 2005 and March 2006.Six adult Sprague Dawley rats weighing 200-350 g, irrespective of gender,were used for this study.The animals were bred at the animal house,College of Medicine,King Faisal University,and fed on rat maintenance diet.Water and standard diet were supplied ad libitum.Animal interventions were carried out according to animal ethical standards.METHODS:Three animals were randomly chosen for avulsion of the right ventral rootlets of C8 spinal nerves.The other three received transection of the right ventral rootlets of C8 spinal nerves.①Avulsion experiment:After rats were anesthetized,the right ventral rootlets of C8 spinal nerves were identified.The ventral rootlets were avulsed from the spinal cord by traction with a fine hook(Fine Science Tools Inc.,No. 10031-13,Germany).Traction was exerted in a direction parallel to the course of the spinal root.Under the operating microscope,the Cs segment was exactly located.After checking the successfulness of the surgical procedure,the Ca segment was separated from the spinal cord.The outcome of the avulsion procedure was as follows:two animals had true avulsion,i.e.,no remaining stump was attached to the spinal cord surface.One rat had a stump still attached

  15. A novel arthroscopic procedure for fixation of avulsion fracture of tibial attachment of anterior cruciate ligament guided by meniscal stitching needle

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chun-li; XU Hu; FAN Hong-bin; MENG Cheng-fei; CHEN Hui; CAO Shi-lei

    2008-01-01

    Objective: To introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the clinical results.Methods : From 1999 to 2005, fifteen cases of tibial eminence avulsion were treated with this new technique. Lysholm scoring scale system was used to assess knee function before and after surgery. Regular plain anteroposterior and lateral X-ray films were undertaken to detect the bony healing of avulsed fragment.Results: The operating time could be controlled within 30 minutes. No complications such as intraarticular infection, iatrogenic injury, fibroarthritis or nonunion of fracture occurred in this group. X-ray film revealed that bony healing in all 15 cases was achieved from 6 weeks to 12 weeks postoperatively. Lysholm score was improved from 19.1±15.2 (ranging from 10 to 56) preoperatively to 97.5 ±3.7 (ranging from 91 to 100) postoperatively on average in 12-54 months follow up ( mean 23 months). The statistically significant difference was shown in Student's t test (t = 18. 483, P = 3. 100 × 10 -11 , P < 0. 01). Wire breakage was found in two patients whose wires were removed 8 months and 14 months after initial operation, respectively.Conclusion : This technique has many advantages, such as simplicity, wide indications from type Ⅱ to type Ⅳ fractures, minimal invasion, short operating time and predictable satisfactory results.

  16. 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.

  17. 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.

  18. 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

  19. Quaternary megafans, large rivers and other avulsive systems: a potential "who is who" in the geological record

    Science.gov (United States)

    Latrubesse, E. M.

    2012-12-01

    A fascinating discussion has been recently calling the attention of sedimentologists and geomorphologists regarding to the dominant fluvial styles preserved in the geological record. While some authors postulate that distributary (or distributive) patterns are the most important systems likely to dominate the alluvial rock record (Weissmann et al.2010, among others) others suggest that a variety of fluvial styles are remarkably preserved in the geological record, rejecting the importance of the distributary systems (such as megafans and other like fans coastal systems) (Fielding et al, 2012 among others). However, the Quaternary record of the largest depositional tracks on Earth has been not assessed in a comparative and detailed way. Here I present results from some of the most important Quaternary areas of sedimentation of the world such as the alluvial belts of the largest rivers, the largest megafans and other impressive fluvial dominated wetlands in active tectonic basins. My study is based on field work I carried out in many of the analyzed areas, a literature review and remote sensing products. Specific examples are discussed from several rivers of the Amazon basin, the Parana River, the Mississippi River, among others. Large depositional tracks in forelands, platforms and intracratonic basins such as the Chaco, the Orinoco Llanos, the Bananal and Pantanal basin, the Ucamara depression, and the Indo-Gangetic plain, which contain a variety of complex avulsive systems and megafans, are discussed. A main conclusion is that megafans and similar distributary systems, avulsive systems with a variety of channel patterns and linear fluvial belts of major rivers, have the potential for preservation in the geological record. The scarcity of purely braided systems in large rivers is noticeable and they are mainly constrained to small-medium size channels, short length piedmont courses or related to relatively small alluvial fans. Meandering and anabranching systems are

  20. Direct anastomosis of contralateral C7 nerve root transfer with affected-side inferior trunk for repair of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    Houjun Yan; Changqing Hu; Yingli Jia; Chunjie Cui; Xuefeng Li; Jingyang Zhang

    2006-01-01

    AIM:To observe the effect of direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk for repair of brachial plexus avulsion injury,and investigate its feasibility. METHODS:Two male patients.with the age of 24 and 41 years respectively,were retrieved.When admitted to the hospital,they were diagnosed as brachial plexus avulsion injury.They subjected the operation in the 252 Hospital of Chinese PLA in March 2006 and May 2006 respectively.The proximal end of contralateral C7 nerve root was dissociated to nerve root pore and the distal end was dissociated to anterior and posterior divisions of middle trunk.The injured C7 nerve root was widely dissociated to inferior trunk,medial cord,ulnar nerve and medial head of median nerve.When elbow and shoulder joints were in flexion,the injured C7 nerve root was directly anastomosed with contralateral C7 nerve root in the gap between affected-side cervical vagina vasorum and esophagus with no tensions. RESULTS:Durling 3 to 5 hours of operation,little hemorrhage was found,nerves were not used for connection.Dyspnea,hoarse voice and other complications did not appear,either.In the postoperative 7th to 8th months.electremyogram examination showed that the growth velocity of anastomosed nerve was normal.CONCLUSION:Direct anastomosis of contralateral C7 nerve root transferred through prespinal route with affected-side inferior trunk can be used for repair of brachial plexus avulsion injury with satisfying therapeutic effects.

  1. Traction avulsion amputation of the major upper limb: a proposed new classification, guidelines for acute management, and strategies for secondary reconstruction.

    Science.gov (United States)

    Chuang, D C; Lai, J B; Cheng, S L; Jain, V; Lin, C H; Chen, H C

    2001-11-01

    Major replantation of a traction avulsion amputation is undertaken with the goal of not only the reestablishment of circulation, but also functional outcome. This type of amputation is characterized by different levels of soft-tissue divisions involving crushing, traction, and avulsion injuries to various structures. Between 1985 and 1998, 27 cases were referred for secondary reconstruction following amputation of the upper extremity involving both arm and forearm. Replantation was performed by at least 12 qualified plastic surgeons using different approaches and management, resulting in different outcomes. Initial replantation management significantly affects the later reconstruction. For comparing studies and prognostic implications, the authors propose a new classification according to the level of injury to muscles and innervated nerves: type I, amputation at or close to the musculotendinous aponeurosis with muscles remaining essentially intact; type II, amputation within the muscle bellies but with the proximal muscles still innervated; type III, amputation involving the motor nerve or neuromuscular junction, thereby causing total loss of muscle function; and type IV, amputation through the joint; i.e., disarticulation of the elbow or shoulder joint. Some patients required further reconstruction for functional restoration after replantation, but some did not. Through this retrospective study based on the proposed classification system, prospective guidelines for the management of different types of traction avulsion amputation are provided, including the value of replantation, length of bone shortening, primary or delayed muscle or nerve repair, necessity of fasciotomy, timing for using free tissue transfer for wound coverage, and the role of functioning free muscle transplantation for late reconstruction. The final functional outcome can also be anticipated prospectively through this classification system.

  2. Primary reconstruction of skin avulsion injury on both feet%双足皮肤脱套伤的一期修复

    Institute of Scientific and Technical Information of China (English)

    刘勇; 张成进; 付兴茂; 王剑利; 张雪涛; 王蕾; 隋志强

    2014-01-01

    目的 探讨利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤的临床效果.方法 2005年6月至2011年8月共利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤4例.其中切取带股前外侧皮神经的股前外侧皮瓣修复足底,胸脐皮瓣或背阔肌肌皮瓣修复足背.结果 4例双足脱套伤均一期修复,皮瓣存活,术后功能外形良好,随访6个月至2年,足底感觉恢复良好,两点辨距觉为14~18 mm,行走正常.结论 利用双侧股前外侧皮瓣联合胸脐皮瓣或背阔肌肌皮瓣一期修复双足皮肤脱套伤,是一种较好的修复方法.%Objective To investigate the therapeutic effect of primary reconstruction of skin avulsion injury with bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.Methods From June 2005 to Aug.2011,4 cases with skin avulsion injury on both feet were treated.The bilateral anterolateral thigh flaps,including with anterolateral thigh cutaneous nerves,were transferred to cover the feet plantar.The thorax umbilicus flap or latissimus dorsi flap were used to cover the feet dorsum.Results All the skin avulsion injury were reconstructed primarily.All the flaps survived completely with good cosmetic and functional results.The patients were followed up for 6 months to 2 years with good sensory recovery(two point discrimination:14-18 mm).Conclusion The skin avulsion injury on both feet can be primarily reconstructed by bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.

  3. 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.

  4. 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.

  5. Avulsion of malleoincudal complex with dislocation: A rare ossicular chain injury by using an indigenous claw-like ear hook with review of literature

    Directory of Open Access Journals (Sweden)

    Produl Hazarika

    2014-01-01

    Full Text Available Direct ear trauma through external auditory canal causing an avulsion injury of malleoincudal complex is a grievous injury that can happen during ear cleaning with indigenous ear hook. One such case of avulsion injury is presented here with its symptomatology, investigation, and management with the review of available literature because of its rarity. Various locally designed indigenous ear hooks are available in street side markets and even online for purchase and used by many without knowing its ill effects on health. Injury caused by these types of hooks may lead to a severe hearing disability, if not properly treated. This presentation is to highlight the fact that indigenous ear hooks; rampantly available online for purchase can cause a potentially major injury leading to hearing disability and thereafter poor quality of life. Reporting and highlighting of such incidents among the ENT community can help increase the public awareness; thereby, eliminating such disastrous consequences. Wikipedia, PubMed, and Google search engine has been used for our data collection and analysis.

  6. Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first posterior (second approach and end-to-side side-to-side grafting neurorrhaphy

    Directory of Open Access Journals (Sweden)

    Abdel-Meguid Amr MS

    2009-06-01

    Full Text Available Abstract Background The superiority of a single stage combined anterior (first posterior (second approach and end-to-side side-to-side grafting neurorrhaphy in direct cord implantation was investigated as to providing adequate exposure to both the cervical cord and the brachial plexus, as to causing less tissue damage and as to being more extensible than current surgical approaches. Methods The front and back of the neck, the front and back of the chest up to the midline and the whole affected upper limb were sterilized while the patient was in the lateral position; the patient was next turned into the supine position, the plexus explored anteriorly and the grafts were placed; the patient was then turned again into the lateral position, and a posterior cervical laminectomy was done. The grafts were retrieved posteriorly and side grafted to the anterior cord. Using this approach, 5 patients suffering from complete traumatic brachial plexus palsy, 4 adults and 1 obstetric case were operated upon and followed up for 2 years. 2 were C5,6 ruptures and C7,8T1 avulsions. 3 were C5,6,7,8T1 avulsions. C5,6 ruptures were grafted and all avulsions were cord implanted. Results Surgery in complete avulsions led to Grade 4 improvement in shoulder abduction/flexion and elbow flexion. Cocontractions occurred between the lateral deltoid and biceps on active shoulder abduction. No cocontractions occurred after surgery in C5,6 ruptures and C7,8T1 avulsions, muscle power improvement extended into the forearm and hand; pain disappeared. Limitations include spontaneous recovery despite MRI appearance of avulsions, fallacies in determining intraoperative avulsions (wrong diagnosis, wrong level; small sample size; no controls rule out superiority of this technique versus other direct cord reimplantation techniques or other neurotization procedures; intra- and interobserver variability in testing muscle power and cocontractions. Conclusion Through providing proper

  7. 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

  8. Management of hard tissue avulsive wounds and management of orofacial fractures. Report No. 6 (annual) 1 Aug 79-1 Aug 80

    Energy Technology Data Exchange (ETDEWEB)

    McCoy, L.G.; Hassler, C.R.

    1980-08-01

    This report summarized results of continued studies for further developing and understanding the in vivo behavior of resorbable calcium phosphate for use in the management of hard tissue avulsive wounds and orofacial fractures. Specific studies have been devoted to the preparation and comparitive in vivo evaluation of porous tricalcium phosphates having various pore distributions. Secondary studies have included attempts to alter the stoichiometry of the material. The in vivo studies suggest that the direction of porosity within the biodegradable material is perhaps the most important parameter determining the success of a biodegradable material which facilitates bone ingrowth. It is recommended that a stoichiometric tricalcium phosphate with highly directional pore structure be the object of future research.

  9. Case report: endodontic and surgical treatment of an upper central incisor with external root resorption and radicular cyst following a traumatic tooth avulsion.

    Science.gov (United States)

    Lux, Hans-Christian; Goetz, Falko; Hellwig, Elmar

    2010-11-01

    In the age group between 6 and 12 years, trauma to the upper incisors happens frequently. In the case of avulsion, a replantation is the state-of-the-art treatment; however, it may lead to several complications, particularly if suitable posttraumatic management is not carried out. External cervical resorptions as well as apical granuloma and cysts due to microbial contamination of the root canal are common complications. In the presented trauma case, a conservative approach was chosen to treat a large cystic lesion combined with cervical and apical resorptions. After initial placement of Ledermix and calcium hydroxide into the root canal, a marsupialization with the temporary insertion of an obturator was performed. The gradual reduction led to a fast recovery of the bony defect and a root canal filling was placed. The 2-year follow-up showed an improved condition. All adjacent teeth remained vital during the course of the treatment.

  10. Repair of Double Head Pectoralis Major Tendon Avulsion into its Native Footprint Using Bi-cortical EndoButtons and Tendon Sliding Technique

    Science.gov (United States)

    Prabhu, Jagadish; Faqi, Mohammed Khalid; Alkhalifa, Fahad; Tayara, Bader Kamal; Awad, Rashad Khamis

    2017-01-01

    Injuries to the pectoralis major muscle are relatively infrequent. The mechanism of injury is usually an eccentric shortening of the pectoralis major under heavy load, such as when performing a bench press exercise. We report a case that presented to us with a history of sudden pain in the left pectoral region while doing heavy bench press exercise. The patient sustained a type III D pectoralis muscle –tendon avulsion. Surgical repair was done through a bi-cortical tendon sliding technique using two cortical buttons. In this article we describe our modifications to the previously described surgical technique for the pectoralis major tendon repair using the EndoButton and tension – slide technique, aiming to overcome the possible complications. PMID:28217216

  11. Identification and management of chronic shoulder pain in the presence of an MRA-confirmed humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion

    Science.gov (United States)

    Karmali, Arif; McLeod, Jennifer

    2016-01-01

    Objective: To present the assessment and conservative management of chronic shoulder pain in the presence of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion in an active individual. Clinical Features: A 47 year-old female office-worker with constant, deep, right shoulder pain with occasional clicking and catching claimed to have “tore something” in her right shoulder five years ago while performing reverse bicep curls. A physical exam led to differential diagnoses of a Superior Labrum Anterior to Posterior (SLAP) lesion, Bankart lesion, and bicipital tendinopathy. A Magnetic Resonance Arthrogram revealed a HAGL lesion. Intervention and Outcome: A conservative chiropractic treatment plan in addition to physical therapy was initiated. The patient reported 75% improvement in symptoms after 4 treatments over a four-week duration. Summary: This case demonstrates the successful implementation of a conservative plan of management suggesting that the treatment provided to this patient should be considered and attempted prior to arthroscopic surgery. PMID:27385837

  12. Clinical effect analysis of hyperbaric oxygen to reduce the swelling and pain caused by limb avulsion%高压氧治疗减轻肢体撕脱伤肿胀、疼痛效果的临床分析

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Background: In recent years, most major avulsion of limb skin were caused by traffic accidents, industry accidents and mechanical traumas, the tissue damage, the operational elimination of subcutaneous fat or skin flap transfer may cause ischemia and hypoxia at the wound, the limb swelling and pain were obvious, the routine treatment was slow and of long recovering time. Objective: To discuss the effects of hyperbaric oxygen to reduce the swelling and pain caused by limb avulsion. Unit: The People's Hospital of Sanshui.

  13. 恒牙撕脱性损伤临床特征的回顾性分析%A retrospective study about the clinical characteristics of avulsion of permanent teeth

    Institute of Scientific and Technical Information of China (English)

    王伟; 黄超; 刘艳丽; 赵寅华; 张旻; 陈永进

    2016-01-01

    目的:分析恒牙撕脱性损伤的分布特征。方法:对131名患者共179个撕脱性损伤患牙进行临床特征回顾性研究,包括年龄、性别、病因、牙保存方法、牙离体时间及是否伴有软硬组织伤等,并对观察半年以上且伴有牙槽骨骨折的撕脱性患牙愈后进行统计分析。结果:主要病因为摔伤(59%),好发于上颌中切牙(78%)。仅3%的人能够在30 min内就医;45%伴发软组织损伤;34%伴发牙槽骨骨折,其中10%牙槽骨骨折在初诊中被漏诊;撕脱性损伤伴牙槽骨骨折牙根吸收率略高于无牙槽骨骨折(P>0.05)。结论:多数患者由于就诊延误再植牙属于延迟再植;牙撕脱性损伤多伴发软硬组织的损伤,但撕脱性损伤患牙是否伴有牙槽骨损伤与其远期根吸收无明显关联。%AIM:To analyze the clinical characteristics of avulsion of permanent teeth.METHODS:A ret-rospective analysis was performed on the dental records of 131 patients with avolsion of 179 permanent teeth.The clinical data of avulsed teeth were collected,and the follow-up period was more than 6 months.The factors were analyzed in re-lation to postoperative outcomes.RESULTS:Wound in fall was the major reason for tooth avulsion (59%),and the maxillary incisors were the mainly avulsed permanent teeth(78%)Tooth avulsion was accompanied with injuries of the alveolar bone in 10% cases,with soft tissue injuries in 45% cases.Only 3% the avulsed teeth were replanted within 30 min at Emergency Department.10%alveolar bone fracture was not diagnosed at the first visit.Tooth avulsion accom-panied with and without injuries of alveolar bone on showed no stastitic significance in root resorption(P>0.05).CON-CLUSION:Most tooth replantation was delayed due to delayed clinical visit.Alveolar bone fracture may not be correla-ted with root resorption in avulsed permanent teeth.

  14. Functional compensative mechanism of upper limb with root avulsion of C5-C6 of brachial plexus after ipsilateral C7 transfer

    Institute of Scientific and Technical Information of China (English)

    SONG Jie; CHEN Liang; GU Yu-dong

    2008-01-01

    Objective: To investigate the compensative mechanism of no further impairment of the upper limb after ipsilateral C7 transfer for treatment of root avuision of C5-C6 of the bra- chial plexus. Methods: Sixty Sprague Dawley SD rats were randomly divided into a CT-transection group and a control group, 30 rats each. In the C7-transection group, the left forelimbs of the animals underwent transection of ipsilat- eral C7 nerve root while C5 and C6 nerve roots were avulsed. In the control group, the left forelimbs only underwent C5 and C6 root avulsion. The representative muscles of C7 innervated mainly by C7 including latissimus dorsi, triceps, extensor carpi radialis brevis and extensor digitorum com- munis were evaluated with neurophysiological investigation, muscular histology and motor end plate histomorphometry 3, 6 and 12 weeks after operation. The right forelimbs of all rats were taken as the control sides. Results: Three weeks after operation, the recovery rates of amplitudes of compound muscle action potential CMAP and CMAP latency, muscular wet weight and cross-sec-tional area of muscle fibers, and area of postsynaptic membranes of those four representative muscles in the C7transection group were significantly lower than those of the control group P <0.05 or P <0.01. Six weeks postoperatively, the recovery rates of CMAP amplitude and latency of the triceps showed no significant difference between the C7transection group and the control group P0.05. For the extensor carpi radialis brevis and the extensor digitorum communis, the recovery rates of the cross-sectional area of muscle fibers, the amplitude and latency of CMAP and the area of postsynaptic membranes showed no significant difference between the two groups P 0.05, while the rest parameters were still significantly different between the two group P <0.05 or P <0.01. As far as the ultramicrostructure was concerned in the C7-transection group, more motor end plates of four representative muscles were

  15. Brain glucose metabolic changes associated with chronic spontaneous Pain due to brachial plexus avulsion:a preliminary positron emission tomography study

    Institute of Scientific and Technical Information of China (English)

    CHEN Fu-yong; TAO Wei; CHENG Xin; WANG Hong-yan; HU Yong-sheng; ZHANG Xiao-hua; LI Yong-jie

    2008-01-01

    Background Previous brain imaging studies suggested that the brain activity underlying the perception of chronic pain maV differ from that underlying acute pain.To investigate the brain regions involved in chronic spontaneous pain due to brachial plexus avulsion(BPA),fluorine-18fluorodeoxygIucose (19F-FDG) positron emission tomography (PET) scanning was applied to determine the glucose metabolic changes in patients with pain due to BPA.Methods Six right-handed patients with chronic spontaneous pain due to left-BPA and twelve right-handed age-and sex-matched healthy control subjects participated in the 18F-FDG PET study.The patients were rated by visual analog scale (VAS) during scanning and Hamilton depression scale and Hamilton anxiety scale after scanning.Statistical parametric mapping 2 (SPM2) was applied for data analysis.Results Compared with healthy subjects,the patients had significant glucose metabolism decreases in the right thalamus and S I(P<0.001,uncorrected),and significant glucose metabolism increases in the right orbitofrontaI cortex (OFC) (BA11),left rostral insula cortex and left dorsolateral prefrontal codex (DLPFC) (BA10/46) (P<0.001,uncorrected).Conclusion These findings suggest that the brain areas involved in emotion.aRention and internal modulation of pain may be related to the chronic spontaneous pain due to BPA.

  16. 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.

  17. Different functional reorganization of motor cortex after transfer of the contralateral C7 to different recipient nerves in young rats with total brachial plexus root avulsion.

    Science.gov (United States)

    Pan, Feng; Wei, Hai-feng; Chen, Liang; Gu, Yu-dong

    2012-12-07

    Clinically, contralateral C7 transfer is used for nerve reconstruction in brachial plexus injuries. Postoperatively, synchronous motions at the donor limb are noteworthy. This study studied if different recipient nerves influenced transhemispheric functional reorganization of motor cortex after this procedure. 90 young rats with total root avulsion of the brachial plexus were divided into groups 1-3 of contralateral C7 transfer to anterior division of the upper trunk, to both the musculocutaneous and median nerves, and to the median nerve, respectively. After reinnervation of target muscles, number of sites for forelimb representations in bilateral motor cortices was determined by intracortical microstimulation at 1.5, 3, 6, 9, and 12 months postoperatively. At nine months, transhemispheric reorganization of nerves neurotized by contralateral C7 was fulfilled in four of six rats in group 1, one of six in group 2 and none in group 3, respectively; at 12 months, that was fulfilled in five of six in group 1, four of six in groups 2 and 3, respectively. Logistic regression analysis showed that rate of fulfilled transhemispheric reorganization in group 1 was 12.19 times that in group 3 (95% CI 0.006-0.651, p=0.032). At 12 months, number of sites for hindlimb representations which had encroached upon original forelimb representations on the uninjured side was statistically more in group 3 than in group 2 (t=9.5, pnerves induces faster transhemispheric functional reorganization of motor cortex than that to median nerve alone in rats.

  18. Establishment of an animal model of sacral nerve root avulsion in rats%大鼠骶丛根性撕脱伤模型的建立

    Institute of Scientific and Technical Information of China (English)

    江曦; 陈爱民; 张志凌; 侯春林; 鹿楠

    2009-01-01

    目的 建立大鼠骶丛撕脱伤模唰并评价其有效性.方法 选用20只成年SD大鼠,雌雄不限,不打开椎板,在神经孔外撕断右侧L神经根,左侧为对照侧.术后观察各组大鼠的存活情况,对受试大鼠进行受试鼠行为学运动(Basso-Beattie-Bresnahan,BBB)评分.并对其进行体感诱发电位(SEP)及双侧股二头肌、小腿三头肌及胫前肌刺激电位检测,辣根过氧化酶(HRP)逆行永踪,双侧股二头肌、小腿三头肌及胫前肌称重及肌肉横截面行双侧对比研究,以评价造模效果.结果 (1)一般情况:19只大鼠存活,1只大鼠死亡,存活率为95.0%.实验大鼠BBB评分为(10.78±3.15)分,而正常大鼠为21分;(2)SEP检测:17只大鼠患肢未在双侧大脑皮层检测到SEP,造模成功率为89.5%;(3)HRP示踪:2只大鼠脊髓L4-6节段内可见阳性反应,17例阴性,造模成功率为89.5%;(4)双侧股二头肌,小腿三头肌及胫前肌称重及肌肉横截面对比,差异有统计学意义;(5)电镜检测撕脱侧肌肉出现萎缩、细胞核中间移位及出现肌卫星细胞等失神经支配征象.结论 通过大鼠椎管外撕脱L4-6造模,是建立大鼠骶丛撕脱伤模型的一种可而理想的方法.%Objective To establish an animal model of sacral nerve root avulsion in rats and e-valuate its efficiency. Methods A total of 20 adult SD rats (either sex) were chosen at random to es-tablish the sacral nerve root avulsion model by avulsing the fight L4-6 nerve roots out of intervertebral fo-ramina without laminectomy. The left side was set as control group. The models were evaluated in aspects of survival rate, Basso-Beattie-Bresnahan (BBB) scores, somatosensory evoked potential (SEP), horse radish peroxidase (HRP) tracing, bilateral weight and cross section area (CSA) of muscle biceps femo-ris, fiber of triceps surae and anterior tibial muscle. Results Of all, 19 rats were survived but one died, with survival rate of 95.0%. The BBB score was (10.78+3.15) points

  19. Halo-vest头环在全头皮撕脱伤再植术中的应用%Application of Halo-vest head ring in replantation of total scalp avulsion

    Institute of Scientific and Technical Information of China (English)

    林涧; 吴立志; 郭宇华; 张天浩; 顾仕林; 王成; 陈忠义; 陈海啸

    2015-01-01

    Objective To investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.Methods We treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.Results One patient' s replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing.All the scalp flaps in the other 10 patients survived.After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.Conclusions The use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.%目的 探讨采用Halo-vest头环进行全头皮撕脱伤再植治疗的临床疗效.方法 2006年12月至2015年2月,我们采取吻合动静脉血管+ Halo-vest头环治疗11例全头皮撕脱伤.结果 本组1例患者因头皮撕挫严重,再植术后坏死,给予游离植皮和换药后创面愈合,无毛发生长.其余10例患者再植全部成活,经过3 ~96个月随访,创面完全愈合,头皮、毛发生长良好,获得满意的外观.结论 利用Halo-vest头环进行全头皮撕脱伤再植处理,能够有效提高成活率和成活面积.

  20. Effects of Se-phenyl thiazolidine-4-carboselenoate on mechanical and thermal hyperalgesia in brachial plexus avulsion in mice: mediation by cannabinoid CB1 and CB2 receptors.

    Science.gov (United States)

    Del Fabbro, Lucian; Borges Filho, Carlos; Cattelan Souza, Leandro; Savegnago, Lucielli; Alves, Diego; Henrique Schneider, Paulo; de Salles, Helena Domingues; Jesse, Cristiano R

    2012-09-26

    In this study, we investigated the therapeutic effects of treatment with (R)-Se-phenyl thiazolidine-4-carboselenoate (Se-PTC), an organic selenium compound with antinociceptive properties, against mechanical and thermal hyperalgesia induced by brachial plexus avulsion (BPA), a neuropathic model in mice. The involvement of cannabinoid CB(1) and CB(2) receptors in the Se-PTC anti-hyperalgesic effect was also investigated. Se-PTC treatment at (25 and 50mg/kg, per oral, p.o.) lowered (BPA model) induced mechanical and thermal hyperalgesia in mice. Pretreatment with cannabinoid CB(1) (AM251; 1mg/kg, intraperitoneally, i.p.), or CB(2) (AM630; 3mg/kg, i.p.) receptor antagonists reverted the mechanical and thermal anti-hyperalgesic effect of Se-PTC (25mg/kg) in the BPA model. Selective CB(1) (ACEA, 10mg/kg, i.p.) and CB(2) (JWH-133, 10mg/kg, i.p.) receptor agonists lowered mechanical and thermal hyperalgesia in the BPA model, and this effect was prevented by selective CB(1) and CB(2) receptor antagonists. Gabapentin (70mg/kg, p.o.), positive control administration also lowered mechanical and thermal hyperalgesia in the BPA model. The results suggest that the mechanical and thermal hyperalgesia observed following BPA in mice is dependent on cannabinoid receptors. The results indicate that modulating cannabinoid receptors represent a valuable approach for the treatment of neuropathic pain. In conclusion, the results suggested that Se-PTC produces pronounced mechanical and thermal anti-hyperalgesic effects in neuropathic models in mice by modulating CB(1) and CB(2) receptors.

  1. 第五跖骨基底部撕脱骨折的手术选择%Surgical options of avulsion fractures of the fifth metatarsal base

    Institute of Scientific and Technical Information of China (English)

    徐海林; 王天兵; 付中国; 张殿英; 姜保国

    2012-01-01

    背景:第五跖骨基底部撕脱骨折是临床常见骨折,以保守治疗为主,在一些情况下需行手术治疗,目前对其手术适应证和具体手术方法尚存争议.目的:探讨第五跖骨基底部撕脱骨折的手术治疗效果与手术适应证.方法:2004年6月至2011年4月手术治疗34例第五跖骨基底部撕脱骨折患者,男18例,女16例;左侧14例,右侧20例;其中6例行克氏针张力带固定,6例行可吸收钉固定,18例行空心钉固定,3例为陈旧骨折不愈合行锁定接骨板固定,1例行骑缝钉固定.均为Dameron分型1区骨折,手术适应证为明显移位超过2mm或累及骰骨第5跖骨关节面超过30%,受伤机制均为扭伤.结果:24例患者获得随访,随访时间为8~78个月,平均27个月,伤口均一期愈合,愈合时间为2.7 ~3.3个月,平均3个月.根据美国足踝协会中前足功能评分为87 ~ 100分,平均(93.0±5.3)分;VAS疼痛评分为0~2分,平均(0.6±0.8)分.结论:第五跖骨基底部撕脱骨折根据骨折情况采取适合的手术治疗可取得良好的治疗效果,但需严格掌握手术适应证.%Background: The fifth metatarsal base avulsion fractures are common in clinical practice. Conservative treatment is its major treatment. But sometimes it need surgical treatment. There are still controvercy in indications and methods of surgical treatment.Objective; The aim of this study is to explore the clinical outcomes and indications of surgical treatment of avulsion fractures of the fifth metatarsal base.Methods; From June 2004 to April 2011, 34 patients with fractures of Dameron Iarea (male 18, female 16, right side 20, left side 14) were operatively treated. Among them, 6 patients were treated by tension band, 6 patients were treated by absorbable screw, 18 patients were treated by cannulated screw, 3 patients with old fracture disunion were treated by locked plate and screw, and 1 patient was treated by staple. Indication of surgical treatment

  2. Creating and coupling a high-resolution DTM with a 1-D hydraulic model in a GIS for scenario-based assessment of avulsion hazard in a gravel-bed river

    Science.gov (United States)

    Aggett, G. R.; Wilson, J. P.

    2009-12-01

    In this paper we explore the development and assimilation of a high resolution topographic surface with a one-dimensional hydraulic model for investigation of avulsion hazard potential on a gravel-bed river. A detailed channel and floodplain digital terrain model (DTM) is created to define the geometry parameter required by the 1D hydraulic model HEC-RAS. The ability to extract dense and optimally located cross-sections is presented as a means to optimize HEC-RAS performance. A number of flood scenarios are then run in HEC-RAS to determine the inundation potential of modeled events, the post-processed output of which facilitates calculation of spatially explicit shear stress ( τ) and level of geomorphic work (specific stream power per unit bed area, ω) for each of these. Further enhancing this scenario-based approach, the DTM is modified to simulate a large woody debris (LWD) jam and active-channel sediment aggradation to assess impact on innundation, τ, and ω, under previously modeled flow conditions. The high resolution DTM facilitates overlay and evaluation of modeled scenario results in a spatially explicit context containing considerable detail of hydrogeomorphic and other features influencing hydraulics (bars, secondary and scour channels, levees). This offers advantages for: (i) assessing the avulsion hazard potential and spatial distribution of other hydrologic and fluvial geomorphic processes; and (ii) exploration of the potential impacts of specific management strategies on the channel, including river restoration activities.

  3. 前交叉韧带胫骨止点撕脱骨折研究进展%Advances in the study of avulsion fracture of the anterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    牛金龙; 黄远章; 王晋豫; 张民

    2016-01-01

    前交叉韧带(ACL)胫骨止点撕脱骨折临床上少见,好发于儿童和青少年。虽然损伤的发生率低,如不及时诊治,将严重影响膝关节的功能。最近,各种内置物的相继出现及关节镜的应用对该疾病的治疗增添了选择性。本文结合流行病学、病因、诊断及治疗方案研究进展等方面对ACL下附着点撕脱骨折进行阐述。%Avulsion fracture of the anterior cruciate ligament (ACL) is rare in clinic, which usually occurs in children and adolescents. Although the incidence of injury is low, if it is not timely diagnosed and treated, it will seriously affect the function of the knee joint. Recently, the emergence of a variety of implants and the use of arthroscopic treatment of the disease has increased the selectivity. In this paper, the combination of epidemiology, etiology, diagnosis and treatment of the progress of the ACL avulsion fracture were described.

  4. 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.

  5. 自制尖齿开口卡压钢板治疗撕脱性骨折%Self-made sharp opening teeth entrapment plate for treatment of avulsion fractures

    Institute of Scientific and Technical Information of China (English)

    陆尧; 刘军; 芮永军; 吴永伟; 马运宏

    2016-01-01

    目的:探讨自制尖齿开口卡压钢板治疗撕脱性骨折的特点和治疗效果。方法2012年1月~2015年2月,应用自制尖齿开口卡压钢板治疗撕脱性骨折16例,男性10例,女性6例。年龄最小20岁,最大63岁,平均43.6岁。其中,膝关节后交叉韧带胫骨止点撕脱性骨折8例,外踝撕脱性骨折2例,肱骨内上髁撕脱性骨折3例,肱骨大结节撕脱性骨折1例,尺骨鹰嘴撕脱性骨折2例。均为新鲜骨折,骨折分型(参照Meyer方法):I型1例,Ⅱ型6例,Ⅲ型9例。术后均早期康复锻炼。分别按Lysholm膝关节评分、Kaikkonen踝关节损伤功能评分和DASH上肢功能调查表,评价各部位患肢功能恢复情况。结果术后切口均I期愈合,无血管神经损伤。16例患者均获随访,随访12~24个月,平均18.1个月。所有骨折均愈合,愈合时间2~3个月,平均2.5个月,未见骨折移位和内固定松动。末次随访,患肢临近关节功能恢复优12例、良4例(优良率100%),无关节不稳和其它不良并发症发生。结论自制尖齿开口卡压钢板治疗撕脱性骨折方法简便、适应证广泛、固定可靠、效果良好。%Objective To investigate the characteristics and therapeutic efficacy of self-made sharp opening teeth entrapment plate for treatment of avulsion fractures. Methods Sixteen cases with avulsion fractures were treated with self-made sharp opening teeth entrapment plate between January 2012 and February 2015. There were 10 males and 6 females, with an age ranging from 20 to 63 years old, averaging 43.6 years old. Among all the cases, there were posterior cruciate ligament tibial avulsion fractures in 8 cases, lateral malleolus avulsion fractures in 2 cases, medial humeral epicondyle avulsion fractures in 3 cases,greater tuberosity of humerus avulsio fractures in 1 cases and olecranon avulsion fractures in 2 cases. All were fresh fractures, and the fracture type(according to

  6. Nursing of tibial avulsion fracture of anterior cruciate ligament with arthroscopy%关节镜下治疗前交叉韧带胫骨止点撕脱性骨折的护理

    Institute of Scientific and Technical Information of China (English)

    孙文萍; 林芃; 陈传霞

    2012-01-01

    目的 探讨关节镜下治疗前交叉韧带(ACL)胫骨止点撕脱性骨折的临床护理.方法 通过对12例ACL胫骨止点撕脱性骨折的患者采取术前心理护理、术前准备、术前适应性训练,术后一般护理、患肢与疼痛的观察护理和康复护理相结合,并在工作中小断总结护理经验,提高护理水平.结果 本组12例患者平均随访16个月,所有骨折均获愈合,未出现骨折移位等并发症.结论 科学、系统、细致的护理措施及有效的功能锻炼是确保治疗成功的关键,有利于ACL胫骨止点撕脱性骨折患者关节功能的恢复,减少并发症的发生.%Objective To explore the clinical nursing of tibial avulsion fracture of anterior cruciate ligament (ACL) with arthroscopy. Methods Twelve patients with tibial avulsion fracture of anterior cruciate ligament were provided with preoperative psychological nursing, perioperative preparation, preoperative adaptive exercise, general postoperative nursing, limb and pain nursing, and rehabilitation nursing. The nursing experience has been summarized in order to improve nursing management. Results An average of 16 -month follow -up of all the 12 patients revealed that all fractures were healed with no complications such as fracture dislocation. Conclusion Scientific, systematic, careful nursing measures and effective functional exercise are essential to a successful treatment, which is conducive to the recovery of patients with tibial avulsion fracture of anterior cruciate ligament and the reduction of complications.

  7. 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

  8. 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

  9. Endovenous laser plus stab avulsion in the treatment of lower-limb varicose veins%腔内激光联合点式剥脱治疗下肢浅静脉曲张206例

    Institute of Scientific and Technical Information of China (English)

    车星; 朱网林; 戴翔; 桑凯

    2013-01-01

    Objective To explore the advantages of endovenous laser plus stab avulsion in the treatment of lower-limb varicose veins. Methods Between July 1, 2010, and June 31, 2012, 206 patients with a total of 267 lower limbs were submitted to EVLT plus a surgical approach. Results The follow-up from 1 month to 25 months showed no recurrence and no clinical symptoms or signs. After treatment, the edema and itching disappeared, the pigmentation reduced, and all the ulcers healed. Conclusion Endovenous laser plus stab avulsion not only ensure the curative effect, but also achieve the purpose of minimally invasive in the treatment of lower-limb varicose veins.%目的 探讨腔内激光联合点式剥脱治疗下肢浅静脉曲张的优势.方法 2010 年7 月至2012 年7月,206 例患者共267 条患肢确诊为下肢浅静脉曲张,采取腔内激光联合手术治疗.结果 术后随访1~25 个月,所有患肢曲张静脉消失,未见复发,肿胀消退,瘙痒消失,色素沉着有所减轻,溃疡均愈合.结论 腔内激光联合手术治疗下肢浅静脉曲张,其在保证疗效的同时,达到了微创的目的.

  10. Arthroscopic treatment of tibial avulsion fracture of posterior cruciate ligament with high-strength suture%关节镜下高强线固定治疗后交叉韧带下止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

    目的 介绍全关节镜下高强度线捆绑固定治疗后交叉韧带(PCL)下止点撕脱骨折的手术方法和临床效果.方法 关节镜下常规探查后,通过后内、后外入路将骨块修整、新鲜化后,采用PCL重建导向器引导并由关节外向关节内骨折块边缘钻孔制备两个骨道,引入高强度线,环线PCL打结后,从骨道引到前方,于胫骨前方皮下打结固定.术后在支具保护4~6周后开始康复训练.结果 2010年1月至2012年6月,采用此方法治疗PCL下止点撕脱骨折18例,结果显示骨折解剖复位、愈合良好.术后2例失访,16例得到随访,时间7~30个月(平均13.6个月).术后6周内膝关节屈曲可达90°,术后8周伸屈恢复正常,术后12周行走正常.术后无血管、神经并发症发生,平均3个月骨折愈合.Lysholm评分从术前(38.9±4.9)分增加到(95.2±3.8)分(t=27.3,P<0.001),IKDC评分从术前(57.1±10.3)分增加到(94.3±4.4)分(t=21.8,P<0.001),术后评分与术前比较均有统计学差异.KT3000检测后向位移从术前(3.6±0.39)mm下降到(1.1±0.27)mm,手术前后评分有统计学差异(t=17.5,P<0.001).15例患者均恢复术前运动水平.结论 全关节镜下高强度线捆绑固定手术方法能直接对PCL下止点撕脱骨折复位、硬固定,不需另外切开操作,骨块固定稳固,达到了切开直视下骨折直接复位固定的效果,固定可靠,利于术后早期康复锻炼,不需二次手术切开取内固定,手术快捷,功能恢复良好.%Objective To evaluate the outcome of arthroscopic treatment using high-strength line for tibial avulsion fracture of posterior cruciate ligament ( PCL) . Methods From January 2010 to June 2012, a total of 18 cases of PCL tibial avulsion fracture were enrolled and followed up after surgery. All the cases were treated by arthroscopy. Both the avulsed bone block and the tibia bone bed were refreshed. The procedure was completed with the assistance of PCL director drill guide

  11. 青少年胫骨结节撕脱性骨折的治疗%Tibial tubercle avulsion fracture in adolescents: 9 cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    王达辉; 马瑞雪; 闵若良; 马巍

    2010-01-01

    目的 对青少年胫骨结节撕脱性骨折临床治疗结果进行分析,并回顾以往文献报告,总结该病的治疗及预后.方法 回顾性分析2003年1月至2008年6月间9例采用非手术和手术方法治疗的胫骨结节撕脱性骨折患儿,均为男性,年龄12岁10个月~16岁3个月,平均年龄14岁7个月;体重50~89 kg,平均66 kg;身高165~180 cm,平均173 cm.均是在运动中跳起或着地时受伤,篮球6例,足球1例,跳高1例,跨栏1例.其中1例有Osgood-Schlatter病,2例受伤前有明显的胫骨结节区疼痛病史.髌韧带撕脱2例,无关节内损伤病例.按照Ogden和Ryu & Debenham改良分型:Ⅰ型1例,Ⅱ型2例,Ⅲ型4例,Ⅳ型2例.非手术治疗3例,手术治疗6例.非手术组均行手法复位管型石膏固定;手术组切开复位内固定治疗,其中空心螺钉固定3例,克氏针及螺钉固定2例,可吸收螺钉固定1例,同期行关节探查3例.两组均行石膏固定6周.随访骨折愈合、关节功能及畸形情况.结果 8例患儿获得随访,1例保守治疗的患儿失随访,随访时间6个月至5年6个月,平均27.5个月.根据Mosier等的标准对患儿肢体功能进行评估,结果 均为优.2例有股四头肌萎缩,1例髌下感觉减退,无骨筋膜室综合症、膝反张、感染、关节屈曲障碍、再骨折、肢体不等长等并发症.结论 对于青少年胫骨结节撕脱性骨折非移位或轻微移位骨折可以保守治疗,但要警惕骨筋膜间室综合症发生.移位性骨折行切开复位空心螺钉内固定,同时修复撕裂的髌韧带、骨膜町以达到满意的疗效.%Objective To review the clinical outcome of tibial tubercle avulsion fracture in adolescents.Methods This was a retrospective analysis of a consecutive series of 9 children with tibial tubercle avulsion fracture managed in our institution between January 2003 and June 2008.All patients were boys,with an average age of 14.6 years(range 12.8-16.3).The average weight was 66 kg

  12. 神经根撕脱后3种鼠类脊髓运动神经元的再生反应%Three species of animals regeneration response of spinal motoneurons following roots avulsion

    Institute of Scientific and Technical Information of China (English)

    刘佛林; 周丽华; 林浩添; 吴荣耀; 谢环; 周靖

    2004-01-01

    BACKGROUND: There are species differences of motoneurons injury degree following roots avulsion and the nNOS gene expression is closely related to the death of motoneurons.OBJECTIVE: To study the diversity of nNOS gene expression in spinal motoneurons following roots avulsionDESIGN: Completely randomized design and control experiment.SETTING and MATERIALS: Twenty male Sprawgue-Dawley rats(200-250 g each), twenty BAL/C mice(20-25 g each) and twenty golden hamsters( 100 - 110 g each) were obtained from the Laboratory Animal Unit of Sun Yat-sen University.INTERVENTION: Avulsion was conducted at right brachial plexus. Two weeks later the C7 segments were separated for nNOS immunocytochemistry,NADPH-d enzyme histochemistry and neutral red staining.MAIN OUTCOME MEASURES: The number of nNOS-positive motoneurons and surviving motoneurons.RESULTS: Both neuronal NOS ICC and NADPH-diaphorase showed the same pattern of nNOS-positive neuron distribution in C7 spinal cords. Large amounts of the nNOS-positive motoneurons with high density were elicited in the lesion side of C7 anterior horns of both rats and hamsters. However, there was no nNOS expression detected in mice motoneurons. The difference of the nNOS-positive motoneurons among three different rodents was significant( F = 501. 502, P < 0. 001 ). The number of nNOS-positive motoneurons was significantly higher in SD rats than in hamsters(55.59% vs 42.26%, t =5. 940, P <0.001) and than in mice(55. 59% vs0%,t=51.651, P <0.001), and it was also significantly higher in hamsters than in mice(42.26% vs 0% , t = 21. 452, P < 0. 001 ). The difference of the surviving motoneurons among these three rodents was also significant( F =110. 588, P < 0. 001 ) . The number of surviving motoneurons was significantly higher in SD rats than in hamsters(87.29% vs 76.01%, t = 5. 252,P < 0.05) and than in mice(87.29% vs 57.38%, t=19.561, P <0. 001), and it was also significantly higher in hamsters than in mice(76.01% vs 57.38%,t

  13. Analysis of the Changes in Circulation of Sub-dermal Vascular Network Flap Made from Flap-type Skin Avulsion and Replanted to Origin Site%皮瓣型皮肤撕脱伤修成暴露真皮下血管网皮瓣回植创面的血循环变化分析

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To find out the characteristics of the changes in circulation of sub-dermal vascular network flap made from flap-type skin avulsion Injury and replanted to origin site. Method: Pig skin avulsion model was used in this experiment. Flap's blood circulation was monitored and surviving flap length measured. Result. Flap blood circulation was markedly improved. Conclusion: Sub-dermal vascular network flap made from skin avulsion flap and replanted to origin site can improved the survival length of the flap.%目的:了解皮肤撕脱伤修成暴露真皮下血管网皮瓣回植创面的血循环变化特点和对皮瓣成活的影响。方法:以猪为实验对象,制作皮肤撕脱伤模型,观察皮瓣的血循环变化和成活情况。结果:将撕脱瓣修成暴露真皮下血管网的皮瓣再回植,可以使皮瓣血循环显著改善。结论:将撕脱瓣修成暴露真皮下血管网的皮瓣再回植,可以使皮瓣成活长度显著增加。

  14. Minimally invasive treatment through arthroscope for anterior cruciate ligament tibial avulsion fracture%关节镜微创治疗前交叉韧带胫骨部撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    崔宗杰; 茹朝阳

    2015-01-01

    目的:探讨关节镜微创治疗前交叉韧带(ACL)胫骨部撕脱骨折的治疗效果。方法关节镜微创治疗ACL胫骨附着部撕脱骨折38例,其中Ⅰ型3例,Ⅱ型12例,Ⅲ型23例。所有患者均采取常规膝关节前外侧入路进镜检查,行骨折复位,然后自胫骨结节两侧钻孔,直达骨折块,用2枚导针穿入,将直径0.7 mm钢丝穿入固定骨块,在骨外拧紧钢丝,观察治疗效果。结果本组38例经4~32个月随访,6周愈合24例,8周愈合8例,12周愈合6例,膝关节功能良好。结论关节镜微创治疗ACL胫骨部撕脱骨折,对膝关节损伤小,用较粗钢丝内固定,固定可靠、恢复快,可早期行膝关节功能锻炼,利于关节功能恢复。%Objective To explore the curative effect of minimally invasive treatment through arthroscope for anterior cruciate ligament (ACL) tibial avulsion fracture.Methods Among 38 patients of ACL tibial avulsion fracture undergoing minimally invasive treatment through arthroscope, there were 3 cases of type Ⅰ, 12 cases of type Ⅱ, and 23 cases of type Ⅲ. Arthroscopy was performed into the front knee with the conventional approach and the reduction of fracture was carried out in all the patients. Then drilling was done from both sides of the tibia to the fracture fragments. After the penetration of two needles, the wire of 0.7 mm diameter was introduced to fix the bone fragments and tightened out of the bone. Curative effects were observed.Results The follow-up of 38 cases lasted 4~32 months. There were 24 healed cases in 6 weeks, 8 healed cases in 8 weeks, and 6 cases in 12 weeks. They all had good knee joint function.Conclusion Minimally invasive treatment through arthroscope for ACL tibial avulsion fracture has few damage to knee joint. Thick wire can provide reliable internal fixation, which can recover quickly. Early exercise of knee joint function can be conducted to benefit joint function recovery.

  15. Arthroscopic Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in 16 Cases%关节镜下治疗前交叉韧带下止点撕脱骨折16例

    Institute of Scientific and Technical Information of China (English)

    俞胜宝; 胡四生; 汪炜; 凌健

    2011-01-01

    Objective To observe the surgical skill and the clinical outcomes of arthroscopic treatment of anterior cruciate ligament(ACL) tibial avulsion fracture. Methods From January 2007 to December 2010,16 cases of avulsion fracture of intercondylar eminence( according to Meyers and Mckeever classification, type Ⅰ 1 case, type Ⅱ 13 cases, type Ⅲ 3 cases) received the arthroscopic treatment. The surgical approach was both sides of the patellar ligament, the fracture reduction was performed under arthroscopy,and then the Kirschner wire was inserted from a point medial to the tibial tubercle to hold the intraarticular fracture fragments. The epidural tube was first penetrated through the Kirschner wire hole,and then the guiding tension suture( No. 2 polyethylene line, diameter was 0.5 - 0.7 mm) was penetrated through the epidural tube to fix the bone block. Results Sixteen patients were followed up for 2 to 36 months,14 cases were healed in 12 weeks,other 2 cases in 18 weeks. 14 cases(87.5% ) recovered completely with a good joint stability and negative drawer test; other 2 cases gained a good functional recovery with a good joint stability but positive drawer test. Conclusion Arthroscopic surgery,with a small incision,simple operation,less postoperafive injury,secure internal fixation, is an effective method for the ACL tibial avulsion fracture. The early functional exercise of knee joint should improve the recovery of knee.%目的 观察关节镜下微创治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术方法及疗效.方法 2007年1月-2010年12月,关节镜下治疗ACL下止点撕脱骨折16例,其中按meyem-meckeever分型1型1例,2型13例,3型2例.常规膝关节髌韧带两侧入路进入关节腔,镜下骨折复位,然后自胫骨结节内侧钻入克氏针,达骨折块,自克氏针孔穿入硬膜外麻醉套管,直径0.5~0.7 mm钢丝导引张力缝线(2号聚乙烯线)经硬膜外麻醉套管穿入固定骨折块.结果 术后16例经2~36

  16. Clinical study on the clinical curative effect of comprehensive rehabilitation for brachial plexus avulsion%综合康复治疗臂丛神经撕脱伤的临床疗效

    Institute of Scientific and Technical Information of China (English)

    周莹; 周丽

    2014-01-01

    Objective To study the clinical curative effect of comprehensive rehabilitation treatment on acupuncture and physiotherapy in brachial plexus avulsion.Methods Totally 184 patients with brachial plexus avulsion in our hospital were se-lected ,and were randomly divided into control group of 92 cases and observation group of 92 cases ,then the control group wsa treated by low-frequency electrical stimulation pulses with neuromuscular electrical stimulation. The observe group was treaded by comprehensive rehabilitation ,including acupuncture management therapy ,massage and IF electric massage ,then pain visual analog scale assessment of pain ,function of the brachial plexus of two groups were analyzed and compared.Results Before treatment ,brachial plexus function and VAS scores in the patients of two groups had no significant difference (P>0 .05).After treatment of 4 and 8 weeks ,the brachial plexus function and VAS scores of two groups improved after treatment than before treatment ,and the observation group was better than the control group (P<0 .05). The total effective rate in the control group was 77 .17% ,which was 90 .22% in observation group. The patients limb functional recovery was significantly better than the control group ,with a significant difference (P<0 .05).Conclusion Acupuncture management therapy ,massage therapy method and frequency electric comprehensive rehabilitation therapy can be helpful in brachial plexus avulsion recovery of limb function , the efficacy is significantly better than the family functional exercise.%目的:探讨以针灸理疗为主的综合康复治疗臂丛神经撕脱伤的临床疗效。方法纳入臂丛神经撕脱伤患者共184例,随机分为对照组和观察组,对照组采用神经肌肉电刺激仪进行低频脉冲电刺激,观察组采用综合康复疗法,包括针灸理疗法、推拿按摩法和中频电疗法,采用疼痛视觉模拟评分评定疼痛程度和臂丛

  17. Exploration the Clinical Effect of Artificial Dermis in Treating Skin Avulsion Injury%人工真皮在治疗皮肤撕脱伤的临床应用

    Institute of Scientific and Technical Information of China (English)

    陈柏秋(通讯作者); 彭文要; 邱加崇; 余继超; 刘冰峰; 招伟峰

    2013-01-01

    Objective:To explore the clinical effect of artificial dermis in treating skin avulsion injury .Methods:48 cases of the skin avulsion injury in our hospital from 2008 January to 2013 January was retrospective analysis , we can randomly divide them into 2 groups . 24 cases in the control group was treated with anti -infection, microcirculation improving, dressing treatment, and operating skin graft-ing or flap repairing when the fresh granulation tissue grew .The observation group included 24 cases, treated with anti -infection, mi-crocirculation improving , early debridement and dressing , after fresh granulation tissue grew , external application of artificial dermis (skin Nike), then induced dermal reconstruction, promoted fresh granulation tissue growth, and operated skin grafting when the granula-tion tissue growing satisfactorily .Results:The average hospitalization days of the control group was 38.2 ±1.3 days.Due to the burn area is larger;the scar hyperplasia of 11 cases among the control group was obvious after the wound was repaired by split -thickness skin or mid-thickness skin.In observation group, the average hospital stay 28.4 ±1.1 days, the scar hyperplasia was not obvious or lighter after the wound was healed .Conclusion:The application of artificial dermis in treatment of skin avulsion injury can effectively shorten the days of hospitalization , reduce the operation risk , promote wound healing , plus the simple operation process and no obvious scar hyper-plasia or lighter , it is truly worth further popularization and application in clinic .%目的:探索人工真皮治疗皮肤撕脱伤的临床效果。方法:回顾性分析我院2008年1月~2013年1月48例皮肤撕脱伤的治疗方法。随机分成2组,对照组24例,予抗感染,改善微循环和换药治疗后,待创面有新鲜肉芽组织生长后行植皮或皮瓣修复术。观察组24例,予抗感染,改善微循环,早期清创、换药,创面有新鲜肉芽

  18. 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

  19. 游离股薄肌移植在臂丛损伤治疗中的临床应用%The Clinical Application of Free Gracilis Muscle Transplantation in Treatment of the Brachial Plexus Avulsion

    Institute of Scientific and Technical Information of China (English)

    林晓岗; 顾立强

    2013-01-01

    目的:探讨游离股薄肌移植在臂丛损伤治疗中的疗效.方法:对47例臂丛根性损伤患者行71次吻合血管、神经的游离股薄肌移植重建上肢主要功能,术后随访观察功能恢复情况.结果:随访32例患者,26例恢复屈肘、伸指、伸拇功能,肌力M3-M4级;18例恢复屈指、屈拇功能,肌力M3-M4级;2例恢复伸肘功能,肌力M3级;4例屈指、屈拇肌力M1级.结论:吻合血管、神经的游离股薄肌移植是治疗臂丛神经根性损伤的有效手术方法.%Objective: To discuss the efficacy of the free gracilis muscle transplantation after brachial plexus injury. Method: 71 free gracilis muscles have been transplanted to reconstruct the main function of upper limb in 47 patients with root avulsion of brachial plexus, after surgery they were followed up to observe the functional recovery. Result: Follow-up were earned out in 32 patients, 26 patients the flexion of elbow and extension of fingers and thumb were restored, Their muscle power were M3 -M4 , 20 of them restored the function of finger and thumb flexion, with muscle power of M3 -M4 , 2 of them restored the function of the elbow extension, with muscle power of M3, the strength of finger and thumb flexion was Mj in the other 4 ca-ses. Conclusion: Free gracilis muscle transplantation with vaseularization and ncurotization is an effective method for treatment of complete root avulsion of brachial plexus.

  20. Erosion and deposition by supercritical density flows during channel avulsion and backfilling: Field examples from coarse-grained deepwater channel-levée complexes (Sandino Forearc Basin, southern Central America)

    Science.gov (United States)

    Lang, Jörg; Brandes, Christian; Winsemann, Jutta

    2017-03-01

    Erosion and deposition by supercritical density flows can strongly impact the facies distribution and architecture of submarine fans. Field examples from coarse-grained channel-levée complexes from the Sandino Forearc Basin (southern Central America) show that cyclic-step and antidune deposits represent common sedimentary facies of these depositional systems and relate to the different stages of avulsion, bypass, levée construction and channel backfilling. During channel avulsion, large-scale scour-fill complexes (18 to 29 m deep, 18 to 25 m wide, 60 to > 120 m long) were incised by supercritical density flows. The multi-storey infill of the large-scale scour-fill complexes comprises amalgamated massive, normally coarse-tail graded or widely spaced subhorizontally stratified conglomerates and pebbly sandstones, interpreted as deposits of the hydraulic-jump zone of cyclic steps. The large-scale scour-fill complexes can be distinguished from small-scale channel fills based on the preservation of a steep upper margin and a coarse-grained infill comprising mainly amalgamated hydraulic-jump zone deposits. Channel fills include repeated successions deposited by cyclic steps with superimposed antidunes. The deposits of the hydraulic-jump zone of cyclic steps comprise regularly spaced scours (0.2 to 2.6 m deep, 0.8 to 23 m long) infilled by intraclast-rich conglomerates or pebbly sandstones, displaying normal coarse-tail grading or backsets. These deposits are laterally and vertically associated with subhorizontally stratified, low-angle cross-stratified or sinusoidally stratified sandstones and pebbly sandstones, which were deposited by antidunes on the stoss side of the cyclic steps during flow re-acceleration. The field examples indicate that so-called spaced stratified deposits may commonly represent antidune deposits with varying stratification styles controlled by the aggradation rate, grain-size distribution and amalgamation. The deposits of small-scale cyclic

  1. 髂前上棘撕脱骨折18例治疗回顾%Treatment of 18 cases with anterior superior iliac spine avulsion fracture: a respective review

    Institute of Scientific and Technical Information of China (English)

    张立峰; 王达辉; 裴新红; 马瑞雪

    2014-01-01

    目的 回顾18例髂前上棘(anterior superior iliac spine,ASIS)撕脱骨折的治疗,分析小儿髂前上棘撕脱骨折受伤机制,手术治疗的效果、预后、并发症.方法 2003年7月至2013年7月复旦大学附属儿科医院共收治髂前上棘撕脱骨折患儿18例.男15例,女3例,年龄3岁8个月至16岁.均为急性损伤:快速跑步时或急加速时14例,打篮球突然跳跃1例,踢球1例,车祸伤2例.X线片及CT了解骨折片的大小及移位情况:2例车祸伤者1例因合并股骨颈骨折行股骨颈切开复位空心钉内固定术,髂前上棘撕脱未处理,1年后X片及CT发现形成骨化中心,无症状未处理;1例行保守治疗骨折愈合;其余均行切开复位空心钉内固定.结果 18例患儿治疗效果优良,术后无深部组织感染,髋关节无活动受限,肌力正常,运动能力恢复,局部无疼痛、无包块.结论 髂前上棘撕脱骨折切开复位空心钉内固定效果好,恢复快,并发症少,并且可避免以后可能出现的股外侧区疼痛症,运动员可尽早恢复训练,但需二次手术取出内固定.%Objective To retrospectively review the treatment experiences of 18 cases of anterior superior iliac spine (ASIS) avulsion fracture so as to analyze its injury mechanism,treatment,complications and prognosis.Methods The clinical follow-up data were collected for 18 children with ASIS avulsion fracture treated at Children's Hospital,Fudan University during the period of July 2003 to July 2013.There were 15 males and 3 females with an age range of 44-192 months.All of them had acute injuries from rapid running or sudden acceleration (n =14),sudden jumping while playing basketball (n =1),football-related (n =1) and traffic accident (n =2).Radiology and computed tomography (CT) scan were used to analyze the size of bone fragments and shifting.One traffic accident patient coupled with femoral neck fractures underwent femoral neck open reduction and cannulated screw fixation while

  2. The clinical study of reconstruction of traumatic brachial plexus root avulsion injury in children%儿童创伤性臂丛神经撕脱伤的屈指功能重建

    Institute of Scientific and Technical Information of China (English)

    王树锋; 栗鹏程; 薛云皓; 李玉成; 陆健; 郑炜; 孙燕琨

    2010-01-01

    目的 观察健侧C_7,经椎体前通路移位与下干直接吻合,重建儿童创伤性臂从神经撕脱伤屈指功能的效果.方法 健侧C_7,在其前后股的远端切断,向近端游离至椎间孔,经椎体前通路牵至患侧.游离患侧臂丛下干及内侧束,切断下干后股及胸前内侧神经.将正中神经、尺神经及前臂内侧皮神经自内侧束的起始处一直游离到上臂中段.息肩前屈、内收至0°位,肘关节屈曲90°,上提患侧下干并与健侧C_7,直接吻合.2004年8月至2008年3月对20例患儿进行了健侧C_7,与患侧下干或内侧束直接吻合术.其中男16例,女4例;年龄5-18岁,平均13岁;伤后到手术时间1-11个月,平均4.6个月.全臂丛撕脱伤13例,中、下干撕脱伤7例.为减少吻合口张力,11例进行了肱骨短缩,短缩长度2.5-4.5 cm,平均(3.1±0.7)cm.结果 术后患者随访时间12-51个月,平均 27.4个月.屈指肌力4级18例,2级2例;屈拇长肌力4级10例、3级8例、2级2例.小指展肌肌力3级l例,2级1例;拇短展肌肌力3级1例.结论 健侧C_7,与患侧下干直接吻合,由于只有一个吻 合口及缩短了神经再生的距离,其重建屈指、屈拇功能的效果满意,并可恢复手内在肌的部分功能.%Objective To observe the primary result of finger flexion reconstruction in the procedure of direct anastomosis of contralateral C_7,transfered through the prespinal route with lower trunk in children suffered traumatic brachial plexus root avulsion injury.Methods On the healthy side.the C_7 nerve root was identified anatomically and transected at the level of division by dissecting its anterior and posterior division as far distal as possible up to the level where the nerve fihers interweaving with other division,then the contralateral C_7,nerve root W88 dissected proximally up to the neuroforamina.The contralateral C_7 nerve root was transferred to contralateral side through the prespinal route.The entire brachial plexus of

  3. A retrospective study on pulpal tissue prognosis of avulsed permanent teeth in children%儿童恒牙全脱出牙髓组织预后的回顾性研究

    Institute of Scientific and Technical Information of China (English)

    白洁; 秦满; 赵玉鸣

    2015-01-01

    Objective:To analyze the pulpal prognosis of replanted permanent teeth in children and to examine the associated factors .Methods:The samples consisted of 67 children with 81 avulsed perma-nent teeth treated in Peking University Hospital of Stomatology from 2000 to 2012 .Their clinical data of the replanted teeth were collected , and the follow-up period was no less than 12 months.The pulpal prognosis was classified as pulp necrosis and pulp non-necrosis .Results: The replantation within 30 minutes after avulsion led to the most significant increase in pulpal healing (P<0.05).The dental pulp of 80% ( 4/5 ) young permanent teeth replanted within 30 minutes remained vital , while all the teeth replanted after 30 minutes developed pulp necrosis within 60 days after replantation .Conclusion: The extra-alveolar period significantly affects the prognosis of pulp in immature permanent teeth after replanta-tion.When the extra-alveolar period is more than 30 minutes, the chance of pulp revascularization after replantation is very low , therefore pulp extirpation should be performed .%目的:观察儿童恒牙全脱出后再植牙的牙髓组织预后类型,牙髓坏死出现的时间,分析影响再植牙牙髓组织预后的因素。方法:对2000年至2012年在北京大学口腔医院就诊的儿童恒牙全脱出且观察期大于12个月的病例进行回顾性研究,观察再植牙的牙髓组织预后方式,牙髓坏死、钙变出现的时间,分析影响再植牙预后的相关因素,并进行统计学分析。结果:超过30 min再植的全脱出牙再植后60 d内全部发生了牙髓坏死,且出现牙髓坏死的时间明显早于30 min内再植的全脱出牙(P<0.05);30 min内再植的牙齿80%(4/5)牙髓存活,主要表现为牙髓钙变。结论:离体时间会影响再植牙的牙髓组织预后,超过30 min再植的牙齿牙髓几乎没有存活机会,临床上应考虑施行牙髓摘除术。

  4. Analysis of 23 cases of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation%张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折23例分析

    Institute of Scientific and Technical Information of China (English)

    张朝凯; 吴莉; 丁晶; 刘庆波; 李迎辉; 吴明贵; 俞超

    2013-01-01

    目的 探讨张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折的效果.方法 23例膝关节后交叉韧带止点撕脱骨折患者,采用张力带钢丝复位固定,并对关节腔进行修整;采用Lysholm膝关节评分法评价疗效.结果 23例患者随访6个月~2年,22例(95.7%)术后膝关节功能恢复良好,1例老年患者术前即有骨性关节炎,关节间隙狭窄,术后仍有慢性疼痛及曲伸功能障碍.结论 张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折简单、经济、有效.%Objective To investigate the outcomes of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation. Methods Twenty-three patients with avulsion fractures of posterior cruciate ligament of knee joint were treated with tension band wire fixation, and the outcomes were evaluated by Lysholm knee joint scoring. Results All the patients were followed up for 6 months to 2 years. Favorable function recovery was achieved in 22 (95.7%) patients. The other senior patient suffered from osteoarthritis and narrow joint space before operation, and there still existed chronic pain and flexion-extension dysfunction after operation. Conclusion Treatment of avulsion fractures of posterior cruciate ligament of knee joint by tension band wire fixation is simple, economical and effective.

  5. Some special treatment of skin avulsion for the elderly patients%老年患者中一些特殊皮肤撕脱伤的治疗体会

    Institute of Scientific and Technical Information of China (English)

    张志华; 王肃生; 梁刚; 冀航; 侯春

    2014-01-01

    目的:探讨老年患者中一些特殊皮肤撕脱伤的特点及治疗体会。方法回顾分析收治的22例特殊老年皮肤撕脱伤患者的诊治,撕脱皮肤均采用清创后原位缝合、加压包扎的治疗方法。结果21例患者中再植皮片全部或大部分成活,1例因感染导致皮片坏死,经清创后二次植皮愈合,经4个月至3年随访,回植皮肤弹性、感觉及活动度良好。结论因此类老年患者皮肤损伤存在撕脱层次浅、撕脱皮肤损伤不重的特点,采用清创后原位缝合、加压包扎的治疗可取得满意的效果。%Objective To investigate the characteristic and experience of special skin avulsion’s treatment with elderly patients. Methods According to 22 cases of special patients tearing for the diagnosis and treatment,avulsion skin are used after debridement suture in situ, pressurized bandaging treatment method. Results All the grafts or most survived,one cases caused a skin graft necrosis by infection, skin graft healing later. From 4 months to 3 years, feeling and activity are good after the replantation skin. Conclusion The features of elderly patients with shallow, less trauma, the clear suture and bandaging treatment can obtain satisfactory effect.

  6. 3D打印技术辅助手术治疗骶骨骨折伴骶丛神经损伤%Surgical treatment of sacral fractures accompanied with lumbosacral plexus avulsion assisted by 3D printing

    Institute of Scientific and Technical Information of China (English)

    杨鹏; 叶添文; 张帆; 杨迪; 朱磊; 何翔; 陈爱民

    2015-01-01

    Objective To report the preliminary results of using 3D printing technology to assist surgical treatment of sacral fractures accompanied with lumbosacral plexus avulsion.Methods From May 2013 to August 2014,11 hospitalized patients with sacral fracture accompanied with lumbosacral plexus avulsion were enrolled in the present study.They were 6 males and 5 females,28 to 57 years of age (mean,42.3 years).Seven fractures were fresh and 4 obsolete.According to the Denis classification,3 fractures were type Ⅱ and 8 type Ⅲ.All the cases experienced a decrease or loss in skin sensation in the saddle area or in the area innervated by the sacral plexus at the lower extremity.Ten cases reported radiating pain and dysfunction of the lower extremity,and 5 had dysfunction of bladder sphincter,anal sphincter,or sexual performance.Their average Injury Severity Score was 21.5.All patients underwent 3D reconstruction of CT scans.Their fracture models were manufactured by 3D printing before operation.A bundle of wire 3 mm in diameter was used to stimulate the course of sacral plexus by which we evaluated the distribution and compression of the nerves.After surgical stimulation on the 3D printing models,operations were performed on the patients.Lumbo-sacral internal fixation,sacral plexus exploration and decompression were taken as the standard surgical pattern.The postoperative sensory and motor function was evaluated according to the criteria proposed by the British Medical Research Council.Results The mean surgical time was 3.2 hours and the mean intraoperative bleeding was 1 845 mL for the 11 patients.All the patients were followed up from 6 to 15 months (average,8.2 months).Their sacral fractures obtained stable fixation and bone healing after 13.5 weeks.Their recovery of motor function increased 2.5 levels and their sensory recovery increased 2.6 levels compared to the preoperation.Radiating pain at the lower limb was alleviated in 10 cases and disappeared in 3.Conclusion 3D

  7. The arthroscopic treatment for children with tibial intercondylar eminence avulsion fractures:a report of 24 cases%关节镜治疗儿童胫骨髁间棘撕脱骨折24例分析

    Institute of Scientific and Technical Information of China (English)

    吴星火; 段德宇; 何宇; 方为志; 苏正兵; 孟春庆; 王洪; 杨述华

    2013-01-01

    Objective To explore minimally invasive treatment for tibial intercondylar eminence avulsion fractures under arthroscopy.Methods From Jan 2009 to Dec 2010,24 patient with skeletal immaturity (16 boys and 8 girls,8~ 14 years old) underwent the arthroscopic reduction and PDS-Ⅱ suture fixation of the anterior cruciate ligament or the avulsion fracture.Having taken the advantage of ACL-aimer,the sutures were pulled out and tied outside the joint accurately.According to the standard of International Knee Documentation Committee (IKDC),the Lysholm knee scoring method was used to measure the knee function preoperatively and postoperatively.Results Twenty-four patients were followed up for 6 to 30 months.All patient gained normal range of motion,and the X ray examination demonstrated bone union in all the cases.At the end of the follow-up,all the patients got improved range of movement without complications such as joint stiffness,joint relaxation,epiphyseal injury or malformations dysfunction.The mean Lysholm knee scores were improved from 48.6 ± 7.2 preoperatively to 94.5 ± 4.1 at the end of the follow-up period (P<0.001)and the mean IKDC subjective evaluation scores were increased from 53.5 ± 4.8 preoperatively to 92.8 ± 3.7 at the end of the follow-up period (P<0.001).Conclusions The arthroscopical operation with absorbable suture fixation,which leads to less trauma,is a simple and effective alternative for patients with the avulsion fracture of tibial intercondylar eminence.%目的 探讨经关节镜下骨折块复位,辅助PDS-Ⅱ丝线内固定治疗儿童胫骨髁间棘撕脱骨折的临床效果.方法 选择我院自2009年1月至2010年12月间胫骨髁间棘撕脱骨折的患儿24例(男16例,女8例,年龄8~14岁),采用经关节镜下骨折块复位,以类似成人前交叉韧带重建方式,自胫骨结节内上方1 cm(骨骺上方)以胫骨定位器定位,以直径1~1.2 mm克氏针钻孔,然后以16号腰穿针导入2根不可吸收的PDS-

  8. The pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy%关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    林瑞新; 董伊隆; 杨国敬

    2010-01-01

    目的 探讨关节镜下双套环技术治疗后十字韧带(posterior cruciate ligament,PCL)胫骨止点撕脱性骨折的方法和临床疗效.方法 2007年1月至2009年7月,自行设计关节镜下双套环技术治疗23例后十字韧带胫骨止点撕脱性骨折,男15例,女8例.年龄28~52岁,平均39.3岁.Meyers-McKeever分型:Ⅱ型4例,Ⅲ型14例,Ⅳ型5例.结合手术前后膝关节Xx线片和MRI,以及手术前后Lysholm评分和Tegner膝关节功能评分,对关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折的疗效进行分析.结果 所有患者手术均在1小时内完成,所有病例均无止血带损伤、血管神经损伤和感染等并发症,术后两周拆线,创口均Ⅰ/甲愈合.所有患者均获得随访,随访时间12~23个月,平均16.5个月.Lysholm膝关节评分从术前(50.3±6.1)分提高到术后半年随访的(89.7±8.3)分(t=18.34,P=0.0007).Tegner膝关节评分从术前(1.7±0.5)分提高到术后半年随访的(5.7±1.3)分(t=13.77,P=0.0008).两组膝关节功能评分有统计意义.结论 关节镜下双套环技术治疗后十字韧带胫骨止点撕脱性骨折具有创伤小、疗效良好且固定可靠等优点,其为后十字韧带胫骨止点撕脱性骨折的治疗提供一种可靠的选择.%Objective To investigate the feasibility and clinical effects of the pair ringer technology for bony avulsion of the posterior cruciate ligament under arthroscopy. Methods From January 2005 to July 2009, 23 patients were treated with the pair ringer technology for bony avulsion of the posterior cruciate ligament by arthroscopy. There were 15 male and 8 female, with an average of 39.3 years (ranging from 28 to 52 years). There were 4 cases of type Ⅱ, 14 type Ⅲ, and 5 type Ⅳ according to Meyer-Mckeever classification. The outcome measures were X-ray and MRI testing, Lysholm and Tegner knee function score. Results All the operations were finished in an hour. There were no complications as

  9. C型臂透视下定位腘窝纵行小切口治疗后交叉韧带止点胫骨嵴撕脱骨折%Treatment of Tibial Plateau Avulsion Fracture Implicating Accreting of Posterior Cruciate Ligament (PCL) through Popliteal with Longitudinal Small Incision under the Orientation of C-Arm X-Ray

    Institute of Scientific and Technical Information of China (English)

    韩立民; 宓士军; 张远成

    2011-01-01

    Objective To explore the methods and efficacy of treatment of tibial plateau avulsion fracture implicating accreting of posterior cruciate ligament ( PCL ) through popliteal with longitudinal small incision under the orientation of C-Arm X - ray to provide effective method for treatment of avulsion fracture of tibial spine. Methods Retrospectively analyze 35 cases admitted from March 2007 to September 2009. Orientation tibial plateau avulsion fracture piece was fixed under C -Arm X -ray, and the fixed piece was reset with longitudinal small incision at popliteal fossa orientation. Results All the patients have little intraoperative bleeding, short operative time, and have no neurological vascular injury. Postoperative follow-up shows that all avulsion fractures show osseous healing, and the average function is 96 7 % by lysholm grade. Conclusion This surgical technique can reduce the surgical incision as well as the operation time, and it is in line with minimally invasive surgical operation.%目的 探讨C型臂透视下定位腘窝纵行小切口治疗后交叉韧带止点胫骨嵴撕脱骨折的手术方法及疗效.方法 2007年3月-2009年9月对35例患者在C型臂透视下定位后交叉韧带止点胫骨嵴撕脱骨折块,在定位处行腘窝纵行小切口将撕脱骨折块复位固定.结果 本组患者术中出血较少,平均20~40 ml,手术时间短,平均25 min,无神经血管损伤.术后全部病例经随访观察,撕脱骨折均获骨性愈合;术后6个月行lysholm评分,平均功能评分96.7分.结论 采用此手术方法可以减小手术切口,缩短手术时间,符合微创外科操作.

  10. 关节镜微创治疗陈旧性肱骨大结节撕脱骨折合并肩袖损伤的临床疗效研究%Arthroscopic-assisted minimally invasive reduction and osteosynthesis of old avulsion fractures of the greater tuberosity with rotator cuff tear

    Institute of Scientific and Technical Information of China (English)

    陈志超; 顾祖超; 段鑫; 李志力

    2016-01-01

    目的:探讨关节镜微创治疗陈旧性肱骨大结节撕脱骨折合并肩袖损伤的临床疗效。方法回顾性分析2011年1月至2013年12月成都市第一人民医院收治的12例陈旧性肱骨大结节撕脱骨折合并肩袖损伤患者在关节镜下行肱骨大结节成形双固定螺钉肩袖修复的治疗方法。12例患者全部获得随访,随访时间6~24个月。按照美国加州洛杉矶大学 UCLA 功能评分标准,术前、术后6个月分别进行评估,观察其疗效。结果患者的美国加州洛杉矶大学 UCLA 功能评分术前为(20.6±5.3)分,术后6个月随访时评分为(31.5±3.6)分,差异有统计学意义(P <0.05),本组患者无明确的术后并发症。结论关节镜下肱骨大结节成形并肩袖修复是一种微创、疗效好、康复快的治疗方法。%Backgroud Old avulsion fracture of the greater tuberosity is a common clinical disease.Patients with no significant dislocation after fresh avulsion fracture of the greater tuberosity usually take conservative treatment,if conservative treatment effect is not ideal or the selection of early treatment method is unreasonable (conservative treatment for displaced fracture),the fragment tend to displace to posterosuperior of the proximal humerus,thus may cause malunion of greater tuberosity,lead to subacromial impingement and rotator cuff injury.All these pathological factors can often lead to pain and limited activity of the shoulder.Now conservative treatment is more often used for pain and restricted movement of the shoulder after avulsion fracture of the greater tuberosity, however,the effect is not ideal.From January 201 1 to December 2013,12 cases of avulsion fracture of the greater tuberosity with rotator cuff tear received arthroscopic-assisted minimally invasive reduction and osteosynthesis in Chengdu First People′s Hospital and obtained ideal clinical effect. Methods (1 )General data.From January 201 1 to December 2013,12 patients

  11. Arthroscopic Reduction and Internal Fixation of Avulsion Fracture of Anterior Cruciate Ligament from Tibial Eminence with Stainless Steel Wire%关节镜下钢丝固定治疗前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    卢华定; 史德海; 董云旭; 王昆; 曾春

    2011-01-01

    Objective To investigate the therapeutic efficacy of arthroscopic internal fixation of avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence with stainless steel wire. Methods Thirteen cases of displaced avulsion fracture of the ACL from the tibial eminence were treated by arthroscopic reduction and internal fixation with stainless steel wire from January 2003 to June 2006.Adjustable brace was used for protection after surgery, and active rehabilitation training was conducted. The Lysholm scoring scale system was used to evaluate knee functions before and after surgery. Regular X-ray plain films at AP and lateral views were conducted to detect the bony healing of avulsed fragments postoperatively. Results Thirteen cases were followed up for 6 to 32 months and the average time was 14 months. No complications of intraarticular infection, iatrogenic injury, anchylosis, loss of knee extension, or nonunion of fracture were found. X-ray films revealed good bone union in all the 13 cases three months after surgery. No knee instability was detected, and knee flexion and extension function was normal in all patients. The Lysholm scores were improved from 39.4±9.98 preoperatively to 95.2±2.94 postoperatively, with significant statistical difference by the student-t test (t = 24.001,P <0.01). Conclusion Arthroscopic reduction and internal fixation with stainless steel wire in the treatment of avulsion fracture of the anterior crnciate ligament from the tibial eminence has advantages of simplicity, broad indications,minimal invasion, and rapid postoperative recovery. It is believed as an ideal choice for such avulsion fracture of the anterior cruciate ligament from the tibial eminence.%目的 探讨关节镜下钢丝内固定治疗前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效.方法 自2003年1月~2009年6月采用关节镜下复位钢丝内固定治疗13例移位的ACL胫骨止点撕脱骨折,术后可调式支具保护,积

  12. TWINFIX TI QUICK-T锚钉治疗跟腱止点撕脱的临床研究%The Clinical Study on the Use of TWINFIX TI QUICK-T Suture Anchor to Repair the Avulsion of the Bony Insertion of the Achilles Tendon at the Calcaneus

    Institute of Scientific and Technical Information of China (English)

    林忠勤; 王伟; 程少文; 张伟; 寇冬权; 彭磊

    2011-01-01

    Objective Using TWINFIX TI QUICK-T suture anchors to repair the Achilles tendon close to its insertion avulsion.Evaluating its efficacy,to provide reference for clinical treatment.Methods Total 16 with the avulsion of the bony insertion of the Achilles tendon at the calcaneus were treated with TWINFIX TI QUICK-T suture anchor from 2007 to now.10 males and 6 females ;aged 22 to 65 years ,mean 44.7 years old.7 cases the left side,right side in 9 cases.By AOFAS ankle and hindfoot scoring function evaluated.Results Followed up 6~24 months,average of 13 months.No one cases happened suture dehiscence ,wound infection occurred ,main blood vessel nerve injury,fixation failure and other complications after operation and were normal anatomic relations and the appearance and function are satisfactory.Among 16cases, 12cases had the excellent results, 2case had the good results, 2case had fair results.The total excellent and good rate was 87.5%.Conclusion More reasonable and secure fixation method is necessary in order to allow early functional rehabilitation.We use a technique to repair the Achilles tendon close to its insertion avulsion or tendon Achilles avulsion fracture (fix the avulsed fragment of Achilles tendon insertion) with TWINFIX TI QUICK-T suture anchors.This can neutralize the pull of the triceps surae and early post-operative rehabilitation program is allowed,it is conducive to a better recovery of the ankle joint function postoperative.%目的 应用TWINFIX TI QUICK-T治疗跟腱止点撕脱伤,评价其疗效,为临床治疗提供参考.方法 2007年9月至2010年5月采用TWINFIX TI QUICK-T锚钉治疗跟腱止点撕脱伤16例,男10例,女6例;平均44.7岁.左侧7例,右侧9例.按AOFAS踝与后足功能评分标准评价疗效.结果 随访6~24个月,平均13个月.术后无一例出现缝线裂开、切口感染、主要血管及神经损伤、内固定失效等并发症,术后恢复正常解剖关系及外观,踝关节功能恢复满意.本组16

  13. Clinical observation of knee arthroscopy with double ETHIBOND sutures in the treatment of tibial avulsion fractures of the posterior cruciate ligament%关节镜下双股ETHIBOND线固定治疗后交叉韧带胫骨止点撕脱骨折的疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪建龙; 时志斌; 党晓谦; 王坤正

    2016-01-01

    Objective To study the surgical method and clinical results of knee arthroscopy with double ETHIBOND sutures in the treatment of tibial avulsion fractures of the posterior cruciate 1igment ( PCL ).Methods From June 2014 to October 2015, a total of 18 patients with PCL tibial avulsion fractures who were treated with double ETHIBOND sutures under knee arthroscopy were enrolled. There were 10 males and 8 females, whose mean age was ( 32.5 ± 8.7 ) years old. Anteromedial, anterolateral, posteromedial and high posteromedial portals were built before the operation, which aimed to explore the knee joint. Both the avulsed bone block and the tibia bone bed were refreshed via the double posteromedial portals. The 2 bone tunnels ( 4.5 mm in diameter ) was completed with the assistance of PCL director drill guide. Double ETHIBOND sutures were used during the reduction to ifx the avulsed bone by double posteromedial portals. The sutures were pulled out through the 2 bone tunnels and tied in front of the tibia. Reduction and healing of the avulsion fractures and mobility degree of the knee were observed after the operation. Lysholm and the international knee documentation committee subjective knee form ( IKDC ) scores were calculated to evaluate the functional recovery of the knee.Results All the cases were followed up from 8 to 24 months, with an average of ( 14.2 ± 3.2 ) months. All the avulsion fracture healing was achiveved without displacement according to the X-ray and CT scanning, and the average healing time was 2.5 months. The posterior drawer test showed negative results in all the cases. The knee extension was unlimited, and 15° lfexion limitation was found in 1 case due to delayed rehabilitation. The average range of lfexion was ( 135.5 ± 3.5 ) °. The average Lysholm scores were increased from ( 37.8 ± 3.5 ) points to ( 95.6 ± 3.2 ) points (P < 0.001 ), and the average IKDC scores were increased from ( 54.7 ± 6.5 ) points to ( 95.2 ± 4.5 ) points (P < 0

  14. Use of hollow screw combined with suture anchor in treatment of tibia avulsion fracture of posterior cruciate ligament%空心钉联合带线锚钉固定治疗后交叉韧带胫骨撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    张平; 舒科杰; 付廷; 付炯; 张松; 秦晋; 李锐冬; 尹良军

    2016-01-01

    Objective To investigate the curative effect of hollow screw combined with suture anchor on tibia avulsion fracture of knee posterior cruciate ligament. Methods Seventeen patients with tibia avulsion fracture of knee posterior cruciate ligament were treated well by hollow screws combined with suture anchors from March 2010 to February 2014. The curative effect was evaluated by Lysholm points-scoring system. Results In the postoperative follow-up survey for 6 to 12 months, bone healing took an average of 4.2 months. The result of Lysholm points-scoring system showed 15 excellent cases and 2 good cases. Conclusions Hollow screw combined with suture anchor is easy to learn and operate for the treatment of tibia avulsion fracture of knee posterior cruciate ligament. Simultaneously, the patients will be more satisfied and get better functions from early rehabilitation training.%目的:探讨经膝关节后内侧小切口空心钉、带线锚钉双联固定治疗后交叉韧带胫骨撕脱骨折的手术效果。方法选取2010年3月-2014年2月该院收治的17例后交叉韧带胫骨撕脱骨折患者,采用后内侧小切口空心钉联合带线锚钉固定,Lysholm膝关节评分系统评价疗效。结果术后随访6~12个月,平均4.2个月骨性愈合,Lysholm评分显示优15例,良2例。结论空心钉和带线锚钉双联固定治疗后交叉韧带胫骨撕脱骨折学习曲线短,操作容易,术后能更早康复锻炼,获得更好的功能,效果满意。

  15. 两种保存液对脱位牙再植术效果影响的实验研究%Experimental research into the influence of two kinds of storage media on the replantation of avulsed tooth

    Institute of Scientific and Technical Information of China (English)

    朱泽群; 陈铭清; 刘茜; 蔡琴; 王珏; 周红艳; 梅予锋

    2014-01-01

    目的:比较常温下脱脂牛奶与汉克斯平衡盐溶液(Hank′s balanced salt solution,HBSS)保存脱位牙对再植牙牙根愈合过程的影响。方法:48只6周龄 SPF级 Wistar雄性大鼠,随机抽取3只为空白对照,直接处死取材拍摄根尖 X线片,标本切片组织学观察;余45只随机分为3组,将上颌第一磨牙脱位后分别采用 HBSS、脱脂牛奶浸泡或干燥室温保存,30 min 后植回牙槽窝,术后1、3、7、14、21 d处死大鼠,拍摄根尖 X线片进行图像分析,标本切片进行组织学观察。结果:再植后各时间点牛奶组与 HBSS 组近中根阴影面积无统计学差异,皆小于干燥组(P<0.01);牛奶组根尖组织炎症反应较轻,根吸收少,根周修复类型与HBSS 基本相同。结论:脱脂牛奶与HBSS 在常温下均为良好的脱位牙体外保存液,可在普通人群中作为再植牙保存液推广使用。%Objective:To evaluate the effect of skimmed milk and Hank′s balanced salt solution(HBSS)as preservation medium on the root healing and root resorption of the avulsed tooth.Methods:3 out of 48 6-week-old SPF Wistar male rats were picked randomly as blank control,and the rest 45 rats were divided into three groups randomly:HBSS group,milk group and dry group.The bilateral maxillary first molars of rats in the three groups was extracted and replanted back into the sockets after being placed seperately in HB-SS,skimmed milk and in the air for 30 min right after extraction.The rats were sacrificed on day 1,day 3,day 7,day 14 and day 21 af-ter the operation.Then the maxillae were scanned with X-ray and the shadow areas around the mesial roots of maxillary first molars were measured with IPP software.After decalcification,the specimens were made into slices and stained with HE for histological obser-vation.Results:There was no statistically significant difference between milk group and HBSS group regarding the shadow area around

  16. 关节镜下钢丝固定治疗后交叉韧带胫骨止点撕脱骨折的临床疗效%Anatomic Fixation Under Athroscopy for Posterior Cruciate Ligament Tibial Avulsion Fractures Using Kirschnerwires

    Institute of Scientific and Technical Information of China (English)

    李明亮; 姜鑫

    2015-01-01

    Objective To investigate the operation methods and clinical ef ect of anatomic fixation under athroscopy for Posterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires.Methods From Jan 2012 to Jan 2013 20 patients with isolated PCL tibial avulsion fractures underwent anatomic fixation under athroscopy treated at our institutionwere selected,in which 14 men, 6women aged 19~35years old, an average of 27 ,8 cases of sports injury history , and 12 cases of traf ic accident injury history. Patients had varying degrees of the symptoms of knee pain,pain arc positive and restricted activitie . Preoperative X-ray and MRI images showed PCL tibial avulsion fractures .Al patients were treated with arthroscopic surgery. The clinical examination, preoperative anterior drawer test, gravity drawer teat was fol owed-up,the knee-joint function was evaluated with Lysholm score,KT-1000 and the ef ectswere analyzed. Results The fol ow-up of 12 months, Lysholm score,KT-1000 have significantly improved relative to preoperative.Conclusion Athroscopy assisted anatomic fixation for Posterior anterior cruciate ligament ( PCL) tibial avulsion fractures using Kirschner wires has the advantages of lit le trauma,firm fixation,early rehabilitation and lit le complications,and the ef ect is satisfactory,more close to the anatomical biomechanical tibial insertion of PCL.%目的:探讨关节镜下钢丝解剖固定治疗后交叉韧带( PCL)胫骨止点撕脱骨折的临床疗效。方法2012年1月~2013年1月对20例后交叉韧带胫骨止点撕脱骨折患者行关节镜下钢丝解剖固定,其中男14例,女6例;年龄19~35岁(平均27岁);左膝9例,右膝11例。8例为运动伤,12例为车祸伤。所有患者均有不程度的膝关节疼痛、肿胀、活动受限,后抽屉试验及重力实验阳性,术前X射线片、MRI检查可见胫骨髁间窝后方撕脱骨折块。全部行关节镜下钢丝固定骨折块治疗。术前及末次随访一般情况、

  17. 上肢大面积皮肤撕脱伤反鼓取皮原位植皮9例分析%In Situ Autologous Skin Grafting with Skin Flap Taken on Reverse Side Using Drum Type Dermatome in the Treatment of Large Area Skin Avul-sion Wound of Upper Limbs (9 Case Reports)

    Institute of Scientific and Technical Information of China (English)

    陈殿伟; 王庆生; 汪强; 蔡延深

    2012-01-01

      Objective To explore the effect of autologous skin transplantation with skin flap taken on reverse side using drum type dermatome in treating extensive skin avulsion of upper limbs. Methods Retrospective analysis was con-ducted on 9 patients with extensive skin avulsion of the upper limbs admitted to our hospital from April 2006 to June 2010. All the patients underwent urgent debridement. The avulsed skin soft tissue deprived of blood supply was removed, shaved into medium split thickness skin flaps using drum type dermatome, and replanted them on the wound. Layering dressing was applied with Amikacin Saline gauzes as the inner layer, aseptic bandages in the middle and cotton pads as the outer layer. The injured extremities were suspended post operation to avoid local compression. The outer layer of dressing was changed 3 days post operation and the suture was removed 12 days post operation. Results More than 95% of the transplant survived in the 9 cases. Sporadical small wounds healed with the dressing change of MEBO and no second operation was required. Function of the injured extremities restored sufficiently with exercise. Conclusion Autologous skin transplantation with skin flap taken on reverse side using drum type dermatome is a relatively ideal surgical approach to treating extensive skin a-vulsion of upper limbs. Adequate debridement and hemostasis with appropriate dressing and overhanging to avoid compres-sion can increase the survival rate of the transplant.%  目的探讨上肢大面积皮肤撕脱伤反鼓取皮植皮术的临床效果。方法回顾性分析2006年4月至2010年6月收治的9例上肢大面积皮肤撕脱伤患者病历资料,急诊行清创术,将撕脱失去血供的皮肤软组织取下,用鼓式取皮机修成中厚皮片后,原位回植于创面,术区分层包扎,内层用阿米卡星盐水纱布、消毒绷带包扎,外层用棉垫包扎,术后悬吊,避免局部受压,术后3 d 更换外层敷料,12 d

  18. Repair of sacral plexus root avulsion with normal sacral nerve root transposition in rats%健侧骶神经根移位修复大鼠骶丛撕脱伤

    Institute of Scientific and Technical Information of China (English)

    张志凌; 郭清河; 杨迪; 江曦; 鹿楠; 陈爱民

    2011-01-01

    Objective To evaluate the efficiency of normal sacral nerve root transposition in repair of the sacral plexus root avulsion. Methods A total of 30 adult SD rats were chosen and divided into three groups,ie,group A(the sciatic nerve received no repair),group B(the autologous sacral plexus root nerve was bridged with the right L6 nerve root by the translocation of the left L6)and group C (the right L5 nerve root nerve was bridged by the translocation of the left L6),10 rats per group.The left side of the rats was used as the control side and the right one as the experimental side.Twelve weeks after operation,the rats in each group were selected for the histomorphological observation of the nerves under the microscope and the electron microscope.The models were evaluated by observing the survival rates of the rats,BBB scores,electron microscope weight and muscle fiber CSA(cross section area)of double biceps femoris,triceps surae and tibial muscle. Results Twelve weeks after operation,the BBB scores in groups B and C was higher than that in group A,with statistical difference(P<0.01)between three groups.A remarkable improvement was found in the ratio of weight and muscle fiber CSA of double biceps femoris,triceps surse and tibial muscle.The repair efficiency in the group C was better than that in the group B.In the group B,the biceps femoris,triceps surae and tibial muscle recovered at different degrees.The biceps femoris recovered the best,when a great deal of myelinated nerve fiber regeneration was observed under the microscope and the electromicroscope.Electromyography revealed the volatility in the muscles of three groups,with larger peak value for the proximal biceps femoris and the triceps muscle but smaller peak value for the distal anterior tibial muscle. Conclusions L6 transposition combined with auto-graft of nerve root or without the auto-graft can reconstruct the partial function of the sciatic nerve in the paraplegia rats,when the latter has the better

  19. BRAIN GRAY MATTER VOLUME CHANGES ASSOCIATED WITH CHRONIC PAIN IN PATIENTS WITH PAIN DUE TO BRACHIAL PLEXUS AVULSION%臂丛神经撕脱伤后疼痛患者脑区灰质容积变化的研究

    Institute of Scientific and Technical Information of China (English)

    陈富勇; 陶蔚; 秦文; 于春水; 胡永生; 李勇杰

    2011-01-01

    Objective: To investigate brain structural changes involved in chronic pain in patients with pain due to brachial plexus avulsion, voxel-based morphometry was used to determine the brain gray matter changes . Methods: Ten right-handed patients with chronic pain due to left brachial plexus avulsion, whose pain reduced more than 75% after DREZotomy, and ten right-handed age- and sex-matched healthy control subjects participated inparticipated in the study. VAS, HADD and HADA were recorded before and 6 months after DREZotomy, respectively. Statistical parametric mapping 5 was applied for data analysis. Results: Compared with healthy subjects, the patients had gray matter decreases in the periaoueductal gray matter (PAG) and ipsilateral hippocampus, and significant gray matter increases in the ipsilateral anterior cingulate cortex (ACC) (BA24), the contralateral inferior frontal cortex (BA47). Comparing with patients during pain before DREZotomy, VBM analysis after DREZotomy showed there were no, significant gray matters changes.Conclusion: These findings suggest that chronic pain is associated with cortical and subcortical reorganization on a structural level, which may play an important role in the process of the chronication of pain in patients with pain due to brachial plexus avulsion.%目的:应用基于体素的形态学分析技术探讨臂丛神经撕脱伤后疼痛患者与慢性疼痛相关的脑结构改变.方法:选择左侧臂丛神经撕脱伤后慢性疼痛,行脊髓背根入髓区切开术后疼痛减轻>75%的患者,共10例,以及10例性别和年龄匹配的健康志愿者纳入研究.疼痛患者分别在术前和术后半年采集MRI数据,同时行视觉模拟评分(VAS),汉密尔顿抑郁(HADD)和焦虑评分(HADA).用统计参数图5( SPM5)软件分析数据.结果:与健康志愿者相比,在臂丛神经撕脱伤后慢性疼痛患者中,灰质容积减低的脑区为中央导水管周围灰质和患肢同侧的海马;灰质容积增高

  20. Arthroscopic Ethibond suture and anchor fixation for avulsion fracture of anterior cruciate ligament tibial insertion%关节镜下爱惜邦缝线锚钉固定法治疗新鲜前交叉韧带胫骨止点撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    段平国; 郭润生; 程明; 周通华; 徐屹; 戴闽

    2016-01-01

    目的 探讨关节镜下爱惜邦不可吸收缝线锚钉固定法治疗前交叉韧带(ACL)胫骨止点撕脱骨折的手术疗效. 方法 回顾性分析2013年7月-2014年6月ACL胫骨止点撕脱骨折患者20例,男12例,女8例;年龄18~41岁,平均25.3岁.Meyers-McKeever分型为Ⅱ型或Ⅲ型骨折.Lachman试验和前抽屉试验均为阳性.所有患者均在伤后3周内手术,均在关节镜下使用爱惜邦不可吸收缝线联合锚钉复位固定ACL胫骨止点.随访复查X线片,采用Lysholm评分和国际膝关节文献委员会(IKDC)评分对膝关节功能进行评价. 结果 手术时间45 ~ 70 min,平均50 min.出血量5~15 ml,平均10 ml.随访12 ~ 24个月,平均16.3个月.所有患者术后复查X线片提示ACL胫骨止点撕脱骨折均复位及愈合良好.术后Lachman试验和前抽屉试验均为阴性,膝关节功能恢复良好.术前Lysholm评分为42 ~61分[(51.1±6.2)分],末次随访时为89~96分[(93.5±2.3)分](P<0.05);术前IKDC评分为46~68分[(55.2±7.0)分],末次随访时为84 ~96分[(91.0±3.9)分](P<0.05). 结论 关节镜下爱惜邦不可吸收缝线锚钉固定法治疗ACL胫骨止点撕脱骨折,其操作简单,创伤小,固定可靠,功能恢复良好,临床疗效满意.%Objective To investigate the clinical effect of Ethibond suture and anchor fixation by arthroscopic technique for the treatment of avulsion fracture of the anterior cruciate ligament (ACL) tibial insertion.Methods Twenty patients with avulsion fracture of the ACL tibial insertion hospitalized between July 2013 and June 2014 were collected retrospectively.There were 12 males and 8 females,aged 18-41 years (mean,25.3 years).All patients were identified with type Ⅱ and type Ⅲ fractures according to the Meyers-McKeever classification.Results of Lachman test and anterior drawer test were both positive.All patients accepted the operation that avulsion fracture of the ACL tibial insertion was treated with the Ethibond suture

  1. 老年患者下肢大面积皮肤撕脱伤急诊修复方法与疗效%Emergency repair method and its effect in treatment of large avulsion injury of lower extremity in elderly patients

    Institute of Scientific and Technical Information of China (English)

    林涧; 林加福; 张天浩; 王之江; 顾漪

    2016-01-01

    Objective To evaluate the emergency repair method and its effect for treatment of extensive avulsion injury of the lower extremity in the elderly patients.Methods From May 2008 to February 2015,11 patients aged over 60 years sustaining large avulsion injury (across the knee or ankle joint) of the lower limb in traffic crushes were treated by emergency debridement and one-stage repair with the procedures of autologous skin replantation,arteriovenous anastomosis and vacuum sealing drainage (VSD).Two patients sustained injury to both lower limbs,and nine patients sustained a unilateral injury.Effect of wound repair was evaluated with skin flap survival area.Active and passive motility of the knee and ankle were recorded at postoperative 24 h.Results One patient with multiple fracture and extensive muscular inactivity due to severe crush injury to the lower limbs had poor blood supply after the replantation and was amputated at postoperative 24 h.The remaining ten patients with large skin avulsion showed 90% of the avulsed skin survived after operation.At the follow-up of 3-24 months,the ten patients showed no obvious pigmentation or scar tissue,were satisfied with the function recovery in knee (106°-110° in flexion and 0°-5°in extension) and ankle joint (15°-20°in dorsiflexion and 30°-35° in plantar flexion),and could walk freely,including excellence outcomes in 3 patients and good outcomes in 6 patients.Conclusion The emergency repair methods including autologous skin replantation,arteriovenous anastomosis and VSD combined with one-stage in situ repair can attain satisfactory clinical effect.%目的 探讨老年患者下肢大面积皮肤撕脱伤急诊原位修复的方法与临床疗效.方法 2008年5月-2015年2月共收治60岁以上由交通伤所致下肢大面积(跨膝/踝关节)撕脱伤患者11例,其中双下肢2例,单肢体9例,均给予急诊清创后行自体皮片回植法、动静脉吻合术及持续负压封闭引流(VSD)技术三种方

  2. Implant fixation of tibial avulsion fracture of the posterior cruciate ligament:knee joint range of motion and functional evaluation%植入物固定后交叉韧带胫骨止点撕脱骨折:膝关节活动度及功能评价

    Institute of Scientific and Technical Information of China (English)

    王良勇; 李建刚; 张春; 张俊; 杜红军; 崔操; 田大为

    2015-01-01

    BACKGROUND:From the biological structure, the posterior cruciate ligament is surrounded by the synovial folds of posterior capsule, arising from the inner side of the medial femoral condyle to the posterior part of tibial intercondyloid spine. The main traditional treatment method for posterior cruciate ligament tibial avulsion fracture is open operation, but it is difficult in anatomic reduction, cannot ful y restore knee joint stability and has a great negative impact on the normal function of posterior cruciate ligament. OBJECTIVE:To investigate the effects of arthroscopic implant internal fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament. METHODS:120 patients with tibial avulsion fracture of the posterior cruciate ligament were randomly assigned into treatment group and control group, with 60 cases in each group. The control group was given the traditional open surgery, and the treatment group was given the arthroscopic surgery. After 3 months, International Knee Documentation Committee (IKDC) scores and Lysholm scores were detected in the two groups;the knee joint range of motion was determined before and 3 months after treatment. RESULTS AND CONCLUSION:Wounds were healed at stage I in al patients with no serious complications. There was no difference in the knee joint range of motion between the two groups before treatment, but the range of motion was increased significantly in both two groups at 3 months after treatment (P<0.05), meanwhile which was higher in the treatment group than the control group (P<0.05). At 3 months after treatment, the excel ent knee function rate was significantly higher in the treatment group (97%) than the control group (88%) according to the Lysholm scores;the IKDC scores were significantly higher in the treatment than the control group in terms of claudication, support, pain, swel ing, and squat (P<0.05). These results indicate that the arthroscopic implant fixation of tibial avulsion

  3. APPLICATION OF COMPUTED TOMOGRAPHIC ANGIOGRAPHY IN REPAIRING SKIN DEFECT AFTER SCALP AVULSION WITH FREE LATISSIMUS DORSI FLAP TRANSPLANTATION%CT血管造影在背阔肌皮瓣游离移植修复头皮撕脱伤创面中的应用

    Institute of Scientific and Technical Information of China (English)

    何永静; 王继华; 杨云; 刘垠; 张景波; 朱礼昆; 郭树忠; 朱剑萍; 刘红莉

    2013-01-01

    目的 探讨CT血管造影(computed tomographic angiography,CTA)及三维重建技术在背阔肌皮瓣游离移植修复头皮撕脱伤伴大面积颅骨外露创面中的应用价值.方法 2007年10月-2012年6月,收治9例严重头皮撕脱伤伴大面积颅骨外露女性患者.年龄23~54岁,平均38岁.致伤原因:机器绞伤6例,交通事故伤2例,高处坠落伤1例.其中3例伤后行头皮原位回植后坏死,6例行清创包扎.伤后至入院时间8h~7d,平均1d.头皮撕脱范围为头皮面积的75%~90%,平均81%;颅骨外露范围为头皮面积的55%~70%,平均63%;2例伴单侧耳廓撕脱.术前对面颈部及背部血管行CTA及三维重建,分析颞浅动、静脉,面动脉,颈外静脉和胸背动、静脉解剖结构并测量管径.根据CTA检查结果,7例以背阔肌皮瓣修复创面,2例以背阔肌肌瓣联合植皮修复.7例患者根据术前设计顺利完成手术;2例术前颞浅血管显示较差者,以大隐静脉作为移植血管与相关血管吻合.背阔肌皮瓣切取范围20 cm×14 cm~25 cm×20 cm,供区减张缝合后植皮修复;肌瓣切取面积分别为23 cm×16 cm及16cm×10cm,供区直接缝合.结果 术中血管管径测量结果与术前比较差异较小,不影响血管吻合.手术时间6~8 h,平均6.5h.术后背阔肌肌(皮)瓣及植皮均成活,创面Ⅰ期愈合;供区切口Ⅰ期愈合.患者均获随访,随访时间3个月~2年,平均6个月.皮瓣质地柔软,皮肤无破溃.结论 采用背阔肌皮瓣游离移植修复头皮撕脱伤伴大面积颅骨外露创面时,术前可行CTA检查明确供、受区可供吻合的血管解剖结构及管径,指导手术方案设计及实施,以缩短手术时间,提高术中血管吻合准确率.%Objective To investigate the clinical value of computed tomographic angiography (CTA) and three-dimensional reconstruction technique in repairing scalp avulsion wound with large skull exposure by the free latissimus dorsi flap

  4. An experiment study and clinical observation of the influence of free-skin-grafted scrotal avulsion injuries on spermatogenesis%皮片游离移植修复阴囊撕脱伤对精子生成影响的实验研究及临床观察

    Institute of Scientific and Technical Information of China (English)

    孙广峰; 王达利; 魏在荣; 罗志军; 聂开瑜; 金文虎

    2012-01-01

    目的 探讨皮片游离移植修复全阴囊皮肤撕脱伤对睾丸生精功能的影响.方法 以育龄期健康新西兰大白兔作为实验动物,雄性42只,雌性24只.将雄兔随机分为实验组(24只)及对照组(18只).将实验组动物双侧阴囊皮肤全层切除,采用腹部中厚皮片游离移植修复缺损.对照组未作处理.对照组及实验组造模后3周末、8周末时按随机数字表法各取6只动物采用温度计埋藏法测量睾丸表面温度,温度测量后取睾丸组织活检,常规HE染色.8周末将两组未采集活检的雄兔各12只分别与雌兔配对喂养半个月,观察对应母兔的生育情况.临床上对3例阴囊皮肤撕脱伤患者采用撕脱阴囊反取皮回植修复,并对其性生活情况及精液质量进行随访观察.结果 模型建立后3周末、8周末实验组的睾丸表面温度[(36.15±0.24)℃、(36.77±0.42)℃]与对照组的睾丸表面温度[(36.12±0.68)℃]接近,两组比较差异无统计学意义(P>0.05);对照组HE染色曲细精管内见各级生精细胞,排列有序,管腔内见较多的成熟精子;实验组模型建立后第3周末的HE染色见曲细精管内生精细胞明显减少,排列紊乱,管腔未见精子,第8周末曲细精管内生精细胞增多,排列相对规整,部分管腔可见成熟的精子;配对喂养对照组雌兔受孕率12/12,平均生崽数(6.0±1.3)只;实验组雌兔受孕率8/12,平均生崽数(4.1±3.2)只,两组受孕率比较差异无统计学意义.临床3例患者游离植皮修复之阴囊在术后1~2个月可见早期皮片挛缩征象,但1年后均出现松弛而下垂,阴囊外形较满意,修复2年后患者的精液质量均恢复至正常.结论皮片游离移植修复全阴囊皮肤缺损对睾丸的精子发生干扰较小,可保留青壮年患者生育能力.%Objective To explore the influence of Free-skin-grafted penoscrotal avulsion injuries on spermatogenesis.Methods Forty-two male New Zealand albino rabbits

  5. Arthroscopic Proximal Epiphyseal Plate Three-dimensional Suture Fixation for the Treatment of Juvenile Tibial Anterior Intercondylar Eminence Avulsion Fracture%关节镜下骺板近端三维缝合固定治疗少年胫骨髁间前棘撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    王军; 姜鑫; 郭永智; 张益民

    2012-01-01

    目的:探讨关节镜下骺板近端三维缝合固定治疗少年胫骨髁间前棘撕脱骨折的临床疗效.方法:2008年5月~2010年5月,对10例少年胫骨髁间前棘骨折移位患者,在关节镜下行骨折断端清理、复位,C臂机透视下避开骨骺建立胫骨隧道,自制缝针、钩针导引普通丝线于前交叉韧带前1/3、1/2处镜下两次穿越,普通丝线导引钢丝及PDS-Ⅱ线穿越前交叉韧带.固定物在冠状面两次穿越骨隧道-前交叉韧带-骨隧道,骑跨式三维固定撕脱骨块,有效防止撕脱骨块前后旋转、左右摆动和上下浮动.拉紧钢丝及PDS-Ⅱ线,关节外打结固定.术后下肢支具外固定并早期进行功能康复.术后采用Lysholm评分标准评估疗效.结果:全部病例均获随访,随访时间6~36个月,平均18.2个月.X线片示骨折均愈合.患者膝关节无疼痛,前抽屉试验阴性,Lachman试验阴性.术前Lysholm评分(45.8±7.6)分,术后(97.2±9.1)分,手术前后评分差异有统计学意义.结论:关节镜下骺板近端三维缝合固定治疗少年胫骨髁间前棘撕脱骨折创伤小,不损伤骺板,操作简单,疗效可靠.%Objective To discuss the advantages of arthroscopic proximal epiphyseal plate three-dimensional suture fixation for the treatment of juvenile tibial intercondylar eminence avulsion fracture. Methods From May ,2008 to May,2010,10 cases of juvenile tibial intercondylar eminence displacement fracture were treated in our hospital. Under arthroscopy, the fracture-end was clear up and replaced, and then tibial tunnel was built with assistance of C-arm machine avoiding epiphysis. Ordinary silk suture was passed through 1/3 in front of ACL,then steel wire and PDS- II thread crossed over the ACL twice under the guidance of the silk suture and crochet hook. After tightening the steel wire and PDS- II , extra-articular knot was made firmly. External fixation of leg was applied and early rehabilitation was carried out after operation

  6. 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

  7. Avulsão do plexo braquial em cães - 2: biópsia fascicular e histologia dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 2: fascicular biopsy and histology of the radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi demonstrar os aspectos clínicos e neurológicos relevantes para o diagnóstico da avulsão do plexo braquial em cães, relacionando estes achados com os resultados da histologia dos nervos radiais, medianos, ulnar e músculo cutânea. A biópsia fascicular destes nervos foi realizada após abordagem cirúrgica às faces lateral e medial do braço afetado. Todos os fascículos submetidos ao exame histológico apresentaram alterações como tumefação axonal, degeneração walleriana e infiltrado inflamatório em graus variados, havendo principalmente nos nervos radial, mediano e ulnar a proliferação de colagem endoneural. A associação destes resultados com as alterações neurológicas e da eletroneuroestimulação (relatados na parte 1 e 3 deste trabalho respectivamente sugeriu envolvimento quase que total das raízes do plexo braquial em todos os casos.The main purposes of this work were the neurological evaluation of dogs with brachial plexus avulsion and correlation of these findings with the results of histology of the radial, median, and ulnar and muscle cutaneous nerves. Fascicular nerve biopsy was performed after surgical approach of medial and lateral aspect of the arm. Ali the submitted fascicles presented histologic alterations compatible with wallerian degeneration, axonal swelling, and inflammatory infiltrate ranging from mild to pronounced, with endoneural collagen proliferation mainly in radial, median and ulnar nerves. The association of these results with neurological and electroneurostimulation exams (respectively described in part 1 and 3 of this work suggested in all cases an almost total involvement of brachial plexus roots.

  8. 关节镜下规避骺板法治疗儿童前交叉韧带胫骨止点撕脱性骨折%Arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference

    Institute of Scientific and Technical Information of China (English)

    宋伟毅; 林超文; 吴宇峰; 高大伟; 冯小仍; 陈滨

    2016-01-01

    目的 探讨关节镜下规避骺板法治疗儿童前交叉韧带(ACL)胫骨止点撕脱性骨折的临床疗效. 方法 回顾性分析2010年2月至2014年2月收治的18例儿童ACL胫骨止点撕脱性骨折患者资料,男12例,女6例;年龄为7~14岁,平均10.4岁.伴有半月板损伤4例,内侧副韧带损伤2例.受伤至手术时间为2~7d,平均4.5d.骨折按Meyers-McKeever分型:Ⅱ型13例,Ⅲ型5例.所有患者均采用关节镜下骨折块复位,并用Ultrabraid缝线打结,经膝横韧带下方将骨块固定于胫骨结节骨骺远方.术后随访根据前抽屉试验、轴移试验、Lachman试验及Lysholm膝关节功能评分评定患者功能恢复情况. 结果 18例患儿术后获10 ~ 24个月(平均15个月)随访.所有患儿骨折均获骨性愈合,愈合时间为3~6个月(平均4.5个月).末次随访时患肢膝关节活动度恢复满意,无关节僵硬、松弛及功能障碍等表现;无骨骺损伤发生.末次随访时前抽屉试验、Lachman试验、轴移试验呈阴性,Lysholm膝关节功能评分由术前平均(45.6±7.4)分提高至(92.4±5.8)分,差异有统计学意义(t=-25.403,P<0.001).结论 关节镜下规避骺板法治疗儿童ACL胫骨止点撕脱性骨折疗效满意,不会影响患儿的骨骼发育.%Objective To evaluate the clinical efficacy of arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference.Methods From February 2010 to February 2014,18 children patients with avulsion fracture of tibial eminence were admitted.They were 12 boys and 6 girls,from 7 to 14 years of age (average,10.4 years).Four cases were complicated with meniscus injury and 2 with medial collateral ligament injury.The mean time from injury to surgery was 4.5 days (range,from 2 to 7 days).According to Meyers-McKeever classification,13 children were type Ⅱ and 5 type Ⅲ.They were treated with Ultrabraid sutures arthroscopically.After reposition,the bone

  9. Obturator nerve transfer to repair Iumbosacral plexus nerve root avulsion injuries: anatomic study and clinical application%闭孔神经移位修复腰骶丛神经根撕脱伤的解剖学观察及临床应用

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    王树锋; 薛云浩; 刘佳勇; 栗鹏程; 褚寅; 熊革; 孙燕琨

    2009-01-01

    Objective To provide an effective and safe motor donor nerve for the treatment of lumbosacral plexus nerve root avulsion injuries. Methods The obturator nerve, lumbar plexus and sacral plexus on both sides were exposed on 15 cadaver specimens. The length of obturator nerve was measured from its origin to entrance of the foramen obturatum. The transverse diameter and thickness of the obturator nerve and femoral nerve on both sides were measured individually. The obturator nerve and femoral nerve of each specimen was cut into histological slice, and the amount of myelinated nerve fiber was counted respectively. There were five patients including 4 patients with traumatic lumbosacral plexus nerve root avulsion injuries and 1 patient with lumbar plexus nerve root injuries. The contralateral obturator nerve as motor donor nerve transferred through the retroperitoneal route and direct coaptation with the femoral nerve was performed in 4 cases, and ipsilateral obturator nerve was transferred to the S1 nerve root in 1 case. Results The length, transverse diameter and thickness of the obturator nerve was (10.5±0.9) cm, (2.03±0.37) mm and (2.78±0.29) mm individually. The transverse diameter and thickness of femoral nerve were (3.79±0.58) mm, (6.53±0.61) mm individually. The obturator nerve contained 5974±1996 myelinated nerve fibers and the femoral nerve contained 15 860±4350 myelinated nerve fibers. In 3-7 d after the operation, the muscle strength of adduction on the donor lower limber was decreased to grade 2-3. The functional recovery of muscle strength of quadriceps reconstructed by contralateral obturator nerve transfer recovered to grade 4 in 2 cases, grade 2 in 1 case and grade 1 in 1 case between 8 months to 5 years postoperatively. The muscle strength of triceps surae and finger flexor reconstructed by ipsilateral obturator nerve transferring to S1 nerve root recovered to grade 3 after 11 months postoperatively. Conclusion The contralateral or ipsilateral

  10. Repairing sacral plexus avulsion with the S1 nerve at the uninjured side as its power source: case report and literature review%健侧骶1为动力源神经移位修复骶丛撕脱伤病例报告及文献回顾

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    陈爱民; 江曦; 李永川; 鹿楠; 杨迪; 张志凌; 郭清河; 李钧; 朱清华

    2011-01-01

    Objective To elevate safety and efficacy of repairing sacral plexus avulsion with transfer of the S1 nerve at the uninjured side as its power source nerve.Methods In November 2007,a 10-year-old boy was admitted into our institute who had undergone surgery in a local hospital for a complex pelvic fracture with dissociation of the sacroiliac joint.Preoperative check-ups showed anesthesia in the glutei,hamstrings,and calf muscles of the left lower limb.X-ray revealed a previous operation on the sacroiliac joint,fractures of the superior and inferior rami of the left pubis,and dislocation of the pubic symphysis.A lumbar myelogram showed multiple pseudomeningoceles involving the right L4 to S1 nerve roots,indicating sacral nerve root avulsion.Electromyography presented a neurogenic injury.Neuropotentials of the left tibial nerve and peroneal nerve disappeared.A surgical reconstruction of the sacral nerve was performed 3 months after the injury,with a nerve graft of approximately 15 cm in length from the common peroneal nerve.One end of the nerve graft was anastomosed to the proximal stump of the right SI nerve root.The distal end of the nerve graft was divided into 2 fascicles,one sutured to the left superior gluteal nerve and the other to the branch of the sciatic nerve innervating hamstrings.Results The operation lasted 5 hours,with perioperative blood loss of 2000 mL and blood transfusion of 1600 mL.The wound healed primarily.The fight lower limb had nearly normal motions 4 days after operation.The patient had numbness in the lateral plantar region of the healthy limb(4 cm × 12 cm in area)4 days after surgery,improved(2 cm × 6 cm in area)20 days after surgery,and the symptom disappeared within 18 months.The strength of the glutei and hamstrings muscles at the left limb improved to the level of M3 18 months after surgery.The patient had M4 weakness in the peroneus longus which recovered within one year.Conclusion The S1 root of the plexus from the healthy side can

  11. The comparison of clinical effects of arthroscopic fixation with sutures versus screws for posterior cruciate ligament tibial avulsion fractures%关节镜下缝线与螺钉固定后十字韧带胫骨止点撕脱骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    李亦丞; 孙学斌; 刘阳; 李纲; 尼加提; 张克远

    2017-01-01

    Objective To compare the clinical effects between arthroscopic suture and screw fixation for posterior cruciate ligament (PCL)tibial avulsion fractures.Methods From February 2013 to January 2016,29 cases with PCL tibial avulsion fracture diagnosed at our department were selected,in which 15 cases of the suture fixation group and 14 cases of the screw fixation group were separated.Operation time, Lysholm score,IKDC score and knee range of motion (ROM)were compared after operation.Results The operation time for the suture fixation group (48.3±1.5)min was significantly longer than that for the screw fixation group (36.4±1.5)min (P<0.05).During the follow-up period,there were no incision in-fection and loosening of the fixation device.The X-ray films showed that all fractures were healed in the first post-operative year.There was a case with synarthrophysis in each group,and the knee function of them returned to normal after rehabilitation training.There were no significant differences between the two groups regarding the Lysholm score (89.9±1.3)for the suture fixation group vs (88.9±1.5)for the screw fixation group),the IKDC score (89.2±1.6)for the suture fixation group vs (89.8±1.5)for the screw fixation group),and the ROM (129.6°±2.8°)for the suture fixation group vs (127.7°±3.2°)for the screw fixation group.Conclusion Arthroscopic fixation with suture vs screw for posterior cruciate ligament tibial avulsion fractures can achieve satisfactory effects,but the operation time of screw fixation has more advantages.%目的:比较关节镜下缝线与螺钉固定后十字韧带(PCL)胫骨止点撕脱性骨折的疗效。方法选择2013年2月—2016年1月新疆医科大学第一附属医院收治的29例PCL胫骨止点撕脱骨折患者,其中术中采用缝线固定15例(缝线固定组)、螺钉固定14例(螺钉固定组),比较两组患者的手术时间、Lysholm评分、IKDC评分及膝关节活动度(ROM)情况。结果缝线

  12. Clinical comparison of arthroscopy versus mini-open surgery for avulsion fracture of the tibial attachment of the posterior cruciate ligament%关节镜与小切口手术治疗后交叉韧带胫骨附丽撕脱骨折的疗效比较

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    洪雷; 张辉; 冯华

    2013-01-01

    目的 比较关节镜与小切口手术治疗后交叉韧带(PCL)胫骨附丽撕脱骨折的临床疗效. 方法 回顾性分析2001年3月至2009年9月收治的84例急性PCL胫骨附丽撕脱骨折患者资料,根据不同时期手术方式不同分为两组:关节镜组35例,男27例,女8例;平均年龄为(29.6±5.6)岁;采用关节镜下骨折复位缝合固定.切开手术组49例,男40例,女9例;平均年龄为(32.2±7.6)岁;采用腘窝内侧小切口入路切开复位空心钉加垫片固定.比较两组患者的临床疗效,膝关节功能采用Lysholm评分和国际膝关节文件编制委员会(IKDC)膝关节功能评分标准评定. 结果 84例患者术后获平均21.5个月(13 ~ 34个月)随访.所有患者骨折均于术后3个月一期愈合.关节镜组和切开手术组末次随访时后抽屉试验阴性率分别为82.9% (29/35)、91.8% (45/49),Lysholm评分平均分别为(95.1±5.6)和(96.1±4.7)分,IKDC分级A级率分别为88.6% (31/35)和91.8% (45/49),膝关节活动度正常率分别为94.3% (33/35)、93.9% (46/49),以上项目两组间比较差异均无统计学意义(P>0.05).而关节镜组和切开手术组患者的手术时间平均分别为(92.4±15.9)、(53.8±14.3) min,两组比较差异有统计学意义(P<0.05).结论 关节镜与小切口手术治疗PCL胫骨附丽撕脱骨折均可以获得满意疗效,但小切口手术的手术时间更短,且骨折固定可靠,能保证患者早期进行膝关节功能锻炼.%Objective To compare the clinical outcomes of arthroscopy versus mini-incision surgery for the treatment of avulsion fracture of the tibial attachment of the posterior cruciate ligament (PCL).Methods From March 2001 to September 2009,84 patients with acute displaced avulsion fracture of the tibial PCL attachment were treated operatively in our department.Thirty-five patients were treated with arthroscopic reduction and suture fixation (Group 1); 49 patients were treated with open reduction

  13. 多组神经移位治疗臂丛C5~C7根性撕脱伤重建肩外展及屈肘功能%Multiple nerve transfer to rebuilt the shoulder abduction and elbow flexion after the avulsion of C5-C7 nerve roots

    Institute of Scientific and Technical Information of China (English)

    聂铭博; 鲍远; 张滋洋; 康皓

    2016-01-01

    Objective To observe the curative effect of the multiple nerve transfer to cure the disabili⁃ty of shoulder abduction and elbow flexion after the avulsion of C5⁃C7 nerve roots. Methods Sixteen cases of the avulsion of C5⁃C7 nerve roots were subjected to multiple nerve transfer to rebuilt the shoulder abduction and elbow flexion during April 2012 to April 2014. We transferred the accessory nerve to suprascapular nerve, the anconeus longus branch of radial nerve to the axillary nerve and ulnar nerve partial fascicle to the musculo⁃cutaneous nerve (Oberlin transfer), respectively. The curative effect was estimated by the DASH questionnaire. Results Fourteen out of 16 patients had been successfully followed up. The mean period of follow⁃up was 25 months (ranging from 24⁃28 months). The range of shoulder abduction was 75°⁃90° and the average recovery time was 14.0 months (ranging from 9.0⁃18.0 months). The range of elbow flexion was 100°⁃160° and the aver⁃age recovery time was 5.8 months (ranging from 4.0⁃7.5 months). The mean value of DASH score was 14.6 (rang⁃ing from 8.0⁃16.0). Conclusion The multiple nerve transfer can successfully rebuilt the shoulder abduction and elbow flexion after the avulsion of C5⁃C7 nerve roots and the ulnar nerve partial fascicle to the musculocuta⁃neous nerve will do no harm to the function of intrinsic muscles in hand.%目的观察联合应用多组神经移位治疗臂丛上、中干根性撕脱伤重建肩外展及屈肘功能的临床效果。方法我科于2012年4月至2014年4月收治臂丛上、中干根性撕脱伤患者16例,采用副神经斜方肌肌支移位修复肩胛上神经、桡神经肱三头肌长头支移位修复腋神经肌支及尺神经部分束支移位肌皮神经(Oberlin术式),联合修复臂丛上、中干根性撕脱伤,以恢复肩外展及屈肘功能。术后随访采用臂肩手功能障碍(the disabilities of the arm, shoulder and hand, DASH)

  14. Arthroscopic fixation with screws versus sutures for anterior cruciate ligament tibial avulsion fractures%关节镜下螺钉与缝线固定前交叉韧带胫骨止点撕脱骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    王庆; 黄华扬; 张涛; 沈洪园; 郑小飞; 李凭跃; 区永亮

    2015-01-01

    Objective To compare the curative effects between arthroscopic screw and suture fixations for anterior cruciate ligament (ACL) tibial avulsion fractures.Methods From November 2007 to November 2012,41 patients with ACL tibial avulsion fracture underwent arthroscopy at our department.They were 32 males and 9 females,8 to 43 years of age (average,18.3 years).By the Meyers-McKeever-Zaricznyj classification,12 cases were type Ⅱ and 29 type Ⅲ.There were 19 cases in the screw fixation group,including 14 males and 5 females,9 to 42 years of age (average,18.9 years).The suture fixation group had 22cases,including 16 males and 6 females,8 to 43 years of age (average,17.8 years).Operation time,knee range of motion (ROM),case of flexion contracture,Lysholm score,international knee documentation committee (IKDC) score,and side-to-side mobile difference by KT-2000 were evaluated.The 2 groups were similar in age,gender,fracture type and time from injury to surgery (P > 0.05).Results The operation time for the suture fixation group (58.9 ±6.7 min) was significantly longer than that for the screw fixation group (51.6±6.2 min) (P < 0.05).There were no significant differences between the 2 groups regarding the Lysholm score (96.2 ± 2.83 for the screw fixation group versus 95.5 ± 2.6 for the suture fixation group),the IKDC score (91.4 ± 6.4 for the screw fixation group versus 88.1 ± 7.5 for the suture fixation group),the side-to-side mobile difference by KT-2000 (2.7 ± 2.6 mm for the screw fixation group versus 2.8 ± 2.7 mm for the suture fixation group (P < 0.05).Flexion contracture of ≥ 5° occurred in 3 cases in the screw fixation group and 2 cases in the suture fixation group,showing no significant difference (P > 0.05).Conclusions In treatment of ACL tibial avulsion fractures of types Ⅱ and Ⅲ,there is no significant difference between arthroscopic screw fixation and suture fixation,because both methods can achieve good stability and functional recovery

  15. 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.

  16. A lesão do trato de Lissauer e do corno posterior da substância cinzenta da medula espinal e a estimulação elétrica do sistema nervoso central para o tratamento da dor por avulsão de raízes do plexo braquial DREZ lesions and electrical stimulation of the central nervous system for treatment of brachial plexus avulsion pain

    Directory of Open Access Journals (Sweden)

    MANOEL JACOBSON TEIXEIRA

    1999-03-01

    Full Text Available Descrevemos os resultados do tratamento operatório de 10 doentes com dor resultante de avulsão de raízes do plexo braquial. Sete foram tratados pela técnica de lesão do trato de Lissauer (TL e do corno posterior da medula espinal (CPME, 4 pela técnica de estimulação elétrica da medula espinal (EM e 2 pela técnica de estimulação talâmica (ET. Três doentes foram tratados por ambos os procedimentos. Foi observada melhora imediata em 50% dos doentes com a técnica de estimulação medular e em apenas 25% dos casos, a longo prazo. Ocorreu melhora imediata, mas recorrência tardia da dor nos 2 doentes tratados pela ET. Houve melhora imediata de todos os doentes tratados pela técnica da lesão e recidiva parcial da dor em 23% dos casos, a longo prazo. Complicações temporárias foram observadas em 28,6% dos casos tratados pela técnica de lesão. Conclui-se que a lesão do TL e do CPME proporcionam resultados mais satisfatórios a longo prazo que a técnica de estimulação (p = 0,0046; entretanto, esta última é mais segura.We analyze the effectiveness of the treatment of 10 patients of brachial plexus avulsion pain. Seven underwent dorsal root entry zone lesions (DREZ, 3, dorsal column stimulation (DCS and, 2 thalamic stimulation (TS. DCS resulted in immediate improvement of pain in 50% of the patients. After a long term follow up period, just 25% of the patients were still better. TS resulted the in temporary improvement of 2 patients. Both had full recurrence few months after the operation. Immediate improvement of the symptoms occurred in all patients treated by DREZ. After a long term follow up period, excellent results were observed in 71.4% of the patients and good results in the remainder. The complication rate was higher among DREZ patients. It is concluded that DREZ is a better procedure for treatment of brachial plexus avulsion pain than DCS and TS (p = 0,0046; however, DCS and TS are safer.

  17. Splitting rivers at their seams: bifurcations and avulsion

    NARCIS (Netherlands)

    Kleinhans, M.G.; Ferguson, R.I.; Lane, S.N.; Hardy, R.J.

    2012-01-01

    River bifurcations are critical but poorly understood elements of many geomorphological systems. They are integralelements of alluvial fans, braided rivers, fluvial lowland plains, and deltas and control the partitioning of water and sediment throughthese systems. Bifurcations are commonly unstable

  18. Splitting rivers at their seams: bifurcations and avulsion

    NARCIS (Netherlands)

    Kleinhans, M.G.; Ferguson, R.I.; Lane, S.N.; Hardy, R.J.

    2012-01-01

    River bifurcations are critical but poorly understood elements of many geomorphological systems. They are integral elements of alluvial fans, braided rivers, fluvial lowland plains, and deltas and control the partitioning of water and sediment through these systems. Bifurcations are commonly unstabl

  19. River diversions, avulsions and captures in the Tortuguero coastal plain

    Science.gov (United States)

    Galve, Jorge Pedro; Alvarado, Guillermo; Pérez Peña, José Vicente; Azañón, José Miguel; Mora, Mauricio; Booth-Rea, Guillermo

    2016-04-01

    The Tortuguero area is a coastal plain that forms part of the North Limón sedimentary basin, the back-arc region of the Caribbean side of Costa Rica. This coastal plain is characterised by an abnormal drainage pattern with river captures, diversions and shifts in channel directions. We are analyzing this anomalous drainage network adopting a classical geomorphological approach combined with geomorphometric techniques. The SRTM DEM at 1 arc-second of resolution (~30 m) from NASA, topographic maps 1:50,000, satellital images and the digital cartography of the drainage network have been used for inventorying the channel pattern anomalies. River segments were categorized according to sinuosity, orientation, slope changes and incision using GIS tools. Initially, anomalies in the analyzed river courses suggested that buried thrust fronts could disrupt their natural pattern. However, we have not identified any evidence to link the activity of buried structures with the disruption of natural drainage. Blind thrusts detected through seismic subsurface exploration in the SE sector of the Tortuguero plain do not seem to produce changes in the sinuosity, orientation, slope and incision of rivers as those observed in the deeply studied tectonically active area of the Po Plain (Italy). The identified river pattern anomalies have been explained due to other alternative causes: (1) the migration of the mouths of Reventazón, Pacuare and Matina rivers is produced by sand sedimentation in the coast because of a successive ridge beach formation. This migration to the SE has the same direction than the main ocean currents those deposited the sand. (2) The anomalous course of Parismina river is most probably conditioned by the fracturation of the dissected volcanic apron of Turrialba volcano. (3) Channel migration and capture of Barbilla river by Matina river can be triggered by the tectonic tilting of the coastal plain towards the SE. The subsidence of the SE sector of the plain was documented before the Limón earthquake in 1991. (4) The Sucio, North Chirripó and Toro Amarillo rivers form a channel that takes an abnormal direction towards the NW instead of taking their natural direction towards the Caribbean Sea in the E. This anomalous behaviour is conditioned by the existence of a megafan recently recognized by using topographic data from the SRTM mission. The developed analysis is the first step towards improving the knowledge about the processes behind the observed anomalies. Current research is analyzing the role of active vulcanism and tectonics on Tortuguero rivers behaviour. This has implications on the consequences of torrent-related hazards (flash floods and lahars) that may divert river channels and change the landscape of the coastal plain in only one event.

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

    Science.gov (United States)

    Andreasen, Jens Ove; Schwartz, Ole; Kofoed, Thomas; Daugaard-Jensen, Jette

    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. 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 with composite or a porcelain laminate. Four recent long-term studies have shown survival rates between 90-98 percent and a single long term study (33 years) showed a survival rate of 90 percent, a survival rate not surpassed by any other type of tooth replacement (fixed or removable prostetics, implants). In conclusion premolar transplantation should be considered in cases of early loss of a permanent tooth.

  1. Inferior glenohumeral joint dislocation with greater tuberosity avulsion

    Institute of Scientific and Technical Information of China (English)

    Mohd Faizan; Latif Zafar Jilani; Mazhar Abbas; Yasir Salam Siddiqui; Aamir Bin Sabir; M.K.A.Sherwani; Saifullah Khalid

    2015-01-01

    Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations.It may be associated with fractures of the adjacent bones and neurovascular compromise.It should be treated immediately by close reduction.The associated neuropraxia usually recovers with time.Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks.Here,we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.

  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. 带线锚钉缝合固定腓骨肌腱治疗第五跖骨基底部撕脱性骨折%Peroneal tendon insertion and reconstruction by suture anchors for treatment of avulsion fractures of the fifth metatarsal base

    Institute of Scientific and Technical Information of China (English)

    李辉; 唐康来; 周建波; 徐格; 陶旭; 常廷杰; 谭晓康; 谢美明

    2010-01-01

    Objective To retrospectively analyze the clinical results of peroneal tendon insertion and reconstruction with suture anchors in the treatment of avulsion fractures of the fifth metatarsal base.Methods Five patients (three males and two females) with the fifth metatarsal base fractures were in zone 1, with average seven days of duration before surgery. The result of radiological examination confirmed that all fractures were in zone 1 of the fifth metatarsal base, with some small, comminuted and obviously displaced pieces. After removal of the small comminuted fracture pieces, the peroneal tendon insertion was dissociated and sutured to the fifth metatarsal base by suture anchors (5 mm in diameter) with line. The feet were immobilized by plaster in the vagus position. The patients began to walk with weightbearing six weeks after operation. Results All patients were followed up for at least six months, which showed no deformity of the feet. The function of forefoot valgus and abduction restored to normal. There was no any loss in muscle force compared with the normal side. Conclusions Peroneal tendon insertion and reconstruction by suture anchors is very helpful to solve the problem in the fixation of the small fracture fragments. The function of the peroneal tendon recovers very well. The surgery has the advantages of easy manipulation and small area of dissection, without requirement of secondary surgery.%目的 回顾分析带线锚钉缝合固定腓骨肌腱治疗第五跖骨基底部撕脱性骨折的临床疗效.方法 5例第五跖骨基底部1区骨折患者(男3例,女2例),术前平均病程7 d.影像检查发现5例均为第五跖骨基底部1区骨折,骨折块较小、粉碎且明显移位.手术去除第五跖骨基底部粉碎骨折块,游离腓骨肌腱止点,用直径5 mm带线锚钉将腓骨肌腱止点编织缝合在第五跖骨基底部,石膏托将患侧足固定于外翻位.术后6周开始逐渐负重行走.结果 本组5例患

  4. 不同离体时间和保存液对犬离体牙牙周膜细胞活力影响的实验研究%Effects of different extra-oral storage time and storage medium on the viability of periodontal ligament cells from avulsed dog teeth

    Institute of Scientific and Technical Information of China (English)

    刘勇; 周三玲; 高黎; 冀坤; 轩昆; 文玲英

    2012-01-01

    目的:探讨完全脱位牙不同离体时间和保存液对牙周膜细胞活力的影响.方法:麻醉拔除犬牙35个,首先将20个牙随机分为5组,分别为室温干燥放置0、30、60、120、240 min组,另15个牙室温干燥放置30 min后,随机分为3组,分别放入牛奶、HBSS液,100 g/L蜂胶液中浸泡2h.各组处理完成后,采用全牙消化法获得牙周膜细胞,并通过4 g/L台盼蓝染色法检测各组牙周膜活细胞数和存活率.结果:室温干燥放置30、60、120、240 min后,牙周膜细胞存活率依次为33.6%、23.6%、18.5%、0.8%,而0 min的牙周膜细胞存活率可达95.5%.拔后30 min,经牛奶、HBSS液和100 g/L蜂胶液中保存2h后,牙周膜细胞均有活力,其细胞存活率大小依次为100 g/L蜂胶液、HBSS液和牛奶,其中100 g/L蜂胶液与HBSS液相比无统计学差异(P>0.05),但与牛奶组相比,均有统计学差异(P<0.05).结论:随着离体时间延长,完全脱位牙根面牙周膜细胞活力明显下降.100 g/L蜂胶液和HBSS液保存犬牙牙周膜细胞活力优于牛奶液.%AIM: To evaluate the effects of different extra-oral storage time and storage medium on the via-bility of periodontal ligament cells from avulsed dog teeth. METHODS: Thirty-five dog teeth were extracted under local anesthesia and were randomly assigned to different treatment groups. Twenty teeth were stored at room temperature for 0, 30, 60, 120, 240 min, with 4 teeth in each time point group. The PDL cells were subsequently isolated by direct enzymatic digestion method. The viabilities of the cells were examined by 0.4% Trypan Blue Stains. The other 15 teeth were stored at room temperature for 30 min. Then they were divided into HBSS, milk and 10% Propolis group (with 5 teeth in each group) and stored in the respective medium for 2 hours. Cell viability were assessed in the same way. RESULTS: The number of viable PDL cells decreased with the increase of storage time. At 0, 30, 60, 120 and 240

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

    Energy Technology Data Exchange (ETDEWEB)

    Nachtrab, O. [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom); Cassar-Pullicino, V.N., E-mail: Victor.Pullicino@rjah.nhs.uk [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom); Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J. [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom)

    2012-12-15

    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.

  6. Management of Hard Tissue Avulsive Wounds and Management of Orofacial Fractures.

    Science.gov (United States)

    2014-09-26

    phase tricalcium phosphate will be the predominant phase in all materials, secondary phases of monetite or hydroxyapatite were always found depending...in all materials, secondary phases of monetite or hydroxyapatite were always found depending upon what border of the compositional range the compound...finished implant. Although B-Ca3(P04) was the predominant phase in all the materials, - there were secondary phases of either monetite (CaHP04) or

  7. 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

  8. Log jams and flood sediment buildup caused channel avulsion in the Pennsylvanian of Atlantic Canada

    DEFF Research Database (Denmark)

    Gibling, Martin R; Bashforth, Arden Roy; Falcon-Lang, Howard J;

    2010-01-01

    channels. The logs include lycopsids, calamiteans, tree ferns, pteridosperms and cordaitaleans, inferred to have grown on inactive braided tracts near the channels. A compaction estimate suggests that one log accumulation was originally more than four times its present thickness. Most accumulations...

  9. Surgical treatment of avulsion fractures of the knee PCL tibial insertion: experience with 21 cases

    OpenAIRE

    2007-01-01

    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-ós...

  10. Arthroscopic repair of peripheral avulsions of the triangular fibrocartilage complex of the wrist: a multicenter study.

    Science.gov (United States)

    Corso, S J; Savoie, F H; Geissler, W B; Whipple, T L; Jiminez, W; Jenkins, N

    1997-02-01

    A multicenter study to assess arthroscopic reconstruction of the peripheral attachment of the triangular fibrocartilage complex was undertaken. A total of 44 patients (45 wrists) from three institutions were reviewed. Twenty-seven of the 45 wrists had associated injuries, including distal radius fracture (4), partial or complete rupture of the scapholunate (7), lunotriquetral (9), ulnocarpal (2), or radiocarpal (2) ligaments. There were two fractured ulnar styloids and one scapholunate accelerated collapse (SLAC) wrist deformity. The peripheral tears were repaired using a zone-specific repair kit. The patients were immobilized in a munster cast, allowing elbow flexion and extension, but no pronation or supination for 4 weeks, followed by 2 to 4 weeks in a short arm cast or VersaWrist splint. All patients were reexamined independently 1 to 3 years postoperatively by a physician, therapist, and registered nurse. The results were graded according to the Mayo modified wrist score. Twenty-nine of the 45 wrists were rated excellent. 12 good, 1 fair, and 3 poor. Overall, 42 of the 45 patients (93%) rated as satisfactory and returned to sports or work activities. One patient had chronic pain, and two patients had ulnar nerve symptoms, although motion was normal in all, and their grip strength was at least 75% of the opposite hand. Arthroscopic repair of peripheral tears of the triangular fibrocartilage complex (TFCC) is a satisfactory method of repairing these injuries.

  11. Replantation after extended dry storage of avulsed permanent incisors: report of a case.

    Science.gov (United States)

    Cobankara, Funda Kont; Ungor, Mete

    2007-08-01

    A 15-year-old boy lost his maxillary right and left central incisor teeth in a bicycle accident. He was referred to our clinic 1 week after the injury. The crown-root integrities of both the teeth were not damaged. Although the teeth were stored under dry conditions for 1 week, reimplantation of the teeth was planned to retain the teeth in the mouth for as long a period as possible because of the patient's age. Following the debridement and sterilization of root surfaces in 2.5% NaOCl, root canals were prepared and filled with calcium hydroxide. Then, about 2 mm of the apexes were resected to ensure that the roots easily seated in the alveolar socket and the prepared cavities in root ends were obturated with the amalgam. The teeth were placed into their respective sockets and splinted temporarily. The root canal therapy was completed 5 weeks later. Ankylosis was observed radiographically after 10 months. The patient is now 23 years old and he is still able to use both the central incisors functionally. However, there is a pink appearance on the cervical buccal surface of left central incisor because of progressive replacement resorption. In this case, the new treatment plan is to perform a permanent restoration with dental implants following the extraction of both teeth. Even though the long-term prognosis is uncertain, this treatment technique has provided an advantage for the patient in his adolescent period by maintaining the height of alveolar bone and making the provision of an aesthetically acceptable permanent restoration at a later age possible.

  12. Late repair of abductor avulsion after the transgluteal approach for hip arthroplasty.

    Science.gov (United States)

    Miozzari, Hermes H; Dora, Claudio; Clark, John M; Nötzli, Hubert P

    2010-04-01

    The abductor release sometimes does not heal after a transgluteal approach for hip arthroplasty. Factors influencing the success of subsequent repair are unclear. We used magnetic resonance imaging (MRI) to compare the condition of the gluteus medius with clinical outcome after late repair of abductor dehiscence in 12 total hip patients. Evaluation included a pain rating, gait evaluation, Trendelenburg test, strength grading, and Harris Hip Score. Most had both prerepair and postrepair MRI studies to assess the repair and to grade abductor muscle fatty degeneration. Two repairs without MRI were explored surgically. Although average pain, limp, and strength scores improved significantly, rerupture occurred in 4 subjects and fatty degeneration in the gluteus medius did not improve, even with intact repair. Nine patients were satisfied; 7 of these had an intact repair. Magnetic resonance imaging and operative observations suggest that chronic degeneration in the abductor mechanism is the major impediment to successful repair.

  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. 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.

  15. 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.)

  16. 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.

  17. Avulsion of the distal tendon of the biceps brachii: reattachment to the radial tuberosity via 1-incision technique.

    Science.gov (United States)

    Gifuni, P; Strada, U

    2001-01-01

    Between 1995 and 1997 a total of 5 patients with injury of the distal tendon of the biceps brachii were treated by reattachment to the radial tuberosity using Henry anterior access to the elbow. The results obtained through a clinical and instrumental evaluation, and the answers to a questionnaire, were good or excellent. What was particular about our work was that we treated all of the patients by a single Henry anterior access and not a double Boyd and Anderson one, which is more commonly used. Our decision was based on the minor amount of surgical invasiveness, the simpler method of reinsertion of the tendon and the minor incidence of possible radio-ulnar synostoses. This surgical approach requires particular care with regard to possible injuries of the radial nerve, that, moreover, are easily avoidable if surgery is performed by experts, with accurate and limited preparation of the site of reattachment.

  18. Knowledge and Attitude of Parents/Caretakers toward Management of Avulsed Tooth in Maharashtrian Population: A Questionnaire Method

    OpenAIRE

    Nikam, Atul Pralhad; Kathariya, Mitesh D; Chopra, Kirti; Gupta, Aditi; Kathariya, Renuka

    2014-01-01

    Background: Traumatic injuries to teeth and their supporting structures during childhood are one of the major problems faced by the dentist in day to day practice. Children usually encounter minor accidents in their routine activities and hence, it of utmost importance to provide emergency care to reduce such outcomes. Most of children with dental trauma present late for treatment due to lack of awareness and knowledge among parents/caretakers resulting in unfavorable long-term prognosis. Thi...

  19. Avulsion fracture of the extensor carpi radialis longus carpal insertion due to a basketball injury: case report and literature review.

    Science.gov (United States)

    Robert, N; Zbili, D; Bellity, J; Doursounian, L; Mauprivez, R

    2014-12-01

    Articular fractures of the base of the 2nd metacarpal involving the extensor carpi radialis longus insertion are unusual and poorly understood. There is no consensus as to how these fractures should be treated. We report the case of a 2nd metacarpal base fracture in a professional basketball player that was treated surgically with open reduction and internal fixation using cannulated screws. The management of this case is compared to similar cases in the literature.

  20. Meios de conservação do dente avulsionado: revisão da literatura = Storage media for avulsed teeth: review of literature

    Directory of Open Access Journals (Sweden)

    Borba, Maristela Gutiérrez de

    2014-01-01

    Full Text Available A avulsão é um traumatismo dentário de graves consequências para o dente permanente pelo dano que pode ocorrer à estrutura periodontal. O reimplante imediato deve ser o tratamento de eleição, porém muitas vezes não é possível, e o sucesso do futuro reimplante dependerá do tempo em que o dente permanece fora do alvéolo e o meio no qual ele é mantido. O objetivo deste trabalho é fazer uma revisão da literatura sobre os meios de conservação devido a sua importância no prognóstico do reimplante. Embora muitos meios venham sendo testados, até o momento nenhum deles preenche todos os requisitos biológicos e ainda esteja disponível no local do acidente. A saliva e a água, embora sejam de fácil acesso, têm demonstrado causar efeitos deletérios nas células do ligamento periodontal. Apesar dos seus efeitos biológicos positivos, os meios de cultura raramente estão ascessíveis no local do acidente, o que torna seu uso impraticável. A própolis e o extrato de chá verde parecem ser promissores e novos estudos ainda precisam ser realizados. O leite, em especial o longa vida desnatado, parece ser uma boa opção, pois apresenta bons resultados com relação à viabilidade celular e costuma estar disponível

  1. Discussing the Avulsing of No - profitable Assets in Coal Enterprises%论国有煤炭企业非经营性资产的剥离

    Institute of Scientific and Technical Information of China (English)

    林爱梅

    2000-01-01

    @@ 一、非经营性资产的现状分析 国有企业的非经营性资产是我国国有资产的重要组成部分.非经营性国有资产从其实物形态及用途角度讲,包括固定资产、材料、低值易耗品、货币资金和其他资产.

  2. Shoulder MR arthrography and injury mechanism of partial articular surface tendon avulsion%肩关节MR造影诊断肩袖关节侧大结节止点处外伤性撕脱的价值

    Institute of Scientific and Technical Information of China (English)

    田春艳; 周宏宇; 郑卓肇; 崔国庆

    2014-01-01

    目的 评估肩关节MR造影诊断肩袖关节侧大结节止点处外伤性撕脱(PASTA损伤)的能力.方法 回顾性分析经关节镜证实的19例PASTA损伤的肩关节MR造影图像.19例PASTA损伤中,职业运动员15例,运动爱好者4例,年龄16 ~ 35岁.总结PASTA损伤的影像特点,并计算肩关节MR造影对PASTA损伤的诊断敏感度.结果 12例PASTA损伤累及冈上肌腱,4例累及冈上肌腱与冈下肌腱交界部,3例累及冈下肌腱.中立位肩关节MR造影可确定15例为肩袖下表面的部分撕裂,诊断敏感度为78.9% (15/19),但只能确定13例为PASTA损伤,诊断敏感度为68.4% (13/19).19例PASTA损伤中,18例合并有盂唇撕裂,肩关节MR造影诊断上方盂唇前后向撕裂的敏感度为100.0%(11/11),前下盂唇撕裂为92.3% (12/13),3例后方盂唇撕裂诊断2例.结论 肩关节MR造影可以较全面的评价PASTA损伤.

  3. Avulsión del plexo braquial traumático no controlado con remifentalino: Papel de la analgesia epidural cervical Traumatic brachial plexus root avulsion unresponsive to remifentanyl role cervical epidural analgesia

    Directory of Open Access Journals (Sweden)

    M. Cortiñas

    2007-04-01

    Full Text Available Presentamos el caso de una paciente que sufrió accidente de tráfico con avulsión del plexo braquial izquierdo, y que presentaba dolor muy intenso (escala visual analógica 8 de características neuropáticas en la fase aguda postraumática. Dosis altas de remifentanilo fueron inefectivas para control del cuadro álgico, el cual se trato con éxito con una infusión de ropivacaína a través de catéter epidural cervical (C5-6. El dolor es controlado en fase crónica (escala visual analógica 2 con agentes específicos contra dolor neuropático (gabapentina, amitriptilina, clonacepam y tramadol.We presented you a patient who suffered a left brachial plexus avulsión with hard neuropatic pain in the posttraumatic acute phase (visual analogue scale 8. High-dose remifentanil infusión was uneffective in controlling pain, which was further ameliorated by ropivacaine infused through a cervical (C5-6 epidural catheter. At discharge pain remained controlled (visual analogue scale 2 with specific treatment against neuropathic pain (gabapentin, amytriptiline, clonacepam, and tramadol.

  4. Delayed replantation after prolonged dry storage

    Directory of Open Access Journals (Sweden)

    Anita Rao

    2014-01-01

    Full Text Available Management of tooth avulsion in the permanent dentition often presents a challenge. Definitive treatment planning and consultation with specialists is seldom possible at the time of emergency treatment. Replantation of the avulsed tooth can restore esthetic appearance and occlusal function shortly after the injury. This article describes the management of a patient with an avulsed maxillary permanent incisor that had been air-dried for about 40 h. The replanted incisor retained its esthetic appearance and functionality 1 year after replantation, yet the long-term prognosis is not good because of progressive replacement root resorption.

  5. The reparation of flyback avulsion injury of skin in foot by anterolateral thigh flap and sural neurovascular flap with their neural anastomosis%股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状撕脱伤

    Institute of Scientific and Technical Information of China (English)

    刘勇; 裴国献; 张成进; 王成琪; 李忠; 姚旺祥; 梅良斌

    2006-01-01

    目的 探讨吻合神经的股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状逆行撕脱伤的临床效果.方法 足部套状逆行撕脱伤患者14例,男10例,女4例;年龄16~58岁,平均31岁.切取带股前外侧皮神经的股前外侧皮瓣移植至足部,将股前外侧皮神经与足底内侧神经吻合,并将足底外侧神经植入股前外侧皮瓣的足底修复区;转移腓肠神经营养血管皮瓣修复足外侧部.将腓浅神经及其分支分别与腓肠内、外侧皮神经吻合.按照Swanson等制定的周围神经损伤临床疗效评定方法,将感觉分成S1~S5 5级,将感觉恢复范围分为R1(<25%)、R2(25%~50%)、R3(50%~75%)与R4(75%~100%)4级.结果 14例移植皮瓣均成活,术后外形良好.术后6个月足部感觉恢复分级:足内侧,S2 6足,S3 8足;足底,S2 9足,S3 5足;足外侧,S2 3足,S3 11足.足部感觉恢复范围:足内侧,R1 4足,R210足;足底,R1 8足、R2 6足;足外侧,R1 4足、R2 10足.术后9个月足部感觉恢复分级:足内侧,S3 7足,S4 7足;足底,S2 2足,S3 6足,S4 6足;足外侧,S3 8足,S4 6足.足部感觉恢复范围:足内侧,R2 5足,R3 8足,R4 1足;足底,R2 8足,R3 4足,R4 2足;足外侧,R2 5足,R3 7足,R4 2足.结论 吻合神经的股前外侧皮瓣和腓肠神经营养血管皮瓣联合修复足部套状逆行撕脱伤具有供区隐蔽、实用,受区感觉恢复理想的特点.

  6. AO spiked washer and screw implantation for the treatment of small or comminuted tibial avulsion fractures of the posterior cruciate ligament in 11 patients%AO齿状垫圈及螺钉置入固定后交叉韧带胫骨小块或粉碎撕脱骨折11例

    Institute of Scientific and Technical Information of China (English)

    俞海明; 姚学东; 林金矿; 戴章生

    2008-01-01

    福建医科大学附属第二医院骨科诊治的11例移位的小块或粉碎性后交叉韧带胫骨撕脱性骨折患者.采用长度35 mm或40mm,直径4.0mm的松质骨螺钉及内径4.0mm的齿状塑料垫幽胃入固定,粉碎骨折块较大的用2枚松质骨螺钉及垫圈置入固定.置入后长腿石膏管型固定屈膝30°位2~4周.11例患者获7~36个月随访,平均18个月.随访患者金属内固定材料无电解、腐蚀反应,齿状塑料垫圈无过敏反应.固定后2个月骨折全部愈合,无骨折块再移化,无膝关节不稳或松弛,膝关节活动度恢复正常,膝关节功能明显改善.

  7. 单臂外固定支架联合腓肠肌内侧头肌皮瓣治疗胫腓骨骨折合并大面积皮肤撕脱伤%Single-arm External Fixation Frame Combined with Medial Head of Gastrocnemius Muscle Musculo-cutaneous Flap for Treating of Tibiofibular Fracture with Extensive Skin Avulsion

    Institute of Scientific and Technical Information of China (English)

    宋德业; 王万春

    2007-01-01

    目的 探讨单臂外固定支架联合腓肠肌内侧头肌皮瓣治疗胫腓骨骨折合并胫前大面积皮肤撕脱伤的疗效.方法 18例患者先进行急诊清创,采用单臂AO外固定支架固定骨折、腓肠肌内侧头肌皮瓣局部旋转覆盖外露胫骨.撕脱的皮肤修成全厚皮片回植供皮区,其中5例仍有缺损,另取同侧大腿全厚皮片移植.结果 均无感染,15例旋转皮瓣完全成活,2例皮瓣远端表皮坏死,经换药治愈,1例皮瓣远端全层坏死,经植皮治愈.撕脱皮片回植13例成活,5例小部分坏死,其中3例经换药治愈,2例经中厚皮片植皮愈合.5例大腿皮片完全成活.平均随访19.5(10~36)个月,骨折平均愈合时间4(3.5~6)个月.所有患者行走正常,3例膝关节屈伸活动受限,4例踝关节屈伸受限.结论 采用单臂外固定支架联合腓肠肌内侧头肌皮瓣治疗胫腓骨骨折合并胫前大面积皮肤撕脱伤,疗效肯定.

  8. Avulsão do plexo braquial em cães - 3: eletroneuroestimulação dos nervos radial, mediano, ulnar e musculocutâneo Brachial plexus avulsion in dogs - 3: electroneurostimulation of radial, median, ulnar and musculocutaneous nerves

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

    Full Text Available O objetivo deste trabalho foi relacionar os aspectos clínicos, neurológicos e histopatológicos (descritos nas partes l e 2 deste trabalho com os resultados obtidos após estimulação elétrica dos nervos radiai, mediano, ulnar e musculocutâneo. Realizou-se a estimulação elétrica destes nervos durante o ato cirúrgico no qual foram coletados os fascículos para histopatolo gia. Os nervos radial, mediano e ulnar de todos os cães submetidos à eletroneuroestimulação apresentaram evidências de degenera- ção. enquanto que o nervo musculocutâneo apresentava função próxima do normal em 25% dos casos. A associação dos resultados do exame neurológico, da histologia e da eletroneuroestimulação sugeriu envolvimento quase que total das raízes do plexo braquial, enfatizando a necessidade de continuidade de pesquisas na área, visando principalmente a recuperação das raízes nervosas envolvidas.The purpose ofthis work was to relate lhe clinicai, neurological and histopathotogical aspects (as described in the sections I and 2 ofthis work with the obtained results after the electric stimulation of radial, median, ulnar and musculocutaneous nerrves. The electric stimulation of these nerves was realized during the cirurgic act, when the fascicle were obtained for the histopathologic examination. The radial, median and ulnar nerves of ali dogs submitted to electroneurostimulation presented evidences of degeneration, while the musculocutaneous nerve present almost normal functions in 25% of the cases. The interpretation ofthe results obtained from neurologic, histologic and electroneurostimulation examination suggested the almost total involvement of brachial plexus in ali cases. This work emphasized the need for further research in this área with lhe main purpose of recuperating the involved roots.

  9. Osseous Injury Associated With Ligamentous Tear of the Knee.

    Science.gov (United States)

    Lee, Chee Hwee; Tan, Chih Feng; Kim, Okwha; Suh, Kyung Jin; Yao, Min-Szu; Chan, Wing P; Wu, Jim S

    2016-11-01

    One of the most common knee injuries is ligament tear, which may initially manifest as an osseous injury in radiographs. Radiologists should therefore be able to recognize ligament tears of the knee as osseous abnormalities in images. This review focuses on the imaging features of knee ligament injuries and their related osseous injuries: anterior cruciate ligament (ACL) tear with Segond fracture; associated marrow contusion; ACL avulsion fracture; posterior cruciate ligament (PCL) tear with osseous avulsion of the ligament including arcuate sign; reverse Segond fracture; PCL avulsion fracture; medial collateral ligament tear with Pellegrini-Stieda disease; lateral collateral ligament tear with avulsion fracture of the fibular head; and patellar ligament injuries with Osgood-Schlatter and Sinding-Larsen-Johansson.

  10. Onychocryptosis: principles of non-operative and operative care.

    Science.gov (United States)

    Murray, W R

    1979-01-01

    Onychocryptosis has many causal factors which contribute to the impingement of the nail edge with the soft tissue nail wall. The treatment protocol for ingrown toenail includes a regimen of conservative care, nail plate avulsion and nail bed ablation.

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

    NARCIS (Netherlands)

    Kleinhans, M.G.; Haas, de T.; 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 tenden

  12. 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.

  13. 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.

  14. “Floating popliteus tendon injury” in a mutiple-ligament knee injury: one case report and arthroscopy-assisted reconstruction

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin; FENG Hua; HONG Lei; WANG Xue-song; ZHANG Hui

    2011-01-01

    A patient with both a femoral attachment injury (peel-off injury) and musculotendinous junction avulsion of the popliteus,a so-called “floating popliteus tendon injury”,received arthroscopy-assisted popliteus reconstruction.The injured ligaments were addressed in the same procedure,including mini-open direct repair of the femoral avulsed fibular collateral ligament (FCL),suture repair of the grade 3 medial collateral ligament (MCL),and reconstruction of the posterior cruciate ligament (PCL).

  15. Extreme river response to climate-induced aggradation in a forested, montane basin, Carbon River, Mount Rainier National Park, Washington, United States

    Science.gov (United States)

    Beyeler, J. D.; Rossi, R. K.; Kennard, P. M.; Beason, S. R.

    2013-12-01

    Climate change is drastically affecting the alpine landscape of Mount Rainier, encouraging glacial retreat, changes in snowpack thickness and longevity, and sediment delivery to downstream fluvial systems, leading to an extremely transport limited system and aggradation of the river valleys. River aggradation encourages devastating interactions between the pro-glacial braided fluvial systems and streamside floodplain ecosystems, in most places occupied by old-growth conifer forests. Current aggradation rates of the channels, bordered by late seral stage riparian forests, inhibit floodplain development, leading to an inverted relationship between perched river channels and lower-elevation adjacent floodplains. This disequilibrium creates a steeper gradient laterally towards the floodplains, rather than downstream; promoting flooding of streamside forest, removal and burial of vegetation with coarse alluvium, incision of avulsion channels, tree mortality, wood recruitment to channels, and ultimately widening the alluviated valley towards the glacially carved hillslopes. Aggradation and loss of streamside old-growth forest poses a significant problem to park infrastructure (e.g. roads, trails, and campgrounds) due to flood damage with as frequent as a two-year event. Other park rivers, the White River and Tahoma Creek, characterize two end-member cases. Despite an extremely perched channel, the White River is relatively stable; experiencing small avulsions while the old-growth streamside forest has remained mostly intact. These relatively small avulsions however severely impact park infrastructure, causing extensive flood damage and closure of the heavily trafficked state highway. Conversely debris flows on Tahoma Creek destroyed the streamside forest and migration across the valley is uninhibited. Mature streamside forests tend to oppose avulsions, sieving wood at the channel margins, promoting sediment deposition and deflection of erosive flows. Our study seeks to

  16. A lesão do trato de Lissauer e do corno posterior da substância cinzenta da medula espinal e a estimulação elétrica do sistema nervoso central para o tratamento da dor por avulsão de raízes do plexo braquial DREZ lesions and electrical stimulation of the central nervous system for treatment of brachial plexus avulsion pain

    OpenAIRE

    MANOEL JACOBSON TEIXEIRA; EVANDRO CÉSAR DE SOUZA; LIN TCHIA YENG; WALTER CARLOS PEREIRA

    1999-01-01

    Descrevemos os resultados do tratamento operatório de 10 doentes com dor resultante de avulsão de raízes do plexo braquial. Sete foram tratados pela técnica de lesão do trato de Lissauer (TL) e do corno posterior da medula espinal (CPME), 4 pela técnica de estimulação elétrica da medula espinal (EM) e 2 pela técnica de estimulação talâmica (ET). Três doentes foram tratados por ambos os procedimentos. Foi observada melhora imediata em 50% dos doentes com a técnica de estimulação medular e em a...

  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. Non-invasive monitoring of vascularization of grafted engineered human oral mucosa

    Science.gov (United States)

    Wolf, D. E.; Seetamraju, M.; Gurjar, R. S.; Kuo, R. S.; Fasi, A.; Feinberg, S. E.

    2012-03-01

    Accident victims and victims of explosive devices often suffer from complex maxillofacial injuries. The lips are one of the most difficult areas of the face to reconstruct after an avulsion. Lip avulsion results in compromised facial esthetics and functions of speech and mastication. The process of reconstruction requires assessment of the vascularization of grafted ex vivo engineered tissue while it is buried underneath the skin. We describe the design and animal testing of a hand-held surgical probe based upon diffuse correlation spectroscopy to assess vascularization.

  19. Osteoconduction exerted by methylpyrrolidinone chitosan used in dental surgery.

    Science.gov (United States)

    Muzzarelli, R A; Biagini, G; Bellardini, M; Simonelli, L; Castaldini, C; Fratto, G

    1993-01-01

    Surgical wounds from wisdom tooth avulsions were medicated with freeze-dried methylpyrrolidinone chitosan, a gel-forming resorbable biopolymer obtained from crab chitosan by chemical modification. Methylpyrrolidinone chitosan promoted osteoconduction and the space left after avulsion was filled with newly formed bone tissue, which conferred desirable mechanical and physiological characteristics to the healed would site. Morphological evidence obtained from biopsies confirmed the radiographic data. Methylpyrrolidinone chitosan was progressively depolymerized by lysozyme and was no longer detected 6 months after surgery. None of the 10 patients reported adverse effects over one year of observation.

  20. Gingival contour and clinical crown length: their effect on the esthetic appearance of maxillary anterior teeth.

    Science.gov (United States)

    Kokich, V G; Nappen, D L; Shapiro, P A

    1984-08-01

    Fractured, congenitally missing, or avulsed maxillary incisors can often jeopardize the esthetic appearance of the remaining maxillary anterior teeth after orthodontic treatment. In many cases the unesthetic appearance is related to the irregular clinical crown lengths of either the fractured teeth or those that have been substituted for the missing teeth. The results of five cases with either fractured or traumatically avulsed central incisors are reported. Selective tooth intrusion and restorative techniques were used during the finishing stages of orthodontic treatment to improve the final esthetic result. The advantages and disadvantages of the intrusion technique are discussed.

  1. Indirect reduction of posterior wall fragment using a suture anchor in acetabular posterior wall fracture with posterior labral root tear.

    Science.gov (United States)

    Yoo, Je-Hyun; Chang, Jun-Dong; Lee, Ho-Won

    2015-02-01

    Posterior wall fractures, which are the most common type of acetabulum fracture, are frequently accompanied with an avulsion tear of the posterior labral root as well as hip dislocation due to the injury mechanism. In the treatment of these fractures with an avulsed posterior labral root attached to posterior wall fragment, the use of a suture anchor can induce indirect reduction of a posterior wall fragment as well as direct repair of a labral root tear simultaneously. We describe the simple and efficient technique using a suture anchor in posterior wall acetabular fractures and surgical outcomes of two cases treated with this technique.

  2. A study on the surgical treatment of ingrowing toe nail with nail excision with chemical matricectomy versus nail excision alone

    Directory of Open Access Journals (Sweden)

    Ashutosh Talwar

    2013-01-01

    Full Text Available An in growing toenail develops when the proper fit of the nail plate in the lateral nail groove is altered. We selected 30 patients of ingrowing toe nail for the study. The patients were divided into two groups of 15 patients each. In group I patients, nail avulsion with chemical matrictectomy with 88%phenol was done. In group II only nail avulsion was done. In group I patients the surgical success rate was 98% and in group II, the surgical success rate was 86.6%. No patient complained about the cosmetic appearance of toe nail after the operation.

  3. 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

  4. 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.

  5. Landscape gradients and patchiness in riparian vegetation on a Middle Pennsylvanian braided-river plain prone to flood disturbance (Nýrany Member, Central and Western Bohemian Basin, Czech Republic)

    DEFF Research Database (Denmark)

    Bashforth, Arden Roy; Drábková, Jana; Opluštil, Stanislav;

    2011-01-01

    to avulsion and flooding. Taphonomic observations and multivariate analysis of 41 quadrats containing mostly (par)autochthonous megafloral assemblages reveal that riparian vegetation comprised a collage of monospecific to low-diversity communities, with patchiness prevalent at local and regional scales...

  6. Precession-scale cyclicity in the lower Eocene fluvial Willwood Formation of the Bighorn Basin, Wyoming (USA)

    NARCIS (Netherlands)

    Abels, H.A.; Kraus, M.J.; Gingerich, P.D.

    2013-01-01

    Little is known about controls on river avulsion at geological time scales longer than 104 years, primarily because it is difficult to link observed changes in alluvial architecture to well-defined allogenic mechanisms and to disentangle allogenic from autogenic processes. Recognition of Milankovitc

  7. A Computational Model to Simulate Groundwater Seepage Risk in Support of Geotechnical Investigations of Levee and Dam Projects

    Science.gov (United States)

    2013-03-01

    process-imitating rules. The model aggrades an alluvial floodplain, creating floodplain architecture by differentiating between sediment deposited by...meandering rivers. The results suggest that the channel aggradation rate influenced heavily the relative channel avulsion frequency during floodplain...composition and organization of the river basin and its floodplain (Schumm 1968). In an actively building ( aggrading ) floodplain, the river channel is

  8. The Dental Needs of Reserve Component Soldiers. Volume 1. Introduction, Methods, and Characteristics of Study Sample

    Science.gov (United States)

    1992-11-01

    recurrent decay or a separate carious lesion, score that surface as decayed. MISSING TEETH Permanent teeth extracted because of caries or periodontal...category are teeth that have been avulsed and those extracted for orthodontic reasons. No marks should be placed in the individual surface columns for

  9. Laceration of a branch of the profunda femoris artery caused by a spike of the displaced lesser trochanter in an inter-trochanteric femoral fracture. A case report

    Directory of Open Access Journals (Sweden)

    Vito Potenza

    2016-01-01

    Conclusion: We believe that intertrochanteric femoral fractures with avulsed lesser trochanter are at risk for femoral vessel injuries caused by the displaced bone spike, and we advise meticulous clinical and laboratory monitoring pre- and post-operatively to prevent serious complications.

  10. 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.

  11. 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.

  12. Fractures of the nasolacrimal fossa and canal: CT findings and clinical significance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chae Kyung; Lee, Hyeon Kyeong; Lee, Jong Hwa; Ku, Kwan Min; Choi, Dae Seob; Oh, Yeon Hee; Kim, Seung Hyeon; Lee, Sung Woo; Han, Jae Sik; Kim, Mi Woon [Dongguk Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    This study was aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidence of nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of the nasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associated complications, clinical records were reviewed were reviewed. Three types of fracture were identified: avulsion, comminuted,and linear. Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and 21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa, ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving the nasolacrimal canal were comminuted and four were linear;all nasolacrimal fractures were associated with other facial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid);the remaining four were simple and unilateral. Nasolacrimal sac and duct-related complications were documented in only two patients; they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the probvlem was resolvced by conservative treatment without surgery. Fractures of the nasolacrimal fossa and canal were accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all were associated with avulsion fractures of the nasolacrimal fossa.=20.

  13. [Postpartum levator ani muscle injuries. Diagnosis and treatment].

    Science.gov (United States)

    Chojnacki, Michał; Borowski, Dariusz; Wielgoś, Mirosław; Węgrzyn, Piotr

    2015-01-01

    Levator ani muscle (LAM) injuries are much more frequent than trauma to sphincter ani muscles, but so far they have been omitted in obstetric handbooks. Levator ani avulsion is observed only after vaginal delivery. Forceps delivery second stage of labor ≥ 110 min., fetal head circumference ≥ 35 cm, episiotomy and coincidence of anal sphincter trauma are risk factors for levator ani avulsion. The most vital issue in that type of trauma is pelvic organ prolapse and 2-4-fold higher risk of recurrence after prolapse surgery. The current level of evidence does not allow to conclusively determine the of role of levator avulsion in urinary incontinence. Levator injuries are occult, what constitutes the main diagnostic problem. Until recently magnetic resonance imaging has been the only diagnostic method until the development of 3-dimensional ultrasound. Nowadays, 3-D ultrasound is an essential technique in static and functional diagnosis of the levator ani. There are no effective methods of levator trauma prevention. Except the risk factors reduction, there are some pilot data about positive role of antepartal perineal muscle training. Physiotherapy plays the main role in reducing the effects of levator trauma. Mesh techniques are the most effective operative methods in coincident pelvic organ prolapse with levator avulsion, but there is still a 2-fold higher risk of recurrence.

  14. POST COITAL FOURTH DEGREE RECTOVAGINOPERINEAL TEAR: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Shashidhar Boraiah, Sheela S.R. and Krishna Shetty M.V.

    2012-11-01

    Full Text Available Postcoital vaginal rupture or tear is a well-known entity to the gynecologist. We highlight case of a marital post coital rectovaginal tear with fecal incontinence and complete avulsion of anal sphincters. Patient underwent layered repair and sphincter reconstruction after bowel preparation. Postoperatively she had a satisfactory continence over flatus and feces.

  15. A Survey of Dental Emergencies among U.S. Army Active Duty Personnel

    Science.gov (United States)

    1993-05-18

    burns; lacerations; hematomas or abrasions; oral malignancies. 12 Temporomandibular joint disorders - myofascial pain dysfunction; dislocation...Temporomandibular joint disorders -myofascial pain dysfunction; dislocation, subluxation or other associated conditions. b Post-operative/ post-surgical...8217 A tooth fracture/avulsion, oral lesions: truumatic or inflamnmxatr, or tpo m tibula joint disorders . * Any post-ope.ative or post-wurgicad ý.nicatiou

  16. 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.

  17. 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 i

  18. Two Extension Block Kirschner Wires' Technique for Bony Mallet Thumb

    Science.gov (United States)

    Takase, Fumiaki; Ueda, Yasuhiro; Shinohara, Issei; Kuroda, Ryosuke; Kokubu, Takeshi

    2016-01-01

    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.

  19. Oral trauma and dental emergency management recommendations of first-aid textbooks and manuals.

    Science.gov (United States)

    Zadik, Yehuda

    2007-10-01

    The recommendations of oral trauma and dental emergencies management of nine first-aid textbooks and manuals from the last two decades were evaluated. Only one book includes all the relevant topics: dental anatomy, management of tooth luxations and avulsion, tooth fracture, mandible dislocation, jaw fracture, intraoral bleeding and dental pain. Two books recommend self-replantation of an avulsed tooth, but four books detail the storage media and evaluate the importance of a quick referral to a dental surgery. In three first-aid books, the only mention of oral trauma is the hazard of choking from tooth fragments, and in one other book, only mandible dislocation is mentioned as oral trauma. The insufficient information of oral trauma management in these first-aid texts partly explains the previous reports of poor and inadequate knowledge in that topic among medics, teachers and the general public.

  20. Replantation of thumb or fingers with skin degloving injury in 30 patients: an outcomes evaluation%30例手指皮肤套脱伤再植术后疗效及评价

    Institute of Scientific and Technical Information of China (English)

    纪秉青; 侯瑞兴; 巨积辉; 金光哲; 王凯

    2016-01-01

    目的 报告应用再植术治疗手指皮肤套脱伤术后的疗效.方法 对我院自2007年至2012年30例共42指采用再植术治疗手指皮肤套脱伤的病例进行2~7年(平均4年)的随访观察,并将示指、中指、环指、小指套脱伤按撕脱平面分为Ⅰ度套脱伤和Ⅱ度套脱伤,应用中华医学会手外科学会断指再植功能评定试用标准及MHQ手功能评价标准对手指功能进行评定.结果 根据中华医学会手外科学会断指再植功能评定试用标准评定,30例手指皮肤套脱伤患者术后恢复优良率达93.3%,其中Ⅰ度皮肤套脱伤术后恢复优良率达100%,Ⅱ度皮肤套脱伤术后恢复优良率87.5%.根据MHQ手功能评价标准,患者主观评价得分较高.结论 运用再植术治疗手指皮肤套脱伤,修复的手指可最大限度地恢复外形和功能,其中Ⅰ度套脱伤术后恢复效果高于Ⅱ度套脱伤术.患者对术后恢复的满意程度较高.%Objective To report the clinical outcomes of replantation of thumb and fingers with skin degloving injuries.Methods Thirty patients with 42 avulsed thumb and fingers treated with replantation from 2007 to 2012 were follow-up for 2 to 7 years (average,4 years).Based on the level of the degloving injury,avulsion of the index,middle,ring and little fingers was categorized into grade Ⅰ avulsion and grade Ⅱavulsion.The results of replantation were assessed by the provisional functional assessment criteria for thumb and finger replantation issued by the Hand Surgery Society of Chinese Medical Association and by the Michigan hand outcomes questionnaire (MHQ).Results According to the provisional functional assessment criteria for thumb and finger replantation issued by the Hand Surgery Society of Chinese Medical Association,93.3 % of the cases achieved excellent and good results.This satisfactory rate was 100% in grade Ⅰ avulsions and 87.5% in grade Ⅱ avulsions.MHQ revealed high patient satisfaction

  1. A Case Report of Dilacerated Crown of a Permanent Mandibular Central Incisor.

    Science.gov (United States)

    Bolhari, Behnam; Pirmoazen, Salma; Taftian, Ensieh; Dehghan, Somayeh

    2016-11-01

    Trauma to primary teeth can lead to devastating sequels in development of permanent successors. The disturbance may range from enamel hypoplasia and/or hypo-calcification to arrest of dental bud development. Crown dilaceration of permanent teeth is one of the consequences of trauma to deciduous teeth mainly due to intrusion or avulsion. This report presents a mandibular central incisor with dilacerated crown and yellowish discoloration with symptomatic apical abscess. History revealed avulsion of primary mandibular central incisors. The purpose of this report is to present: 1. Reasons of dilacerated crown, yellowish discoloration and necrotic pulp in this case, 2. Treatment options in different types of crown dilacerations and also in this case. The tooth was successfully managed by nonsurgical root canal therapy and restoration with composite resin to restore esthetics. We emphasize that trauma to deciduous teeth should not be understated, and regular follow up is essential.

  2. The effectiveness of matrix cauterization with trichloroacetic acid in the treatment of ingrown toenails.

    Science.gov (United States)

    Terzi, Erdinc; Guvenc, Ulas; Türsen, Belma; Kaya, Tamer İrfan; Erdem, Teoman; Türsen, Ümit

    2015-01-01

    Ingrown toenail is an often painful clinical condition that usually affects the big toe. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results. However, it produces extensive tissue destruction that can result in drainage and delayed healing. Alternatives such as sodium hydroxide and trichloroacetic acid (TCA) have therefore come into vogue. A total of 39 patients with 56 ingrown toenail edges underwent chemical matricectomy with 90% TCA after partial nail avulsion. In most of the patients, adverse effects such as postoperative pain and drainage were minimal. One patient who underwent matricectomy had recurrence in a single nail edge (1.8%) at 12 months follow-up. No recurrence was observed among 38 patients during the mean follow-up period. This was considered to be statistically significant (P < 0.001). Partial nail avulsion followed by TCA matricectomy is a safe, simple, and effective method with low rates of postoperative morbidity and high rates of success.

  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. 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.

  5. On the Connections Between Surficial Processes and Stratigraphy in River Deltas

    CERN Document Server

    Puma, Michael J; Paola, Chris; Rinaldo, Andrea; Rodriguez-Iturbe, Ignacio

    2016-01-01

    We explore connections between surficial deltaic processes (e.g. avulsion, deposition) and the stratigraphic record using a simple numerical model of delta-plain evolution, with the aim of constraining these connections and thus improving prediction of subsurface features. The model represents channel dynamics using a simple but flexible cellular approach, and is unique in that it explicitly includes backwater effects that are known to be important in low-gradient channel networks. The patterns of channel deposits in the stratigraphic record vary spatially due to variation in avulsion statistics with radial distance from the delta's source of water and sediment. We introduce channel residence time as an important statistical measure of the surface channel kinematics. The model suggests that the mean channel residence time anywhere within the delta is nicely described by a power law distribution showing a cutoff that depends on radial distance. Thicknesses of channel deposits are not uniquely determined by the...

  6. Acquired maxillofacial defects from motor vehicle accidents: statistics and prosthodontic considerations.

    Science.gov (United States)

    Wiens, J P

    1990-02-01

    Trauma from motor vehicle accidents is one of the leading causes of death in the United States; moreover, the costs related to personal harm are only second to cancer. Head and neck injuries predominate and involve contact with the vehicle's interior (80%), contact with the vehicle's exterior (12%), or noncontact with the vehicle (8%). The patient with maxillofacial defects resulting from motor vehicle accident will have numerous soft tissue and hard tissue injuries ranging from neurologic involvement to fractures and/or avulsions of the temporomandibular joint, maxillae, mandible, teeth, and supporting structures. Tooth avulsions, pulpitis, and fractures without pulpitis have been found in a 4:2:1 ratio. The prosthodontist plays an important team role by anticipating the increased functional demands that may be placed on the required prostheses and by anticipating the preprosthetic procedures and counseling that may be necessary to assist in the total treatment.

  7. 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.

  8. A Case Report of Dilacerated Crown of a Permanent Mandibular Central Incisor

    OpenAIRE

    Bolhari, Behnam; Pirmoazen, Salma; Taftian, Ensieh; Dehghan, Somayeh

    2016-01-01

    Trauma to primary teeth can lead to devastating sequels in development of permanent successors. The disturbance may range from enamel hypoplasia and/or hypo-calcification to arrest of dental bud development. Crown dilaceration of permanent teeth is one of the consequences of trauma to deciduous teeth mainly due to intrusion or avulsion. This report presents a mandibular central incisor with dilacerated crown and yellowish discoloration with symptomatic apical abscess. History revealed avulsio...

  9. A Case Report of Dilacerated Crown of a Permanent Mandibular Central Incisor

    OpenAIRE

    Behnam Bolhari; Salma Pirmoazen; Ensieh Taftian; Somayeh Dehghan

    2017-01-01

    Trauma to primary teeth can lead to devastating sequels in development of permanent successors. The disturbance may range from enamel hypoplasia and/or hypo-calcification to arrest of dental bud development. Crown dilaceration of permanent teeth is one of the consequences of trauma to deciduous teeth mainly due to intrusion or avulsion. This report presents a mandibular central incisor with dilacerated crown and yellowish discoloration with symptomatic apical abscess. History revealed avulsio...

  10. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    OpenAIRE

    Ying, Tao; Li, Qin; Xu, Lian; Liu, Feifei; Hu, Bing

    2012-01-01

    The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP) women using translabial three-dimensional (3D) ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72%) cases. The puborectalis was avulsed in 18 (36%) cases and the pelvic ...

  11. Functional motor recovery from motoneuron axotomy is compromised in mice with defective corticospinal projections.

    Directory of Open Access Journals (Sweden)

    Yuetong Ding

    Full Text Available Brachial plexus injury (BPI and experimental spinal root avulsion result in loss of motor function in the affected segments. After root avulsion, significant motoneuron function is restored by re-implantation of the avulsed root. How much this functional recovery depends on corticospinal inputs is not known. Here, we studied that question using Celsr3|Emx1 mice, in which the corticospinal tract (CST is genetically absent. In adult mice, we tore off right C5-C7 motor and sensory roots and re-implanted the right C6 roots. Behavioral studies showed impaired recovery of elbow flexion in Celsr3|Emx1 mice compared to controls. Five months after surgery, a reduced number of small axons, and higher G-ratio of inner to outer diameter of myelin sheaths were observed in mutant versus control mice. At early stages post-surgery, mutant mice displayed lower expression of GAP-43 in spinal cord and of myelin basic protein (MBP in peripheral nerves than control animals. After five months, mutant animals had atrophy of the right biceps brachii, with less newly formed neuromuscular junctions (NMJs and reduced peak-to-peak amplitudes in electromyogram (EMG, than controls. However, quite unexpectedly, a higher motoneuron survival rate was found in mutant than in control mice. Thus, following root avulsion/re-implantation, the absence of the CST is probably an important reason to hamper axonal regeneration and remyelination, as well as target re-innervation and formation of new NMJ, resulting in lower functional recovery, while fostering motoneuron survival. These results indicate that manipulation of corticospinal transmission may help improve functional recovery following BPI.

  12. Multiple dentoalveolar traumatic injury: a case report (3 years follow up).

    Science.gov (United States)

    Koyuturk, Alp Erdin; Kusgoz, Adem

    2008-08-01

    Dental trauma with children and adolescents is a serious dental public health problem. Traumatic injuries on permanent teeth are common, and dramatic episodes can occur during childhood. Cases of dental avulsions and reimplantations, dentoalveolar fractures, several forms (lateral, extrusive and intrusive) of luxations, concussion, subluxation, gingival lacerations and hard, pulpal dental tissue lesions have been extensively reported. This case report presents the therapy for severe trauma caused by multiple traumatic injuries to the dentoalveolar complex of a patient.

  13. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    OpenAIRE

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a frac...

  14. 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.

  15. Invasive cervical resorption: treatment challenges

    OpenAIRE

    2012-01-01

    Invasive cervical resorption is a relatively uncommon form of external root resorption. It is characterized by invasion of cervical region of the root by fibrovascular tissue derived from the periodontal ligament. This case presents an invasive cervical resorption occurring in maxillary lateral incisor, following damage in cervical cementum from avulsion and intracoronal bleaching procedure. Flap reflection, debridement and restoration with glass ionomer cement were performed in an attempt to...

  16. [OVERUSE INJURIES IN THE YOUNG ATHLETE].

    Science.gov (United States)

    Journeau, Pierre; Polirzstok, E; Launay, F; Barbier, D

    2015-10-01

    Sport injuries are common in children and teenaggers, especially overuse injuries. Typical musculoskelotal disorders include apophyseal pains or avulsion, stess fractures, and also epiphyseal ostoochondritis. Some lesions are specific according the practice, such spine or wrist lesions. Prevention of sport injury should be the main priority as well for the parents than the coaches and children themselves. Proper education and preparation, specific training and streching are essential for all sports activities.

  17. Caritas Convalescent Centre, Merrion Road, Dublin 4.

    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.

  18. 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.)

  19. Effet paradoxal du type d’excision sur la prise et le délai de cicatrisation des greffes expansées pour le traitement des brûlures aiguës: a propos de 1129 cas

    Science.gov (United States)

    Guibert, M.; Chaouat, M.; Boccara, D.; Marco, O.; Lavocat, R.; Alameri, O.; Deslandes, E.; Montlahuc, C.; Mimoun, M.

    2016-01-01

    Summary La greffe de peau mince expansée est très employée dans le traitement des brûlures aiguës. Nous avons étudié l’influence de la préparation du sous-sol sur le taux de prise et le délai de cicatrisation des greffes expansées. Nous avons analysé rétrospectivement les 1 129 greffes expansées réalisées dans notre service entre 1995 et 2005 pour le traitement des brûlures aiguës. Leur taux de prise a été significativement meilleur après une préparation du sous-sol par avulsion (82%) par rapport à une préparation du sous-sol par excision tangentielle (75%). Ce taux était meilleur lorsque l’avulsion était pratiquée dans les 7 jours suivant la brûlure (83% vs 73%). Pour une prise en charge entre 7 et 21 jours, ce taux a semblé être meilleur après excision tangentielle, mais de façon non significative. La durée d’évolution jusqu’à cicatrisation était significativement raccourcie pour une préparation du sous-sol par excision tangentielle par rapport à une préparation du sous-sol par avulsion. Ces résultats montrent, paradoxalement, qu’une préparation du sous-sol par avulsion favorise la prise des greffes expansées mais rallonge leur délai de cicatrisation au contraire de l’excision tangentielle. PMID:28149235

  20. Sonas Melview Nursing Home, Prior Park, Clonmel, Tipperary.

    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.

  1. 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, Álvaro; Iroumé, Andrés.; Ulloa, Héctor; Castro, Jonathan

    2016-07-01

    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).

  2. Treatment of Combined Injuries of the Axillary and Suprascapular Nerves with Scapulothoracic Dissociation

    OpenAIRE

    Sano, Kazufumi; Ozeki, Satoru

    2015-01-01

    A 20-year-old man suffered the combined axillary and suprascapular nerve palsies associated with scapulothoracic dissociation by motorcycle accident. The dislocated shoulder girdle was reduced and stabilized with osteosynthesis of the fractured clavicle and reattachment of the trapezius avulsed from the scapular spine for removal of continuous traction force to these damaged nerves. Because of no evidence of recovery on manual muscle test and electromyogram, exploration for these nerves was a...

  3. Anterior inferior iliac spine fracture: Another component of seat belt syndrome?

    Directory of Open Access Journals (Sweden)

    Paisal HUSSIN

    2013-04-01

    Full Text Available Seat belt syndrome occurs when seat belts are used improperly, and it is a cause of significant morbidity and mortality. The spectrum of seat belt syndrome includes spinal, intra-abdominal and vascular injury. Here, we report the case of anterior inferior iliac spine avulsion fracture in association with seat belt injuries in a 24-year old man involved in a head on motor vehicle collision. 

  4. Replantation of multiple digits and hand amputations: four case reports

    OpenAIRE

    Salah, Mohammed Murshid; Khalid, Khalid N

    2008-01-01

    This study reports four cases of hand avulsion at the proximal wrist level and multiple digits amputation were received in plastic and hand surgery unit during the year 2007–2008. All patients were male labors between 22–30 years old, and the amputation due to machine injuries. Successful replantation were achieved, after a period of follow up with occupational therapy all patients regain good functional and cosmetic results. This study proves the strong indication of replantation of multiple...

  5. Tooth loss treatment in the anterior region: Autotransplantation of premolars and cryopreservation

    OpenAIRE

    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...

  6. Partial tear of the quadriceps tendon in a child

    Energy Technology Data Exchange (ETDEWEB)

    Khanna, Geetika; El-Khoury, George [University of Iowa Hospitals and Clinics, Department of Radiology, Iowa City, IA (United States)

    2008-06-15

    We present a case of partial rupture of the quadriceps tendon in an 8-year-old girl. This is one of the youngest patients reported with a quadriceps tendon rupture, an entity seen predominantly in middle-aged people. The strength of the muscle tendon unit in a child makes tendon injuries extremely unusual as compared to apophyseal avulsions. The MR imaging findings of this unusual pediatric injury are illustrated. (orig.)

  7. Partial tear of the quadriceps tendon in a child.

    Science.gov (United States)

    Khanna, Geetika; El-Khoury, George

    2008-06-01

    We present a case of partial rupture of the quadriceps tendon in an 8-year-old girl. This is one of the youngest patients reported with a quadriceps tendon rupture, an entity seen predominantly in middle-aged people. The strength of the muscle tendon unit in a child makes tendon injuries extremely unusual as compared to apophyseal avulsions. The MR imaging findings of this unusual pediatric injury are illustrated.

  8. 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.

  9. 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.

  10. 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).

  11. Supraspinatus rupture at the musculotendinous junction in a young woman

    OpenAIRE

    Benazzo, Francesco; MARULLO, MATTEO; Pietrobono, Luigi

    2013-01-01

    The vast majority of rotator cuff tears occur within the tendon or as an avulsion from the greater tuberosity. Supraspinatus injury at the musculotendinous junction is a very uncommon event. We describe a case of supraspinatus rupture at the musculotendinous junction, with successful conservative treatment. It occurred in a 23-year-old woman, the youngest patient with this uncommon type of injury. To our knowledge, this is the first case of rupture of the supraspinatus muscle at the musculote...

  12. 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

  13. Apical Revascularization after Delayed Tooth Replantation: An Unusual Case

    Science.gov (United States)

    Nelson-Filho, Paulo; Silva, Lea Assed Bezerra; Silva, Raquel Assed Bezerra; de Carvalho, Fabricio Kitazono; de Queiroz, Alexandra Mussolino

    2016-01-01

    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. PMID:27882250

  14. Refractory epilepsy is highly associated with severe dentoalveolar and maxillofacial injuries.

    Science.gov (United States)

    Costa, Andre Luiz F; Yasuda, Clarissa Lin; França, Marcondes C; Morita, Marcia Elisabete; Cendes, Fernando

    2011-03-01

    Dental intrusion and avulsion, crown fracture and mandibular fractures are important dentofacial complications in patients with epilepsy-related traumas. The objective of the present study was to describe the occurrence of orofacial injuries in patients with epilepsy. One hundred and nine consecutive patients (60 women; mean age 38.81 ± 14 years), treated for refractory epilepsy (45 with extratemporal epilepsy and 64 with temporal epilepsy) at the outpatient clinic of our University Hospital, were included in the present study. Orofacial injury occurring as a direct result of a seizure was determined by clinical examination and interview. In addition, seizure frequency, use of medication, and the occurrence and type of injury to other parts of the body, were documented. We employed regression analyses to investigate the association between teeth fractures and frequency of seizures. The majority of injuries were crown fractures (42 subjects), followed by mandibular fractures (eight subjects) and tooth avulsion (eight subjects). Sixteen patients had more than two fractured teeth. Patients with mandibular trauma also suffered concomitant injuries (teeth fracture, avulsion and dislocation). The number of fractured teeth was associated with seizure frequency (r(2) = 0.59, p dentoalveolar and maxillofacial injuries in patients with poorly controlled epileptic seizures.

  15. Frequency of root resorption following trauma to permanent teeth.

    Science.gov (United States)

    Soares, Adriana J; Souza, Gustavo A; Pereira, Andrea C; Vargas-Neto, Julio; Zaia, Alexandre A; Silva, Emmanuel J N L

    2015-06-01

    This retrospective study evaluated the frequency of development of root resorption in dental trauma cases involving supporting tissue. For 249 traumatized teeth of 125 patients aged between 7 and 51 years, we collected data on the gender and age of the patient, the teeth involved, the type of trauma, and the period between dental injury and initial examination. Radiographic parameters examined in relation to root resorption included the presence of inflammatory external root resorption, internal root resorption, replacement resorption, and canal calcification. Data were analyzed by chi-squared test, Fisher's exact test, and mult iple logistic regression (P resorption (P = 0.0199), as well as the type of injury (P = 0.0406). Furthermore, external resorption was most frequently associated with intrusive luxation (92.8%), followed by avulsion (89.0%), lateral luxation (80.2%), and extrusive luxation (77.4%). Among the types of dental injury, replacement resorption was observed more frequently in cases of avulsion (87.2%). The only factor that was significantly associated with this type of resorption was the type of injury (P resorption is observed more frequently and its risk of development is higher in cases of severe trauma, especially avulsion and intrusive luxation.

  16. 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.

  17. 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.

  18. Management of the ingrown toenail.

    Science.gov (United States)

    Heidelbaugh, Joel J; Lee, Hobart

    2009-02-15

    Ingrown toenail, or onychocryptosis, most commonly affects the great toenail. Many anatomic and behavioral factors are thought to contribute to ingrown toenails, such as improper trimming, repetitive or inadvertent trauma, genetic predisposition, hyperhidrosis, and poor foot hygiene. Conservative treatment approaches include soaking the foot in warm, soapy water; placing cotton wisps or dental floss under the ingrown nail edge; and gutter splinting with or without the placement of an acrylic nail. Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization. Electrocautery, radiofrequency, and carbon dioxide laser ablation of the nail matrix are also options. Oral antibiotics before or after phenolization do not improve outcomes. Partial nail avulsion followed by either phenolization or direct surgical excision of the nail matrix are equally effective in the treatment of ingrown toenails. Compared with surgical excision of the nail without phenolization, partial nail avulsion combined with phenolization is more effective at preventing symptomatic recurrence of ingrowing toenails, but has a slightly increased risk of postoperative infection.

  19. 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.

  20. Dam-induced and natural channel changes in the Saskatchewan River below the E.B. Campbell Dam, Canada

    Science.gov (United States)

    Smith, Norman D.; Morozova, Galina S.; Pérez-Arlucea, Marta; Gibling, Martin R.

    2016-09-01

    The E.B. Campbell Dam on the Saskatchewan River, east-central Saskatchewan, was constructed in 1962, forming Tobin Lake (2.2 billion m3 capacity), which today impounds most fluvial sediment and disrupts normal outflow patterns. Thirty-five kilometers below the dam, the river diverts into a 500 km2 belt of alluvial sediment initiated by an avulsion ~ 140 years ago, rejoining the parent channel 108 km from the dam. Effects of the dam on channel geomorphology, including the historical channel (reach I) and the more recent avulsion-affected channels, were investigated by pre- and post-dam cross section surveys combined with grain-size and bedload measurements. Twenty-three sites were surveyed at least twice, and 14 were resurveyed annually in 2003-2014 (except 2007) during which significant floods occurred in 2005, 2011, and 2013. All channel cross sections up to 81 km below the dam have coarsened and enlarged since closure, resulting in excavation of 35.4 × 106 m3 of channel-perimeter sediment since 1962. The most proximal segment is armored and has changed little in recent years. Since 2003, channel enlargement has been greatest in the 35-81 km segment between the avulsion site and the Forks (reaches II, III), manifested as widening and deepening. Enlargement rates were greatest during the three floods, and the paucity of bedload has prevented degraded portions of the channel bed from replenishment following flooding. Budget calculations based on bedload measurements and channel cross-section areas suggest that > 30 years would be required to replace the sediment removed between 2003 and 2014, assuming all available bedload remains in the affected reach. Dam effects appear to be absent or uncertain beyond 81 km, a multichanneled region of varied stages of activity (reach IV), recombining and eventually rejoining the parent Saskatchewan River channel at km 108 (reach V). Sediment evacuated from reaches I-III is sufficient to sustain modest aggradation in some distal

  1. Fluvial geomorphic elements in modern sedimentary basins and their potential preservation in the rock record: A review

    Science.gov (United States)

    Weissmann, G. S.; Hartley, A. J.; Scuderi, L. A.; Nichols, G. J.; Owen, A.; Wright, S.; Felicia, A. L.; Holland, F.; Anaya, F. M. L.

    2015-12-01

    Since tectonic subsidence in sedimentary basins provides the potential for long-term facies preservation into the sedimentary record, analysis of geomorphic elements in modern continental sedimentary basins is required to understand facies relationships in sedimentary rocks. We use a database of over 700 modern sedimentary basins to characterize the fluvial geomorphology of sedimentary basins. Geomorphic elements were delineated in 10 representative sedimentary basins, focusing primarily on fluvial environments. Elements identified include distributive fluvial systems (DFS), tributive fluvial systems that occur between large DFS or in an axial position in the basin, lacustrine/playa, and eolian environments. The DFS elements include large DFS (> 30 km in length), small DFS (uniformitarianism, sedimentary basins from the past most likely had a similar configuration of geomorphic elements. Facies distributions in tributary positions and those on DFS appear to display specific morphologic patterns. Tributary rivers tend to increase in size in the downstream direction. Because axial tributary rivers are present in confined settings in the sedimentary basin, they migrate back and forth within a relatively narrow belt (relative to the overall size of the sedimentary basin). Thus, axial tributary rivers tend to display amalgamated channel belt form with minimal preservation potential of floodplain deposits. Chute and neck cutoff avulsions are also common on meandering rivers in these settings. Where rivers on DFS exit their confining valley on the basin margin, sediment transport capacity is reduced and sediment deposition occurs resulting in development of a 'valley exit' nodal avulsion point that defines the DFS apex. Rivers may incise downstream of the basin margin valley because of changes in sediment supply and discharge through climatic variability or tectonic processes. We demonstrate that rivers on DFS commonly decrease in width down-DFS caused by infiltration

  2. 个体化涤纶套中央静脉导管置入方法的安全性及成功率分析%The safety and success rate of different Individual cuffed catheter central venous catheter insert methods

    Institute of Scientific and Technical Information of China (English)

    李康峰; 严连喜; 周玉坤; 石平; 汤小芳; 张玉强

    2013-01-01

    Objective To observe the safety and success rate of different individual cuffed catheter central venous catheter insert methods. Methods 46 patients of cuffed central venous catheters insert were divided into group A used avulsion sheath catheter method, group B by jugular vein insert cuffed central venous catheter and group C by the way of non-avulsioninsert cuffed central venous catheters method. Intraoperative,postoperative complications were observed, Kt/V values were calculated. Dialysis blood flow, venous pressure were recorded. Results Groups B and group C comparing with the classic avulsion sheath insert,classic avulsion sheath cathete method was one-time success,and hemorrhage was than that of the other two groups. All three groups showed subcutaneous tunnel hemorrhage after the operation. There was no statistically difference in dialysis venous pressure,blood flow,and Kt/V values among group A, groups B and group C. Catheter lifetime of non-avulsioninsert method less than avulsion sheath catheter method(P<0. 05). The overall failure rate of groups B and group C operations (24. 14%) was higher than classic avulsion sheath insert method. Conclusion Classic avulsion sheath catheter method was as the preferred for cuffed catheter central venous catheter insert method, and it was a safety and a higher success rate method with fewer complications.%目的 观察不同带涤纶套中央静脉导管置入方法的安全性及手术成功率.方法 46例患者行带涤纶套中央静脉导管置入术,分为A组(经撕脱鞘方法置管)、B组(经颈外静脉入路置管)和C组(非撕脱鞘方式置管).观察3组患者手术成功率和术中、术后并发症情况,记录透析中血流量、静脉压指标,计算尿素清除指数(Kt/V),B、C两组与经典撕脱鞘方法置管相对比.结果 经典撕脱鞘置管患者均一次性成功,但术中出血量多于另外两组.术后3组均表现为皮下隧道渗血.3组患者透析中静脉压、血流量及Kt

  3. Single-unit analysis of the spinal dorsal horn in patients with neuropathic pain.

    Science.gov (United States)

    Guenot, Marc; Bullier, Jean; Rospars, Jean-Pierre; Lansky, Petr; Mertens, Patrick; Sindou, Marc

    2003-04-01

    Despite the key role played by the dorsal horn of the spinal cord in pain modulation, single-unit recordings have only been performed very rarely in this structure in humans. The authors report the results of a statistical analysis of 64 unit recordings from the human dorsal horn. The recordings were done in three groups of patients: patients with deafferentation pain resulting from brachial plexus avulsion, patients with neuropathic pain resulting from peripheral nerve injury, and patients with pain resulting from disabling spasticity. The patterns of neuronal activities were compared among these three groups. Nineteen neurons were recorded in the dorsal horns of five patients undergoing DREZotomy for a persistent pain syndrome resulting from peripheral nerve injury (i.e., nondeafferented dorsal horns), 31 dorsal horn neurons were recorded in nine patients undergoing DREZotomy for a persistent pain syndrome resulting from brachial plexus avulsion (i.e., deafferented dorsal horns), and 14 neurons were recorded in eight patients undergoing DREZotomy for disabling spasticity. These groups were compared in terms of mean frequency, coefficient of variation of the discharge, other properties of the neuronal discharge studied by the nonparametric test of Wald-Wolfowitz, and the possible presence of bursts. The coefficient of variation tended to be higher in the deafferented dorsal horn group than in the other two groups. Two neurons displaying burst activity could be recorded, both of which belonged to the deafferented dorsal horn group. A significant difference was found in term of neuronal behavior between the peripheral nerve trauma group and the other groups: The brachial plexus avulsion and disabling spasticity groups were very similar, including various types of neuronal behavior, whereas the peripheral nerve lesion group included mostly neurons with "nonrandom" patterns of discharge (i.e., with serial dependency of interspike intervals).

  4. 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.

  5. 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.)

  6. The need for complementary hydraulic analysis in post-restoration monitoring of river restoration projects

    Directory of Open Access Journals (Sweden)

    T. A. Endreny

    2011-03-01

    Full Text Available River restoration design methods are incrementally improved by studying and learning from monitoring data in previous projects. In this paper, we report post-restoration monitoring data for a Natural Channel Design (NCD restoration project along 1600 m (10 channel wavelengths of the Batavia Kill in the Catskill Mountains, NY, implemented in 2001 and 2002. The NCD project used a reference-reach to determine channel form, empirical relations between the project site and reference site bankfull dimensions to size channel geometry, and hydraulic and sediment computations to test channel capacity and sediment stability. In addition 12 cross-vanes and 48 j-hook vanes used in NCD for river training were installed to protect against bank erosion and maintain scour pools for fish habitat. Changes in pool depths were monitored with surveys from 2002–2004, and then after the channel-altering April 2005 flood. Aggradation in pools was attributed to cross-vane arms not concentrating flow in the center of the channel, which subsequently caused flow splitting and 4 partial point bar avulsions during the 2005 flood. Hydrodynamic simulation at the 18 m3s−1 bankfull flow suggested avulsions occurred where vanes allowed erosive bank scour to initiate the avulsion cut, and once the flow was split, the diminished in-channel flow caused more aggradation in the pools. In this project post-restoration monitoring had detected aggradation and considered it a problem. The lesson for the larger river restoration community is monitoring protocol should include complementary hydraulic and sediment analysis to comprehend potential consequences and develop preventative maintenance. River restoration and monitoring teams should be trained in robust hydraulic and sediment analytical methods that help them extend project restoration goals.

  7. Conceptual framework for assessing the response of delta channel networks to Holocene sea level rise

    Science.gov (United States)

    Jerolmack, Douglas J.

    2009-08-01

    Recent research has identified two fundamental unit processes that build delta distributary channels. The first is mouth-bar deposition at the shoreline and subsequent channel bifurcation, which is driven by progradation of the shoreline; the second is avulsion to a new channel, a result of aggradation of the delta topset. The former creates relatively small, branching networks such as Wax Lake Delta; the latter generates relatively few, long distributaries such as the Mississippi and Atchafalaya channels on the Mississippi Delta. The relative rate of progradation to aggradation, and hence the creation of accommodation space, emerges as a controlling parameter on channel network form. Field and experimental research has identified sea level as the dominant control on Holocene delta growth worldwide, and has empirically linked channel network changes to changes in the rate of sea level rise. Here I outline a simple modeling framework for distributary network evolution, and use this to explore large-scale changes in Holocene channel pattern that have been observed in deltas such as the Rhine-Meuse and Mississippi. Rapid early- to mid-Holocene sea level rise forced many deltas into an aggradational mode, where I hypothesize that avulsion and the generation of large-scale branches should dominate. Slowing of sea level rise in the last ˜6000 yr allowed partitioning of sediment into progradation, facilitating the growth of smaller-scale distributary trees at the shorelines of some deltas, and a reduction in the number of large-scale branches. Significant antecedent topography modulates delta response; the filling of large incised valleys, for example, caused many deltas to bypass the aggradational phase. Human effects on deltas can be cast in terms of geologic controls affecting accommodation: constriction of channels forces rapid local progradation and mouth-bar bifurcation, while accelerated sea level rise increases aggradation and induces more frequent channel

  8. 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.

  9. 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.

  10. Fluvial fan evolution during Late Quaternary climate changes: field and chronological constraints from the Indo-Gangetic basin

    Science.gov (United States)

    Singh, A.; Gupta, S.; Sinha, R.; Densmore, A.; Thomsen, K. J.; Nayak, N.; Joshi, S. K.; van Dijk, W. M.; Buylaert, J. P.; Mondal, S.; Kumar, D.; Mason, P. J.; Murray, A. S.; Kumar, M.; Shekhar, S.; Rai, S. P.

    2015-12-01

    The stratigraphic evolution of fluvial fans is to a large extent governed by channel avulsion. Spatial variations in alluvial architecture are influenced by avulsion magnitude and frequency. However due to the absence of long-term chronostratigraphic records of fan stratigraphy, it has proved difficult to test patterns of fan evolution against records of climate variability. In order to understand the processes of channel avulsion during fan evolution, it is important to determine the spatio-temporal pattern of fluvial channel aggradation, incision, and migration. In this study, we reconstruct the shallow sub-surface alluvial stratigraphy of fluvial fan systems formed by the major Himalayan rivers, the Sutlej and Yamuna, in the northwestern Indo-Gangetic basin. We map the spatial distribution of channel sand bodies deposited by these rivers and develop a chronostratigraphic model for the fluvial succession in a depositional dip perpendicular transect. Sediment cores up to ~50 m deep along two transects are used to reconstruct the shallow stratigraphy of the fan systems. Discontinuous channel sand bodies are separated by floodplain fines which occasionally show weak pedogenesis that mark the end of episodes of channel aggradation. Optically stimulated luminescence (OSL) dating is used to bracket the timing of channel-filling episodes, and their spatial distribution. Mapping of sand bodies coupled with chronostratigraphic constraints allows reconstruction of channel migration patterns and their timing across the Sutlej-Yamuna fans. Chronostratigraphy permits temporal correlation with published measures of monsoon variability. We find that fluvial aggradation at the western end of studied transects, near the middle of the Sutlej fan, terminated around ~20 ka. We also show that abandonment of the paleo-Sutlej and major fan-scale avulsion occurred after ~15 ka, and was followed by formation of incised valleys that confined the modern fluvial system in northwestern Indo

  11. Early dental implant failure in patient associated with oral bisphosphonates

    Directory of Open Access Journals (Sweden)

    Ridhimaa Gupta

    2012-01-01

    Full Text Available Oral bisphosphonates are routinely prescribed to post menopausal women. These have shown to increase the risk of osteonecrosis. However, this action may be augmented by local factors. A case report is presented showing an early implant failure in a patient taking oral bisphosphonates. Two implants were placed in left maxillary incisor area. Central incisor was associated with a previous endodontic failure and extraction. Lateral incisor was avulsed 3 years back. After 4 weeks of an implant placement, necrotic bone was evident along with the failing implant in central incisor area. This case report emphasizes on the incidence and an increased risk of implant failure in patients taking oral bisphosphonates.

  12. Premature loss of primary anterior teeth due to trauma--potential short- and long-term sequelae.

    Science.gov (United States)

    Holan, Gideon; Needleman, Howard L

    2014-04-01

    Traumatic dental injuries (TDIs) can result in the premature loss of primary anterior teeth due to an immediate avulsion, extraction later after the injury because of poor prognosis or late complications, or early exfoliation. There are a number of potential considerations or sequelae as a result of this premature loss that have been cited in the dental literature, which include esthetics, quality of life, eating, speech development, arch integrity (space loss), development and eruption of the permanent successors, and development of oral habits. This article provides a comprehensive review of the dental literature on the possible consequences of premature loss of maxillary primary incisors following TDI.

  13. Emergency treatment of dentoalveolar trauma: essential tips for treating active patients.

    Science.gov (United States)

    Honsik, Kenneth A

    2004-09-01

    Dentoalveolar trauma in sports is common. One third of dental injuries in the United States occur in sports-related activities, so team physicians should be able to recognize and properly treat dental injuries on the field. Tooth fracture, luxation, avulsion, and socket injury are the main types of dentoalveolar trauma. In many cases, other maxillofacial trauma can be associated with dental injuries, so physicians who examine these patients should be aware of additional associated injuries. Tooth injury is often preventable with the appropriate use of properly fitted mouth guards. Physicians should be familiar with different types and be able to suggest the correct mouth guard for a given activity.

  14. 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.

  15. Lingual frenectomy using multiple series Z-plasty.

    Science.gov (United States)

    Vyloppilli, Suresh; Prathap, Akhilesh

    2010-06-01

    The tongue is an important structure for speech, mastication and deglutition. Avulsion of a portion of tongue can significantly limit the range of motion thereby impairing its functions. This is the case report of a traumatically amputated tongue which was reconstructed to fulfill its function effectively. Z-plasty is one of the most commonly used soft tissue corrective procedures in plastic surgery. Here we describe the use of a modification of the Z-plasty-multiple series Z-plasty for a tongue frenectomy.

  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. 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

    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...... fragment; Gsta4, encoding glutathione S-transferase alpha-4. Confirmation with real-time PCR shows higher Gsta4 expression in PVG compared with DA both in naïve animals and at several time points after injury. Immunolabeling with a custom made rat Gsta4 antibody demonstrates a neuronal staining pattern...

  18. Water tubing injury: An overlooked boating injury statistic

    Directory of Open Access Journals (Sweden)

    Jonathan D Baum

    2013-04-01

    Full Text Available A 23-year-old female sustained a large avulsion injury to the groin while water tubing on a local waterway. The laceration began at the mons pubis, extended along the labia majora with involvement of the external anal sphincter. The pubic bone and the pectineus muscle were exposed. Six weeks after surgery, she had resumed full activity without sequlae. Lack of data and the potential for significant injury caused by water tubing as described in this case report are a real concern. Water tubing injury should be classified as a primary accident type and analyzed by the U.S. Coast Guard.

  19. [Postoperative Osteomyelitis of a Distal Phalanx Caused by Raoultella ornithinolytica].

    Science.gov (United States)

    Schmutz, N; Adler, T; Schelhorn, N; Wirz, S; Fricker, R

    2016-06-01

    We report on a case of osteomyelitis of a distal phalanx of the right ring finger of a 62-year-old patient, which occurred 11 months after transosseous-transungual refixation of a closed flexor digitorum profundus tendon avulsion caused by Raoultella ornithinolytica. R. ornithinolytica is an encapsulated Gram-negative aerobic bacillus. In the literature only 13 cases of human infection by R. ornithinolytica are mentioned. To the best of our knowledge, this is the first case of an osteomyelitis caused by R. ornithinolytica.

  20. Sonographic diagnosis of an acute Stener lesion: a case report.

    Science.gov (United States)

    Mattox, Ross; Welk, Aaron B; Battaglia, Patrick J; Scali, Frank; Nunez, Mero; Kettner, Norman W

    2016-01-01

    This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic imaging with ultrasound confirmed displacement of the fully torn ligament. Surgical repair followed the diagnosis. Diagnostic ultrasound in this case provided an accurate diagnosis obviating further imaging. This allowed an optimal outcome due to early intervention.

  1. Traumatic Mallet Toe of the Hallux in a Paediatric Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Jason Chow

    2013-06-01

    Full Text Available We describe a case of traumatic avulsion fracture of the distal phalanx of the hallux in a paediatric patient. The patient had a Salter Harris type III fracture of the distal phalanx with 40% of the articular cartilage involved and a clinical extension lag. We treated the injury non-operatively with applying a fibreglass dorsiflexion interphalangeal plaster for 6 weeks. An excellent outcome was achieved with normal range of interphalangeal motion and solid painless union of fracture at 12 weeks.

  2. Cross-arm replantation for traumatic bilateral upper extremity amputations: a case report.

    Science.gov (United States)

    Liang, Kailu; Zhong, Gang; Yin, Jiahui; Xiang, Zhou; Cen, Shiqiang; Huang, Fuguo

    2011-02-01

    A 40-year-old woman had her right extremity avulsed at the proximal upper arm level and the wrist and hand of her left extremity irretrievably injured in a traffic accident. The right distal forearm was surgically amputated and replanted onto the stump of the left distal forearm. New strategy for nerve repair was applied and the function recovery of the cross-replanted hand was favorable. We thought that cross-extremity replantation was indicated when the patient suffered from bilateral total or subtotal amputation at different levels and orthotopic replantation was impossible.

  3. Neurological Disorder

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    13.1 Neurophysiology 2006115 Regional modulation of primary motor cortex after peripheral nerve injury: a functional magnetic resonance imaging study CAO Ge - jun (高歌军 ), et al. Dept Radiol, Huashan Hosp Shanghai 200040. Natl Med J China 2005 ;85(25) : 1752 -1756. Objective:To map dynamic changes of primary motor cortex after total brachial plexus traction injury by using functional magnetic resonance imaging, and to explore underlying probable mechanisms. Methods:Five patients with total traumatic root avulsions of the brachial plexus underwent varied kinds of nerve transfer to restore partial-

  4. 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.

  5. Cavo-atrial bypass with a polytetrafluoroethylene graft for the treatment of a complete, traumatic transection of the suprahepatic inferior vena cava.

    Science.gov (United States)

    Prevot, Flavien; Berna, Pascal; Badoux, Louise; Regimbeau, Jean-Marc

    2016-09-27

    In the event of injury to the vena cava, the surgeon's goal is to control the bleeding and then repair the vascular damage. Given the wide range of lesions observed, the repair step has not been standardized. There are a few case reports of simple venoplasty or cavocaval bypass with a polytetrafluoroethylene graft. The present report introduces another treatment option for total avulsion of the suprahepatic inferior vena cava when a lack of remnant venous tissue below the heart prevents direct repair: cavo-atrial bypass with a polytetrafluoroethylene graft.

  6. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  7. Applications of basic fibroblastic growth factor (FGF-2, bFGF) in dentistry.

    Science.gov (United States)

    Sonmez, Ayse B; Castelnuovo, Jacopo

    2014-04-01

    Recent developments in research have been based on the maintenance and regeneration of natural organs and tissues; among such developments is the use of growth factors (GFs). The use of basic fibroblastic growth factors (bFGF) may be indicated in different disciplines of dentistry such as periodontics and dental traumatology. These cells' ability to induce proliferation and differentiation of cells may make GFs a useful source for the development of natural structures. This mini-review will discuss how bFGF can be beneficial to dentistry in relation to 1) re-implantation/autotransplantation of avulsed teeth and 2) periodontal regeneration.

  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. Physical and chemical injury as causes of sudden cardiac death: the forensic forum.

    Science.gov (United States)

    Riddick, L

    1994-01-01

    Physical and chemical injuries account for the largest number of sudden, unexpected cardiac deaths in persons between the ages of 1 and 44 years. Blunt-force injuries, lacerations, avulsions, and contusions of the heart and great vessels sustained during motor vehicle crashes constitute the most prevalent type of lethal physical trauma to the cardiovascular system. The second most prevalent type of trauma is from penetrating and perforating wounds inflicted by firearms. The mechanisms of these injuries are discussed, with emphasis placed on those factors contributing to lethality. The three most prevalent chemicals associated with sudden cardiac death-ethyl alcohol, cocaine, and tricylic antidepressants-are briefly mentioned.

  10. 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.

  11. Transverse posterior element fractures associated with torsion

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Substance P mRNA expression in the rat spinal cord following selective brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Na Liu; Longju Chen; Feng Li; Wutian Wu

    2008-01-01

    BACKGROUND: The neuropeptide, substance P, has various bioactivities and is widely distributed in the central nervous system. Substance P participates in neural transmission in the spinal cord and plays an important role in regeneration and repair of nerve injury.OBJECTIVE: To investigate substance P mRNA expression in the anterior horn of the spinal cord following brachial plexus injury.DESIGN, TIME AND SETTING: A molecular cell biology randomized controlled study was performed at the Department of Anatomy, Zhongshan Medical College, Sun Yat-sen University and the DaAn Gene Laboratory in May 2005.MATERIALS: A total of 29 adult male Sprague Dawley rats were randomly assigned to a control group (n=5) and an injury group (n = 24).METHODS: The injury group was divided into three subgroups. In subgroup A, the right seventh cervical vertebra (C7) anterior root was avulsed, and the residual nerve root at the distal end was removed. In subgroup B, the right C7 anterior root was avulsed, and the right C5 first thoracic vertebrae (TO posterior root was incised. Thus afferent pathways of the posterior root that connected with the anterior horn motor neurons were blocked. In subgroup C, the right C7 anterior root was avulsed, and a right C5-6 hemisection was performed. Thus the descending fiber pathways of the cortex that connected with anterior horn motor neurons were blocked. In the control group, the C5-T1 vertebral plate was opened, and then the skin was sutured.MAIN OUTCOME MEASURE: Substance P mRNA expression in the anterior horn of the spinal cord was quantified using fluorescent quantitative reverse transcription-polymerase chain reaction.RESULTS: Substance P mRNA expression was low in the anterior horn of the rat spinal cord in the control group. Substance P mRNA expression in the anterior horn of the spinal cord was upregulated and was significantly higher in the injury group compared with the control group (P < 0.01 ). Substance P mRNA expression was highest in

  13. 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

    and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations......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...

  14. Lingual frenectomy using multiple series Z-plasty

    OpenAIRE

    Vyloppilli, Suresh; Prathap, Akhilesh

    2010-01-01

    The tongue is an important structure for speech, mastication and deglutition. Avulsion of a portion of tongue can significantly limit the range of motion thereby impairing its functions. This is the case report of a traumatically amputated tongue which was reconstructed to fulfill its function effectively. Z-plasty is one of the most commonly used soft tissue corrective procedures in plastic surgery. Here we describe the use of a modification of the Z-plasty—multiple series Z-plasty for a ton...

  15. Calcitonin gene-related peptide in anterior and posterior horns of spinal cord after brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Longju Chen; Peijun Wang; Feng Li; Wutian Wu

    2007-01-01

    BACKGROUND: The changes of calcitonin gene-related peptide (CGRP) expression are closely associated with peripheral nerve injury, whereas it should be further investigated whether the damage of central nerve can lead to the changes of CGRP expression, and whether it is associated with the neural regeneration and repair.OBJECTIVE: To observe the changing law of CGRP expression in the anterior and posterior horns of spinal cord following brachial plexus injury.DESIGN: A randomized controlled trial.SETTINGS: Department of Anatomy, Yunyang Medical College; Department of Anatomy, Basic Medical College, Sun Yat-sen University.MATERIALS: Sixty-five adult male SD rats of clean degree, weighing 180 - 220 g, provided by the experimental animal center of the Basic Medical College, Sun Yat-sen University, were randomly divided into control group (n =5) and experimental group (n =60), and the latter was subdivided into three damage groups: avulsion of anterior root group (n =20), disjunction of posterior root group (n =20) and transection of spinal cord group (n =20). Diaminobenzidine (DAB) chromogen, rabbit anti-CGRP polyclonal antibody were the products of Sigma Company; Leica image analytical apparatus was produced by QUIN Company (Germany); Histotome by Sigma Company.METHODS: The experiments were carried out in the Department of Anatomy, Basic Medical College, Sun Yat-sen University from September 2004 to March 2005. Three kinds of models of brachial plexus injury were established: In the avulsion of anterior root group, right C7 anterior root was avulsed, and the distal nerve residual root was transected. In the disjunction of posterior root group, right C7 anterior root was avulsed and right C5 - T1 posterior horns were cut to block the sensory afferent pathway. In the transection of spinal cord group, right C7 anterior root was avulsed and C5-6 segments of right spinal cord were semi-transected to block the cortical descending pathway. In the control group, C5 - T1

  16. 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.

  17. Effect of Four Different Media on Periodontal Ligament Cells Viability of Dry- Stored Dog Teeth

    Science.gov (United States)

    Moazzami, Fariborz; Asheghi, Bahar; Sahebi, Safoura

    2017-01-01

    Statement of the Problem: The maintenance of viable periodontal ligament cells is the most important issue in the long-term preservation of avulsed teeth. Purpose: The aim of this study was to assess aloe vera as a new storage media in maintaining the cell viability of dry-stored teeth in comparison with soy milk, Hank`s balanced salt solution (HBSS), and milk. Materials and Method: Twenty one extracted dog premolar teeth were dried for 30 minutes and stored in soy milk, HBSS, milk, and aloe vera extract (50%) for 45 minutes (n=6 for each). Furthermore, positive and two negative control groups (n=6), corresponding to 0 min, 30 min, and 2-hour drying times were also prepared respectively. The number of viable cells was counted following storage using Trypan blue exclusion. Data were statistically analyzed using the one-way ANOVA and post hoc Tukey-HSD test. Results: Statistical analysis showed no significant differences in cell viability among aloe vera, soymilk, and HBSS- stored teeth; however, they were all superior to milk. Conclusion: Aloe vera extract can be recommended as a suitable storage media for avulsed teeth. PMID:28280756

  18. [Assessment of traumatic tooth injuries in the emergency room].

    Science.gov (United States)

    Risheim, Helge

    2006-04-27

    Many patients with facial injuries are first seen by doctors in the emergency room. Injuries affecting teeth and alveolar process are common in children; approximately half of all children have sustained such an injury before adulthood. Dentoalveolar trauma does not pose a significant morbid risk for the trauma patient. However, failure to recognise or obtain appropriate consultation can result in premature tooth or alveolar bone loss, resulting in problematic prosthetic rehabilitation. Emergency room doctors should know the initial treatment guidelines for traumatic dental injuries to provide optimal treatment before the patient can seen by a dentist. An avulsed tooth should be replanted immediately, or kept moist until it can be replanted. Prognosis is related to storage media and the length of the extra-alveolar period. Teeth replanted within 5 minutes have the best prognosis. If the primary consultation is by phone the patient, or the parent, should be informed to replant the avulsed tooth. If this is not feasible the tooth should be stored in milk, saliva (oral cavity) or physiologic saline until replanted. Primary teeth are not replanted.

  19. The role for 'reminders' in dental traumatology: 1. Current practices in the UK and Ireland.

    Science.gov (United States)

    Day, Peter F; Duggal, Monty S

    2006-10-01

    The aim of this study was to investigate the current method for recording trauma in UK dental hospitals. A standard questionnaire was sent out to all 19 UK and Irish dental hospitals to investigate how trauma was recorded both at initial presentation and at review appointments. Where a standard form was used, a copy was requested. Each form was analysed to assess what information was being recorded and whether prompts were used. For the initial presentation of trauma, nine institutions had a standard trauma form, one used a standard form for avulsions only, seven had no form and two did not respond. For subsequent follow-up visits of trauma cases, six hospitals had a standard form, one used a standard from for avulsions only, 10 had no form and two did not respond. There was considerable variation in the questions that were asked at initial presentation of trauma cases and follow-up reviews in dento-alveolar trauma. Without consistent recording, there is little chance that multi-centred prospective clinical trials can take place in the field of dental trauma.

  20. Referral practice of military corpsmen regarding dento-alveolar trauma.

    Science.gov (United States)

    Zadik, Yehuda; Levin, Liran

    2008-06-01

    The aim of this study was to evaluate the Israeli military corpsmens' practice of referral to professional treatment regarding traumatic dental injuries. The study consisted of 250 corpsmen during their military service. Questionnaire and slide show were used to present clinical photos with short history descriptions of dento-alveolar traumatic injuries. Participants were asked to indicate the preferred referral destination for each case to state the urgency of referral to the destination and to note their regional emergency department with an oral and maxillofacial surgery consultant and the nearest 24-h emergency dental clinic. Corpsmen immediately evacuated the wounded with full-thickness lip laceration (59%), tooth avulsion (79%), alveolar fracture (88%) and mandibular fracture (100%). Most corpsmen referred crown fracture to a dental clinic and alveolar- or mandibular-bone fracture to the emergency department. Tooth avulsion cases were equally distributed between the emergency department and dental clinic and full-thickness lip laceration between the emergency department and general medical office. Familiarity with the nearest 24-h emergency dental clinic was found in 38% and with the regional emergency department with an oral and maxillofacial surgery consultant in 57%. The knowledge of this group of military corpsmen regarding referral practices was encouraging. However, further continuing education with regards to the regionally available emergency services is needed. Special emphasis should be given to provide primary caregivers with the relevant education to improve their knowledge and ability of dealing dental trauma.

  1. 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.

  2. Multidisciplinary approach in the immediate replantation of a maxillary central incisor - A six and a half year follow-up

    Directory of Open Access Journals (Sweden)

    Cristina Braga Xavier

    2015-01-01

    Full Text Available This report proposes a discussion of the various peculiarities of a tooth 21 replantation in a 9-year-old patient and describes different treatment facets and a 6-year follow-up of the case. The splint was maintained for a 3-month period. After a 1΍ year therapy with calcium hydroxide to control inflammatory resorption, the final canal obturation was performed 18 months after trauma with mineral trioxide aggregate. Two years after replantation, the orthodontic treatment had been initiated and 5 years after avulsion, whitening of tooth 21 was also done. Clinical and radiographic follow-up at regular intervals revealed that the treated tooth was still functional, showing normal mobility, resorption stabilization, and normal appearance of the bone tissue and lamina dura, testifying the treatment has been so far successful. The possibility of submitting avulsed teeth to other dental treatments once, there is close professional monitoring by controlling the risks and benefits of each therapy, as well as the patient′s cooperation, extra-oral time, and storage media for transport to the dentist among other details is emphasized.

  3. Taekwondo coaches knowledge about prevention and management of dental trauma.

    Science.gov (United States)

    Vidović, Dina; Gorseta, Kristina; Bursac, Danijel; Glavina, Domagoj; Skrinjarić, Tomislav

    2014-06-01

    The aim of this study was to assess level of knowledge about prevention and dental trauma management among taekwondo coaches in Croatia. The questionnaire submitted to the taekwondo coaches contained 16 items about dental trauma prevention and management. The questionnaires were filled in by 131 taekwondo coaches; 28 females and 103 males. Descriptive statistics was used to describe and analyze the obtained data. The coaches were familiar with dental injuries in high percentage: 41 (31.3%) have observed dental injury and 36 (27.5%) have experienced a dental injury themselves. Eight of them had tooth avulsion, fourteen crown fracture, and eight had tooth luxation. About half of all interviewed coaches 68 (52.7%) were aware of the possibility of replanting avulsed teeth. Twenty six (19.8%) were familiar with the tooth rescue kit. Only 99 out of 131 coaches (75.6%) have used a mouthguard. The obtained results show low knowledge about possibilities for prevention of dental trauma. Insufficient use of mouthguards in this contact sport requires more attention of dentists and coaches education about dental trauma prevention.

  4. Expression of nitric oxide synthase in the spinal cord after selective brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Na Liu; Feng Li; Longju Chen; Wutian Wu

    2006-01-01

    BACKGROUND: Some researches showed that motoneurons in spinal cord anterior horn wound die following brachial plexus injury, but the concrete mechanism of motoneurons death remains unclear.OBJECTIVE: To observe the expression of nitric oxide synthase (NOS) and survival of C7 motoneurons in spinal cord of rats after selective brachial plexus injury.DESIGN: A randomized controlled animal experiment.SETTING: Department of Anatomy, Sun Yet-sen Medical College, Sun Yet-sen University.MATERIALS: Totally 35 adult healthy male Sprague-Dawley rats with the body mass of 200-300 g were provided by Experimental Animal Center, Sun Yet-sen Medical College, Sun Yat-sen University. The rats were divided into control group (n =5) and experimental group (n=30) by random number table method, and the experimental group was divided into three injury subgroups: anterior root avulsion group, dorsal root transection group and spinal cord hemisection group, 10 rats in each group. There were horse anti-neuronal NOS (Nnos) polycolonal antibody (Sigma company) and nicotina mideadeninedinucleotide phosphate (NADPH-d) (SigmaCompany).METHODS: The experiment was performed at Department of Anatomy, Sun Yet-sen Medical College, Sun Yet-sen University between September 2004 and April 2005. ①After anesthetizing the rats, the spinous process of second thoracic vertebra as a marker, the vertebra was exposed from C5 to T1 and the lamina of vertebra was unclenched, and spinal dura mater was carved to expose the spinal nerve dorsal roots of C5-T1.The right ventral root of C7 was avulsed, and the residual root was removed in anterior root avulsion group. The right ventral root of C7 was avulsed and the right dorsal roots of brachial plexus (C5-T1) were cut off in dorsal root transection group. In spinal cord hemisection group, the hemisection between the C5 and C6 spinal segment on right side and avulsion of right ventral root of C7 were made. In the control group, the vertebra from C5 to T1 was

  5. 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.   

  6. The effectiveness of matrix cauterization with trichloroacetic acid in the treatment of ingrown toenails

    Directory of Open Access Journals (Sweden)

    Erdinc Terzi

    2015-01-01

    Full Text Available Ingrown toenail is an often painful clinical condition that usually affects the big toe. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results. However, it produces extensive tissue destruction that can result in drainage and delayed healing. Alternatives such as sodium hydroxide and trichloroacetic acid (TCA have therefore come into vogue. A total of 39 patients with 56 ingrown toenail edges underwent chemical matricectomy with 90% TCA after partial nail avulsion. In most of the patients, adverse effects such as postoperative pain and drainage were minimal. One patient who underwent matricectomy had recurrence in a single nail edge (1.8% at 12 months follow-up. No recurrence was observed among 38 patients during the mean follow-up period. This was considered to be statistically significant (P < 0.001. Partial nail avulsion followed by TCA matricectomy is a safe, simple, and effective method with low rates of postoperative morbidity and high rates of success.

  7. 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.

  8. Joint loads resulting in ACL rupture: Effects of age, sex, and body mass on injury load and mode of failure in a mouse model.

    Science.gov (United States)

    Blaker, Carina L; Little, Christopher B; Clarke, Elizabeth C

    2016-09-07

    Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterize a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anesthetized C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex, and body mass on ACL injury mechanisms. The ACL injury load (whole joint load required to rupture the ACL) was measured from force-displacement data, and mode of failure was assessed using micro-dissection and histology. ACL injury load was found to increase with body mass and age (p mode of ACL failure varied with both age and sex groups. Avulsion fractures (complete or mixed with mid-substance tears) were common in all age groups but the proportion of mixed and mid-substance failures increased with age. Females were more likely than males to have a major avulsion relative to a mid-substance tear (p model. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  9. Threatened fertility and gonadal function after a polytraumatic, life-threatening injury

    Directory of Open Access Journals (Sweden)

    Ward Michael

    2010-01-01

    Full Text Available Trauma literature regarding management of genitalia trauma affecting future fertility and gonadal function in the face of coexisting life-threatening injuries is underdeveloped. We present a unique case that necessitated integrative management of a 24-year-old male who became entangled within the blades of a manure spreader and presented with life-threatening trauma in addition to severe genital trauma, including penile degloving, bilateral testicular avulsion and bilateral spermatic cord laceration. During the initial stabilization and surgical management, urology and plastic surgery were consulted to assess the urogenital injuries. Together, the surgical team orchestrated potentially life-saving interventions while successfully performing both a testicular sperm extraction and a testicular revascularization. Viable sperm was collected on the day of surgery and initial follow-up showed preserved sexual function and adequate perfusion to the testicle. This report presents a case and provides a review discussing the management of traumatic genital injuries and the importance of early involvement of surgical specialties in genitalia trauma to optimize future fertility and gonadal function. The literature search was performed in August 2008 using Medline for articles only in English, including any of the following terms: polytrauma, trauma, penis, testicle, degloving, avulsion, spermatic cord, laceration, fertility, reproduction or revascularization.

  10. Multiple toe transfer and sensory free flap use after a traumatic amputation of multiple digits. Surgery done in a single setting: a case study.

    Science.gov (United States)

    Galpern, David W; Tsai, Tsu-Min

    2011-09-01

    Crush avulsion injuries to the hand with concomitant traumatic amputation of multiple digits can be a devastating injury to the patient. These injuries have multiple issues occurring under emergency conditions. When feasible, replantation of the multiple digits is optimal, but in many cases, it is not possible. Because of the crushing force on the digits, they are not viable candidates for replantation. The usual course of treatment for these patients is a two stage procedure, usually involving a groin flap. Here, we present the case of a patient who had a left hand skin avulsion of the whole palm and P1 of index, long, ring and small fingers. The left index finger had a complete amputation at the P2 level, the long, ring and small fingers all had complete amputations at the P1 level. This injury was dealt with by a left foot second and third toe transplant, a sensory free flap from the left big toe and a fourth toe microvascular free transfer to the left hand. The remainder of the defect was managed with a 10 × 14 cm reversed radial forearm flap and a combination of full and split thickness skin grafts. The procedure was performed in a single operation, obviating the need for a second surgery. This procedure optimized the patient's outcome during a single setting, making it an ideal choice in an emergency setting.

  11. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging.

    Science.gov (United States)

    Bencardino, J T; Rosenberg, Z S; Brown, R R; Hassankhani, A; Lustrin, E S; Beltran, J

    2000-10-01

    Magnetic resonance (MR) imaging is the imaging modality of choice for evaluation of acute traumatic musculotendinous injuries of the knee. Three discrete categories of acute injuries to the musculotendinous unit can be defined: muscle contusion, myotendinous strain, and tendon avulsion. Among the quadriceps muscles, the rectus femoris is the most susceptible to injury at the myotendinous junction due to its superficial location, predominance of type II fibers, eccentric muscle action, and extension across two joints. Among the muscles of the pes anserinus, the sartorius is the most susceptible to strain injury due to its superficial location and biarticular course. The classic fusiform configuration of the semimembranosus along with a propensity for eccentric actions also make it prone to strain injury. MR imaging findings associated with rupture of the iliotibial tract include discontinuity and edema, which are best noted on coronal images. The same mechanism of injury that tears the arcuate ligament from its fibular insertion can also result in avulsion injury of the biceps femoris. The gastrocnemius muscle is prone to strain injury due to its action across two joints and its superficial location. Injuries of the muscle belly and myotendinous junction of the popliteus are far more common than tendinous injuries.

  12. Anatomy and growth pattern of Amazon deep-sea fan as revealed by long-range side-scan sonar (GLORIA) and high-resolution seismic studies

    Energy Technology Data Exchange (ETDEWEB)

    Damuth, J.E.; Flood, R.D.; Kowsmann, R.O.; Belderson, R.H.; Gorini, M.A.

    1988-08-01

    Imaging of the Amazon deep-sea fan with long-range side-scan sonar (GLORIA) has, for the first time, revealed the anatomy, trends, and growth pattern of distributary channels on this fan. Only one channel-levee system was active at any given time and extended from the Amazon Submarine Canyon downslope onto the lower fan (> 4,200 m). Formation of new channel-levee systems occurred when a currently active channel-levee system was cut off and abandoned through avulsion, and a new channel-levee system was established nearby. Through time, successive channel-levee formation and abandonment built two broad levee complexes consisting of groups of overlapping, coalescing segments of channel-levee systems across the present fan surface. These, plus older, now buried levee complexes, indicate that fan growth is radially outward and downslope through development of successive levee complexes. The most striking characteristic of the distributary channels is their intricate, often recurving, meanders with sinuosities of up to 2.5. Cutoffs and abandoned meander loops indicate that the channels migrate laterally through time. Channel bifurcation results predominantly from avulsion when flows breach a channel levee, thereby abandoning the present channel and establishing a new channel-levee segment nearby. No clear evidence of channel branching (i.e., division of a single channel into two active segments) or braiding was observed. 22 figs.

  13. Knowledge, attitude, and perception of mothers towards emergency management of dental trauma in Salem district, Tamil Nadu: A questionnaire study

    Directory of Open Access Journals (Sweden)

    Kruthika Murali

    2014-01-01

    Full Text Available Background: Dental trauma is one of the main oral health problems in childhood, and can cause pain and distress. It is important to provide emergency care to combat the aftermaths of trauma. Aim: The aim of the study is to assess the knowledge and attitude of mothers regarding dental trauma and its management. Materials and Methods: A questionnaire consisting of 33 closed-ended questions were used to interview 150 mothers who participated in the study. The questions assessed the knowledge and attitude of mothers towards their child′s dental visit, dental trauma, and its management. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS version 17.0. Results: Mother′s previous experience of dental trauma when associated with the preservation of avulsed tooth of the child, those mothers who had the experience of dental trauma reported that they would discard the tooth which was found to be statistically significant (P < 0.05 when compared to the mothers with no experience of trauma. The education status of the study population when associated with the knowledge variables of avulsion, it was found that most of the variables had statistically significant association with P < 0.05. Conclusion: This study reveals that there is a lack of awareness among the mothers regarding the emergency management of dental trauma. This warrants the need of an effective communication between dental professionals and mothers for better handling of dental emergencies.

  14. 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.

  15. 产瘫患儿Horner征的临床观察%Clinical observation of concurrent Horner's sign in infants with obstetric brachial plexus palsy

    Institute of Scientific and Technical Information of China (English)

    李清; 陈亮; 胡韶楠

    2012-01-01

    Objective To discuss the diagnostic value of concurrent Horner's sign in infants with obstetric brachial plexus palsy and discover the clinical characteristics of Horner's syndrome caused by C7 nerve root avulsion alone.Methods From January 2009 to July 2009,39 infants with OBPP were identified with concurrent Horner' s syndrome.Clinical signs of Homer's syndrome were recorded which include ipsilateral blepharoptosis,pupillary miosis and facial anhidrosis.Lesions of brachial plexus nerve roots were confirmed during the surgery by direct visualization and electrophysiology.After a period of 6-month follow-up,these signs were recorded again.Results The initial age of Horner's sign evaluation of these OBPP patients was(3.58 ±0.87)months.Average postoperative follow-up interval was(6.19 ± 1.10)months.C7 nerve root avulsion alone was confirmed in 11 patients(case group),while the other 28 patients(control group)lind avulsion of at least one root of C8 and T1 nerve roots.There were not significant differences in anisocoria and blepharoptosis between the two groups(P > 0.05).Facial gland secretary function was recovered more rapidly among patients in case group than their counterparts(P < 0.05).Conclusion In newborns with OBPP,Horner' s syndrome can be correlated with C7 nerve root avulsion alone.No unique feature of Horner's syndrome which caused by C7 nerve root avulsion was found among patients of 3 months old.%目的 探讨Horner征在产瘫中的诊断意义,寻找单纯C7神经根撕脱导致Horner征的特异性临床体征.方法 对2009年1月至7月在我院接受手术治疗的39例Horner征阳性的产瘫患儿,术前记录患侧Horner征3项临床体征:瞳孔大小,睑裂大小及面部汗腺分泌功能.术中通过直视观察联合神经电生理检查明确患儿神经根损伤程度,并在患儿术后首次随访时再次记录Horner征的各项体征.结果 产瘫患儿平均首次评估Horner征时间为(3.58±0.87)个月.

  16. 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

  17. Investigating the impact of vegetation on alluvial fans using laboratory experiments

    Science.gov (United States)

    Clarke, Lucy; McLelland, Stuart; Tom, Coutlhard

    2016-04-01

    Riparian vegetation can significantly influence the geomorphology of fluvial systems, affecting channel geometry and flow dynamics. However, there is still limited understanding of the role vegetation plays in the development of alluvial fans, despite the large number of vegetated fans located in temperate and humid climates. An understanding of the feedback loops between water flow, sediment dynamics and vegetation is key to understanding the geomorphological response of alluvial fans. But it is difficult to investigate these relationships in the natural world due to the complexity of the geomorphic and biological processes and timescales involved, whereas the controlled conditions afforded by laboratory experiments provide the ideal opportunity to explore these relationships. To examine the effects of vegetation on channel form, flow dynamics and morphology during fan evolution, a series of experiments were conducted using the Total Environment Simulator (operated by the University of Hull). The experiments followed a 'similarity of processes' approach and so were not scaled to a specific field prototype. Live vegetation (Medicago Sativa) was used to simulate the influence of vegetation on the fan development. A range of experiments were conducted on 2x2m fan plots, the same initial conditions and constant water discharge and sediment feed rates were used, but the vegetation density and amount of geomorphic time (when the sediment and water were running and there was active fan development) between seeding / vegetation growth varied between runs. The fan morphology was recorded at regular intervals using a laser scanner (at 1mm resolution) and high resolution video recording and overhead photography were used to gain near-continuous data quantifying fan topography, flow patterns, channel migration and avulsion frequency. Image analysis also monitored the spatial extent of vegetation establishment. The use of these techniques allowed collection of high resolution

  18. 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折%Treatment of anterior cruciate ligament tibial eminence avulsionfractures with hollow screw through arthroscopy

    Institute of Scientific and Technical Information of China (English)

    李云华; 刘春磊; 王贵清; 王湘江; 邹华

    2013-01-01

    Objective To observe the clinical effect of treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.Method 13 cases with anterior cruciate ligament tibial eminence avulsion fractures were treated through arthroscopy from February 2010 to March 2011.Fractures were reduction and fixed with hollow screw through arthroscopy.All the cases were followed-up more than 1 year.The evaluation of knee function was taken with Lysholm score system.Result All the cases were followed-up with mean time 16months (12~25months).The preoperative Lysholm scores ranged from 23 to 65,with a mean of (48.45±5.23),and the postoperative Lysholm scores ranged from 83 to 96,with a mean of (91.34±6.53).11 cases were excellent,1 good and 1 fair,the excellent and good rate was 92.3%.Conclusion It is an effiective method in the treatment of anterior cruciate ligament tibial eminence avulsion fractures with hollow screw through arthroscopy.it may produce less trauma and with quick healing.%目的 观察关节镜下空心螺钉固定ACL胫骨止点撕脱骨折的临床效果.方法 2010年2月~2011年3月,关节镜下空心螺钉固定ACL胫骨止点撕脱骨折13例,在关节镜下复位骨折块,空心螺钉固定骨折块.通过1年以上随访行疗效评定.患者膝关节功能以Lysholm评分系统评分.结果 全部病例获完整随访,平均随访16m(12~25m).Lysholm膝关节功能评分:术前23~65分,平均(48.45±5.23)分;术后83~96分,平均(91.34±6.53)分.优11例,良1例,中1例,优良率92.3%.结论 关节镜下空心螺钉固定ACL胫骨止点撕脱骨折创伤小、恢复快,是一种可行的方法.

  19. Risk of Fragments in Ulnar Collateral Ligament Injuries Of Baseball Players

    Science.gov (United States)

    Furushima, Kozo; Itoh, Yoshiyasu; Mitsui, Yasuhiro; Kusano, Hiroshi

    2016-01-01

    Objectives: Many baseball players with UCL injuries have avulsed persistent fragments by throwing disorder in the youth. The presence of fragments results in discontinuity of the medial elbow joint support structures; therefore, a ligament with fragments is considered more fragile than the normal ligament. This study compared three types (fragment, malunion, and normal) of throwing-related UCL injuries and prospectively examined the risk of surgical treatment. Methods: The total subjects were 439 baseball players (age 14-30 years; mean age, 17.5 years) diagnosed with UCL injuries at our hospital between November 2009 and June 2013. At the time of the initial examination, the medial epicondyle was assessed on plain frontal radiographs with the elbow flexed at 45°. Based on this assessment, subjects were divided into three groups: group with persistent fragments (fragment [F] group), group with complete union following avulsion fracture (malunion [M] group), and a group with no history of avulsion fracture (normal [N] group). Each patient’s ability to return to playing baseball was assessed after at least 3 months of systematic rehabilitation. Subjects who failed to comply with rehabilitation, played only recreationally, or with pain in sites other than the elbow were excluded. In this series, 220 cases were left for investigation. The Conway-Jobe scale was used as a standard to assess the return to playing after conservative therapy; subjects with excellent or good ratings were deemed able to return to playing baseball, whereas those with fair or poor ratings were deemed unable to return to playing baseball. The return rates were calculated for the F, M, and N groups respectively. The Magnetic resonance (MR) images consisted of three slices along the long axis of the anterior oblique ligament; these images were used to classify injuries as severe or mild, which were then compared with each other. SPSS 20.0 was used to perform the statistical analysis. Results: A

  20. Patterns and processes of fluvial discontinuity and sediment residence times on the lower Macquarie River, Murray-Darling Basin, Australia

    Science.gov (United States)

    Larkin, Zacchary; Ralph, Timothy; Hesse, Paul

    2014-05-01

    The supply, transport and deposition of fine-grained sediment are important factors determining the morphology of lowland rivers that experience channel breakdown and have wetlands on their lower reaches. Sediment supply and residence time determine whether reaches accumulate sediment (wetland areas) or erode sediment (channelised areas). This research investigated how processes of sedimentation and erosion drive channel breakdown and reformation in the Macquarie Marshes, a large anastomosing wetland system in the Murray-Darling Basin, Australia. Channel breakdown is attributed to a dominance of in-stream sedimentation that leads to a point where single-thread river channels cannot be maintained and so avulsion and floodout processes create smaller distributary channels and wetlands. Avulsions may reconnect channels, changing the sediment supply regime in those particular channels. Channel reformation occurs on the trunk stream where the floodplain gradient steepens enough to allow convergence of small tributaries, locally increasing stream power (and erosive energy in channels). As each river reach reforms following channel breakdown, the channel is smaller, shallower and straighter than the previous reach. One reach in this system recently (in the 1970s) became connected with a parallel channel through avulsion and has morphological characteristics that indicate a significant change in flow and sediment supply. In a pilot study using uranium-series disequilibrium methods and OSL dating, a sediment residence time of 58 +/- 2 ka was determined for sediment in the base of the active channel and a sediment residence time of 153 +/- 5 ka was determined for sediment buried in an adjacent meander that was cut off from the main channel 1,000 years ago. The apparent dramatic decrease in sediment residence time to this active channel poses an interesting question about the role of relatively new channels in transporting and depositing sediment more rapidly than the

  1. 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

  2. 尾闾河道自组织过程动态模拟%Cellular model-based approach to self-organization channel formation in fluvial-deltaic systems.

    Institute of Scientific and Technical Information of China (English)

    黄翀; 刘高焕; 叶宇; 宋创业

    2011-01-01

    河流尾闾改道后新河道的形成演化具有非线性复杂性.文中在元胞地貌演化模型框架下,提出一种改进后的多流路算法,基于简化的水流和沉积物运移规则,通过元胞间局部的相互作用,模拟河流尾闾改道后三角洲平原上的水沙运移及侵蚀/沉积过程,再现了新河道从无到有的突现特征以及微地形调整的复杂动态.对模型的敏感性分析表明,新河道的突现是三角洲河流-平原系统内在的自组织作用结果和本质特征.%Channel avulsion and evolution in deltaic plain tends to be complicated by a wide range of different types of non-linear processes. Understanding the ways in which channel development after avulsion is critical to tackling many geomorphologic and river management problerms. In the paper, a cellular framework was used to explore the dynamics of new channel development processes after avulsion in a fluvial deltaic system. An improved multi-flow routing algorithm was integrated into the framework for modeling water and sediment across the landscape. Erosion and deposition caused by flowing water follow simple rules considering the slope between neighboring cells and other variables. Specifically, the algorithm allows for lateral transfer of water and sediment at angles of up to approximately 90° to the downstream direction. Modeling results appear able to reproduce many of the larger-scale emergent and self-organizing features observed in natural environment. This study demonstrates the utility of relatively simple algorithms to simulate complex emergence features of channel processes in fluvial-deltaic system.

  3. Augmentation of partially regenerated nerves by end-to-side side-to-side grafting neurotization: experience based on eight late obstetric brachial plexus cases

    Directory of Open Access Journals (Sweden)

    Moharram Ashraf N

    2006-12-01

    Full Text Available Abstract Objective The effect of end-to-side neurotization of partially regenerated recipient nerves on improving motor power in late obstetric brachial plexus lesions, so-called nerve augmentation, was investigated. Methods Eight cases aged 3 – 7 years were operated upon and followed up for 4 years (C5,6 rupture C7,8T1 avulsion: 5; C5,6,7,8 rupture T1 avulsion:1; C5,6,8T1 rupture C7 avulsion:1; C5,6,7 ruptureC8 T1 compression: one 3 year presentation after former neurotization at 3 months. Grade 1–3 muscles were neurotized. Grade0 muscles were neurotized, if the electromyogram showed scattered motor unit action potentials on voluntary contraction without interference pattern. Donor nerves included: the phrenic, accessory, descending and ascending loops of the ansa cervicalis, 3rd and 4th intercostals and contralateral C7. Results Superior proximal to distal regeneration was observed firstly. Differential regeneration of muscles supplied by the same nerve was observed secondly (superior supraspinatus to infraspinatus regeneration. Differential regeneration of antagonistic muscles was observed thirdly (superior biceps to triceps and pronator teres to supinator recovery. Differential regeneration of fibres within the same muscle was observed fourthly (superior anterior and middle to posterior deltoid regeneration. Differential regeneration of muscles having different preoperative motor powers was noted fifthly; improvement to Grade 3 or more occurred more in Grade2 than in Grade0 or Grade1 muscles. Improvements of cocontractions and of shoulder, forearm and wrist deformities were noted sixthly. The shoulder, elbow and hand scores improved in 4 cases. Limitations The sample size is small. Controls are necessary to rule out any natural improvement of the lesion. There is intra- and interobserver variability in testing muscle power and cocontractions. Conclusion Nerve augmentation improves cocontractions and muscle power in the biceps, pectoral

  4. Ultrasound for critical care physicians: unchain my heart

    Directory of Open Access Journals (Sweden)

    Mansfield W

    2017-02-01

    Full Text Available No abstract available. Article truncated after first page. A 46-year-old man presented after a motor vehicle collision. He suffered abdominal injuries (liver laceration, avulsed gall bladder which were successfully managed non-operatively. The patient remained intubated on mechanical ventilation and remained hypotensive after the injuries resolved. The patient required norepinephrine at low doses to maintain a normal blood pressure. It was noted the patient had a history of remote tricuspid valve replacement. A bedside echocardiogram was then performed to determine the etiology of the patient’s persistent hypotension after hypovolemia had been excluded. What tricuspid pathology do the following videos and images demonstrate? 1. Mobile vegetation; 2. Tricuspid Regurgitation; 3. Tricuspid Stenosis; 4. All of the above.

  5. Syncope as the Presenting Feature of Splenic Rupture after Colonoscopy

    Directory of Open Access Journals (Sweden)

    Daniel Jamorabo

    2014-01-01

    Full Text Available Splenic rupture is a rare, catastrophic complication of colonoscopy and an exceptional cause of syncope. This injury is believed to be from direct trauma or tension on the splenocolic ligament with subsequent capsule avulsion or else from direct instrument-induced splenic injury. Diagnosis requires a high index of suspicion that may be absent because presentation can be subtle, nonspecific, and delayed anywhere from hours to days and therefore not easily attributed to a recent endoscopy. We describe a case of syncope as the initial manifestation of splenic rupture after colonoscopy. Our patient’s pain was delayed; his discomfort was mild and not localized to the left upper quadrant. Clinicians should consider syncope, lightheadedness, and drop in hemoglobin in absence of rectal bleeding following a colonoscopy as possible warning signs of imminent or emergent splenic injury.

  6. Spontaneous fracture of the mandibular genial tubercles. A case report.

    Science.gov (United States)

    Gallego, Lorena; Junquera, Luis; Villarreal, Pedro; de Vicente, Juan Carlos

    2007-12-01

    Fracture of the mandibular genial tubercles is an uncommon pathology affecting edentulous patients with severe maxillary atrophy. Usually occurs spontaneously which complicates the diagnosis. Their importance lies in the functional alterations, which occur as a consequence of the disinsertion of the genihyoid and genioglossus muscles. The treatment of fracture of the genial tubercles is controversial, including no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. There have been only 11 cases reported in the literature of this fracture, most of them spontaneous. We present a difficult diagnosis situation of spontaneous fracture of the genial tubercles in an 86-year-old edentulous female with a painful sublingual and submental hematoma and anterior cervical echimosis. Computerized Tomography should be made to confirm the diagnosis. Surgical treatment was not necessary, and follow-up at 6 months revealed complete symptomatic recovery, and full return of function.

  7. New thoughts on the origin of Pellegrini-Stieda: the association of PCL injury and medial femoral epicondylar periosteal stripping

    Energy Technology Data Exchange (ETDEWEB)

    McAnally, James L.; Southam, Samuel L.; Mlady, Gary W. [University of New Mexico, Department of Radiology, Albuquerque, NM (United States)

    2009-02-15

    For the past 100 years, Pellegrini-Stieda disease has been described as calcification and ossification within the tibial collateral ligament, although these typical radiographic findings are often located more superior than the most proximal extent of the ligament. In this article, we demonstrate four magnetic resonance imaging cases of knee trauma with complete posterior cruciate ligament tear or avulsion, each demonstrating that injury to the medial collateral ligamentous complex can involve significant stripping of the tissue proximal to the medial epicondyle. Classic radiographic findings of Pellegrini-Stieda calcifications can be caused by stripping of the femoral periosteum proximal to the femoral attachment of the tibial collateral ligament, which appears to be associated with a complete posterior cruciate ligament injury. (orig.)

  8. Three-dimensional Ultrasound Appearance of Pelvic Floor in Nulliparous Women and Pelvic Organ Prolapse Women

    Directory of Open Access Journals (Sweden)

    Tao Ying, Qin Li, Lian Xu, Feifei Liu, Bing Hu

    2012-01-01

    Full Text Available The present study investigated the morphology and structure of pelvic floor in 50 nulliparous and 50 pelvic organ prolapse (POP women using translabial three-dimensional (3D ultrasound. The levator hiatus in POP women was significantly different from that in nullipara women. In POP women, the size of pelvic floor increased, with a circular shape, and the axis of levator hiatus departed from the normal position in 36 (72% cases. The puborectalis was avulsed in 18 (36% cases and the pelvic organs arranged abnormally in 23 (46% cases. In summary, 3D ultrasound is an effective tool to detect the pelvic floor in POP women who presented with abnormalities in the morphology and structure of pelvic floor.

  9. “Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture

    Directory of Open Access Journals (Sweden)

    Sirilak Suksompong

    2014-01-01

    Full Text Available We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed.

  10. Electroacupuncture attenuates neuropathic pain after brachial plexus injury

    Institute of Scientific and Technical Information of China (English)

    Shenyu Zhang; Hailiang Tang; Junming Zhou; Yudong Gu

    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 electroacu-puncture stimulation at bilateralQuchi(LI11),Hegu(LI04),Zusanli(ST36) andYanglingquan (GB34). After electroacupuncture therapy, chronic neuropathic pain in the rats’ upper limbs was signiifcantly attenuated. Immunolfuorescence staining showed that the expression of β-endorphins in the arcuate nucleus was signiifcantly increased after therapy. Thus, experimental ifndings indi-cate that electroacupuncture can attenuate neuropathic pain after brachial plexus injury through upregulatingβ-endorphin expression.

  11. A retrospective study of dento-alveolar injuries of children in Ankara, Turkey.

    Science.gov (United States)

    Altay, N; Güngör, H C

    2001-10-01

    Information concerning age and sex distribution, etiology, types, place and extent of trauma as well as seasonal variations, time difference between traumatic injury and seeking of dental care and number of traumatic injuries was recorded retrospectively from 150 patients. The study comprised 91 boys and 59 girls representing 246 dental injuries and 332 injured teeth (72 primary and 260 permanent teeth). The most common injuries were uncomplicated crown fracture (23.57%), subluxation (15.85%), avulsion (10.16%), lateral luxation (9.75%), complicated crown fracture and intrusion (8.4% and 8.94%, respectively). The occurrence of uncomplicated crown fractures was significantly higher (P<0.05) in the 10-12 years age group than other age groups. Lateral luxation and intrusion were significantly higher in the 1-6 and 7-9 years age groups (P<0.05, respectively).

  12. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    Directory of Open Access Journals (Sweden)

    Yeliz Guven

    2015-01-01

    Full Text Available The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  13. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries.

    Science.gov (United States)

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case.

  14. Management of maxillary alveolar bone fracture and severely intruded maxillary central incisor: report of a case.

    Science.gov (United States)

    Yonezawa, Hisanobu; Yanamoto, Souichi; Hoshino, Tomonori; Yamada, Shin-Ichi; Fujiwara, Taku; Umeda, Masahiro

    2013-10-01

    An 11-year-old male who injured his maxilla and right maxillary central incisor and lip during a fall was presented to our hospital. His lower lip and upper gingiva were lacerated with swelling and epistaxis, and he had a maxillary alveolar bone fracture and severe intrusion of the right maxillary central incisor, which had penetrated the floor of the nasal cavity with avulsion. Under local anesthesia, we repositioned the incisor and bone segment and fixed them with a titanium micromesh plate and self-tapping screws and splints. The incisor was also treated by root canal 3 days after the operation and was restored with a crown. We performed root canal filling 1 month later. Five months later, the plate and screws were removed. In prognosis of our case, no symptoms of inflammatory root resorption or ankylosis have observed for more than 1 year and 6 months of follow up based on both clinical and radiographic findings.

  15. Hand reconstruction using heterotopic replantation of amputated index and little fingers

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CHEN Ke-ming; ZHANG Jun-hua; WANG Shi-yong

    2011-01-01

    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.

  16. Orthopaedics in China:its past and present%中国骨科的过去与现在

    Institute of Scientific and Technical Information of China (English)

    冯传汉

    2005-01-01

    Orthopaedics in china originated chinese medicine and Western medicine. In the first half of twentieth century , Dr. meng chimao(Beijing),New Way Sung (Shanghai),Fang Hsienchi, and others contributed a great deal to development of modern orthopaedics in china. The orthopaedic group was organized under the auspecies of Chinese Medical Association in 1937. The chinese Medical Association Orthopaedic Society was wstablished in 1980. The main achievements of Orthopaedics in China include replantation of severed limb or fingres,toe teansplantation for thumb and fonger reconstruction, nerve teansfer for brachial plexus avulsion, resrarch and manufacturing of domestic prostheses and the techniques of artifival joint replacement, surgical treatment of severe scoliosis and classification of idiopathic scoliosis, operative tireatment of bone tumor, and basic research on giant cell tumor of bone.

  17. Successful microsurgical penile replantation following self amputation in a schizophrenic patient

    Directory of Open Access Journals (Sweden)

    Saurabh Gyan

    2010-01-01

    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient .The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  18. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  19. The Flail and Pulseless Upper Limb: an Extreme Case of Traumatic Scapulo-thoracic Dissociation

    Directory of Open Access Journals (Sweden)

    Maria SW

    2015-07-01

    Full Text Available Scapulo-thoracic dissociation is an infrequent injury resulting from high energy trauma which is often associated with severe neurological and vascular injuries which may be unrecognised at the time of presentation. A 24 year-old female presented with bilateral rib fractures, pneumothorax, liver and kidney injuries following a road traffic accident. She also sustained fractures of her right scapula, odontoid, right transverse processes of the thoracic and lumbar vertebrae and a closed fracture of her right femur. Her right upper limb was later noted to be flail and pulseless, due to complete right brachial plexus injury, scapula-thoracic dissociation and subclavian artery avulsion. We managed the upper limb injuries non-operatively, and focused on resuscitation of the patient. Early exploration of the complete brachial plexus injury was not undertaken in spite of the possible associated poor functional outcome as there was no life-threatening indication.

  20. Modification of the Bankart reconstruction using a suture anchor.

    Science.gov (United States)

    Traina, S M; Holtgrewe, J L; King, S

    1998-01-01

    A prospective study was done to determine the effectiveness of a suture anchor in doing a Modified Bankart Reconstruction on the traumatic unidirectional Bankart lesion shoulder. From 1989 to 1991, 26 patients encompassing 27 shoulders with recurrent instability had modified Bankart reconstructions. A minimum 18-month follow-up was obtained by examination of 24 patients with telephone interviews done on two patients. The average follow-up was 23.6 months. A 93.1% good-to-excellent result was obtained using the Bankart rating scale. There were no failures or complications. The surgeon involved in the study thought the suture anchor facilitated the attachment of the avulsed capsulolabral complex in doing the Bankart procedure.

  1. Acute cervical motor radiculopathy induced by neck and limb immobilization in a patient with Parkinson disease.

    Science.gov (United States)

    Shimizu, Toshio; Komori, Tetsuo; Hayashi, Hideaki

    2006-01-01

    A 68-year-old woman with Parkinson disease (PD) presented with acute monoplegia of her left upper extremity after the neck and limb immobilization for several hours. Her sensory function was normal, and the chest X-ray showed left phrenic nerve palsy. Electrophysiological studies showed multi-segment muscle involvement (C3 to T1) including denervation potentials and reduced interference of motor units in needle electromyography. M wave amplitude in peripheral nerve stimulation was preserved except for the ulnar nerve, suggesting both axonal injury and conduction block at the anterior spinal roots. The patient showed fair recovery in several months, suggesting sufficient reinnervation and recovery of conduction block. Incomplete root avulsion was thought to be the pathomechanism of acute cervical motor radiculopathy.

  2. Osteonecrosis in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Poeschl, M.

    1981-12-01

    The following forms are discussed: spontaneous osteonecrosis (Ahlbaeck's necrosis), which extends subchondrally into one of the femur condyles. It usually occurs in older patients, especially females. Blunt trauma may cause similar lesions. These often occur with cartilage and bone avulsions (flake fractures), which are often diagnosed much later (arthroscopy). Patellar chondropathy is increasing in frequency due to more intensive participation in sports. Pain localized at the apex of the patella (patellar apex syndrome) can develop from chondropathy, tendon lesions or primary juvenile necrosis of the patellar apex. Gas emboli occur near the knee joint during deep sea diving. Similar cartilage infarctions are seen in many hemoglobinopathies. The incidence of this is increasing due to the increased number of people immigrating from regions where these diseases are common. We have also observed vascular juvenile lesions of the epi- and metaphyses in Klippel-Trenaunay-Weber's syndrome. Their radiological appearance is similar to that of necroses.

  3. Restorative rehabilitation in a patient with sports trauma

    Science.gov (United States)

    Rashid, Haroon; Vohra, Fahim; Lillywhite, Graeme R.

    2016-01-01

    Sports trauma frequently involves insult to oral soft and hard tissues resulting in loss of tooth structure and tooth loss. Multiple sporting equipment's are employed to prevent irreversible damage to oro-facial structures, and to reduce the overall cost of treatment. However in the undesired consequence of loss of oral structures, multiple treatment options are utilized to restore, esthetics, comfort and function. Osseointegrated implant supported rehabilitation of oral structures in trauma cases provides highly predictable treatment outcomes along with preservation of remaining tissues. This case report presents the management of avulsed teeth caused by hockey stick injury, with osseointegrated dental implant supported fixed partial dentures in esthetic zone using contemporary restorative techniques. PMID:28042278

  4. "Don juan-fracture" as a hint to aortic isthmus rupture.

    Science.gov (United States)

    Suksompong, Sirilak; von Bormann, Benno

    2014-01-01

    We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called "Don-Juan fracture," and aortic rupture at the site of ligamentum arteriosum are discussed.

  5. “Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture

    Science.gov (United States)

    Suksompong, Sirilak; von Bormann, Benno

    2014-01-01

    We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed. PMID:25478249

  6. Stratigraphic evolution of the late Holocene Ganges Brahmaputra lower delta plain

    Science.gov (United States)

    Allison, M. A.; Khan, S. R.; Goodbred, S. L.; Kuehl, S. A.

    2003-02-01

    Sediment cores from the Ganges-Brahmaputra delta in Bangladesh were examined for sedimentological character, clay mineralogy, elemental trends (C, N, S), and 14C geochronology to develop a model for the sedimentary sequence resulting from lower delta plain progradation in the late Holocene. A widespread facies succession from Muddy Sand to Interbedded Mud records progradation of shoal-island complexes and the transition from subtidal to intertidal conditions. Mangrove-vegetated islands and peninsulas represent the final phase of progradation; a Mottled Mud that is deposited by penetration of turbid coastal water into the mangroves during high water events. Organic matter preservation is generally low (Holocene was influenced by regional subsidence patterns in the tectonically active Bengal Basin, which controlled distributary channel avulsion and migration, and the creation of accommodation space.

  7. MRI of the brachial plexus and its region: anatomy and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Wouter van Es, H. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Witkamp, T.D. [Dept. of Radiology, University Hospital, Utrecht (Netherlands); Feldberg, M.A.M. [Dept. of Radiology, University Hospital, Utrecht (Netherlands)

    1995-08-01

    Magnetic resonance imaging (MRI) of the brachial plexus and its region has become the imaging modality of choice, due to its multiplanar capabilities and inherent contrast differences between the brachial plexus, related vessels, and surrounding fat. A total of 41 patients with clinically suspected brachial plexus pathology or tumors in its region were studied. A normal anatomy was found in 12 patients. Pathologic entities included: traumatic nerve-root avulsion (n = 2), hematoma (n = 1), postoperative changes after scalenotomy (n = 2), primary tumor of the brachial plexus (n = 2), primary (n = 8) and metastatic (n = 1) tumors in the superior sulcus, primary (n = 5) and metastatic (n = 4) tumors in the axillary, supra- or infraclavicular region, and changes after nodal dissection and radiation therapy for breast carcinoma (n = 5; 1 patient also had had a prior scalenotomy). There was a positive correlation with surgery in 11 patients, and a negative correlation in 1 patient. (orig.)

  8. Review for the generalist: evaluation of pediatric hip pain

    Directory of Open Access Journals (Sweden)

    Houghton Kristin M

    2009-05-01

    Full Text Available Abstract Hip pathology may cause groin pain, referred thigh or knee pain, refusal to bear weight or altered gait in the absence of pain. A young child with an irritable hip poses a diagnostic challenge. Transient synovitis, one of the most common causes of hip pain in children, must be differentiated from septic arthritis. Hip pain may be caused by conditions unique to the growing pediatric skeleton including Perthes disease, slipped capital femoral epiphysis and apophyseal avulsion fractures of the pelvis. Hip pain may also be referred from low back or pelvic pathology. Evaluation and management requires a thorough history and physical exam, and understanding of the pediatric skeleton. This article will review common causes of hip and pelvic musculoskeletal pain in the pediatric population.

  9. Retroperitoneal hematoma after manual reduction of indirect inguinal hernia.

    Science.gov (United States)

    Xu, Xiequn; Hong, Tao; Li, Binglu; Liu, Wei; Zheng, Chaoji; He, Xiaodong

    2013-07-01

    This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. There was contrast leaked out, which was suspected from inferior epigastric artery. He underwent successful laparotomy. The bleeding ruptured inferior epigastric artery at the interior side of the deep inguinal ring was found, the deep inguinal ring was avulsed, ligature of the inferior epigastric artery and removal of the retroperitoneal hematoma were done, and the patient was discharged from hospital on the seventh postoperative day. This is the first report in the literature on retroperitoneal hematoma caused by manual reduction of indirect inguinal hernia.

  10. 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.)

  11. Risk Factors of Medial Tibial Stress Syndrome(MTSS)

    Institute of Scientific and Technical Information of China (English)

    Sae Yong Lee

    2009-01-01

    @@ Background According to Mubarak[1,2],who first coined the term medial tibial stress syndrome (MTSS)in 1982,the definition of MTSS is " a symptom complex in athletes who experience exercise-induced pain along thedistalposteromedialaspectofthetibia."Previous studies have shown that MTSS accounts for 6 to 15 percent of running related injuries [3-9] and has an incidence among certain populations (ie,military recruits) of up to 35 percent [10].The etiology of MTSS is not well known,but it is commonly believed that the cause is inflammation and possibly an avulsion of the origins of the posterior tibialis and/or the soleus from the periosteum of the posteromedial tibia [10].Traction at the periosteal interface is thought to lead to inflammation and pain at the periosteal-fascial junction.The location of the pain is usually localized over the posterior medial edge of the distal third of the tibia.

  12. 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.

  13. Nerve transfer for treatment of brachial plexus injury:comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves

    Institute of Scientific and Technical Information of China (English)

    侯之启; 徐中和

    2002-01-01

    Objective:To compare the effect of using partial median and ulnar nerves for treatment of C5-6 orC5-7 avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves.Methods:The patients were divided into 2groups randomly according to different surgical procedures.Twelve cases were involved in the first group.The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft,and the spinal accessary nerve was to the suprascapular nerve.Eleven cases were classified into the second group.A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve.The cases were followed up from 1to 3years and the clinical outcome was compared between the two groups.

  14. Occipital Condyle Fracture with Accompanying Meningeal Spinal Cysts as a result of Cervical Spine Injury in 15-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Łukasz Wiktor

    2015-01-01

    Full Text Available The occipital condyle fracture is rare injury of the craniocervical junction. Meningeal spinal cysts are rare tumors of the spinal cord. Depending on location, these lesions may be classified as extradural and subdural, but extradural spinal cysts are more common. We present the case of a 15-year-old girl who suffered from avulsion occipital condyle fracture treated with use of “halo-vest” system. We established that clinical effect after completed treatment is very good. Control MRI evaluation was performed 12 months after removal of “halo-vest” traction, and clinically silent extradural meningeal spinal cysts were detected at the ventral side of the spinal cord in the cervical segment of the spine. Due to clinically silent course of the disease, we decided to use the conservative treatment. The patient remains under control of our department.

  15. Multidisciplinary treatment for a young patient with severe maxillofacial trauma from a snowmobile accident: a case report.

    Science.gov (United States)

    Yamano, Seiichi; Nissenbaum, Mark; Dodson, Thomas B; Gallucci, German O; Sukotjo, Cortino

    2010-01-01

    Abstract This clinical report describes the oral rehabilitation of a 15-year-old male patient who was involved in a snowmobile accident and suffered multiple mid-face and mandibular fractures. Consequences of the accident included avulsion of teeth numbers 5 to 10 and 21 to 26, and a significant amount of maxillary and mandibular anterior alveolar bone loss. The patient underwent open reduction and rigid fixation of the fractured left zygoma, comminuted LeFort I maxillary fracture, and left body of the mandible; closed reduction of the bilateral condylar fractures; autologous corticocancellous bone grafting to the maxilla and mandible; implant placement; and prosthesis fabrication. This multidisciplinary approach successfully restored function and esthetics.

  16. Management of Acute Skin Trauma

    Institute of Scientific and Technical Information of China (English)

    Joel W. Beam

    2010-01-01

    @@ Acute skin trauma (ie, abrasions, avulsions, blisters, incisions, lacerations, and punctures) is common among individuals involved in work, recreational, and athletic activities. Appropriate management of these wounds is important to promote healing and lessen the risk of cross-contamination and infection. Wound management techniques have undergone significant changes in the past 40 years but many clinicians continue to manage acute skin trauma with long-established, traditional techniques (ie, use of hydrogen peroxide, adhesive strips/patches, sterile gauze, or no dressing) that can delay healing and increase the risk of infection. The purpose of this review is to discuss evidence-based cleansing, debridement, and dressing techniques for the management of acute skin trauma.

  17. Total carpometacarpal joint dislocation combined with trapezium fracture, trapezoid dislocation and hamate fracture

    DEFF Research Database (Denmark)

    Gvozdenovic, R; Vadstrup, Lars Soelberg

    2015-01-01

    Multiple metacarpal dislocations combined with carpal fracture - dislocations are rare injuries. We report a new combination of these injuries where fracture-dislocation of the base of the 1st metacarpal bone occurred simultaneously with a comminuted fracture of the trapezium, dislocation...... of the trapezoid and metacarpal joints (2nd to 5th) and an avulsion fracture of the hamate. This specific carpal injury has not been previously described and our description will contribute to understanding the mechanism of these complex injuries. The injury pattern in the case featured here was multifaceted...... and resulted from rupture of both transverse and longitudinal carpal columns. According to the Garcia-Elias classification of axial carpal disruptions, this particular injury mechanism was a combined axial-radial-ulnar type injury. These injuries are extremely rare and are only sporadically described...

  18. Knowledge of Primary School Teachers about the Management of Dental Trauma in Kermanshah, 2012

    Directory of Open Access Journals (Sweden)

    Roohollah Sharifi

    2014-04-01

    Full Text Available Timing and the performance are important factors in the management of dental trauma. The present study was conducted to determine knowledge and effect of demographic factors of primary school teachers in Kermanshah on the management of dental trauma. In this descriptive cross-sectional study, 145 randomly selected primary school teachers were investigated. A self-administered questionnaire was used to collect the data. Data were analyzed by SPSS 17 software. Findings of this study indicated that knowledge of the primary school teachers about the management of dental trauma was insufficient and no significant relationship was observed between gender, experience, academic rank, the number of exposures to dental trauma and the teachers’ knowledge regarding the management of the avulsed or fractures teeth (P>0.05. We recommend in-service training courses and updating the teachers’ information for the management of dental trauma.

  19. Decoronation of an ankylosed tooth for preservation of alveolar bone prior to implant placement.

    Science.gov (United States)

    Filippi, A; Pohl, Y; von Arx, T

    2001-04-01

    A 12-year-old patient sustained avulsions of both permanent maxillary central incisors. Subsequently, both teeth developed replacement resorption. The left incisor was extracted alio loco. The right incisor was treated by decoronation (removal of crown and pulp, but preservation of the root substance). Comparison of both sites demonstrated complete preservation of the height and width of the alveolar bone at the decoronation site, whereas the tooth extraction site showed considerable bone loss. In addition, some vertical bone apposition was found on top of the decoronated root. Decoronation is a simple and safe surgical procedure for preservation of alveolar bone prior to implant placement. It must be considered as a treatment option for teeth affected by replacement resorption if tooth transplantation is not feasible.

  20. Exuberant callus formation misdiagnosed as osteosarcoma: a case report

    Institute of Scientific and Technical Information of China (English)

    Fariba Binesh; Mohammad Sobhan; Reza Nafisi Moghadam; Ali Akhavan

    2013-01-01

    Reactive lesions of bone and soft tissue can appear alarming on histologic examination because they are often cellular and have atypical cytologic features, such as distinct nucleoli, mild hyperchromasia, and mitotic activity. Reactive lesions of bone and periosteum also produce bone and cartilage matrix, resulting in confusion with osteosarcoma or chon-drosarcoma. Careful attention to key cytomorphological features such as the pattern of bone formation, uniform appearance of cells, and absence of atypical mitoses should help identify the reactive nature of a lesion. Correlation with clinical and radiological findings is also imperative to avoid misclassification of the tumor because reactive lesions often arise at sites where osteosarcoma and chondrosarcoma are rare (eg, the hand) and lack aggressive radiological features. Here we pres-ent a case of exuberant callus formation after avulsion fracture of tibia in a three year-old Iranian girl which misdiagnosed as osteosarcoma.

  1. Approach to management of eyes with no light perception after open globe injury

    Directory of Open Access Journals (Sweden)

    Neelakshi Bhagat

    2016-01-01

    Full Text Available Loss of light perception (LP after open globe injury (OGI does not necessarily mean the patient will have permanent complete visual loss. Findings that seem to be associated reliably with permanent profound vision loss after OGI include optic nerve avulsion, optic nerve transection, and profound loss of intraocular contents, which can be identified with CT/MRI imaging albeit with varying degrees of confidence. Eyes with NLP after OGI that undergo successful primary repair with intact optic nerves may be considered for additional surgery, particularly if there is: (1 recovery of LP on the first day after primary repair; (2 treatable pathology underlying NLP status (e.g., extensive choroidal hemorrhage, dense vitreous and subretinal hemorrhage; (3 NLP in the fellow eye. We counsel patients that the chance of recovering ambulatory vision under these circumstances is very low (~5%.

  2. Series of Nine Cases of Axial Displacement of Distal Tibial and/or Fibular Shafts from Aircraft Crashes with Proposal of Potential Mechanisms

    Directory of Open Access Journals (Sweden)

    Richey Stephen L.

    2015-12-01

    Full Text Available Previously, a pair of aircraft crash fatalities was reported by Byard and Tsokos involving extreme trauma to the lower legs with avulsion of the musculature and extrusion of the distal tibial shaft through the inferior aspect of the feet and shoes. This report was important to both the forensics and the injury prevention fields because it demonstrates a finding that may help to indicate not only the severity and nature/direction of an impact but also the position of the extremities at the time of collision with the terrain. Thus, here are reported an additional nine cases out of a larger series of 1182 aircraft fatalities (0.7% with similar findings and discuss the biomechanical origins of such injuries.

  3. Nonoperative management of pediatric aortic injury with seat belt syndrome.

    Science.gov (United States)

    Parrish, Dan W; Barnhorst, Amanda; Trebska-McGowan, Katarzyna; Amendola, Michael; Haynes, Jeffrey H

    2015-08-01

    "Seat belt syndrome" was first described by Garret and Braunstein in 1962. The syndrome involves skin and abdominal wall ecchymosis (seat belt sign) intra-abdominal solid organ and visceral injuries, as well as Chance fractures (compression and/or wedging deformity of the anterior portion of the vertebral body with disruption or fracture of the posterior elements, generally at L1-L3). We present a case of a 12-year-old male involved in a high-speed motor vehicle collision wearing only a lap belt resulting in seat belt syndrome, with disruption of the abdominal wall, mesenteric avulsion with multiple intestinal perforations, abdominal aortic dissection, and an L2 Chance fracture with cord transection. Intraoperative decision making is outlined with this scenario of complex injuries, and the literature of seat belt syndrome associated with blunt aortic injuries and its management is reviewed.

  4. Scapulothoracic dissociation: An emerging high-energy trauma in medical literature

    Directory of Open Access Journals (Sweden)

    Andrew McCague

    2012-01-01

    Full Text Available Scapulothoracic dissociation (STD is a devastating consequence of high-energy trauma sustained by the shoulder girdle that can easily result in rapid mortality. Since described by Oreck et al. in 1984, STD has been reported in a handful of journals and individual case series, though is still considered a rare occurrence in the context of shoulder injuries. In this report, we examine the case of a 25-year-old female involved in a high-speed rollover auto accident. Unique to this case was the discovery of a completely transected axillary artery and vein with intracorporeal bleeding and complete avulsion of the ipsilateral brachial plexus requiring immediate ligation of the vessels followed by interval above-elbow-amputation and later glenohumeral disarticulation.

  5. Platelet-Rich Fibrin: An Autologous Fibrin Matrix in Surgical Procedures: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Amir Hossein Nejat

    2011-01-01

    Full Text Available Introduction: The healing process after surgery is a challenging issue for surgeons. Various materials and techniques have been developed to facilitate this process and reduce its period. Fibrin adhesives are often used in cardiothoracic and vascular surgery to seal diffuse microvascular bleeding and in general and plastic surgery to seal wound borders. This Case report and literature review will introduce the various usages of platelet-rich fibrin in different surgical procedures and the method of producing the matrix. Case Report: A 24-year old man with periorbital skin avulsion treated with PRF membrane has been reported and discussed in this paper.  Conclusion: Platelet-rich fibrin is a natural autologous fibrin matrix, which can be produced with a simple blood sample and a table centrifuge. The material has been used in a wide range of surgical procedures to shorten the healing period and reduce post-surgical complications.

  6. Operative and endovascular management of extracranial vertebral artery aneurysm in Ehlers-Danlos syndrome:a clinical dilemma--case report and literature review.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2002-01-01

    The most prevalent lesion of the vertebral artery is an atheromatous plaque located at its origin from the subclavian artery. A case of successful management of a symptomatic vertebral artery aneurysm due to Ehlers-Danlos syndrome is reported. The patient had asymptomatic posterior intracerebral artery dissection on the contralateral side. A common carotid artery to V-3 segment bypass using reversed saphenous vein graft was carried out. Avulsion of the V-2 segment occurred peroperatively and endovascular coil embolization of the vertebral artery aneurysm was performed. Endovascular equipment and training must be in the armamentarium of vascular surgeons as more complex cases are being treated, which demands new approaches for ultimate clinical success. This unique case outlines what might unexpectedly occur. Endovascular intervention as an adjuvant procedure provides a satisfactory outcome in what could have been a catastrophe.

  7. Microneurovascular reimplantation in a case of total penile amputation

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common aetiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis, which was successfully reattached by using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  8. 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.

  9. Nerve transfer helps repair brachial plexus injury by increasing cerebral cortical plasticity

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Zuopei Wu; Xinhong Wang; Xiaoxiao Tan; Yudong Gu

    2014-01-01

    In the treatment of brachial plexus injury, nerves that are functionally less important are trans-ferred onto the distal ends of damaged crucial nerves to help recover neuromuscular function in the target region. For example, intercostal nerves are transferred onto axillary nerves, and accessory nerves are transferred onto suprascapular nerves, the phrenic nerve is transferred onto the musculocutaneous nerves, and the contralateral C7 nerve is transferred onto the median or radial nerves. Nerve transfer has become a major method for reconstructing the brachial plexus after avulsion injury. Many experiments have shown that nerve transfers for treatment of brachi-al plexus injury can help reconstruct cerebral cortical function and increase cortical plasticity. In this review article, we summarize the recent progress in the use of diverse nerve transfer methods for the repair of brachial plexus injury, and we discuss the impact of nerve transfer on cerebral cortical plasticity after brachial plexus injury.

  10. The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, Javier; Jbara, Marlena; Maimon, Ron [Department of Radiology, Maimonides Medical Center, 4802 Tenth Avenue, NY 11219, Brooklyn (United States); Matityahu, Amir; Hwang, Ki [Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, NY (United States); Padron, Mario [Department of Radiology, Clinica CEMTRO, Madrid (Spain); Mota, Javier [Department of Radiology, Instituto Clinica Corachan, Barcelona (Spain); Beltran, Luis [New York Medical College, Valhalla, NY (United States); Sundaram, Murali [Department of Radiology, Mayo Clinic, Rochester, MN (United States)

    2003-08-01

    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.)

  11. Hip ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Martinoli, Carlo, E-mail: carlo.martinoli@libero.it [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa [Radiologia, DISC, Università di Genova, Largo Rosanna Benzi 8, I-16132 Genoa (Italy); Valle, Maura [Radiologia, Gaslini Children Hospital, Genova (Italy); Tagliafico, Alberto [Radiologia, National Institute for Cancer Research, Genoa (Italy)

    2012-12-15

    In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.

  12. Pattern of injury in those dying from traumatic amputation caused by bomb blast.

    Science.gov (United States)

    Hull, J B; Bowyer, G W; Cooper, G J; Crane, J

    1994-08-01

    Traumatic amputation of limbs caused by bomb blast carries a high risk of mortality. This paper describes 73 amputations in 34 deaths from bomb blast in Northern Ireland. The principal aim was to determine the sites of traumatic amputation to provide a biophysical basis for the development of protective measures. Few amputations were through joints; nearly all were through the bone shafts. The most common site in the tibia was the upper third. The distribution of femoral sites resulting from car bombs differed from that characterizing other types of explosion. For car bombs the principal site of amputation was the upper third; for other types of device it was the lower third. It is concluded that flailing is not a notable contributor to limb avulsion. The pattern of amputation is consistent with direct local pressure loads leading to bone fracture; the amputation itself is a secondary event arising from the flow of combustion products.

  13. Neurotrophin-3-mediated regeneration and recovery of proprioception following dorsal rhizotomy.

    Science.gov (United States)

    Ramer, Matt S; Bishop, Thomas; Dockery, Peter; Mobarak, Makarim S; O'Leary, Donald; Fraher, John P; Priestley, John V; McMahon, Stephen B

    2002-02-01

    Injured dorsal root axons fail to regenerate into the adult spinal cord, leading to permanent sensory loss. We investigated the ability of intrathecal neurotrophin-3 (NT3) to promote axonal regeneration across the dorsal root entry zone (DREZ) and functional recovery in adult rats. Quantitative electron microscopy showed robust penetration of CNS tissue by regenerating sensory axons treated with NT3 at 1 and 2 weeks postrhizotomy. Light and electron microscopical anterograde tracing experiments showed that these axons reentered appropriate and ectopic laminae of the dorsal horn, where they formed vesicle-filled synaptic buttons. Cord dorsum potential recordings confirmed that these were functional. In behavioral studies, NT3-treated (but not untreated or vehicle-treated) rats regained proprioception. Recovery depended on NT3-mediated sensory regeneration: preventing regeneration by root excision prevented recovery. NT3 treatment allows sensory axons to overcome inhibition present at the DREZ and may thus serve to promote functional recovery following dorsal root avulsions in humans.

  14. Fracture of posterior margin of lumbar vertebral body

    Directory of Open Access Journals (Sweden)

    Krishnan Ajay

    2005-01-01

    Full Text Available Background: Avulsion or fracture of posterior ring apophysis of lumbar vertebra is not a common clinical entity and is missed often. These fractures are mostly traumatic lesions typically seen in adolescents and young adults, because fusion in this area is not complete until the age of 18 to 25 years. These fractures are occult on plain radiographs and are frequently missed due to unfamiliarity with the entity. But, CT scanning and MR imaging shows characteristic picture. Methods: We had 21 cases of fracture of posterior margin of a lumbar vertebral body from 1991 to 2002. Fracture in all patients were classified according to CT imaging, into the three types described by Takata et al. Out of these, 8 patients were of type I, 4 patients of type II and 9 patients of type III respectively. Focal deficit / muscle weakness was present in only three patients. No fractures of type IV (Epstein et al was found. Twelve patients were treated conservatively and 9 patients were treated by posterior decompression with total laminectomy and removal of retropulsed fragment and discectomy. Results: The mean follow-up period was of 42 months. Conventional radiography could locate the fracture in only 6 cases and CT scan was required in all cases for stamping the diagnosis and classification. Though it is uncommon, high index of suspicion is required to diagnose it, in especially adolescent patients. All the 21 patients had good outcome following the management. Conclusion: Avulsion or fracture of posterior margin of lumbar vertebral body is not so rare entity. In children and young adults diagnosed as having lumbar disc herniation, this lesion may be the proper diagnosis. These fractures need to be accurately diagnosed because as compared to simple disc herniations these fractures require more extensive exposure and resection to relieve the nerve impingent.

  15. Genesis of textural contrasts in subsurface soil horizons in the Northern Pantanal-Brazil

    Directory of Open Access Journals (Sweden)

    Alexandre Ferreira do Nascimento

    2013-10-01

    Full Text Available The Pantanal region can be characterized as a quaternary floodplain with predominant sedimentation in the form of alluvial fans. In the geomorphologic and sedimentary evolution, the avulsion process is inherent to this depositional system and its dynamics, together with surface water floods, influence soil sedimentation on this plain. The knowledge and differentiation of these two events can contribute to a better understanding of the variability of soil properties and distribution under the influence of these sedimentation processes. Therefore, this study investigated the genesis of soils in the Northern Pantanal with textural contrasts in deeper horizons and their relationship with the depositional system dynamics. We analyzed four soil profiles in the region of Barão de Melgaço, Mato Grosso State, Brazil (RPPN SESC Pantanal. Two profiles were sampled near the Rio Cuiabá (AP1 and AP4 and two near the Rio São Lourenço (AP10 and AP11. In AP11, the horizons contrast in particle size between the profile basis and the surface. In AP1, AP4 and AP10, the horizons overlaying the sand layer have similar particle size properties, mainly in terms of sand distribution. In the first case, floods (surface water seem to have originated the horizons and layers with contrasting texture. In the second case, avulsion is the most pronounced process. Therefore, the two modes can form soils with contrasting texture that are discriminable by soil morphology, based on the distinct features associated to the specific sedimentation processes.

  16. Channel arrangements and depositional styles in the São Lourenço fluvial megafan, Brazilian Pantanal wetland

    Science.gov (United States)

    Assine, Mario Luis; Corradini, Fabrício Anibal; Pupim, Fabiano do Nascimento; McGlue, Michael Matthew

    2014-03-01

    The Brazilian Pantanal is an extensive lowland tropical basin characterized by the presence of fluvial megafans and seasonally-inundated savanna floodplain wetlands. With an area of about 16,000 km2, the São Lourenço is the second largest megafan in the Pantanal. Three distinct fluvial channel styles that formed at different times during the late Quaternary are found here. A geomorphological and sedimentary assessment of these depositional patterns provides valuable insight on the environmental context of their evolution. New optically stimulated luminescence data indicate that the upper five meters of sediment in the São Lourenço megafan has been accumulating since the late Pleistocene. Ancient fan lobes, located in upper and intermediate fan settings, consist of medium- and coarse-grained fluvial sands and exhibit well-preserved distributary braided paleochannels on their surfaces. As the megafan evolved through time, Pleistocene lobes were incised by a prominent valley filled with Holocene-aged meander belt deposits, which consist of silts interbedded with very fine sands and clays. Currently, the incised valley is a zone of sediment bypass. Modern deposition occurs along the distal toe of the megafan system, where lobes characterized by distributary channel-levee ridges are widespread. These features formed by progradation of avulsion belts into a broad swampy floodbasin, which caused the lower portion of the meander belt to be abandoned. The significant differences observed in intra-fan morphology appear to be linked to the variability in effective precipitation. Fan lobes deposited with braided distributary channels occurred under relatively dry conditions in the late Pleistocene. By contrast, aggradational meander belt deposits and lobes with distributary channel-levee ridges formed during fluctuating precipitation conditions of the Holocene, when the Pantanal emerged from deglacial aridity. Modern lobes form under heavy seasonal flooding and deposition

  17. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery.

    Science.gov (United States)

    Del Corso, Marco; Vervelle, Alain; Simonpieri, Alain; Jimbo, Ryo; Inchingolo, Francesco; Sammartino, Gilberto; Dohan Ehrenfest, David M

    2012-06-01

    Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In periodontology and dentoalveolar surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this first article, we describe and discuss the current published knowledge about the use of PRP and PRF during tooth avulsion or extraction, mucogingival surgery, Guided Tissue Regeneration (GTR) or bone filling of periodontal intrabony defects, and regeneration of alveolar ridges using Guided Bone Regeneration (GBR), in a comprehensive way and in order to avoid the traps of a confusing literature and to highlight the underlying universal mechanisms of these products. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the systematic use of L-PRF (Leukocyte- and Platelet- Rich Fibrin) clots and membranes during tooth avulsion, cyst exeresis or the treatment of gingival recessions by root coverage. The use of L-PRF also allowed to define new therapeutic principles: NTR (Natural Tissue Regeneration) for the treatment of periodontal intrabony lesions and Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges. In periodontology, this field of research will soon find his golden age by the development of user-friendly platelet concentrate procedures, and the definition of new efficient concepts and clinical protocols.

  18. Repair of distal biceps brachii tendon assessed with 3-T magnetic resonance imaging and correlation with functional outcome

    Energy Technology Data Exchange (ETDEWEB)

    Alemann, Guillaume; Dietsch, Emmanuel [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Gallinet, David; Obert, Laurent [University Hospital of Besancon, Department of Orthopedic Surgery, Besancon (France); Kastler, Bruno; Aubry, Sebastien [University Hospital of Besancon, Department of Musculoskeletal Imaging, Besancon (France); Franche Comte University, I4S Laboratory-EA 4268-IFR 133, Besancon (France)

    2015-05-01

    Objectives were to study the MRI appearance of the repaired distal biceps tendon (DBT), anatomically reinserted, and to search for a correlation between tendon measurements and functional results. Twenty-five patients (mean age, 49 ± 4.9 years old) who benefited from 3-T MRI follow-up of the elbow after surgical reinsertion of the DBT were retrospectively included and compared to a control group (n = 25; mean age, 48 ± 10 years old). MRI was performed during the month of clinical follow-up and on average 22 months after surgery. Delayed complications (secondary avulsion, new rupture), intratendinous osteoma, tendinous signal on T1-weighted (T1{sub w}) and fat-suppressed proton density-weighted (FS-PD{sub w}) images as well as DBT measurements were recorded. The maximum isometric elbow flexion strength (MEFS) and range of motion of the elbow were assessed. Repaired DBT demonstrated a heterogeneous but normally fibrillar structure. Its low T1{sub w} signal was less pronounced than that of normal tendons, and the FS-PD{sub W} image signal was similar to that of T1{sub w} images. MRI detected seven osteomas (Se = 53 % vs. plain radiography), one textiloma and one secondary avulsion. Repaired DBT measurements were significantly correlated with MEFS (dominant arm R2: 0.38; nondominant arm R2: 0.54); this correlation involved the insertion surface (Δ = -75.7 mm{sup 2}, p = 0.046), transverse diameter (Δ = -2.6 mm, p = 0.018), anteroposterior diameter at the level of the radial head (Δ = -3.9 mm, p = 0.001) and DBT cross-sectional area (Δ = -50.2 mm{sup 2}, p = 0.003). The quality of functional outcome after anatomical elbow rehabilitation of DBT correlates with the extent of tendinous hypertrophy during the healing process. (orig.)

  19. Arthroscopic rotator cuff repair: analysis of technique and results at 2- and 3-year follow-up.

    Science.gov (United States)

    Tauro, J C

    1998-01-01

    We present 53 patients who underwent arthroscopic rotator cuff repair and had a minimum of 2-year follow-up. Most tears were avulsions of the supraspinatus from the greater tuberosity, some with associated longitudinal tears. Longitudinal tears were repaired with a side-to-side suturing technique. Avulsion tears from the tuberosity were repaired using nonretrievable suture anchors. Traditional open-mobilization techniques, such as elevating the cuff off the glenoid neck and scapular fossa, and cutting the coraco-humeral ligament, were performed arthroscopically as needed. All repairs were performed using O-PDS or 1-PDS suture and a 7-mm suture punch for suture delivery. Both simple and mattress suture configurations were used. An anterolateral operative portal was used in most cases. A modified UCLA rating system that included additional points for abduction range of motion and strength was adapted for clinical evaluation in this study (maximum score, 45 points). The average preoperative rating was 17 (range, 9 to 26). The average postoperative rating was 41 (range, 16 to 45). There were 36 excellent (41 to 45 points), 13 good (36 to 40 points), 1 fair (30 to 35 points), and 3 poor (mobilization is relatively simple and has allowed us to repair larger tears. Based on our experience, arthroscopic rotator cuff repair is technically achievable and a superior alternative in selected cases for an experienced shoulder arthroscopist. Patients who underwent arthroscopic repairs had less scarring and shorter hospital stays and, we believe, less postoperative pain and easier rehabilitation compared with open repairs.

  20. A model for simulating the deposition of water-lain sediments in dryland environments

    Directory of Open Access Journals (Sweden)

    M. A. Bunch

    2004-01-01

    Full Text Available A numerical process-imitating model, the Discrete Storm Event Sedimentation Simulator (DSESS, has been developed to represent the climatic and hydraulic conditions of drylands in modelling their geomorphological development and sedimentary facies distributions. The ultimate aim is to provide insights into the lateral variability of permeability in the Triassic Sandstone aquifers of the UK for the study of solute movement. DSESS employs discrete storm-flood automata, released across a cellular landscape, to model sediment transport: erosion, migration and deposition. Sediment classes with different grain sizes can be modelled. Empirical process-based equations are used to quantify the movement of the automata, their erosion potential, sediment-carrying capacity and interaction with the underlying sediments. The approach emphasises the sequence of dryland storm events and associated floods rather than their timing. Flood events are assumed to be discrete in time. Preliminary tests carried out with DSESS using simple systems and idealised initial conditions produce lithological and land surface features characteristic of dryland settings and indicate the potential of the model for large-scale, long-time modelling of sedimentary facies development. Markedly different results are observed across the range of tests carried out in response to the non-linear interactions between the different elements of the landscape and the floodwaters simulated with DSESS. Simulations show that sediment accumulations develop concave upward radial profiles, plano-convex cross-profiles and possess a general lateral grading of sediment with distance from source. The internal grain size architecture shows evidence of both persistent and rapidly changing flow conditions, with both lateral and longitudinal stepping of coarse bodies produced by ‘scour and fill’ events and random avulsions. Armoured layers form so that near-surface sediments have increased likelihood of

  1. 自体富血小板纤维蛋白用于延迟牙再植1例%Using platelet-rich fibrin as an autologous media for delayed teeth replantation:a cases report

    Institute of Scientific and Technical Information of China (English)

    王伟; 黄超; 刘艳丽; 赵寅华; 张旻; 陈永进

    2016-01-01

    PRF ( platelet rich fibrin) is a kind of second generation platelet concentrate with a three dimensional reticular structure which can regulate inflammation, accelerate tissue healing, and release a variety of growth factors slowly and continuously. However, no clinical study has used PRF for the treatment of avulsed tooth. In this study, a delayed and dry-reserved avulsion tooth was replanted with autologous PRF. 12-month follow-up showed that the tooth recovered well, the peridental membrane was healed, no root resorption occurred, and the height of alveolar bone was restored.%富血小板纤维蛋白( PRF)是一种立体三维网状结构的第二代血小板浓缩物,它能够调节炎症,促进组织愈合。并且能够缓慢持续释放多种生长因子。大量文献报道PRF可以促进口腔软硬组织的愈合,但尚未将其应用于临床牙再植的治疗中。本文联合自体PRF颗粒对1例撕脱2 h且干燥保存的离体牙进行延迟再植、复位固定及后续牙髓治疗。随访1年,脱位牙恢复良好,达到牙周膜性愈合,没有出现牙根吸收,且牙槽骨高度得到恢复。

  2. Constraints on the duration of the Paleocene-Eocene Thermal Maximum by orbitally-influenced fluvial sediment records of the northern Bighorn Basin, Wyoming, USA

    Science.gov (United States)

    van der Meulen, Bas; Abels, Hemmo; Meijer, Niels; Gingerich, Philip; Lourens, Lucas

    2016-04-01

    The addition of major amounts of carbon to the exogenic carbon pool caused rapid climate change and faunal turnover during the Paleocene-Eocene Thermal Maximum (PETM) around 56 million years ago. Constraints are still needed on the duration of the onset, main body, and recovery of the event. The Bighorn Basin in Wyoming provides expanded terrestrial sections spanning the PETM and lacking the carbonate dissolution present in many marine records. Here we provide new carbon isotope records for the Polecat Bench and Head of Big Sand Coulee sections, two parallel sites in the northern Bighorn Basin, at unprecedented resolution. Cyclostratigraphic analysis of these fluvial sediment records using descriptive sedimentology and proxy records allows subdivision into intervals dominated by avulsion deposits and intervals dominated by overbank deposits. These sedimentary sequences alternate in a regular fashion and are related to climatic precession. Correlation of the two, 8-km-spaced sections shows that the avulsion-overbank cycles are laterally consistent. The presence of longer-period alternations, related to modulation by the 100-kyr eccentricity cycle, corroborates the precession influence on the sediments. Sedimentary cyclicity is then used to develop a floating precession-scale age model for the PETM carbon isotope excursion (CIE). We find a CIE body encompassing 95 kyrs aligning with marine cyclostratigraphic age models. The duration of the CIE onset is estimated at 5 kyrs, but difficult to determine because sedimentation rates vary at the sub-precession scale. The CIE recovery starts with a 2 to 4 per mille step and lasts 40 or 90 kyrs, depending on what is considered the carbon isotope background state.

  3. EFFECT OF SCROTAL RECONSTRUCTION WITH FREE SKIN GRAFT ON SPERMATOGENESIS%游离植皮重建阴囊对生精功能的影响

    Institute of Scientific and Technical Information of China (English)

    孙广峰; 王达利; 魏在荣; 金文虎; 邓呈亮

    2011-01-01

    Objective To summarize the effect of free skin graft for repairing scrotal avulsion injury, and to investigate the repair impact of the method on spermatogenesis. Methods Between June 2001 and June 2010, 8 cases of complete avulsion injury of the scrotal skin were treated with the free skin graft, aged 22 to 64 years (mean, 29 years). The causes of injury included machine twisting in 4 cases, animal attack in 3 cases, and traffic accident in 1 case. The time between injury and hospital ization was 1-7 hours (mean, 3.5 hours). Five cases complicated by avulsion of penile skin, 3 by perineal laceration with exposure of testes and spermatic cord, and 1 by avulsion of leg skin. Results After 10 days, 80% to 95% grafted skin survived. The reconstructed scrotum had shrinks and the wound healed by first intention after dressing change. Eight patients were followed up 12 to 24 months (mean, 16 months). At last follow-up, the patients had relaxed and droop scrotum, and penile erection was normal. Semen quality analysis showed: semen volume of 2-6 mL (mean, 4.2 mL); complete liquefaction with liquefaction time of 15-30 minutes (mean, 23 minutes); sperm density of (12-27) x 106/mL (mean, 16 x 106/mL); sperm motility of 45%-65% (mean, 56%); and sperm motility (grade A) of 25%-42% (mean, 32%). Conclusion Complete avulsion of the scrotal skin can be repaired by free skin graft, which has no significant effect on spermatogenesis.%目的 总结撕脱皮肤反取皮回植重建阴囊治疗阴囊皮肤完全撕脱伤的疗效,探讨该方法修复后对生精功能的影响.方法 2001年6月一2010年6月,对8例阴囊皮肤完全撕脱伤患者行撕脱皮肤反取皮回植修复重建阴囊.年龄22~64岁,平均29岁.致伤原因:机器绞伤4例,家畜攻击致伤3例,交通事故伤1例.伤后至入院时间为1~7 h,平均3.5 h.伴阴茎皮肤撕脱伤5例,会阴处部分撕裂伤3例,睾丸、精索均外露,无明显挫伤;伴大腿皮肤撕脱伤1例.结果 术后10d

  4. Analysis of the 2006 block-and-ash flow deposits of Merapi Volcano, Java, Indonesia, using high-spatial resolution IKONOS images and complementary ground based observations

    Science.gov (United States)

    Thouret, Jean-Claude; Gupta, Avijit; Liew, Soo Chin; Lube, Gert; Cronin, Shane J.; Surono, Dr

    2010-05-01

    On 16 June 2006 an overpass of IKONOS coincided with the emplacement of an active block-and-ash flow fed by a lava dome collapse event at Merapi Volcano (Java, Indonesia). This was the first satellite image recorded for a moving pyroclastic flow. The very high-spatial resolution data displayed the extent and impact of the pyroclastic deposits emplaced during and prior to, the day of image acquisition. This allowed a number of features associated with high-hazard block-and-ash flows emplaced in narrow, deep gorges to be mapped, interpreted and understood. The block-and-ash flow and surge deposits recognized in the Ikonos images include: (1) several channel-confined flow lobes and tongues in the box-shaped valley; (2) thin ash-cloud surge deposit and knocked-down trees in constricted areas on both slopes of the gorge; (3) fan-like over bank deposits on the Gendol-Tlogo interfluves from which flows were re-routed in the Tlogo secondary valley; (4) massive over bank lobes on the right bank from which flows devastated the village of Kaliadem 0.5 km from the main channel, a small part of this flow being re-channeled in the Opak secondary valley. The high-resolution IKONOS images also helped us to identify geomorphic obstacles that enabled flows to ramp and spill out from the sinuous channel, a process called flow avulsion. Importantly, the avulsion redirected flows to unexpected areas away from the main channel. In the case of Merapi we see that the presence of valley fill by previous deposits, bends and man-made dams influence the otherwise valley-guided course of the flows. Sadly, Sabo dams (built to ameliorate the effect of high sediment load streams) can actually cause block-and-ash flows to jump out of their containing channel and advance into sensitive areas. Very-high-spatial resolution satellite images are very useful for mapping and interpreting the distribution of freshly erupted volcanic deposits. IKONOS-type images with 1-m resolution provide opportunities to

  5. Coastal morphodynamics and Chenier-Plain evolution in southwestern Louisiana, USA: A geomorphic model

    Science.gov (United States)

    McBride, Randolph A.; Taylor, Matthew J.; Byrnes, Mark R.

    2007-08-01

    ridge, and spit. To understand the long-term evolution of a coastal depositional system, primary process-response mechanisms and patterns found along the modern Chenier-Plain coast were first identified, especially tidal-inlet processes associated with the Sabine, Calcasieu, and Mermentau Rivers. Tidal prism ( Ω) and quantity of littoral transport ( Mtotal) are the most important factors controlling inlet stability. Greater discharge and/or tidal prism increase the ability of river and estuarine systems to interrupt longshore sediment transport, maintain and naturally stabilize tidal entrances, and promote updrift deposition. Thus, prior to human modification and stabilization efforts, the Mermentau River entrance would be classified as wave-dominated, Sabine Pass as tide-dominated, and Calcasieu Pass as tide-dominated to occasionally mixed. Hoyt [Hoyt, J.H., 1969. Chenier versus barrier, genetic and stratigraphic distinction. Am. Assoc. Petrol. Geol. Bull., 53: 299-306] presented the first detailed depositional model for chenier genesis and mudflat progradation, which he attributed to changes in Mississippi River flow direction (i.e., delta switching) caused by upstream channel avulsion. However, Hoyt's model oversimplifies Chenier-Plain evolution because it omits ridges created by other means. Thus, the geologic evolution of the Chenier Plain is more complicated than channel avulsions of the Mississippi River, and it involved not only chenier ridges (i.e., transgressive), but also ridges that are genetically tied to regression (beach ridges) and lateral accretion (recurved spits). A six-stage geomorphic process-response model was developed to describe Chenier-Plain evolution primarily as a function of: (i) the balance between sediment supply and energy dissipation associated with Mississippi River channel avulsions, (ii) local sediment reworking and lateral transport, (iii) tidal-entrance dynamics, and (iv) possibly higher-than-present stands of Holocene sea level

  6. Laws, Place, History and the Interpretation of Earth Surface Systems

    Science.gov (United States)

    Phillips, Jonathan

    2016-04-01

    The state of an Earth surface system (ESS is determined by three sets of factors: Laws, place, and history. Laws (L = L1, L2, . . . , Ln) are the n general principles, relationships, and representations applicable to any such system at any time. Place factors (P = P1, P2, . . . , Pm) are the m relevant properties or characteristics of the local or regional environment - e.g., climate, tectonic setting, geology, traits of the local biota, etc. History factors (H = H1 , H2, . . . , Hq) include the previous evolutionary pathway of the ESS, its stage of development, past disturbance, and in some contexts initial conditions. Geoscience investigation may be focused on laws (e.g., theoretical deductions, process modeling, laboratory experiments), place (e.g., regional geology or geography, soil-landscape studies), or history (e.g., paleoenvironmental studies, environmental history, historical geology or geography). Ultimately, however, all three sets of factors are necessary to fully understand and explain ESS. Beyond providing a useful checklist (analogous to the factorial models often used in pedology and ecology), the LPH framework gives us analytical traction to some difficult research problems. For example, studies of the avulsions of three southeast Texas rivers showed substantial differences in avulsion regimes and resulting alluvial morphology, despite the proximity and superficial similarity of the systems. Avulsion dynamics are governed by the same laws in all three cases [L(A) = L(B) = L(C)], and the three rivers, once part of a single system at lower sea-levels, have undergone the same sea-level, climate, and tectonic histories, as well as the same general types of anthropic impacts [H(A) ≈ H(B) ≈ H(C)]. Though the regional-scale environmental controls are similar, local details such as the location of the modern main channel relative to Pleistocene meander channels differ, and thus these place factors explain the differences between the rivers. The LPH

  7. Ganges-Brahmaputra Delta: Balance of Subsidence, Sea level and Sedimentation in a Tectonically-Active Delta (Invited)

    Science.gov (United States)

    Steckler, M. S.; Goodbred, S. L.; Akhter, S. H.; Seeber, L.; Reitz, M. D.; Paola, C.; Nooner, S. L.; DeWolf, S.; Ferguson, E. K.; Gale, J.; Hossain, S.; Howe, M.; Kim, W.; McHugh, C. M.; Mondal, D. R.; Petter, A. L.; Pickering, J.; Sincavage, R.; Williams, L. A.; Wilson, C.; Zumberge, M. A.

    2013-12-01

    Bangladesh is vulnerable to a host of short and long-term natural hazards - widespread seasonal flooding, river erosion and channel avulsions, permanent land loss from sea level rise, natural groundwater arsenic, recurrent cyclones, landslides and huge earthquakes. These hazards derive from active fluvial processes related to the growth of the delta and the tectonics at the India-Burma-Tibet plate junctions. The Ganges and Brahmaputra rivers drain 3/4 of the Himalayas and carry ~1 GT/y of sediment, 6-8% of the total world flux. In Bangladesh, these two great rivers combine with the Meghna River to form the Ganges-Brahmaputra-Meghna Delta (GBMD). The seasonality of the rivers' water and sediment discharge is a major influence causing widespread flooding during the summer monsoon. The mass of the water is so great that it causes 5-6 cm of seasonal elastic deformation of the delta discerned by our GPS data. Over the longer-term, the rivers are also dynamic. Two centuries ago, the Brahmaputra River avulsed westward up to 100 km and has since captured other rivers. The primary mouth of the Ganges has shifted 100s of km eastward from the Hooghly River over the last 400y, finally joining the Brahmaputra in the 19th century. These avulsions are influenced by the tectonics of the delta. On the east side of Bangladesh, the >16 km thick GBMD is being overridden by the Burma Arc where the attempted subduction of such a thick sediment pile has created a huge accretionary prism. The foldbelt is up to 250-km wide and its front is buried beneath the delta. The main Himalayan thrust front is geologic research in Bangladesh is that the rapid sediment accumulation preserves a detailed structural and stratigraphic archive. We have been tapping into these records using the combination of a local, low-cost drilling method, resistivity imaging and MCS seismics, while GPS, seismology and other geophysical methods are helping to unravel GBMD dynamics. Five transects of >130 wells are

  8. Imaging beneath the skin of large tropical rivers: Clay controls on system morphodynamics revealed by novel CHIRP sub-surface sonar and deep coring along the Fly and Strickland Rivers, Papua New Guinea (Invited)

    Science.gov (United States)

    Aalto, R. E.; Grenfell, M.; Lauer, J. W.

    2010-12-01

    Tropical rivers dominate Earth’s fluvial fluxes for water, carbon, and mineral sediment. They are characterized by large channels and floodplains, old system histories (in comparison to many temperate rivers), frequent and prolonged periods of flooding, and a clay-dominated sediment flux transported above a sandy bed. However, limited insight is available regarding the underlying bed & floodplain strata -- material that underpins system mobility and morphodynamics. Available data commonly stems from “skin-deep” approaches such as GIS analysis of imagery, shallow sampling of a surface veneer, & topographic profiling during lower river stages. Given the large temporal & spatial scales of such systems, new approaches are needed to see below lag deposits on mobile sandy beds & deep into expansive floodbasins. Furthermore, such data are needed to test whether we can usefully interpret large tropical river morphology using direct analogies to observations from small temperate sytems. Systems responding to sea level rise, pending avulsions, or an increase/contrast in sediment load would provide especially valuable insight. We conducted a field campaign along the Fly and Strickland Rivers in Papua New Guinea (discharge ~ 5,400 CMS). Immediate results were obtained using a dual-frequency CHIRP sub-bottom profiler optimized for fluvial environments, with which we were able to image 10-20m below the river/lake bed. We were able to distinguish sandy deposits from harder clay and silt lenses and also collected bed grab samples to verify our sonar results. Deep borehole samples (5-15m), push cores, and cutbank profiles of material strength confirmed observations from the sonar profiling. We simultaneously collected side-scan sonar imagery plus DGPS water/bed elevations. Findings include: 1) The prevalence of hard clay beneath the bed at many locations along the Lower Fly and Strickland Rivers, retarding migration; 2) Unusual bed morphology along the lower Middle Fly River

  9. Fluvial system response to late Pleistocene-Holocene sea-level change on Santa Rosa Island, Channel Islands National Park, California

    Science.gov (United States)

    Schumann, R. Randall; Pigati, Jeffrey S.; McGeehin, John P.

    2016-09-01

    Santa Rosa Island (SRI) is one of four east-west aligned islands forming the northern Channel Islands chain, and one of the five islands in Channel Islands National Park, California, USA. The island setting provides an unparalleled environment in which to record the response of fluvial systems to major changes of sea level. Many of the larger streams on the island occupy broad valleys that have been filled with alluvium and later incised to form steep- to vertical-walled arroyos, leaving a relict floodplain as much as 12-14 m above the present channel. The period of falling sea level between the end of the last interglacial highstand at ~ 80 ka and the last glacial lowstand at ~ 21 ka was marked by erosion and incision in the uplands and by deposition of alluvial sediment on the exposed marine shelf. Sea level rose relatively rapidly following the last glacial lowstand of - 106 m, triggering a shift from an erosional to a depositional sedimentary regime. Accumulation of sediment occurred first through vertical and lateral accretion in broad, shallow channels on the shelf. Channel avulsion and delta sedimentation produced widespread deposition, creating lobes or wedges of sediment distributed across relatively large areas of the shelf during the latest Pleistocene. Backfilling of valleys onshore (landward of present sea level) appears to have progressed in a more orderly and predictable fashion throughout the Holocene primarily because the streams were confined to their valleys. Vertical aggradation locally reduced stream gradients, causing frequent overbank flooding and lateral channel shift by meandering and/or avulsion. Local channel gradient and morphology, short-term climate variations, and intrinsic controls also affected the timing and magnitudes of these cut, fill, and flood events, and are reflected in the thickness and spacing of the episodic alluvial sequences. Floodplain aggradation within the valleys continued until at least 500 years ago, followed by

  10. Geomorphic response to large-dam removal: Impacts of a massive sediment release to the Elwha River, Washington

    Science.gov (United States)

    Magirl, C. S.; Ritchie, A.; Bountry, J.; Randle, T. J.; East, A. E.; Hilldale, R. C.; Curran, C. A.; Pess, G. R.

    2015-12-01

    The 2011-2014 staged removals of two nearly century-old dams on the Elwha River in northwest Washington State, the largest dam-removal project in the United States, exposed 21 million m3 of reservoir-trapped sand and gravel to potential fluvial transport. The river downstream from the dams is gravel bedded with a pool-riffle morphology. The river flows 20 km to the marine environment through a riparian corridor lined with large wood and having relatively few anthropogenic alterations. This moderately natural pre-dam-removal condition afforded an unprecedented opportunity to study river response to an anticipated massive sediment release. Four years into the project, 12 million m3 of sediment eroded from the former reservoirs with about 90% of the total load transported to the marine environment. Annualized sediment discharge was as great as 20 times the background natural load. Initial river response to the arrival of the first large sediment pulse was the nearly complete filling of the river's previously sediment-starved pools, widespread filling of side channels, and increased braiding index. In year 2, during maximum aggradation, the river graded to a plane-bedded system, efficiently conveying sediment to the marine environment. Modest peak flows (<2-yr return period) in year 2 promoted sediment transport but caused little large-scale geomorphic disturbance by channel migration or avulsions. As the river processed the sediment pulse, pools returned and the braiding index decreased in years 3-4. Higher peak flows in year 4 caused localized channel widening and migration but no major avulsions. Gauging indicated sand dominated the first stages of sediment release, but fluvial loads coarsened through time with progressive arrival of larger material. The literature suggests the Elwha River sediment wave should have evolved through dispersion with little translation. However, morphologic measurements and data from a stage-gauge network indicated patterns of

  11. Fluvial system response to late Pleistocene-Holocene sea-level change on Santa Rosa Island, Channel Islands National Park, California

    Science.gov (United States)

    Schumann, R. Randall; Pigati, Jeffery S.; McGeehin, John P.

    2016-01-01

    Santa Rosa Island (SRI) is one of four east-west aligned islands forming the northern Channel Islands chain, and one of the five islands in Channel Islands National Park, California, USA. The island setting provides an unparalleled environment in which to record the response of fluvial systems to major changes of sea level. Many of the larger streams on the island occupy broad valleys that have been filled with alluvium and later incised to form steep- to vertical-walled arroyos, leaving a relict floodplain as much as 12–14 m above the present channel. The period of falling sea level between the end of the last interglacial highstand at ~ 80 ka and the last glacial lowstand at ~ 21 ka was marked by erosion and incision in the uplands and by deposition of alluvial sediment on the exposed marine shelf. Sea level rose relatively rapidly following the last glacial lowstand of − 106 m, triggering a shift from an erosional to a depositional sedimentary regime. Accumulation of sediment occurred first through vertical and lateral accretion in broad, shallow channels on the shelf. Channel avulsion and delta sedimentation produced widespread deposition, creating lobes or wedges of sediment distributed across relatively large areas of the shelf during the latest Pleistocene. Backfilling of valleys onshore (landward of present sea level) appears to have progressed in a more orderly and predictable fashion throughout the Holocene primarily because the streams were confined to their valleys. Vertical aggradation locally reduced stream gradients, causing frequent overbank flooding and lateral channel shift by meandering and/or avulsion. Local channel gradient and morphology, short-term climate variations, and intrinsic controls also affected the timing and magnitudes of these cut, fill, and flood events, and are reflected in the thickness and spacing of the episodic alluvial sequences. Floodplain aggradation within the valleys continued until at least 500 years ago

  12. Resistivity imaging of strata and faults in Bangladesh

    Science.gov (United States)

    Hosain, A.; Steckler, M. S.; Akhter, S. H.

    2015-12-01

    The Ganges-Brahmaputra-Meghna Delta, the largest in the world, is subject to deformation by active tectonics and dynamic river systems. It lies near the juncture of the Indian, Eurasian and Burmese plates and is being overthrust by both the Shillong Massif and the Indo-Burman Ranges. There are multiple major and minor active faults in Bangladesh, many of which are buried by the sedimentation. For example, the Madhupur tract is a Pleistocene upland in the middle part of Bengal Basin. Whether it is a passive interfluve of the river system or a tilted and tectonically uplifted block has been debated for decades. The Tippera Surface, in Comilla at the eastern part of the basin, is composed of uplifted and oxidized Holocene strata and overlies buried anticlines of the Indo-Burman fold belt. Furthermore, the rivers are subject to migrations, avulsions and other changes in course. The last major avulsion of the Brahmaputra River was only ~200 years ago. During the sea level fall in the last glaciation the major rivers created large incised valleys. In much of the exposed uplands there was the development of a weathered clay surface. This now forms a clay layer separating the Pleistocene and Holocene strata in large parts of Bangladesh. We use electrical resistivity surveying and hand-drilled borehole lithological data to better understand the subsurface discontinuities and structures. The resistivity system consists of an 84 electrode array powered by 2 car batteries and is capable of imaging lithologies to ~100m depth, similar to the depths of the boreholes used to calibrate the data. We extend our previous work on the western margin of the Madhupur Tract with additional lines on the eastern flank of Madhupur. Resistivity lines along the exposed Lalmai anticline in Comilla image the now tilted Holocene-Pleistocene clay layer. Additional lines along the subsurface continuation of the anticline provide additional information on the subsurface lithologies associated with

  13. Prevalence and patterns of combat sport related maxillofacial injuries

    Directory of Open Access Journals (Sweden)

    Shirani Gholamreza

    2010-01-01

    Full Text Available Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc., site of facial injury (jaw, nose, malar bone, teeth, etc., dental injuries (tooth fracture, displacement, luxation, and avulsion, causative sport (boxing, taekwondo, kickboxing, and Muay Thai as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and c2 , ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Results: Of 120 subjects, 95 male subjects (79.2%, aged 18-25 years (avg. 20 years, had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma, dental injuries (displacement, luxation, fracture, and avulsion, and mandibular dislocation which were recorded in 83 (69.2%, 55 (45.1%, 53 (44.2%, and 8 (6.7% cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7% were the most common dental injuries, and the nose (84.7% was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%. Injuries were significantly greater in professional rather

  14. MRI of early symptomatic metal-on-metal total hip arthroplasty: a retrospective review of radiological findings in 20 hips

    Energy Technology Data Exchange (ETDEWEB)

    Toms, A.P. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)], E-mail: andoni.toms@nnuh.nhs.uk; Marshall, T.J.; Cahir, J. [Department of Radiology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Darrah, C.; Nolan, J. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Donell, S.T. [Institute of Health, University of East Anglia, Norwich, Norfolk (United Kingdom); Barker, T. [Department of Pathology, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom); Tucker, J.K. [Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, Norfolk (United Kingdom)

    2008-01-15

    Aim: To perform a retrospective review of all the conventional radiographic and magnetic resonance imaging (MRI) studies performed in patients with early postoperative pain following cobalt-chrome metal-on-metal total hip arthroplasty. Methods: A retrospective review of the radiology, surgical findings and histology in nineteen patients who had undergone a total of 20 hip arthroplasties using a cobalt-chromium on cobalt-chromium alloy prosthesis was undertaken. Results: Measures of implant placement on the immediate postoperative radiographs were all within the normal ranges (n = 20). Where more than one postoperative radiograph was available statistical analysis revealed no evidence of progressive change before the MRI examination (14). The median postoperative time to MRI was 35 months (range 11-63 months). Abnormalities were demonstrated using MRI in all symptomatic hips (n = 20). These comprised: periprosthetic fluid collections (20), which were isointense to muscle on T1-weighted images in 19 cases and hyperintense on T2-weighted images in 18 cases, periprosthetic bone marrow oedema (n = 6), muscle oedema (n = 4), avulsion of the gluteus minimus and medius tendons (n = 5), atrophy of piriformis (n = 15) and obturator internus (n = 17), and fracture of the medial calcar (n = 1). Operative findings in patients who had undergone revision surgery (n = 15) included: fluid-filled cavities (n = 11), soft tissue necrosis (n = 8), gluteal tendon avulsion (n = 5), proximal femoral diaphyseal necrosis (n = 4), and pitting and corrosion of the femoral stems (n = 8), which were, in all cases, firmly fixed to the cement mantle. Histology revealed viable tissue in six hips with necrosis (n = 12) and fibrin deposition (n = 15) being the predominate findings. Other findings included a perivascular lymphocytic infiltrate (n = 5), features of active inflammation (n = 4), and metallosis (n = 1). Conclusion: A significant number of patients with metal-on-metal hip replacements

  15. Holocene evolution of the western Orinoco Delta, Venezuela

    Science.gov (United States)

    Aslan, A.; White, W.A.; Warne, A.G.; Guevara, E.H.

    2003-01-01

    The pristine nature of the Orinoco Delta of eastern Venezuela provides unique opportunities to study the geologic processes and environments of a major tropical delta. Remote-sensing images, shallow cores, and radiocarbon-dating of organic remains form the basis for describing deltaic environments and interpreting the Holocene history of the delta. The Orinoco Delta can be subdivided into two major sectors. The southeast sector is dominated by the Rio Grande-the principal distributary-and complex networks of anastomosing fluvial and tidal channels. The abundance of siliciclastic deposits suggests that fluvial processes such as over-bank flooding strongly influence this part of the delta. In contrast, the northwest sector is represented by few major distributaries, and overbank sedimentation is less widespread relative to the southeast sector. Peat is abundant and occurs in herbaceous and forested swamps that are individually up to 200 km2 in area. Northwest-directed littoral currents transport large volumes of suspended sediment and produce prominent mudcapes along the northwest coast. Mapping of surface sediments, vegetation, and major landforms identified four principal geomorphic systems within the western delta plain: (1) distributary channels, (2) interdistributary flood basins, (3) fluvial-marine transitional environments, and (4) marine-influenced coastal environments. Coring and radiocarbon dating of deltaic deposits show that the northern delta shoreline has prograded 20-30 km during the late Holocene sea-level highstand. Progradation has been accomplished by a combination of distributary avulsion and mudcape progradation. This style of deltaic progradation differs markedly from other deltas such as the Mississippi where distributary avulsion leads to coastal land loss, rather than shoreline progradation. The key difference is that the Orinoco Delta coastal zone receives prodigious amounts of sediment from northwest-moving littoral currents that transport

  16. Multi-method Assessment of the Braided Planform Stability - Toklat River, Alaska

    Science.gov (United States)

    Adema, G. W.; Podolak, C.

    2011-12-01

    Maintaining infrastructure in the vicinity of a dynamic braided river is a challenging, yet necessary activity in Alaska and it requires some understanding of likely future river planform configurations. The intersection of the 150-kilometer-long gravel road which carries all of the traffic in the Denali National Park, AK, with the Toklat River, draining the north side of the glaciated Alaska Range, highlights several of these challenges. Immediately downstream from two bridges and a causeway crossing the 800-meter-wide braid plain, park infrastructure (a rest stop and a maintenance facility) is being threatened by bank erosion. In order to better protect this section of the park the National Park Service sought a geomorphic assessment of the Toklat River from the USGS. The assessment of likely planform configurations was conducted with a four-method approach - analyzing 1) channel patterns in the downstream direction, 2) changes in the lateral slope of the braidplain over time, 3) influences on the geometry of a significant tributary junction, and 4) probable post-avulsion channel configurations. This suite of analyses based on a series of cross section surveys and a large airborne LiDAR dataset were carried out using MATLAB, Quick Terrain Modeler, and ArcGIS. Patterns in the down- and cross-valley slopes, the braid plain width, and the cross-sectional forms demonstrate persistent forcings on the channel planform. Temporal trends in the cross section surveys, photographic evidence, and vegetation patterns show a braidplain that is regularly reworked. Relative discharge was estimated from two basins using a USGS-developed empirical method. The discharge was used along with confluence geometry constrain likely planform patterns downstream of a significant tributary junction. A simple momentum-based model showed a likely persistence of the current planform. The LiDAR-derived topography was used in a probabilistic analysis of likely avulsion scenarios and the likely

  17. Sediment Dynamics Affecting the Threatened Santa Ana Sucker in the Highly-modified Santa Ana River and Inset Channel, Southern California, USA

    Science.gov (United States)

    Minear, J. T.; Wright, S. A.

    2015-12-01

    In this study, we investigate the sediment dynamics of the low-flow channel of the Santa Ana River that is formed by wastewater discharges and contains some of the last remaining habitat of the Santa Ana Sucker (Catostomus santaanae). The Santa Ana River is a highly-modified river draining the San Bernardino Mountains and Inland Empire metropolitan area east of Los Angeles. Home to over 4 million people, the watershed provides habitat for the federally-threatened Santa Ana Sucker, which presently reside within the mainstem Santa Ana River in a reach supported by year-round constant discharges from water treatment plants. The nearly constant low-flow wastewater discharges and infrequent runoff events create a small, approximately 8 m wide, inset channel within the approximately 300 m wide mainstem channel that is typically dry except for large flood flows. The sediment dynamics within the inset channel are characterized by constantly evolving bed substrate and sediment transport rates, and occasional channel avulsions. The sediment dynamics have large influence on the Sucker, which rely on coarse-substrate (gravel and cobble) for their food production. In WY 2013 through the present, we investigated the sediment dynamics of the inset channel using repeat bathymetric and substrate surveys, bedload sampling, and discharge measurements. We found two distinct phases of the inset channel behavior: 1. 'Reset' flows, where sediment-laden mainstem discharges from upstream runoff events result in sand deposition in the inset channel or avulse the inset channel onto previously dry riverbed; and 2. 'Winnowing' flows, whereby the sand within the inset channel is removed by clear-water low flows from the wastewater treatment plant discharges. Thus, in contrast to many regulated rivers where high flows are required to flush fine sediments from the bed (for example, downstream from dams), in the Santa Ana River the low flows from wastewater treatment plants serve as the flushing

  18. Paleomagnetic constrains in the reconstruction of the recent stratigraphic evolution of the Po delta

    Science.gov (United States)

    Correggiari, Annamaria; Vigliotti, Luigi; Remia, Alessandro; Perini, Luisa; Calabrese, Lorenzo; Luciani, Paolo

    2014-05-01

    The delta and prodelta deposits are characterized by a complex stratigraphic architecture that can be approached with several multidisciplinary tools. We present an example from the Po delta system characterized by alternating phases of rapid advance and abandonment of its multiple deltaic lobes that has been investigated through: (1) a review of historical cartography extending back several centuries; (2) integrated surveys of VHR seismic profiles recorded offshore of the modern delta from water depths as shallow as 5 m to the toe of the prodelta in about 30 m; and (3) sedimentological and geochronological data from precisely positioned sediment cores. Within this well known stratigraphic framework we have acquired seismic data and sediment cores in the area of the post roman Po delta system. However a precise dating of the recent evolution of depositional delta lobes is difficult because of the lack of suitable dating methods. To constrain the emplacement timing of the Renaissance lobes a paleomagnetic studies was carried out on a sedimentary sequence representing a seismic facies well correlated in the cores by whole core magnetic susceptibility profile. Forty eight samples were collected from a core section (RER96-1) characterized by a fine grained lithology suitable for paleomagnetic investigations. The characteristic remanent magnetization (ChRM) of the sediments has been obtained by applying an AF cleaning between 10 and 30 millitesla. The results have been compared with the directions recorded by the historical lavas of the Etna and Vesuvius. The combination of the trends observed in the declination and inclination suggests that the results can be compatible with the directions of the secular variation of the earth magnetic field occurring during the XVII century. This allow to date the sismic unit as representative of the beginning of the new delta following the Porto Viro avulsion made by the Venice Republic in 1604 AD. This delta history reflects the

  19. Estudo epidemiológico das lesões traumáticas de plexo braquial em adultos Epidemiological study of the traumatic brachial plexus injuries in adults

    Directory of Open Access Journals (Sweden)

    Leandro Pretto Flores

    2006-03-01

    Full Text Available OBJETIVO: Determinar informações epidemiológicas sobre as variáveis relacionadas ao trauma de plexo braquial em adultos. MÉTODO: Foram analisados 35 pacientes, de maneira prospectiva, atendidos consecutivamente no período de um ano. RESULTADOS: A maioria das lesões apresentou localização supraclavicular (62%, sendo 21 lesões por mecanismo de tração (60%, nove por projétil de arma de fogo (25%, três por compressão (8,5% e dois ferimentos cortantes (5,7%. Acidentes motociclísticos responderam por 54% das causas do trauma. A TC-mielografia identificou avulsão radicular em 16 casos (76%. Melhora neurológica parcial espontânea foi observada em 43% dos pacientes. Dor neuropática foi observada em 25 casos (71% sendo que em 16 (64% pôde ser controlada com medicações orais. CONCLUSÃO: Os traumas de plexo braquial são mais freqüentemente associados aos mecanismos de tração, sendo comum identificação de avulsão radicular. Em geral produzem dor no membro afetado e estão associados a lesões em outros órgãos. Na presente série, a incidência calculada para a população de abrangência foi 1,75/100000/ano.OBJECTIVE: This study aims to provide information about epidemiological factors related to traumatic brachial plexus injuries in adults. METHOD: Prospective analysis of 35 consecutive cases, observed in a period of one year. RESULTS: Most of the lesions were supraclavicular (62%. Twenty-one cases occurred due to traction (60%, 9 to gun shot wound (25%, 3 to compression (8.5% and two perforation/laceration (5.7%. Motorcycle accidents were the cause of trauma in 54% of patients. CT myelography demonstrated root avulsion in 16 cases (76%. Parcial spontaneous neurological recovery was observed in 43% of the patients. Neuropathic pain occurred in 25 (71% cases, and the use of some oral intake drugs (as amitriptiline or carbamazepine controlled it in 64% of times. CONCLUSION: Traction is the most frequent mechanism related to

  20. Occurrence and timing of complications following traumatic dental injuries: A retrospective study in a dental trauma department

    Science.gov (United States)

    Lin, Shaul; Pilosof, Nir; Karawani, Munir; Wigler, Ronald; Kaufman, Arieh Y.; Teich, Sorin T.

    2016-01-01

    Background This study explores the pattern of complications occurrence resulting from traumatic dental injuries, the relation of this pattern to the number of years from the time of the injury to its first diagnosis, and other contributing characteristics such as root development and trauma characteristic. Material and Methods Patients’ data treated following dental trauma from 2002 to 2014 were classified and grouped according to age, gender, tooth type, injury type, diagnosis and the time that elapsed between the traumatic event and the diagnosis of complications (TIC). The distribution function of the quantitative parameters was determined with the Kolmogorov-Smirnov test. Fisher exact test was used to test differences between categorical parameters. Results The review identified 166 patients (114 male and 52 female), with a total of 287 traumatized teeth, and a mean of 1.8 injured teeth per incident. Maxillary teeth were involved significantly more often in traumatic dental injuries. The follow-up period range (TIC) had a mean of 2.99 years. The most frequent complication was pulp necrosis (34.2%). The most frequent complication related to avulsion was ankylotic root resorption (50%) diagnosed after a median TIC of 1.18 years. Open apices at the occurrence of trauma were observed in 52 teeth. Of these, 54.9% experienced pulp necrosis and 9.8% inflammatory root resorption with a median TIC of 1.63 years. Teeth that experienced multiple traumatic events showed significantly more late pulp necrosis compared to teeth that experienced a single traumatic injury (61.9% vs. 25.3%, respectively, p<0.0001). Conclusions Follow-up periods should be based on the type of traumatic dental injury and the severity of the potential complications for the tooth. Current recommendations for follow-up after traumatic dental injury should be revised to reflect the need for more frequent and overall prolonged follow-up. Key words:Dental trauma, avulsion, open apex, pulp necrosis

  1. Fluvial response to sudden input of pyroclastic sediments during the 2008-2009 eruption of the Chaitén Volcano (Chile): The role of logjams

    Science.gov (United States)

    Umazano, Aldo M.; Melchor, Ricardo N.; Bedatou, Emilio; Bellosi, Eduardo S.; Krause, Javier M.

    2014-10-01

    The rhyolitic Plinian eruption of the Chilean Chaitén Volcano, initiated on May 2, 2008, suddenly introduced abundant pyroclastic sediments in the Blanco River catchment area, which experienced important modifications. Before May 2, the river was characterised by gravelly and moderate to low-sinuosity channels crossing a vegetated and locally urbanised (Chaitén City) floodplain. This river, limited by steep and densely forested highlands, was connected with the Pacific Ocean via a tidally-influenced delta plain. After heavy rains in May 11-20, the river discharge increased and triggered several responses including logjam formation and breakage, crevassing, avulsion (and channel abandonment), changes in the pattern and dimensions of channels, and construction of a new delta plain area. In this context, the goals of this contribution were: i) to document the sedimentological processes within a detailed geomorphic framework and ii) to understand the influence of logjams on fluvial dynamics. Upstream of the logjam zone, the deposits are mostly composed of ash and lapilli with abundant palaeovolcanic (epiclastic) sediments, which were produced by dilute currents and debris flows. Downstream of the logjam zone, deposits are composed by ash and lapilli, both pumice-rich and lacking important participation of older (epiclastic) sediments. The abandoned and filled palaeochannel, and the proximal part of crevasse splays experienced transient dilute flows with variable sediment concentration and, subordinately, hyperconcentrated flows. The distal sectors of crevasse splays mostly record settling from suspension. At the delta plain, tephra transported by the Blanco River was mixed with older sediments by tide and wave action (dilute flows). We conclude that immediately after eruption, both geomorphic and sedimentary processes of the river were mainly controlled by a combination of high availability of incoherent pyroclastic sediments on steep slopes, abundant rains, large

  2. [Surgery of post-traumatic ptosis].

    Science.gov (United States)

    Morax, S; Baudoin, F; Hurbli, T

    1995-12-01

    Post-traumatic ptosis may be classified as follows: ptosis occurring during lid avulsion, ptosis associated with fractures of the orbital roof and with foreign bodies, post-contusional ptosis, cicatricial ptosis, neurogenic ptosis and post-surgical ptosis. The patient must be thoroughly examined, including examination of the eye-ball, extra-ocular muscles, eyelid and evaluation of upper eyelid levator function and orbital and facial examination. The various surgical methods proposed include levator muscle surgery, aponeurotic surgery, Müller's muscle surgery and frontalis suspension surgery. Surgical indications and choice of surgical method essentially depend on the anatomo-clinical forms. The general rule is to operate under local anesthesia to obtain better control of the muscular function. Some cases are simple to treat such as post-contusional ptosis with good levator function which allows functional surgery with excellent static and dynamic results. Other relatively simple cases with non functional levators may only be treated on a static basis. Last but not least are more difficult cases in which levator function is difficult to evaluate pre-operatively because of severe fibrosis. The aim in such cases is to explore the eyelid by an anterior approach under local anesthesia and to propose either muscular surgery or a frontalis suspension according to the anatomical and functional status of the levator muscle.

  3. Efficacy of enamel matrix derivatives (Emdogain) in treatment of replanted teeth--a systematic review based on animal studies.

    Science.gov (United States)

    Wiegand, Annette; Attin, Thomas

    2008-10-01

    The objective of the current systematic review was to evaluate the efficacy of enamel matrix derivative (EMD) (Emdogain) on healing of replanted or autotransplanted permanent teeth. A review of the published literature [search term: (Emdogain OR enamel matrix derivative OR enamel matrix protein] AND [avulsion OR replantation OR autotransplantation)] was conducted by two independent investigators according to defined selection criteria. For data extraction of the identified animal studies, the following histomorphometric findings were considered: (i) healed PDL, (ii) surface resorption, (iii) inflammatory resorption and (iv) replacement resorption. The heterogeneity of data collection and the small amount of identified publications did not allow for statistical analysis. Four controlled trials (CT) conducted in animals, but no randomized controlled trials (RCT) or clinical controlled trials (CCT) could be received from the systematic search. From the selected studies, two CT gave evidence of EMD treatment to be effective in inducing healing of replanted teeth, while one CT found no differences between EMD treated teeth and controls. Finally, one CT compared EMD and sodium fluoride application, but revealed no differences between the treatments. The data of controlled trials available are limited and conflicting. No firm conclusion regarding the efficacy of EMD application on healing of replanted or autotransplanted permanent teeth can be drawn because of lack of RCT and CCT.

  4. The effects of strain rate on the properties of the medial collateral ligament in skeletally immature and mature rabbits: a biomechanical and histological study.

    Science.gov (United States)

    Woo, S L; Peterson, R H; Ohland, K J; Sites, T J; Danto, M I

    1990-09-01

    The effects of strain rate on the structural properties of the femur-medial collateral ligament-tibia complex (FMTC) and on the mechanical (material) properties of the medial collateral ligament (MCL) of skeletally immature and skeletally mature rabbits were studied. The FMTCs were tested in tension to failure, at five extension rates (0.008 mm/s-113 mm/s). For the FMTCs from the skeletally immature animals, values of load, elongation, and energy absorbed at failure increased substantially with extension rates. Such increases also existed for skeletally mature animals, but they were much less in magnitude. All samples from the skeletally immature animals failed by tibial avulsion, whereas samples from the skeletally mature animals failed within the ligament substance. The mechanical properties of the ligament substance were minimally strain-rate sensitive for both groups. Histological sections of the ligament substance and insertion sites from the failed samples were examined, and these observations were correlated with the biomechanical findings. For the rabbit model used in this study, we conclude that skeletal maturity has more influence on the biomechanical properties of the MCL than does strain rate.

  5. Giganti sull'acropoli. Atene, Pergamo e la Gigantomachia

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    Elio Manunta

    2008-05-01

    Full Text Available Il suggestivo scenario creatosi sull’acropoli di Atene intorno alla metà del II secolo a.C., quando la Gigantomachia del cd. “Piccolo Donario” attalide eretto a S del Partenone venne a trovarsi in diretto contatto visivo con le sue metope orientali scolpite con il medesimo soggetto - testimonianza concreta dello stretto legame tra Pergamo e Atene -, offre lo spunto per un’indagine tipologica sull’iconografia del Gigante nelle rappresentazioni scultoree e pittoriche comprese tra questi due estremi artistico-cronologici. L’analisi delle singole figure dei Giganti, tuttavia non avulse dal proprio contesto monumentale e storico-artistico, conduce a una classificazione tipologica in grado di illuminare sulla tradizione, la circolazione e la persistenza, fino alla citazione puntuale, degli schemi iconografici e delle soluzioni compositive impiegati nella lunga storia della Gigantomachia, con lo scopo precipuo di appurare quanto di quel legame sia possibile rintracciare attraverso la lettura e il confronto iconografici dei due monumenti.

  6. Is there an association between the presence of dental fluorosis and dental trauma amongst school children?

    Science.gov (United States)

    Oliveira, Lorenna Fonseca Braga de; Souza, João Gabriel Silva; Mendes, Rafael Inácio Pompeu; Oliveira, Rodrigo Caldeira Nunes; Oliveira, Carolina de Castro; Lima, Carolina Veloso; Martins, Andréa Maria Eleutério de Barros Lima

    2016-03-01

    Our objective was to evaluate whether there is an association with the different levels of dental fluorosis and the presence of dental trauma amongst school children. A transversal study was conducted amongst school children from the age of 12. Dental examinations were conducted by 24 well trained and fully qualified dental surgeons. Data was collected from 36 randomly selected public schools amongst 89 schools in a municipality. The criteria used to diagnose dental fluorosis was based on the Dean's fluorosis Index and for diagnosing dental trauma we looked for clinical signs of crown fractures and dental avulsions. Multiple descriptive analysis, which was bivariate, was carried out. Amongst the 2,755 school children that took part in the study 1,089 (39.6%) were diagnosed with dental fluorosis and 106 (3.8%) had one tooth or more with dental trauma. We noted a high prevalence of dental fluorosis, independent of the level of severity, amongst individuals with one tooth or more who had dental trauma. This association was even more evident where there were severely high levels of fluorosis. We also noted that the presence of fluorosis was greater amongst those that actively paid more attention to discoloration on their teeth and who received treatment from a dental professional at their schools. Nevertheless dental fluorosis was associated with the presence of dental trauma, independent of its severity.

  7. Life-threatening complications after ureteroscopy for urinary stones: survey and revision of the current literature.

    Science.gov (United States)

    Cindolo, Luca; Castellan, Pietro; Primiceri, Giulia; Hoznek, Andras; Cracco, Cecilia M; Scoffone, Cesare M; Galfano, Antonio; Petralia, Giovanni; DE Angelis, Michele; Annino, Filippo; Malacasa, Emilio; Cormio, Luigi; Acquati, Pietro; DE Lorenzis, Elisa; Maugeri, Orazio; Arena, Giuseppe; Celia, Antonio; Giusti, Guido; Schips, Luigi

    2017-02-01

    Retrograde ureteroscopy (URS) has become a common procedure for the management of urinary stones. Although its efficacy and safety are well known, the literature about major complications is still poor. This study highlighted some cases of life-threatening complications after semirigid ureteroscopy (s-URS) or flexible ureteroscopy (f-URS). We enrolled experienced endourologists (more than 75 cases/year in the last 3 years) and we performed a survey asking to review their series and report the cases encumbered by major complications (Clavien-Dindo IIIb-IV grade). Eleven urologists reported on 12 major complications (4 after s-URS, 8 after f-URS). Eight patients developed a kidney injury, 1 an arteriovenous fistula, 2 a ureter avulsion and 1 acute sepsis. Six patients underwent open nephrectomy, two surgical repair, one open pyeloplasty, one coil artery embolization and two superselective artery embolization. Guidelines and clinical practice give useful recommendations about intraoperative safety and prevention of life-threatening events. The careful postoperative observation and the surgical active treatment of this complications play a key role in reducing morbidity, kidney loss and mortality. This study encourages a strict and active care of patients, supports a routine reporting of complications, and highlights the need for systematic use of standardized classification systems.

  8. Prevalence of Traumatic Dental Injuries among Contact Sport Practitioners in Northeast of Iran in 2012

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    Armita Rouhani

    2016-06-01

    Full Text Available Introduction: Contact sports may lead to dental injures, which may often be prevented by using mouthguards. The purpose of this study was to evaluate the prevalence of traumatic dental injuries (TDI in professional contact sport athletes and to determine the awareness regarding use of mouthguards in this group. Methods: A questionnaire containing a number of  questions regarding the demographic data of participants, experiences of trauma and their behavior after that and use of mouthguard, was distributed amongst 100 contact sport athletes. Results: eighty athletes returned the questionnaire. The age range of most of the participants (44.2%  was between 20-30  .Also most of them had been practicing in contact sports for 1 to 5 years (37.3%. 26.2% of the athletes had experienced some sort of dental trauma. There was no significant difference between the injuries in males and females (p> 0.05. Luxation injuries were the most common type of TDI (47.7%, followed by crown fractures (42.1% and avulsion (10.5%. 89.7% of athletes had already been informed about using mouthguards, however only 10.3% reported having used them. Conclusion: According to the results of this study, the rate of TDI among contact sport practitioners in Iran is high; however the use of mouthguards by athletes is low. Dentists and sports authorities should promote the use of mouthguards in contact sports to decreases the risk of dental trauma and tooth loss.

  9. Wandering gravel-bed rivers and high-constructive stable channel sandy fluvial systems in the Ross River area, Yukon Territory, Canada

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    Darrel G.F. Long

    2011-07-01

    Gravel-dominated strata, inter-bedded with, and overlying coal-bearing units, are interpreted as deposits of wandering gravel-bed rivers, with sinuosity approaching 1.4. In most exposures they appear to be dominated by massive and thin planar-bedded granule to small pebble conglomerates, which would traditionally be interpreted as sheet-flood or longitudinal bar deposits of a high-gradient braided stream or alluvial fan. Architectural analysis of exposures in an open-pit shows that the predominance of flat bedding is an artefact of the geometry of the roadside exposures. In the pit the conglomerates are dominated by large scale cross stratification on a scale of 1–5.5 m. These appear to have developed as downstream and lateral accretion elements on side-bars and on in-channel bars in water depths of 2–12 m. Stacking of strata on domed 3rd order surfaces suggests development of longitudinal in-channel bar complexes similar to those observed in parts of the modern Rhône River system. Mudstone preserved in some of the channels reflects intervals of channel abandonment or avulsion. Minimum channel width is from 70 to 450 m.

  10. Common Dental Injury Management in Athletes

    Science.gov (United States)

    Young, Eliot J.; Macias, C. Roger; Stephens, Lindsay

    2015-01-01

    Context: Orofacial and dental trauma continues to be a commonly encountered issue for the sports medicine team. All sports have some risk for dental injury, but “contact sports” presumably incur more risk. Immediate evaluation and proper management of the most common injuries to dentition can result in saving or restoration of tooth structure. Despite the growing body of evidence, mouth guard use and dental protection have not paralleled the increase in sports participation. Evidence Acquisition: A PubMed search from 1960 through April 2012 was conducted, as well as a review of peer-reviewed online publications. Results: Common dental injuries in sports include tooth (crown) fractures; tooth intrusion, extrusion, and avulsion; and temporomandibular joint dislocation. Mouth guards help prevent most injuries and do not significantly affect ventilation or speech if fitted properly. Conclusion: A working knowledge of the presentation as well as management of commonly encountered dental trauma in sports is essential to the immediate care of an athlete and returning to play. Mouth guard use should be encouraged for athletes of all ages in those sports that incur significant risk. PMID:26131303

  11. Sequelae of Trauma to Primary Dentition

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    Cíntia ZEMBRUSKI-JABER

    2006-08-01

    Full Text Available Objective: The aim of this study was to determine the presence of clinical and radiographic signs of injury to the maxillary primary incisors and the children carers' knowledge about dental trauma ocurrence in a 45 children group from three to eight years old. Method: Before the clinical examination, the carers were asked about their children's dental trauma events. After that, took course the maxillary incisors clinical and radiographical examination, excluding the ones with caries, fillings, or pulpar treatments. Results: Discoloration (50.0% was the most common present sign of trauma followed by avulsion (17.6% and the pulp canal obliteration (56.3% was the major result of the radiographical signal. Boys had more trauma recorded than girls and the maxillary central incisors were the most vulnerable to injury. Besides, the amount of trauma recorded by clinical and radiographic examination was bigger than that reported in the questionnaire by mothers or children carers. Conclusion: The results related in this study reinforce the need of immediate attention to trauma on deciduous dentition and long term observation of the developing permanent successor.

  12. 四肢脱套伤的处理%Management of degloving injuries of limbs

    Institute of Scientific and Technical Information of China (English)

    戴亚辉; 梅炯

    2015-01-01

    Degloving injuries of limbs occur relatively rarely but pose extreme challenges to surgeons, which are usually caused by trafifc accidents or industrial trauma. The key point that differentiates this kind of injury from others is that certain arteries will get damaged due to the separation of the skin and subcutaneous soft tissues from muscles, tendons and fascias, leading to the block of blood lfow. Loss of blood supply means the degloving skin and other soft tissues can hardly live. Mismanagement of such kind of injuries may result in delayed full-thickness necrosis of the avulsed skin lfap, higher complication rate, increased hospitalization and rehabilitation cost, even greater risk of amputation and death. By reviewing past scholars’ management of different types of degloving injuries, it is found that although there are many options available for the management, it is still disputed on how to choose effective treatment strategies and techniques. Some traditional methods are efficient and can be easily put into use in clinic. With the development of science and technology in recent years, new technologies and materials like microsurgical techniques and vaccum sealing drainage ( VSD )/vaccum assisted closure ( VAC ) can provide new options for these injuries, which could greatly reduce the heavy nursing care burden after surgery and decrease the postoperative infection rate. This article is introducing the classification of degloving injuries of limbs, storage methods of degloved skin and discussing the treatment strategies, surgical techniques and prognosis of this kind of injury, aiming to provide some recommendations to surgeons who will face these injuries.

  13. Reduced functional connectivity within the primary motor cortex of patients with brachial plexus injury.

    Science.gov (United States)

    Fraiman, D; Miranda, M F; Erthal, F; Buur, P F; Elschot, M; Souza, L; Rombouts, S A R B; Schimmelpenninck, C A; Norris, D G; Malessy, M J A; 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 state fMRI scanning. The analysis of empirical functional correlations between neighboring voxels revealed faster correlation decay as a function of distance in the M1 region corresponding to the arm in BPA patients as compared to the control group. No differences between the two groups were found in the face area. We also investigated whether such larger decay in patients could be attributed to a gray matter diminution in M1. Structural imaging analysis showed no difference in gray matter density between groups. Our findings suggest that the faster decay in neighboring functional correlations without significant gray matter diminution in BPA patients could be related to a reduced activity in intrinsic horizontal connections in M1 responsible for upper limb motor synergies.

  14. US of acute scrotal trauma: optimal technique, imaging findings, and management.

    Science.gov (United States)

    Deurdulian, Corinne; Mittelstaedt, Carol A; Chong, Wui K; Fielding, Julia R

    2007-01-01

    The primary causes of scrotal trauma are blunt, penetrating, degloving, and electrical burn injuries to scrotal contents. Knowledge of the scrotal anatomy and appropriate imaging techniques are key for accurate evaluation of scrotal injuries. Ultrasonography (US) is the first-line imaging modality to help guide therapy for scrotal trauma, except in degloving injury, which results in scrotal skin avulsion. Blunt injury (eg, from an athletic accident or motor vehicle collision) is the most common cause of scrotal trauma, followed by penetrating injury from gunshot or other assault. Trauma often may result in hematoma, hydrocele, hematocele, testicular fracture, or testicular rupture. The timely diagnosis of rupture, based on a US finding of discontinuity of the echogenic tunica albuginea, is critical because emergent surgery results in salvage of the testis in 80%-90% of rupture cases. The radiologist should be familiar also with other nuances associated with penetrating trauma, iatrogenic and postoperative complications, and electrical injury. Color flow and duplex Doppler imaging are highly useful techniques not only for assessing testicular viability and perfusion but also for evaluating associated vascular injuries such as pseudoaneurysms. A thorough familiarity with the US findings of scrotal trauma helps facilitate appropriate management. Supplemental material available at radiographics.rsnajnls.org/cgi/content/full/27/2/357/DC1.

  15. The evolution of Sf. Gheorghe (Danube asymmetric deltaic lobe

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    Alfred VESPREMEANU-STROE

    2014-11-01

    Full Text Available The wave asymmetric Sf. Gheorghe lobe is the only active in the Danube delta where river mouth bar (and the associated barrier islands and spits continuously deployed a cyclic development for almost two millennia. During first stage, the Sf. Gheorghe distributary had a small discharge (with an order of magnitude lower than present which after that experienced a rapid increase in consequence of the successive avulsions of Împuţita (southern distributary of Sulina arm and Dunavăţ distributaries. Our morphological analyses together with the newly obtained chronology, revealed the multiple ridgesets structure of Sf. Gheorghe deltaic lobe. In fact, all ridgesets (10 follow a common morphodynamic pattern characterized by the cyclic succession of three stages: i subaqueous mouth bar development, ii barrier island emergence, iii barrier spit phase with several secondary spits derived from an updrift trunk ridge. The size of each ridgeset increased exponentially with every new cycle due to the constant lengthening of the coastline as the downdrift side of the lobe advances seaward through a series of progressively larger similar quadrilaterals, yielding to a constant enlargment of the delta front size. 

  16. Can bed load transport drive varying depositional behaviour in river delta environments?

    Science.gov (United States)

    van der Vegt, H.; Storms, J. E. A.; Walstra, D. J. R.; Howes, N. C.

    2016-11-01

    Understanding the processes and conditions at the time of deposition is key to the development of robust geological models which adequately approximate the heterogeneous delta morphology and stratigraphy they represent. We show how the mechanism of sediment transport (the proportion of the sediment supply transported as bed load vs. suspended load) impacts channel kinematics, delta morphology and stratigraphy, to at least the same extent as the proportion of cohesive sediment supply. This finding is derived from 15 synthetic delta analogues generated by processes-based simulations in Delft3D. The model parameter space varies sediment transport mechanism against proportions of cohesive sediment whilst keeping the total sediment mass input constant. Proximal morphology and kinematics previously associated with sediment cohesivity are also produced by decreasing the proportion of bed load sediment transport. However, distal depositional patterns are different for changes in sediment transport and sediment load cohesivity. Changes in sediment transport mechanisms are also shown to impact clinoform geometry as well as the spatiotemporal scale of autogenic reorganisation through channel avulsions. We conclude that improving insight into the ratio of bed load to suspended load is crucial to predicting the geometric evolution of a delta.

  17. Changing river courses in the western part of the Ganga-Brahmaputra delta

    Science.gov (United States)

    Rudra, Kalyan

    2014-12-01

    The Ganga-Brahmaputra delta is the largest on Earth, the product of two of the world's largest and siltiest rivers. It is formed in a basin located over the zone where the Indian plate subducts beneath the Himalaya to the north and the Indo-Burman ranges to the east. The distributaries in the south-western part of the delta remain disconnected from the Ganga-Padma during the lean season, although they are still active in bank erosion and sediment transport during the monsoon. Four distributaries of the Bhagirathi-Hugli (the westernmost branch of the Ganga) have gone dry during known historical period. In many cases, the natural decay of rivers has been exacerbated by the human intervention, especially where rivers are embanked and no allowance made for their migration through meandering and avulsion. In the coastal zone where mangroves were cleared and creeks were embanked since the late 18th century, decay of channels, and advancement of the sea towards inland have been aggravated. The subsequent attempt of flushing the sediment load to the sea from the estuary to improve the status of navigation in the Bhagirathi-Hugli River was not successful to the level of expectation. This paper deals with the decay and changing courses of rivers in the western part of the Ganga-Brahmaputra delta.

  18. [Decoronation: treatment protocol for ankylotic root resorption as a consequence of dental trauma].

    Science.gov (United States)

    Lin, S; Fuss, Z; Wigler, R; Karawani, M; Ashkenazi, M

    2013-10-01

    Severe dental traumatic injuries, such as the complete displacement of a tooth from its socket (Avulsion) or the displacement of a tooth within its socket (Intrusive Luxation), may result in extensive injury to the root surface. As a result, the root surface injury heals without cementum and there is fusion between the alveolar bone and the exposed dentin or anorganic exposed cementum, without any attachment apparatus between them. This phenomenon is known as "dento-alveolar ankylosis" and is accompanied by ankylotic resorption of the root. In a process that results subsequent to the ankylosis, the root surface resorbs, and this is part of the remodeling of the alveolar bone (ankylotic resorption). When the traumatic injury occurs at a young age, lateral and apical growth of the alveolar bone continues without continued physiological eruption of the tooth. As a result, the position of the ankylotic tooth does not change, and with time thetooth appears infra-occluded resulting in severe esthetic and functional consequences. Extraction of the ankylotic tooth is difficult and sometimes even impossible due to the rigid fusion between the bone and the tooth. In addition, attempted extraction of the ankylotic tooth may lead to fracture of the buccal plate and resorption of the alveolar bone. Retention of the ankylotic tooth may lead to damage in bone deposition in the verticaldimension, leading to difficulties in future prosthodonticrehabilitation, research-based information has been incorporated

  19. Evaluation of care of dentoalveolar trauma

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    Luiz Fernando Fariniuk

    2010-08-01

    Full Text Available OBJECTIVES: The aim of this study was to evaluate cases of dental trauma treated at the specialized center of Pontifical Catholic University of Paraná, Curitiba, Brazil, during a period of 2 years. MATERIAL AND METHODS: A total of 647 patients were evaluated and treated between 2003 and 2005. Data obtained from each patient were tabulated and analyzed as to gender, age, etiology, time elapsed after the injury, diagnosis (type of trauma, and affected teeth. RESULTS: The results revealed that male individuals aged 7 to 13 years presented the highest prevalence of injury, and falling was the main causal factor. In most cases, the time elapsed between the accident and the first care ranged from 4 to 24 h. A total of 1,747 teeth were affected, with higher incidence of concussion/subluxation and coronal fracture, followed by lateral luxation and avulsion. The permanent maxillary central incisors were the most commonly affected teeth. CONCLUSION: The frequency and causes of dentoalveolar trauma should be investigated for identification of risk groups, treatment demands and costs in order to allow for the establishment of effective preventive measures that can reduce the treatment duration and costs for both patients and oral health services.

  20. Management of dentoalveolar injuries in children: a case report.

    Science.gov (United States)

    Das, U M; Viswanath, D; Subramanian, V; Agarwal, M

    2007-01-01

    Children aged 6-15 years old experience more injuries to their teeth and the injuries sustained are more serious as evidenced by a higher percentage of luxations, avulsions, fractures and dislocations. The mandible is the most frequently fractured facial bone and mandibular alveolar injuries have been reported to range between 8.1-50.6%. Those with mandibular or midface fractures have a higher incidence of associated chest, extremity, abdomen and cervical spine injuries. The growing patient with facial injuries presents the clinician with a series of thought-provoking circumstances. Dentoalveolar and mandibular injuries are especially important to understand because of the potential complications related to tooth eruption, alveolar development, occlusion and facial growth. However, the principles involved in the treatment for children need to be modified by certain anatomical, physiological and psychological factors specifically related to childhood. This case report documents the trauma, management and follow-up care of an 11-year-old boy who sustained undisplaced infraorbital, nasal fractures and mandibular dentoalveolar fracture along with other associated injuries of the extremities.

  1. Assessment of awareness amongst school teachers regarding prevention and emergency management of dentoalveolar traumatic injuries in school children in Pune City, before and 3 months after dental educational program.

    Science.gov (United States)

    Karande, Namrata; Shah, Preetam; Bhatia, Mitali; Lakade, Laxmi; Bijle, Mohammed Nadeem Ahmed; Arora, Nitin; Bhalla, Monika

    2012-11-01

    Children have boundless energy, so, they are continuously engaged in some or the other physical activity. It is seen that when child reaches school age, accidents in the school environment in the form of falls, injuries due to contact sports, fights, abuse, etc. are very common and the main cause of traumatic dental injuries. Trauma may vary from minor enamel chipping or avulsion to extensive maxillofacial damage, more serious neck and brain injury, which may cause pain, disfigurement and mental agony, having immediate and long lasting effects. In such cases, a school teacher is in the right position to handle such an emergency and refer the child to the concerned dental surgeon or a pedodontist for further needful care. The main reason for delayed treatment of dental trauma is that people present at the site of injury are unaware of protocol of rapid and appropriate management leading to improper first aid treatment. The purpose of this study was to investigate the awareness of a group of school teachers from different schools about the prevention and emergency management of dental trauma in school children, by means of a questionnaire. Then educating them and reassessing their knowledge after a period of 3 months. Unfortunately, the public is unaware of the risks and does not have enough information about first aid emergency treatment or to avoid traumatic injuries.

  2. Bimaxillary protrusion with an atrophic alveolar defect: orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.

    Science.gov (United States)

    Chiu, Grace S C; Chang, Chris H N; Roberts, W Eugene

    2015-01-01

    Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved.

  3. Advanced imaging of the scapholunate ligamentous complex

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, Maryam; Maeseneer, Michel de; Boulet, Cedric; Mey, Johan de [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels (Belgium); Staelens, Barbara; Scheerlinck, Thierry [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedics and Traumatology, Brussels (Belgium); Overstraeten, Luc van [Hand and Foot Surgery Unit (HFSU), Tournai (Belgium)

    2015-12-15

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies. (orig.)

  4. Multi-disciplinary management of a patient with a post-traumatised incisor presenting concurrent replacement and inflammatory resorption: a case report.

    Science.gov (United States)

    Doğramaci, Esma J; Rossi-Fedele, Giampiero; Jonest, Allan G

    2015-11-01

    This case report describes the multidisciplinary management of a young male who presented with a Class I incisor relationship and bi-maxillary dento-alveolar protrusion on a Class I skeletal base. The occlusion was complicated by an ankylosed and moderately infra-positioned upper left permanent central incisor, an anterior crossbite, crowding, a reduced overbite and centreline discrepancy. The incisor was traumatised and avulsed when the root was immature and the tooth was reimplanted with delay. On referral for orthodontic treatment at age 11 .5 years, the upper left central incisor was experiencing ankylosis-related (osseous replacement) resorption and external root resorption simultaneously. Aside from the orthodontic aims, it was important to address the disrupted alveolar development to facilitate later prosthodontic replacement of the upper left permanent central incisor by idealising the inter-coronal and inter-radicular spaces. Treatment consisted of fixed orthodontic appliances in conjunction with the extraction of all second premolars and the upper left permanent central incisor with episodic surgical curettage. An upper Hawlix retainer was provided immediately at debond and a cantilevered resin-retained bridge was placed four months later.

  5. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

    Science.gov (United States)

    Ionta, Franciny Querobim; de Oliveira, Gabriela Cristina; de Alencar, Catarina Ribeiro Barros; Gonçalves, Priscilla Santana Pinto; Alcalde, Murilo Priori; Minotti, Paloma Gagliardi; Machado, Maria Aparecida de Andrade Moreira; Rios, Daniela

    2016-01-01

    The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered.

  6. Reduced functional connectivity within the primary motor cortex of patients with brachial plexus injury

    Directory of Open Access Journals (Sweden)

    D. Fraiman

    2016-01-01

    Full Text Available 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 state fMRI scanning. The analysis of empirical functional correlations between neighboring voxels revealed faster correlation decay as a function of distance in the M1 region corresponding to the arm in BPA patients as compared to the control group. No differences between the two groups were found in the face area. We also investigated whether such larger decay in patients could be attributed to a gray matter diminution in M1. Structural imaging analysis showed no difference in gray matter density between groups. Our findings suggest that the faster decay in neighboring functional correlations without significant gray matter diminution in BPA patients could be related to a reduced activity in intrinsic horizontal connections in M1 responsible for upper limb motor synergies.

  7. A preliminary study on investigating the attachment of soft tissue onto micro-arc oxidized titanium alloy implants

    Energy Technology Data Exchange (ETDEWEB)

    Chen, G J; Wang, Z [Department of Orthopaedics, Xijing hospital, Fourth Military Medical University, Xi' an 710032 (China); Bai, H [Department of Toxicology, Fourth Military Medical University, Xi' an 710032 (China); Li, J M [School of Material Science and Engineering, Xi' an University of Technology, Xi' an 710048 (China); Cai, H, E-mail: wangzhen_fmmu@live.c [School of Science, Xi' an Jiaotong University, Xi' an 710049 (China)

    2009-02-15

    Intraosseous transcutaneous amputation prostheses (ITAP) rely on the integrity of the soft tissue-implant interface as a barrier to exogenous agents, and in the prevention of avulsion and marsupilization. This experimental work aimed at the in vivo evaluation of soft tissue attachment to Ti alloy (Ti{sub 6}Al{sub 4}V) transcutaneous custom-made screws treated by a micro-arc oxidation (MAO) method. Prior to implantation, the surface of the MAO treated implants was analyzed by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and x-ray diffraction (XRD). The experimental model comprised implantation of 16 transcutaneous screws (two groups: MAO and machined (control); total eight implants/group) in the medial aspect of the left tibia of eight female goats. The animals were euthanized at eight weeks and the samples harvested and processed for histological and histomorphometrical analysis of soft tissue attachment to the implant surface. Significant higher soft tissue attachment was observed in the MAO-modified group compared to the control. The in vivo data indicated that MAO-modified Ti alloy could be a useful biomaterial for tissue engineering and benefit applications where bone-anchored transcutaneous implants are used.

  8. Bone and soft tissue tumors of hip and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Bloem, Johan L., E-mail: j.l.bloem@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands); Reidsma, Inge I., E-mail: i.i.reidsma@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands)

    2012-12-15

    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  9. A new approach for evaluating the impact of fluvial type heterogeneity in CO2 storage reservoir modeling

    Science.gov (United States)

    Issautier, Benoît; Viseur, Sophie; Audigane, Pascal; Chiaberge, Christophe; Le Nindre, Yves-Michel

    2016-09-01

    In this sensitivity analysis on a 3D model of a heterogeneous fluvial reservoir, two scenario orders have been considered. The first one focuses on the first-order heterogeneity (i.e. a fluvial belt with a 100% sand content), and the other one on the second-order heterogeneity accounting for the internal sedimentary fill within the fluvial belt (oxbow lakes). CO2 injections were simulated using THOUGH2, and the dynamic simulations show large variations of reservoir performances. The first-order heterogeneity generates a large spectrum of storage capacities ranging from 30 to 50 Mt, to be related to the natural connectivity variability between fluvial belts induced by the avulsion process. Considering second-order heterogeneity reduces the storage capacities by 30%, highlighting the importance of representing such objects in complex heterogeneous systems. Moreover, it increases the dissolution process, increasing by the way the storage efficiency. The CO2 plume extension and geometry is also estimated to be strongly dependent on the level of heterogeneity. Finally, trapping into poorly connected fluvial point bars affects strongly the storage capacity of the mobile CO2 as well as the pressure field.

  10. "THE STUDY OF DOSE-RESPONSE MITOGENIC EFFECT OF L-DOPA ON THE HUMAN PERIODONTAL LIGAMENT FIBROBLAST CELLS"

    Directory of Open Access Journals (Sweden)

    M. Zarabian

    2004-10-01

    Full Text Available Avulsion is one of the most serious emergencies in dental office. In the event of any problem, the tooth should be stored in a medium that supports the periodontal ligament cell viability. In other clinical situations, preserving media, growth factors and mitogenic products may be useful in repairing the traumatized tissues. It has been previously reported that levodopa (L-dopa accelerates healing by increasing the growth hormone level. In this study, the local effect of L-dopa, as a mitogen, on human periodontal ligament fibroblast (HPLF cells was evaluated. Samples from impacted or semiimpacted wisdom or canine teeth, which were devoid of inflammation, were taken. The cells obtained from this tissue were cultured in an appropriate medium. The passage numbers between 3-6 were taken for further experiments. The viability of HPLF cells, which were treated by L-dopa, was evaluated by trypan blue dye exclusion and neutral red assay. Results indicated that low concentration of L-dopa produces significant increase of these cells compared to control group. These results confirmed previous studies about direct action of L- dopa on the viability of HPLF cells. On the basis of this study and previous reports, presence of L-dopa in preserving media may be useful in increasing the self-life transferring HPLF cells.

  11. Arthroscopically assisted treatment for Schatzker type I-V tibial plateau fractures

    Institute of Scientific and Technical Information of China (English)

    DUAN Xiao-jun; YANG Liu; GUO Lin; CHEN Guang-xing; DAI Gang

    2008-01-01

    Objective: To report the clinical outcome of arthroscopically assisted treatment for tibial plateau fractures.Methods: A total of 39 patients with tibial plateau fractures were treated by arthroscopic fixation from February 2002 to December 2005,including 11 patients with bony avulsion of the anterior cruciate ligament and 19 with meniscal injury.There were 4 cases of type I fracture,12 type II,9 type III,12 type IV and 2 type V according to Schatzker criteria.Firstly,the combined injuries were treated.Then the plateau fractures with the displacement over 3 mm or more were reduced and fixed.Finally,the internal fixation was observed by X-ray equipment.Postoperative management was early motion and delayed weight bearing.Results: All the fractures healed in 3 or 4 months.All patients were followed up for 1 to 5 years after operation.No case had severe complications,such as poor wound healing,infection,osteofascial compartment syndrome and osteoarthritis.According to the Rasmussen scoring system,36 cases obtained excellent or good results and the other 3 cases had moderate clinical results.The average score was 26 ± 3.Conclusions: As an adjuvant treatment of intraarticular fractures such as tibial plateau fracture,arthroscopy has many advantages.It can treat associated intraarticular soft tissue components,visualize the chondral surface reduction,lavage the hematoma and smaller loose fragments,decrease soft tissue dissection,reduce the risk of scarring and promote rapid recovery.

  12. Arthroscopic anterior cruciate ligament distal graft rupture: a method of salvage.

    Science.gov (United States)

    Larrain, Mario V; Mauas, David M; Collazo, Cristian C; Rivarola, Horacio F

    2004-09-01

    We describe a rare case of anterior cruciate ligament (ACL) distal graft rupture in a high-demand rugby player. Fifteen months before this episode, he underwent an ACL reconstruction (autologous patellar tendon graft surgery) plus posterolateral reconstruction with direct suture and fascia lata augmentation. Radiographs revealed correct positioning of tunnels and fixation screws. Magnetic resonance imaging showed that the graft rupture was close to the tibial bone block and presented a signal compatible to the optimal graft incorporation. Surgery recording and clinical records were reviewed. No failures were found. After careful evaluation we concluded that the primary cause of failure was trauma. Based on these findings a salvage surgery technique was performed. Return to sport activities was allowed after four months when sufficient strength and range of motion had returned. Recent follow up (2 years 8 months postoperative) has shown an excellent result with a Lysholm score of 100, International Knee Documentation Committee (IKDC) score of 100, and a KT-1000 arthrometer reading of between 0 and 5 mm. The athlete has returned to his previous professional level. We believe this simple, specific, nonaggressive, and anatomic reconstructive technique may be used in the case of avulsion or distal detachment caused only by trauma and with a graft that is likely to heal.

  13. Reliability of phantom pain relief in neurorehabilitation using a multimodal virtual reality system.

    Science.gov (United States)

    Sano, Yuko; Ichinose, Akimichi; Wake, Naoki; Osumi, Michihiro; Sumitani, Masahiko; Kumagaya, Shin-Ichiro; Kuniyoshi, Yasuo

    2015-01-01

    The objective of this study is to demonstrate the reliability of relief from phantom limb pain in neurore-habilitation using a multimodal virtual reality system. We have developed a virtual reality rehabilitation system with multimodal sensory feedback and applied it to six patients with brachial plexus avulsion or arm amputation. In an experiment, patients executed a reaching task using a virtual phantom limb displayed in a three-dimensional computer graphic environment manipulated by their real intact limb. The intensity of the phantom limb pain was evaluated through a short-form McGill pain questionnaire. The experiments were conducted twice on different days at more than four-week intervals for each patient. The reliability of our task's ability to relieve pain was demonstrated by the test-retest method, which checks the degree of the relative similarity between the pain reduction rates in two experiments using Fisher's intraclass correlation coefficient (ICC). The ICC was 0.737, indicating sufficient reproducibility of our task. The average of the reduction rates across participants was 50.2%, and it was significantly different from 0 (p virtual reality system reduces the phantom limb pain with sufficient reliability.

  14. Gene therapy in peripheral nerve reconstruction approaches.

    Science.gov (United States)

    Haastert, Kirsten; Grothe, Claudia

    2007-06-01

    Gene transfer to a transected peripheral nerve or avulsed nerve root is discussed to be helpful where neurosurgical peripheral nerve reconstruction alone will not result in full recovery of function. Axonal regeneration is supposed to be facilitated by this new therapeutic approach via delivery of specific regeneration promoting molecules as well as survival proteins for the injured sensory and motor neurons. Therefore gene therapy aims in long-term and site-specific delivery of those neurotrophic factors. This paper reviews methods and perspectives for gene therapy to promote functional recovery of severely injured and thereafter reconstructed peripheral nerves. Experimental in vivo and ex vivo gene therapy approaches are reported by different groups. In vivo gene therapy generally uses direct injection of cDNA vectors to injured peripheral nerves. Ex vivo gene therapy is based on the isolation of autologous cells followed by genetic modification of these cells in vitro and re-transplantation of the modified cells to the patient as part of tissue engineered nerve transplants. Vectors of different origin are published to be suitable for peripheral nerve gene therapy and this review discusses the different strategies with regard to their efficiency in gene transfer, their risks and their potential relevance for clinical application.

  15. Elbow tendinopathy and tendon ruptures: epicondylitis, biceps and triceps ruptures.

    Science.gov (United States)

    Rineer, Craig A; Ruch, David S

    2009-03-01

    Lateral and medial epicondylitis are common causes of elbow pain in the general population, with the lateral variety being more common than the medial by a ratio reportedly ranging from 4:1 to 7:1. Initially thought to be an inflammatory condition, epicondylitis has ultimately been shown to result from tendinous microtearing followed by an incomplete reparative response. Numerous nonoperative and operative treatment options have been employed in the treatment of epicondylitis, without the emergence of a single, consistent, universally accepted treatment protocol. Tendon ruptures about the elbow are much less frequent, but result in more significant disability and loss of function. Distal biceps tendon ruptures typically occur in middle-aged males as a result of an event that causes a sudden, eccentric contraction of the biceps. Triceps tendon ruptures are exceedingly rare but usually have a similar etiology with a forceful eccentric contraction of the triceps that causes avulsion of the tendon from the olecranon. The diagnosis of these injuries is not always readily made. Complete ruptures of the biceps or triceps tendons have traditionally been treated surgically with good results. With regard to biceps ruptures, there continues to be debate about the best surgical approach, as well as the best method of fixation of tendon to bone. This article is not meant to be an exhaustive review of the broad topics of elbow tendinopathy and tendon ruptures, but rather is a review of recently published information on the topics that will assist the clinician in diagnosis and management of these conditions.

  16. Concurrent little leaguer's elbow and shoulder in a 15-year-old baseball pitcher and football quarterback.

    Science.gov (United States)

    Domes, Christopher M; Petering, Ryan C; Chesnutt, James C; Mirarchi, Adam

    2012-01-16

    Little leaguer's elbow and Little leaguer's shoulder are overuse pathologies seen in overhead-throwing athletes. No instance of simultaneously occurring pathologies has been published. A 15-year-old baseball pitcher and football quarterback developed pain in his throwing shoulder and elbow during spring baseball, which partially resolved with several months of rest. During fall football practice, he felt a pop and pain over his medial throwing elbow. Five days after the initial injury, medial elbow tenderness, mild swelling, and decreased range of motion were noted. Radiographs revealed a Salter I avulsion fracture of the medial humeral epicondyle (Little leaguer's elbow) and a periosteal reaction along the lateral aspect of the humeral metadiaphysis with slight widening (Little leaguer's shoulder). Surgical fixation of the medial epicondyle fracture and nonoperative treatment of the shoulder pathology were performed. Two-year follow-up radiographs showed a healed medial epicondylar fracture and resolution of the periosteal reaction of the humeral metadiaphysis. The patient returned to full activity and was starting quarterback for his football team. Biomechanical forces specific to overhead-throwing activities are associated with the development of Little leaguer's elbow and shoulder. Treatments of both pathologies remain controversial, with either initial operative vs nonoperative care. In this patient, a good outcome was achieved with surgical fixation of the elbow fracture and conservative management of the shoulder pathology. Educating coaches and parents on proper throwing technique and pitching limits should be the first step in reducing the occurrence of either pathology in this population.

  17. Ingrown toenails

    Directory of Open Access Journals (Sweden)

    Niti Khunger

    2012-01-01

    Full Text Available Onychocryptosis or ingrown toenail is a very common pathology of the toenail unit, chiefly affecting adolescents and young adults. The ingrown toenail is responsible for disabling complaints like pain and difficulty in walking. It is associated with significant morbidity, hampering the quality of life as it interferes with sporting activities, school, or work. It principally occurs in the hallux. It is ascribed to poor trimming of the nails in combination with local pressure due to ill-fitting footwear, hyperhidrosis, poor foot hygiene and nail abnormalities. Pain, swelling and discharge are the main clinical features. Four stages of the condition have been described. Diagnosis is usually evident, but it should be differentiated from subungual exostosis and tumors of the nail bed. The current standard of care focuses on conservative treatment like the gutter splint technique in the initial stages, and in cases that are resistant to medical management or recurrent, surgical correction is the treatment of choice. There are various surgical techniques that are described in literature. Although there is no ideal technique, lateral nail plate avulsion with lateral matricectomy by phenol is commonly used and reported to be more effective in reducing recurrences. The aim of this review article is to focus on this common pathology of the nail, the various techniques employed in management and aid in the selection of treatment according to the stage and severity of the disease.

  18. Using 80% trichloroacetic acid in the treatment of ingrown toenails*

    Science.gov (United States)

    Barreiros, Hugo; Matos, Diogo; Goulão, João; Serrano, Pedro; João, Alexandre; Brandão, Francisco Menezes

    2013-01-01

    BACKGROUND Ingrown nails are a very common problem. There are different stages of disease and diverse therapeutic options. Phenol and sodium hydroxide are commonly used agents for chemical matricectomy but both frequently entail excessive healing times. OBJECTIVE This prospective study aimed mainly to evaluate the efficacy of partial nail avulsion and selective chemical cauterization of the matrix using 80% TCA in the treatment of the ingrowing nail. METHODS One-hundred-and-thirty-three patients with 197 ingrown toenails were included in this study. Preoperatively, we tried to find predisposing factors to the disease. In the postoperative period, patients were evaluated for potential complications at days 3, 30, 180, 270 and 360. Pain was measured before surgery, as well as 24 hours and 72 hours after surgery. RESULTS There were only 3 cases (out of 197) of ingrown nail recurrence. Preoperatively, we found the presence of drainage in 82% of patients, which, following the first visit after surgery, was reduced to 19%. Persistent granulation tissue was found in 3% of the patients (versus 75% prior to surgery). The most frequent predisposing factors for the ingrown nail were excessive trimming of the lateral nail plate (63%), plantar hyperhidrosis (58%) and heavy nail folds (39%). Pain was substantially reduced after surgery. CONCLUSION It is assumed that chemical procedures for the ingrown toenail are associated with delayed healing times but our results demonstrated quick recovery. Using 80% TCA for selective matricectomy in the ingrown toenail is an effective, quick and easy method. PMID:24474095

  19. Controlled trial comparing the efficacy of 88% phenol versus 10% sodium hydroxide for chemical matricectomy in the management of ingrown toenail

    Directory of Open Access Journals (Sweden)

    Chander Grover

    2015-01-01

    Full Text Available Background: Partial nail avulsion with lateral chemical matricectomy is the treatment of choice for ingrown toenails. Phenol (88% is the most widely used chemical agent but prolonged postoperative drainage and collateral damage are common. Sodiumhydroxide (NaOH 10% has fewer side-effects. Methods: Adult, consenting patients with ingrown toenails were alternately allocated into two treatment groups in the order of their joining the study, to receive either 88% phenol (Group 1, n = 26 or 10% NaOH (Group 0, n = 23 chemical matricectomy. The patients as well as the statistician were blinded to the agent being used. Post-procedure follow-up evaluated median duration of pain, discharge, and healing along with recurrence, if any, in both the groups. The group wise data was statistically analyzed. Results: Both the groups responded well to treatment with the median duration of postoperative pain being 7.92 days in Group 0 and 16.25 days in Group 1 (P < 0.202. Postoperative discharge continued for a median period of 15.42 days (Group 0 and 18.13 days (Group 1 (P < 0.203. The tissue condition normalized in 7.50 days (Group 0 and 15.63 days (Group 1 (P < 0.007. Limitations: Limited postsurgical follow up of 6 months is a limitation of the study. Conclusion: Chemical matricectomy using NaOH is as efficacious as phenolisation, with the advantage of faster tissue normalization.

  20. Management of ingrown toenails.

    Science.gov (United States)

    Zuber, T J; Pfenninger, J L

    1995-07-01

    Patients with an ingrown toenail are frequently encountered in primary care practice. Ingrown toenails are the result of an alteration in the proper fit of the nail plate in the lateral nail groove. The alteration can be caused by such factors as wearing shoes that do not fit properly or an incorrect nail-trimming technique. Conservative approaches, including soaking the foot in warm water, use of topical or oral antibiotics, proper nail-trimming technique and elevation of the corner of the nail, are often used in patients with mild stage 1 disease. Stage 2 disease is characterized by worsening of symptoms, drainage and infection, and can be managed conservatively or surgically. Stage 3 disease is characterized by lateral wall hypertrophy and is best treated with partial nail avulsion, lateral matricectomy and destruction of the lateral wall granulation tissue. Chemical matricectomy with phenol is effective, but electrosurgical matricectomy may offer more controlled tissue destruction and less postoperative drainage. A modern office technique for managing stage 3 ingrown toenails is reviewed.