WorldWideScience

Sample records for avulsions

  1. Complete Ureteral Avulsion

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    V. Gupta

    2005-01-01

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

  2. Complete Ureteral Avulsion

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    Gupta, V.; Sadasukhi, T. C.; K.K. Sharma; R. G. Yadav; Mathur, R; Tomar, V.; Yadav, S.S.; Priyadarshi, S.; Gupta, P.

    2005-01-01

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

  3. 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

  4. Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging

    International Nuclear Information System (INIS)

    Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized. (orig.)

  5. Avulsion fractures and chronic avulsion injuries of the knee: role of MR imaging

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    Mellado, J.M.; Ramos, A.; Salvado, E.; Camins, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona (Spain); Calmet, J. [Department of Orthopaedic Surgery, Hospital Universitari de Tarragona Joan XXIII, 43007 Tarragona (Spain)

    2002-10-01

    Avulsion fractures and chronic avulsion injuries of the knee are common lesions in sports-related trauma, especially among adolescents. Magnetic resonance imaging may prove useful in detecting and characterizing such lesions, and has several advantages with regard to other imaging modalities. We review, illustrate, and discuss the MR imaging features of some of the more frequent avulsion fractures and chronic avulsion injuries of the knee, including avulsion fractures of the cruciate ligaments, avulsion fractures of lateral and medial stabilizers, avulsion fractures and chronic avulsion injuries of the extensor mechanism, and avulsive cortical irregularities of the distal femur. The role of MR imaging in evaluating such lesions is emphasized. (orig.)

  6. Face Avulsion and Degloving

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    Panse, Nikhil; Sahasrabudhe, Parag; Joshi, Namrata

    2014-01-01

    There have been sparse reports in literature of avulsion and degloving injuries of individual areas of face like the nose, eyelids, ear and even mandible. Hemi-facial degloving is extremely rare. We present a case of post-assault degloving of the nose, part of forehead with anterior wall of frontal sinus, entire upper and lower eyelids and the cheek. Proper planning and staging of the surgical procedures and use of local flaps, meticulous and proper alignment of tissues gave us good aesthetic...

  7. 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.

  8. Proximal Rectus Femoris Avulsion Repair.

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    Dean, Chase S; Arbeloa-Gutierrez, Lucas; Chahla, Jorge; Pascual-Garrido, Cecilia

    2016-06-01

    Proximal rectus femoris tendon avulsions are rare and occur mostly in male athletes. Currently, the standard of care for complete tendinous avulsions of the direct arm of the rectus femoris is nonoperative treatment. However, surgical repair may be considered in high-level athletes who have a high demand for repetitive hip flexion performed in an explosive manner or in patients in whom nonoperative treatment has failed. The purpose of this technical note is to describe the method for surgical repair of the proximal direct arm of the rectus femoris to its origin at the anterior inferior iliac spine using suture anchors. PMID:27656376

  9. 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.

  10. 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…

  11. 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

  12. 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. PMID:26403089

  13. Triceps tendon avulsion and associated injuries of the elbow

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    Canbora, Kerem; Ozyurek, Selahattin; Gumussuyu, Gurkan; Kose, Ozkan

    2013-01-01

    A rupture or avulsion of the triceps tendon is very rare but concomitant elbow injuries with avulsion of the triceps tendon are even rarer. In this study, an extraordinary and unusual injury combination (radial head and trochlear fracture associated with triceps tendon avulsion), which happened during a fall onto the elbow with outstretched hand, was identified and has been discussed in the literature.

  14. Modeling coupled avulsion and earthquake timescale dynamics

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    Reitz, M. D.; Steckler, M. S.; Paola, C.; Seeber, L.

    2014-12-01

    River avulsions and earthquakes can be hazardous events, and many researchers work to better understand and predict their timescales. Improvements in the understanding of the intrinsic processes of deposition and strain accumulation that lead to these events have resulted in better constraints on the timescales of each process individually. There are however several mechanisms by which these two systems may plausibly become linked. River deposition and avulsion can affect the stress on underlying faults through differential loading by sediment or water. Conversely, earthquakes can affect river avulsion patterns through altering the topography. These interactions may alter the event recurrence timescales, but this dynamic has not yet been explored. We present results of a simple numerical model, in which two systems have intrinsic rates of approach to failure thresholds, but the state of one system contributes to the other's approach to failure through coupling functions. The model is first explored for the simplest case of two linear approaches to failure, and linearly proportional coupling terms. Intriguing coupling dynamics emerge: the system settles into cycles of repeating earthquake and avulsion timescales, which are approached at an exponential decay rate that depends on the coupling terms. The ratio of the number of events of each type and the timescale values also depend on the coupling coefficients and the threshold values. We then adapt the model to a more complex and realistic scenario, in which a river avulses between either side of a fault, with parameters corresponding to the Brahmaputra River / Dauki fault system in Bangladesh. Here the tectonic activity alters the topography by gradually subsiding during the interseismic time, and abruptly increasing during an earthquake. The river strengthens the fault by sediment loading when in one path, and weakens it when in the other. We show this coupling can significantly affect earthquake and avulsion

  15. Elbow Dislocation with Complete Triceps Avulsion

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    S. V. Karuppiah

    2014-01-01

    Full Text Available Radio-ulnar Fracture dislocation of the elbow is a high-energy trauma which can be associated with significant ligamentous injury in adults. We report an unusual triad of injury in a patient with avulsion injury of the triceps. This injury can be thought of as a variant of “terrible triad” with dislocation of radio-ulnar joint, radial head fracture, and medial collateral ligament injury with avulsion of the triceps. Elbow has to be stabilized with early repair of the ligaments for a successful outcome.

  16. Heel pad avulsion injury: an approach with hyperbaric oxygen therapy

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    Pradeoth Korambayil Mukundan

    2015-04-01

    Full Text Available Aim: Crush injuries of the foot are often associated with partial or complete degloving of the heel pad. The purpose of this study is to present an algorithm for the management of various types of heel pad avulsion injuries, including hyperbaric oxygen (HBO therapy in the treatment regimen. Methods: We present a prospective study of 27 patients with various types of heel pad avulsion managed in our institution from December 2012 to June 2013. Heel pad avulsion injuries were classified according to the angiosomal pattern. Partial or complete avulsions were classified and treated accordingly. HBO therapy was administered postoperatively. The postoperative period, hospital course, and follow-up were documented in patients with heel pad avulsion injuries. Results: Of 27 patients, 20 cases presented with partial avulsion and 7 cases were complete avulsion. Of 20 cases of partial avulsion, one of the flaps was anchored with K-wire. Nineteen cases of partial heel pad avulsion were managed by suturing. Eight patients out of 20 required skin grafting as a secondary procedure at a later date. Out of 7 cases of complete avulsion, one was managed by full-thickness skin grafting, one case by reverse sural artery flap coverage, and four cases were managed by free tissue transfer. No flap revisions were required, and no complications were experienced for the transferred flaps. Conclusion: HBO therapy may be a useful adjunct in the treatment of heel pad avulsion injuries.

  17. Triceps tendon avulsion and associated injuries of the elbow

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    Canbora, Kerem; Ozyurek, Selahattin; Gumussuyu, Gurkan; Kose, Ozkan

    2013-01-01

    A rupture or avulsion of the triceps tendon is very rare but concomitant elbow injuries with avulsion of the triceps tendon are even rarer. In this study, an extraordinary and unusual injury combination (radial head and trochlear fracture associated with triceps tendon avulsion), which happened during a fall onto the elbow with outstretched hand, was identified and has been discussed in the literature. PMID:23667221

  18. 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.

  19. 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.)

  20. 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.

  1. Combined Tibial Tubercle Avulsion Fracture and Patellar Avulsion Fracture: An Unusual Variant in an Adolescent Patient.

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    Stepanovich, Matthew T; Slakey, Joseph B

    2016-01-01

    Traumatic extensor dysfunction of the knee in children is a rare injury, with the majority resulting from tibial tubercle avulsion fracture or patellar sleeve fracture. We report a rare case of combined patellar avulsion fracture and tibial tubercle fracture. With open anatomic reduction, both injuries were successfully treated. While many variations of tibial tubercle fracture have been reported, the authors believe this to be the first report in the English-language literature of this particular combined injury to the knee extensor mechanism in an adolescent. Advanced imaging with computed tomography provided vital information to aid with operative planning, especially since the majority of the unossified tubercle was not seen on plain radiographs, and all fracture fragments were originally believed to be from the tibial tubercle. Computed tomography distinguished the patellar fracture from the tibial tubercle fragments, verifying preoperatively the complexity of the injury. PMID:26761925

  2. Functional reconstruction following brachial plexus root avulsion

    Institute of Scientific and Technical Information of China (English)

    Guixin Sun; Cunyi Fan; Yudong Gu

    2007-01-01

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

  3. APOPHYSEAL FRACTURE OR AVULSION OF THE GREATER TROCHANTER

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    FREITAS, ANDERSON; MACEDO, SÍLVIO LEITE DE

    2016-01-01

    ABSTRACTS The apophyseal fracture or avulsion of the greater trochanter occurs in skeletally immature patients. It has at etiological factors indirect mechanisms (avulsion) and direct mechanisms (trauma on the trochanter), the latter being the most common. The clinical presentation is easily identified and a simple X- ray can confirm the diagnosis. Regardless of the treatment chosen, this pathology has a high correlation with osteonecrosis of the femoral head, even as a rare fact, however with innocent appearance, on this pathology. PMID:27217820

  4. [Aspects of expert opinions of avulsion fractures].

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    Schröter, F

    2016-03-01

    The apophyses as secondary ossification centers are connected with the bone by cartilage. During the growth phase of puberty, the apophyseal plate is a mechanical weak spot. Especially, apophyses in the hip and pelvic area are exposed to considerable tensile and sheer stresses due to the strong muscles which are inserted here. The frequency of injuries to the apophyses correlates with the extent of sporting activities. For athletes participating in "Youth Train for the Olympics", this is the most common injury of all. Most often, the apophysis of the rectus femoris muscle is affected at the anterior inferior iliac spine. In adults, after complete ossification of the apophyseal plate such injuries are rare. However, in a very unusual mechanism of injury with maximum forced hip flexion and simultaneous maximum knee extension, avulsions of the ischial tuberosity are observed in adults. During the causality test-especially in the legal area of statutory accident insurance-the question is always whether the alleged course of events has to be regarded as a legally significant (partial) cause or if a longer period of time has been involved, so that the resulting morbid apophysis detachment was predominately due to fate, in which the alleged event must be interpreted as legally immaterial. PMID:26924516

  5. 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.

  6. 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.

  7. Transosseous-Equivalent Repair for Distal Patellar Tendon Avulsion.

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

    2016-04-01

    Extensor mechanism disruptions are relatively uncommon injuries involving injury to the quadriceps tendon, patella, or patellar tendon. Patellar tendon avulsions from the tibial tubercle in adults are rare; as such, little technical information has been written regarding surgical management of this injury in the adult. Transosseous-equivalent repairs have been described in the management of several types of tendon ruptures, including rotator cuff and distal triceps tendon ruptures, but not previously in patellar injuries. We present a technique for repairing an avulsion injury of the patellar tendon from the tibial tubercle using suture anchors in a transosseous-equivalent manner. This technique for treating distal patellar tendon avulsion injuries likely increases contact area at the repair site while potentially improving fixation strength. PMID:27462538

  8. Subtle Radiological Features of Splenic Avulsion following Abdominal Trauma

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    S. A. Rehim

    2010-01-01

    Full Text Available Splenic trauma in children following blunt abdominal injury is usually treated by nonoperative management (NOM. Splenectomy following abdominal trauma is rare in children. NOM is successful as in the majority of instances the injury to the spleen is contained within its capsule or a localised haematoma. Rarely, the spleen may suffer from an avulsion injury that causes severe uncontrollable bleeding and necessitates an emergency laparotomy and splenectomy. We report two cases of children requiring splenectomy following severe blunt abdominal injury. In both instances emergency laparotomy was undertaken for uncontrollable bleeding despite resuscitation. The operating team was unaware of the precise source of bleeding preoperatively. Retrospective review of the computed tomography (CT scans revealed subtle radiological features that indicate splenic avulsion. We wish to highlight these radiological features of splenic avulsion as they can help to focus management decisions regarding the need/timing for a laparotomy following blunt abdominal trauma in children.

  9. 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.

  10. 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.

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

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    Hajime Matsumine, MD, PhD

    2015-01-01

    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 drai...

  12. 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.

  13. 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

  14. Heterotopic ossification following surgical treatment of avulsion fracture of the anterior inferior iliac spine

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    Gojković Zoran; Harhaji Vladimir; Milankov Miroslav Ž.; Drapšin Miodrag

    2011-01-01

    Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports act...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. TIBIAL TUBERCLE AVULSION FRACTURE IN A MALE ADOLESCENT.

    Science.gov (United States)

    Matoković, Damir; Šimić-Klarić, Andrea; Rajić, Marijana Tomić; Crnković, Helena Tesari; Jurinić, Mislav; Jovanović, Savo

    2015-06-01

    Tibial tuberosity fractures are rare in childhood, most frequently due to excessive quadriceps muscle contraction. On performing long jump, a 15-year-old boy sustained tibial tuberosity avulsion fracture type II according to Watson-Jones. The patient was treated operatively with fragment repositioning and screw fixation. Ten months after the injury and rehabilitation, he resumed his sports activities with full range knee motion. PMID:26415319

  19. Finger avulsion injuries: A report of four cases

    Directory of Open Access Journals (Sweden)

    Fejjal N

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Iversen, Jonas Vestergård; Krogsgaard, Michael Rindom

    2012-01-01

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

  1. 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.

  2. Storage media for avulsed teeth: a literature review.

    Science.gov (United States)

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

    2013-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries because it causes damage to several structures and results in the complete displacement of the tooth from its socket in the alveolar bone. The ideal situation is to replant an exarticulated tooth immediately after avulsion because the extraoral time is a determinant factor for treatment success and for a good prognosis. However, it is not always possible. The success of replantation depends on a number of factors that may contribute to accelerate or minimize the occurrence of root resorption or ankylosis, among which is the type and characteristics of the medium used for temporary storage during the time elapsed between avulsion and replantation. Maintaining the tooth in an adequate wet medium that can preserve, as longer as possible, the vitality of the periodontal ligament cells that remain on root surface is the key to success of replantation. Recent research has led to the development of storage media that produce conditions that closely resemble the original socket environment, with adequate osmolality (cell pressure), pH, nutritional metabolites and glucose, and thus create the best possible conditions for storage. Although these storage media can now be purchased in the form of retail products, the most common scenario is that such a product will not be readily available at the moment of the accident This paper reviews the literature on the different storage media that have been investigated for avulsed teeth based on full-length papers retrieved from PubMed/Medline, Lilacs, BBO and SciELO electronic databases using the key words 'storage medium', 'transportation medium', 'avulsion', 'tooth avulsion', 'replantation', 'tooth replantation', 'milk' and 'propolis'. After application of inclusion and exclusion criteria, 39 papers were selected and critically reviewed with respect to the characteristics, efficacy and ease of access of the storage medium. The review of the literature showed that a

  3. 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

  4. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, A.R.; Barnes, J.C.; Ogden, J.A.

    1987-10-01

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

  5. Break dance hip: Chronic avulsion of the anterior superior iliac spine

    International Nuclear Information System (INIS)

    A case of chronic, progressive avulsion of the anterior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing. (orig.)

  6. Diagnosing adductor muscle avulsion at the symphysis pubis with ultrasound.

    Science.gov (United States)

    Chen, David J; Caldera, Franklin E; Kim, Woojin

    2014-04-01

    A 58-yr-old woman presented after experiencing left hip and groin pain for 1 mo. She denies any history of trauma, falls or any bruising, or history of sports injury or extreme physical exertion before her symptoms. On ultrasonography, she was found to have an avulsion tear at the origin of the adductor muscles, predominantly involving the adductor longus and brevis muscles. The treatment course was conservative: nonsteroidal anti-inflammatory drugs for pain control and physical therapy for muscle strengthening and balance improvement. Upon follow-up, she demonstrated significant improvement and resolution of her pain. PMID:24196970

  7. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  9. Avulsion fracture of the iliac crest in a child☆☆☆

    Science.gov (United States)

    Mortati, Rafael Borghi; Borghi Mortati, Lucas; Silva Teixeira, Matheus; Itiro Takano, Marcelo; Armelin Borger, Richard

    2014-01-01

    Avulsion fractures of the apophysis of the iliac crest have rare incidence and are little known. In this article, we report the case of an 11-year-old female patient who presented this injury after indirect trauma. From careful radiographic analysis, an avulsion fracture of the iliac crest was identified. It was decided to use nonsurgical treatment comprising analgesia and load restriction. This case report emphasizes the importance of suspecting avulsion fractures in cases of low-energy trauma, and also guides the treatment, so as to prevent functional deficit and deformities. PMID:26229818

  10. Skin avulsion injury during endotracheal tube extubation – case report of an unusual complication

    Directory of Open Access Journals (Sweden)

    Gurunluoglu Raffi

    2008-05-01

    Full Text Available Abstract We report a geriatric case with a full-thickness skin avulsion injury during extubation due to a tube securing tape used to fixate the endotracheal tube. The avulsed skin was sutured back to its original place. Based on this single geriatric patient, we recommend anesthesiologists/anesthetists and surgeons be aware of the potential risk of avulsing the skin with tape during a standard extubation procedure. This may especially occur in geriatric patients who have age related changes as decreased elasticity and resistance to shearing forces that predispose the skin to get traumatized easily.

  11. Partial salvage of avulsed tissue after dog bite.

    Science.gov (United States)

    Øregaard, J S; Lang, C L; Venzo, A

    2016-02-01

    Injuries to the nose can be severe from both a functional and cosmetic perspective. After suffering a dog bite to the central part of the face, an 18-year old woman underwent replantation of the avulsed tissue with the help of microsurgical arterial anastomosis. A venous anastomosis was impossible and venous congestion was treated with leech therapy. Subsequent skin necrosis occurred after a few days and the replantation was revised, revealing healthy tissue immediately below. The defect was covered with a full-thickness skin graft. At follow-up review eight months later, the functional and cosmetic result was satisfactory. To our knowledge, this is one of few cases where an injury of this severity healed with a cosmetically acceptable result. PMID:26673050

  12. 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.

  13. First Results in new technique of Arthrosc. Button-to-Button repair of PCL avulsion injuries

    OpenAIRE

    Thiele, Joern; Woelfl, Christoph; von Recum, Jan

    2016-01-01

    Aims and Objectives: The goal of the study was to describe the short time results of our new surgical technique of arthroscopic Button-to-Button fixation for acute tibial posterior cruciate ligament (PCL) avulsion fractures. Concerning clinical and radiographic outcomes, and complication rates. Materials and Methods: This prospective study includes patients with an acute tibial avulsion fracture of the PCL. The reduction and fixation was performed all arthroscopic, reduction and suture fixati...

  14. 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.

  15. The Riverbed Evolution, Avulsions and Backwater Hydrodynamics on the Huanghe River Delta

    Science.gov (United States)

    Chu, Z.; Ganti, V.; Lamb, M. P.

    2013-12-01

    The Huanghe River is known for high suspended sediment concentration and resultant heavy sedimentation and frequent channel-shifting among major rivers in the world. This plain coastal river is the main contributor of terrestrial sediment to the Bohai Sea and the Yellow Sea. Since 1855, there have been 11 major avulsions (versus 4 avulsions on the Mississippi River during the Holocene) on the lower reach with an recurrence interval of ~10 years, developing individual lobes that build up the modern Huanghe River delta. We summarize the main features of riverbed evolution on the delta with a database of measured data. The observed avulsions on the delta often occurred along a persistent spatial node, whose distance from the shoreline scales with the computed backwater length. In order to explain the avulsion locations on the delta, and meanwhile to test the viewpoint of river backwater controls on avulsion locations on deltas, we simulate the long profile evolution of the riverbed on the delta considering river discharge, river plume spreading, land subsidence and sea level rise, with a 1D fluvial morphodynamic model. The main results from the numerical simulations provide insights into how the long profile of the river on the delta evolves at the time scales of flood events and avulsions.

  16. 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.

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Abeer M. Abdellatif

    2011-04-01

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

  19. Knowledge of physical education teachers about emergency management of tooth avulsion

    Directory of Open Access Journals (Sweden)

    Claudia Londero Pagliarin

    2011-01-01

    Full Text Available A great number of traumatic dental injuries occur at school, during sports-related activities. However, physical education teachers are often not prepared to provide emergency management of dental trauma in general and of tooth avulsion in particular. The aim of this study was to assess the knowledge of emergency management of tooth avulsion among physical education teachers at public and private schools of a city in southern Brazil. A questionnaire covering personal and professional information and eight multiple-choice questions to assess knowledge of emergency management of tooth avulsion was sent to 217 physical education teachers. Of a total of 217 questionnaires distributed, 102 returned. Only 23.5% of the teachers had received prior information on dental trauma. When asked about the fi rst action to be taken if faced with an avulsed tooth, only 12.7% informed they would attempt to replant the tooth. Fifty two teachers (51% were not aware of the optimum extraoral time. Signifi cant differences were found between teachers who had and who had not received prior information with regard to adequate transport medium and adequate time for replantation (chi-square, p = 0.03 and p = 0.02, respectively. There is a general lack of knowledge of emergency management of avulsed teeth among physical education teachers, pointing to an urgent need to implement regular, continuing education so as to increase the level of knowledge and improve prognosis of this important traumatic dental injury.

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

    Directory of Open Access Journals (Sweden)

    A de Lima Ludgero

    2012-01-01

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

  1. One-dimensional modeling of a recent Ganga avulsion : Assessing the potential effect of tectonic subsidence on a large river

    NARCIS (Netherlands)

    Gupta, Niladri; Kleinhans, Maarten G.; Addink, Elisabeth A.; Atkinson, Peter M.; Carling, Paul A.

    2014-01-01

    River avulsion as studied in small-sized and medium-sized rivers is partly explained by the water surface gradient advantage of a new channel course over the old course, caused by spatial differences in aggradation and compaction. Recently, the effect of meandering upstream of the avulsion node, or

  2. Reversal of phantom pain and hand-to-face remapping after brachial plexus avulsion.

    Science.gov (United States)

    Tsao, Jack W; Finn, Sacha B; Miller, Matthew E

    2016-06-01

    Following left brachial plexus avulsion, a 20-year-old man had phantom limb pain and remapping of sensation from his paralyzed hand onto his face. Mirror therapy (15 min daily, 5 days/week) led immediately to good movement of the phantom limb with decreased pain. Within 2 weeks following nerve graft surgery, remapping of hand sensation onto the face disappeared along with resolution of phantom limb pain. Mirror therapy coupled with nerve grafting may relieve phantom limb pain due to brachial plexus avulsion and reverse hand-to-face remapping, suggesting that both peripheral and central mechanisms mediate development of phantom limb pain and cortical reorganization/neuroplasticity after brachial plexus avulsion. PMID:27547774

  3. Avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissue.

    Science.gov (United States)

    Resnick, J M; Carrasco, C H; Edeiken, J; Yasko, A W; Ro, J Y; Ayala, A G

    1996-08-01

    Patients who have sustained an avulsion fracture and present clinically during the healing phase of the injury may manifest a mass that clinically and radiographically mimics a malignant neoplasm. A 15-year-old male soccer goalkeeper presented with a large ossified mass in the soft tissues overlying the right hip 6 months after experiencing a popping sensation in his hip joint during a game. Although an osteosarcoma was suspected clinically and radiographically, a Tru-Cut needle biopsy of the lesion revealed reactive bone formation. Correlation of the clinical, radiographic, and pathologic findings indicated an avulsion fracture of the anterior inferior iliac spine with abundant reactive ossification in the soft tissues. The healing phase of an avulsion fracture may clinically and radiographically be mistaken for neoplasia. In such cases, a Tru-Cut needle biopsy may reveal the reactive nature of the process. PMID:8865496

  4. Avulsion of the brachial plexus in a great horned owl (Bubo virginaus)

    Science.gov (United States)

    Moore, M.P.; Stauber, E.; Thomas, N.J.

    1989-01-01

    Avulsion of the brachial plexus was documented in a Great Horned Owl (Bubo virginianus). A fractured scapula was also present. Cause of these injuries was not known but was thought to be due to trauma. Differentiation of musculoskeletal injury from peripheral nerve damage can be difficult in raptors. Use of electromyography and motor nerve conduction velocity was helpful in demonstrating peripheral nerve involvement. A brachial plexus avulsion was suspected on the basis of clinical signs, presence of electromyographic abnormalities in all muscles supplied by the nerves of the brachial plexus and absence of median-ulnar motor nerve conduction velocities.

  5. Avulsion fractures of the anterior inferior iliac spine: spectrum of imaging findings

    International Nuclear Information System (INIS)

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

  6. Coconut Water (Cocos nucifera) as Storage Media for the Avulsed Tooth

    OpenAIRE

    Aan Mi’dad Arrizza; Amatul Firdaus Ramadhan

    2012-01-01

    Avulsion is a condition of tooth displacement outside the socket due to the trauma. In a case of tooth avulsion case of per-manent teeth, the treatment of choice is replanting the tooth back to the socket. The main concern prior to tooth replanta-tion is to maintain the vitality of periodontal ligament (PDL) cells. The vitality of PDL cells is crucial to form new perio-dontal ligament tissue to support the teeth in order to achieve the success of replantation treatment. Therefore the tooth st...

  7. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Polyzoidis, Konstandinos; Vranos, Georgios [Department of Neurosurgery, Medical School, University of Ioannina, 45110, Ioannina (Greece); Petropoulou, Calliope; Argyropoulou, Paraskevi I.; Argyropoulou, Maria I. [Department of Radiology, Medical School, University of Ioannina, 45110, Ioannina (Greece); Sarmas, Ioannis [Department of Neurology, Medical School, University of Ioannina, 45110, Ioannina (Greece)

    2002-09-01

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

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. First Results in new technique of Arthrosc. Button-to-Button repair of PCL avulsion injuries

    Science.gov (United States)

    Thiele, Joern; Woelfl, Christoph; von Recum, Jan

    2016-01-01

    Aims and Objectives: The goal of the study was to describe the short time results of our new surgical technique of arthroscopic Button-to-Button fixation for acute tibial posterior cruciate ligament (PCL) avulsion fractures. Concerning clinical and radiographic outcomes, and complication rates. Materials and Methods: This prospective study includes patients with an acute tibial avulsion fracture of the PCL. The reduction and fixation was performed all arthroscopic, reduction and suture fixation by Tight Rope ABS and 2 ABS Buttons (Fa. Arthrex). Indication for image-proven displaced tibial PCL avulsion fractures with posterior knee instability of grade II or higher. The mean follow-up period was 6 months. Follow-up assessment included clinical assessment, functional scores, and radiographic evaluation. Results: First Results showed that Patients had better range of motion compared to Patients with an open technique. The postoperative physiotherapy was not limited by the dorsal approach. We have seen no leck of extension after 6 months due to all arthroscopic technique. All fractures achieved union. We have seen no procedure connected complications like wound infections, Button dislocations or nonunions. Conclusion: Treatment of tibial PCL avulsion fractures by all arthroscopic Button-to-Button fixation seems to be a successful technique. The benefit with an stable fixation without a dorsal approach helps the postoperative treatment and avoids soft tissue problems , especially limitations of the extension due to Arthrofibrosis and dorsal scar formation. Intermediate and long term results have to prove the clinical results.

  13. Possible complications of ureteroscopy in modern endourological era: two-point or "scabbard" avulsion.

    Science.gov (United States)

    Gaizauskas, Andrius; Markevicius, Marius; Gaizauskas, Sergejus; Zelvys, Arunas

    2014-01-01

    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. PMID:25610699

  14. 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

  15. 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. PMID:19459922

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

    Directory of Open Access Journals (Sweden)

    Umut Hatay Gölge

    2015-06-01

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

  17. 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

  18. Long-term effects of a lumbosacral ventral root avulsion injury on axotomized motor neurons and avulsed ventral roots in a non-human primate model of cauda equina injury.

    Science.gov (United States)

    Ohlsson, M; Nieto, J H; Christe, K L; Havton, L A

    2013-10-10

    Here, we have translated from the rat to the non-human primate a unilateral lumbosacral injury as a model for cauda equina injury. In this morphological study, we have investigated retrograde effects of a unilateral L6-S2 ventral root avulsion (VRA) injury as well as the long-term effects of Wallerian degeneration on avulsed ventral roots at 6-10 months post-operatively in four adult male rhesus monkeys. Immunohistochemistry for choline acetyl transferase and glial fibrillary acidic protein demonstrated a significant loss of the majority of the axotomized motoneurons in the affected L6-S2 segments and signs of an associated astrocytic glial response within the ventral horn of the L6 and S1 spinal cord segments. Quantitative analysis of the avulsed ventral roots showed that they exhibited normal size and were populated by a normal number of myelinated axons. However, the myelinated axons in the avulsed ventral roots were markedly smaller in caliber compared to the fibers of the intact contralateral ventral roots, which served as controls. Ultrastructural studies confirmed the presence of small myelinated axons and a population of unmyelinated axons within the avulsed roots. In addition, collagen fibers were readily identified within the endoneurium of the avulsed roots. In summary, a lumbosacral VRA injury resulted in retrograde motoneuron loss and astrocytic glial activation in the ventral horn. Surprisingly, the Wallerian degeneration of motor axons in the avulsed ventral roots was followed by a repopulation of the avulsed roots by small myelinated and unmyelinated fibers. We speculate that the small axons may represent sprouting or axonal regeneration by primary afferents or autonomic fibers. PMID:23830908

  19. 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.

  20. Stress avulsion of the tibial tuberosity after tension band wiring of a patellar fracture: a case report

    OpenAIRE

    Hirschmann, Michael T; Wind, Björn; Mauch, Christian; Ickler, Gesa; Friederich, Niklaus F

    2009-01-01

    Introduction To the best of our knowledge there is no other report of an elderly patient who was surgically treated for a patellar fracture with tension band wiring and who subsequently suffered from an avulsion fracture of the tibial tuberosity. The combination of a patellar fracture and avulsion of the patellar ligament has only been described as complication after bone-patellar tendon-bone anterior cruciate ligament reconstructions. However, due to demographic changes and more elderly pati...

  1. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures.

    Science.gov (United States)

    Nakamura, Toshiyasu; Iwamoto, Takuji; Matsumura, Noboru; Sato, Kazuki; Toyama, Yoshiaki

    2014-02-01

    Background As the triangular fibrocartilage complex (TFCC) anchors the distal radius to the ulna via the radioulnar ligament (RUL), a severely displaced distal fragment of the radius may be associated with a foveal avulsion of the TFCC. The purpose of this retrospective study was to assess, radiographically and arthroscopically, the relationship between displacement of the radius, the ulnar styloid, and avulsion of the RUL resulting in distal radioulnar joint (DRUJ) instability. Materials and Methods Twenty-nine wrists of 29 patients with intra- and extra-articular distal radius fractures/malunion who underwent reduction or a corrective osteotomy of the displaced/malunited fracture, and/or wrist arthroscopy, were assessed radiographically and arthroscopically. Radial translation, radial inclination, radial shortening, volar or dorsal tilt, and the presence of an ulnar styloid fracture with more than 4 mm of displacement were measured from the initial films. Radiocarpal arthroscopy was used to assess peripheral lesions of the TFCC, while DRUJ arthroscopy was used to assess the foveal attachment. The relationship between displacement of the distal radius or the ulnar styloid fracture and the TFCC injury, including avulsion of the RUL, was recorded. Results Univariate analysis revealed that increased radial translation, decreased radial inclination, increased radial shortening, and an ulnar styloid fragment radially displaced by more than 4 mm were significant predictors of RUL avulsion at the fovea. Volar or dorsal tilt of the radius and ulnar variance did not correlate with RUL avulsion or TFCC injuries. Multiple logistic regression analysis revealed that radial translation was an independent risk factor of foveal avulsion of the RUL. Conclusions Increased radial translation and radial shortening and decreased radial inclination of the distal fragment can be associated with a foveal avulsion of the RUL. Radial translation can be an independent risk

  2. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Nishiura, Yasumasa; Ochiai, Naoyuki; Miyauchi, Yukio; Niitsu, Mamoru [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine

    2002-10-01

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

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

    International Nuclear Information System (INIS)

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

  5. Scintigraphy for diagnosis of avulsions of the origin of the suspensory ligament in horses: 51 cases (1980-1993)

    International Nuclear Information System (INIS)

    The medical records of 34 horses with a diagnosis of avulsion of the origin of the suspensory ligament that had been admitted to the veterinary medical teaching hospital between 1980 and 1993 were identified. In addition to clinical examination, 21 of 34 horses had scintigraphy and radiography performed during their examination. The usefulness of scintigraphy and radiography were assessed by comparing the initial findings reported in the medical record to those obtained in a retrospective review of the images. Thirty other horses with scintigraphic lesions of the proximal aspect of the third metacarpal/metatarsal bone but with a confirmed diagnosis other than avulsion of the suspensory ligament served as controls for lesion specificity. Scintigraphy (bone phase, n = 21) revealed increased uptake in all horses in both reviews. Only 14 of 21 (67%) horses radiographed, however, had at least 1 lesion during the initial radiographic evaluation that was reported to be suggestive of avulsion. When the radiographs were reviewed retrospectively, the radiologist identified 18 of 21 (86%) horses with lesions consistent with avulsion. The interpretation of scintigraphy appeared to be a more repeatable and sensitive diagnostic method than radiography. However, though scintigraphy was sensitive in identifying inflammation of the proximal aspect of the metacarpal/metatarsal region, no specific diagnosis of avulsion could be made without coincident radiography; the specificity of scintigraphy in diagnosing avulsion of the suspensory ligament was only 41% (21/51)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-04-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

    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. (orig.)

  9. Cervical myelography of nerve root avulsion injuries using water-soluble contrast media.

    Science.gov (United States)

    Cobby, M J; Leslie, I J; Watt, I

    1988-08-01

    Eight cases of cervical nerve root avulsion injury are presented which were investigated by cervical myelography using a water-soluble contrast medium. The previous literature describes the appearances of this lesion using an oil-based agent and has resulted in emphasis being placed on looking for a traumatic meningocele rather than an abnormality of the roots themselves. The excellent definition of the nerve rootlets and axillary pouch that are obtained with a water-soluble contrast medium resulted in more root lesions per patient being detected than with an oil-based medium. There was complete correlation with the surgical findings at all but one root level explored. The appearances of root avulsion injuries and the advantages of using a water-soluble contrast medium are discussed. PMID:3416107

  10. 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.

  11. Acute Traumatic Musculotendinous Avulsion of the Flexor Pollicis Longus Tendon Treated with Primary Flexor Digitorum Superficialis Transfer: A Novel Technique of Management

    Directory of Open Access Journals (Sweden)

    P. Kiran Sasi

    2016-01-01

    Full Text Available Traumatic musculotendinous junction avulsions are rare injuries except in avulsion amputations. They pose a significant challenge to the treating surgeon. We present a 24-year-old male who sustained an open musculotendinous avulsion of the flexor pollicis longus tendon. He was treated with primary tendon transfer using the flexor digitorum superficialis of ring finger, in flexor zone 3. The functional result at 10 months following surgery was excellent.

  12. Polish school nurses’ knowledge of the first-aid in tooth avulsion of permanent teeth

    OpenAIRE

    Baginska, Joanna; Rodakowska, Ewa; Milewski, Robert; Wilczynska-Borawska, Magdalena; KIERKLO, Anna

    2016-01-01

    Background The frequency of dental trauma in schools is secondary only to accidents at home. The aim of this study was to evaluate the knowledge of first aid in the avulsion of permanent teeth presented by Polish school nurses from different areas. Methods A cross-sectional study with the use of a structured self-administrative questionnaire was conducted in 2014 on school nurses working in randomly selected Polish provinces. The instrument consisted of demographic questions, questions referr...

  13. Adductor insertion avulsion syndrome with stress fracture of femoral shaft: MRI findings

    International Nuclear Information System (INIS)

    Full text: Chronic vague hip pain may be caused by stress-related injury in the proximal or mid-femoral diaphysis. This has been described as an entity called adductor insertion avulsion syndrome, or thigh splints. In the appropriate clinical setting, the radiologist interpreting the magnetic resonance imaging must be aware of this condition as its imaging findings are subtle. The diagnosis will help the clinician plan the appropriate management. Magnetic resonance imaging can also depict the complications such as stress fracture

  14. Flexor digitorum profundus tendon avulsion in an amateur basketball player: Jersey finger

    OpenAIRE

    KUYUBAŞI, Numan Sabit; ÇIRAKLI, Alper; ZENGİN, Çağatay Eyüp; Murat ERDOĞAN; PİŞKİN, Ahmet

    2013-01-01

    Flexor tendon injury of the finger may be open or closed, but it is not as common as extensor tendon injuries. Pathogenesis is associated with many factors. Sports injuries are also among those causes. Applied treatment approach is primary repair or pull-out technique. In this paper, we discussed the case in the light of the literature, that we performed repair via pull out technique for flexor digitorum profundus tendon avulsion in an amateur sportsman.

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

    OpenAIRE

    Samaneh Badakhsh; Tahereh Eskandarian; Tahereh Esmaeilpour

    2014-01-01

    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 differe...

  16. The Effectiveness of Oral Rehydration Solution at Various Concentrations as a Storage Media for Avulsed Teeth

    OpenAIRE

    Eskandarian, Tahereh; Badakhsh, Samaneh; Esmaeilpour, Tahereh

    2013-01-01

    Introduction Following avulsion, the periodontal ligament (PDL) cells are at risk of necrosis. To achieve a favorable survival prognosis, the PDL cells must be kept viability. Therefore, immediate replantation is considered as the treatment of choice and in case it is not possible, storing the tooth in an appropriate storage media should be considered. Oral Rehydration Solution (ORS) is a glucose-electrolyte solution which can keep the optimal osmolality as well as pH and can even provide nut...

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

    Directory of Open Access Journals (Sweden)

    Lijun Li

    2015-01-01

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

  18. 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...

  19. Heterotopic ossification following surgical treatment of avulsion fracture of the anterior inferior iliac spine

    Directory of Open Access Journals (Sweden)

    Gojković Zoran

    2011-01-01

    Full Text Available Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports activities. Two years later, due to the pain in the hip an x-ray and MR image were made, which established the existence of crescent formation, a heterotopic bone, in the area of the anterior inferior iliac spine, which was surgically removed. Physical and medical therapy was conducted and after four months, the professional athlete was back playing football. Two years after the surgical excision of heterotopic ossification, the patient was completely asymptomatic with the same ROM without any thigh muscle hypotrophy, although isokinetic muscle testing did show some weakness of the thigh extensor muscles. An x-ray did not show any signs of heterotopic ossification.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    Sara Tavassoli-Hojjati

    2014-04-01

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

  2. 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...

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

    Science.gov (United States)

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

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

  4. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  6. Bilateral atraumatic tibial tubercle avulsion fractures: case report and review of the literature.

    Science.gov (United States)

    Khoriati, Al-Achraf; Guo, Shigong; Thakrar, Raj; Deol, Rupinderbir S; Shah, Khalil Y

    2015-04-01

    An avulsion fracture of the tibial tubercle is an uncommon injury, comprising less than 1% of all physeal injuries. The occurrence of such injuries bilaterally is even rarer. We report a case of bilateral atraumatic tibial tubercle avulsion fractures and its presentation, mechanism of injury, surgical management, post-operative rehabilitation and implications for clinical practice. A 17-year-old healthy male presented to the emergency department with severe pain on the anterior aspect of both knees and was unable to walk, having been brought in by ambulance after hearing a crack whilst jogging. On examination, there was significant swelling of both knees which were held in extension. On both sides there was a prominent deformity on the region of the tibial tubercle with a palpable gap, although no open skin wound. He was unable to actively move either knee joint. No neurovascular deficit was present. Plain radiographs revealed bilateral tibial tubercle avulsion fractures. Gentle manipulation was performed in the emergency department to the fragments in order to remove the tension from the skin. The fragments were reduced and fixed surgically with 4mm cannulated screws in an anterior to posterior direction. Both limbs were placed in temporary casts in 20 degrees of flexion. Postoperatively, the patient was kept non-weight bearing for four weeks then placed into a range of motion brace and movement commenced. Full weight bearing was permitted at the one month stage and he was advised to avoid any sporting activity until the 8 week stage and contact sports until the 10 week stage. Full movement of both joints was regained and the patient returned to full sporting activity in the absence of symptoms. This case emphasises the need for a high degree of vigilance when faced with such a presentation and a low threshold for further investigation and surgical intervention. PMID:25638599

  7. Stress avulsion fracture of the tarsal navicular. An uncommon sports-related overuse injury.

    Science.gov (United States)

    Orava, S; Karpakka, J; Hulkko, A; Takala, T

    1991-01-01

    We report nine cases of stress-related avulsion fracture of the tarsal navicular in athletes. This uncommon over-use injury is thought to occur following repetitive cyclic compressive loading secondary to an impingement of the tarsal navicular. The small dorsal triangular fragment is best seen in weightbearing lateral view radiographs and isotope scan and/or tomography help confirm the diagnosis. We feel that operative treatment is the method of choice in highly symptomatic cases and among top athletes because of the shorter recovery time. PMID:1897656

  8. 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.

  9. COMBINED TIBIAL AVULSION OF ANTERIOR AND POSTERIOR CRUCIATE LIGAMENT OF KNEE JOINT: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Ajaybir

    2015-01-01

    Full Text Available Avulsion fractures of tibial intercondylar eminence is a rare injury mainly affecting the pediatric population between 8 to 14 and is even rarer in adults with very few cases reported in literature. It occurs with high energy trauma in adults and may be associated with knee dislocation and neurovascular injuries. A 30 yr old male presented with a painful swollen left knee , limite d knee motion , and difficulty with weight bearing after a history of fall from motorcycle. Imaging revealed Type 3 Meyers and McKeever tibial spine avulsion of both ACL and PCL. A two staged surgical procedure was performed : (a Arthroscopic reduction and fixation with headed cannulated sc r ew of ACL tibial fragment; (b ORIF with headed cannulated screw of PCL tibial fragment via posterior approach to knee. Good functional outcome and early mobilization was achieved. Diagnostic arthroscopic helps to evaluat e the condition of the cruciate ligaments as well as fracture bed. Simultaneously fixation of ACL fragment with cannulated screw can be done , which is a simpler procedure to suture fixation. ORIF of PCL fragment in a staged manner has helped to address the injury in a detailed manner achieving goal of anatomical reduction and early mobilization.

  10. 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.

  11. 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.

  12. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    NARCIS (Netherlands)

    Weemhoff, M.; Vergeldt, T.F.; Notten, K.; Serroyen, J.; Kampschoer, P.H.; Roumen, F.J.M.E.

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. METHODS: In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visi

  13. 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.

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

    International Nuclear Information System (INIS)

    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.)

  15. Diagnosis of nerve root avulsion injuries in adults with traumatic brachial plexopathies: MRI compared with CT myelography

    Directory of Open Access Journals (Sweden)

    Ewoudt van der Linde

    2015-03-01

    Full Text Available Background: Computed tomography myelography (CTM has been broadly adopted as the ‘gold standard’ imaging technique in the diagnosis of nerve root avulsion injuries in traumatic brachial plexopathies. CTM has the distinct advantage of better spatial resolution than magnetic resonance imaging (MRI; however, this technique is invasive and can result in significant patient discomfort. MRI, therefore, seems relatively more advantageous as it is less invasive (requires no lumbar puncture, lacks radiation exposure, has no adverse reactions related to intrathecal contrast agents and confers excellent soft-tissue contrast. Objectives: To compare the sensitivity and specificity of MRI with CTM in the diagnosis of preganglionic nerve root avulsion injuries in adults with traumatic brachial plexopathies at the Inkosi Albert Luthuli Central Hospital.Method: A retrospective comparative analysis was performed on 16 adult patients with traumatic preganglionic brachial plexopathies who underwent both MRI and CTM at Inkosi Albert Luthuli Central Hospital. Radiologists experienced in both CTM and MRI interpreted the data and a comparison was made using CTM as the gold standard. Results: The sensitivity and specificity for MRI detecting preganglionic nerve root avulsion injuries and pseudomeningoceles was 82% and 100% respectively. The interobserver agreement between CTM and MRI for the detection of preganglionic nerve root avulsion injuries was 81.25% (Kappa = 0.77 and 87.5% (Kappa = 0.84 for the detection of pseudomeningoceles. Conclusion: MRI was as sensitive as CTM at detecting preganglionic nerve root avulsion injuries and pseudomeningoceles of spinal nerve roots C7–T1 of the brachial plexus. Some mild discrepancies existed at the C5 and C6 nerve root levels. Owing to the invasiveness of the procedure and resultant patient discomfort, CTM should be reserved for complicated cases or for patients with contraindications to MRI.

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    Victor W. Wong

    2012-01-01

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

  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...... thick of sigmoidal cross-beds, plane beds, and antidunes, deposited rapidly at highflow-stage. These strata are commonly capped by accumulations up to 2.5 m thick of flattened, coalified logs and coal intraclasts (originally peat fragments), many of which are overlain by mudstone laid down in abandoned...... 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...

  19. Type IV FDP avulsion: lessons learned clinically and through review of the literature.

    Science.gov (United States)

    Henry, Steven L; Katz, Mark A; Green, David P

    2009-12-01

    The type IV flexor digitorum profundus avulsion is a rare injury involving fracture of the volar base of the distal phalanx and separation of the tendon from the fracture fragment. Recommendations for management are sparse and are substantiated only by a few isolated case reports. We recently encountered two of these injuries, both of which proved challenging, particularly with regard to joint incongruity and tendon adhesions. In reviewing the literature, it is apparent that no consensus exists regarding surgical strategies. However, based on our experience and that of other authors, we can suggest the following: (1) high index of suspicion of this potentially deceptive injury, with use of magnetic resonance imaging or ultrasound if preoperative confirmation is needed; (2) rigid bony fixation that prevents dorsal subluxation of the distal phalanx; (3) tendon repair that is independent of the bony fixation; and (4) early range of motion therapy. PMID:19399559

  20. 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.

  1. 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.

  2. 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.

  3. Experimental studies on the treatment of traumatic dental avulsion in dogs

    International Nuclear Information System (INIS)

    The experiments were performed on 7 dogs aged between 2 and 4 years weighing 12-16 kg in the period October 1998- January 2000. After anaesthesia, the following dental procedures were accomplished; performance of a dental avulsion, endodontic treatment, apical dentotomy, tooth replantation and fixation with an orthodontic splint, figure-of-eight wire ligature and photopolymer. The treatment was effective in 71.4% of experimental replantations of incisors and the replanted teeth persisted for more than 8-9 months. The radiological survey showed that the regeneration began as early as the first post replantation days. In the period between days 30-45, a bone bridging was observed and the regeneration was complete by the end of the second month

  4. One-dimensional modeling of a recent Ganga avulsion: Assessing the potential effect of tectonic subsidence on a large river

    Science.gov (United States)

    Gupta, Niladri; Kleinhans, Maarten G.; Addink, Elisabeth A.; Atkinson, Peter M.; Carling, Paul A.

    2014-05-01

    River avulsion as studied in small-sized and medium-sized rivers is partly explained by the water surface gradient advantage of a new channel course over the old course, caused by spatial differences in aggradation and compaction. Recently, the effect of meandering upstream of the avulsion node, or bifurcation, was shown to have an equally large effect on avulsion duration as gradient advantage. These effects remain poorly understood for the largest rivers on Earth, where gradients are very small, subtle gradient advantages are affected by tectonics, and often several anabranches remain active simultaneously. Our objective was to assess the relative importance of these factors in the River Ganga in determining the pacing of an avulsion. We used a combination of historical data, remote sensing, and one-dimensional modeling. The course of the Ganga in historical times was through the present Ganga-Bhagirathi system but then there was either a gradual or sudden shift to the present Ganga-Padma system. Historical evidence and remnant paleochannels, as observed in satellite sensor data, corroborate the changing pattern of the Ganga River system, but the exact causes of the shifting and of the short avulsion duration remain unclear. Based on generalized data, using a one-dimensional model we ran idealized scenarios bracketing different tectonic subsidence estimates for long-term morphodynamic evolution of the upstream channel and the two downstream bifurcates. The model predicts flow and sediment partitioning at the bifurcation node, and includes the effect of migrating meanders at the bifurcation and width adjustment of the bifurcates. Our modeling demonstrates that the old and the new branches can remain 'open' and morphologically active for a long time because of the large backwater effect and the high mobility of the sediment. The bifurcation stabilizes at an asymmetrical flow and sediment division, which in smaller rivers (such as the River Rhine) would be followed

  5. 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.

  6. 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.

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

    Science.gov (United States)

    Jain, Anshul; Baliga, Shridhar

    2015-07-01

    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

  8. 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.

  9. 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.

  10. A Prospective Outcome Evaluation of Humeral Avulsions of the Glenohumeral ligament (HAGL) Tears Repairs in an Active Population

    OpenAIRE

    Provencher, Matthew; McCormick, Frank; LeClere, Lance E.; Dewing, Christopher B.; Solomon, Daniel J.

    2014-01-01

    Objectives: Humeral Avulsions of the Glenohumeral ligament (HAGL) are an infrequent and underappreciated cause of shoulder instability and dysfunction. The purposes of this study are to prospectively evaluate the presentation, clinical history and surgical outcomes of patients with HAGL tears. Methods: Over an eight-year period, patients with failed non-operative shoulder dysfunction with a confirmed HAGL tear on MR Arthrogram, who elected to undergo surgical treatment were prospectively inve...

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

    OpenAIRE

    Anshul Jain; Shridhar Baliga

    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 pla...

  12. Avulsion of puborectalis muscle and other risk factors for cystocele recurrence: a 2-year follow-up study

    OpenAIRE

    Weemhoff, Mirjam; Vergeldt, Tineke F. M.; Notten, Kim; Serroyen, Jan; Kampschoer, Paul H. N. M.; Roumen, Frans J. M. E.

    2011-01-01

    Introduction and hypothesis This study aimed to determine the relationship of recurrent cystocele with avulsion of puborectalis muscle and other risk factors. Methods In this prospective observational cohort study, 245 women undergoing anterior colporrhaphy were invited for a 2-year follow-up visit consisting of a questionnaire, physical examination, and translabial 3D ultrasonography. Women with and without recurrent cystocele were compared to identify recurrence risk factors. Results Of the...

  13. Lithium accelerates functional motor recovery by improving remyelination of regenerating axons following ventral root avulsion and reimplantation.

    Science.gov (United States)

    Fang, Xin-Yu; Zhang, Wen-Ming; Zhang, Chao-Fan; Wong, Wai-Man; Li, Wen; Wu, Wutian; Lin, Jian-Hua

    2016-08-01

    Brachial plexus injury (BPI) often involves the complete or partial avulsion of one or more of the cervical nerve roots, which leads to permanent paralysis of the innervated muscles. Reimplantation surgery has been attempted as a clinical treatment for brachial plexus root avulsion but has failed to achieve complete functional recovery. Lithium is a mood stabilizer drug that is used to treat bipolar disorder; however, its effects on spinal cord or peripheral nerve injuries have also been reported. The purpose of this study was to investigate whether lithium can improve functional motor recovery after ventral root avulsion and reimplantation in a rat model of BPI. The results showed that systemic treatment with a clinical dose of lithium promoted motor neuron outgrowth and increased the efficiency of motor unit regeneration through enhanced remyelination. An analysis of myelin-associated genes showed that the effects of lithium started during the early phase of remyelination and persisted through the late stage of the process. Efficient remyelination of the regenerated axons in the lithium-treated rats led to an earlier functional recovery. Therefore, we demonstrated that lithium might be a potential clinical treatment for BPI in combination with reimplantation surgery. PMID:27185485

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

    Science.gov (United States)

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

    2011-12-01

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

  15. 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

  16. 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

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

    Directory of Open Access Journals (Sweden)

    Ceretti Marco

    2013-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Marco Ceretti; Sara Di Renzo

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Qing-jun LIU

    2015-08-01

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

  20. Improved C3-4 transfer for treatment of root avulsion of the brachial plexus upper trunk

    OpenAIRE

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

    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...

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

    OpenAIRE

    Takeshi Oshima; Junsuke Nakase; Hitoaki Numata; Yasushi Takata; Hiroyuki Tsuchiya

    2015-01-01

    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-y...

  2. 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.

  3. A new model of skin avulsion injuries in rats%一种大鼠皮肤撕脱伤模型初探

    Institute of Scientific and Technical Information of China (English)

    王忠堂; 郭树忠; 修志夫; 鲁开化; 李青山

    2008-01-01

    目的 建立稳定可靠的大鼠皮肤撕脱伤模型.方法 雄性SD大鼠30只,随机分为轴型皮瓣(9cm×3cm)对照组及牵拉组,任意皮瓣(6cm×4cm)对照组及牵拉组.轴型皮瓣施予牵拉力6kg,任意皮瓣施予牵拉力8kg,牵拉时间分别为8秒和12秒.观察创面收缩及皮瓣坏死情况.结果 术后第7天,牵拉组较对照组创面收缩率明显增加(P<0.05);术后第14天,牵拉组创面收缩率较术后第7天时增加近1倍(P<0.01),但牵拉8秒组与12秒组间差异无统计学意义.术后第7天,牵拉组皮瓣100%发生部分或大部坏死.轴型皮瓣牵拉8秒导致38%~77%面积坏死,牵拉12秒导致40%~80%面积坏死;任意皮瓣牵拉8秒导致17%~40%面积坏死,牵拉12秒导致24%~43%面积坏死.结论 应用大鼠制作皮肤撕脱伤模型是可行的.%Objective To create a stable and reliable model of skin avulsion in rats.Methods 30 male,SD rats were randomly divided into axial pattern skin flap(9cm×3cm)group and random pattern skin flap group(6cm×4cm),each having the control groups and avulsion groups.Flaps were subjected to avulsion force of 6 kg in axial pattern skin flaps or 8 kg in random pattern skin flaps,and the lasting time was 8s or 12s,respectively.Retraction of wounds and necrosis of skin flaps were observed.Results There was more significant wound retraction in avulsion groups than that in control groups on post-operation day 7(P<0.05).The proportion of the wound retraction increased by 1 fold in avulsion groups on post-operation day 14 as compared to post-operation day 7(P<0.01).Interestingly,necrosis of partial or most of skin flaps was observed in all animals of avulsion groups,while slight necrosis happened in one of six in control animals.The necrosis area of flaps was 38%~77%when avulsed for 8s,and was 40%~80%when avulsed for 12s in axial pattern skin flaps.However,the necrosis area in random pattern skin flaps was smaller than that in axial pattern skin flaps

  4. Avulsion at a drift-dominated mesotidal estuary: The Chubut River outlet, Patagonia, Argentina

    Science.gov (United States)

    Isla, Federico; Espinosa, Marcela; Rubio, Belén; Escandell, Alejandra; Gerpe, Marcela; Miglioranza, Karina; Rey, Daniel; Vilas, Federico

    2015-10-01

    The Chubut River flows from the Andes to the Atlantic Ocean, and is interrupted by a single dam built at the middle valley. The lower valley is dominated by the aggradation of an alluvial plain induced by a complex of spits that enclosed the inlet in the last 5000 years. The river has reduced its flow because the blocking of the upper basin by terminal moraines during the Upper Pleistocene. At least the last two marine transgressions have flooded this estuary, and contributed to the aggradation during regressions. The area is of particular interest in regard to irrigation channels practiced since the XIX century. Today, the mean monthly flow is less than 10 m3/s although peaks of 95 m3/s have been recorded in Gaiman in July 2001. The dynamics of the estuary is dominated by waves (wave-dominated estuary) as tidal effects attenuate in less than 5 km. Three vibracores were collected within this floodplain: (a) at Gaiman, an area without any effect of the sea (35 km from the coast); (b) at Trelew, at the former avulsion plain of the river (18 km from the coast); and (c) at Playa Magagna, a saltmarsh located 0.4 km from the beach. At the Gaiman core (1.54 m long) fresh-water epiphytic diatoms dominate (Epithemia sorex, Cocconeis placentula, Ulnaria ulna) suggesting the aggradation of an alluvial plain. The Trelew core (2.19 m long) was collected from a deltaic plain. It was composed by fine sand with organic matter at the base that evolved into silty layers to the top. Several unconformities and laminae with heavy minerals were detected by their geochemical composition analysed by micro X-ray fluorescence (Itrax XRF core scanner). Fine-sand laminated layers were perfectly detected by their high content in S and Cl. On the other hand, mud layers presented lower content in Mg and Al with increments in Ca and V. The core from the marsh area (1.67 m long) was analysed in terms of the diatom evolution in order to detect Holocene sea-level and salinity effects. The sand flats

  5. 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.

  6. 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

  7. Avulsion in action: reconstruction and modeling sedimentation pace and upstream flood water levels following a Medieval tidal-river diversion catastrophe (Biesbosch, The Netherlands, 1421–1750 AD)

    NARCIS (Netherlands)

    Kleinhans, M.G.; Weerts, H.J.T.; Cohen, K.M.

    2010-01-01

    Deltaic land inundated by storm surges may reform by sedimentation from natural or human-induced river diversions. This is a well-known trigger mechanism for creation of new channels in coastal plains and deltas, which may develop into main channels and lead to abandonment of older (avulsion), parti

  8. 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.

  9. 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

  10. Fixation of tibial avulsion fractures of the posterior cruciate ligament using pull through suture and malleolar screw

    Directory of Open Access Journals (Sweden)

    Farzad Omidi Kashani

    2007-05-01

    Full Text Available BACKGROUND: Tibial avulsion fractures of the posterior cruciate ligament are not infrequent. However, controversies exist between the fixation of the fragments and their reconstruction in the cases with small bony fragments. This prospective study was undertaken to study the results after fixation of the fragments by the malleolar screw and the pull through suture techniques.  METHODS: From June 2003 to March 2005, 26 patients with acute isolated posterior cruciate ligament avulsion fracture of the tibial attachment were treated surgically at Qhaem and Emam Reza hospitals at Mashhad University of Medical Sciences. The screw fixation was used in 18 cases with large bony fragments and the suturing method for other cases who had small or comminuted fragments. The patients were followed for an average of 14 months; and according to The International Knee Documentation Committee the results were evaluated.  RESULTS:  All our patients were men and all the avulsion fractures achieved union at an average of 4.8 months (range, 3-8 months. All the patients had sever posterior instability (>10mm pre-operatively. However, when the union of the fracture was achieved, no one suffered severe instability.

    CONCLUSIONS: Both of these two techniques (especially screw fixation had satisfactory results. Although the number

  11. 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.

  12. 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.

  13. Legacy Morphologies: Channel Avulsions and Historical Engineering Structures Drive Form and Process in the Lower Yuba and Feather Rivers, California

    Science.gov (United States)

    James, L. A.; Singer, M. B.; Aalto, R.

    2008-12-01

    Geomorphic changes in the lower Yuba and Feather Rivers due to hydraulic mining provide a chance to study centennial-scale processes. Channel changes over 150 years were determined using channel-bank stratigraphy, geochemical signatures (total Hg, grain-size distributions, bulk geochemistry, fallout radionuclides, and Sr/Nd isotopes), and spatial analyses of high-resolution topographic data, historical maps, and aerial photos. Repeated avulsions and broad erosion/deposition patterns are shown, including a downstream shift in activity through time. In the 20th century, both rivers experienced deep main-channel incision and floodplain alluviation of natural levees and abandoned channels. Buried trees rooted in pre- mining soils indicate the Feather has not returned to pre-mining base levels below the Yuba confluence. Early engineering works controlled channel responses and recovery. For example, the Feather River avulsed into a channel dredged through Shanghai Bend (c.1907) so it now crosses resistant Quaternary alluvium over a 3-m knickpoint bench that could soon be breached. Moreover, levees and channelization near the Yuba-Feather confluence at Marysville (c.1905) narrowed and deepened flows, encouraging the bed incision noted by Gilbert. Effects of legacy sediment on channel processes are well known. Here, channel recovery was also constrained by channel morphologies engineered with boulder wing dams and revetment in the Yuba and channelization and levees in the Feather. The resulting bed incision reduces lateral connectivity between channels and floodplains and increases sediment conveyance. Historical and anthropogenic perspectives are essential to explaining channel dynamics at these scales. Unless models of channel and floodplain evolution recognize historical changes and engineering works, they may miss crucial components of geomorphic change and potential impacts downstream. In such systems, the historical dimension is essential to river management, water

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

    Science.gov (United States)

    Pohl, Yango; Filippi, Andreas; Kirschner, Horst

    2005-04-01

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

  15. 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.

  16. 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.

  17. Avulsion fracture of the coracoid process in a patient with chronic anterior shoulder instability treated with the Latarjet procedure: a case report

    OpenAIRE

    Schneider, Marco Michael; Balke, Maurice; Koenen, Paola; Bouillon, Bertil; Banerjee, Marc

    2014-01-01

    Introduction Shoulder dislocations can cause acute and chronic instabilities that need to be addressed in order to restore joint functioning. The transfer of the coracoid process has become a feasible surgical procedure in patients with shoulder instability. Several concomitant injuries after recurrent dislocations have been described. Case presentation A 32-year-old German man presented to our department with a history of recurrent shoulder dislocations. He was diagnosed with an avulsion fra...

  18. 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

  19. Suture Anchor Fixation for Avulsion Fracture Around Knee%缝合锚钉技术治疗膝关节周围撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    曾金; 戴闽; 姚浩群; 李卫平; 张志宏; 刘虎诚; 雷刚刚

    2013-01-01

    Objective To investigate the feasibility and clinical efficacy of suture anchor fixation in avulsion fracture around the knee. Methods Thirty-seven cases of avulsion fracture a-round the knee were treated with Twinfix suture anchors,including 18 cases of avulsion fracture of lower pole of the patella,13 cases of avulsion fracture of medial femoral condyle,and 6 cases of avulsion fracture of external femoral condyle. Knee function and activity were assessed using the HSS knee score. Results were followed up with X-ray examination. Results All patients were fol-lowed-up for an average of 19. 3 months (range 12 to 48 months). After 6 months of follow-up,X-ray examination revealed the healing of avulsion fracture. HSS knee score was 86. 5 ± 4. 3. Among the 37 cases,the outcome was excellent in 28,good in 7 and fair in 2. The excellent and good rate was 94. 95%. Knee function was improved without ligamentous laxity and instability and other complications. Conclusion Suture anchor fixation is reliable for avulsion fracture around the knee. The technique conduces to the recovery of joint function and does not require the secondary surgery.%目的 探讨缝合锚钉技术治疗膝关节周围撕脱性骨折的方法和临床效果.方法 对37例膝关节周围撕脱性骨折患者采用Twinfix带线锚钉治疗,其中髌骨下极撕脱性骨折18例,股骨内髁撕脱性骨折13例,股骨外髁撕脱性骨折6例.评估术后膝关节HSS功能评分及膝关节活动度,随访X线检查结果.结果 所有患者均获得随访,随访时间12~48个月,平均19.3个月.术后6个月随访摄X线片显示撕脱性骨折均获得骨性愈合;HSS膝关节功能评分(86.5±4.3)分,优28例,良7例,中2例,优良率94.95%;无韧带松弛不稳及其他并发症,功能明显改善.结论 采用缝合锚钉技术治疗膝关节周围撕脱性骨折具有固定可靠、有助于关节功能恢复,且不需要二次手术的优点.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Traumatic avulsion of kidney and spleen into the chest through a ruptured diaphragm in a young worker: a case report

    Directory of Open Access Journals (Sweden)

    Stamatiou Konstantinos

    2007-12-01

    Full Text Available Abstract Introduction Rupture of the diaphragm is almost always due to major trauma. Diaphragmatic injuries are rare (5–7%, usually secondary to blunt, or more rarely to penetrating, thoracic or abdominal trauma. No single investigation provides a reliable diagnosis of diaphragmatic rupture when a patient first arrives at hospital. Almost 33% are suspected on initial chest x-ray, but the percentage is lower in patients who are immediately intubated. Mortality in patients with diaphragmatic rupture following blunt abdominal trauma is generally associated with coexistent vascular and visceral injuries that could be rapidly fatal. It's mandatory that the right diagnosis is reached as soon as possible given that mortality is influenced by the time elapsing between trauma and diagnosis. Case presentation A 35-year-old worker was hit by a heavy object while working in the factory. He was transferred immediately to our emergency room. Chest x-ray showed massive left hemothorax without any additional signs to suggest diaphragmatic injury. It was decided to perform immediate surgical exploration before further radiological examination. During surgery, the right kidney and liver appeared normal, but the left kidney and spleen were not found in their anatomical position. The left hemidiaphragm had a10-cm oblique posterior tear. The left kidney was found lacerated in the left side of the chest, separated completely from its vascular pedicle and ureter, along with the entire spleen which was also separated from its vascular tree. Conclusion The avulsion of both kidney and spleen following abdominal trauma is uncommon and survival depends on prompt diagnosis and treatment.

  6. 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.

  7. 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.

  8. Quaternary evolution of the rivers of northeast Hainan Island, China: Tracking the history of avulsion from mineralogy and geochemistry of river and delta sands

    Science.gov (United States)

    Pe-Piper, Georgia; Piper, David J. W.; Wang, Ying; Zhang, Yongzhan; Trottier, Corwin; Ge, Chendong; Yin, Yong

    2016-03-01

    The mineralogy and geochemistry of sands were investigated in the Nandu and Wanquan rivers, Hainan Island, China, to determine the history of avulsion in the lower reaches of the Nandu River. The study also provided the opportunity to assess the utility of geochemical analysis of sands as a provenance tool. Much of the heavy mineral fraction in the rivers consists of subangular Fe-Ti oxide and Fe-(hydr)oxide minerals, and less stable minerals such as amphibole, epidote, and andalusite, whereas rounded resistant ilmenite, rutile, tourmaline and zircon predominate on the deltaic coast. Mineral assemblage and chemical composition of individual samples are related to specific source areas and river tributaries. The results demonstrate northwestwards flow of the Nandu River during the mid-Holocene and earlier avulsion of the river to the northeast coast, probably during a Late Pleistocene marine highstand. Minor basement tilting, producing little relief, was sufficient to divert the lower reaches of rivers, and this effect was enhanced where basalt flows dammed former river courses. Bulk sample REE geochemistry is largely controlled by the relative abundance of monazite, allanite, titanite, zircon and epidote, derived principally from granites. Detrital geochemistry alone shows too much variability to interpret provenance. However, a smaller number of heavy mineral analyses provide an understanding of the mineralogical origins of geochemical variation, thus enabling interpretations of provenance.

  9. The significance of diagnostic MRI for visualisation of trauma-induced cervical nerve root avulsion. Case report; Die Bedeutung der MRT-Diagnostik zur Darstellung traumatisch bedingter zervikaler Wurzelausrisse. Kasuistik

    Energy Technology Data Exchange (ETDEWEB)

    Muth, C.P. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Biemelt, F. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie; Kamenz, M. [Carl-Thiem-Klinikum, Cottbus (Germany). Inst. fuer Radiologie

    1996-11-01

    The article is intended to show the value of MRI for diagnostic visualisation and evaluation of posttraumatic nerve root avulsion as a brachial plexus injury. (orig./MG) [Deutsch] Das Ziel der Arbeit besteht in der Darstellung des Wertes der MRT-Diagnostik bei der Abklaerung traumatischer Wurzelausrisse im Bereich des Plexus brachialis. (orig./MG)

  10. 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

  11. Morphological and sedimentological evidences of repeated avulsions of Someşu Mic River (Romania), associated to salt tectonics

    Science.gov (United States)

    Persoiu, I.; Radoane, M.

    2009-04-01

    . Four palaeochannels are visible on the floodplain's surface, these being also evident in the sedimentary structure of the valley infill, as revealed by the electrical imaging and drilling. Former channel infills consist mainly of massive and sandy clays (low electrical resistivity - 5.8 ohm.m), whereas the sectors between them are filled by pebbles and sands interpreted to be channel deposits (high values of the electrical resistivity - 80 ohm.m).The absence of coarse gravels from the bottom, direct disposal of fine sediments on marls and the presence of massive clay suggests 3 stages in the channels evolution. The first one is a long period of stability, supposed to be associated to a low sinuous course, when river incised the sedimentary complex of the floodplain, until it was intersected the valley bottom. The second stage is an abrupt avulsion to the right, produced probably during an important flood, and the third stage corresponds to the period of complete abandonment of it and the evolution as oxbow lake. If we take in consideration the presence of the diapiric syncline on the right side of the valley, and the disposal of parallel channels with it (including the present-day one), we conclude that this behavior is caused by a lateral tilting of the floodplain trough the right.

  12. 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

  13. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial.

    Science.gov (United States)

    Berman, Jonathan S; Symonds, Catherine; Birch, Rolfe

    2004-12-01

    The objective was to investigate the effectiveness of cannabis-based medicines for treatment of chronic pain associated with brachial plexus root avulsion. This condition is an excellent human model of central neuropathic pain as it represents an unusually homogenous group in terms of anatomical location of injury, pain descriptions and patient demographics. Forty-eight patients with at least one avulsed root and baseline pain score of four or more on an 11-point ordinate scale participated in a randomised, double-blind, placebo-controlled, three period crossover study. All patients had intractable symptoms regardless of current analgesic therapy. Patients entered a baseline period of 2 weeks, followed by three, 2-week treatment periods during each of which they received one of three oromucosal spray preparations. These were placebo and two whole plant extracts of Cannabis sativa L.: GW-1000-02 (Sativex), containing Delta(9)tetrahydrocannabinol (THC):cannabidiol (CBD) in an approximate 1:1 ratio and GW-2000-02, containing primarily THC. The primary outcome measure was the mean pain severity score during the last 7 days of treatment. Secondary outcome measures included pain related quality of life assessments. The primary outcome measure failed to fall by the two points defined in our hypothesis. However, both this measure and measures of sleep showed statistically significant improvements. The study medications were generally well tolerated with the majority of adverse events, including intoxication type reactions, being mild to moderate in severity and resolving spontaneously. Studies of longer duration in neuropathic pain are required to confirm a clinically relevant, improvement in the treatment of this condition. PMID:15561385

  14. 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.

  15. Type V avulsion injury of the insertion of the lfexor digitorum profundus tendon:2 cases report%V 型指深屈肌腱撕脱性损伤附二例报告

    Institute of Scientific and Technical Information of China (English)

    李文军; 陈山林; 田光磊; 田文; 王树锋; 张友乐

    2014-01-01

    Objective To report uncommon and non-sports type V avulsion injury of the insertion of the lfexor digitorum profundus tendon and to investigate the treatment methods. Methods The clinical results of 2 patients who were both treated in our department on October 29, 2012 were retrospectively analyzed. Results A male patient was 38 years old, whose left ring finger injuries were caused by heavy things. A female patient was 31 years old, whose left little ifnger injures were caused by collision. They were both treated with Kirschner wire ifxation combined with snap pullout of the absorbable polydioxanone suture ( PDS ) II. The 2 patients were followed up for 14 months. The active range of motion of the distal interphalangeal ( DIP ) joint recovered to 90%of that of the normal side. Conclusions Type V avulsion injury of the insertion of the lfexor digitorum profundus tendon is uncommon, and the early diagnosis and surgical treatment is a good choice, with good clinical results.

  16. 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

  17. Arthroscopic Treatment for Tibial Avulsion Fractures of Anterior Crucial Ligament with Orthocord Suture Fixation%关节镜下Orthocord缝线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)

    王洪; 孙川; 孟春庆; 杨述华; 杜靖远; 邵增务

    2011-01-01

    Objective To investigate the methods and effects of the arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament. Methods Twenty seven patients with tibial avulsion fractures were treated with operation. The avulsion fragment was reduced under arthroscopy. Two bone tunnels were drilled from internal tibial tuberosity to the both sides of the avulsed fragment.2# Orthocord suture was used for arthroscopic fixation of the fractures. Results All patients were followed up for 12.3 months on average (7-24 months). X-ray confirmed satisfactory healing. At the latest follow-up, the average Lysholm knee score was 93.1 points (84-100 points), the Lach-man test and anterior drawer test were both negative and the range of motion was normal in 22 cases while limited in 5 cases. Conclusion Arthroscopic treatment for tibial avulsion fractures of anterior crucial ligament with Orthocord suture fixation is easy and minimally invasive. It can lead to reliable fixation and less complications, and facilitate early rehabilitation.%目的 探讨前交叉韧带(ACL)胫骨止点撕脱骨折关节镜下治疗的方法及疗效.方法 对27例ACL胫骨止点撕脱骨折进行手术,关节镜下将骨折复位后,从胫骨结节内侧向骨折块的两侧钻取两个骨隧道,使用2号Orthocord缝线固定骨折.结果 本组均得到随访,平均12.3个月(7~24个月),X线片示骨折愈合良好.术后末次随访Lysholm评分平均93.1分(84~100分),Lachman试验及前抽屉试验均为阴性,22例关节活动度达到正常,5例存在关节活动受限.结论 关节镜下使用Orthocord缝线固定治疗ACL胫骨止点撕脱骨折具有固定可靠、操作简单、手术创伤小、术后恢复快、并发症少等优点.

  18. 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.

  19. 可吸收螺钉治疗膝后交叉韧带胫骨附着点撕脱骨折%Treatment of tibial avulsion fracture of the posterior cruciate ligament with absorbable screw

    Institute of Scientific and Technical Information of China (English)

    刘笠; 任国文; 王振汉

    2011-01-01

    目的 探讨应用可吸收螺钉治疗膝后交叉韧带胫骨附着点撕脱性骨折的治疗效果.方法 2006年1月~2011年1月对16例膝后交叉韧带胫骨附着点撕脱骨折进行可吸收螺钉内固定治疗.结果 经3个月~1年随访,无感染、瘘道形成,无骨折再移位和关节僵硬,16例骨折全部愈合,按HSS膝关节评分法,优13例,良3例,优良率100%.结论 可吸收螺钉在后交叉韧带撕脱骨折固定治疗中具有较好的疗效.%Objective To investigate the therapeutic effect of absorbable screw in treating tibial avulsion fracture of the posterior cruciate ligolnent. Methods Froln Jan. 2006 to Jan. 2011,16 cases of tibial avulsion fracture of the posterior crueiate ligoment were internally fixated by using absorbable screw,and were retrospectively analyzed.Results The follow-up tilne ranged ffoln 3 months to 1 year,indicating no itffeetion,no stiffness,no fistula formation and no re-displacelnent of fracture. And the 16 eases were totally healed. According to the HSS score of knee joint,13 eases were excellent,3 cases were good,with excellent and good rate of 100%. Conclusion Application of absorbable screw is a good way in treating tibia] avulsion fracture of the posterior cruciate ligoment.

  20. A modified replantation for thumb rotating avulsion amputation%拇指旋转撕脱离断的再植术式改进

    Institute of Scientific and Technical Information of China (English)

    李瑞华; 阚世廉; 高燕新; 王晓刚; 殷中罡

    2012-01-01

    Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.%目的 对拇指旋转撕脱离断再植术进行改良,并评估其近期临床疗效.方法 2007年1月至2009年7月,对

  1. 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.

  2. 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.

  3. 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.

  4. Surgical treatment of tibial avulsion fracture at the posterior ligament- to- bone insertion site%手术治疗后交叉韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    陈红峰; 王东明; 徐明勇

    2012-01-01

    Objective To study the clinical effect of the medial knee after surgical fixation of posterior cruciate ligament surgery tibial avulsion fracture. Methods Fifteen cases of cruciate ligament tibial avulsion fractures were performed with knee down "L-shaped" incision and anatomic fracture reduction was fixed with hollow screws and anchors. Patients were followed up for 6 months. Data regarding fractures, healing and joint stability, and range were collected. The recovery of knee function was assessed by Lysholm scale for knee function. Results All patients were cured after 8 to 13 weeks with no displacement. After 6 months, 2 cases of posteriordrawer test was weakly positive. There was 1 case with mild knee flexion limitation, but no knee extension limitation was observed. Lysholmknee score was (92 ± 2. 4) points. Conclusion Knee medial approach with a line of hollow screw and anchor screw fixation of posterior cruciate ligament tibial avulsion fracture is simple, safe, effective and reliable.%目的 探讨膝关节后内侧入路手术内固定治疗手术后交叉韧带胫骨止点撕脱性骨折的临床效果.方法 对15例交叉韧带胫骨止点撕脱性骨折患者行膝后倒“L”形小切口显露,解剖复位骨折,予以中空螺钉及带线锚钉内固定.术后随访6个月,收集骨折复位、愈合及关节稳定性、活动度以及Lysholm膝关节功能评分标准评估膝关节功能恢复情况.结果 术后8~13周均骨性愈合,未见位移.术后6个月,有2例后抽屉试验弱阳性,1例轻度屈膝受限,无伸膝受限,Lysholm膝关节功能评分( 92.0±2.4)分.结论 膝后内侧入路中空螺钉及带线锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折操作简单、安全、效果可靠.

  5. 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.

  6. 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

  7. Vacuum sealing drainage for skin avulsion of the limbs%高分子泡沫材料覆盖负压封闭引流用于四肢皮肤撕脱伤

    Institute of Scientific and Technical Information of China (English)

    谢志进; 方跃; 王彦川; 石磊; 余强; 刘勇

    2012-01-01

    BACKGROUND: Vacuum sealing drainage technique has been increasingly popular in clinical treatment of skin avulsion injuries.OBJECTIVE: To investigate and generalize technical issues and details of the vacuum sealing drainage method in the treatment of limb skin avulsion.METHODS: A total of 22 patients with limb skin avulsion were admitted and then treated with vacuum sealing drainage after skin replantation. Firstly, the main points and difficulties of the treatment process were retrospectively reviewed, and then the appropriate technical approach was proposed.RESULTS AND CONCLUSION: Although 21 eligible patients received effective treatment and the clinical results were quite satisfactory, there were six cases of failure to complete primary healing. All of these cases provide us a good clinical support for the summary of the related technical points. To conclude, skin replantation combined with vacuum sealing drainage technique is a good way to deal with limb skin avulsion, and a better grasp of technical issues and details of the approach helps improve the cure rate.%背景:高分子泡沫材料覆盖负压封闭引流技术现已广泛地应用于皮肤撕脱伤的临床治疗.目的:探讨并归纳高分子泡沫材料覆盖负压封闭引流治疗四肢皮肤撕脱伤过程中的技术要点和细节处理方法.方法:纳入22 例四肢皮肤撕脱伤患者,行撕脱皮肤回植的高分子泡沫材料覆盖负压封闭引流治疗,然后归纳总结治疗过程中的要点、难点,并提出相应的技术处理办法.结果与结论:21 例有效病例创面均获得治愈,临床疗效满意,但仍有6 例创面未能完全一期成活,这些实例为总结相关技术要点提供了良好的临床支持.通过总结可以认为皮片回植结合高分子泡沫材料覆盖负压封闭引流技术是治疗四肢皮肤撕脱伤的良好方法,更好的把握技术要点和细节处理方法有助于提高治愈率.

  8. 55例踝关节外侧副韧带损伤合并外踝撕脱骨折的手术治疗分析%Surgical treatment for ankle lateral collateral ligament injury with avulsion fracture:a report of 55 cases

    Institute of Scientific and Technical Information of China (English)

    谢兴; 胡跃林; 焦晨; 江东; 陈临新; 梅宇; 郭秦炜

    2015-01-01

    Background:Injury of the lateral collateral ligament (LCL) is one of the most common ankle injuries. There are many stud-ies on isolated ankle LCL injury. However, few studies have been reported on combined injuries of the LCL and avulsion fracture in ankle joint. Objective:To evaluate clinical features and outcomes of ankle LCL injury combined with avulsion fracture. Methods:A total of 55 patients who suffered from ankle LCL injury combined with avulsion fracture and received modified Broström procedure and avulsion bone resection between January 2013 and January 2014 were enrolled in the study. Preop-erative X-ray and MRI were performed in all patients. AOFAS hindfoot functional evaluation system was used preoperative-ly and 6 months postoperatively. Results:Avulsion fracture was found in 51 patients by X-ray and in 4 by MRI. As compared with preoperative one, AOFAS score was significantly increased 6 months postoperatively (54.62±10.31 vs 87.70±3.22, P Conclusions:X-ray and MRI can accurately diagnose avulsion fractures of the lateral malleolus. The lateral ligament injury with avulsion fracture of ankle should be treated as soon as possible so as to prevent chronic instability. Modified Broström procedure and avulsion bone resection can achieve good clinical outcomes for the patients suffered from lateral collateral ligament injury with avulsion fracture of the ankle.%背景:踝关节外踝韧带损伤是最高发的踝关节损伤,目前针对外踝韧带损伤方面的研究较多,而对于外踝韧带损伤合并撕脱骨折的报道较少。  目的:评价踝关节外侧副韧带损伤合并外踝撕脱骨折的临床特点及手术治疗效果。  方法:2013年1月至2014年1月,55例踝关节外侧副韧带损伤合并外踝撕脱骨折患者接受了改良Broström法外踝韧带修复和撕脱骨块切除术。术前行X线片检查及MRI,术前及术后6个月随访时进行AOFAS踝-后足功能评分。  结果:55

  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. 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。

  11. 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

  12. 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

  13. 改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱骨折%Treatment of Avulsion Fracture of the Tibial insertion of Posterior Cruciate Ligament with Improved Small Incision

    Institute of Scientific and Technical Information of China (English)

    李海波; 苟永胜; 付柏林; 王勇; 车峥; 李蓉

    2016-01-01

    Objective:To investigate the effect of treatment of avulsion fracture of the tibial insertion of posterior cruciate ligament( PCL) through improved small incision .Methods:Patients prone , intraoperative first palpable lateral fibular head , knee joint posterior median offset from the plane to the proximal fibular head vertex incision , about 2-3cm, along the margin between medial gastrocnemius muscle and semitendinosus finger blunt separation into the gastrocnemius soleus , medial head retracted medially , the lateral head of gas-trocnemius soleus , tibialis artery and vein , posterior tibial nerve retracted laterally , open the rear part of the joint capsule , expose the pos-terior cruciate ligament tibial attachment point , cruciate ligament tibial avulsion fracture with absorbable screw block or anchor fixation af -ter reduction.Results:All cases were followed up for 6-36 months, average 12.5 months follow-up.Postoperative fracture was satis-factory reduction, and healed in 3-6 months.Knee joint function recovered satisfactorily , without obvious complications .Conclusion:It has advantages of minimal invasion and enough exposure in the treatment of avulsion fracture of PCL through improved small incision .%目的:评价改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折的手术疗效,为临床治疗单纯膝后交叉韧带胫骨止点撕脱骨折提供帮助。方法:2010年9月~2013年9月我院进行改良小切口治疗单纯膝后交叉韧带胫骨止点撕脱性骨折共48例,男性33例,女性15例,平均年龄38.5岁;患者采用俯卧位,术中先扪及外侧腓骨头,于膝关节后正中偏内从腓骨头顶点平面向近端延长切口,约2~3cm,沿半腱肌与腓肠肌内侧缘之间用手指钝性分离进入,将胫动静脉、胫神经、小腿三头肌外侧头牵向外侧,小腿三头肌内侧头牵向内侧,将部分后方关节囊切开,显露出膝后交叉韧带胫骨止点撕脱骨

  14. 锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折%Open reduction and internal fixation with anchor screw for tibial avulsion fracture of the posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    李建赤; 黄必留; 梁江声; 谭加群; 徐自强; 吴春辉

    2013-01-01

    Objective To investigate the clinical efficacy of the treatment for tibial avulsion fracture of the posterior cruciate ligament ( PCL) with open reduction and anchor screw internal fixation. Methods 32 patients of tibial avulsion fracture of the posterior cruciate ligament were treated with open reduction and anchor screw internal fixation through inverted L-shaped posterior-medial approach. All the patients were given postoperative plaster immobilization of knee at 30° flexion for about four weeks. The patients were allowed to appropriate functional exercise of knee flexion and extension after removal of the plaster. Results 30 patients were followed up for seven to 30 months with an average of (13 ±5.2) months. The bony union was achieved in all the patients after operation in two to four months, (3 ±0. 6) months in average. According to Lysholm knee score system, six months after surgery, 26 cases were excellent, three cases were good and one case was fair . The excellent rate was 96. 7%. Conclusions Inverted L-shaped posterior-medial approach and anchor screw internal fixation is a safe, effective method for tibial avulsion fracture of PCL. Reliable internal fixation may be effective in the early reconstruction of the knee stability and restoring knee function.%目的 探讨锚钉内固定治疗后交叉韧带(PCL)胫骨止点撕脱性骨折的临床疗效.方法 对32例膝关节PCL胫骨止点撕脱骨折患者,采用膝关节后内侧倒"L"形入路切开复位,以锚钉内固定治疗,术后给予石膏托固定膝关节屈曲30°约4周,拆除石膏外固定后适当行膝关节伸屈功能锻炼.结果 30例获得随访,时间7~30个月,平均(13 ± 5.2)个月.术后2~4个月均获骨性愈合,平均为(3 ± 0.6)个月.手术6个月后依据Lysholm 等膝关节评分系统评估膝关节功能,评定优26 例,良3例,可1例,优良率96.7%.结论 膝后内侧"L"形入路应用锚钉内固定治疗PCL胫骨止点撕脱骨折是安全有效、内固

  15. 带线锚钉治疗后交叉韧带胫骨止点撕脱骨折21例报告%Surgical treatment with anchor screws for tibial avulsion fracture of the posterior cruciate ligament

    Institute of Scientific and Technical Information of China (English)

    张中兴; 许峰; 金伟

    2016-01-01

    目的:探讨带线锚钉治疗后交叉韧带( posterior cruciate ligament,PCL )胫骨止点撕脱骨折的临床疗效。方法对21例膝关节 PCL 胫骨止点撕脱骨折患者采用带线锚钉治疗,术后给予膝关节屈曲30°石膏固定4周,拆除石膏外固定后进行膝关节功能锻炼。结果所有患者均获7~11个月随访,平均9.2个月。Lysholm 评分术前与术后6个月分别为:(59.4±8.1)分,(86.4±9.1)分,差异有统计学意义( P<0.05);关节活动度术前与术后6个月分别为:(86.8±13.5)°(139.1±8.9)°,差异有统计学意义( P<0.05);IKDC 评分术前与术后6个月分别为:(50.6±6.1)分,(92.8±5.5)分,差异有统计学意义( P<0.05)。结论带线锚钉治疗 PCL 胫骨止点撕脱骨折内固定可靠,安全有效,可早期有效重建膝关节稳定性,恢复膝关节功能。%Objective To investigate clinical effects on the treatment of tibial avulsion fracture of the posterior cruciate ligament with anchor screws. Methods Twenty-one patients of tibial avulsion fracture of the posterior cruciate ligament were treated with anchor screws. All patients had been applied postoperative plaster immobilization of the knee at 30° flexion for 4 weeks. Functional exercises of the knee were conducted after the removal of the plaster. Results All patients were followed up for 7 - 11 months with the average of 9.2 months. The Lysholm score preoperatively and 6 months postoperatively were ( 59.4 ± 8.1 ) point, ( 86.4 ± 9.1 ) point, respectively. Differences were statistically significant ( P < 0.05 ). The range of motion of the knee preoperatively and 6 months postoperatively were ( 86.8 ± 13.5 ) °, ( 139.1 ± 8.9 ) °, respectively. Differences were statistically significant ( P <0.05 ). IKDC score preoperatively and 6 months postoperatively were ( 50.6 ± 6.1 ) point, ( 92.8 ± 5.5 ) point, respectively. Differences were statistically significant ( P < 0.05 ). Conclusions

  16. 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.

  17. 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

  18. 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

  19. Insuficiência aórtica aguda por avulsão de comissura valvar aórtica Acute aortic insufficiency due to avulsion of aortic valve comissure

    Directory of Open Access Journals (Sweden)

    Claudio Ribeiro da Cunha

    2012-03-01

    Full Text Available Paciente do sexo masculino, de 66 anos, previamente hipertenso, com história de ortopneia, palpitações e dor precordial de início súbito, que teve o diagnóstico de avulsão espontânea de uma comissura valvar aórtica e consequente insuficiência aórtica aguda, evoluindo com insuficiência cardíaca esquerda refratária ao tratamento clínico. O paciente foi submetido precocemente à substituição cirúrgica da valva aórtica por uma bioprótese, e apresentou evolução pós-operatória satisfatória. Atualmente, quatro anos após o evento, continua em acompanhamento ambulatorial em classe funcional I.A 66-year-old male patient, prior hypertension, a history of orthopnea, palpitations and chest pain of sudden onset, which was diagnosed as spontaneous avulsion of aortic valve commissure and consequent aortic insufficiency progressing to acute left heart failure refractory to medical treatment. The patient underwent early surgical replacement of the aortic valve by a bioprosthesis, and presented satisfactory postoperative course. Currently, four years after the event, still in attendance in functional class I.

  20. 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

  1. 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。

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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-

  7. 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

  8. Treatment of the avulsion fractures of calcaneal tuberosity in elderly osteoporotic patients with fixation of shaped locking plate%锁定钢板塑形固定治疗老年骨质疏松性跟骨后结节撕脱骨折

    Institute of Scientific and Technical Information of China (English)

    王旭; 王晨; 张超; 黄加张; 马昕

    2014-01-01

    Objective To investigate the clinical results after treatment of the avulsion fractures of calcaneal tuberosity in elderly patients using shaped locking plate. Methods We retrospectively reviewed the elderly patients with the avulsion fractures of calcaneal tuberosity who received ORIF (open reduction internal fixation) with shaped locking plate from January 2006 to December 2011. Only the patients aged more than 60 were included. The AOFAS hindfoot scale was used for clinical evaluation at the last follow-up.Results Seventeen patients were identified with a mean age of 67.2. The follow-up durations was ranged from 1.2-7.1 years, 4.3 years in average. All the fractures achieved bony union and one patient associated with wound delayed healing was finally recovered by dress changing. The mean AOFAS hindfoot score at the last follow-up was 91.2. Discussion The avulsion fractures of calcaneal tuberosity were prone to happen in elderly patients. The peak occurrence age was around 70. The osteoporotic calcaneaus was avulsed by the Achilles tendon due to reduced biomechanical strength. It could be comsed by the strongly dorsiflexed ankle, the isometric contraction of gastrocnemius or the direct stress. Such mechanism was different from the fractures of calcaneal medial tuberosity in young patients which was caused by longitudinal forces. Most studies were recommended for surgical intervention of the calcaneal avulsion fractures. However, due to the risk factors of diabetes, hyperlipidemia or lower limb vascular dysfunction, the occurrence of wound problems was increased. Meanwhile, the results of clinical reports varied due to different choice of internal fixations. The present study found that satisfied stability and clinical result could be achieved by fixed the avulsion fragment to the inferior medial side of the calcaneaus with shaped locking plate. Conclusion The treatment of avulsion fractures of calcaneal tuberosity in elderly patients using shaped locking plate

  9. Clinical analysis of tibial avulsion fracture of posterior cruciate ligament using bold screw in 19 cases%Bold空心螺钉治疗后交叉韧带胫骨撕脱骨折19例临床分析

    Institute of Scientific and Technical Information of China (English)

    郭珊成; 张峡; 郝勇

    2011-01-01

    Objective To evaluate the results of treatment of tibial avulsion fracture of the posterior cruciate ligament using bold screw.Methods A retrospective analysis of 19 cases of tibial avulsion fracture of the posterior cruciate ligament was conducted.Results The operation was all right in all patients,no case happened infection and deep venous thrombosis of lower limbs.Followedup period ranged from 6 months to 24 months (average 9 months) in all cases.All fractures were healed in Ⅰ period.Lysholm score reached 96.6.Conclusion Treatment of tibial avulsion fracture of the posterior cruciate ligament using bold screw is safe and effective methods,the effect is satisfied by postoperative function exercise.%目的 评价应用bold空心螺钉治疗后交叉韧带胫骨撕脱骨折的方法 及疗效.方法 回顾性分析bold空心螺钉治疗后交叉韧带胫骨撕脱骨折19例.结果 本组手术过程顺利,住院期间无感染及下肢深静脉血栓形成等并发症.19例均获门诊随访复查,随访时间6~24个月,平均9个月,所有患者术后骨折均Ⅰ期愈合,膝关节活动度均正常,Lysholm评分由术前平均65.4分提高至最后一次随访平均96.6分.结论 应用bold空心螺钉治疗后交叉韧带胫骨撕脱骨折是一种的安全、有效方法 .术后配合功能锻炼可获得满意的疗效.

  10. 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。

  11. Clinical experience of 11 cases of avulsion fracture of the tibial eminence to approach the anterior cruciate ligament insersion under arthroscope%关节镜辅助内固定治疗胫骨髁间嵴骨折11例临床体会

    Institute of Scientific and Technical Information of China (English)

    宋琦

    2011-01-01

    目的 探讨关节镜辅助下治疗胫骨髁间嵴前交叉韧带止点撕脱骨折的手术方式.方法 对11例患者根据髁间嵴骨折不同的形态类型,分别选择丝线、克氏针、可吸收螺钉、空心螺钉固定前交叉韧带止点撕脱骨块,术后指导功能锻炼.结果 所有病例随访3~36个月,术后3~4个月骨折部位均愈合,采用Lysholm膝关节评价疗效,平均得分92.6分.结论 关节镜辅助下根据髁间嵴撕脱骨折的不同类型选择不同内固定方式,可得到准确的复位、良好的骨折愈合及满意的膝关节功能恢复.%Objective To discuss the operation approach which treats avulsion fracture of the tibial eminence to approach the anterior cruciate ligament insersion under arthroscope. Methods 11 cases respectively chose silk suture, Kirschner wire, absorbed screw, hollow screw to fix avulsion bone on the anterior cruciate ligament insersion according to different types of the tibial eminence fracture, and postoperative functional exercise were directed. Restlts All cases were followed up from 3 to 36 months, all cases healed after 3 to 4 months on fracture part. According to the Lysholm knee joint score which was used to evaluate the curative effect, the average score was 92.6. Conclusion Through different internal fixation under arthroscope according to different avulsion fracture of the tibial eminence ,we can abtain precise reduction, good union of fracture and satisfactory functional recovery of knee joint.

  12. Lateral progression of brachial plexus avulsion injury

    Institute of Scientific and Technical Information of China (English)

    GU Yudong

    2007-01-01

    @@ All reports on brachial plexus injury which were presented on the 9th International Hand Surgery Meeting (2004),the 5th Asia-Pacific Area Hand Surgery Meeting (2005),the 10th Europe Hand Surgery Meeting (2005) and 49th Japan Hand Surgery Meeting (2006),were collected and reviewed.We also went through our own research on brachial plexus injury,and a cumulative review of all these reports and researches was made.

  13. 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、

  14. Segmental Embedding for Curing Full-thickness Complete Ureteral Avulsion(a report of 1 case and literature review)%分段包埋法治愈输尿管全层全段撕脱伤(附1例报告并文献复习)

    Institute of Scientific and Technical Information of China (English)

    唐顺利; 钟明; 李凯

    2012-01-01

    [Objective] To summarize the treatment of ureteral avulsion in order to provide the reference and guidance for clinical practice. [Methods]Full-thickness complete ureteral avulsion occurred in a 53-year-old female patient with oracle ureteral junction obstruction(UPJO) undergoing ureteroscopy. The patient was cured by ureteropelvic anastomosis in situ, ureteral segment embedding and ureter-bladder anastomosis. The literature was combined for analysis and discussion. [Results]No complication occurred during and after operation. No hydronephrosis was found by B-ultrasound reexamination 3 months after operation. B-ultrasound re-examination a half year after operation showed slight dropsy of left kidney. B-ultrasound a year after operation showed moderate dropsy of left kidney. IVP showed UPJO and moderate dropsy of left kidney. Reoperation including the resection of the stenosis of left kidney and nephropyelopolasty was performed. The patient recovered well after operation. During a year of follow-up, B-ultrasound showed that blood supply and size of the kidney were normal and no hydronephrosis was found. [Conclusion]The operation is the ideal method for the treatment of full-thickness complete ureteral avulsion, and the reference for long-segment uretheral avulsion. The surgical procedure is relatively simple and safe with few complications.%[目的]总结输尿管撕脱伤的处理方法,为临床工作提供借鉴和指导.[方法]报告1例53岁女性肾盂输尿管连接部梗阻(UPJO)患者行输尿管镜检查时发生输尿管全层全段撕脱,经采用输尿管肾盂原位吻合、输尿管分段包埋及输尿管膀胱吻合术而治愈,结合文献进行分析讨论.[结果]术中、术后无并发症发生,术后3个月B超复查无肾积水;术后半年B超复查示左肾轻度积水,1年后B超示左肾中度积水,IVP示UPJO并左肾中度积水,遂再次手术行左肾盂输尿管连接部(UPJ)狭窄段切除及肾盂成

  15. 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

  16. 关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折%The Research about Figure of 8 Suture Fixation with Cannulated Screw and washer Under Arthroscopic in the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture

    Institute of Scientific and Technical Information of China (English)

    吴健

    2015-01-01

    Objective to analyze the value of figure of 8 suture fixation with cannulated screw and washer under arthroscopic in the treatment of anterior cruciate ligament tibial avulsion fracture. Methods the Lysholm knee score and the Lachman test negative rate of 68 cases of patients before and after surgical operation were compared to evaluate the value of the 8 suture fixation with cannulated screw and washer under arthroscopic. Results all fractures were healed well. Postoperative Lysholm score was (92.84+1.65),which was significantly higher than that before operation with score (28.46±1.37)(t=33.486,P=0.000). Postoperative Lachman negative rate was 0%,which was significantly lower than that before operation with 100.00% (χ2=36.942, P=0.000).Conclusion figure of 8 suture fixation with cannulated screw and washer under arthroscopic has good effect in the treatment of anterior cruciate ligament tibial avulsion fracture.%目的:分析关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折的价值。方法以68例患者为对象,比较患者术前、后Lysholm膝关节功能评分和Lachman试验阴性率。结果:所有患者骨折均愈合良好。术后Lysholm评分为(92.84±1.65)分,显著高于术前(28.46±1.37)的评分(t=33.486,P=0.000)。术后Lachman阴性率为0.00%,显著低于术前100.00%的阳性率(χ2=36.942,P=0.000)。结论关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折具有较好的近期疗效。

  17. 关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折%The Research about Figure of 8 Suture Fixation with Cannulated Screw and Washer Under Arthroscopic in the Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture

    Institute of Scientific and Technical Information of China (English)

    吴健

    2015-01-01

    目的:分析关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折的价值。方法以68例患者为对象,比较患者术前、后Lysholm膝关节功能评分和Lachman试验阴性率。结果所有患者骨折均愈合良好。术后Lysholm评分为(92.84±1.65)分,显著高于术前(28.46±1.37)的评分(t=33.486,P=0.000)。术后Lachman阴性率为0.00%,显著低于术前100.00%的阳性率(c2=36.942,P=0.000)。结论关节镜下缝线“8”字打结空心钉固定治疗前交叉韧带胫骨止点撕脱性骨折具有较好的近期疗效。%Objective to analyze the value of figure of 8 suture fixation with cannulated screw and washer under arthroscopic in the treatment of anterior cruciate ligament tibial avulsion fracture.Methods The Lysholm knee score and the Lachman test negative rate of 68 cases of patients before and after surgical operation were compared to evaluate the value of the 8 suture fixation with cannulated screw and washer under arthroscopic.Results all fractures were healed well. Postoperative Lysholm score was (92.84 +1.65), which was significantly higher than that before operation with score (28.46±1.37)(t=33.486,P=0.000). Postoperative Lachman negative rate was 0%, which was significantly lower than that before operation with 100.00% (c2=36.942,P=0.000).Conclusion figure of 8 suture fixation with cannulated screw and washer under arthroscopic has good effect in the treatment of anterior cruciate ligament tibial avulsion fracture.

  18. 关节镜下空心螺钉和钢丝治疗前交叉韧带胫骨止点撕脱骨折对比疗效分析%Effect of Arthroscopic Treatment of Tibial Avulsion Fracture of Anterior Cruciate Ligament with Hollow Screws and Steel Wire

    Institute of Scientific and Technical Information of China (English)

    牛金龙; 黄远章; 王晋豫; 王勇卓; 谭亚运; 马技; 张民

    2016-01-01

    目的:空心螺钉和钢丝是治疗前交叉韧带胫骨止点撕脱骨折常用的固定方法。即使一些生物力学研究比较了两者固定技术的稳定性,但是临床对照研究相对较少。本研究的目的是比较关节镜下空心螺钉和钢丝固定在前交叉韧带胫骨止点撕脱骨折的手术疗效。方法对我院2010年10月至2015年4月关节镜下治疗前交叉韧带胫骨止点撕脱骨折患者进行回顾性分析,根据内植物不同,分为空心螺钉组(11例)和钢丝组(21例)。随访内容包括膝关节功能及韧带的稳定性评价。采用 Lysholm、IKDC 及 Tegner 评分系统评价膝关节功能,通过 Lachman 试验及 Pivot-shift 试验评价膝关节稳定性。结果本组32例患者均获随访,随访时间6~12个月,未发生切口及关节内感染等并发症。本研究中交通伤占75%,平均手术时间螺钉组为57 min、钢丝组为67 min(P ﹤0.05)。术后6个月时,Lysholm、IKDC、Tegner 评分:螺钉组分别为(94.59±1.28)分、(93.95±1.50)分、(8.2±0.39)分;钢丝组分别为(93.98±1.16)分、(93.27±1.38)分、(8.2±0.33)分,(P 值分别为0.182、0.203、0.878)。Lachman 试验:螺钉组1例阳性,10例阴性,阳性率为9.1%;钢丝组1例阳性,20例阴性,阳性率为4.8%(P =1.000),Pivot-shift 试验:螺钉组1例阳性,10例阴性,阳性率为9.1%;钢丝组1例阳性,20例阴性,阳性率为5.3%(P =1.000)。结论关节镜下空心螺钉和钢丝治疗前交叉韧带胫骨止点撕脱骨折疗效满意,钢丝固定手术时间较长,但在膝关节功能和稳定性方面,两者并没有显著性差异。%Objective The screw and steel wire is a common fixation method for the treatment of avulsion fracture of the tibial eminence. Even though some biomechanical studies have compared the stability of the two,the clinical reports are less. The aim of this study

  19. 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

  20. 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

  1. 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

  2. 缝线结合空心钉与缝线内固定治疗前交叉韧带胫骨髁间棘撕脱骨折疗效比较%Effect comparison of suture combined with cannulated screw fixation and suture fixation in treating anterior cruciate ligament tibial eminence avulsion fracture

    Institute of Scientific and Technical Information of China (English)

    罗灏; 刘君

    2014-01-01

    目的:比较缝线结合空心钉与缝线内固定治疗前交叉韧带胫骨髁间棘撕脱骨折疗效。方法将该院诊治的78例前交叉韧带胫骨髁间棘撕脱骨折患者随机分入A组与B组,A组患者接受缝线内固定,B组患者接受缝线结合空心钉内固定治疗,评估两组临床疗效。结果两组患者随访10~18个月,所有患者均骨性愈合。 B组患者术后Lysholm膝关节评分显著高于A组[(96.73±6.56) vs(91.26±6.17),P<0.05];术后B组患者Lachman试验和前抽屉试验结果显著优于A组(P<0.05);术后B组与A组IKDC2000主观膝关节评分差别具有统计学意义(P<0.05)。结论与缝线内固定相比,缝线结合空心钉内固定前交叉韧带胫骨髁间棘撕脱骨折效果更为理想,患者关节功能恢复好。%Objective To compare the effect of suture combined with cannulated screw fixation and suture fixation in treating anterior cruciate ligament tibial eminence avulsion fracture. Methods Seventy-eight cases with anterior cruciate ligament tibial eminence avul-sion fracture were randomized into group A and group B. Group A received suture fixation and group B was given suture combined with cannulated screw fixation. Clinical effects were compared between two groups. Results All the patients were followed up for 10~18 months,who obtained bony union. Postoperative Lysholm knee assessment score in group B was much higher than that in group A [(96. 73±6. 56) vs(91. 26±6. 17),P<0. 05]. Postoperative Lachman test result and anterior drawer test result in group B were su-perior to those in group A (P<0. 05). There were significant differences in IKDC2000 scores between group A and group B (P<0. 05). Conclusions Compared with suture fixation,suture combined with cannulated screw fixation has better clinical effects with ide-al recovery of joint function.

  3. 前交叉韧带胫骨髁间棘撕脱骨折三种内固定生物力学研究%A biomechanical comparison of anterior cruciate ligament tibial eminence avulsion fracture under various techniques of fixation

    Institute of Scientific and Technical Information of China (English)

    韩亮; 黄长明; 范华强; 董辉详

    2012-01-01

    Objective To compare various techniques of fixation for anterior cruciate ligament tibial eminence avulsion fracture biomechanically. Methods By using 15 cadaveric human knees, three different fixation techniques of anterior cruciate ligament tibial eminence avulsion fractures were compared between suture fixation group, suture and cannulated screw fixation group, cannulated screw fixation group. The knee joint specimens were fixed at flexion of 30°and subject to continuous stretch stresses of 60, 90, 120 and 150 N respectively on a Material Test System-585, which conducted a simulated Lachman test. The specimens were scanned by 3D Digital Corp. Data were recorded and processed by geomagic studio 5.0 software to establish three techniques of fixation. Results There were significant differences between each fixation group in the mean length change of ACL (P <0.05). Suture and cannulated screw fixation group's was (3.53±0.24)mm, which was significantly the strongest among the three groups. Suture fixation group's was (5.75±0.53)mra, which was the smallest. Cannulated screw fixation group's was (4.63 ±0.37 )mm. Conclusion The initial ultimate strength of suture and cannulated screw fixation of tibial eminence fractures in these specimens is the strongest, followed by cannulated screw fixation. The suture fixation is the weakest%目的 探讨前交叉韧带(ACL)胫骨髁间棘撕脱骨折3种内固定方式的生物力学性能比较.方法 取防腐成人膝关节标本15具,随机分为三组,每组5具,标本制作成ACL胫骨髁间棘撕脱骨折后不同内固定方式模型,分别为:缝线组、缝线结合空心钉组、空心钉组.每具标本分别在MTS-858材料测试系统进行屈曲30°加载60、90、120、150 N正常、术后及疲劳后测试,模拟Lachman试验.实验过程中三维激光扫描仪从不同角度自动捕捉膝关节运动变化,采集实验数据,用geomagic studio 5.0软件处理.结果 不同应力及不同状态下三组

  4. 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

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. Airbag-induced thumb avulsion: two case reports

    OpenAIRE

    Stoel, Anne-Marie C. C.; Vanhaecke, Jeroen; Dezillie, Marleen; Oosterlinck, Dirk; Stockmans, Filip

    2014-01-01

    Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.

  14. Airbag-induced thumb avulsion: two case reports.

    Science.gov (United States)

    Stoel, Anne-Marie C C; Vanhaecke, Jeroen; Dezillie, Marleen; Oosterlinck, Dirk; Stockmans, Filip

    2015-03-01

    Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision. PMID:25762890

  15. 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.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 下牙槽神经撕脱术对三叉神经痛患者下颌骨骨密度的影响%Effect of Surgical Avulsion of the Inferior Alveolar Nerve on the Mandible Bone Density

    Institute of Scientific and Technical Information of China (English)

    张军生; 刘延考; 牛怀恩; 李岩

    2006-01-01

    目的:研究下牙槽神经撕脱术对三叉神经痛患者下颌骨骨密度的影响.方法:对32例单侧型三叉神经第Ⅲ支疼痛患者行下牙槽神经撕脱术,使用双能X线测量仪于术前1 d、术后第2、5年测量双侧下颌骨骨密度.结果:与术前比较,总体上患侧下颌骨骨密度于术后第5年明显降低,其中女性患者于术后第2年已显著下降(P<0.05),而健侧下颌骨骨密度却无明显变化.结论:下牙槽神经的丧失可导致区域性下颌骨代谢紊乱,从而引起骨质疏松.

  4. 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.

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

    OpenAIRE

    Mônica Vicky Bahr Arias; Ângelo João Stopiglia

    1997-01-01

    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, ...

  6. 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

    OpenAIRE

    M. Cortiñas; G. Moreno-Pardo; S. Uña; M. Arcasa; M. R. Calero; Parra, R.; R. Gálvez

    2007-01-01

    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 age...

  7. 髋臼发育不良与髋臼盂唇撕裂120例临床分析%Analysis of 120 cases of developmental displasia of the hip and acetabular labral avulsion

    Institute of Scientific and Technical Information of China (English)

    李可大; 庞智晖; 何伟

    2007-01-01

    目的 探讨髋臼发育不良(DDH)患者的髋部疼痛与髋臼盂唇撕裂(ALA)的关系.方法 128例DDH患者均接受手术治疗并在术中探查髋臼盂唇的完整性.128例患者中有124例为ALA(96.87%),分别为左侧99例,右侧25例;其中105例是女性,19例是男性,平均年龄 37.4 岁 (16~52 岁).其中120例获得了随访,时间为3~8年,平均5年.结果 参照Severin髋关节功能临床评价标准,120例患者中获得优、良、可、差的例数分别是98例(81.66%)、12 例(10%) 、8例 (6%)和2例 (1.66%).结论 ALA是引起DDH疼痛的主要原因.采用改良Chairi截骨加盖、切除撕裂的盂唇的手术方法对治疗DDH的髋臼盂唇撕裂有较好的疗效,明显改善了髋关节功能,包括行走活动能力.

  8. 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.

  9. 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.

  10. 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

    OpenAIRE

    Sérgio Rocha Piedade; Martha Maria Mischan

    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...

  11. GAP-43 mRNA expression of the motor neurons and nerve roots induced by brachial plexus avulsion injury%臂丛损伤脊髓运动神经元与神经根GAP-43 mRNA表达

    Institute of Scientific and Technical Information of China (English)

    陈龙菊; 李峰; 刘娜; 司文章; 吴武田

    2005-01-01

    目的:探讨臂丛根性撕脱伤后脊髓腹角运动神经元胞体及其神经根GAP-43 mRNA的表达变化及其影响因素,为臂丛损伤的修复治疗提供理论依据.方法:本实验创立三种臂丛根性撕脱伤模型:C7前根撕脱(Ⅰ组);C7前根撕脱+切断同侧C5~T1后根(Ⅱ组);C7前根撕脱+C5和C6之间作同侧脊髓半横断(Ⅲ组).术后2周按CBS评分标准检查动物神经缺失症状,用SYBR Green荧光定量RT-PCR方法检测脊髓腹角运动神经元胞体及其神经根GAP-43 mRNA的表达改变.结果:根据CBS评分标准,对照组计为0分,Ⅰ组计分较低、Ⅲ组计分最高.对照组C7神经元胞体和C7神经根中GAP-43 mRNA表达量相近,但三种损伤组术后2周神经元胞体内GAP-43 mRNA表达均上调,而神经根内表达却下调.结论:(1)臂丛根性撕脱伤后脊髓腹角运动神经元胞体GAP-43 mRNA表达受突触前机制的调控;(2)臂丛损伤2周时神经元胞体内GAP-43 mRNA表达呈现高峰期,此时进行神经移位术将显著提高神经修复的效果.

  12. 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.

  13. 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

    OpenAIRE

    Mônica Vicky Bahr Arias; Ângelo João Stopiglia

    1997-01-01

    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 degener...

  14. 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

    OpenAIRE

    Mônica Vicky Bahr Arias; Ana Paula Frederico Loureiro Bracarense; Ângelo João Stopiglia

    1997-01-01

    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 wallerian...

  15. 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

  16. Intraarticular Entrapment of Os Subfibulare Following a Severe Inversion Injury of the Ankle: A Case Report

    OpenAIRE

    Kose, Ozkan; Kilicaslan, Omer Faruk; Guler, Ferhat; Aktan, Cemil

    2015-01-01

    Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is ...

  17. 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.

  18. Penile Degloving Injury in an Adolescent with Congenital Hypothyroid

    OpenAIRE

    Joseph DeCostanza; Daniel Pust; Byron Pazmino; Oksana Prychyna; Matthew Porcelli; Chauniqua Kiffin

    2012-01-01

    This case follows a 17-year-old boy with congenital hypothyroidism who sustained penile skin avulsion secondary to a dog bite. Initially, an attempt was made to repair the wound using the avulsed skin flap itself as coverage. The repair was done immediately upon presentation to enhance the chances of adequate flap viability; however, the dorsal portion of the reconstruction necrosed within the following week. Ultimately a full thickness surgical graft (FTSG) repair was performed to ensure the...

  19. 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.

  20. “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).

  1. 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...

  2. 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.

  3. Imaging the infrapatellar tendon in the elite athlete

    International Nuclear Information System (INIS)

    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

  4. Penile Degloving Injury in an Adolescent with Congenital Hypothyroid

    Directory of Open Access Journals (Sweden)

    Chauniqua Kiffin

    2012-01-01

    Full Text Available This case follows a 17-year-old boy with congenital hypothyroidism who sustained penile skin avulsion secondary to a dog bite. Initially, an attempt was made to repair the wound using the avulsed skin flap itself as coverage. The repair was done immediately upon presentation to enhance the chances of adequate flap viability; however, the dorsal portion of the reconstruction necrosed within the following week. Ultimately a full thickness surgical graft (FTSG repair was performed to ensure the most desirable outcome.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  6. 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.

  7. 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.

  8. 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.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  10. Physical education undergraduates and dental trauma knowledge.

    Science.gov (United States)

    Panzarini, Sônia Regina; Pedrini, Denise; Brandini, Daniela Atili; Poi, Wilson Roberto; Santos, Manoel Ferreira; Correa, João Paulo Toscani; Silva, Fernando Ferreira

    2005-12-01

    The aim of the present study was to assess the level of knowledge of undergraduates from the College of Physical Education (Toledo, Araçatuba) concerning dental avulsion injuries. Data showed that 95% of the respondents did not know what dental avulsion is, 73.5% said they know how to define dental replantation, however, only 26% were able to do it correctly. When asked about first emergency measures after an avulsion, 50% of the respondents said they know what they should do, and the most cited measure was to seek a dentist. When asked about optimal storage media, 45.5% would keep it in a favorable one, and 28% did not know where to keep the tooth until treatment. Only 25.6% indicated a suitable extra-oral time for replantation; 90.3% of the respondents had received no advice about the emergency management of dental avulsion; 90% said they consider this an important and necessary subject. The results indicated that educational campaigns are necessary to improve the emergency management of dental injuries by those future P.E. professors for a better prognosis of dental replantation. PMID:16262617

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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...

  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. Metaphyseal cortical irregularities in children: A new perspective on a multi-focal growth variant

    International Nuclear Information System (INIS)

    The occurrence of metaphyseal cortical irregularities in adolescents in many different bones indicates a commonality of these lesions as a variation of normal growth, rater than a stress or avulsive by-product. The histologically recognized incomplete nature of the metaphysical cortex in children offers an attractive explanation for this phenomenon. (orig.)

  18. Injury of anterior cruciate ligament with associated bony lesions: MR image

    International Nuclear Information System (INIS)

    To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. Complete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37%), and combined bony lesion in 14 (52%). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23%) of partial ACL tears;combined bony lesion was seen in four such cases(31%). There were eight cases of avulsion fracture;the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6);the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear

  19. Injury of anterior cruciate ligament with associated bony lesions: MR image

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soon; Oh, Yeon Hee; Lee, Chang Wook [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Yong Min [Chungbuk Univ. College of Medicine, Chongju (Korea, Republic of); Lee, Hyeon Kyeong; Kim, Seung Hyeon; Lee, Sung Woo [Dongguk Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-05-01

    To evaluate the characteristic MR findings in injury of the anterior cruciate ligament (ACL) with associated bony lesions. We reviewed MR findings and the corresponding arthroscopic or operative results of 48 patients with ACL injuries, and evaluated ACL signal intensity and contour. In associated bony lesions, we determined the location of avulsion fracture and bony bruise. Complete ACL tears were seen in 27 cases, partial tears in 13, and avulsion injury in eight. Complete tears showed heterogeneously increased signal intensity with contour bulging in ten cases (37%), and combined bony lesion in 14 (52%). ACL with a thin continous low signal intensity band surrounding heterogeneously-increased signal intensity suggested partial tears, and was seen in three of 13 proven cases (23%) of partial ACL tears;combined bony lesion was seen in four such cases(31%). There were eight cases of avulsion fracture;the most frequent site was the anterolateral portion of the tibial spine (n=6). The most frequent sites of bony lesion were at the midportion of the lateral femoral condyle (n=6), and the posterior portion of the lateral tibial plateau (n=6);the next most frequent site was the anterior portion of the lateral tibial plateau (n=5). Tearing of the ACL was seen on MRI as ligament discontinuity, and heterogeneously increased signal intensity with ACL contour bulging. The most frequent sites of associated bony lesions were the midportion of the lateral femoral condyle, and the posterior portion of the lateral tibial plateau. In associated bony lesions, bony contusion suggested ACL tearing, but avulsion fracture suggested ligament avulsion injury without tear.

  20. Intraarticular Entrapment of Os Subfibulare Following a Severe Inversion Injury of the Ankle: A Case Report

    Science.gov (United States)

    Kose, Ozkan; Kilicaslan, Omer Faruk; Guler, Ferhat; Aktan, Cemil

    2015-01-01

    Introduction: Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. Case Presentation: Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented. Conclusions: To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results. PMID:26101763

  1. The role of the reversed oblique radiograph in trauma of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Geyskens, W.; Brys, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Janzing, H. [Dept. of Traumatology, University Hospitals, Leuven (Belgium)

    2000-03-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  2. [Spontaneous compensation of severe mitral insufficiency secondary to rupture of chordae tendineae in an athlete].

    Science.gov (United States)

    Ordzhonikidze, Z G; Pavlov, V I; Mazxerkina, I A; Druzhinin, A E

    2007-01-01

    The article describes an observation of spontaneous compensation of severe mitral insufficiency due to chordal avulsion in a 52-year-old sportsman adapted to hard physical load. After a physical load, the sportsman developed symptoms of acute mitral insufficiency. EchoCG revealed myxomatous degeneration of mitral cusps, chordal avulsion, severe mitral insufficiency, and volume overload of the left heart. The patient refused surgical treatment; conservative therapy was conducted. A three-year follow-up revealed an unexpectedly fast decrease in the size of heart cavities and the speed of regurgitation. The authors reckon that the these fast changes took place due to the sportsmen's heart adaptation to volume overload. PMID:17564044

  3. 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.

  4. MR imaging of posterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobuyuki [Tsukuba Univ., Ibaraki (Japan). Hospital; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

    2001-07-01

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  5. MR imaging of posterior cruciate ligament injuries

    International Nuclear Information System (INIS)

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  6. In Vitro Periodontal Ligament Cell Viability in Different Storage Media.

    Science.gov (United States)

    Sharma, Meenakshi

    2016-01-01

    The aim of this study was to evaluate the viability of periodontal ligament cells of avulsed teeth in three different storage media. Forty-five mature premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into three groups according to the storage medium: milk (control), rice water and egg white. After placing extracted teeth for 30 min in storage media, the scrapings of the periodontal ligament (PDL) were collected in Falcon tubes containing collagenase in 2.5 mL of phosphate buffer saline and were incubated for 30 min and centrifuged for 5 min at 800 rpm. Cell viability was analyzed by Trypan blue exclusion. Rice water had a significantly higher number of viable cells compared to egg white and milk. There was no statistically significant difference between egg white and milk. Rice water may be able to maintain PDL cell viability of avulsed teeth better than egg white or milk. PMID:27652702

  7. 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.

  8. 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...

  9. Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study

    OpenAIRE

    Sônia Regina Panzarini; Denise Pedrini; Wilson Roberto Poi; Celso Koogi Sonoda; Daniela Atili Brandini; José Carlos Monteiro de Castro

    2008-01-01

    The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were exa...

  10. Alluvial plain dynamics in the southern Amazonian foreland basin

    OpenAIRE

    Lombardo, U

    2015-01-01

    Alluvial plains are formed with sediments that rivers deposit on the adjacent flood-basin, mainly through crevasse splays and avulsions. These result from a combination of processes, some of which push the river towards the crevasse threshold, while others act as triggers. Based on the floodplain sedimentation patterns of large rivers in the southern Amazonian foreland basin, it has been suggested that alluvial plain sediment accumulation ...

  11. Contralateral C7 root transfer over the last 20 years in China

    Institute of Scientific and Technical Information of China (English)

    GU Yu-dong

    2007-01-01

    @@ The surgical procedure of C7 root transfer from the healthy side was first performed successfully on August 26, 1986.1,2 Since then, this procedure has proved one of the major treatments for brachial plexus root avulsions.Nowadays, attitudes of doctors towards this operation have changed from doubt and surprise to deep conviction and acceptance.3,4 The latest progresses in experimental and clinical studies on contralateral C7 root transfer are reviewed in this article.

  12. Determination of prevalence of glenoid bony lesions after recurrent anterior shoulder dislocation using the 3-D CT scan

    OpenAIRE

    Guity, Mohamad Reza; Akhlaghpour, Shaharam; Yousefian, Reza

    2014-01-01

    Background: Glenoid bone damages consisting of anterior rim erosion and bony avulsion are very important in decision making for treatment of recurrent dislocation in shoulder joint. This study was aimed to determine the prevalence of these damages in patients with anterior recurrent shoulder dislocation. Methods: The study was a cross-sectional study evaluating patients with unstable shoulder joint. Glenoid bone damage was assessed using three dimensional (CT) scan implementing either glenoid...

  13. Traction injuries of the brachial plexus: Radiographic diagnosis by enhanced computed tomography (CT) and magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    The exact radiographic localisation of supraganglionic lesions of the brachial plexus provides important information for the prognosis and clinical management of these injuries. The authors report on the results of enhanced CT scanning and MRI of the cervical spine in five patients with surgically proven root avulsions caused by traction injuries. All lesions were correctly diagnosed by enhanced CT scanning. MRI, by comparison, identified only about 70% of the neural lesions. (orig.)

  14. 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).

  15. SURGICAL ANATOMY OF DORSAL ROOT ENTRY ZONE OF CERVICAL SPINAL NERVES : CADAVERIC STUDY

    OpenAIRE

    A Arun Kumar; Sudha Seshayyan; V.Tamilalagan; Sindou, M

    2014-01-01

    Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five...

  16. The Arcuate Sign: A Marker of Potential Knee Dislocation? A Report of Two Cases

    OpenAIRE

    Crimmins, Jason T.; Wissman, Robert D.

    2015-01-01

    The arcuate sign is a well described finding of fibular head avulsion at the insertion site of the arcuate complex. It has been associated with posterolateral corner knee injury and resulting instability. The authors report two patients presenting with the arcuate sign following knee dislocation, which has not been previously described. As unrecognized spontaneously reduced knee dislocation often results in significant morbidity, the authors propose that the arcuate sign should raise clinical...

  17. 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.)

  18. 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.

  19. Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site

    OpenAIRE

    LaPrade, Robert F.; Padalecki, Jeffrey Ryan; Jansson, Kyle; Smith, Sean; Dornan, Grant; Pierce, Casey; Wijdicks, Coen A

    2014-01-01

    Objectives: Complete radial tears near the medial meniscus posterior root attachment site disrupt the circumferential integrity of the meniscus (similar to a posterior root avulsion). These tears can compromise the circumferential integrity and have been reported in biomechanical studies to simulate the meniscectomized state. The purpose of the study was to quantify the tibiofemoral contact load and contact area changes that occur in cadaveric knees from complete posterior horn radial tears a...

  20. 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.

  1. MR imaging of the posterior cruciate ligament of the knee

    International Nuclear Information System (INIS)

    The significance of posterior cruciate ligament (PCL) tears is controversial, and the reliability of physical examination has recently been questioned in the orthopedic literature. The authors reviewed the MR examinations of 60 patients. Normal anatomy of the PCL and surrounding structures, including the ligaments of Humphrey and Wrisberg, are identified on anatomic drawings and MR images. Changes in the PCl with varying degrees of flexion are demonstrated. Examples of tear and avulsions of the PCL confirmed with arthroscopy or arthrotomy are presented

  2. Primary repair of ear laceration with wedge resection

    Directory of Open Access Journals (Sweden)

    Bhupinder Singla

    2015-03-01

    Full Text Available Although major contributions have been made in the field of reconstructive surgery, reconstructive surgery of the auricle is a daunting prospect even for the most experienced surgeons. Here, we present a case who presented to us in the emergency surgical ward with a history of an accidental laceration of right ear. Primary repair of the ear laceration after wedge resection of the avulsed part was done. The cosmesis achieved by this technique is discussed.

  3. Efficacy of enamel matrix derivatives (Emdogain) in treatment of replanted teeth – a systematic review based on animal studies

    OpenAIRE

    Wiegand, A.; Attin, T.

    2008-01-01

    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...

  4. 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 ...

  5. One-Dimensional Hydraulic Theory Applied to Experimental Subaqueous Fans with Supercritical Distributaries

    Science.gov (United States)

    Hamilton, P.; Strom, K.; Hoyal, D. C. J. D.

    2015-12-01

    Subaqueous fans are distributive channel systems that form in a variety of settings including offshore marine, sub-lacustrine, and reservoirs. These distributive systems create complex sedimentation patterns through repeated avulsion to fill in a basin. Here we ran a series of experiments to explore the intrinsic controls on avulsion cycles on subaqueous fans. Experiments are a convenient way to study these systems since the time-scale of fan development is dramatically shortened compared to natural settings, all boundary conditions can be controlled, and the experimental domain can be instrumented to monitor the pertinent hydraulic and morphologic variables. Experiments in this study used saline underflows and crushed plastic sediment fed down an imposed slope covered in the sediment. Avulsion cycles are a central feature in these experiments which are characterized by: (1) channel extension and stagnation; (2) bar aggradation and hydraulic jump initiation; (3) upstream retreat; and (4) flow avulsion. Looking at and analyzing these cycles yield the following conclusions: (1) distributive channels cease progradation due to a drop in sediment transport capacity in an expanded region ahead of the channel; (2) mouth bar aggradation leads to a large flow obstacle to cause the hydraulic jump feedback; (3) hydraulic jump regions are a significant locus of deposition; and (4) the upstream retreat rate is a function of sediment supply and the strength of the jump. We found that simple one-dimensional hydraulic principles such as the choked flow condition and the sequent depth ratio help to explain hydraulic jump initiation and emplaced lobe thickness respectively.

  6. 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.)

  7. 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.

  8. Radiologic findings in lesions of the ligamentum bifurcatum of the midfoot

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, S.; Agnholt, J.; Christensen, H.

    1987-02-01

    In a consecutive study of 106 patients presenting with a history of ankle sprain, 40.5% showed clinical signs of damage to the ligamentum bifurcatum. Eighteen of these patients showed 20 radiologic signs related to a lesion of this ligament; these signs included avulsions from the points of insertion and laxity in the lateral part of the transverse tarsal joint. The supplementary radiographs revealing these signs are demonstrated, and a more differentiated radiologic handling of the patient with ankle sprain is suggested.

  9. Unusual Variant of the Nutcracker Fracture of the Calcaneus and Tarsal Navicular

    OpenAIRE

    Gajendran, Varun K.; Yoo, Brad J.; Hunter, John C.

    2015-01-01

    A 62-year-old woman with severe seizure disorder presented with right ankle and foot pain after being found down, presumably following a seizure recurrence. Imaging showed an acute comminuted fracture of the anterolateral aspect of the right calcaneus, as well as an acute avulsion fracture of the right navicular tuberosity at the site of insertion of the tibialis posterior tendon. This fracture pattern suggests forced abduction of the midfoot or forefoot with severe compression of the lateral...

  10. 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.

  11. 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.

  12. Reconstructing landscape evolution in the Lower Khuzestan plain (SW Iran): integrating imagery, historical and sedimentary archives

    OpenAIRE

    Walstra, Jan; Verkinderen, Peter; Heyvaert, Vanessa

    2010-01-01

    During the late Holocene, an avulsion-controlled Karun megafan developed in the Lower Khuzestan plain. Based on the interpretation of satellite data, at least three different Karun channels were detected. A chronological framework is provided by archaeological sites and textual sources. The presence of extensive irrigation systems highlights the important role of human activity in the development of the plain. In addition, there is clear evidence of human actions (constru...

  13. 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).

  14. 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. PMID:27374014

  15. Ligament-induced sacral fractures of the pelvis are possible.

    Science.gov (United States)

    Steinke, Hanno; Hammer, Niels; Lingslebe, Uwe; Höch, Andreas; Klink, Thomas; Böhme, Jörg

    2014-07-01

    Pelvic ring stability is maintained passively by both the osseous and the ligamentous apparatus. Therapeutic approaches focus mainly on fracture patterns, so ligaments are often neglected. When they rupture along with the bone after pelvic ring fractures, disrupting stability, ligaments need to be considered during reconstruction and rehabilitation. Our aim was to determine the influence of ligaments on open-book injury using two experimental models with body donors. Mechanisms of bone avulsion related to open-book injury were investigated. Open-book injuries were induced in human pelves and subsequently investigated by anatomical dissection and endoscopy. The findings were compared to CT and MRI scans of open-book injuries. Relevant structures were further analyzed using plastinated cross-sections of the posterior pelvic ring. A fragment of the distal sacrum was observed, related to open-book injury. Two ligaments were found to be responsible for this avulsion phenomenon: the caudal portion of the anterior sacroiliac ligament and another ligament running along the ventral surface of the third sacral vertebra. The sacral fragment remained attached to the coxal bone by this second ligament after open-book injury. These results were validated using plastination and the structures were identified. Pelvic ligaments are probably involved in sacral avulsion caused by lateral traction. Therefore, ligaments should to be taken into account in diagnosis of open-book injury and subsequent therapy. PMID:24452928

  16. Magnetic resonance imaging in brachial plexus injury.

    Science.gov (United States)

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

    2013-08-01

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

  17. Biomechanical Characterization of a Model of Noninvasive, Traumatic Anterior Cruciate Ligament Injury in the Rat.

    Science.gov (United States)

    Maerz, Tristan; Kurdziel, Michael D; Davidson, Abigail A; Baker, Kevin C; Anderson, Kyle; Matthew, Howard W T

    2015-10-01

    The onset of post-traumatic osteoarthritis (PTOA) remains prevalent following traumatic joint injury such as anterior cruciate ligament (ACL) rupture, and animal models are important for studying the pathomechanisms of PTOA. Noninvasive ACL injury using the tibial compression model in the rat has not been characterized, and it may represent a more clinically relevant model than the common surgical ACL transection model. This study employed four loading profiles to induce ACL injury, in which motion capture analysis was performed, followed by quantitative joint laxity testing. High-speed, high-displacement loading repeatedly induces complete ACL injury, which causes significant increases in anterior-posterior and varus laxity. No loading protocol induced valgus laxity. Tibial internal rotation and anterior subluxation occurs up to the point of ACL failure, after which the tibia rotates externally as it subluxes over the femoral condyles. High displacement was more determinative of ACL injury compared to high speed. Low-speed protocols induced ACL avulsion from the femoral footprint whereas high-speed protocols caused either midsubstance rupture, avulsion, or a combination injury of avulsion and midsubstance rupture. This repeatable, noninvasive ACL injury protocol can be utilized in studies assessing PTOA or ACL reconstruction in the rat. PMID:25777293

  18. Awareness of emergency management of dental trauma

    Directory of Open Access Journals (Sweden)

    Ritu Namdev

    2014-01-01

    Full Text Available Aim: Traumatic dental injuries frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents′ knowledge of appropriate emergency measures. This study is aimed at evaluating the awareness level of a sample of Indian (Rohtak, Haryana parents in the management of dental trauma. Materials and Methods: A total of 1500 parents were surveyed using a self-administered structured questionnaire. The questionnaire was divided into three parts. The tabulated data were statistically analyzed using the Chi-square test. Result: This study indicated a low level of knowledge regarding tooth avulsion and replantation procedures to be followed in emergency. The residing area and age of parent did not affect the knowledge and awareness of parents. Moreover, well-educated parents also had very little or no information about dental trauma first-aid. The lack of significance in correct answers between those with and without such experience indicated that past experience did not seem to have increase the knowledge of the correct emergency procedures. Very little or no information about tooth avulsion and replantation had been given to most of them. Conclusion: Dental injury prevention and management should be recognized as a major public health issue and adequate resources to be allocated for research in this area. Educational programs to improve the knowledge and awareness among the parents have to be implemented.

  19. 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

  20. The clinical analysis of high resolution MR image diagnosing brachial plexus root avuision injury%高分辨率MRI诊断臂丛根性撕脱伤的临床研究

    Institute of Scientific and Technical Information of China (English)

    张德春; 顾立强; 向剑平; 戚剑; 秦本刚; 傅国; 刘小林; 朱家恺

    2011-01-01

    目的 探讨臂丛根性撕脱伤的高分辨率磁共振成像特点,为早期诊断臂丛根性撕脱伤提供帮助.方法 筛选于2006年2月-2011年2月收治臂丛损伤的病例,术前均行臂丛MRI检查,术中探查证实为臂丛根性撕脱伤45例,总结臂丛根性撕脱伤的高分辨率磁共振表现特点及MR诊断臂丛根性撕脱伤的应用价值.结果 臂丛根性撕脱伤的MRI表现为:①创伤性脊膜囊肿最为常见,有42例,出现率为93.3%;②脊髓偏移,有25例,出现率为55.6%;③脊神经前后根消失,有8例,出现率为17.8%;④“黑线”征,有18例,出现率为40.0%.核磁共振对臂丛根性撕脱伤诊断的敏感性为95.7%,特异性为77.8%,准确性为94.6%.结论 臂丛根性撕脱伤患者的MRI中以创伤性脊膜囊肿最为常见,可对臂丛损伤的定位诊断及手术治疗提供参考依据.%Objective To discuss the characteristic of brachial plexus root avulsion injury of high resolution MR imaging and the value in diagnosing of brachial plexus root avulsion injury early.Methods Fourty-five cases of brachial plexus root avulsion injury patients had being used for investigation to find the characteristic and diagnostic value of MR image of brachial plexus root avulsion injury,which all have pre-operative MR imaging and were diagnosed brachial plexus root avulsion injury by intra-operative exploration and electrophysiology form February 2006 to February 2011.Results Post-traumatic spinalmeningolceles were seen in 42 cases,the frequency was 93.3%; Displacement of spinal cord was seen in 25 cases,the frequency was 55.6%; Absence of anterior and posterior root of spinal nerve was seen in 8 eases,the frequency was 17.8%;"Black line sign" was seen in 18 cases,the frequency was 40.0%.The sensitivity,specificity,and accuracy of MRI in diagnosing brachial plexus root injury were 95.7%,77.8% and 94.6% respectively.Conclusion Posttraumatic spinalmeningolceles are most often

  1. Long-term interactions between man and the fluvial environment - case of the Diyala alluvial fan, Iraq

    Science.gov (United States)

    Heyvaert, Vanessa M. A.; Walstra, Jan; Mortier, Clément

    2014-05-01

    The Mesopotamian alluvial plain is dominated by large aggradading river systems (the Euphrates, Tigris and their tributaries), which are prone to avulsions. An avulsion can be defined as the diversion of flow from an existing channel onto the floodplain, eventually resulting in a new channel belt. Early civilizations depended on the position of rivers for their economic survival and hence the impact of channel shifts could be devastating (Wilkinson 2003; Morozova 2005; Heyvaert & Baeteman 2008). Research in the Iranian deltaic part of the Mesopotamian plain has demonstrated that deliberate human action (such as the construction of irrigation canals and dams) triggered or obstructed the alluvial processes leading to an avulsion on fluvial megafans (during preconditioning, triggering and post-triggering stages) (Walstra et al. 2010; Heyvaert et al. 2012, Heyvaert et al.2013). Thus, there is ample evidence that the present-day alluvial landscapes in the region are the result of complex interactions between natural and anthropogenic processes. Here we present a reconstruction of the Late Holocene evolution of the Diyala alluvial fan (one of the main tributaries of the Tigris in Iraq), with particular attention to the relations between alluvial fan development, changes in channel pattern, the construction of irrigation networks and the rise and collapse of societies through historic times. The work largely draws on the use of remote sensing and GIS techniques for geomorphological mapping, and previously published archaeological field data (Adams 1965). By linking archaeological sites of known age with traces of ancient irrigation networks we were able to establish a chronological framework of alluvial activity of the Diyala alluvial fan. Our results demonstrate that centralized and technologically advanced societies were able to maintain a rapidly aggradading distibutary channel system, supplying water and sediment across the entire alluvial fan. As a consequence

  2. Evaluation of the topical effect of alendronate on the root surface of extracted and replanted teeth. Microscopic analysis on rats' teeth.

    Science.gov (United States)

    Lustosa-Pereira, Adriana; Garcia, Roberto Brandão; de Moraes, Ivaldo Gomes; Bernardineli, Norberti; Bramante, Clovis Monteiro; Bortoluzzi, Eduardo Antunes

    2006-02-01

    The treatment of choice for tooth avulsion is replantation. The ideal replantation should be realized as quickly as possible, or at least, the avulsed tooth should be kept in an adequate solution to preserve the periodontal ligament attached to the root. If that is not possible, treatment of the radicular surface should be done in order to prevent radicular resorption. The purpose of this study was to test sodium alendronate as a substance for topical treatment of the radicular surface of avulsed teeth in an attempt to prevent the occurrence of dental resorptions. Fifty-four rat maxillary right central incisors were extracted and replanted. Group I--extra-alveolar dry period of 15 min, intracanal dressing with calcium hydroxide (CALEN, S.S. White, Artigos Dentários LTDA, Rio de Janeiro, Brazil) and replantation; Groups II and III - extra-alveolar dry periods of 30 and 60 min, respectively, immersion in 1% sodium hypochlorite for 30 min for removal of the periodontal ligament, washing in saline solution for 5 min, and treatment of the radicular surface with 3.2 mg/l sodium alendronate solution for 10 min. Intracanal dressing with calcium hydroxide and replantation followed. At 15, 60, and 90 days post-reimplantation, the animals were killed and the samples obtained and processed for microscopic analysis. The results indicated that sodium alendronate was able to reduce the incidence of radicular resorption, but not of dental ankylosis. No significant differences were observed regarding variations in the extra-alveolar periods among the groups. PMID:16422756

  3. 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.

  4. Evaluation of the hamstring muscles after injury

    International Nuclear Information System (INIS)

    Full text: The aim of this study was to describe the imaging findings following acute hamstring injury. We retrospectively reviewed the imaging findings of 224 examinations in 208 patients (192 male, 16 female, mean age 28.2 years). MR imaging was performed in 102 cases and sonography in 156 cases (both modalities were performed in 34 examinations). The mean duration of symptoms was 4.7 days (range 1-10 days). Attention was directed to the frequency of muscle movement, the location of the injury within the musculotendinous unit, the extent of the injury and discriminating avulsion from musculotendinous injury. Sixteen patients underwent surgery. The biceps femoris was the most common muscle injured (150/224). Sixteen patients with surgical confirmation of a hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps alone) were reliably diagnosed with MR imaging (16/16), but less so with ultrasound (7/12). Eighty-six patients (86/150) had injuries of the musculotendinous junction of biceps, 51/150 myofascial injuries and 13/150 muscle belly alone. Proximal injuries of the biceps were more common that the distal. Sixty-eight patients had injuries of semitendinosus and eight patients semimebranosus.The semitendinosus muscle was more often injured in the distal half of the muscle (42/68) as was semimebranosus (7/8). Three patients had a distal rupture of semitendinosus muscle with retraction. Haematoma was a common finding (170/224) and often tracked around the myofascial layer.This was felt to be a reliable sign for hamstring injury. Discriminating a hamstring tendon avulsion from myotendinous strain is important as these patients necessitate surgical management as opposed to conservative treatment. MR imaging is the preferred modality in the investigation of hamstring muscle and tendon injury. Ultrasound has a complimentary role and may be used to monitor hamstring tendon injuries prior to return to competitive sport. Copyright (2002) Blackwell Science Pty

  5. Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury

    International Nuclear Information System (INIS)

    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. 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.

  7. Historical adjustments by Walker River to lake-level fall over a tectonically tilted half-graben floor, Walker Lake Basin, Nevada

    Science.gov (United States)

    Blair, Terence C.; McPherson, John G.

    1994-08-01

    Historical records of lake and river adjustments in the tectonically active, north—south elongated, Walker Lake extensional basin of west-central Nevada provide important insight to the style and rate that rivers react to tectonic tilt in half grabens. The northern part of this basin, historically containing Walker Lake, is now occupied by the south-flowing Walker River. Walker Lake, presently restricted to the central basin sector, is a perennial water body 30 m deep sustained by, and forming the terminus of, Walker River. Both the river and lake have a strongly asymmetric distribution, located preferentially near the active Walker Lake fault bounding the western basin margin. Walker Lake has withdrawn from the northern basin sector since 1882 due to a 45 m drop in lake level caused by human diversion of the river upstream. This withdrawal has forced Walker River to incrementally lengthen, and to sequentially reposition its delta along the retreating northern lake margin. Twelve deltas have been deposited since 1882 in response to these changes. The initiation of eight of the twelve post-1882 deltas was associated with channel avulsion, and four with channel lengthening. Ten of the twelve channel and delta relocation events entailed significant westward lateral movements toward the Walker Lake fault, illustrating the dominating influence of the basin-floor tectonic tilt on river adjustments. The two eastward shifts were triggered intrinsically by avulsions resulting from erosion of the outer bank of channel meanders. The three phases of progressive westward shifting of the river towards the Walker Lake fault occurred over periods of 18, 6, and 16 years, respectively, documenting the rapid response time of Walker River to basin-floor tectonic tilt despite the countering effects of the intrinsic avulsions, and hindrances to lateral migration caused by the muddy substrate of the former lake bottom deposits within which the river is incised.

  8. Tipping Points in Texas Rivers

    Science.gov (United States)

    Phillips, Jonathan

    2016-04-01

    Anticipating geomorphic tipping points requires that we learn from the past. Major geomorphic changes in coastal plain rivers of Texas resulting in river metamorphosis or regime shifts were identified, and the major driving factors determined. Nine fluvial tipping points were identified from contemporary observations, historical records, and Quaternary reconstructions. Two of the tipping points (between general aggrading and degrading valley states) are associated with reversals in a fundamental system control (sea-level). One (stable or aggrading vs. degrading channels) is associated with an abrupt change in sediment supply due to dam construction, and two others (changes from meandering to anastomosing channel patterns, and different anastomosis styles) are similarly related to changes in sediment supply and/or transport capacity, but with additional elements of historical contingency. Three tipping points are related to avulsions. One, from a regime dominated to reoccupation of former channels to one dominated by progradation into flood basins, is driven by progressive long term filling of incised valleys. Another, nodal avulsions, are driven by disturbances associated with tectonics or listric faults. The third, avulsions and related valley metamorphosis in unfilled incised valleys, is due to fundamental dynamical instabilities within the fluvial system. This synthesis and analysis suggests that geomorphic tipping points are sometimes associated with general extrinsic or intrinsic (to the fluvial system) environmental change, independent of any disturbances or instabilities. Others are associated with natural (e.g., tectonic) or human (dams) disturbances, and still others with intrinsic geomorphic instabilities. This suggests that future tipping points will be equally diverse with respect to their drivers.

  9. The rivers of civilization

    Science.gov (United States)

    Macklin, Mark G.; Lewin, John

    2015-04-01

    The hydromorphic regimes that underpinned Old World river-based civilizations are reviewed in light of recent research. Notable Holocene climatic changes varied from region to region, whilst the dynamics of floodplain environments were equally diverse, with river channel changes significantly affecting human settlement. There were longer-term trends in Holocene hydroclimate and multi-centennial length 'flood-rich' and 'flood-poor' episodes. These impacted on five identified flooding and settlement scenarios: (i) alluvial fans and aprons; (ii) laterally mobile rivers; (iii) rivers with well-developed levees and flood basins; (iv) river systems characterised by avulsions and floodouts; and (v) large river-fed wetlands. This gave a range of changes that were either more or less regular or incremental from year-to-year (and thus potentially manageable) or catastrophic. The latter might be sudden during a flood event or a few seasons (acute), or over longer periods extending over many decades or even centuries (chronic). The geomorphic and environmental impacts of these events on riparian societies were very often irreversible. Contrasts are made between allogenic and autogenic mechanism for imposing environmental stress on riverine communities and a distinction is made between channel avulsion and contraction responses. Floods, droughts and river channel changes can precondition as well as trigger environmental crises and societal collapse. The Nile system currently offers the best set of independently dated Holocene fluvial and archaeological records, and the contrasted effects of changing hydromorphological regimes on floodwater farming are examined. The persistence of civilizations depended essentially on the societies that maintained them, but they were also understandably resilient in some environments (Pharaonic Egypt in the Egyptian Nile), appear to have had more limited windows of opportunity in others (the Kerma Kingdom in the Nubian Nile), or required

  10. 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.

  11. A preclinical dental trauma teaching module.

    Science.gov (United States)

    Marriot-Smith, Charlotte; Marino, Victor; Heithersay, Geoffrey Sinclair

    2016-06-01

    A dental trauma exercise using the anterior segment of a sheep mandible as a model has been incorporated into the undergraduate dental programme at the University of Adelaide since 2011. Students are required to replant a simulated tooth avulsion, reposition a laterally luxated tooth injury and then apply a flexible splint consisting of 40 lb fishing nylon attached with a resin-modified glass ionomer cement, GC Fuji Ortho LC. The exercise concludes with the simple removal of the splint with a spoon excavator. The acrylic mounted formalin-fixed sheep mandible is reusable, which has obvious economic and practical advantages. PMID:26667108

  12. Liver trauma and transection of the inferior vena cava

    International Nuclear Information System (INIS)

    CT of a child with severe liver trauma due to a seat belt injury demonstrated avulsion of a portion of the lateral segment of the left lobe of the liver. The location of nondependent extravasated contrast material aided in identification of the visceral fracture site (the sentinel contrast sign). Associated transection of the inferior vena cava was evidenced by hypoatenuating zones adjacent to all the major hepatic veins and vena cava (hepatic perivenous tracking). Recognition of these two signs is important so that the radiologist can help the surgeon select the optimal operative approach. (orig.)

  13. Traumatic ureteropelvic disruption in the child

    International Nuclear Information System (INIS)

    Traumatic disruption of the ureter from the renal pelvis is a rare injury because the ureteropelvic junction is situated deep in the retroperitoneum and is thus protected by the spine and paraspinal muscles. The mechanism for this injury is thought to be the stretching of the proximal ureter by sudden extreme hyperextension of the trunk. As a non-fatal injury, this occurs only in the child because of the greater elasticity and mobility of the young skeleton. At The Children's Hospital we have seen 3 cases of avulsion of the ureter from the pelvis following blunt trauma. (orig.)

  14. 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

  15. Las fracturas por avulsión de la tuberosidad posterior del clacáneo

    OpenAIRE

    Arenas Miquélez, A.; Ayala Palacios, Higinio; Arenas Planelles, Antonio; Garbayo Marturet, Antonio Jesús

    2004-01-01

    Se presentan 6 casos de fractura por avulsión de la tuberosidad posterior del calcáneo (fracturas en pico de pato), tratadas todas ellas en nuestro centro, 5 de ellas quirúrgicamente (reducción abierta + osteosíntesis con tornillos). Los resultados han sido satisfactorios en todos los casos tanto en el aspecto cosmético como funcional. The authors present 6 cases of avulsion fracture of the posterior tuberosity of the calcaneus (beak fractures), treated all of them in our hospital, 5 of...

  16. Radiology of sport injuries of pelvic apophyses

    International Nuclear Information System (INIS)

    Pelvic apophyses are places of insertion of strong muscles and tendons and are therefore places of least resistance at the end of skeletal growth. Avulsions and disruptions of pelvic apophyses can be caused by overstrain during different kinds of sport activity. Typical radiological findings in 8 different cases of ruptures of apophyses, osteochondropathies, and resulting conditions of sport injuries are demonstrated. The difficulties of correct diagnosis and different diagnosis are pointed out. The significance of hormonal impairment of ossification for development and stress factor of pelvic apophyses is exposed. Questions of treatment and follow-up studies are discussed. (orig.)

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. Radiologic findings in lesions of the ligamentum bifurcatum of the midfoot

    International Nuclear Information System (INIS)

    In a consecutive study of 106 patients presenting with a history of ankle sprain, 40.5% showed clinical signs of damage to the ligamentum bifurcatum. Eighteen of these patients showed 20 radiologic signs related to a lesion of this ligament; these signs included avulsions from the points of insertion and laxity in the lateral part of the transverse tarsal joint. The supplementary radiographs revealing these signs are demonstrated, and a more differentiated radiologic handling of the patient with ankle sprain is suggested. (orig.)

  2. 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.

  3. [Legal aspects of sports injuries].

    Science.gov (United States)

    Allard, R H B

    2005-05-01

    Victims of sports injuries have to be advised about aspects of legal liablity, especially in case of luxation or avulsion of teeth, since there still may be dental consequences years later. The transference of information by the first-aid-dentist to the sportsman's own dentist should take place with care. If the patient has no family dentist, the first-aid-dentist should at least keep the sportsman free of pain, for example by starting endodontic treatment. Because sports injuries mostly occur beyond normal practice-hours, there may be reasons to deviate from the clinical guideline. PMID:15932047

  4. [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.

  5. Two Pelvic Digits on Same Side: Double Trouble?

    Science.gov (United States)

    Khatri, Kavin; Goyal, Darsh; Paul, Rajesh; Sandhu, H S

    2015-06-01

    Pelvic digit is a rare congenital anomaly of pelvis usually discovered incidentally on plain radiography. It usually develops in the soft tissue adjacent to the normal skeletal tissue. Its importance lays in its differentiation from heterotopic ossification, osteochondroma, Fong's disease and traumatic avulsion injuries of pelvis to avoid any unnecessary investigations and interventions. Here, we report a 32-year-old male presenting with complain of pain in right hip, was subjected to radiographic examination and two pelvic digits were noticed arising from the iliac bone in addition to features of osteoarthritis of hip joint. The symptomatology was attributed to osteoarthritis of hip after thorough physical examination and imaging investigations. PMID:26266172

  6. 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.

  7. 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.)

  8. First aid for dental trauma caused by sports activities: state of knowledge, treatment and prevention.

    Science.gov (United States)

    Emerich, Katarzyna; Kaczmarek, Jan

    2010-05-01

    In view of the widespread lack of knowledge of first aid procedures in cases of dental trauma, this article describes the current state of knowledge and highlights the need for education of those likely to witness or be victims of dental trauma while practising sports. Dental and oral injuries, the commonest type of orofacial injuries, are often sustained by athletes playing contact sports; indeed, they represent the most frequent type of sporting injury. Studies of a large group of children and adults have shown that as many as 31% of all orofacial injuries are caused by sporting activities. Furthermore, current literature on the subject emphasizes that awareness of appropriate triage procedures following dental trauma is unsatisfactory. Delay in treatment is the single most influential factor affecting prognosis. What should we know and, more importantly, what should we do? Immediate replantation of an avulsed tooth is the best treatment option at the site of the accident. If replantation is impossible, milk is the preferred transport medium for the avulsed tooth. There is a general low level of awareness about the need for prompt triage of traumatic dental injuries sustained in sports, despite their relative frequency. When a cohort of Swiss basketball players was interviewed, only half were aware that an avulsed tooth could be replanted. Cheap, commercially available tooth storage devices containing an isotonic transport medium (so-called 'Save-a-Tooth boxes'), can maintain the viability of an avulsed tooth for up to 72 hours, prior to replantation. More readily available storage media such as milk, sterile saline or even saliva may be used, but knowledge of this information is rare among sports participants. For example, just 6.6% of the Swiss basketball players interviewed were aware of the 'Tooth Rescue box' products. Sporting organizations seem to offer very little information about sports-related risks or preventive strategies for orodental trauma. Having

  9. Posterior Tibial Labrum Injury in a Professional Soccer Player: A Case Report.

    Science.gov (United States)

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Maestu, Rodrigo

    2016-01-01

    Ankle ligament injuries are one of the most frequent lesions identified in professional soccer players. In most cases, the ligaments involved are the anterior talofibular ligament and the calcaneal fibular ligament. In the present report, we describe a professional soccer player who sustained an ankle sprain that did not respond to initial therapy. The findings from radiographic and magnetic resonance images were inconclusive. Ultimately, rupture of the posterior, transverse ligament with avulsion of the tibial labrum was identified as the cause of his ongoing ankle pain. Confirmation of the pathologic findings and successful treatment were performed arthroscopically. PMID:25459088

  10. 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-

  11. Painful/unstable shoulder

    International Nuclear Information System (INIS)

    This paper reports on the diagnostic performance of CT-arthrography of the painful/unstable shoulder that was evaluated in more than 300 patients. We have encountered a great variety of painful shoulder pathology, including impingement syndrome, cuff tear arthropathy, lesions of the long head of the biceps tendon, calcifying tendinitis, adhesive capsulitis, dead arm syndrome, and degenerative joint disease. Lesions related to instability include cases of capsular avulsions, disruption of the glenohumeral ligaments, labral pathology, glenoid fractures, Hill-Sachs lesions, and changes in glenoid angulation. CT-arthrography is an accurate exploration for both unstable and painful shoulders

  12. 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

  13. 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

  14. Incidence of Soft-Tissue Injuries in Patients with Posterolateral Tibial Plateau Fractures: A Retrospective Review from 2009 to 2014.

    Science.gov (United States)

    Wang, Yanqing; Cao, Fujiang; Liu, Minghui; Wang, Jiantao; Jia, Shikong

    2016-08-01

    Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures. PMID:27183240

  15. Three phase bone scan in sports injuries

    International Nuclear Information System (INIS)

    Full text: Sports injuries are common in individual who participate in sports and exercise related activities. In majority of sports related injuries such as stress fracture, periosteitits, acute stress reaction of bone, the radiological investigations are usually normal in early stages. These injuries can lead to serious complications if not detected early and managed properly. This study was jointly carried out in premier medical institutes. All patients were referred from premier sports institute of the country and also by orthopedic surgeons. All patients were subjected for relevant radiological investigations and 3 phase bone scan. Total number of cases included in this study was 70 (N=70) among which bone scan was positive for stress fracture in 45 patients and shin splint was detected in 15 patients and avulsion injury seen in 3 patients. However, only one patient showed features of avulsion injury in X ray and in 1 patient X-ray was inconclusive. Conclusion:-The study shows that 3 phase bone scan is the most sensitive and relatively an inexpensive study. Bone scan has the ability for early detection of sports injuries and provide physiological information and evaluate multiple sites in single examination.SPECT study will help in the diagnostic specificity. (author)

  16. Experimental river delta size set by multiple floods and backwater hydrodynamics.

    Science.gov (United States)

    Ganti, Vamsi; Chadwick, Austin J; Hassenruck-Gudipati, Hima J; Fuller, Brian M; Lamb, Michael P

    2016-05-01

    River deltas worldwide are currently under threat of drowning and destruction by sea-level rise, subsidence, and oceanic storms, highlighting the need to quantify their growth processes. Deltas are built through construction of sediment lobes, and emerging theories suggest that the size of delta lobes scales with backwater hydrodynamics, but these ideas are difficult to test on natural deltas that evolve slowly. We show results of the first laboratory delta built through successive deposition of lobes that maintain a constant size. We show that the characteristic size of delta lobes emerges because of a preferential avulsion node-the location where the river course periodically and abruptly shifts-that remains fixed spatially relative to the prograding shoreline. The preferential avulsion node in our experiments is a consequence of multiple river floods and Froude-subcritical flows that produce persistent nonuniform flows and a peak in net channel deposition within the backwater zone of the coastal river. In contrast, experimental deltas without multiple floods produce flows with uniform velocities and delta lobes that lack a characteristic size. Results have broad applications to sustainable management of deltas and for decoding their stratigraphic record on Earth and Mars. PMID:27386534

  17. 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.   

  18. The elusive character of discontinuous deep-water channels: New insights from Lucia Chica channel system, offshore California

    Science.gov (United States)

    Maier, K.L.; Fildani, A.; Paull, C.K.; Graham, S.A.; McHargue, T.R.; Caress, D.W.; McGann, M.

    2011-01-01

    New high-resolution autonomous underwater vehicle (AUV) seafloor images, with 1 m lateral resolution and 0.3 m vertical resolution, reveal unexpected seafloor rugosity and low-relief (<10 m), discontinuous conduits over ~70 km2. Continuous channel thalwegs were interpreted originally from lower-resolution images, but newly acquired AUV data indicate that a single sinuous channel fed a series of discontinuous lower-relief channels. These discontinuous channels were created by at least four avulsion events. Channel relief, defined as the height from the thalweg to the levee crest, controls avulsions and overall stratigraphic architecture of the depositional area. Flowstripped turbidity currents separated into and reactivated multiple channels to create a distributary pattern and developed discontinuous trains of cyclic scours and megaflutes, which may be erosional precursors to continuous channels. The diverse features now imaged in the Lucia Chica channel system (offshore California) are likely common in modern and ancient systems with similar overall morphologies, but have not been previously mapped with lower-resolution detection methods in any of these systems. ?? 2011 Geological Society of America.

  19. 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.

  20. 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.

  1. An earth systems approach to understanding the tectonic and cultural landscapes of linked marine embayments: Avon-Heathcote Estuary (Ihutai) and Lake Ellesmere (Waihora), New Zealand

    Science.gov (United States)

    McFadgen, Bruce G.; Goff, James R.

    2005-03-01

    An earth systems study of the Avon-Heathcote Estuary (Ihutai), New Zealand, shows that tectonic activity has a marked direct and indirect control upon its geomorphology and human settlement in the area. We discuss the Late Holocene history of the embayment in relation to large earthquakes and their after-effects. Of particular note is the rapid fluvial transfer of sand to the coast causing dune formation and a more delayed pulse of coarser sediment causing channel avulsion of the Waimakariri River. While dune system development seems to occur soon after tectonic activity, river channel avulsion, spit/barrier formation and ongoing geomorphological changes may well relate to periods of tectonic activity that occurred 100-200 years previously. The interaction between these two sediment delivery systems causes significant, and often rapid, changes to coastal geomorphology and ecosystems that have serious implications for human populations living at or near the coast. We show a more region-wide picture of the direct and indirect effects of tectonic activity, by comparing two embayments that represent coastal points of entry at opposite ends of the Waimakariri River floodplain: the Avon-Heathcote Estuary (Ihutai) and Lake Ellesmere (Waihora).

  2. [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.

  3. Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

    Directory of Open Access Journals (Sweden)

    Fujimori Takahito

    2012-09-01

    Full Text Available Abstract Introduction Acute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs. Case presentation An 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared. Conclusion Our experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.

  4. Detailed river stage mapping and head gradient analysis during meander cutoff in a laboratory river

    Science.gov (United States)

    Han, Bangshuai; Endreny, Theodore A.

    2014-02-01

    Analytical models of river evolution predict meander narrowing and elongation which creates sinuosity-driven hyporheic exchange across the meander neck, by decreasing flow distance and increasing head loss. We used a laboratory river table and close range photogrammetry to map and analyze sinuosity as a driver of head gradients and hyporheic exchange during cutoff. The river valley had relatively high slopes (1.8%) and moderately cohesive sediment (10% talc, 90% sand) to facilitate cutoff, and ratios of horizontal to vertical scaling were distorted to achieve dynamic similitude (Re = 3200). Incipient to cutoff, the head gradient across the neck increased due to a narrowing neck, upstream aggradation, and downstream degradation. Longitudinal and transverse river surface slopes around the meander bend increased as the meander approached cutoff. The steep head gradient across the moderately cohesive meander neck generated seepage erosion and scour that formed a low-sinuosity avulsion. Sediment-rich flow in the avulsed channel aggraded the downstream bed and separated the active channel and oxbow lake. The limitation in geometric and dynamic similitude in the river table limits extrapolation to natural rivers, yet river evolution may involve aggradation and degradation induced channel head loss and turnover hyporheic exchange as well as seepage-induced meander neck erosion. Our submillimeter maps of meander morphology and water stage provide data to parameterize river evolution and hyporheic exchange models, and may inform analysis and mapping of field sites.

  5. A case of patellar fractures in monozygotic twin gymnasts

    Directory of Open Access Journals (Sweden)

    Beamish Andrew J

    2012-06-01

    Full Text Available Abstract We present a case of near identical patellar fractures in adolescent monozygotic twins who are both high-level competitive gymnasts. These patients presented 14 months apart with almost identical history and clinical findings. Both had an intense training regime involving over 30 hours per week of load-bearing exercise. Clinical and radiological examinations suggested avulsion or sleeve fracture of the inferior pole of the patella with minimal displacement. Diagnoses of patellar stress fracture with avulsion of the distal pole and symptomatic bipartite patella could not be reliably excluded. Both fractures were treated conservatively with immobilisation of the knee in extension. An excellent functional result was observed in both patients with return to full activity at 8 weeks. This is the first published case of identical injury to the patella in monozygotic twins. A significant genetic influence on bone mineral density (BMD has been reported and low BMD is associated with increased susceptibility to fracture. These injuries corroborate a genetic influence on susceptibility to fracture. There is a requirement for further work to investigate genetic factors influencing susceptibility to fracture.

  6. Experimental river delta size set by multiple floods and backwater hydrodynamics

    Science.gov (United States)

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

    2016-01-01

    River deltas worldwide are currently under threat of drowning and destruction by sea-level rise, subsidence, and oceanic storms, highlighting the need to quantify their growth processes. Deltas are built through construction of sediment lobes, and emerging theories suggest that the size of delta lobes scales with backwater hydrodynamics, but these ideas are difficult to test on natural deltas that evolve slowly. We show results of the first laboratory delta built through successive deposition of lobes that maintain a constant size. We show that the characteristic size of delta lobes emerges because of a preferential avulsion node—the location where the river course periodically and abruptly shifts—that remains fixed spatially relative to the prograding shoreline. The preferential avulsion node in our experiments is a consequence of multiple river floods and Froude-subcritical flows that produce persistent nonuniform flows and a peak in net channel deposition within the backwater zone of the coastal river. In contrast, experimental deltas without multiple floods produce flows with uniform velocities and delta lobes that lack a characteristic size. Results have broad applications to sustainable management of deltas and for decoding their stratigraphic record on Earth and Mars. PMID:27386534

  7. 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.

  8. Unilateral traumatic oculomotor nerve paralysis

    International Nuclear Information System (INIS)

    The present authors report a case of unilateral traumatic oculomotor nerve paralysis which shows interesting CT findings which suggest its mechanism. A 60-year-old woman was admitted to our hospital with a cerebral concussion soon after a traffic accident. A CT scan was performed soon after admission. A high-density spot was noted at the medial aspect of the left cerebral peduncle, where the oculomotor nerve emerged from the midbrain, and an irregular, slender, high-density area was delineated in the right dorsolateral surface of the midbrain. Although the right hemiparesis had already improved by the next morning, the function of the left oculomotor nerve has been completely disturbed for the three months since the injury. In our case, it is speculated that an avulsion of the left oculomotor nerve rootlet occurred at the time of impact as the mechanism of the oculomotor nerve paralysis. A CT taken soon after the head injury showed a high-density spot; this was considered to be a hemorrhage occurring because of the avulsion of the nerve rootlet at the medial surface of the cerebral peduncle. (J.P.N.)

  9. The POLPSA lesion: MR imaging findings with arthroscopic correlation in patients with posterior instability

    International Nuclear Information System (INIS)

    Objective. To evaluate the features of the posterior labrocapsular periosteal sleeve avulsion (POLPSA) lesion on MR imaging in athletes with posterior shoulder instability.Design and patients. Six male athletes (age range 19-43 years) with avulsion of the posterior glenoid periosteum were identified on MR imaging. There were four football players, one wrestler, and one competitive weightlifter. The weightlifter had a bilateral condition so that seven shoulders were evaluated. MR imaging was performed with a 1.5 T magnet utilizing conventional and fat-saturated fast spin-echo coronal oblique and sagittal oblique sequences and a 3D-GRE transaxial sequence. Surgical correlation was available in all shoulders.Results. All patients presented with pain and a joint effusion. The size of the periosteal sleeve and redundant joint recess was variable. Fibrous proliferation was noted arthroscopically in four shoulders beneath the sleeve. Although the posterior labrum was detached in all studies, only one labrum had a tear while two showed marked degeneration.Conclusion. The POLPSA lesion is an abnormality that can be associated with posterior instability. It differs from a reverse Bankart lesion because the periosteum, although detached, remains intact with the posterior capsule and detached posterior labrum. This lesion may represent an acute form of a Bennett lesion. (orig.)

  10. Predicting the planform configuration of the braided Toklat River, AK with a suite of rule-based models

    Science.gov (United States)

    Podolak, Charles J.

    2013-01-01

    An ensemble of rule-based models was constructed to assess possible future braided river planform configurations for the Toklat River in Denali National Park and Preserve, Alaska. This approach combined an analysis of large-scale influences on stability with several reduced-complexity models to produce the predictions at a practical level for managers concerned about the persistence of bank erosion while acknowledging the great uncertainty in any landscape prediction. First, a model of confluence angles reproduced observed angles of a major confluence, but showed limited susceptibility to a major rearrangement of the channel planform downstream. Second, a probabilistic map of channel locations was created with a two-parameter channel avulsion model. The predicted channel belt location was concentrated in the same area as the current channel belt. Finally, a suite of valley-scale channel and braid plain characteristics were extracted from a light detection and ranging (LiDAR)-derived surface. The characteristics demonstrated large-scale stabilizing topographic influences on channel planform. The combination of independent analyses increased confidence in the conclusion that the Toklat River braided planform is a dynamically stable system due to large and persistent valley-scale influences, and that a range of avulsive perturbations are likely to result in a relatively unchanged planform configuration in the short term.

  11. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, John J.; Ginai, Abida Z. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Beumer, Annechien; Moonen, Adrianus F.C.M. [Amphia Hospital, Department of Orthopaedics, Breda (Netherlands); Hop, Wim C.J. [Erasmus University Medical Center, Department of Biostatistics, Rotterdam (Netherlands)

    2012-02-15

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement ({kappa}) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes ({kappa} 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique

  12. 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

  13. Tibiofibular syndesmosis in acute ankle fractures: additional value of an oblique MR image plane

    International Nuclear Information System (INIS)

    To evaluate the additional value of a 45 oblique MRI scan plane for assessing the anterior and posterior distal tibiofibular syndesmotic ligaments in patients with an acute ankle fracture. Prospectively, data were collected for 44 consecutive patients with an acute ankle fracture who underwent a radiograph (AP, lateral, and mortise view) as well as an MRI in both the standard three orthogonal planes and in an additional 45 oblique plane. The fractures on the radiographs were classified according to Lauge-Hansen (LH). The anterior (ATIFL) and posterior (PTIFL) distal tibiofibular ligaments, as well as the presence of a bony avulsion in both the axial and oblique planes was evaluated on MRI. MRI findings regarding syndesmotic injury in the axial and oblique planes were compared to syndesmotic injury predicted by LH. Kappa and the agreement score were calculated to determine the interobserver agreement. The Wilcoxon signed rank test and McNemar's test were used to compare the two scan planes. The interobserver agreement (κ) and agreement score [AS (%)] regarding injury of the ATIFL and PTIFL and the presence of a fibular or tibial avulsion fracture were good to excellent in both the axial and oblique image planes (κ 0.61-0.92, AS 84-95%). For both ligaments the oblique image plane indicated significantly less injury than the axial plane (p < 0.001). There was no significant difference in detection of an avulsion fracture in the axial or oblique plane, neither anteriorly (p=0.50) nor posteriorly (p=1.00). With syndesmotic injury as predicted by LH as comparison, the specificity in the oblique MR plane increased for both anterior (to 86% from 7%) and posterior (to 86% from 48%) syndesmotic injury when compared to the axial plane. Our results show the additional value of an 45 oblique MR image plane for detection of injury of the anterior and posterior distal tibiofibular syndesmoses in acute ankle fractures. Findings of syndesmotic injury in the oblique MRI plane were

  14. 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

  15. Megafans of the Northern Kalahari Basin

    Science.gov (United States)

    Wilkinson, M. J.; Miller, R. McG.; Eckardt, F.; Kreslavsky, M. A.

    2016-01-01

    We identify eleven megafans (partial cones of fluvial sediment, >80 km radius) in the northern Kalahari Basin, using several criteria based on VIS and IR remotely sensed data and SRTM-based surface morphology reconstructions. Two other features meet fewer criteria of the form which we class as possible megafans. The northern Kalahari megafans are located in a 1700 km arc around the southern and eastern flanks of the Angola's Bié Plateau, from northern Namibia through northwest Botswana to western Zambia. Three lie in the Owambo subbasin centered on the Etosha Pan, three in the relatively small Okavango rift depression, and five in the Upper Zambezi basin. The population includes the well-known Okavango megafan (150 km), Namibia's Cubango megafan, the largest megafan in the region (350 km long), and the largest nested group (the five major contiguous megafans on the west slopes of the upper Zambezi Valley). We use new, SRTM-based topographic roughness data to discriminate various depositional surfaces within the flat N. Kalahari landscapes. We introduce the concepts of divide megafans, derived megafans, and fan-margin rivers. Conclusions. (i) Eleven megafan cones total an area of 190,000 sq km. (ii) Different controls on megafan size operate in the three component basins: in the Okavango rift structural controls become the prime constraint on megafan length by controlling basin dimensions. Megafans in the other les constricted basins appear to conform to classic relationships fan area, slope, and feeder-basin area. (iii) Active fans occupy the Okavango rift depression with one in the Owambo basin. The rest of the population are relict but recently active fans (surfaces are relict with respect to activity by the feeder river). (iv) Avulsive behavior of the formative river-axiomatic for the evolution of megafans-has resulted in repeated rearrangements of regional drainage, with likely effects in the study area well back into the Neogene. Divide megafans comprise the

  16. 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.

  17. 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

  18. 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 130 wells are illuminating the Holocene shifts of the Brahmaputra River and subsidence patterns. Very high resolution MCS seismics on the rivers shows deformation by subsidence and compaction. Resistivity is further mapping surfaces warped by the anticlinal folds. GPS geodesy is quantifying the rates of overthrusting and differential subsidence across the delta. Optical fiber strain meters

  19. 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.

  20. Approach to Management of Eyes with no Light Perception after Open Globe Injury.

    Science.gov (United States)

    Bhagat, Neelakshi; Turbin, Roger; Langer, Paul; Soni, N G; Bauza, A M; Son, J H; Chu, David; Dastjerdi, Mohammad; Zarbin, Marco

    2016-01-01

    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%). PMID:27621791

  1. 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.

  2. Flow dynamics in lowland rivers and influence on fluvial-deltaic stratigraphy: Comparing the modern Mississippi River system to the Campanian Castlegate Sandstone

    Science.gov (United States)

    Nittrouer, J. A.; Petter, A. L.

    2012-12-01

    Where rivers enter the coastal zone, gradually varied non-uniform flow conditions develop in the river channel. The section of the river affected by non-uniform flow is commonly referred to as the backwater segment, and for large lowland rivers, backwater flow can extend many tens to hundreds of kilometers upstream of the river outlet. Here we show the results of field-observation and modeling studies from the modern Mississippi River that document the persistence of backwater hydrodynamics, which influence sediment mobility through the lower five-hundred kilometers of the river. Reach-average shear stress varies temporally in the backwater segment, in accordance with the annual hydrograph, thereby affecting the timing, magnitude, and grain size of sediment in transport. Importantly, a net reduction in shear stress restricts the movement of the coarse-grain sediment in the Mississippi River, to the extent that this portion of the river's sediment load does not reach the ocean receiving basin. Instead, coarse sediment is caught at the backwater hydrodynamic transition and is sequestered in the river channel, thereby producing channel bed aggradation. We use this information in conjunction with stratigraphic data collected from the Campanian Castlegate Sandstone (Utah) to present a theoretical framework for the movement of coarse sediment from a river to the receiving basin: over time, channel bed aggradation will push the backwater transition toward the ocean outlet, thereby facilitating the downstream movement of coarse sediment into the receiving basin. However, an aggrading channel bed will also promote super elevation of the channel bed and therefore facilitate avulsions, whereby the active channel is abandoned in favor of an alternative path to the ocean basin. Given an avulsion event, the abandoned, inactive channel and its coarse-grain sediment fill are incorporated into the long-term stratigraphy of the river's distributary system. Therefore, the tendency

  3. 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.

  4. 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.)

  5. Rehabilitation of Patient of Glass Cut Injury With Forehead Flap Repositioning and Implant-Retained Nasal Prosthesis.

    Science.gov (United States)

    Pruthi, Gunjan; Bansal, Kirti; Sharma, Rakesh; Goel, Ruchi; Mangtani, Nidhi; Jain, Veena

    2016-07-01

    Traumatic injuries, especially in maxillofacial region, not only lead to physical debilitation but also cause severe psychological distress in the affected individuals. Complete cosmetic and functional rehabilitation of such patients is a challenging task and thus requires a strategic treatment planning and a multidisciplinary team to execute the treatment. This patient report presents a patient who suffered with a severe glass cut injury leading to massive avulsion of face involving forehead, nose, upper lip, and anterior teeth. Patient was rehabilitated with a combined surgical and prosthetic approach, which involved flap repositioning in forehead, nasal and lip regions and an implant-supported nasal prosthesis to replace missing nose. Missing anterior teeth were replaced with fixed dental prostheses. PMID:27391509

  6. 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.

  7. Sonography and MRI of latissimus dorsi strain injury in four elite athletes

    International Nuclear Information System (INIS)

    The objective of this study was to describe the MR and sonographic findings in latissimus dorsi (LD) muscle strain in athletes, and to review the most common injuries described in the literature, most of which are humeral avulsions. Four injuries and two reinjuries of the myotendinous junction of the LD were followed from the day of injury until the return to play. Sonography (US) and MR imaging were performed in each case to confirm the diagnosis and to monitor the healing process. All cases had acute and isolated pain in the back of the shoulder while performing an eccentric maneuver of the arm and the shoulder. US and MR images demonstrated that injuries were located in the middle and cranial portion of the latissimus dorsi surrounding the myotendinous junction. After rehabilitation, all players played at high level again. Isolated lesions of LD are very rare. They can be demonstrated by US and MR images. (orig.)

  8. 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.)

  9. An Everting Ureteral Access Sheath: Concepts and In Vitro Testing

    Science.gov (United States)

    Lee, Keith L.; Stoller, Marshall L.

    2007-04-01

    Ureteral access sheaths have been a recent innovation in facilitating ureteral stone surgery. Once properly placed, access sheaths allow the movement of ureteroscopes and other instruments through the ureter with minimal injury to the urothelium. However, there are shortcomings of the current device designs. Initial sheath placement requires significant force, and shear stress can injure the ureter. In addition, inadvertent advancement of the outer sheath without the inner introducer stylet can tear and avulse the ureter. A novel eversion design incorporating a lubricous film provides marked improvement over current access sheaths. In bench top and animal models, the eversion shealths require less force during advancement, cause less injury to the urothelial tissue, and have a lower potential of introducing extraneous materials (e.g., microbes) into a simulated urinary tract. While, the everting design provides important advantages over traditional non-everting designs, further preclinical and clinical trials are required.

  10. 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.

  11. Traumatic and compressive pathology of the peripheral nerves: value of the MRI; Patologia traumatica y compresiva de los nervios perifericos: valor de la RM

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, M. L.; Romero, J.; Hernandez, L.; Miguel, E. de [Hospital General Universitario Gregorio Maranon. Madrid (Spain)

    2000-07-01

    Evaluate the usefulness of the magnetic resonance (MRI) in the diagnosis of traumatic and compressive pathology of the peripheral nerves and analyze the etiology of the lesions and their severity. 25 MRI in patients with compressive and traumatic lesions of the peripheral nerves are analyzed. They were studied with MRI (1,5T) using T1 weighted spin-echo (SE), T2 gradient echo (GE) and STIR sequences. The morphological and nerve signal alterations make it possible to locate the lesion site and to assess the course of the lesion with successive studies. In our series, the most frequent cause of compressive pathology is fibrosis. Brachial plexus root avulsion is the most frequent finding in traumatic lesions. The MTI capacity for multiplanar study and its high resolution make it possible for us to detect small lesions in the peripheral nerves and to plan the best treatment. (Author) 17 refs.

  12. 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.

  13. 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.

  14. 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.

  15. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  16. 'Hip' pain.

    Science.gov (United States)

    Zacher, Josef; Gursche, Angelika

    2003-02-01

    'Hip' pain is usually located in the groin, upper thigh or buttock and is a common complaint. Slipped capital femoral epiphysis, avascular femoral head necrosis and apophyseal avulsion are the most common diagnoses in childhood and adolescents. Strains and fractures are common in sport-active adults. Osteoarthritis occurs in middle-aged and older adults. Trauma may result in femoral head fracture or typical muscle and tendon sprains and bursitis. Septic or inflammatory arthritis can occur at every age. Septic arthritis, fractures and acute epiphyseal slipping are real emergency cases. Congenital dysplasia of the hip joint may lead to labral tears and early osteoarthritis. The most important hip problems in children, adolescents, adult and older people are discussed; these problems originate from intra-articular disorders and the surrounding extra-articular soft tissues. Medical history, clinical examination and additional tests, including imaging, will be demonstrated. Principles of treatment are given for specific disorders. PMID:12659822

  17. Hip ultrasound.

    Science.gov (United States)

    Martinoli, Carlo; Garello, Isabella; Marchetti, Alessandra; Palmieri, Federigo; Altafini, Luisa; Valle, Maura; Tagliafico, Alberto

    2012-12-01

    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. PMID:21571471

  18. 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.

  19. Difficulty in Clinical Evaluation of Radial Nerve Injury due to Multiple Trauma to the Humerus, Wrist, and Hand

    Directory of Open Access Journals (Sweden)

    Balik Mehmet Sabri

    2014-01-01

    Full Text Available Radial nerve damage is frequently encountered in humeral fractures. The radial nerve is primarily damaged when the humerus gets fractured, while secondary damage maybe due to post-traumatic manipulations and surgical exploration. High impact traumatic nerve injury, serious neuropathic pain, lack of response to therapeutic interventions, and indifference to the Tinel test are indications for surgical intervention. Since most humeral fracture-induced low impact radial nerve injuries resolve spontaneously, conservative therapy is preferred. We present a patient with humeral fracture-associated radial nerve injury, accompanied with digital amputation and flexor tendon avulsion on the same arm. These injuries required immediate surgery, thus rendering the clinical evaluation of the radial nerve impossible. We would like to highlight and discuss the inherent difficulties associated with multiple trauma of the upper arm.

  20. [Onychomatricoma, a rare lesion of the nail].

    Science.gov (United States)

    Pommepuy, Isabelle; Roblet, Denis; Blaise, Sophie; Delage-Corre, Manuela; Bonnetblanc, Jean-Marie; Fayol, Jacqueline; Labrousse, François

    2004-09-01

    Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment. PMID:15567955

  1. 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.)

  2. 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.

  3. 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%.

  4. 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.

  5. 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.

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

    International Nuclear Information System (INIS)

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

  7. 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.

  8. 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.

  9. Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

    Science.gov (United States)

    Farret, Marcel M; Farret, Milton M B; da Luz Vieira, Gustavo; Assaf, Jamal Hassan; de Lima, Eduardo Martinelli S

    2015-08-01

    This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results. PMID:26232842

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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.

  15. Apophyseal damage in adolescent athlete

    International Nuclear Information System (INIS)

    The increasing demands on the adolescent athlete in high perfomance sports puts high biomechanical stress on the growing structures of the active and passive locomotor system. The ''growing factor'' itself increases stretching forces on tendon insertions, which are often overloaded when a physical demanding sport is performed additionally. The apophysis is an ossification nucleus near the tendon insertion, which appears before the growing age resumes and these apophysis finally fuses with the adjacent bone. The tensile forces from vigorous sports activity leads to a chronic or acute avulsion of the ossifying tendon insertion. The radiological appearance of this apophyseal damage with ossification and osteolytic processes is sometimes difficult with respect to differential diagnoses. Apophyseal impairment is associated with pain, tenderness to palpation and decreased muscle function. If it is not diagnosed and treated properly it can lead to end of career in many adolescent athletes. (orig.)

  16. 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. PMID:7953338

  17. 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.

  18. 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.)

  19. 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.

  20. Validation of a Parcel-Based Reduced-Complexity Model for River Delta Formation (Invited)

    Science.gov (United States)

    Liang, M.; Geleynse, N.; Passalacqua, P.; Edmonds, D. A.; Kim, W.; Voller, V. R.; Paola, C.

    2013-12-01

    Reduced-Complexity Models (RCMs) take an intuitive yet quantitative approach to represent processes with the goal of getting maximum return in emergent system-scale behavior with minimum investment in computational complexity. This approach is in contrast to reductionist models that aim at rigorously solving the governing equations of fluid flow and sediment transport. RCMs have had encouraging successes in modeling a variety of geomorphic systems, such as braided rivers, alluvial fans, and river deltas. Despite the fact that these models are not intended to resolve detailed flow structures, questions remain on how to interpret and validate the output of RCMs beyond qualitative behavior-based descriptions. Here we present a validation of the newly developed RCM for river delta formation with channel dynamics (Liang, 2013). The model uses a parcel-based 'weighted-random-walk' method that resolves the formation of river deltas at the scale of channel dynamics (e.g., avulsions and bifurcations). The main focus of this validation work is the flow routing model component. A set of synthetic test cases were designed to compare hydrodynamic results from the RCM and Delft3D, including flow in a straight channel, around a bump, and flow partitioning at a single bifurcation. Output results, such as water surface slope and flow field, are also compared to field observations collected at Wax Lake Delta. Additionally, we investigate channel avulsion cycles and flow path selection in an alluvial fan with differential styles of subsidence and compare model results to laboratory experiments, as a preliminary effort in pairing up numerical and experimental models to understand channel organization at process scale. Strengths and weaknesses of the RCM are discussed and potential candidates for model application identified.

  1. 'Hard discs' associated with lumbar disc herniation: CT analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Il Kwon; Bang, Dae Hong; Yim, Jung Ik; Lee, Jae Mun; Bahk, Yong Whee [Catholic University Medical College, Seoul (Korea, Republic of)

    1989-02-15

    Thirty cases showing hard discs were collected from 206 consecutive cases of posterior disk herniation during the past one and a half years period. According to the shape of hard disk and the presence of marginal bone defect (MBD) of vertebral end plate, 30 cases could be categorized into 4 distinct groups. They were small hard disc with focal MBD (group 1), large hard disc with broad based MBD (group 2), hard disc separated from vertebral body without MBD (group 3) and hard disc fused with vertebral body without MBD (group 4). There were 14 patients in group 1. In all but one case, the hard disc and MBDs were located at the paramedial aspect of the posterior margin of the end plate. Ten (76.9%) of these had Schmorl's nodes and these were considered to represented an avulsion from the weakened bone margin as the disk herniated acutely. The posterior longitudinal ligament seemed to have prevented detachment of the bony fragment. Group 2 included 2 patients and CT findings as well as plain X-ray features were identical to a limbus vertebra. This was considered to represent passive displacement of bony fragment by the intravertebral herniation of the disk. Nine patients belonged to group 3 and represent dystrophic calcifications of herniated disk. Group 4 included 5 patients and was disclosed as a simple osteophyte. From our study, it was concluded; (1) that the hard disc seen in lumbar CT scan was probably the results of the detachment of a bone fragment from the vertebral end plate which has an underlying weak area due to the herniated disc as well as a calcification or osteophyte formation and (2) specific terms (avulsed fragment, limbus vertebra, calcification or spur formation) is more preferable to use than hard disc which is inaccurate.

  2. Fractal Analysis of KOSI, Gandak and Baghmati River

    Science.gov (United States)

    Maheswaran, R.; Parmar, V.; Khosa, R.

    2015-12-01

    Scale issues are present in all the geophysical processes. In understanding the river morphology too there is wide scale gap from coarse topography scale to fine micro scale. In the study presented here the fractal dimension of the rivers Kosi, Gandak and Baghmati are analyzed to understand the scaling attributes of their respective morphometric features. Kosi is a major tributary of the Ganga system and is notorious for its vulnerability to frequent avulsions that inevitably lead to its shifting course. These destructive episodes have also earned the river its sobriquet of 'Sorrow of Bihar'. Gandak and Baghmati are two sister river systems that, like Kosi, also rise in Nepal Himalayas and flow into the North Bihar Plains of India. While Gandak outfalls directly into river Ganga near Hajipur, Baghmati is a tributary river of Kosi and joins the latter near Khormaghat. It is indeed noteworthy that heavy silt laden discharges are a distinctive feature of all these rivers but the latter two (i.e. Baghmati and Gandak) do not show any definite proclivity to morphological avulsion and accompanying course instability. The seemingly distinctive morphological dynamics of Kosi is clearly seen to be at odds with the morphological regime of Baghmati and Gandak. LANDSAT 8 imageries (USGS) are used to estimate the fractal dimensions of the three rivers using the box counting technique. The analysis of the fractal study done here shows multifractal behavior in all the three rivers. However, the fractal dimensions of Kosi River are found to be in contrast with its sister rivers which elucidate the curious behavior of the River.

  3. TreatmentandEvaluationofSneakPeelInjuryoftheAdvancedtheLegSkin%晚期小腿大面积皮肤潜行剥脱伤的治疗及评价

    Institute of Scientific and Technical Information of China (English)

    杨广令; 朱鑫; 周晓敏; 赵志坚; 陈坤峰

    2013-01-01

    Objective To explore the negative pressure drainage technology (vacuum sealing drajnage,VSD) in treatment of advanced leg skin creeping stripping operation methods and the clinical results of injury. Methods Application of negative pressure suction with a plant area of thin thickness skin therapeutic method for advanced leg skin subcutaneous avulsion injury in 14 cases. Results Postoperative skin survival rate is high,the appearance, feel with satisfactory restoration. Conclusion Method of suction with a plant area of thin thickness skin, for the treatment of advanced leg skin sneak peel treatment avulsion injury provides a good operation mode. It is worthy of clinical promotion.%  目的探讨负压引流技术(VSD)治疗晚期小腿大面积皮肤潜行剥脱伤的手术方法及临床效果。方法应用负压吸引配合创区植薄型全厚皮方法治疗晚期小腿大面积皮肤潜行剥脱伤14例。结果术后皮肤成活率高,外形、感觉恢复均满意。结论负压吸引配合创区植薄型全厚皮的方法,为治疗晚期小腿大面积皮肤潜行剥脱伤的治疗提供一个良好手术方式。值得临床推广。

  4. 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.

  5. Geomorphological and sedimentary evidence for late Pleistocene to Holocene hydrological change along the Río Mamoré, Bolivian Amazon

    Science.gov (United States)

    Plotzki, A.; May, J.-H.; Preusser, F.; Veit, H.

    2013-11-01

    Aerial photography and satellite imagery reveal manifold geomorphological evidence of a dynamic evolution of past and present rivers in the Bolivian Amazon. Comparison of oxbow lake and meander scar dimensions along an inactive meander belt of the Río Mamoré (Llanos de Moxos, north-eastern Bolivia) and its modern counterpart suggests significant regional paleohydrological variability. We used these features as geomorphological and sedimentary archives to enhance our understanding of longer-term variations of the fluvial system. Late Pleistocene to Holocene hydrological changes of the Río Mamoré are inferred from: (i) the analysis of satellite imagery, (ii) discharge estimates from meander morphology, (iii) stratigraphic, and (iv) chronological information based on luminescence and radiocarbon dating. The combined data from three oxbows indicate that the now abandoned meander belt - the paleo-Mamoré - continued to be active at least until ∼5 ka, and likely even postdating 3 ka. An up to threefold increase in discharge is estimated for the modern Río Mamoré versus the paleo-Mamoré. The altered runoff regime may have triggered an avulsive shift towards the currently active Río Mamoré. The preceding increase in discharge in turn, was possibly related to a shift in climatic conditions, which changed markedly between the mid- and late Holocene in tropical South America. In addition, it may have been the indirect result of capturing the avulsive Río Grande system to the east of the Río Mamoré. Alternative explanations for the differences in dimensions of the paleo versus the modern Río Mamoré, i.e. contemporaneous activity of both rivers or alteration of site factors such as the channel/floodplain relationship, are considered to be unlikely.

  6. 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.

  7. 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.)

  8. Sonography of injury of the ulnar collateral ligament of the elbow - initial experience

    International Nuclear Information System (INIS)

    The purpose of this study is to describe the sonographic appearance of injuries of the ulnar collateral ligament (UCL) of the elbow. Eight non-professional male baseball pitchers, ages 13-35 years, with medial elbow pain and clinical suspicion of ulnar collateral ligament injury, were referred for imaging. All eight underwent sonography of the affected and contralateral asymptomatic elbow, and six also underwent MR imaging. Neither valgus stress nor power Doppler was used during the sonographic examinations. Time from onset of symptoms to imaging was 1.5 weeks to 6 months. Three patients had surgical confirmation of their injuries, with time from imaging to surgery of 2 days to 9 months. In four patients, the UCL was ruptured, manifest sonographically in three cases as discontinuity of the normally hyperechoic ligament with anechoic fluid in the gap and in one case as non-visualization of the ligament with heterogeneous echogenicity in the expected location of the ligament. Two adolescent patients had avulsions of the UCL from the medial epicondyle, with sonographic demonstration of the avulsed echogenic bony fragment in both cases. One patient had a mild sprain, manifest as mild thickening and decreased echogenicity of the ligament sonographically compared with the contralateral normal elbow, with mild surrounding hypoechoic edema. The eighth patient had a small partial tear of the deep surface of the distal aspect of the ligament, visualized as a hypoechoic focus between the deep surface of the ligament and its ulnar attachment. Tears of the ulnar collateral ligament are manifested sonographically as non-visualization of the ligament or alteration of the normal morphology. (orig.)

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. The Late Miocene paleogeography of the Amazon Basin and the evolution of the Amazon River system

    Science.gov (United States)

    Latrubesse, Edgardo M.; Cozzuol, Mario; da Silva-Caminha, Silane A. F.; Rigsby, Catherine A.; Absy, Maria Lucia; Jaramillo, Carlos

    2010-05-01

    On the basis of paleontological content (vertebrates and palynology) and facies analysis from river banks, road cuts, and three wells, we have assigned the uppermost levels of the Solimões Formation in western Amazonia, Brazil, to the Late Miocene. The vertebrate fossil record from outcropping sediments is assigned to the Huayquerian-Mesopotamian mammalian biozones, spanning 9-6.5 Ma. Additionally, we present results that demonstrate that deposits in Peruvian Amazonia attributed to Miocene tidal environments are actually fluvial sediments that have been misinterpreted (both environmentally and chronologically) by several authors. The entire Late Miocene sequence was deposited in a continental environment within a subsiding basin. The facies analysis, fossil fauna content, and palynological record indicate that the environment of deposition was dominated by avulsive rivers associated with megafan systems, and avulsive rivers in flood basins (swamps, lakes, internal deltas, and splays). Soils developed on the flatter, drier areas, which were dominated by grasslands and gallery forest in a tropical to subtropical climate. These Late Miocene sediments were deposited from westward of the Purus arch up to the border of Brazil with Peru (Divisor Ranges) and Bolivia (Pando block). Eastward of the Iquitos structural high, however, more detailed studies, including vertebrate paleontology, need to be performed to calibrate with more precision the ages of the uppermost levels of the Solimões Formation. The evolution of the basin during the late Miocene is mainly related to the tectonic behavior of the Central Andes (˜ 3°-15°S). At approximately 5 Ma, a segment of low angle of subduction was well developed in the Nazca Plate, and the deformation in the Subandean foreland produced the inland reactivation of the Divisor/Contamana Ranges and tectonic arrangements in the Eastern Andes. During the Pliocene southwestern Brazilian Amazonia ceased to be an effective sedimentary

  15. 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

  16. Management of toenail onychomycosis with 2% butenafine and 20% urea cream: a placebo-controlled, double-blind study.

    Science.gov (United States)

    Syed, T A; Ahmadpour, O A; Ahmad, S A; Shamsi, S

    1998-10-01

    Onychomycosis is an increasingly common and recalcitrant fungal nail infection world-wide. The purpose of this placebo-controlled, double-blind study was to determine the clinical efficacy, chemical avulsion, and tolerability of 2% butenafine hydrochloride and 20% urea incorporated in a cream to cure toenail onychomycosis in a preselected population. Sixty patients (38M, 22F), ranging between 18 and 60 years (mean 27.4), with more than 25% involvement of the big toenail were enrolled in the study. The diagnosis of onychomycosis was established by mycologic identification and reconfirmed by positive fungal culture. A precoded 25-g tube was randomly assigned to each patient (50 active and 10 placebo) with instructions to apply the trial medication to their infected toenail twice daily with an occlusive dressing for one week. The affected nail was removed with a nail clipper. No occlusive dressing was maintained after the initial one week regimen. To assess the chemical avulsion of the infected toenail, mycologic cure, clinical effectiveness of the treatment, and overall success, patients were examined twice a week for 16 weeks and thereafter on a weekly basis for a further 36 weeks. The treatment was well tolerated by all the patients throughout the study, with no dropouts. Marked improvement was seen in 73.3% patients after weeks 8, 16 and 24 with clinically and mycologically confirmed negative fungal culture. Code disclosure revealed that active butenafine and urea cream cured significantly more patients than placebo (88% versus 0%; p < 0.0001). Of the 60 patients 91.6% reported no drug-related adverse symptoms. Five patients reported non-objective mild inflammation without discontinuation of the treatment. During one year follow-up of the study phase, none of the cured patients had a relapse. In conclusion, the mycologic and overall assessment of this study demonstrate that 2% butenafine HCl and 20% urea incorporated in a cream for keratinolysis is safe to use and

  17. Evolution and stability of tidal river bifurcations

    Science.gov (United States)

    Kleinhans, M. G.

    2011-12-01

    At bifurcations, water and sediment are partitioned, so that long-term evolution of fluvial and deltaic channels is determined by the bifurcation stability. Recent work in fluvial environments showed that bifurcations are commonly unstable so that avulsion results. For tidal rivers it could be argued that the discharge fluctuation enhances transport so that it simply closes of faster than in steady flow, but it could also be argued that tidal phase differences between the bifurcates cause a residual flow that counteracts the closing trend and keeps both bifurcates open. A physics-based numerical model (Delft3D) was used to model fixed-bank fork-shaped bifurcations with and without tides, and with short and long length relative to tidal wavelength. In all cases the bifurcations remained as unstable as without tides and ended invariably in avulsion. Tidal bifurcations unbalanced more rapidly than fluvial bifurcations, because of the increased ebb current and nonlinearity of sediment transport. On the other hand, discharge partitioning at the final bifurcation was much less asymmetrical with tides than without. Tidal wave deformation and production of higher harmonics in the longer channels affected sediment partitioning in the unstable phase but seems to have no effect on equilibrium morphology. Significant phase differences between the bifurcates caused a tidal floss effect, which scoured the bifurcation. In conclusion, symmetrical bifurcations affected by tides are unstable, but their final equilibrium is more symmetrical than without tides unless bifurcates have significant tidal phase differences. Furthermore I modelled growing deltas with self-formed distributary channels with and without cohesive sediment and with and without tides. Here, tides cause the flow to be more focussed in fewer and larger channels, whilst the few bifurcations are relatively stable. Combined fluvial discharge and tidal ebb flow in the channels transports more sediment than in fluvial

  18. The raft of the Saint-Jean River, Gaspé (Québec, Canada): A dynamic feature trapping most of the wood transported from the catchment

    Science.gov (United States)

    Boivin, Maxime; Buffin-Bélanger, Thomas; Piégay, Hervé

    2015-02-01

    The rivers of the Gaspé Peninsula, Québec (Canada), a coastal drainage system of the St. Lawrence River, receive and transport vast quantities of large wood. The rapid rate of channel shifting caused by high-energy flows and noncohesive banks allows wood recruitment that in turn greatly influences river dynamics. The delta of the Saint-Jean River has accumulated wood since 1960, leading to frequent avulsions over that time period. The wood raft there is now more than 3-km in length, which is unusual but natural. This jam configuration allows a unique opportunity to estimate a wood budget at the scale of a long river corridor and to better understand the dynamics of large wood (LW) in rivers. A wood budget includes the evaluation of wood volumes (i) produced by bank erosion (input), (ii) still in transit in the river corridor (deposited on sand bars or channel edges), and (iii) accumulated in the delta (output). The budget is based on an analysis of aerial photos dating back to 1963 as well as surveys carried out in 2010, all of which were used to locate and describe large wood accumulations along a 60-km river section. The main results of this paper show that the raft formation in the delta is dynamic and can be massive, but it is a natural process. Considering the estimated wood volume trapped in the delta from 1963 to 2013 (≈ 25,000 m3), two important points are revealed by the quantification of the wood recruitment volume from 1963 to 2004 (≈ 27,000 m3 ± 400 m3) and of the wood volume stored on the bars in 2010 (≈ 5950 m3). First, the recruitment of large wood from lateral migration for the 40-year period can account for the volume of large wood in the delta and in transit. Second, the excess wood volume produced by lateral migration and avulsion represents a minimum estimation of the large wood trapped on the floodplain owing to wood volume that has decomposed and large wood that exited the river system. Rafts are major trapping structures that provide

  19. 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

  20. 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

  1. 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

  2. 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

  3. Fluvial geomorphological response along the upland sediment cascade during the record-breaking December 2015 floods, Cumbria, UK

    Science.gov (United States)

    Russell, Andrew; Perks, Matthew; Large, Andrew; Dunning, Stuart; Warburton, Jeff

    2016-04-01

    Between 0900 GMT on 4th December and 0900 GMT on 6th December 2015, Atlantic Storm Desmond produced over 260 mm of rainfall in Cumbria, northwest England, representing a new UK 48 hour rainfall maximum, and breaking previous records set in 2005 and 2009. The December 2015 event resulted in a number of rivers significantly exceeding their 2009 levels, over-topping recently-commissioned flood defences, destroying bridges and flooding thousands of homes. Our research aim is to identify factors controlling significant geomorphological and sedimentary response during Storm Desmond along the upland sediment cascade including: Rattling Beck (Glenridding), a high gradient upland stream draining the flanks of Helvellyn (950 m.a.o.d.), and a 25km extended reach of the lower gradient piedmont Derwent River corridor downstream of Bassenthwaite Lake. Rattling Beck descends steeply from the eastern slopes of the Helvellyn massif draining across an alluvial fan into Lake Ullswater. On 5th December 2015 the village of Glenridding was severely impacted by flooding which deposited boulder-sized sediment within the centre of the village, completely blocking the pre-existing stream course and causing avulsion of waning stage flows through riverside properties. A major new sediment lobe was deposited on the existing alluvial fan downstream of the village, grading to the temporarily raised lake water level. Although a number of hillslope failures occurred in the higher catchment, the majority of the sediment transported by Rattling Beck and impacting the village was acquired within a 2km reach upstream of Glenridding through erosion of older glacial and alluvial sediments. Lateral channel erosion was enhanced by inability of flood flows to rework highly resistant boulder bar lag deposits related to a previous mine tailings dam failure in 1927. The River Derwent corridor extends for 30km downstream of Bassenthwaite Lake to the Irish Sea at Workington and has a sinuous course ranging in

  4. 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

  5. Terrestrial astronomical age model for Eocene Thermal Maximum 2 and H2 hyperthermal events

    Science.gov (United States)

    Abels, Hemmo; Lourens, Lucas; Gingerich, Philip

    2013-04-01

    Knowledge of the duration and the rates of onset and recovery of early Paleogene hyperthermal events is crucial for understanding Earth's system response to massive input of greenhouse gases into the exogenic carbon pool. The second largest hyperthermal, Eocene Thermal Maximum 2 (ETM2), and its immediate successor H2 occur around 54 million years ago. Relative chronologies have been constructed for ETM2 and H2 in deep-sea records at Walvis Ridge in the southern Atlantic Ocean (Stap et al. 2009). Here, we construct an independent astronomical age model for these hyperthermals in terrestrial successions in the Bighorn Basin, Wyoming (Abels et al. 2012). We first generated parallel carbon isotope records of the ETM2-H2 interval in the Creek Star Hill, West Branch, and Purple Butte sections located between 1 and 3 km of the previously analyzed Upper Deer Creek (UDC) section. The carbon isotope patterns in the three new sections mimic both in time and magnitude the ETM2-H2 carbon isotope patterns from the UDC section. This confirms the reproducibility of the carbon isotope time series in these floodplain successions. The four sections were subsequently correlated by lateral tracing of distinctive paleosol horizons representing time lines at the sub-precession time scale. The correlation was confirmed by overbank-avulsion sedimentation cycles coevally occurring in the four sections. The constructed stratigraphic fence panel allows disentangling local fluvial variability in sedimentation from the regional signal. Coeval overbank-avulsion cyclicity at the precession time scale (Abels et al. 2013) are then used to construct an astronomical age model for the ETM2-H2 hyperthermal events. References Abels, H.A., W.C. Clyde, P.D. Gingerich, F.J. Hilgen, H.C. Fricke, G.J. Bowen, L.J. Lourens, 2012. Terrestrial carbon isotope excursions and biotic change during Palaeogene hyperthermals. Nature Geoscience 5, 326-329. Abels, H.A., M.J. Kraus, P.D. Gingerich, 2013. Precession

  6. 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

  7. 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

  8. Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study

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    Sônia Regina Panzarini

    2008-09-01

    Full Text Available The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP, Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09% was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%. There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.

  9. Treatment of root surface in delayed tooth replantation: a review of literature.

    Science.gov (United States)

    Panzarini, Sônia Regina; Gulinelli, Jéssica Lemos; Poi, Wilson Roberto; Sonoda, Celso Koogi; Pedrini, Denise; Brandini, Daniela Atili

    2008-06-01

    The time elapsed between a trauma and tooth replantation usually ranges from 1 to 4 h. The chances of root surface damage are higher when tooth replantation is not performed immediately or if the avulsed tooth is not stored in an adequate medium. This invariably leads to necrosis of pulp tissue, periodontal ligament cells and cementum, thus increasing the possibility of root resorption, which is the main cause of loss of replanted teeth. This paper presents a comprehensive review of literature on root surface treatments performed in cases of delayed tooth replantation with necrotic cemental periodontal ligament. Journal articles retrieved from PubMed/MedLine, Bireme and Scielo databases were reviewed. It was observed that, when there are no periodontal ligament remnants and contamination is under control, replacement resorption and ankylosis are the best results and that, although these events will end up leading to tooth loss, this will happen slowly with no loss of the alveolar ridge height, which is important for future prosthesis planning. PMID:18410388

  10. Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study.

    Science.gov (United States)

    Panzarini, Sônia Regina; Pedrini, Denise; Poi, Wilson Roberto; Sonoda, Celso Koogi; Brandini, Daniela Atili; Monteiro de Castro, José Carlos

    2008-01-01

    The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed. PMID:18949308

  11. Intracanal dressing and root canal filling materials in tooth replantation: a literature review.

    Science.gov (United States)

    Panzarini, Sônia Regina; Trevisan, Carolina Lunardelli; Brandini, Daniela Atili; Poi, Wilson Roberto; Sonoda, Celso Koogi; Luvizuto, Eloá Rodrigues; Dos Santos, Cláudia Letícia Vendrame

    2012-02-01

    The prognosis of tooth replantation is usually related to the need of endodontic treatment, which has a direct relationship with the occurrence of root resorptions. Several studies have been undertaken in an attempt to prevent, delay, or treat these complications, which are the main causes of loss of replanted teeth. This literature review examines research evidence on intracanal dressings and root canal filling materials used in cases of tooth replantation. A comprehensive search was performed in the Medline/Pubmed, Bireme and Scielo full-text electronic journal databases to retrieve English-language articles referring to these topics that had been published between 1964 and 2010. Calcium hydroxide (CH) remains the usually recommended choice as an intracanal medicament in replanted teeth; however, there is evidence to support the initial use of a corticosteroid-antibiotic combination such as Ledermix paste to control potential early resorption, prior to the introduction of CH where the beneficial effect in the treatment of progressive root resorption has been well proven. Regarding root filling materials, CH-containing sealers are a good option because of their biological properties. Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth. PMID:22230725

  12. Influences of Relative Sea-Level Rise and Mississippi River Delta Plain Evolution on the Holocene Middle Amite River, Southeastern Louisiana

    Science.gov (United States)

    Autin, Whitney J.

    1993-01-01

    The Holocene geomorphic history of southeastern Louisiana's middle Amite River is recorded in the stratigraphy of three alloformations, identified in decreasing age as the Watson (WAT), Denham Springs (DS), and Magnolia Bridge (MAG). The WAT meander belt formed by at least 9000 yr B.P., when sea level was lower and the Amite River was tributary to a larger ancestral drainage basin. The DS became an active meander belt by at least 3000 yr B.P., in response to relative sea-level rise and eastward progradation of the Mississippi River delta plain. The MAG developed its meander belt, in part, during the European settlement of the drainage basin, and is now attempting to adjust to modern anthropogenic influences. Geomorphic influences on the middle Amite River floodplain have temporal and spatial components that induce regional- and local-scale effects. Regional extrinsic influences caused meander belt avulsion that produced alloformations. However, local influences produced intrinsic geomorphic thresholds that modified channel morphology within a meander belt but did not induce alloformation development. Base-level influences of the relative sea-level rise and the Mississippi River delta plain were so dominant that the effects of possible climate change were not recognized in the Holocene Amite River system.

  13. Interactions of Growth-faulting with Incised Valleys and Channels on the Late Miocene to Recent Mississippi River Delta, LA

    Science.gov (United States)

    Armstrong, C. P.; Mohrig, D.; Steel, R. J.

    2011-12-01

    The interaction between incised valleys and growth-fault related subsidence is poorly understood in the Late Miocene to Recent Mississippi River Delta. Previous work has found little evidence that growth-faults are able to affect the course or geometry of small ( 1km in width and 25m in depth) has not been previously evaluated in this area. We use a 1400 km2 3D seismic volume located under Breton Sound, LA, integrated with a selection of well logs to document the effect of growth-faults on 12 valleys and 14 channels present within the upper 1.5 kilometers of the seismic volume. In contrast to the majority of smaller distributary channels found within the survey, valleys appear to be steered along or away from growth-faults. This observation suggests that faults are able to affect the course of valleys to a greater extent than small channels. We suggest that this is because valleys are long lived features which do not avulse before being influenced by shorter time scale faulting events. This study contributes to our understanding of the dynamics of growth-faults and valleys in the subsurface and has important long term societal implications for populations living near large rivers in areas with active growth-faulting.

  14. The Mississippi Delta Region: Past, Present, and Future

    Science.gov (United States)

    Blum, Michael D.; Roberts, Harry H.

    2012-05-01

    The Mississippi delta region of south Louisiana houses a wealth of resources within a dynamic, subsiding landscape. Foundations for the delta region reflect Neogene evolution of the depocenter, whereas details of the modern landscape reflect late Pleistocene to Holocene evolution of the alluvial-deltaic plain. The Holocene delta plain was constructed by cyclical growth of deltaic headlands, followed by avulsion and relocation of the fluvial sediment source. Abandoned headlands were then submerged and reworked while a new headland was created at the site of active fluvial sediment input. Historic-period levees have decoupled the delta plain from its fluvial sediment source at the same time global sea-level rise was accelerating, which has accelerated delta-plain submergence. Diversions of Mississippi River water and sediment are necessary to achieve delta plain sustainability, but upstream dams trap ˜50% of the total sediment load, and there is not enough supply to keep pace with subsidence and accelerated sea-level rise. The future delta region will not resemble the recent past, and significant drowning is inevitable.

  15. 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.

  16. Environmental changes in the western Amazônia: morphological framework, geochemistry, palynology and radiocarbon dating data.

    Science.gov (United States)

    Horbe, Adriana M C; Behling, Hermann; Nogueira, Afonso C R; Mapes, Russell

    2011-09-01

    The sediments from the Coari lake, a "terra firme" lake sculpted into Plio-Pleistocene deposits, and the Acará lake, a flooding-type lake developed on Quaternary sediments in the floodplain of the mid-Solimões river, in the western Amazônia, Brazil, were studied to investigate the environmental condition of their developing. This study includes mineral composition, geochemistry, Pb isotope, palinology, radiocarbon-age and morphological framework of the lakes obtained from SRTM satellite images. The geological and the environmental conditions in the two lakes are highly variable and suggest that their evolution reflect autogenic processes under humid rainforest condition. Although kaolinite, quartz, muscovite, illite, and smectite are the main minerals in both lakes, the geochemistry indicates distinct source, the Acará lake sediments have higher concentrations of Al(2)O(3), Fe(2)O(3), FeO, CaO, K(2)O, MgO, Na(2)O, P(2)O(5), Ba, V, Cu, Ni, Zn, Pb, Sr, Li, Y and La and have more radiogenic Pb than the Coari lake sediments. The radiocarbon ages suggest that at 10160 yr BP the Coari lake started to be developed due to avulsion of the Solimões river, and the Acará lake was formed by the meander abandonment of Solimões river retaining its grass dominated shore at ca. 3710 yr BP. PMID:21830005

  17. Co-infusion of autologous adipose tissue derived neuronal differentiated mesenchymal stem cells and bone marrow derived hematopoietic stem cells, a viable therapy for post-traumatic brachial plexus injury: A case report

    Directory of Open Access Journals (Sweden)

    Umang G Thakkar

    2014-08-01

    Full Text Available Stem cell therapy is emerging as a viable approach in regenerative medicine. A 31-year-old male with brachial plexus injury had complete sensory-motor loss since 16 years with right pseudo-meningocele at C5-D1 levels and extra-spinal extension up to C7-D1, with avulsion on magnetic resonance imaging and irreversible damage. We generated adipose tissue derived neuronal differentiated mesenchymal stem cells (N-AD-MSC and bone marrow derived hematopoietic stem cells (HSC-BM. Neuronal stem cells expressed β-3 tubulin and glial fibrillary acid protein which was confirmed on immunofluorescence. On day 14, 2.8 ml stem cell inoculum was infused under local anesthesia in right brachial plexus sheath by brachial block technique under ultrasonography guidance with a 1.5-inch-long 23 gauge needle. Nucleated cell count was 2 × 10 4 /μl, CD34+ was 0.06%, and CD45-/90+ and CD45-/73+ were 41.63% and 20.36%, respectively. No untoward effects were noted. He has sustained recovery with re-innervation over a follow-up of 4 years documented on electromyography-nerve conduction velocity study.

  18. 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. PMID:27547727

  19. The EpiNo® Device: Efficacy, Tolerability, and Impact on Pelvic Floor-Implications for Future Research.

    Science.gov (United States)

    Kavvadias, Tilemachos; Hoesli, Irene

    2016-01-01

    Aims. The aim of this review is to provide a comprehensive overview of the available literature on preventing perineal trauma with the EpiNo. Methods. We perfomed a literature research in the MedLine and EMBASE databases for studies referring to EpiNo published between 1990 and 2014, without restrictions for language and study type. Results. Five published studies were identified, regarding the effect of EpiNo on the rate of episiotomy and perineal tears, pelvic floor muscle function, and fetal outcome. The device seems to reduce episiotomy and perineal tears' rate, as well as the risk for levator ani microtrauma and avulsion, though not always statistically significant. It does not seem to have an effect on duration of second stage of labour and fetal outcome. The device is well tolerated and the adverse events are rare and mild. However, design and reporting bias in the reviewed articles do not allow evidence based conclusions. Conclusions. The EpiNo device seems to be promising, with potential positive effects on natural birth, while being uncomplicated to use and without major complications. Well designed, randomized trials are needed in order to understand the effects of EpiNo on pelvic floor and make evidence based recommendations on its use. PMID:26981126

  20. Role of Cone Beam Computed Tomography in Rehabilitation of a Traumatised Deficient Maxillary Alveolar Ridge Using Symphyseal Block Graft Placement

    Directory of Open Access Journals (Sweden)

    Shipra Arora

    2013-01-01

    Full Text Available Deficiencies in the alveolar ridges cause multiple problems in achieving aesthetic and functional outcome of implant therapy and are commonly restored by using onlay graft from intraoral source. Careful assessment of the recipient as well as the donor site using cone beam computed tomography (CBCT is a prerequisite to ideal treatment planning. This paper highlights the critical role of CBCT in planning a successful rehabilitation of traumatised deficient anterior maxillary alveolar ridge using autogenous block graft from mandibular symphysis, followed by implant placement. A 21-year-old male reported with missing right maxillary lateral incisor due to traumatic avulsion 6 months back. A concavity was found on the labial aspect of edentulous area. Serial transplanar images on CBCT revealed gross irregular radiolucency in place of labial cortical plate. Using CBCT, size of the required block was estimated, and mandibular symphyseal area was evaluated for the feasibility of harvesting a graft of suitable dimension. Onlay block graft was harvested from mandibular symphysis and placed at the edentulous site to augment the alveolar ridge. Implants were placed 5 months later and loaded successfully after osseointegration. After 1 year of followup, implant-based prosthesis is working well, without any complications.

  1. Specific industrial medicine in lignite mining

    Energy Technology Data Exchange (ETDEWEB)

    Zerlett, G.; Toussaint, R.; Hilfert, R.; Koehne, G.

    1986-11-01

    Lignite is almost exclusively mined open-cast in West Germany. Mining is carried out at present in deep open-cast mines (with depths up to 400 m) using modern mining conveyer techniques with large-scale equipment (rotary bucket excavators and thickeners) conveyer belt and railway links as well as earth-moving equipment (accessory equipment). Specific occupational diseases are not known in lignite mining. Occupational diseases in the sense of degenerative processes of the lumbar spine and avulsion fractures of spinous processes of the lower cervical spine in drivers of earth-moving equipment as a result of whole-body vibration stress have been observed. In the context of occupational disease and industrial accident prevention, close collaboration and a division of labor between industrial physicians and safety engineers of ergonomics specialists have proved to be very efficient. Industrial medical preventive examinations based on statutory regulations and the lignite mining ordinance have a long tradition and are given a great deal of space. First aid at work is organized in a largely decentralized manner owing to the extensiveness of the mining area. The industrial medical care of the employees takes place on site in the various sections (open-cast mining, workshops, brickett factories, processing units etc.). The entire medical technical diagnostics is carried out centrally in an industrial medical center.

  2. Supraspinatus and biceps brachii tendinopathy in dogs

    International Nuclear Information System (INIS)

    Calcifying tendinopathy was seen on radiographic views of the scapulohumeral joint in 12 of 183 (7 per cent) dogs reviewed retrospectively. Calcifying tendinopathy was identified only in large breed dogs, five being labradors. All the affected dogs, except one, were presented for unilateral thoracic limb lameness, which was typically of a chronic and intermittent pattern. Pain on manipulation of the scapulohumeral joint in the lame leg was present in eight of 12 dogs (67 per cent). Calcification of the supraspinatus tendon was seen in eight dogs and calcification of the biceps brachii tendon was seen in the other four dogs. Radiographic changes indicative of biceps brachii tendon avulsion were found in conjunction with calcification of the contralateral biceps brachii tendon in two dogs. Filling defects, indicative of bicipital tenosynovitis, were also seen in positive contrast arthrograms of two dogs with biceps brachii calcification. Of the eight dogs for which radiographic views of both scapulohumeral joints were available, six dogs had bilateral radiographic signs of calcifying tendinopathy. Overall, radiographic signs of calcifying tendinopathy were seen in 18 scapulohumeral joints, but lameness was apparent in only nine limbs, suggesting the lesion may at times be asymptomatic. Further prospective investigation of calcifying tendinopathy is needed to determine why lameness does not always appear to be associated with the presence of the lesion

  3. Orofacial injuries associated with prehospital management of febrile convulsion in Nigerian children.

    Science.gov (United States)

    Ndukwe, Kizito C; Folayan, Morenike O; Ugboko, Vincent I; Elusiyan, Jerome B E; Laja, Olajumoke O

    2007-04-01

    The aim of this prospective study was to determine in a population of pediatric patients with febrile convulsions the prevalence and pattern of orofacial and dental injuries caused by traditional remedies used in a suburban Nigerian community. Over the study period of 28 months, 75 cases of febrile convulsion presented to the Children's Emergency unit of our hospital. Of these, 27 children (36%) sustained orofacial injuries caused by forceful insertion of a spoon into the mouth (96.3%) or a bite (3.7%) during convulsive episodes. The ages of the patients ranged from 12 to 84 months with a mean 39.8 +/- 18.3 months. There were 15 males and 11 females with a male to female ratio of 1.4:1. The orofacial and dental injuries sustained from prehospital treatment at home were lacerations and bruising of soft tissues including lips, tongue, mucosa and commissures and tooth subluxation, displacement or avulsion. Other injuries sustained outside the mouth include second-degree burns to the feet, a chin laceration and facial bruises resulting from a fall. Many oral injuries were overlooked by pediatricians. Prompt recognition and appropriate management of febrile convulsion would be of great benefit to the pediatric patients. PMID:17367452

  4. Prevalence of Traumatic Dental Injuries among Contact Sport Practitioners in Northeast of Iran in 2012

    Directory of Open Access Journals (Sweden)

    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.

  5. Bone marrow edema in sports: General concepts

    International Nuclear Information System (INIS)

    This paper will discuss the value of medical imaging in the detection and follow-up of bone marrow edema (BME), resulting from acute and chronic trauma in sports. MR imaging is the only imaging technique that allows direct evaluation of bone marrow edema in sports medicine. The use of fat suppressed T2-weighted or STIR images is particularly appropriate to detect bone marrow edema. The extent of bone marrow edema reflects the biomechanics of trauma. Compressive forces between two bony structures will result in extensive areas of bone marrow edema, whereas distraction forces provoke more subtle areas of bone marrow edema at the insertion of supporting structures of joints. In most clinical situations, a combination of compression and distraction forces is present, causing a complex pattern of bone marrow edema. A meticulous pattern approach of the distribution of these bone marrow changes around a joint can reveal in most instances the underlying mechanism of trauma. This may be helpful to analyze which joint supporting structures may be at risk. In the acute setting, plain radiography and CT scan may have an additional role in the detection of small avulsion fractures occurring at the site of minor areas of bone marrow edema. The clinical significance and natural history of bone marrow edema is still a matter of debate

  6. TOUGHENING AND STIFFENING EFFECTS OF T-ZnOw WHISKERS ON POLYSTYRENE

    Institute of Scientific and Technical Information of China (English)

    Zheng-bao He; Yong Wang; Hong-wei Bai; Bo Song

    2008-01-01

    The main subject of this work is about the effect of T-ZnOw on the toughness and stiffness of polystyrene (PS). In order to avoid the rupture of T-ZnOw during the melt processing, T-ZnOw/PS composites were obtained via the combination of solution blending and injection moulding methods. Although the tensile strength of the composites decreases slightly, the impact strength and tensile modulus increase with the increase of the T-ZnOw content in the matrix. The stiffness and toughness of the composites are enhanced simultaneously. SEM results of the impact-fractured surface show more polymer avulsions, ridges and micro-cracks formed in the T-ZnOw/PS composites, companied with pullout of T-ZnOw from PS matrix and local yielding of PS matrix around T-ZnOw during the impact processing. The possible reasons for the toughness increment of T-ZnOw/PS composites are attributed to the interracial debonding, pullout of T-ZnOw from PS matrix,anchoring effect of T-ZnOw's special three dimensional structure, local yielding of PS matrix and the formation and propagation of micro-cracks.

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

    Directory of Open Access Journals (Sweden)

    Hua Jin

    2015-01-01

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

  8. Catchment- and reach-scale controls on the distribution and expectation of geomorphic channel adjustment

    Science.gov (United States)

    Lisenby, Peyton E.; Fryirs, Kirstie A.

    2016-05-01

    Variability in channel function (behavior) can be assessed by characterizing different forms of adjustment over time. Here, historical channel adjustments in three tributary systems of the Lockyer Valley, Southeast Queensland (SEQ) are analyzed in order to evaluate the range of catchment- and reach-scale controls on channel behavior. Over 300 individual adjustments and 13 forms of adjustment were identified over a ˜130 year time span. We measured the width-to-depth ratio (W:D), mean stream power (ω), and basin area (A) at the location of all observed adjustments. The most common forms of adjustment were avulsions, lateral expansion of the channel, and bend adjustments. The tributary systems behave distinctly different from one another according to statistical comparisons between the W:D, ω, and A data for these forms of adjustment. We find that it is possible to develop process domains or typologies for forms of geomorphic adjustment found in the Lockyer Valley. These domains or typologies provide the foundations for synoptic comparisons between catchments and assessing the expectation of channel adjustment (forecasting), which should be included in process-based river management practice.

  9. [Case report and literature review: elbow fracture dislocation in children].

    Science.gov (United States)

    Guzmdn, R; Rincón, D; Camacho, J

    2015-01-01

    Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child's growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.

  10. Management of child victims of acute sexual assault: Surgical repair and beyond

    Directory of Open Access Journals (Sweden)

    Minakshi Sham

    2013-01-01

    Full Text Available Aim: To evaluate the outcome of definitive repair of anogenital injuries (AGI in child victims of acute sexual assault. settings and Design: It is a prospective study of emergency care provided to child victims of acute sexual assault at a tertiary care Pediatric Surgical Unit in Maharashtra, India. Material and Methods : Out of 25 children, who presented during January 2009-December 2010 with suspected sexual assault, five children (one male and four female, between 4-9 years of age, had incurred major AGI. These children underwent definitive repair and a diverting colostomy. Perineal pull-through was performed in the male child with major avulsion of rectum. One 4-year-old girl with intraperitoneal vaginal injury required exploratory laparotomy in addition. Results : The postoperative period and follow-up was uneventful in all our patients. Four out of five patients have excellent cosmetic and functional outcome with a follow-up of 2-4 years. Our continence results are 100%. Conclusion : Children with acute sexual assault need emergency care. To optimally restore the distorted anatomy, all major AGI in such children should be primarily repaired by an expert, conversant with a child′s local genital and perineal anatomy. Along with provision of comprehensive and compassionate medical care, prevention of secondary injuries should be the ultimate goal.

  11. Identification of new deep sea sinuous channels in the eastern Arabian Sea.

    Science.gov (United States)

    Mishra, Ravi; Pandey, D K; Ramesh, Prerna; Clift, Peter D

    2016-01-01

    Deep sea channel systems are recognized in most submarine fans worldwide as well as in the geological record. The Indus Fan is the second largest modern submarine fan, having a well-developed active canyon and deep sea channel system. Previous studies from the upper Indus Fan have reported several active channel systems. In the present study, deep sea channel systems were identified within the middle Indus Fan using high resolution multibeam bathymetric data. Prominent morphological features within the survey block include the Raman Seamount and Laxmi Ridge. The origin of the newly discovered channels in the middle fan has been inferred using medium resolution satellite bathymetry data. Interpretation of new data shows that the highly sinuous deep sea channel systems also extend to the east of Laxmi Ridge, as well as to the west of Laxmi Ridge, as previously reported. A decrease in sinuosity southward can be attributed to the morphological constraints imposed by the elevated features. These findings have significance in determining the pathways for active sediment transport systems, as well as their source characterization. The geometry suggests a series of punctuated avulsion events leading to the present array of disconnected channels. Such channels have affected the Laxmi Basin since the Pliocene and are responsible for reworking older fan sediments, resulting in loss of the original erosional signature supplied from the river mouth. This implies that distal fan sediments have experienced significant signal shredding and may not represent the erosion and weathering conditions within the onshore basin at the time of sedimentation. PMID:27386293

  12. "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.

  13. Environmental changes in the western Amazonia: morphological framework, geochemistry, palynology and radiocarbon dating data

    International Nuclear Information System (INIS)

    The sediments from the Coari lake, a 'terra firme' lake sculpted into Plio-Pleistocene deposits, and the Acara lake, a flooding-type lake developed on Quaternary sediments in the flood plain of the mid-Solimoes river, in the western Amazonia, Brazil, were studied to investigate the environmental condition of their developing. This study includes mineral composition, geochemistry, Pb isotope, palinology, radiocarbon-age and morphological framework of the lakes obtained from SRTM satellite images. The geological and the environmental conditions in the two lakes are highly variable and suggest that their evolution reflect autogenic processes under humid rain forest condition. Although kaolinite, quartz, muscovite, illite, and smectite are the main minerals in both lakes, the geochemistry indicates distinct source, the Acara lake sediments have higher concentrations of Al2O3, Fe2O3, Fe O, Ca O, K2O, Mg O, Na2O, P2O5, Ba, V, Cu, Ni, Zn, Pb, Sr, Li, Y and La and have more radiogenic Pb than the Coari lake sediments. The radiocarbon ages suggest that at 10160 yr BP the Coari lake started to be developed due to avulsion of the Solimoes river, and the Acara lake was formed by the meander abandonment of Solimoes river retaining its grass dominated shore at ca. 3710 yr BP. (author)

  14. Environmental changes in the western Amazonia: morphological framework, geochemistry, palynology and radiocarbon dating data

    International Nuclear Information System (INIS)

    The sediments from the Coari lake, a 'terra firme' lake sculpted into Plio-Pleistocene deposits, and the Acara lake, a flooding-type lake developed on Quaternary sediments in the flood plain of the mid-Solimoes river, in the western Amazonia, Brazil, were studied to investigate the environmental condition of their developing. This study includes mineral composition, geochemistry, Pb isotope, palynology, radiocarbon-age and morphological framework of the lakes obtained from SRTM satellite images. The geological and the environmental conditions in the two lakes are highly variable and suggest that their evolution reflect autogenic processes under humid rain forest condition. Although kaolinite, quartz, muscovite, illite, and smectite are the main minerals in both lakes, the geochemistry indicates distinct source, the Acara lake sediments have higher concentrations of Al2O3, Fe2O3, FeO, CaO, K2O, MgO, Na2O, P2O5, Ba, V, Cu, Ni, Zn, Pb, Sr, Li, Y and La and have more radiogenic Pb than the Coari lake sediments. The radiocarbon ages suggest that at 10160 yr BP the Coari lake started to be developed due to avulsion of the Solimoes river, and the Acara lake was formed by the meander abandonment of Solimoes river retaining its grass dominated shore at ca. 3710 yr BP. (author)

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  16. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury:electrophysiological characteristics

    Institute of Scientific and Technical Information of China (English)

    Ying Liu; Xun-cheng Xu; Yi Zou; Su-rong Li; Bin Zhang; Yue Wang

    2015-01-01

    Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we per-formed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduc-tion function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regener-ated potentials ifrst appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ‘ex-cellent’ and ‘good’ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The func-tional recovery of a transplanted nerve can be dynamically observed after the surgery.

  17. Bone marrow edema in sports: General concepts

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium) and University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)]. E-mail: filip.vanhoenacker@telenet.be; Snoeckx, A. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium); University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)

    2007-04-15

    This paper will discuss the value of medical imaging in the detection and follow-up of bone marrow edema (BME), resulting from acute and chronic trauma in sports. MR imaging is the only imaging technique that allows direct evaluation of bone marrow edema in sports medicine. The use of fat suppressed T2-weighted or STIR images is particularly appropriate to detect bone marrow edema. The extent of bone marrow edema reflects the biomechanics of trauma. Compressive forces between two bony structures will result in extensive areas of bone marrow edema, whereas distraction forces provoke more subtle areas of bone marrow edema at the insertion of supporting structures of joints. In most clinical situations, a combination of compression and distraction forces is present, causing a complex pattern of bone marrow edema. A meticulous pattern approach of the distribution of these bone marrow changes around a joint can reveal in most instances the underlying mechanism of trauma. This may be helpful to analyze which joint supporting structures may be at risk. In the acute setting, plain radiography and CT scan may have an additional role in the detection of small avulsion fractures occurring at the site of minor areas of bone marrow edema. The clinical significance and natural history of bone marrow edema is still a matter of debate.

  18. Advanced imaging of the scapholunate ligamentous complex.

    Science.gov (United States)

    Shahabpour, Maryam; Staelens, Barbara; Van Overstraeten, Luc; De Maeseneer, Michel; Boulet, Cedric; De Mey, Johan; Scheerlinck, Thierry

    2015-12-01

    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.

  19. Isolated adult Tillaux fracture: a report of two cases.

    Science.gov (United States)

    Oak, Nikhil R; Sabb, Brian J; Kadakia, Anish R; Irwin, Todd A

    2014-01-01

    A fracture of the lateral margin of the distal tibia has commonly been called a Tillaux fracture, which is an avulsion-type fracture that can result from the pull of the anterior inferior tibiofibular ligament. The common mechanism of injury described and observed has been one of external rotation of the foot relative to the tibia. Historically, this fracture pattern has been noted in the pediatric and adolescent populations and classified as a Salter-Harris III fracture through the epiphysis. It has typically occurred in children aged 12 to 14 years and is not commonly seen in adults. We discuss 2 cases of isolated Tillaux fractures in skeletally mature adults, aged 47 and 37 years, a population in which this fracture pattern to our knowledge and after review of the published data has not been described. It is important to recognize these distinct injuries and appropriately treat the pathologic features to prevent further instability and arthritis. PMID:24795204

  20. Integrating engineering principles into the medico-legal investigation of a rare fatal rollover car accident involving complex dynamics.

    Science.gov (United States)

    Grassi, Vincenzo M; Castagnola, Flaminia; Miscusi, Massimo; De-Giorgio, Fabio

    2016-09-01

    Rollover car accidents can be the result of forceful steering or hitting an obstacle that acts like a ramp. Mortality from this type of car accident is particularly high, especially when occupants are thrown out of the vehicle. We report a case of a 67-year-old man who died after a rollover accident that occurred when he was driving a car equipped with a glass moonroof. He was found inside his car with his safety belt correctly fastened and the roof shattered. At autopsy, a wide avulsion injury of the head was observed, which was associated with an atlanto-axial dislocation and full-thickness fracture of the cervical body and posterior facet joints of the seventh cervical vertebra. The data collected at the scene of the accident were integrated with the autopsy results to yield a forensic engineering reconstruction. This reconstruction elucidated the dynamics of the event and correctly ascribed the lesions observed at autopsy to the phases of the rollover. Afterward, an analysis of the scientific literature concerning rollover crash tests was conducted to understand why the driver sustained fatal injuries even though his seatbelt was properly fastened. PMID:27406628

  1. Phrenic nerve transfer to the musculocutaneous nerve for the repair of brachial plexus injury: electrophysiological characteristics

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2015-01-01

    Full Text Available Phrenic nerve transfer is a major dynamic treatment used to repair brachial plexus root avulsion. We analyzed 72 relevant articles on phrenic nerve transfer to repair injured brachial plexus that were indexed by Science Citation Index. The keywords searched were brachial plexus injury, phrenic nerve, repair, surgery, protection, nerve transfer, and nerve graft. In addition, we performed neurophysiological analysis of the preoperative condition and prognosis of 10 patients undergoing ipsilateral phrenic nerve transfer to the musculocutaneous nerve in our hospital from 2008 to 201 3 and observed the electromyograms of the biceps brachii and motor conduction function of the musculocutaneous nerve. Clinically, approximately 28% of patients had brachial plexus injury combined with phrenic nerve injury, and injured phrenic nerve cannot be used as a nerve graft. After phrenic nerve transfer to the musculocutaneous nerve, the regenerated potentials first appeared at 3 months. Recovery of motor unit action potential occurred 6 months later and became more apparent at 12 months. The percent of patients recovering ′excellent′ and ′good′ muscle strength in the biceps brachii was 80% after 18 months. At 12 months after surgery, motor nerve conduction potential appeared in the musculocutaneous nerve in seven cases. These data suggest that preoperative evaluation of phrenic nerve function may help identify the most appropriate nerve graft in patients with an injured brachial plexus. The functional recovery of a transplanted nerve can be dynamically observed after the surgery.

  2. Multiple cervical spinous process fractures in a novice golf player.

    Science.gov (United States)

    Kim, Sei-Yoon; Chung, Sang Ki; Kim, Dong-Yun

    2012-12-01

    Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture. PMID:23346334

  3. A review of terminology for equine juvenile osteochondral conditions (JOCC) based on anatomical and functional considerations.

    Science.gov (United States)

    Denoix, J-M; Jeffcott, L B; McIlwraith, C W; van Weeren, P R

    2013-07-01

    This manuscript describes a new classification of the various joint-related lesions that can be seen in the young, growing horse based on their anatomical and functional aetiopathogenesis. Juvenile osteochondral conditions (JOCC) is a term that brings together specific disorders according to their location in the joint and their biomechanical origin. When a biomechanical insult affects the process of endochondral ossification different types of osteochondrosis (OC) lesions may occur, including osteochondral fragmentation of the articular surface or of the periarticular margins, or the formation of juvenile subchondral bone cysts. In severe cases, osteochondral collapse of the articular surface or the epiphysis or even an entire small bone may occur. Tension on ligament attachments may cause avulsion fractures of epiphyseal (or metaphyseal) ossifying bone, which are classified as JOCC, but do not result from a disturbance of the process of endochondral ossification and are not therefore classified as a form of OC. The same applies to 'physitis' which can result from damage to the physeal growth plate. PMID:23683533

  4. 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. PMID:27367632

  5. The proximal hamstring muscle–tendon–bone unit: A review of the normal anatomy, biomechanics, and pathophysiology

    International Nuclear Information System (INIS)

    Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle–tendon–bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation.

  6. Channel Evolution on the Lower Elwha River, Washington, 1939-2006

    Science.gov (United States)

    Draut, Amy E.; Logan, Joshua B.; McCoy, Randall E.; McHenry, Michael; Warrick, Jonathan A.

    2008-01-01

    Analyses of historical aerial photographs of the lower Elwha River, Clallam County, Washington, reveal rates and patterns of channel change in this dammed, anabranching river between 1939 and 2006. Absolute positional changes of the active-floodplain margins, which commonly exceeded 50 m over that interval, have exceeded 400 m locally. Annualized rates of channel movement were typically ~2 to 10 m/yr; higher annualized rates over some time intervals are attributable to the formation of new channels by episodic avulsion. Channel movement by more gradual lateral meander migration was also common. Anthropogenic modification of the floodplain between the 1940s and 1980s substantially altered channel form and position. This analysis of rates and patterns of channel change over nearly 70 years on the lower Elwha River is intended to characterize the evolution of the river throughout most of the time interval when two large dams have been in place upstream. Channel morphology and rates of channel movement are expected to change significantly in response to removal of the dams and re-establishment of the upstream sediment supply during a major river-restoration project.

  7. SURGICAL ANATOMY OF DORSAL ROOT ENTRY ZONE OF CERVICAL SPINAL NERVES : CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    A.Arun Kumar

    2014-06-01

    Full Text Available Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five adult formalin fixed cadavers are taken for this study. Conventional Spinal cord dissection is followed as per Cunningham’s Dissection Mannual. Findings: The parameters included are Number of dorsal rootlets, Longitudinal Length of DREZ, Distance between two successive DREZ, Length of dorsal rootlets, Distance between right and left DREZ, Distance between DREZ and Ligamentum denticulatum, Cranial angles of Superior & inferior rootlets. Results: Results were noted for all the parameters and are compared with the previous studies. The significant observations are obtained. Conclusion: Surgical anatomy of Dorsal Root Entry Zone (DREZ of cervical spinal nerves will be useful for the neurosurgeons doing Drezotomy procedure, in which the nociceptive fibres alone are specifically severed with preservation of other sensations

  8. 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.

  9. A preliminary study on investigating the attachment of soft tissue onto micro-arc oxidized titanium alloy implants

    International Nuclear Information System (INIS)

    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 (Ti6Al4V) 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.

  10. Evaluation of Periodontal Ligament Cell Viability in Three Different Storage Media: An in Vitro Study

    Directory of Open Access Journals (Sweden)

    Meenakshi Sharma

    2016-01-01

    Full Text Available Objectives: This study was undertaken to evaluate the viability of periodontal ligament (PDL cells of avulsed teeth in three different storage media.Materials and Methods: Forty-five premolars extracted for orthodontic therapeutic purposes were randomly and equally divided into three groups based on storage media used [Group I: milk (control; Group II: aloe vera (experimental; Group III: egg white (experimental]. Following extractions, the teeth were placed in one of the three different storage media for 30 minutes, following which the scrapings of the PDL from these teeth were collected in Falcon tubes containing collagenase enzyme in 2.5 mL of phosphate buffered saline. The tubes were subsequently incubated for 30 minutes and centrifuged for five minutes at 800 rpm. The obtained PDL cells were stained with Trypan Blue and were observed under optical microscope. The percentage of viable cells was calculated.Results: Aloe vera showed the highest percentage of viable cells (114.3±8.0, followed by egg white (100.9±6.3 and milk (101.1±7.3.Conclusion: Within the limitations of this study, it appears that aloe vera maintains PDL cell viability better than egg white or milk.

  11. Clinical anatomic study of the lower lumbar anterolateral vein: with respect to retroperitoneal endoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    LU Sheng; XU Yong-qing; DING Zi-hai; WANG Yue-li; SHI Ji-hong; ZHONG Shi-zhen

    2008-01-01

    To study the anatomy of veins of the lower lumbar spine and provide the anatomic basement for laparoscopic lumbar surgery.Methods:A total of 15 formaldehyde-preserved cadavers were studied with special attention to the variety and surrounding structure of ascending lumbar vein(ALV)and iliolumbar veins(ILV),and their relationship with lumbar plexus.Results:ALV and ILV can be found on every sides,which have four variants including separate entry and common entry. The ascending vein and iliolumbar vein separately enter common iliac vein in 18 cases, and as a common stem enter the common iliac vein in 12 cases. Retracting common iliac vein medially both the ascending lumbar and the iliolumbar veins are always at risk of avulsion on exposure of the disc space. The injury of obturator nerve and lumbosacral trunk of lumbar plexus should be avoided.Conclusion:Awareness of these anatomic variation can prevent the hemorrhage and be helpful for the surgeon in performing a careful ligation of these veins before medial retraction of the common iliac vein. Our findings emphasize the need for proper dissection of ALV and ILV before ligature during exposure of the lower lumbar spine.

  12. Irrigation-coupled bipolar cautery unit: A practical, economical, and simple version

    Directory of Open Access Journals (Sweden)

    Sharma Shekhar

    2008-01-01

    Full Text Available Hemostasis is a fundamental principle of surgery for which electrocoagulation is universally used. Bipolar electrocautery has an advantage over monopolar electrocautery in terms of the precision of the extent of tissue coagulation and the lateral extent of thermal tissue injury. However, secondary to the thermal changes induced in the tissue due to electric current passage, there is charring of tissue, which adheres to the cautery tip. This, not only decreases its effectiveness, but also, by getting avulsed while removing the cautery tip from the surgical field, causes rebleeding and more trauma to the tissue. Irrigation of the surgical field during application of cautery reduces the charring effect, thereby improving the efficiency and efficacy. Irrigation-coupled electrocautery devices are available but are costly to acquire and maintain. We describe a simple and reliable version of an irrigation-coupled cautery device, which is of immense functional utility in our experience. It decreases the amount of charring of the tissue and its adherence to the bipolar forceps tips, thereby decreasing the frustrating loss of effectiveness and also increases the life of the bipolar forceps as cleaning needs to be less frequent. By virtue of its simplicity and cost-effectiveness, it can be used in almost all hospitals and situations.

  13. 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.

  14. The potential for dams to impact lowland meandering river floodplain geomorphology.

    Science.gov (United States)

    Marren, Philip M; Grove, James R; Webb, J Angus; Stewardson, Michael J

    2014-01-01

    The majority of the world's floodplains are dammed. Although some implications of dams for riverine ecology and for river channel morphology are well understood, there is less research on the impacts of dams on floodplain geomorphology. We review studies from dammed and undammed rivers and include influences on vertical and lateral accretion, meander migration and cutoff formation, avulsion, and interactions with floodplain vegetation. The results are synthesized into a conceptual model of the effects of dams on the major geomorphic influences on floodplain development. This model is used to assess the likely consequences of eight dam and flow regulation scenarios for floodplain geomorphology. Sediment starvation downstream of dams has perhaps the greatest potential to impact on floodplain development. Such effects will persist further downstream where tributary sediment inputs are relatively low and there is minimal buffering by alluvial sediment stores. We can identify several ways in which floodplains might potentially be affected by dams, with varying degrees of confidence, including a distinction between passive impacts (floodplain disconnection) and active impacts (changes in geomorphological processes and functioning). These active processes are likely to have more serious implications for floodplain function and emphasize both the need for future research and the need for an "environmental sediment regime" to operate alongside environmental flows. PMID:24587718

  15. The Potential for Dams to Impact Lowland Meandering River Floodplain Geomorphology

    Directory of Open Access Journals (Sweden)

    Philip M. Marren

    2014-01-01

    Full Text Available The majority of the world's floodplains are dammed. Although some implications of dams for riverine ecology and for river channel morphology are well understood, there is less research on the impacts of dams on floodplain geomorphology. We review studies from dammed and undammed rivers and include influences on vertical and lateral accretion, meander migration and cutoff formation, avulsion, and interactions with floodplain vegetation. The results are synthesized into a conceptual model of the effects of dams on the major geomorphic influences on floodplain development. This model is used to assess the likely consequences of eight dam and flow regulation scenarios for floodplain geomorphology. Sediment starvation downstream of dams has perhaps the greatest potential to impact on floodplain development. Such effects will persist further downstream where tributary sediment inputs are relatively low and there is minimal buffering by alluvial sediment stores. We can identify several ways in which floodplains might potentially be affected by dams, with varying degrees of confidence, including a distinction between passive impacts (floodplain disconnection and active impacts (changes in geomorphological processes and functioning. These active processes are likely to have more serious implications for floodplain function and emphasize both the need for future research and the need for an “environmental sediment regime” to operate alongside environmental flows.

  16. Tears at the rotator cuff footprint: Prevalence and imaging characteristics in 305 MR arthrograms of the shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffeler, Christoph; Mueller, Dirk; Rummeny, Ernst J.; Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Kirchhoff, Chlodwig [Technische Universitaet Muenchen, Department of Orthopedics and Traumatology, Munich (Germany); Wolf, Petra [Technische Universitaet Muenchen, Institute of Medical Statistics and Epidemiology, Munich (Germany)

    2011-07-15

    To evaluate the prevalence, imaging characteristics and anatomical distribution of tears at the rotator cuff (RC) footprint with MR arthrography (MR-A) of the shoulder. MR arthrograms obtained in 305 patients were retrospectively reviewed. Partial articular-sided supraspinatus tendon avulsions (PASTA), concealed interstitial delaminations (CID), reverse PASTA lesions and full-thickness tears (FT) at the humeral tendon insertion were depicted. Anatomical locations were determined and depths of tears were classified. 112/305 patients showed RC tears, including 63 patients with 68 footprint tears. 34 PASTA lesions were detected with 20/34 involving the anterior supraspinatus (SSP) tendon and 17/34 PASTA lesions were grade I lesions. Most CID lesions (14/23) occurred at the posterior SSP and 20/23 were classified as grade I or II. 9 FT and 2 reverse PASTA lesions were found. Statistical analysis revealed no difference in anatomical location (p = 0.903) and no correlation with overhead sports activity (p = 0.300) or history of trauma (p=0.928). There were significantly more PASTA lesions in patients <40 years of age (p = 0.029). Most RC tears detected with MR-A involve the SSP footprint and are articular-sided with predominance in younger patients, but concealed lesions are not as uncommon as previously thought. (orig.)

  17. 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.

  18. Large Urethro-Vesico-Vaginal Fistula due to a Vaginal Foreign Body in a 22-Year-Old Woman: Case Report and Literature Review.

    Science.gov (United States)

    D'Elia, Carolina; Curti, Pierpaolo; Cerruto, Maria Angela; Monaco, Carmelo; Artibani, Walter

    2015-01-01

    In the non-industrialized countries of Africa and Asia obstetric fistulas are more frequently caused by prolonged labour, whereas in countries with developed healthcare systems they are generally the result of complications of gynaecological surgery or, rarely, benign pathologies like inflammation or foreign bodies. A 22-year-old woman was brought to the gynaecology clinic because of foul-smelling vaginal discharge. On pelvic examination a ring-like foreign body was impacted between the anterior and posterior vaginal wall. MRI scan confirmed the presence of a cylindrical foreign body in the vagina and the patient revealed that she had 'involuntarily' inserted a plastic bubble bath cap into the vagina. At surgery removal of the cap was difficult and at the end of the manoeuver evidence of a huge urethro-vesico-vaginal fistula occurred. The patient was discharged with bilateral ureteral stents and suprapubic catheter. After 3 months we performed an end-to-end anastomotic urethroplasty to repair the urethral avulsion and restored the bladder/trigonal and vaginal/cervical defects with 3 layers of sutures; 3 months later the patient had no complaints. Complex genital fistulas represent an extremely debilitating morbidity. In our case, a vaginal approach was successful, but the choice between an abdominal or vaginal approach depends on the surgeon's experience and training. PMID:25138359

  19. Nonsurgical factors of digital replantation and survival rate A metaanalysis

    Directory of Open Access Journals (Sweden)

    Huawei Yu

    2015-01-01

    Full Text Available The aim of this metaanalysis was to evaluate the association between nonsurgical factors and survival rate of digital replantation. A computer search of MEDLINE, OVID, EMBASE and CNKI databases was conducted to identify literatures for digital replantation, with the keywords of "digit," "finger" and "replantation" from their inception to June 10, 2014. Based on the inclusion and exclusion criteria, data were extracted independently by two authors using piloted forms. Review Manager 5.2 software was used for data analysis. The effect of some nonsurgical factors (gender, age, amputated finger, injury mechanisms, ischemia time and the way of preservation on the survival rate of digital replantation was assessed. The metaanalysis result suggested that gender and ischemia time had no significant influence on the survival rate of amputation replantation. However, the survival rate of digital replantation of adults was significantly higher than that of children. The guillotine injury of a finger was easier to replant successfully than the crush and avulsion. The little finger was more difficult for replantation than thumb. Survival rate of fingers stored in low temperature was higher than that in common temperature. The present metaanalysis suggested that age, injury mechanism, amputated finger and the way of preservation were significantly associated with the survival rate of digital replantation.

  20. Floodplain morphology, sedimentology, and development processes of a partially alluvial channel

    Science.gov (United States)

    Thayer, James B.; Ashmore, Peter

    2016-09-01

    The floodplain morphology, sediment deposits, and development mechanisms of a partially alluvial, low-moderate energy channel flowing over a mixed gravel/cobble-till bed are investigated and compared to existing ideas of floodplain development. The findings partially support the idea of a floodplain developed through lateral accretion capped with vertically accreted sediments as predicted by the energy-based classification scheme of Nanson and Croke (1992), though oblique accretion and partial channel avulsion are also important. Channel migration consists of limited cross-valley migration and downstream meander translation. Because of low channel sinuosity, well-formed neck cutoffs are rare, and instead the channel cuts headward along the insides of confined or underdeveloped meander bends forming a localized anabranching pattern. The floodplain architecture can be divided into gravel bar and bed deposits (GB), lateral accretion deposits (LA), overbank deposits (FF), and abandoned channel deposits (FF(CH)), which are described with four alluvial facies. Owing to the limited supply of coarse and fine sediment, none of the architectural elements are particularly thick, with total floodplain thickness being channels is compared within a new floodplain discrimination framework. Comparisons with common facies models of single-thread, coarse-grained channels show important differences that suggest that the floodplain deposits and formative processes described herein represent a subset of single-thread systems that may be common in partially alluvial channels, particularly in slightly sinuous, coarse-grained channels of low-moderate energy with partly confined floodplains.