WorldWideScience

Sample records for avulsions

  1. Complete Ureteral Avulsion

    Directory of Open Access Journals (Sweden)

    V. Gupta

    2005-01-01

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

  2. Complete Ureteral Avulsion

    OpenAIRE

    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. Chronic avulsive injuries of childhood

    International Nuclear Information System (INIS)

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

  4. Chronic avulsive injuries of childhood

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-03-01

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

  5. Umbilical cord avulsion in waterbirth.

    Science.gov (United States)

    Schafer, Robyn

    2014-01-01

    Umbilical cord avulsion (or "cord snapping") is often cited as a risk associated with waterbirth. This article discusses a case study in which a cord avulsed during a waterbirth and uses it as a basis to explore the incidence, etiology, and associated risk factors of umbilical cord avulsion. The diagnosis, clinical presentation, and management of cord avulsion in waterbirth is presented along with a thorough review of the literature and relevant professional standards. This article offers recommendations for clinical practice to minimize the risk of a cord avulsion and highlights the need for additional research and provider education to ensure optimal care of women and newborns. PMID:24588881

  6. 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.)

  7. 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.)

  8. Face Avulsion and Degloving

    OpenAIRE

    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...

  9. 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.

  10. Delayed replantation of avulsed teeth

    OpenAIRE

    Adil N; Ahmed S; Jindal M; Arshad S

    2007-01-01

    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.

  11. Nail avulsion: Indications and methods (surgical nail avulsion

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    Deepika Pandhi

    2012-01-01

    Full Text Available The nail is a subject of global importance for dermatologists, podiatrists and surgeons. Nail avulsion is a frequently undertaken, yet simple, intriguing procedure. It may either be surgical or chemical, using 40% urea. The former is most often undertaken using the distal approach. Nail avulsion may either be useful for diagnostic purposes like exploration of the nail bed, nail matrix and the nail folds and before contemplating a biopsy on the nail bed or for therapeutic purposes like onychocryptosis, warts, onychomycosis, chronic paronychia, nail tumors, matricectomy and retronychia. The procedure is carried out mostly under local anesthesia with or without epinephrine (1:2,00,000 dilution. Besides the above-mentioned indications, the contraindications and complications of nail avulsion are briefly outlined.

  12. Tooth Avulsion in the School Setting

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    Krause-Parello, Cheryl A.

    2005-01-01

    Tooth avulsions occur when a tooth is displaced from its socket. Tooth avulsions are common dental injuries that may occur before, during, or after school. Therefore, it is essential that school nurses be well prepared to intervene when such a dental emergency arises. It is also imperative that school nurses and school personnel are fully equipped…

  13. First-Aid Algorithms in Dental Avulsion

    Science.gov (United States)

    Baginska, Joanna; Wilczynska-Borawska, Magdalena

    2012-01-01

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

  14. Replantation of ring avulsion amputations

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    Sabapathy R

    2003-01-01

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

  15. Radiological findings in cervical radicular avulsion

    International Nuclear Information System (INIS)

    Special aspects of examination techniques and positive myelographic findings in cervical radicular avulsion are reported. In addition, the possibilities and limits of myeloscintigraphy are discussed. Some observations and experiences with neuroradiological diagnosis of cervical radicular avulsion are reported which are of importance for the prognosis in brachial plexus injuries. It is determined that no direct relationship between myelographic-findings and nerve functions damage exists. The possibility of regeneration in serious traumatic injuries with extensive dural avulsion is demonstrated in two cases. Despite neuroradiological findings suggesting severe damage and the possibility of functional restitution is emphasized. (orig.)

  16. 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

  17. Talus avulsion fractures: are they accurately diagnosed?

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    Robinson, Karen P; Davies, Mark B

    2015-10-01

    Dorsal talus avulsion fractures occurring along the supination line of the foot can cause pain and discomfort. Examination of the foot and ankle using the Ottawa ankle rules does not include examination of the talus, an injury here is easily missed causing concern to the patient. This is a retrospective study carried out in a major trauma centre to look at the assessment and diagnosis of all patients with a dorsal talus and navicular avulsion fractures over a one year period. Nineteen patients with an isolated dorsal talus avulsion fracture and five patients with an isolated dorsal navicular fracture were included. The correct diagnosis was made in 12 of patients with isolated dorsal talus avulsion fractures, 7 patients were given an incorrect diagnosis after misreading of the radiograph. Four patients with a dorsal navicular avulsion fracture were given the correct diagnosis. If not correctly diagnosed on presentation patients can be overly concerned that a 'fracture was missed' which can lead to confusion and anxiety. Therefore these injuries need to be recognised early, promptly diagnosed, treated symptomatically and reassurance given. We recommend the routine palpation of the talus in addition to the examination set out in the Ottawa Ankle Rules and the close inspection of plain radiographs to adequately diagnose an injury in this area. PMID:26190632

  18. What is the Best Root Surface Treatment for Avulsed Teeth?

    OpenAIRE

    Elif B. Tuna; YAMAN, Duygu; Yamamato, Seiko

    2014-01-01

    Dental avulsion is the most severe type of traumatic tooth injuries since it causes damage to several structures and results in avulsion of the tooth from its socket. Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long-term prognosis and survival of these teeth. The prognosis of the treatment as well as the survival of an avulsed tooth depends on intrinsic and extrinsic factors, such as the duration of ...

  19. 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.

  20. Ureteral avulsion as a complication of ureteroscopy

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    J.M. Alapont

    2003-02-01

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

  1. 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

  2. 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.

  3. Management of full-length complete ureteral avulsion

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    Kaifa Tang

    2016-02-01

    Full Text Available ABSTRACT Introduction Complete ureteral avulsion is one of the most serious complications of ureteroscopy. The aim of this report was to look for a good solution to full-length complete ureteral avulsion. Case presentation A 40-year-old man underwent ureteroscopic management. Full-length complete avulsion of ureter occurred during ureteroscopy. Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis were performed 6 hours after ureteral avulsion. The patient was followed-up during 34 months. Double-J tube was removed at 3 months after operation. Twenty three months after the first operation, the patient developed hydronephrosis because of a new ureter upside stone, then rigid ureteroscopy and holmium laser lithotripsy were used successfully. Conclusion Pyeloureterostomy plus greater omentum investment outside the avulsed ureter and ureterovesical anastomosis may be a good choice for full-length complete ureteral avulsion.

  4. 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

  5. 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.

  6. MRI of radiographically occult ischial apophyseal avulsions

    International Nuclear Information System (INIS)

    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.)

  7. 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.)

  8. Calcaneal insufficiency avulsion fractures in diabetic patients

    International Nuclear Information System (INIS)

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

  9. 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

  10. Delayed Tooth Replantation after Traumatic Avulsion: A Case Report

    OpenAIRE

    Khalilak, Zohreh; Shikholislami, Mahshid; Mohajeri, Ladan

    2008-01-01

    Avulsion is a serious injury which causes damage to dental and supportive tissues, ranging from 1-16 % among dental injuries and it mostly occurs in maxillary incisors. This report presents a case of replantation of a traumatically avulsed central incisor. The left central incisor of an 8 year-old boy with open apex was avulsed and was left in unclean and dry conditions. Tooth was replaced after 270 min and splinted. After 24 hours, tooth was treated endodontically. The calcium hydroxide past...

  11. 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

  12. 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

  13. Esthetic Management of an Anterior Avulsed Tooth: A Case Report

    OpenAIRE

    AR, Prabhakar; Sugandhan,; KB, Roopa; Gulati, Akanksha

    2009-01-01

    Avulsion and luxation account for up to 16% of all traumatic injuries in the permanent dentition and 7.2% of injuries in the primary dentition. A range of treatment options are available that can help conserve the tooth after a traumatic episode. There are, however, occasions where loss of the traumatized tooth is inevitable with special regard to avulsion injuries. replantation of teeth having doubtful long-term prognosis. Following the traumatic loss of an anterior tooth it is important tha...

  14. 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.

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

    OpenAIRE

    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...

  16. Microsurgical reconstruction of major scalp defects following scalp avulsion

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    Gurdayal Singh Kalra

    2013-01-01

    Full Text Available Introduction: Total scalp avulsion is a serious injury, commonly occurring in Indian females working with industrial and agricultural machines. Their long hairs often get caught in a rapidly revolving machines, resulting in total avulsion of scalp. Lack of education and awareness in Indian villages often result in these patients coming late to the hospitals when replantation is not possible and scalp reconstruction remains the only available option. Materials and Methods: We performed our study on 22 cases of scalp avulsion injury presented to us between June 2007 and April 2012 at Department of Burn, Plastic & Reconstructive Surgery, SMS Hospital, Jaipur. In all of them a free tissue transfer was performed as an elective procedure. Results: Twenty two patients underwent free tissue transfer and followed up for an average period of 6 months. All patients included in this study were females with mean age of 28 yrs. Five patients in our study reported with partial necrosis of the free flaps which were subsequently managed with split-thickness skin graft (STSG. Two patients reported total necrosis of the flap which was re-operated using latissimus dorsi along with serratus anterior muscle (LDSA from the contralateral side. Conclusion: As scalp avulsion because of rapidly rotating machine leads to large size defect not amenable for local tissue reconstruction. We performed reconstruction using LDSA and omental free flaps with split thickness skin graft (STSG for large scalp defect and achieved good and stable soft tissue cover with satisfactory cosmesis.

  17. Radicular avulsion resulting from spinal injury: Assessment of diagnostic modalities

    International Nuclear Information System (INIS)

    The diagnostic utility of imaging techniques in injuries to the intramedullary and subarachnoid portions of the brachial plexus, with possibly complete avulsion of one or more nerve roots from the spinal cord and extramedullary meningocoele was compared in 18 patients studied by unenhanced computed tomography (CT), cervical myelography, myelographic CT (MCT) and magnetic resonance imaging (MRI). Emphasis was placed on the lesions of the subarachnoid roots. CM was the only diagnostic modality to show avulsion of 18 nerve roots and their levels in 8 patients (100% = gold standard), and to verify 2 incomplete avulsions. MCT reliably revealed 8 of 18 (45%) and MRI 1 out of 18 (6%) avulsions. Myelography with MCT showed intact subarachnoid nerve roots in 10 additional patients. MRI and MCT (16 out of 16 = 100%) were superior to myelography (14/16 = 88%) for demonstrating 16 traumatic meningocoeles in 8 patients; follow-up MRI (6-24 months) showed no increase in their size. We recommend a subsequent CT to role out fracture to the spinal column; MRI should provide significant information concerning oedema or haemorrhage in the spinal cord. Myelography with segmental MCT is performed to differentiate pre- from post-ganglionic lesions, data which are essential for deciding whether exploration of the plexus or a motor substitution operation is indicated. (orig.)

  18. Simultaneous bilateral tibal tubercle avulsion: A rare fracture

    Directory of Open Access Journals (Sweden)

    Hasan Metineren

    2013-12-01

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

  19. All-arthroscopic treatment of tibial avulsion fractures of the posterior cruciate ligament

    OpenAIRE

    Gwinner, Clemens; Hoburg, Arnd; Wilde, Sophie; Schatka, Imke; Krapohl, Björn Dirk; Jung, Tobias M.

    2016-01-01

    Background: The posterior cruciate ligament (PCL) avulsion fracture from its tibial insertion is a rare condition. Despite the further technical advent in refixation of avulsion fractures, the reported failure rate of current approaches remains high and the optimal surgical technique has not been elucidated yet. The purpose of the current study is to present an all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the PCL and initial clinical outcomes. Methods...

  20. Posterior cruciate ligament mediated avulsion fracture of the lateral tibial condyle: a case report

    OpenAIRE

    Ogawa Hiroyasu; Sumi Hiroshi; Shimizu Katsuji

    2010-01-01

    Abstract Avulsion fractures of the posterior cruciate ligament (PCL) are uncommon. On the basis of the site of damage of the PCL, hyperflexion, pretibial trauma, and hyperextension are proposed as mechanisms of PCL injuries. On the other hand, avulsion fractures of the tibial condyle are also rare. We report a PCL-mediated avulsion fracture of the lateral tibial condyle along with the tibial insertion of the PCL by extension-distraction force on the knee that has not been previously described...

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

    OpenAIRE

    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...

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

    OpenAIRE

    Harkiran Kaur; Supreet Kaur; Hargundeep Kaur

    2012-01-01

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

  3. Avulsion of permanent teeth with open apex: a systematic review of the literature

    OpenAIRE

    Felipe G. Belladonna; Ane Poly; João M. S. Teixeira; Viviane D. M. A. Nascimento; Sandra R. Fidel; Rivail A. S. Fidel

    2012-01-01

    Introduction: Considered the most serious of dental in Considered the most serious of dental injuries, uries,avulsion is known as the total displacement of tooth out of its socket. Treatment includes immediate replantation and its success is directly related to several factors. Objective: This paper aimed to review the literature in a systematic way on dental avulsion of in a systematic way on dental avulsion of permanent teeth with open apex, covering various topics such as: reason for av...

  4. 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.

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

    Science.gov (United States)

    O'Neill, Barry J; Sweeney, Laura A; Moroney, Paul J; Mulhall, Kevin 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. PMID:24521754

  6. 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.

  7. 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

  8. 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.

  9. 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.

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

    OpenAIRE

    Nima Moradi Majd; Heidar Zohrehei; Alireza Darvish; Hamed Homayouni; Mamak Adel

    2014-01-01

    Introduction. Tooth avulsion in the young permanent dentition is a frequent finding, and its prognosis depends on the treatment of the avulsed tooth before replantation, the extra-alveolar time, the storage medium, and the patient’s general health. The present report describes management of an immature avulsed lower central incisor 90 minutes after the accident. Methods. A right lower central incisor of a 7-year-old girl was avulsed, and it was soaked in a glass of milk. 90 minutes after avul...

  11. 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...

  12. Late Glacial and Holocene avulsions of the Rio Pastaza Megafan (Ecuador- Peru): frequency and controlling factors

    OpenAIRE

    Bernal, Carolina; Christophoul, Frédéric; Darrozes, José; Soula, Jean-Claude; Baby, Patrice; Burgos, José

    2011-01-01

    The geomorphological study by mean of remote sensing imagery of the Rio Pastaza Megafan (Ecuador and northern Peru), reveals the traces of numerous avulsions. 108 avulsion sites have been defined. The location of these sites, the available radiocarbon ages as well as historical maps of the 17th century, enable us to propose an evolution history of the migration and avulsions of the Rio Pastaza since the Last Glacial Maximum. The first avulsions of the Río Pastaza occurred after the LGM in a z...

  13. Management of a rare combination of avulsion and intrusive luxation: A case report

    Directory of Open Access Journals (Sweden)

    Umesh Dharmani

    2014-01-01

    Full Text Available In traumatic dental injury, concomitant occurrence of avulsion and intrusive luxation is exceptional. This is because the vectors of forces responsible for both avulsive and intrusive injuries are in different directions. The present case report reviews the management of a rare combination of avulsion in right maxillary lateral incisor (tooth #12 and intrusive luxation in right maxillary central incisor (tooth #11 in a 22-year-old Asian male. Clinical and radiographic evaluation was done at 12-month follow-up. Various treatment modalities and complications associated with both avulsion and intrusion are also discussed in the paper.

  14. 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

  15. 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.)

  16. Maintaining vitality of immediately reimplanted avulsed tooth: Two-year follow-up case report

    OpenAIRE

    A N Munavalli; R J Sachhi; S S Kambale; S D Bandekar

    2013-01-01

    Management of tooth avulsion in the permanent dentition often presents a challenge. Such injuries should be recognized and treated expeditiously because several studies support a more likely favorable prognosis with timely and appropriate initial management. This article describes the immediate management of an avulsed maxillary permanent incisor with afollow-up of 1 year.

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Harkiran Kaur

    2012-01-01

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

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

    OpenAIRE

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

    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 prem...

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

    OpenAIRE

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

    2014-01-01

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

  5. Neuroprotection and immunomodulation by xenografted human mesenchymal stem cells following spinal cord ventral root avulsion

    OpenAIRE

    Ribeiro, Thiago B.; Duarte, Adriana S. S.; Longhini, Ana Leda F.; Fernando Pradella; Farias, Alessandro S.; Angela C. M. Luzo; Oliveira, Alexandre L. R.; Sara Teresinha Olalla Saad

    2015-01-01

    The present study investigates the effects of xenotransplantation of Adipose Tissue Mesenchymal Stem Cells (AT-MSCs) in animals after ventral root avulsion. AT-MSC has similar characteristics to bone marrow mesenchymal stem cells (BM-MSCs), such as immunomodulatory properties and expression of neurotrophic factors. In this study, Lewis rats were submitted to surgery for unilateral avulsion of the lumbar ventral roots and received 5 × 105 AT-MSCs via the lateral funiculus. Two weeks after cell...

  6. [Treatment of complete traumatic avulsion of an incisor tooth in adults].

    Science.gov (United States)

    Benmansour, A

    2013-05-01

    It is possible to replant an incisor tooth completely avulsed after trauma in adults. These cases are relatively frequent among athletes. It is essential to conserve the tooth in saline solution. The time before replantation must be as short as possible. The simple technique described here, which requires a minimum of material and no dental chair, makes it possible to replant an avulsed incisor with a good success rate. PMID:23803559

  7. 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.

  8. Surgical management of a completely avulsed adductor longus muscle in a professional equestrian rider.

    Science.gov (United States)

    Quah, Conal; Cottam, Andrew; Hutchinson, James

    2014-01-01

    Avulsion injuries of the adductor longus muscle tendon are rare and a challenge to manage especially in athletes. There has been little published literature on the outcome of conservative and operative treatment for these injuries. We report the first case of an acute adductor longus avulsion injury which was surgically repaired in a professional equestrian rider. Return to full preinjury function was achieved at 3 months with surgical repair using 3 suture anchors. PMID:24711943

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

    OpenAIRE

    Conal Quah; Andrew Cottam; James Hutchinson

    2014-01-01

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

  10. 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...

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

    OpenAIRE

    Claudia Londero Pagliarin; Clacir Londero Zenkner; Fernando Branco Barletta

    2011-01-01

    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 informat...

  12. 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.

  13. Human Embryonic Stem Cell-Derived Progenitors Assist Functional Sensory Axon Regeneration after Dorsal Root Avulsion Injury

    OpenAIRE

    Hoeber, Jan; Trolle, Carl; König, Niclas; Du, Zhongwei; Gallo, Alessandro; Hermans, Emmanuel; Aldskogius, Håkan; Shortland, Peter; Zhang, Su-Chun; Deumens, Ronald; Kozlova, Elena N

    2015-01-01

    Dorsal root avulsion results in permanent impairment of sensory functions due to disconnection between the peripheral and central nervous system. Improved strategies are therefore needed to reconnect injured sensory neurons with their spinal cord targets in order to achieve functional repair after brachial and lumbosacral plexus avulsion injuries. Here, we show that sensory functions can be restored in the adult mouse if avulsed sensory fibers are bridged with the spinal cord by human neural ...

  14. Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury.

    Science.gov (United States)

    Chu, Bin; Wang, Huan; Chen, Liang; Gu, Yudong; Hu, Shaonan

    2016-06-01

    The purpose of this study was to investigate the effectiveness of shoulder function restoration by dual nerve transfers, spinal accessory nerve to the suprascapular nerve and 2 intercostal nerves to the anterior branch of the axillary nerve, in patients with shoulder paralysis that resulted from brachial plexus avulsion injury. It was a retrospective analysis to assess the impact of a variety of factors on reanimation of shoulder functions with dual nerve transfers. A total of 19 patients were included in this study. Most of these patients sustained avulsions of C5, C6, and C7 nerve roots (16 patients). Three of them had avulsions of C5 and C6 roots only. Through a posterior approach, direct coaptation of the intercostal nerves and the anterior branch of the axillary nerve was performed, along with accessory nerve transfer to the suprascapular nerve. Satisfactory shoulder function recovery (93.83° of shoulder abduction and 54.00° of external rotation on average) was achieved after a 62-month follow-up. This dual nerve transfer procedure provided us with a reliable and effective method for shoulder function reconstruction after brachial plexus root avulsion, especially C5/C6/C7 avulsion. The level of evidence is therapeutic IV. PMID:26835823

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.)

  20. 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...

  1. 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.

  2. 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)

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

    OpenAIRE

    Hoogervorst, Paul; 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 functional result following minimally invasive pseudo-arthrosis repair of a posterior cruciate ligament avulsion fracture. There are no previous reports of similar pseudo-arthrosis repairs, and other aut...

  4. 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.

  5. Marrow MR signal abnormality associated with bilateral avulsive cortical irregularities in a gymnast

    International Nuclear Information System (INIS)

    Abnormal marrow signal and marrow enhancement have not been described in association with benign avulsive cortical irregularity. We present the case of an 11-year-old gymnast with such findings that partially resolved over time. The marrow MR abnormalities are believed to represent an extension or spectrum of findings associated with avulsive cortical irregularity, and should not instantly suggest infection or malignancy, as has been previously indicated. Careful and close clinical and radiological follow-up is required to confirm its benign course. (orig.)

  6. Splinting rationale and contemporary treatment options for luxated and avulsed permanent teeth.

    Science.gov (United States)

    Lambert, Douglas L

    2015-01-01

    The continued growth in athletic participation among children and adults has increased the potential incidence of sports-related dental injuries. Regardless of preventive measures, damage and injury to the oral cavity can occur during participation in sports. Luxations, root fractures, bony fractures, and avulsions involving 1 or more teeth are a possibility. Many of these injuries require specific protocols for splinting of the traumatized tooth or teeth to allow the best possible outcomes. This article identifies luxation and avulsion injuries, explains the rationale for splinting, reviews guidelines for splint duration, and discusses contemporary material options available to stabilize affected permanent dentition. PMID:26545276

  7. 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.

  8. 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.

  9. 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

  10. Lateral collateral ligament avulsion of the humeroradial joint in a horse

    International Nuclear Information System (INIS)

    This report describes traumatic avulsion of the lateral collateral ligament of the humeroradial joint in a horse. The history and diagnostic procedures are included with relevant radiographs and ultrasonographs. The poor prognosis associated with this injury is due to degenerative joint disease

  11. 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

  12. 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

  13. Primary School Teachers’ Knowledge Regarding Emergency Management of Avulsed Permanent Incisors in Ahvaz, Iran

    OpenAIRE

    Basir; Hashemy; Khataminia; Ghasemzadeh; Ansarifar

    2013-01-01

    Background Traumatic dental injuries can have a significant impact on the life of a child, since it causes both physiological and physical pain. Objectives The current study aimed to evaluate the primary school teachers’ knowledge about emergency management of avulsed teeth in Ahvaz, Iran. Patients and Methods The study was conducted in twenty randomly selected primary schools of A...

  14. 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.

  15. Delayed replantation of an avulsed maxillary premolar with open apex: A 24 months follow-up case report

    Directory of Open Access Journals (Sweden)

    K S Ravi

    2013-01-01

    Full Text Available Avulsion of permanent teeth is most serious of all dental injuries and accounts for 1-16% of all traumatic injuries, of which maxillary incisors are most commonly involved. However, in this report a rare case of isolated avulsed immature premolar has been described. The patient had reported more than 3 hours after the trauma with a tooth stored in dry condition and soil contamination. The prognosis depends on measures taken at the place of accident or the time immediately after avulsion. Replantation is the treatment of choice, but cannot always be performed immediately. An appropriate emergency management and treatment plan is important for good prognosis. In this report stepwise management of an avulsed immature maxillary premolar with extended period of dry storage has been described followed up for a period of 2 yrs.

  16. Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device

    OpenAIRE

    Gwinner, Clemens; Kopf, Sebastian; Hoburg, Arnd; Haas, Norbert P; Jung, Tobias M.

    2014-01-01

    Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament using the TightRope device (Arthrex, Naples, FL).

  17. Role Of Cervical Paraspinal Electromyography In Cervical Spinal Root Avulsions And Its Correlations With Intra Operative Findings

    OpenAIRE

    Arulmozhi T; Dhanaraj M; Jayavelu A

    2004-01-01

    The diagnosis of cervical spinal root avulsion in patients with brachial plexus injuries is major challenge of the present day with the available investigatory procedures. To validate the use of the paraspinal electromyography was done in20 successive patients who all had sustained injuries to their upper limb nerves following road traffic accidents. Electromyographic abnormalities indicative of root avulsion were identified. All of them underwent explorative surgery. The results of the par...

  18. 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...

  19. 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

  20. 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

  1. 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

  2. Role Of Cervical Paraspinal Electromyography In Cervical Spinal Root Avulsions And Its Correlations With Intra Operative Findings

    Directory of Open Access Journals (Sweden)

    Arulmozhi T

    2004-01-01

    Full Text Available The diagnosis of cervical spinal root avulsion in patients with brachial plexus injuries is major challenge of the present day with the available investigatory procedures. To validate the use of the paraspinal electromyography was done in20 successive patients who all had sustained injuries to their upper limb nerves following road traffic accidents. Electromyographic abnormalities indicative of root avulsion were identified. All of them underwent explorative surgery. The results of the paraspinal electromyography were correlated with the intra-operative findings. Paraspinal electromyography was abnormal in six and normal in 14. All the six patients with abnormal results had evidence of multiple spinal root avulsion. Among those with normal paraspinal electromyography, two showed single spinal root avulsion and in the remaining 12 they were intact. The sensitivity of this test was 75% specificity 100% positive predictive value 100% and negative predictive value 85%. Paraspinal electromyography is an useful test in identifying cervical root avulsions because of its high positive predictive value. However with single root avulsion the sensitivity of the test falls. Somato sensory evoked potential and magnetic resonance imaging studies may be valuable adjuncts in diagnosing such cases.

  3. 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.

  4. 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

  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. 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.)

  7. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Ryul; Song, Ji Hun; Lee, Ju Hong [Chonbuk National University, Medical School, Department of Orthopaedic Surgery, Jeonju (Korea); Lee, Sang Yong [Chonbuk National University, Medical School, Department of Diagnostic Radiology, Jeonju (Korea); Yoo, Wan Hee [Chonbuk National University, Medical School, Department of Rheumatology, Jeonju (Korea)

    2008-04-15

    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  8. Cartilaginous avulsion fracture of the tibial spine in a 5-year-old girl

    International Nuclear Information System (INIS)

    Fractures of the tibial spine usually occur in children aged 8 to 14 years. Usually, radiographs will demonstrate a tibial spine fracture, with the degree of displacement. Tibial spine fractures in younger children have not been reported in the previously published literature. We report a tibial spine fracture that occurred in 5-year-old girl. The cartilaginous avulsion fracture of the tibial spine was not revealed by radiographs because it was limited to the cartilaginous portion of the proximal tibia. (orig.)

  9. 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.

  10. 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...

  11. 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

  12. 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...

  13. 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.

  14. 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...

  15. 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...

  16. Knowledge and attitude regarding management of tooth avulsion injuries among school teachers in rural India

    OpenAIRE

    Shamarao, Supreetha; Jain, Jithesh; Ajagannanavar, Sunil Lingaraj; Haridas, Reshmi; Tikare, Shreyas; Kalappa, Amrutha Ammanichanda

    2014-01-01

    Objectives: Traumatic dento-alveolar injuries are frequent in children and adolescents, affecting teeth, their supporting structures, and adjacent soft tissues. Because school teachers are likely to be in contact with the child soon after injury, it is important to ascertain their knowledge and attitude about this. Aim: The study aimed to assess the knowledge and attitude of school teachers in Coorg with regard to immediate management of avulsed teeth. Materials and Methods: This cross-sectio...

  17. X-ray and MRI diagnostic value of avulsion fracture in intercondylar eminence of tibia

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of X-ray and MRI of avulsion fracture in tibial intercondylar eminence. Methods: X-ray and MRI images of 32 patients with avulsion fracture in tibial intercondylar eminence were retrospectively analyzed. All the cases were confirmed by arthroscopy. X-ray examinations were obtained from a standard anteroposterior and lateral views, part of them with oblique views. Axial FSE-T2WI, sagittal SE-T1WI, FSE-T2WI, STIR and coronal FSE-T2WI, GRE-STIR were examined in MRI examinations. Results: X-ray showed 28 correct diagnoses (87.5%) and 4 occult fracture misdiagnosis (12.5%), however, all the cases were correctly diagnosed with MRI (100%). In the patients which were correctly diagnosed by X-ray, MRI showed other lesions of knee joints (28/28), including 26 cases cruciate ligament trauma, 7 cases meniscus trauma, 4 cases collateral ligament trauma, 26 cases bone-contusion, and 6 cases other fracture. In the patients which were missed diagnoses in X-ray examinations, 3 cases showed cruciate ligament trauma, 1 case showed meniscus trauma, and 2 cases showed bone-contusion in MRI. Conclusion: Avulsion fracture in tibial intercondylar eminence were often associated with other knee joints lesions, which can be treated by arthroscopy directly if they were diagnosed by X-ray examinations. However, occult fractures should be examined by MRI, which can offer detailed information for clinic treatment. (authors)

  18. 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.

  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. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. Nonoperative Damage Control: The Use of Extracorporeal Membrane Oxygenation in Traumatic Bronchial Avulsion as a Bridge to Definitive Operation.

    Science.gov (United States)

    Schmoekel, Nathan H; O'Connor, James V; Scalea, Thomas M

    2016-06-01

    The conventional treatment for an avulsed bronchus is emergent thoracotomy and repair or lobectomy. The principles of damage control thoracic operations include initial hemorrhage control with delayed definite repair after physiologic resuscitation. We report a multiply injured patient with avulsion of the left lower lobe bronchus. Profound acidosis, hypercarbia, and hypoxia precluded an emergent operation, and venovenous extracorporeal membrane oxygenation (V-V ECMO) was used for organ support during physiologic resuscitation. After the achievement of physiologic repletion, a thoracotomy and lobectomy were performed while the patient was supported by V-V ECMO. PMID:27211954

  6. Arthroscopic-assisted repair of triangular fibrocartilage complex foveal avulsion in distal radioulnar joint injury

    Science.gov (United States)

    Woo, Sung Jong; Jegal, Midum; Park, Min Jong

    2016-01-01

    Background: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. Materials and Methods: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013. These patients were followed up for an average of 19 months (range 14–25 months). The avulsed TFCC were reattached to the fovea using a transosseous pull-out suture or a knotless suture anchor. At the final followup, the range of motion, grip strength and DRUJ stability were measured as objective outcomes. Subjective outcomes were assessed using the Visual Analog Scale (VAS) for pain, patient rated wrist evaluation (PRWE), Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score) and return to work. Results: Based on the DRUJ stress test, 5 patients had normal stability and 7 patients showed mild laxity as compared with the contralateral side. Postoperatively, the mean range of pronation supination increased from 141° to 166°, and the mean VAS score for pain decreased from 5.3 to 1.7 significantly. The PRWE and DASH questionnaires also showed significant functional improvement. All patients were able to return to their jobs. However, two patients complained of persistent pain. Conclusions: Arthroscopically assisted repair of TFCC foveal injury can provide significant pain relief, functional improvement and restoration of DRUJ stability. PMID:27293286

  7. Neuroprotection and immunomodulation by xenografted human mesenchymal stem cells following spinal cord ventral root avulsion.

    Science.gov (United States)

    Ribeiro, Thiago B; Duarte, Adriana S S; Longhini, Ana Leda F; Pradella, Fernando; Farias, Alessandro S; Luzo, Angela C M; Oliveira, Alexandre L R; Olalla Saad, Sara Teresinha

    2015-01-01

    The present study investigates the effects of xenotransplantation of Adipose Tissue Mesenchymal Stem Cells (AT-MSCs) in animals after ventral root avulsion. AT-MSC has similar characteristics to bone marrow mesenchymal stem cells (BM-MSCs), such as immunomodulatory properties and expression of neurotrophic factors. In this study, Lewis rats were submitted to surgery for unilateral avulsion of the lumbar ventral roots and received 5 × 10(5) AT-MSCs via the lateral funiculus. Two weeks after cell administration, the animals were sacrificed and the moto neurons, T lymphocytes and cell defense nervous system were analyzed. An increased neuronal survival and partial preservation of synaptophysin-positive nerve terminals, related to GDNF and BDNF expression of AT-MSCs, and reduction of pro-inflammatory reaction were observed. In conclusion, AT-MSCs prevent second phase neuronal injury, since they suppressed lymphocyte, astroglia and microglia effects, which finally contributed to rat motor-neuron survival and synaptic stability of the lesioned motor-neuron. Moreover, the survival of the injected AT- MSCs lasted for at least 14 days. These results indicate that neuronal survival after lesion, followed by mesenchymal stem cell (MSC) administration, might occur through cytokine release and immunomodulation, thus suggesting that AT-MSCs are promising cells for the therapy of neuronal lesions. PMID:26548646

  8. 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.

  9. 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.

  10. 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.)

  11. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-03-01

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

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

    International Nuclear Information System (INIS)

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

  14. 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.

  15. 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

    interpreted as stable ‘‘transport log jams’’ formed during floods, although some may have been ‘‘unstable jams’’ stranded on bars during peak-flow recession. Associated with the logs are extrabasinal gravel and intraclasts of mudstone and coal, which suggest that floods in sediment-choked channels undercut...... banks of gravelly sand capped by mud and forested peat, widened the channels, and toppled riparian vegetation. An estimated blockage ratio of 8% for one accumulation (ratio of the cross-sectional areas of the log jam and host channel) is close to the 10% value considered to cause substantial blockage in...... some modern rivers. In two instances, a radical change in paleoflow between pre- and post-abandonment channels is consistent with an interpretation that log jams and flood sediment buildup promoted channel-belt avulsion. Although large trees had evolved by Middle to Late Devonian times, it is unlikely...

  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. 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

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

    Science.gov (United States)

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

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

  19. 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

  20. 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.

  1. Dry Endoscopic-Assisted Mini-Open Approach With Neuromonitoring for Chronic Hamstring Avulsions and Ischial Tunnel Syndrome

    Science.gov (United States)

    Gómez-Hoyos, Juan; Reddy, Manoj; Martin, Hal D.

    2015-01-01

    Chronic hamstring origin avulsions and ischial tunnel syndrome are common causes of posterior hip pain. Although physical therapy has shown benefits in some cases, recent evidence has reported better outcomes with surgical treatment in appropriately selected patients. The full-open approach has been the classic procedure to address this problem. However, the complications related to extensive tissue exposure and the proximity of the incision to the perianal zone have led to the description of full-endoscopic techniques. Achieving an accurate hamstring repair could be technically demanding with a full-endoscopic procedure. Accurate reattachment is crucial in hamstring repair because of the functional demand of the muscles crossing of 2 major joints (hip and knee). This surgical note describes a mixed technique including a mini-open approach, neuromonitoring, and dry endoscopic-assisted repair of the hamstring origin as an alternative for treating patients with chronic hamstring avulsions and ischial tunnel syndrome that remain symptomatic despite nonoperative treatment. PMID:26258031

  2. 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

  3. 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.

  4. 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...

  5. 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.

  6. Radiographic, computed tomographic and magnetic resonance imaging evaluation of a chronic long digital extensor tendon avulsion in a dog

    International Nuclear Information System (INIS)

    Long digital extensor tendon avulsion is reported in a 5 month old Great Dane, Clinically the dog presented with a unilateral weight-bearing pelvic limb lameness, Joint effusion was present and there was pain and crepitance associated with flexion of the stifle, Orthopedic evaluation and radiographs were suggestive of a long digital extensor tendon injury which was confirmed by computed tomography and magnetic resonance imaging, The injury was surgically repaired with screw and spikedwasher fixation

  7. 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...

  8. A Complete Radial Collateral Ligament Avulsion of the Small Finger Metacarpophalangeal Joint with Displacement through the Radial Sagittal Band

    OpenAIRE

    Dennison, David G.

    2008-01-01

    A displaced complete radial collateral ligament avulsion with associated injury to the sagittal band of the metacarpophalangeal joint of the small finger, if left untreated, may result in chronic pain, instability, weakness, and deformity. A case of a displaced radial collateral ligament that ruptured through the radial sagittal band of the small finger, with resultant injury to the extensor mechanism, is described and discussed with a review of the literature. Proper identification of this i...

  9. 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...

  10. Magnetic resonance imaging of the cervical nerve root avulsion in brachial plexus injuries. New imaging technique and classification

    International Nuclear Information System (INIS)

    The Author describes a new magnetic resonance (MR) imaging technique of the cervical nerve roots in traumatic brachial plexus injury. The overlapping coronal-oblique slice MR imaging procedure of the cervical nerve root was performed in 35 patients with traumatic brachial plexus injury. The results were retrospectively evaluated and classified into four major categories (normal rootlet, rootlet partial injuries, avulsion, and meningocele), after diagnosis by surgical exploration. In this study, the sensitivity of detection of the cervical nerve root avulsion in MR imaging was the same (92.9%) as that of myelography and CT myelography. The reliability and reproducibility of the MR imaging classification was prospectively in 10 patients with traumatic brachial plexus injury, assessed by eight independent observers, and its diagnostic accuracy was compared with that of myelography and CT myelography. In this study, interobserver reliability and intraobserver reproducibility showed that there were no statistically significant difference between both modalities. This new MR imaging technique is a reliable and reproducible method for detecting nerve root avulsion, and the MR imaging information provided valiable data for helping to decide whether to proceed with exploration, nerve repair, primary reconstruction, or other imaging modalities. (author)

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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.

  16. Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

    Science.gov (United States)

    Chen, Wei; Luo, Wei; Chen, Zhiqing; Jiang, Yi

    2016-01-01

    INTRODUCTION To investigate the feasibility and clinical efficacy of using a toothed plate and hollow lag screw in the surgical treatment of posterior cruciate ligament (PCL) avulsion fractures of the tibia. METHODS A total of 21 patients were treated with open reduction and internal fixation using a toothed plate and hollow lag screw, through a posteromedial approach using an inverted L-shaped incision. The patients were allowed appropriate functional exercises, including knee flexion and extension, after removal of the plaster at postoperative weeks 3–6. The follow-up period was between six months and two years. RESULTS This was a retrospective study of patients with PCL avulsion fractures of the tibia caused by road traffic accidents (n = 9), sports-related injuries (n = 6), falls (n = 5) and machinery-related injuries (n = 1). 20 patients presented with fresh fractures and one with an old fracture. The patients (13 men, eight women) had a mean age of 41.5 (range 19–72) years. Anatomical reduction of the fracture and satisfactory fixation were achieved in all 21 patients. Bony union was achieved in all patients at 8–12 weeks after surgery. Six months after surgery, knee flexion was 121.9° ± 10.4° and extension was 0°. According to the Lysholm Knee Scoring Scale, 19 patients were rated as ‘excellent’ and two as ‘good’. CONCLUSION The use of a toothed plate and hollow lag screw could be a simple and reliable approach for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery. PMID:26831316

  17. 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...

  18. 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...

  19. 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

  20. 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

  1. 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

  2. Avulsion fractures of tibial tributary's in adolescents: Treatment with closed reduction and percutaneous screwing, using MRI to identify combined intraarticular lesions

    International Nuclear Information System (INIS)

    Avulsion fracture of the tibial tuberosity is an uncommon lesion generally seen in adolescents. Intra-articular lesions combined with a tibial tuberosity fracture reported in the literature are; 3 patellar tendon ruptures, 2 anterior cruciate ligament tears, 2 medial collateral ligament tears, 2 medial meniscus tears, one arcuate ligament tear, and one lateral meniscus tear. In our study, both cases sustained an avulsion fracture of the tibial tuberosity. Preoperative MRI in one case revealed posterior cruciate ligament rupture. Under the image intensifier, we treated both patients by closed reduction and percutaneous screwing with 2 cancellous screws. Radiographic assessment showed complete healing of the avulsion fractures in both cases. Both of our patients gained previous levels of daily and sporting activity prior to the injury, and were completely asymptomatic. Our objective in reporting this case study is to point to the fact that there is no previous reporting of the avulsion fracture of the tibial tuberosity accompanied by posterior cruciate ligament rupture in the literature and to evaluate the findings of the minimal invasive treatment method we applied to both cases. (author)

  3. 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

  4. 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.

  5. Computed tomography myelography with coronal and oblique coronal views for diagnosis of nerve root avulsion in brachial plexus injury

    International Nuclear Information System (INIS)

    We describe a new computed tomography (CT) myelography technique with coronal and oblique coronal views to demonstrate the status of the cervical nerve rootlets that are involved in brachial plexus injury. We discuss the usefulness of this technique for the diagnosis of nerve root avulsion compared with that of CT myelography with axial view. CT myelography was performed with enhancement of the cervical subarachnoid space by using a contrast medium. Subsequently, coronal and oblique coronal reconstructions were created. The results of CT myelography were evaluated and classified in the presence of pseudomeningocele, intradural ventral nerve rootlets, and intradural dorsal nerve rootlets. The diagnosis was based on the findings of extraspinal surgical exploration with or without spinal evoked potential measurements and choline acetyltransferase activity measurement in 25 patients and recovery by a natural course in 3 patients. The diagnostic accuracies of CT myelography with coronal and oblique coronal views and that with axial view were compared and correlated with the surgical findings or natural course in 57 cervical roots in 28 patients. Coronal and oblique coronal views were superior to axial views in the visualization of the rootlets and orientation of the exact level of the root. They showed 100% sensitivity, 96% specificity, and 98% diagnostic accuracy (26 true-positive findings, 27 true-negative findings, none false-positive findings, and one false-negative findings) for diagnosing root avulsion. No statistically significant difference was observed between the coronal and oblique coronal views and the axial views. The information obtained using coronal and oblique coronal slice CT myelography enabled the assessment of the rootlets of the brachial plexus and provided valuable data for deciding the appropriate treatment strategy, namely, exploration, nerve repair, or primary reconstruction. (author)

  6. 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

  7. Knowledge and attitude of 2,000 parents (urban and rural - 1,000 each) with regard to avulsed permanent incisors and their emergency management, in and around Davangere

    OpenAIRE

    Shashikiran N; Reddy VVS; Nagaveni N

    2006-01-01

    It is well recognized today that for long-term success, the management of traumatized teeth optimally should be carried out as soon as possible. Since, majority of traumatic injuries occur at home, the ultimate prognosis of an avulsed tooth may depend on knowledge of the treatment procedure, possessed by his or her parents. The purpose of this study was therefore to evaluate the parental knowledge and attitude regarding the emergency management of avulsed teeth in children (in Davangere - bot...

  8. 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

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

    International Nuclear Information System (INIS)

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

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

    LENUS (Irish Health Repository)

    Hanley, C

    2012-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  12. Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle mass

    OpenAIRE

    Daglar, Bulent; Delialioglu, Onder M.; Ceyhan, Erman; Altas, Okyar; Bayrakci, Kenan; Gunel, Ugur

    2009-01-01

    Triceps tendon ruptures are rare injuries. Coexistence of ipsilateral ulnar collateral ligament injury is even rarer. Here, we describe an unusual combination injury to elbow of a 39-year-old male construction worker consisting of triceps tendon rupture, avulsion of elbow ulnar collateral ligament and flexor pronator muscle origin ipsilaterally. A simultaneous repair and reconstruction of all damaged structures was proposed with individualized postoperative rehabilitation. Return to pre-injur...

  13. 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...

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

    Institute of Scientific and Technical Information of China (English)

    Khulood M.AL-Khater; Bassem Y.Sheikh

    2008-01-01

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2016-07-01

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

  17. 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

  18. Knowledge and attitude of 2,000 parents (urban and rural - 1,000 each with regard to avulsed permanent incisors and their emergency management, in and around Davangere

    Directory of Open Access Journals (Sweden)

    Shashikiran N

    2006-09-01

    Full Text Available It is well recognized today that for long-term success, the management of traumatized teeth optimally should be carried out as soon as possible. Since, majority of traumatic injuries occur at home, the ultimate prognosis of an avulsed tooth may depend on knowledge of the treatment procedure, possessed by his or her parents. The purpose of this study was therefore to evaluate the parental knowledge and attitude regarding the emergency management of avulsed teeth in children (in Davangere - both urban and rural, 1,000 each.

  19. 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.

  20. 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.

  1. 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.

  2. 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)

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

    Directory of Open Access Journals (Sweden)

    Abdel-Meguid Amr MS

    2009-06-01

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

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. Correlation of preoperative MRI with the long-term outcomes of dorsal root entry zone lesioning for brachial plexus avulsion pain.

    Science.gov (United States)

    Ko, Andrew L; Ozpinar, Alp; Raskin, Jeffrey S; Magill, Stephen T; Raslan, Ahmed M; Burchiel, Kim J

    2016-05-01

    OBJECT Lesioning of the dorsal root entry zone (DREZotomy) is an effective treatment for brachial plexus avulsion (BPA) pain. The role of preoperative assessment with MRI has been shown to be unreliable for determining affected levels; however, it may have a role in predicting pain outcomes. Here, DREZotomy outcomes are reviewed and preoperative MRI is examined as a possible prognostic factor. METHODS A retrospective review was performed of an institutional database of patients who had undergone brachial plexus DREZ procedures since 1995. Preoperative MRI was examined to assess damage to the DREZ or dorsal horn, as evidenced by avulsion of the DREZ or T2 hyperintensity within the spinal cord. Phone interviews were conducted to assess the long-term pain outcomes. RESULTS Between 1995 and 2012, 27 patients were found to have undergone cervical DREZ procedures for BPA. Of these, 15 had preoperative MR images of the cervical spine available for review. The outcomes were graded from 1 to 4 as poor (no significant relief), good (more than 50% pain relief), excellent (more than 75% pain relief), or pain free, respectively. Overall, DREZotomy was found to be a safe, efficacious, and durable procedure for relief of pain due to BPA. The initial success rate was 73%, which declined to 66% at a median follow-up time of 62.5 months. Damage to the DREZ or dorsal horn was significantly correlated with poorer outcomes (p = 0.02). The average outcomes in patients without MRI evidence of DREZ or dorsal horn damage was significantly higher than in patients with such damage (3.67 vs 1.75, t-test; p = 0.001). A longer duration of pain prior to operation was also a significant predictor of treatment success (p = 0.004). CONCLUSIONS Overall, the DREZotomy procedure has a 66% chance of achieving meaningful pain relief on long-term follow-up. Successful pain relief is associated with the lack of damage to the DREZ and dorsal horn on preoperative MRI. PMID:26406799

  9. 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.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Rogério de Almeida Tárcia

    2006-06-01

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

  12. 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

  13. 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.

  14. 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.

  15. Surgical treatment for ankle lateral collateral ligament injury with avulsion fracture:a report of 55 cases%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

    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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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.

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

    OpenAIRE

    Carlos Marcelo Lopes; Ana Maria Sell; Denise Fernanda de Melo; Mirian Murabayashi Hidalgo

    2003-01-01

    This study aims to compare the viability of the human mononuclear cells for 24 hours at 20ºC in different storage media for avulsed teeth: distillated water, type C pasteurized milk, whole ultra-pasteurized milk, saliva, physiologic solution, and McCoy culture cells medium. At times 0, 30min, 1h, 3h, 6h, 10h and 24h was extracted sample and analyzed for the exclusion with Trypan blue method. The pH of each storage medium was also measured. The tests indicated that all media performed better t...

  2. Neuroradiological evaluation of cervical nerve root avulsion

    International Nuclear Information System (INIS)

    Considering therapy as well as prognosis in brachial plexus injuries it is essential to discern whether there is a pre- or post-ganglionic lesion or a combination of both. Since neurological findings and electrophysiological tests may not be decisive in such cases, the diagnostic contribution of imaging modalities shall be assessed. CT myelography is shown to be significant in visualizing the traumatic root or roots. Only MRI, however, can clearly visualize concomitant lesions of the spinal cord - edema and/or intramedullary hemorrhage. Moreover extra-spinal lesions of the brachial plexus can be demonstrated with magnetic resonance imagination. CT myelography as well as MRI should be carried out for assessing on injury that has caused signs of a brachial lesion. This applies particularly to cases in which surgical therapy is considered. (authors)

  3. The avulsion fracture of tibial tubercle

    OpenAIRE

    Seyhan, Fahri; Cetinoglu, Mehmet Sait; Tozun, I. Remzi

    2004-01-01

    Tibia Tüberkülünün Avulsiyon Kırığı ender görülen bir olgu olduğu için kiliniğimize müraccat eden erkek hastanın klinik ve radyografik bulguları ve tedavisi sunularak, literatür ışığı altında tartışılmıştır.

  4. 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

  5. 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

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

    Directory of Open Access Journals (Sweden)

    Sérgio Rocha Piedade

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mônica Vicky Bahr Arias

    1997-03-01

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

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Carlos Marcelo Lopes

    2003-04-01

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

  10. 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.

  11. 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.

  12. 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.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    . Secondly the tooth precipitates growth of the alveolar procces and allows treatment to be performed at an early age (10-12 years) where the trauma incidence is at its maximum. Finally transplanted teeth can be moved orthodontically. These characteristics make implant solutions appealing in a number of...

  14. 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.

  15. 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

  16. 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.

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

    OpenAIRE

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

    2013-01-01

    In the Holocene Rhine-Meuse delta, the geography, architecture, and chronology of the channel belts and their flood basins is known in exceptional high detail. This is due to a long history of intensive geological, geomorphological, and archeological research by various universities and knowledge institutes and archaeological consultancy companies. A first reconstruction showing the build-up and palaeogeographical development of the delta in 500 year time-slices was published in 2001 by Beren...

  18. Decompression–Avulsion of the Auriculotemporal Nerve for Treatment of Migraines and Chronic Headaches

    Science.gov (United States)

    Sanniec, Kyle; Borsting, Emily; Amirlak, Bardia

    2016-01-01

    Summary: Surgical decompression of peripheral branches of the trigeminal and occipital nerves has been shown to alleviate migraine symptoms. Site II surgery involves decompression of the zygomaticotemporal branch of the trigeminal nerve by the technique developed by Guyuron. Failure of site II surgery may occur secondary to an inability to recognize a second temporal trigger: site V, the auriculotemporal nerve. A direct approach for site V has been used with no clear description in the literature. Herein, we describe a safe and efficient method for auriculotemporal nerve decompression during the Guyuron endoscopic approach. Close attention to all temporal sites is necessary to avoid potential failure of migraine decompression surgery. PMID:27200240

  19. 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.

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

    International Nuclear Information System (INIS)

    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.

  1. 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.

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

    OpenAIRE

    Ziad Harb; Arfan Malhi

    2015-01-01

    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. Treatme...

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

    Directory of Open Access Journals (Sweden)

    Ziad Harb

    2015-01-01

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

  4. [Subtotal avulsion of the lower limb after traumatic section in a 2 and a half-year-old child].

    Science.gov (United States)

    Costecalde, M; Gaubert, J; Bourse, P; Hornus, D; Fries, F; Thillaye du Boullay, C; Bardier, M

    1989-01-01

    Reimplantation after subtotal section of the right lower limb under the Scarpa triangle was been attempted and was successful. Section and contusion of the femoral artery and vein required 2 end-to-end saphenous bypass grafts. The use of the lower limb is correct, after to a follow up of 4 years. The risks, inherent to all proximal section, with important muscular masses, in a small child, are described. Functional prognosis depends on three aspects: bone, vessels, and nerves. A tibial pseudarthrosis had to be operated secondarily with significant lengthening. A partial stenosis of the graft was demonstrated arteriographically. Pes equinus, a result of paralysis, has been fitted with an orthesis. This observation is almost an experimental one: what can be the future of a reimplanted lower limb in the child. PMID:2930140

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

    OpenAIRE

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

    2014-01-01

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

  6. ASSESSING THE EFFECTIVENESS OF A SCHOOL BASED ORAL HEALTH PROMOTION AMONGST SCHOOL TEACHERS WITH REGARD TO MANAGEMENT OF TOOTH AVULSION

    OpenAIRE

    Rajesh; Abi M

    2014-01-01

    BACKGROUND: School teachers play a crucial role in managing traumatic dental injuries because they are in close proximity to children and are frequently called upon to assist any traumatic incidents. Previous studies reveal that school personnel have little knowledge about emergency management of dental injuries. This raises concerns as the loss of a permanent tooth has detrimental effect on growing children. MATERIAL AND METHODS: The present study was conducted to assess ...

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

    OpenAIRE

    Fabio Janson Angelini; Eduardo Angeli Malavolta; Caio Oliveira D'Elia; José Ricardo Pécora; Arnaldo Hernandez; Gilberto Luis Camanho

    2007-01-01

    Descreve-se neste artigo um padrão de lesão descrito na literatura apenas duas vezes, num total de quatro casos, denominado Segond reverso por apresentar achados clínicos e radiológicos exatamente opostos aos da clássica lesão de Segond. Semelhantemente aos casos previamente descritos, apresentou fratura avulsão do planalto tibial medial, na inserção do ligamento colateral medial profundo, associada a lesão do ligamento cruzado posterior. Assim como em um dos casos prévios, foi constatada les...

  8. 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.

  9. 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, ...

  10. 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...

  11. 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.

  12. 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.

  13. 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

    OpenAIRE

    Simone Requião Thá Rocha; Alexandre Moro; Ricardo César Moresca; Gilson Sydney; Fabian Fraiz; Flares Baratto Filho

    2010-01-01

    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 cuidado...

  14. Anterior fixed interim prosthesis with natural tooth crown as pontic subsequent to replantation failure

    OpenAIRE

    Sivakumar Nuvvula; Abinash Mohapatra; M Kiranmayi; Rekhalakshmi, K

    2011-01-01

    Facial trauma resulting in tooth avulsion results in problems of physical and emotional nature for the patient and a challenge for the dentist. Avulsion accounts for 0.5–16% of traumatic injuries in the permanent dentition that can occur at any age and is most common in the young permanent dentition. As an emergency procedure, it is advisable to replant a traumatically avulsed tooth, but unfortunately long-term success is rather low. After unsuccessful replantation and subsequent extraction, ...

  15. 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.

  16. 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...

  17. 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...

  18. 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...

  19. 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

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

    International Nuclear Information System (INIS)

    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. (orig.)

  1. The epiphyseal spur

    International Nuclear Information System (INIS)

    A small spur seen at the edge of an open epiphyseal line indicates the presence of an open epiphysis when this is not clear radiographically. In addition, the spur should be mistaken for an avulsion fracture. (orig.)

  2. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... great deal of hemorrhage that we can actually control with the robotic instruments. If one of the ... is avulsed, we are 3 usually able to control that with a robotic instrument and have an ...

  3. Broken or knocked out tooth

    Science.gov (United States)

    Pfenninger JL, Fowlder GC. Management of dental injuries and reimplantation of an avulsed tooth. In: Pfenninger JL, Fowlder GC, eds. Pfenninger & Fowler's Procedures for Primary Care . 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 81

  4. 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 ...

  5. 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.

  6. 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.

  7. 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...

  8. “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).

  9. APLIKASI KOMPOSIT RESIN UNTUK PENATALAKSANAAN KEGOYANGAN GIGI AKIBAT TRAUMA

    OpenAIRE

    Venita Venita

    2015-01-01

    Injuries to the teeth range from minor coronal fractures to total avulsion. If the injuries cause totl avulsion or luxation, there will be varying levels of injuries to the periodontal ligament, alveolus and microvascular supply. Management of the injured teeth ranges from inspection and treatment which includes stabilization by splinting. Usually splinting is accomplished by a segment of arch bar. Due to the ebsence of arch bar appliances, dentists often referred patients to an oral surgeon....

  10. Arthroscopic repair of "peel-off" lesion of the posterior cruciate ligament at the femoral condyle.

    Science.gov (United States)

    Rosso, Federica; Bisicchia, Salvatore; Amendola, Annunziato

    2014-02-01

    Posterior cruciate ligament (PCL) injuries are uncommon, and most occur in association with other lesions. The treatment of PCL injuries remains controversial; in addition, PCL injuries have been documented to have a propensity to heal. In the literature several different patterns of PCL injury have been described including midsubstance tears/injuries, tibial bony avulsions, femoral bony avulsions, and femoral "peel-off" injuries. A peel-off injury is a complete or incomplete soft-tissue disruption of the PCL at its femoral attachment site without associated bony avulsion. In recent years arthroscopic repair of femoral avulsion and peel-off lesions of the PCL has been reported. In most of these articles, a transosseous repair with sutures passed through 2 bone tunnels into the medial femoral condyle has been described. We present a case of a femoral PCL avulsion in a 20-year-old collegiate football player with an associated medial collateral ligament injury, and we report about a novel technique for PCL repair using 2 No. 2 FiberWire sutures and two 2.9-mm PushLock anchors (Arthrex) to secure tensioning the ligament at its footprint. PMID:24749037

  11. 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...

  12. 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

  13. 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.

  14. Anterior fixed interim prosthesis with natural tooth crown as pontic subsequent to replantation failure

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2011-01-01

    Full Text Available Facial trauma resulting in tooth avulsion results in problems of physical and emotional nature for the patient and a challenge for the dentist. Avulsion accounts for 0.5-16% of traumatic injuries in the permanent dentition that can occur at any age and is most common in the young permanent dentition. As an emergency procedure, it is advisable to replant a traumatically avulsed tooth, but unfortunately long-term success is rather low. After unsuccessful replantation and subsequent extraction, it is prudent to replace the lost tooth to avoid aesthetic, masticatory, and psychological difficulties and also to prevent arch length discrepancy with various alternatives are available for the same. We presented a method for management of one of the two replanted teeth that showed failure, using the natural crown as pontic in a fixed semi-permanent bridge until a more definitive prosthesis can be fabricated at a later age for better patient compliance.

  15. 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.

  16. 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 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....

  17. 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...

  18. Radiologic imaging and percutaneous interventions for complications following ureteroscopic stone removal

    International Nuclear Information System (INIS)

    Transurethral rigid ureteroscopy is rapidly becoming an accepted modality for the removal of ureteral stones. Complications such as edema, stricture, perforation, and avulsion of the ureter occur in 1%-8% of cases. The authors have encountered 13 patients who experienced complications, eight with proximal and five with distal ureteral injuries. Four avulsions required surgical repair. Five patients with edema and perforation were treated by percutaneous nephrostomy alone. Four patients with strictures underwent antegrade ureteral stenting, one of them after percutaneous balloon dilation of the stricture. Radiologic recognition and treatment of ureteral injuries incurred during ureteroscopy contribute greatly to the management of these iatrogenic injuries

  19. 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

  20. 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.

  1. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?

    International Nuclear Information System (INIS)

    (1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity. In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury. (orig.)

  2. Comparison of CT and MRI in patients with tibial plateau fracture: can CT findings predict ligament tear or meniscal injury?

    Energy Technology Data Exchange (ETDEWEB)

    Mui, Leonora W.; Engelsohn, Eliyahu; Umans, Hilary [Jacobi Medical Center, Albert Einstein College of Medicine, Department of Radiology, Bronx, NY (United States)

    2007-02-15

    (1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly greater in patients with meniscal injury compared with those without meniscal injury, ROC analysis demonstrated no clear threshold for gap or depression that yielded a combination of high sensitivity and specificity. In the acute setting, CT offers high sensitivity and specificity for depicting osseous avulsions, as well as high negative predictive value for excluding ligament injury. However, MRI remains necessary for the preoperative detection of meniscal injury. (orig.)

  3. 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

  4. 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.

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

    International Nuclear Information System (INIS)

    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

  6. 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.)

  7. Evaluation of brachial plexus injury by CT myelography

    International Nuclear Information System (INIS)

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

  8. 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

  9. 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.

  10. 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

  11. [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

  12. 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)

  13. 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)

  14. 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...

  15. 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.)

  16. APLIKASI KOMPOSIT RESIN UNTUK PENATALAKSANAAN KEGOYANGAN GIGI AKIBAT TRAUMA

    Directory of Open Access Journals (Sweden)

    Venita Venita

    2015-08-01

    Full Text Available Injuries to the teeth range from minor coronal fractures to total avulsion. If the injuries cause totl avulsion or luxation, there will be varying levels of injuries to the periodontal ligament, alveolus and microvascular supply. Management of the injured teeth ranges from inspection and treatment which includes stabilization by splinting. Usually splinting is accomplished by a segment of arch bar. Due to the ebsence of arch bar appliances, dentists often referred patients to an oral surgeon. It would cost extra time, for an immediate action to help the patients. This paper is a case report of a traumatized tooth which has been successfully stabilized with acid etched wire-composite. The use of composite resin is considered as a quick and an easy solution for dental trauma therapy.

  17. 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...

  18. Pediatric ACL injuries: evaluation and management

    OpenAIRE

    Mall, Nathan A.; Paletta, George A.

    2013-01-01

    The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness l...

  19. 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 ...

  20. CT appearance of intercostal nerve neurotisation

    OpenAIRE

    Gadahadh, R; Rachapalli, V; Roberts, D. E.

    2012-01-01

    A nerve transfer or neurotisation procedure is performed to repair damaged nerves, in particular those of the brachial plexus following an avulsion injury. An intercostal to phrenic nerve transfer to re-innervate the diaphragm in patients with high cervical spine injury has also been reported in the literature. We present the imaging finding in a 65-year-old female who had an intercostal nerve transfer for a damaged phrenic nerve following a resection for a non-small cell lung carcinoma.

  1. 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.

  2. 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 ...

  3. Retrospective evaluation of tooth injuries and associated factors at a hospital emergency ward

    OpenAIRE

    Ferreira, Meire Coelho; Batista, Anne Margareth; Marques, Leandro Silva; Ferreira, Fernanda de Oliveira; Medeiros-Filho, João Batista; Ramos-Jorge, Maria Letícia

    2015-01-01

    Background The aim of study was to determine the occurrence of tooth injuries and associated factors among patients treated at a hospital emergency ward. Methods A cross-sectional study was conducted involving the analysis of 790 patient charts. The independent variables were gender, place of residence and type of accident. The dependent variable was tooth injury (fractures, concussion, luxation and avulsion). Statistical analysis involved the chi-square test, Poisson analysis and logistic re...

  4. 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

  5. Awareness of emergency management of dental trauma

    OpenAIRE

    2014-01-01

    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 divide...

  6. 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...

  7. 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...

  8. 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.

  9. 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...

  10. 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...

  11. 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

    , the composition and structure of megafloral assemblages remains unchanged through thin stratigraphic intervals, indicating short-term persistence and resilience of communities. Non-metric multi-dimensional scaling exposes habitat partitioning between different plant groups, which were organized along...... 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. The...

  12. 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.

  13. EndoVascular Laser Therapy (EVLT) of Varicose Veins

    OpenAIRE

    S. Akhlaghpour; M.R. Zafar Ghandi; Ebrahimi, M.; Alinaghizadeh

    2005-01-01

    Introduction & Background: Tens of millions of people – up to 40% of women and 25% of men – suffer from lower limb varicose veins. Several risk factors are also identified including genetics, gender, age, obesity, hor-mones, pregnancy, and occupation. Sclerotheraphy is commonly used to treat small varicose veins. Medium-sized and large varicose veins can be removed by a surgical procedure called Stab avulsion or phlebectomy. EVLT is a new alternative surgical method for varicose veins. Pa...

  14. 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...

  15. 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...

  16. 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.)

  17. Frog Appliance- An Innovative Treatment Option for the Replacement of Missing Teeth in An Epileptic Child

    OpenAIRE

    Raghavendra M Shetty; Goyal, Anita; Reddy, Hanumanth; Sajjnar, Arun B; Jain, Sonal

    2015-01-01

    Epilepsy is a chronic neurological disease which may result in various oro-facial injuries among which fracture of crown and avulsion of tooth are commonly reported. Challenges come in growing epileptic children where fixed prosthesis could not be delivered and it demands a fixed semi-permanent prosthesis that needs strength along with esthetics. The present paper reports an innovative appliance which has fulfilled fore mentioned criteria; with the appliance named-frog appliance.

  18. Management of dentoalveolar injuries in children: A case report

    OpenAIRE

    Das U; Viswanath D; Subramanian V.; Agarwal M

    2007-01-01

    Children aged 6-15 years old experience more injuries to their teeth and the injuries sustained are more serious as evidenced by a higher percentage of luxations, avulsions, fractures and dislocations. The mandible is the most frequently fractured facial bone and mandibular alveolar injuries have been reported to range between 8.1-50.6%. Those with mandibular or midface fractures have a higher incidence of associated chest, extremity, abdomen and cervical spine injuries. The growing pa...

  19. Knowledge on dental trauma and orthodontic tooth movement held by a group of orthodontists

    OpenAIRE

    Pedro Marcelo Tondelli; Marcos Rogério de Mendonça; Osmar Aparecido Cuoghi; Alex Luiz Pozzobon Pereira; Mauro Carlos Agner Busato

    2010-01-01

    The objective of this work was to assess the knowledge about orthodontic tooth movement and dental trauma held by a group of orthodontists in specific areas of Brazil. For this purpose, 166 questionnaires with 15 objective questions about this subject were distributed. One hundred and five questionnaires were properly filled and collected after 30 days. It was concluded that, except for avulsion, the knowledge on dental injuries held by the professionals interviewed was considered unsatisfact...

  20. Knowledge, attitude and practice in emergency management of dental injury among physical education teachers: A survey in Bangalore urban schools

    OpenAIRE

    Mohandas U; Chandan G

    2009-01-01

    The purpose of this study was to assess, by means of a self administered structured questionnaire, the level of Knowledge, Attitude and Practice of physical education teachers in Bangalore city with regards to emergency management of dental injuries. The questionnaire surveyed the physical education teacher′s background, knowledge of management of tooth fracture, avulsion, luxation injuries, it also investigated physical education teacher′s attitude and the way they handle the i...

  1. 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...

  2. 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.)

  3. Traumatic Tricuspid Regurgitation Following Cardiac Massage

    OpenAIRE

    Na, Sungwon; Nam, Sang Beom; Lee, Yong Kyung; Oh, Young Jun; Kwak, Young-Lan

    2007-01-01

    We report a 66-yr-old male patient who developed tricuspid regurgitation secondary to internal cardiac massage. After uneventful off-pump coronary artery bypass surgery, the subject experienced cardiac arrest in the intensive care unit. External cardiac massage was initiated and internal cardiac massage was performed eventually. A transesophageal echocardiography revealed avulsion of the anterior papillary muscle and chordae to the anterior leaflet after successful cardiopulmonary resuscitati...

  4. A Reappraisal of the Ascending Systems in Man, with Emphasis on the Medial Lemniscus

    OpenAIRE

    Marani, E; Schoen, J.H.R.

    2005-01-01

    This volume of "Advances in Anatomy, Embryology and Cell Biology" is based on material assembled by Dr. Jaap H.R. Schoen who was one of the few neuroanatomists to apply the Nauta method to human material. Gaining insight in the consequences of longitudinal damage to the human spinal cord is necessary before reimplantation of the avulsed rootlets or an autologous transplant can be performed in man.

  5. 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

  6. Oral health: treatment of dental trauma and pain.

    Science.gov (United States)

    Martonffy, Andrea Ildiko

    2015-01-01

    Dental trauma is common among adults and children. As children become mobile, they frequently experience trauma to their primary teeth because of falls. Injuries to permanent teeth are common results of falls, motor vehicle accidents, sports injuries, and violence. Trauma can affect the tooth enamel, dentin, pulp, root, periodontal ligament, gum, or alveolar bone. Avulsions are characterized by complete displacement of the tooth from the socket. Avulsed primary teeth should not be replanted because replantation is associated with a risk of damage to the developing permanent tooth. Avulsed permanent teeth are considered a dental emergency and should be replanted by the first individual capable of doing so. If immediate replantation is not possible, the tooth should be stored in cold animal or human milk; it also can be stored in the mouth, adjacent to the buccal mucosa, if the patient is capable of doing so. Water should be avoided as a storage medium because it impedes healing of the periodontal ligament, but storage in water is superior to dry storage. Intruded teeth (ie, pushed into the jaw) may need immediate extraction, depending on their orientation. All patients with dental trauma should follow up promptly with a dentist. Patients presenting with chronic dental pain without an obvious treatable etiology will benefit from ongoing support from their family physicians. PMID:25594450

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. Multi-slice CT and MRI findings of the Listranc's ligament injuries

    International Nuclear Information System (INIS)

    Objective: To explore the multislice CT and MRI features of the Lisfranc's ligament injuries. Methods: In 23 cases of the tarsometatarsal joins injuries, 16 are men and 7 are women. The average age is 37 years(range 17-67 years). Ten cases are induced by the direct force and 13 cases are caused by the indirect force. All of the 23 cases were examined by the Siemens 64-slice CT scan, and then reformatted the tarsometatarsal joins with the MPR, CPR, SSD and VR. Ten of 23 cases were examined by oblique axial, sagittal and coronal view of the Siemens 1.5 T MRI. Results: On CT, the distance between the second metatarsus base and the medial cuneiform showed increase in 14 cases and the distance between the base of the second metatarsus and the first metatarsus was over 2 mm. In addition, the inside base of the second metatarsus and the lateral edge of the first cuneiform bone revealed fractures in 5 cases, respectively. The above CT characteristics may suggest the injuries of Lisfranc's ligament. Ten of the 14 cases were examined by MRI. The Lisfranc ligament was found to have injuries in these cases. The injuries were divided into 3 types: type I (Lisfranc ligament breaks) was 5 cases; type II (Lisfranc ligament shape is complete, but accompanied with avulsion fracture of the second metatarsal bone basis interior margin of attachment point of Lisfranc ligament) was 4 cases; and type III (Lisfranc ligament shape is complete, but accompanied with avulsion fracture of exterior margin of the inside cuneiform of attachment point of Lisfranc ligament) was 1 case. Conclusion: CT can demonstrate local soft tissue swelling, suggesting the Lisfranc ligament damage, and demonstrate clearly avulsion fracture of attachment point of Lisfranc ligament, but MRI can appraise accurately the Lisfranc ligament injuries. (authors)

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

    Science.gov (United States)

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

    2015-12-01

    Since tectonic subsidence in sedimentary basins provides the potential for long-term facies preservation into the sedimentary record, analysis of geomorphic elements in modern continental sedimentary basins is required to understand facies relationships in sedimentary rocks. We use a database of over 700 modern sedimentary basins to characterize the fluvial geomorphology of sedimentary basins. Geomorphic elements were delineated in 10 representative sedimentary basins, focusing primarily on fluvial environments. Elements identified include distributive fluvial systems (DFS), tributive fluvial systems that occur between large DFS or in an axial position in the basin, lacustrine/playa, and eolian environments. The DFS elements include large DFS (> 30 km in length), small DFS (discharge through climatic variability or tectonic processes. We demonstrate that rivers on DFS commonly decrease in width down-DFS caused by infiltration, bifurcation, and evaporation. In proximal areas, channel sands are amalgamated through repeated avulsion, reoccupation of previous channel belts, and limited accumulation space. When rivers flood on the medial to distal portions of a DFS, the floodwaters spread across a large area on the DFS surface and typically do not re-enter the main channel. In these distal areas, rivers on DFS commonly avulse, leaving a discrete sand body and providing high preservation potential for floodplain deposits. Additional work is needed to evaluate the geomorphic character of modern sedimentary basins in order to construct improved facies models for the continental sedimentary rock record. Specifically, models for avulsion, bifurcation, infiltration, and geomorphic form on DFS are required to better define and subsequently predict facies geometries. Studies of fluvial systems in sedimentary basins are also important for evaluating flood patterns and groundwater distributions for populations in these regions.

  19. Comparative analysis of MR myelography and conventional myelography in diagnosing traumatic brachial plexus lesions

    International Nuclear Information System (INIS)

    Nerve root avulsion is the most serious type of traumatic brachial plexus injury. The main radiological sign of this lesion is traumatic meningocele. Until recently the imaging method of choice in these cases was X-ray myelography, which in some patients was supplemented by computed tomography myelography (CT myelography). Recently, non-invasive magnetic resonance myelography (MR myelography) has an increasing significance. The aim of the study was to assess the value of MR myelography in diagnosing nerve root avulsions in patients with traumatic brachial plexus injuries by comparing it with X-ray myelography and to establish if MR myelography could replace X-ray myelography. Material consisted of 30 patients with traumatic brachial plexus injury, in whom MR myelography and X-ray myelography (in 4 cases also CT myelography) were performed. In 16 patients MR myelography was performed using open low-field MR unit (FSE 2D sequence) and in the remaining 14 patients middle-field closed MR unit was used (PSIF 3D sequence). MR myelography revealed traumatic meningoceles in 18 patients, while in 12 patients it showed normal appearance. MR myelography was compatible with X-ray myelography in 25 cases (83.3%). Among the not compatible or partially compatible results of the studies mentioned above, 4 patients were operated on. In 3 of them surgery confirmed the result of MR myelography and in 1 - of X-ray myelography. Among all 20 patients who were operated on, MR myelography was confirmed by surgery in 18 cases (90%), while X-ray myelography - in 17 patients (85%). MR myelography is not inferior and in some cases even superior to conventional invasive X-ray myelography in diagnosing nerve root avulsion injuries, therefore it could replace it in most cases. X-ray myelography and CT myelography remain the methods of choice in patients with contraindications to MR study. (author)

  20. 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.

  1. Diversion of water flow from a floodplain wetland stream: an analysis of geomorphological setting and hydrological and ecological consequences.

    Science.gov (United States)

    Ellery, W N; Dahlberg, A C; Strydom, R; Neal, M J; Jackson, J

    2003-05-01

    Diversion of water has been ongoing in the Mkuze Wetland for several decades. Two canals form the focus of this study; the Mpempe-Demazane Canal and the Tshanetshe Canal. The former involved an ambitious excavation over a distance of 13.5 km in the lower part of the wetland, while the latter was a minor excavation over a distance of approximately 100 m in the upper part of the wetland. Although ambitious and costly, the Mpempe-Demazane Canal resulted in little downward or headward erosion, and there was minor diversion of flow. However, the minor excavation of the Tshanetshe Canal resulted in erosion downstream of the excavation (the Tshanetshe Stream), downward and lateral erosion of the excavated section, and headward erosion that has propagated almost 4 km upstream along the Mkuze River. Most of the flow of the Mkuze River has been captured by the Tshanetshe Canal and Stream. The impact of canalisation on floodplain wetlands is thus more dependent on the location than the scale of activity. The avulsion of the Mkuze River into the Tshanetshe Canal and Stream is due to a large difference in elevation between the Mkuze River and floodplain into which it was diverted, and the fact that in this region the river typically has high discharges. This avulsion may have been inevitable as a result of natural processes of sedimentation. In contrast, the difference in elevation between the Mkuze River and the basin into which it was diverted via the Mpempe Canal was small as is discharge of the Mkuze River in this part of the wetland. Thus, the diversion was unsuccessful. The presence of hippos that create hydraulically efficient pathways that are oriented parallel to the regional hydraulic slope, may accelerate avulsion in large African wetlands. Overall, it is argued that the environmental consequences of excavation need to be viewed against the background that wetlands are dynamic features within the landscape. PMID:12767862

  2. 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.

  3. 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.)

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

    Science.gov (United States)

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

    2006-02-01

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

  5. [Neurorehabilitation for Neuropathic Pain].

    Science.gov (United States)

    Hozumi, Jun; Osumi, Michihiro; Ogata, Toru; Sumitani, Masahiko

    2015-07-01

    Deafferentation, like as in limb amputation, brachial plexus avulsion injury and spinal cord injury, is usually followed by neuropathic pain. Neuropathic pain is a debilitating condition and it impairs the quality of life profoundly. Based on recent advances in the cognitive neuroscience, we explain intimate relationships among neuropathic pain, reorganization of primary sensory and motor cortices and the sensorimotor integration of the deafferentated limb. From the standpoint of the sensorimotor integration theory for emerging phantom limb pain, we further discuss the analgesic mechanism of neurorehabilitation techniques such as mirror visual feedback treatment and its related neurorobotics advancement for neuropathic pain. PMID:26422941

  6. 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...

  7. 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.)

  8. Eş zamanlı bilateral tuberositas tibia avulsiyonu: Nadir bir kırık

    OpenAIRE

    Hasan Metineren; Ali Güleç; Serdar Toker; Mustafa Yel; Burkay Kaçıra

    2013-01-01

    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 fract...

  9. [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

  10. Management of Otic and Nasopharyngeal, and Nasal Polyps in Cats and Dogs.

    Science.gov (United States)

    Greci, Valentina; Mortellaro, Carlo Maria

    2016-07-01

    Feline inflammatory polyps are the most common nonneoplastic lesion of ear and nasopharynx in cats. Minimally invasive techniques for polyp removal, such as traction avulsion combined with curettage of the tympanic cavity and per-endoscopic transtympanic traction, have been successful for long-term resolution. Feline nasal hamartomas are benign lesions of the nasopharynx, and most have a good prognosis after surgical removal. Canine aural and nasopharyngeal inflammatory polyps are rare and have a similar clinical presentation as cats with these lesions. In dogs, it is important to achieve an accurate histologic diagnosis of these masses before appropriate surgical treatment can be planned. PMID:26947114

  11. 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

  12. The triceps preserving approach to total elbow arthroplasty.

    Science.gov (United States)

    Pierce, T D; Herndon, J H

    1998-09-01

    Elbow arthroplasty most commonly is performed through a posterior approach by detaching or reflecting the triceps off the olecranon. Surgical approaches to the elbow joint that dissociate the triceps from the olecranon have distinct disadvantages. Triceps avulsion, triceps weakness, and wound healing problems have been reported. Such complications necessitate more surgery and predispose the joint to an infection. To avoid these complications a modified posterior approach to the elbow joint that preserves the triceps muscle insertion on the olecranon was used in 10 consecutive elbow arthroplasties. This method provides adequate exposure, allows early rehabilitation, and avoids triceps weakness. PMID:9755773

  13. 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

  14. Patterns of Hamstring Muscle Tears in the General Population: A Systematic Review

    Science.gov (United States)

    Kuske, Barbara; Hamilton, David F.; Pattle, Sam B.; Simpson, A. Hamish R. W.

    2016-01-01

    Background Hamstring tears are well recognised in the sporting population. Little is known about these injuries in the general population. Purpose Evaluating the rates, patterns and risk factors of non-sporting hamstring tears, compared to sporting related hamstring tears. Data Sources MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (1989–2015). Study Selection Studies reporting patients with a grade 2 or 3 hamstring muscle tear, identified clinically, confirmed by MRI imaging or direct visualisation during surgical exploration. Data Synthesis 144 sets of linked data were extracted for analysis. Most injuries were in males (81.3%), where mean age at injury was lower (30.2, 95% CI 29.1–31.3) than in females (35.4, 95% CI 32.4–38.4) p = 0.06. Key differences were found in the proportion of non-sporting injuries in patients under and over the age 40 (p = 0.001). The proportion of non-sporting injuries was significantly higher in females compared to males (25.9% female non-sporting injuries, versus 8.5% male; p = 0.02). Avulsions were more frequently reported in non-sporting activities (70.5%). The proportion of such injuries was notably higher in females, though this failed to meet significance (p = 0.124). Grouped by age category a bimodal distribution was noted, with the proportion of avulsions greater in younger (age 40) (p = 0.008). 86.8% of patients returned to pre-injury activity levels with a similar frequency across all study variables; age, activity (sporting vs non-sporting) and injury type (avulsion vs tear). Conclusion This review highlights a proportion of adults suffering grade 2 or 3 hamstring injuries from activities other than the classic sports trauma. The majority of these non-sporting injuries were avulsion injuries that clustered in older female and skeletally immature patients suggesting a potential link to bone mineral density. PMID:27144648

  15. 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.)

  16. Alar ligaments: radiological aspects in the diagnosis of patients with whiplash injuries

    International Nuclear Information System (INIS)

    Post-traumatic changes of the alar ligaments have been proposed to be the cause of chronic pain in patients after whiplash injury of the cervical spine. In addition to an asymmetric dens position, widening of the atlantodental distance to more than 12 mm can be an indirect sign of an alar ligament rupture. CT is recommended for detection of a avulsion fracture of the occipital condyle. Isolated ruptures of the alar ligaments are best visualized on MRI. In patients with chronic impairments after whiplash injuries changes of the alar ligaments on MRI must be differentiated from normal variants in healthy individuals. (orig.)

  17. Complications of sodium hydroxide chemical matrixectomy: nail dystrophy, allodynia, hyperalgesia.

    Science.gov (United States)

    Bostancı, Seher; Koçyiğit, Pelin; Güngör, Hilayda Karakök; Parlak, Nehir

    2014-11-01

    Ingrown toenails are seen most commonly in young adults, and they can seriously affect daily life. Partial nail avulsion with chemical matrixectomy, generally by using either sodium hydroxide or phenol, is one of the most effective treatment methods. Known complications of phenol matrixectomy are unpredictable tissue damage, prolonged postoperative drainage, increased secondary infection rates, periostitis, and poor cosmetic results. To our knowledge, there have been no reports about the complications related to sodium hydroxide matrixectomy. Herein, we describe three patients who developed nail dystrophy, allodynia, and hyperalgesia after sodium hydroxide matrixectomy. PMID:25514278

  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. 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

  20. 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

  1. Radiographic clues to fractures of the unossified medial humeral condyle in young children

    International Nuclear Information System (INIS)

    A fracture involving the trochlear ossification center as well as the medial epicondyle is a more serious injury than simple avulsion of the medial epicondyle. This diagnosis may be difficult in young children before the secondary centers are ossified. Radiographic clues to this injury in a young child are localized soft tissue swelling over the medial aspect of th elbow accompanied by a metaphyseal flake and/or a positive fat pad sign. In the older child, separation of the ossified medial epicondyle with a positive fat pad sign suggests a more complex injury. (orig.)

  2. 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.)

  3. 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.)

  4. Knowledge on dental trauma and orthodontic tooth movement held by a group of orthodontists

    Directory of Open Access Journals (Sweden)

    Pedro Marcelo Tondelli

    2010-03-01

    Full Text Available The objective of this work was to assess the knowledge about orthodontic tooth movement and dental trauma held by a group of orthodontists in specific areas of Brazil. For this purpose, 166 questionnaires with 15 objective questions about this subject were distributed. One hundred and five questionnaires were properly filled and collected after 30 days. It was concluded that, except for avulsion, the knowledge on dental injuries held by the professionals interviewed was considered unsatisfactory, and about 40% of them were not acquainted with the recommendations for the orthodontic movement of traumatized teeth.

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Traumatic cervical root injury: Diagnostic value of MR imaging

    International Nuclear Information System (INIS)

    Although superior soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelography has been the imaging modality of choice in evaluation cervical root injury. We assessed the role of MRI and compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR imagings of cervical root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patients). MR findings were compared with myelography and surgical results. In 29 roots (8 patients), which were confirmed by myelography or exploration, the MR findings were focal extradural CSF collections (pseudomeningocele) in 21/29 (72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickening of dura in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to T1-weighted and protein-density- weighted images for delineation root avulsion. The sensitivity and specificity of MRI were 72.7% and 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of MRI and myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the modality of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensitivity. MRI, however, may obviate the myelography with some technical refinements

  11. COMPLETE LEFT MAIN BRONCHUS DISRUPTION DUE TO BLUNT CHEST TRAUMA

    Directory of Open Access Journals (Sweden)

    Mohammed Nasser Aldahmashi

    2014-12-01

    Full Text Available Isolated tracheobronchial disruption is an uncommon injury usually associated with severe blunt thoracic trauma. We report a 14 year-old female case with avulsion of the left main bronchus occurring after blunt chest trauma due to a down fallen wall. A successful surgical repair of the totally avulsed left main bronchus was carried out. The postoperative course was uneventful with improvement in the respiratory status. The patient regained wellness within days in the intensive care unit, and the diagnosis of traumatic rupture of the left main bronchus was approved by bonchoscopy and the computerized tomography (CT scan of the chest. Surgical repair of the disrupted left main bronchus was accomplished 10 days from the admission and the bronchoscopic evaluation of the anastomosis and patency was achieved. The patient was discharged with her lung fully expanded on chest X-ray. The diagnosis and preoperative management of this uncommon post traumatic condition is discussed. We conclude that, in a patient with sustained severe blunt thoracic trauma, a high index of suspicion for trachea-bronchial disruptions must be maintained to detect these rare lesions. Skilful and early surgical treatment is required for proper management of such cases.

  12. 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)

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

    Directory of Open Access Journals (Sweden)

    Cristina Braga Xavier

    2015-01-01

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

  14. 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

  15. 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

  16. 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.

  17. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    Science.gov (United States)

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months. PMID:1831010

  18. 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

  19. 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.)

  20. 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.

  1. 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.)

  2. Twin Valve Caval Stent for Functional Replacement of Incompetent Tricuspid Valve: A Feasibility Animal Study

    International Nuclear Information System (INIS)

    Objective: To evaluate feasibility of a twin valve caval stent (TVCS) for functional replacement of an incompetent tricuspid valve (TV) in an acute animal study. Methods: One swine and three sheep were used in the study. TVCS placement was tested in a swine with a normal TV. TVCS function was tested in three sheep with TV regurgitation created by papillary muscle avulsion. Cardiac angiograms and pressure measurements were used to evaluate TVCS function. Two sheep were studied after fluid overload. Results: TVCS was percutaneously placed properly at the central portions of the superior vena cava (SVC) and inferior vena cava (IVC) in the swine. Papillary muscle avulsion in three sheep caused significant tricuspid regurgitation with massive reflux into the right atrium (RA) and partial reflux into the SVC and IVC. TVCS placement eliminated reflux into the SVC and IVC. After fluid overload, there was enlargement of the right ventricle and RA and significant increase in right ventricle, RA, SVC, and IVC pressures, but no reflux into the IVC and SVC. Conclusion: The results of this feasibility study justify detailed evaluation of TVCS insertion for functional chronic replacement of incompetent TV.

  3. 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.

  4. Channel Extension in Deep-Water Distributive Systems

    Science.gov (United States)

    Hoyal, D. C.; Sheets, B. A.

    2007-12-01

    The cyclic nature of channel and lobe formation in submarine fans is the result of the unstable and ephemeral nature of newly formed distributary channels. Avulsion cycles are initiated as unconfined sheet flow immediately following avulsion followed by stages of channel incision and extension, deposition of channel mouth deposits, and often channel backfilling. In contrast with those in alluvial and deltaic environments, avulsion cycles in submarine fans are relatively poorly understood due to the difficulty of observing deep ocean processes, either over short timescales needed to measure the hydrodynamics of active turbidity currents, or over longer timescales needed for the morphodynamic evolution of individual distributary channels and avulsion events. Here we report the results of over 80 experiments in a 5m x 3m x1m deep tank using saline (NaCl) density flows carrying low-density plastic sediment (SG 1.5) flowing down an inclined ramp. These experiments were designed to investigate trends observed in earlier self-organized experimental submarine fans with well-developed avulsion cycles, in which distributive lobes were observed to form on relatively high slopes. In particular, we were interested in investigating the relationship between channel extension length (distance from the inlet to the point where the flow becomes de-channelized, transitioning into a mouth-bar/lobe) and slope. The results of the experiments are clear but counter-intuitive. Channels appear to extend in discrete segments and channel extension length is inversely related to slope over a wide range of slopes (5-17 degrees). In addition, channel extension seems largely independent of inlet flow density (salt concentration) over the experimental range (10-24 g/cc). Measurements of densimetric Froude number (Fr') indicate Fr' increases downstream to near critical conditions at the channel lobe transition. Our preliminary interpretation is that distributary channels become unstable due to

  5. 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.

  6. 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

  7. 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

  8. Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury

    International Nuclear Information System (INIS)

    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

  9. 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

  10. 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

  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. Differential expression of the capsaicin receptor TRPV1 and related novel receptors TRPV3, TRPV4 and TRPM8 in normal human tissues and changes in traumatic and diabetic neuropathy

    Directory of Open Access Journals (Sweden)

    Bountra Chas

    2007-05-01

    Full Text Available Abstract Background Transient receptor potential (TRP receptors expressed by primary sensory neurons mediate thermosensitivity, and may play a role in sensory pathophysiology. We previously reported that human dorsal root ganglion (DRG sensory neurons co-expressed TRPV1 and TRPV3, and that these were increased in injured human DRG. Related receptors TRPV4, activated by warmth and eicosanoids, and TRPM8, activated by cool and menthol, have been characterised in pre-clinical models. However, the role of TRPs in common clinical sensory neuropathies needs to be established. Methods We have studied TRPV1, TRPV3, TRPV4, and TRPM8 in nerves (n = 14 and skin from patients with nerve injury, avulsed dorsal root ganglia (DRG (n = 11, injured spinal nerve roots (n = 9, diabetic neuropathy skin (n = 8, non-diabetic neuropathic nerve biopsies (n = 6, their respective control tissues, and human post mortem spinal cord, using immunohistological methods. Results TRPV1 and TRPV3 were significantly increased in injured brachial plexus nerves, and TRPV1 in hypersensitive skin after nerve repair, whilst TRPV4 was unchanged. TRPM8 was detected in a few medium diameter DRG neurons, and was unchanged in DRG after avulsion injury, but was reduced in axons and myelin in injured nerves. In diabetic neuropathy skin, TRPV1 expressing sub- and intra-epidermal fibres were decreased, as was expression in surviving fibres. TRPV1 was also decreased in non-diabetic neuropathic nerves. Immunoreactivity for TRPV3 was detected in basal keratinocytes, with a significant decrease of TRPV3 in diabetic skin. TRPV1-immunoreactive nerves were present in injured dorsal spinal roots and dorsal horn of control spinal cord, but not in ventral roots, while TRPV3 and TRPV4 were detected in spinal cord motor neurons. Conclusion The accumulation of TRPV1 and TRPV3 in peripheral nerves after injury, in spared axons, matches our previously reported changes in avulsed DRG. Reduction of TRPV1 levels

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

    International Nuclear Information System (INIS)

    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.)

  14. Tratamento cirúrgico de ferimentos descolantes nos membros inferiores: proposta de protocolo de atendimento Degloving injuries of lower extremity: proposal of a treatment protocol

    Directory of Open Access Journals (Sweden)

    Dimas André Milcheski

    2010-06-01

    Full Text Available OBJETIVO: Apresentação e avaliação de protocolo para atendimento de pacientes com ferimentos descolantes dos membros inferiores através da retirada de enxerto de pele do tecido avulsionado e cobertura do leito cruento na fase aguda do trauma. MÉTODOS: Este estudo avaliou retrospectivamente os pacientes com ferimentos descolantes em membros inferiores, em que o tratamento realizado baseou-se em protocolo de atendimento para ferimentos descolantes utilizado em nosso serviço,com pacientes atendidos na Unidade de Emergência. RESULTADOS: Foram avaliados 21 pacientes. A etiologia do trauma foi atropelamento em 11 pacientes (52,4% e acidente de motocicleta em 10 (47,6%. Os pacientes foram tratados conforme o protocolo apresentado a seguir: Os pacientes são inicialmente separados em instáveis e estáveis, conforme a condição hemodinâmica. Nos pacientes considerados instáveis (dois pacientes nesta casuística realiza-se a retirada da pele e acondicionamento em banco de tecidos para enxertia posterior. Nospacientes considerados estáveis (19 pacientes avalia-se a viabilidade do retalho através de parâmetros clínicos e do uso da fluoresceína. Se considerado viável, faz-se a sutura do retalho à posição original, e, se considerado inviável (todos os 19 pacientes, faz-se a ressecção e emagrecimento do tecido e realiza-se a enxertia da pele em malha com aplicação de curativo a vácuo sobre o enxerto. CONCLUSÃO: Os ferimentos descolantes devem ter seu atendimento padronizado a fim de se obter melhores resultados no tratamento e prevenir necrose da porção desenluvada e assim evitar nova área doadora para enxerto de pele.OBJECTIVE: Degloving injuries on the lowerextremities are often serious injuries. It is difficult to decide on the most appropriate treatment, whether flap repositioning and suturing or converting the avulsed flap tosplit-thickness skingrafting. METHODS: This study assessed patients with degloving injuries in lower

  15. 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.)

  16. 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.)

  17. Eyelid Reconstruction: Everything Is Not Lost When All Is Lost.

    Science.gov (United States)

    Gupta, Ashish; Gupta, Ashok K; Patil, Kiran; Arora, Kamal

    2015-12-01

    Eyelid injuries are a common emergency room challenge in patients presenting with history of road traffic accidents. Overzealous debridement can result in tissue loss in which primary repair becomes impossible along with loss of critical landmarks especially in tissue as fragile as the eyelids. We present a 45-year-old male with avulsion injury of the right lower eyelid compounded by debridement at a primary health care facility. Nasolabial flap reconstruction was done with release of the bulbar conjunctiva to achieve aesthetic and functional endpoints. Adhering to the fundamental guidelines of repair of the eyelids as a primary and definitive surgery holds the crux to the best cosmetic and functional outcome. PMID:27011590

  18. MR imaging of Segond fractures and related lateral tibial condyl injuries

    International Nuclear Information System (INIS)

    The authors evaluated 54 patients with lateral tibial condyl contusion. On the basis of MR and plain film findings, these patients were divided into three groups. The first group consisted of 12 patients with Segond fractures. The second group (29 patients) had identical findings on MR but no Segond fracture on plain films. The third group of 13 patients demonstrated a different constellation of MR findings. The authors concluded that the Segond fracture has a characteristic constellation of osseous and ligamentous findings on MR imaging and that a Segond-type injury mechanism exists that results in a knee injury with MR findings similar to those of the Segond fracture but without the cortical avulsion

  19. Traumatic and compressive pathology of the peripheral nerves: value of the MRI

    International Nuclear Information System (INIS)

    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

  20. 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.

  1. 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.

  2. Naturally occurring genetic variability in expression of Gsta4 is associated with differential survival of axotomized rat motoneurons

    DEFF Research Database (Denmark)

    Mikael, Ström; Al Nimer, Faiez; Lindblom, Rickard;

    2012-01-01

    A large number of molecular pathways have been implicated in the degeneration of axotomized motoneurons. We previously have demonstrated substantial differences in the survival rate of axotomized motoneurons across different rat strains. Identification of genetic differences underlying such...... naturally occurring strain differences is a powerful approach, also known as forward genetics, to gain knowledge of mechanisms relevant for complex diseases, like injury-induced neurodegeneration. Overlapping congenic rat strains were used to fine map a gene region on rat chromosome eight previously shown...... to regulate motoneuron survival after ventral root avulsion. The smallest genetic fragment, R5, contains 35 genes and displays a highly significant regulatory effect on motoneuron survival. Furthermore, expression profiling in a F2(DAxPVG) intercross demonstrates one single cis-regulated gene within...

  3. Extensive posterior exposure of the elbow. A triceps-sparing approach.

    Science.gov (United States)

    Bryan, R S; Morrey, B F

    1982-06-01

    Difficulty with triceps avulsion or loss of continuity after total elbow arthroplasty has prompted the development of a modified posterior approach to the elbow joint. The characteristic feature of this approach is that the triceps mechanism is reflected from medial to lateral in continuity with the forearm fascia and the olecranon and ulnar periosteum. A variant of the technique reflects the extensor mechanism from lateral to medial. The ulnar collateral ligament may be released from the humerus to provide more exposure, but the ligament must then be securely reattached. This approach, which provides extensive exposure to the elbow joint, has been employed in 49 consecutive total elbow arthroplasties and results show no loss of triceps function and no significant weakness. The approach has proved useful for treatment of intra-articular fractures of the distal end of the humerus and with synovectomy in the rheumatoid arthritic patient. PMID:7083671

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

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    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.

  5. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-08-01

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

  8. Myelography in obstetric palsies of brachial plexus

    International Nuclear Information System (INIS)

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

  9. 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.

  10. 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.)

  11. 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.

  12. The superficial soft tissues

    International Nuclear Information System (INIS)

    Because the soft parts of the body are much less radiopaque than the bones, they may be overlooked when a reoentgenogram, obtained primarily to bring out bone detail, is being examined. Nevertheless, the soft tissues, even in a heavily exposed film, exert a distinct influence on the appearance of the bones that they cover. One has only to compare the difference in density of a part of a bone over which there is a loss of soft tissue because of ulceration, traumatic avulsion, or surgical removal with that of the adjacent uninvolved part to appreciate how much radiation is absorbed by the soft tissues. The soft tissues can be seen in practically every roentgenogram, even those that have been heavily exposed, by viewing the film with a strong beam of light (in addition to the usual illuminators). Some type of spotlight should always be available for the scrutiny of overexposed roentgenograms and particularly for the study of the soft tissues

  13. Microneurovascular reimplantation in a case of total penile amputation

    Directory of Open Access Journals (Sweden)

    Bhatt Yogesh

    2008-01-01

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

  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. A rare case of chronic suppurative otitis media with foreign body in external auditory canal and mastoid antrum

    Directory of Open Access Journals (Sweden)

    Vijayendra Simha

    2015-04-01

    Full Text Available Foreign bodies in External Auditory Canal (EAC are common in both adults and children. Removal of foreign body requires skill but usually successfully performed in the ENT department. A 40 year old female patient presented with right ear discharge with decreased hearing. On examination, a pale, scanty, mucopurulent discharge, foul smelling with blood tinge, persisting even after medications. After aural toileting, tympanic membrane was perforated with granulation tissue in middle ear. Multiple broom sticks were found in the external auditory canal, mastoid antrum was removed via post auricular approach with excision of polyp with radical mastoid exploration. Removal of foreign body from EAC is an essential skill for ENT surgeon. Careful removal can prevent further trauma and complications. An aural polyp with ear discharge, never attempt to pull/avulsion. [Int J Res Med Sci 2015; 3(4.000: 1030-1031

  16. 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.)

  17. 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.

  18. 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.)

  19. Groin pain in athletes.

    Science.gov (United States)

    Weber, M-A; Rehnitz, C; Ott, H; Streich, N

    2013-12-01

    Groin pain in athletes is one of the most difficult to treat clinical entities in sports medicine. The reasons are the amount of differential diagnoses, complexity of pathophysiologic causes and the long time of limited participation in sport. In order to maximize efficient treatment, thorough diagnostics and a clear therapeutic regimen are crucial. To succeed with this issue, a close cooperation between physicians and radiologists is mandatory. MRI is gold standard in the diagnostic work-up of the principal differential diagnoses, such as muscle tears, avulsion injuries, stress fractures, tears of acetabular labrum, and osteitis pubis. The article gives a comprehensive overview of the special anatomy and biomechanics of the pubic region and of typical MRI findings in athletes with groin pain. The use of dedicated imaging protocols is also discussed. PMID:23893752

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

    International Nuclear Information System (INIS)

    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.)

  1. Suprascapular Nerve Neuropathy: A Case Report

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    Cengiz BAHADIR

    2008-10-01

    Full Text Available Isolated suprascapular nerve ınjury is rarely seen. It may cause shoulder pain and functional limitation. This neuropathy should be considered in the differential diagnosis of shoulder pain with glenohumeral instability, rotator cuff disease, cervical radiculopathies, tendinitis, adhesive capsulitis, trauma and degenerative disease. Trauma, repetitive abnormal motions of scapula and iatrogenic causes take place in etiology. Injury of the nerve due to traction and elongation is the most probable pathomechanism. Shoulder pain and limitation of motion are the symptoms that may help to define the nerve damage before devoloping muscle atrophy. While tumoral lesions that can cause nerve entrapment and avulsions due to traction are treated surgically; overuse and elongation ınjuries are treated with physical theraphy modalities. In this report, a case with the complaints of shoulder pain and weakness due to isolated suprascapular neuropathy was discussed. Turk J Phys Med Rehab 2008;54:118-21.

  2. 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.)

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. '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

  9. 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

  10. Common conditions in the overhead athlete.

    Science.gov (United States)

    Edmonds, Eric W; Dengerink, Douglas D

    2014-04-01

    The overhead athlete is at unique risk for injury because of the mechanics associated with rapid shoulder elevation, abduction, and external rotation. Angulation of the humeral head against the posterosuperior glenoid can cause rotator cuff tendon and labral impingement. The throwing or striking motion of baseball, softball, water polo, tennis, racquetball, and volleyball may result in scapular dyskinesis, partial articular-sided supraspinatus avulsions, and posterosuperior labral tears. The SICK scapula syndrome (scapular malposition, inferior medial border prominence, coracoid pain and malposition, and dyskinesis of scapular movement) is thought to increase the risk of injury in the overhead athlete. Special physical examination maneuvers and magnetic resonance imaging may be helpful in diagnosing intra-articular pathology. Rehabilitation of injuries associated with internal impingement of the shoulder should include three basic components: strengthening, stretching, and sport-specific exercises. Arthroscopic surgery may be considered if symptoms do not improve after three months of conservative management. PMID:24695599

  11. 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

  12. Delayed Carotid Dissection Following Lower Lip Revascularization in the Setting of Hyoid Fracture--A Case Report and Review of the Literature.

    Science.gov (United States)

    Misra, Shantum; Haas, Corbett A; August, Meredith; Eberlin, Kyle R

    2016-01-01

    Traumatic injuries to the lip are common, but injuries that require revascularization of the lower lip are infrequent and pose a major challenge to the reconstructive surgeon. This report describes the case of a 53-year-old woman who sustained a lower lip avulsion injury, a comminuted mandibular parasymphyseal fracture, and a hyoid bone fracture secondary to a bicycle accident. Trauma workup included computed tomographic angiography of the head and neck, which did not show vascular injury. Despite successful revascularization of the lower lip, on postoperative day 11 the patient developed a large internal carotid artery dissection and middle cerebral artery stroke. This case highlights the importance of careful postoperative monitoring after high-energy facial trauma, particularly in the setting of vascular and bony injuries. PMID:26435401

  13. Life cycles of traumatized teeth: long-term observations from a cohort of dental trauma victims.

    Science.gov (United States)

    Heithersay, G S

    2016-03-01

    Life cycles of dental trauma victims can provide important clinical information, especially when viewed over many years. In this first series of life cycles, the pulp and periodontal responses to traumatic injuries of four patients are documented over periods varying from 26 to 51 years. The dynamics of pulp survival following an intrusive luxation and two avulsions are followed, with particular reference to pulp canal calcification to which a new term, root canal stenosis, has been proposed. The life cycles include the successful management of inflammatory root resorption in a replanted tooth with an open apex contrasting with the early prophylactic endodontic treatment of two replanted teeth in a patient with mature apices. The long-term development of invasive cervical resorption in one of the patient's life cycle highlights the importance of ongoing follow-up examinations for dental trauma victims. PMID:26923453

  14. Contradictions in the treatment of traumatic dental injuries and ways to proceed in dental trauma research

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Lauridsen, Eva; Andreasen, Frances Meriam

    2010-01-01

    Almost all treatment procedures used for dental traumas are still today not evidence-based, a fact, which makes it difficult to analyse the long-term outcome of healing and its relationship to treatment. Crown fractures with extensive dentin exposure represent a dominant injury in the permanent...... dentition. Accepted treatment philosophy is dentin coverage (dental liner and/or dentin bonded restoration) to prevent bacteria penetration into the pulp. Today there is, apart from deep proximal fractures, no evidence that this treatment is necessary to protect the pulp. In case of luxation injuries, the...... that short-term splinting with a semi-rigid splint appears to optimize fracture healing. In tooth avulsion with subsequent replantation, cleansing of the root surface for contamination and systemic antibiotics has been considered essential for pulp and periodontal healing. These treatment concepts have...

  15. Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses

    International Nuclear Information System (INIS)

    The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture. Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament

  16. 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.

  17. 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.

  18. MRI of fractures of the distal radius: comparison with conventional radiographs

    International Nuclear Information System (INIS)

    Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Boulevard, 11021, Great Neck, NY (United States); Adler, Ronald S. [Department of Imaging and Nuclear Medicine, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY (United States); Friedman, Lawrence [Department of Radiology, Hamilton Health Sciences - Henderson Division, 711 Concession Street, L8V 1C3, Hamilton, Ontario (Canada)

    2004-07-01

    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.)

  20. MRI of fractures of the distal radius: comparison with conventional radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Spence, L.D.; Eustace, S. [Medical Center, Boston, MA (United States). Dept. of Radiol.; Savenor, A.; Nwachuku, I.; Tilsley, J. [Department of Orthopedics, Boston Medical Center, Boston, MA 02118 (United States)

    1998-05-01

    Objective. To compare the evaluation of fractures of the distal radius with MRI and conventional radiographs. To demonstrate the ability of MRI to detect unsuspected soft tissue derangement accompanying this common injury. Design and patients. Twenty-one consecutive inpatients admitted following fracture of the distal radius underwent preoperative evaluation with both conventional radiographs and MRI. In each case, analysis was made of both the osseous and soft tissue injury. MRI findings were compared with those identified on conventional radiographs and at subsequent surgical fixation. Results. Of 21 patients with fractures of the distal radius, 20 had extension to the radiocarpal articulation, 14 had distal radio-ulnar joint extension and 5 had avulsion of the ulnar styloid.Occult carpal bone fractures accompanying fracture of the distal radius were identified in two patients: one of the capitate and the other of the second metacarpal base. Ten patients (48%) had associated soft tissue injury: six patients had scapholunate ligament rupture, two patients had disruption of the triangular fibrocartilage, one patient had extensor carpi ulnaris tenosynovitis and one patient had a tear of a dorsal radiocarpal ligament. Of five patients with ulnar styloid avulsions, none had evidence of triangular fibrocartilage tears. Conclusion. MRI affords better evaluation of osseous injury accompanying distal radial fractures than conventional radiographs. Intra-articular soft tissue injury accompanies distal radial fractures in almost 50% of cases. Scapholunate ligament disruption commonly accompanies intra-articular fracture through the lunate facet of the distal radius. Fracture of the ulnar styloid is infrequently associated with tear of the triangular fibrocartilage. (orig.) With 5 figs., 16 refs.

  1. 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. PMID:21740371

  2. '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.

  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. 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.)

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

    International Nuclear Information System (INIS)

    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 (T1w) and fat-suppressed proton density-weighted (FS-PDw) 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 T1w signal was less pronounced than that of normal tendons, and the FS-PDW image signal was similar to that of T1w 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 mm2, 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 mm2, 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.)

  7. 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.)

  8. 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.

  9. 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.

  10. Dynamic response to strike-slip tectonic control on the deposition and evolution of the Baranof Fan, Gulf of Alaska

    Science.gov (United States)

    Walton, Maureen A. L.; Gulick, Sean P. S.; Reece, Robert S.; Barth, Ginger A.; Christeson, Gail L.; VanAvendonk, Harm J.

    2014-01-01

    The Baranof Fan is one of three large deep-sea fans in the Gulf of Alaska, and is a key component in understanding large-scale erosion and sedimentation patterns for southeast Alaska and western Canada. We integrate new and existing seismic reflection profiles to provide new constraints on the Baranof Fan area, geometry, volume, and channel development. We estimate the fan’s area and total sediment volume to be ∼323,000 km2 and ∼301,000 km3, respectively, making it among the largest deep-sea fans in the world. We show that the Baranof Fan consists of channel-levee deposits from at least three distinct aggradational channel systems: the currently active Horizon and Mukluk channels, and the waning system we call the Baranof channel. The oldest sedimentary deposits are in the northern fan, and the youngest deposits at the fan’s southern extent; in addition, the channels seem to avulse southward consistently through time. We suggest that Baranof Fan sediment is sourced from the Coast Mountains in southeastern Alaska, transported offshore most recently via fjord to glacial sea valley conduits. Because of the translation of the Pacific plate northwest past sediment sources on the North American plate along the Queen Charlotte strike-slip fault, we suggest that new channel formation, channel beheadings, and southward-migrating channel avulsions have been influenced by regional tectonics. Using a simplified tectonic reconstruction assuming a constant Pacific plate motion of 4.4 cm/yr, we estimate that Baranof Fan deposition initiated ca. 7 Ma.

  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. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Holocene evolution of the western Orinoco Delta, Venezuela

    Science.gov (United States)

    Aslan, A.; White, W.A.; Warne, A.G.; Guevara, E.H.

    2003-01-01

    The pristine nature of the Orinoco Delta of eastern Venezuela provides unique opportunities to study the geologic processes and environments of a major tropical delta. Remote-sensing images, shallow cores, and radiocarbon-dating of organic remains form the basis for describing deltaic environments and interpreting the Holocene history of the delta. The Orinoco Delta can be subdivided into two major sectors. The southeast sector is dominated by the Rio Grande-the principal distributary-and complex networks of anastomosing fluvial and tidal channels. The abundance of siliciclastic deposits suggests that fluvial processes such as over-bank flooding strongly influence this part of the delta. In contrast, the northwest sector is represented by few major distributaries, and overbank sedimentation is less widespread relative to the southeast sector. Peat is abundant and occurs in herbaceous and forested swamps that are individually up to 200 km2 in area. Northwest-directed littoral currents transport large volumes of suspended sediment and produce prominent mudcapes along the northwest coast. Mapping of surface sediments, vegetation, and major landforms identified four principal geomorphic systems within the western delta plain: (1) distributary channels, (2) interdistributary flood basins, (3) fluvial-marine transitional environments, and (4) marine-influenced coastal environments. Coring and radiocarbon dating of deltaic deposits show that the northern delta shoreline has prograded 20-30 km during the late Holocene sea-level highstand. Progradation has been accomplished by a combination of distributary avulsion and mudcape progradation. This style of deltaic progradation differs markedly from other deltas such as the Mississippi where distributary avulsion leads to coastal land loss, rather than shoreline progradation. The key difference is that the Orinoco Delta coastal zone receives prodigious amounts of sediment from northwest-moving littoral currents that transport

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. Legacy Sediments and Channel Morphology in the Feather and Yuba Rivers, California

    Science.gov (United States)

    James, A.; Ghoshal, S.; Megison, M. E.; Singer, M. B.; Aalto, R.

    2007-12-01

    Channel aggradation and morphologic change following 19th century hydraulic gold-mining in the Sierra Nevada, California, differed substantially between the lower Feather and Yuba Rivers. These differences can be explained in part by topographic position in the Sacramento Valley but also by differences in early 20th century engineering structures and management policies. Both rivers experienced extreme aggradation by mining sediment and substantial avulsions but the timing and mechanics of channel adjustments were dissimilar, in part due to varying strategies in river-training and flood control. River engineering and management in the late 19th century identified the lower Yuba River as a repository zone where mining sediment could be sequestered to reduce deliveries to navigable rivers downstream. Levees were set back up to 4 km allowing formation of a multi-thread channel system across a broad floodplain that is now deeply buried by mining sediment. In contrast, levees along the lower Feather were given narrow spacings to encourage self-scouring of channels and promote navigability of channels. The lower Feather River drains a larger basin and has a lower gradient than the Yuba River. Construction of Fremont Weir across the mouth of the Yolo Basin raised flood levels in the lower Feather River and may have reduced transport of bed sediment. This could explain the persistence of large sand sheets at and below the Bear River confluence. Data from historical maps, topographic surveys, aerial photographs, and 1999 LiDAR swath mapping are used to document and contrast channel changes and floodplain evolution between these two rivers. Topographic changes derived by differencing detailed 1906-1909 topographic maps and 1999 LiDAR data indicate substantial channel morphologic changes including channel filling, lateral migration, and evolution towards single-thread channel systems. Modern streambank stratigraphy reflects the differences in channel responses. Sites where

  6. 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

  7. 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

  8. 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

  9. 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

  10. Reliability of phantom pain relief in neurorehabilitation using a multimodal virtual reality system.

    Science.gov (United States)

    Sano, Yuko; Ichinose, Akimichi; Wake, Naoki; Osumi, Michihiro; Sumitani, Masahiko; Kumagaya, Shin-Ichiro; Kuniyoshi, Yasuo

    2015-08-01

    The objective of this study is to demonstrate the reliability of relief from phantom limb pain in neurore-habilitation using a multimodal virtual reality system. We have developed a virtual reality rehabilitation system with multimodal sensory feedback and applied it to six patients with brachial plexus avulsion or arm amputation. In an experiment, patients executed a reaching task using a virtual phantom limb displayed in a three-dimensional computer graphic environment manipulated by their real intact limb. The intensity of the phantom limb pain was evaluated through a short-form McGill pain questionnaire. The experiments were conducted twice on different days at more than four-week intervals for each patient. The reliability of our task's ability to relieve pain was demonstrated by the test-retest method, which checks the degree of the relative similarity between the pain reduction rates in two experiments using Fisher's intraclass correlation coefficient (ICC). The ICC was 0.737, indicating sufficient reproducibility of our task. The average of the reduction rates across participants was 50.2%, and it was significantly different from 0 (p phantom limb pain with sufficient reliability. PMID:26736797

  11. Structured movement representations of a phantom limb associated with phantom limb pain.

    Science.gov (United States)

    Osumi, Michihiro; Sumitani, Masahiko; Wake, Naoki; Sano, Yuko; Ichinose, Akimichi; Kumagaya, Shin-Ichiro; Kuniyoshi, Yasuo; Morioka, Shu

    2015-09-25

    The relation between phantom limb pain (PLP) and the movement representation of a phantom limb remains controversial in several areas of neurorehabilitation, although there are a few studies in which the representation of phantom limb movement was precisely evaluated. We evaluated the structured movement representation of a phantom limb objectively using a bimanual circle-line coordination task. We then investigated the relation between PLP and the structured movement representation. Nine patients with a brachial plexus avulsion injury were enrolled who perceived a phantom limb and had neuropathic pain. While blindfolded, the participants repeatedly drew vertical lines using the intact hand and intended to draw circles using the phantom limb simultaneously. "Drawing of circles" by the phantom limb resulted in an oval transfiguration of the vertical lines ("bimanual coupling" effect). We used an arbitrary ovalization index (OI) to quantify the oval transfiguration. When the OI neared 100%, the trajectory changed toward becoming more circular. A significant negative correlation was observed between the intensity of PLP and the OI (r=-0.66, pphantom limb are necessary for alleviating PLP. PMID:26272300

  12. Motor cortex electric stimulation for the treatment of neuropathic pain

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    Walter J. Fagundes-Pereyra

    2010-12-01

    Full Text Available OBJECTIVE: Motor cortex stimulation (MCS is considered to be an effective treatment for chronic neuropathic pain. The aim of the present study was to assess the efficacy of MCS for treating neuropathic pain. METHOD: 27 patients with chronic neuropathic pain were operated. Electrodes were implanted with the use of an stereotactic frame. Electrophysiological evaluations (motor stimulation and somatosensory evoked potentials were performed, with guidance by means of three-dimensional reconstruction of magnetic resonance images of the brain. 10 patients (37% presented central neuropathic pain (post-stroke pain and 17 others (63% presented peripheral neuropathic pain (brachial plexus avulsion, phantom limb pain or trigeminal pain. RESULTS: In 15 patients (57.7% the pain relief was 50% or more; while in ten patients (38.5%, more than 60% of the original pain was relieved. No differences were found in relation to central and peripheral neuropathic pain (p=0.90, pain location (p=0.81, presence of motor deficit (p=0.28 and pain duration (p=0.72. No major complications were observed. CONCLUSION: MCS was efficient for treating patients presenting chronic central or peripheral neuropathic pain.

  13. 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.

  14. Advanced imaging of the scapholunate ligamentous complex

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, Maryam; Maeseneer, Michel de; Boulet, Cedric; Mey, Johan de [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels (Belgium); Staelens, Barbara; Scheerlinck, Thierry [Universitair Ziekenhuis Brussel (UZ Brussel), Department of Orthopaedics and Traumatology, Brussels (Belgium); Overstraeten, Luc van [Hand and Foot Surgery Unit (HFSU), Tournai (Belgium)

    2015-12-15

    The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies. (orig.)

  15. Sequelae of Trauma to Primary Dentition

    Directory of Open Access Journals (Sweden)

    Cíntia ZEMBRUSKI-JABER

    2006-08-01

    Full Text Available Objective: The aim of this study was to determine the presence of clinical and radiographic signs of injury to the maxillary primary incisors and the children carers' knowledge about dental trauma ocurrence in a 45 children group from three to eight years old. Method: Before the clinical examination, the carers were asked about their children's dental trauma events. After that, took course the maxillary incisors clinical and radiographical examination, excluding the ones with caries, fillings, or pulpar treatments. Results: Discoloration (50.0% was the most common present sign of trauma followed by avulsion (17.6% and the pulp canal obliteration (56.3% was the major result of the radiographical signal. Boys had more trauma recorded than girls and the maxillary central incisors were the most vulnerable to injury. Besides, the amount of trauma recorded by clinical and radiographic examination was bigger than that reported in the questionnaire by mothers or children carers. Conclusion: The results related in this study reinforce the need of immediate attention to trauma on deciduous dentition and long term observation of the developing permanent successor.

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Horbe, Adriana M.C., E-mail: ahorbe@ufam.edu.b [Universidade Federal do Amazonas (UFAM), Manaus, AM (Brazil). Dept. de Geociencias; Behling, Hermann [Georg August Universitaet Goettingen (Germany). Albrecht von Haller Institut fuer Pflanzenwissenschaften. Abteilung fuer Palynologie und Klimadynamik; Nogueira, Afonso C.R. [Universidade Federal do Para (UFPA), Belem, PA (Brazil). Inst. de Geociencias; Mapes, Russell [University of North Carolina, Chapel Hill, NC (United States). Dept. of Geological Science

    2011-09-15

    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 Al{sub 2}O{sub 3}, Fe{sub 2}O{sub 3}, FeO, CaO, K{sub 2}O, MgO, Na{sub 2}O, P{sub 2}O{sub 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 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)

  18. 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

  19. [Non pharmacologic treatment of neuropathic pain].

    Science.gov (United States)

    Guastella, Virginie; Mick, Gérard; Laurent, Bernard

    2008-02-01

    Nondrug treatments of neuropathic pain should always begin at the same time as pharmacologic treatment. There are three types of nondrug treatment for neuropathic pain: physical, surgical, and "psychocorporal" and psychotherapeutic treatment. Transcutaneous electrical nerve stimulation (TENS) is a simple physical treatment that strengthens local inhibitory controls and is indicated in focal neuropathic pain when upstream stimulation is possible for a superficial sensitive nerve trunk. Destructive surgery is represented today by "DREZotomy", destruction of nociceptive fibers and their dorsal root entry zones. It is indicated essentially in intractable pain due to plexus avulsion. Functional surgery is implanted electric stimulation--either spinal or central (encephalic)--of structures that exert inhibitory control on the pain pathways. Spinal stimulation is performed at the level of the posterior spinal cord and is indicated essentially in segmental mononeuropathies refractory to drug treatment. Central stimulation is performed at the motor cortex and is indicated for refractory central pain. "Psychocorporal" techniques (relaxation, sophrology, hypnosis) are useful to reduce anxiety and neurovegetative hypertonicity, both factors that aggravate neuropathic pain. PMID:18191370

  20. [Decoronation: treatment protocol for ankylotic root resorption as a consequence of dental trauma].

    Science.gov (United States)

    Lin, S; Fuss, Z; Wigler, R; Karawani, M; Ashkenazi, M

    2013-10-01

    Severe dental traumatic injuries, such as the complete displacement of a tooth from its socket (Avulsion) or the displacement of a tooth within its socket (Intrusive Luxation), may result in extensive injury to the root surface. As a result, the root surface injury heals without cementum and there is fusion between the alveolar bone and the exposed dentin or anorganic exposed cementum, without any attachment apparatus between them. This phenomenon is known as "dento-alveolar ankylosis" and is accompanied by ankylotic resorption of the root. In a process that results subsequent to the ankylosis, the root surface resorbs, and this is part of the remodeling of the alveolar bone (ankylotic resorption). When the traumatic injury occurs at a young age, lateral and apical growth of the alveolar bone continues without continued physiological eruption of the tooth. As a result, the position of the ankylotic tooth does not change, and with time thetooth appears infra-occluded resulting in severe esthetic and functional consequences. Extraction of the ankylotic tooth is difficult and sometimes even impossible due to the rigid fusion between the bone and the tooth. In addition, attempted extraction of the ankylotic tooth may lead to fracture of the buccal plate and resorption of the alveolar bone. Retention of the ankylotic tooth may lead to damage in bone deposition in the verticaldimension, leading to difficulties in future prosthodonticrehabilitation, research-based information has been incorporated PMID:24660573

  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. 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

  3. 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.

  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. 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.

  7. An upcoming drug for onychomycosis: Tavaborole

    Directory of Open Access Journals (Sweden)

    Neha Sharma

    2015-01-01

    Full Text Available Fungal infection of the nail as well as nail bed is termed as 'onychomycosis'. It is caused by dermatophytes, non-dermatophytic fungal species and yeasts like Candida albicans. It is traditionally treated by topical antifungals, systemic agents like ketoconazole, griseofulvin, itraconazole, fluconazole, etc. Chemical avulsion or surgical removal of nail can also be tried to treat this disease. In spite of all these treatment options available, podiatrists were always in search of an ideal drug molecule with lesser side effects and which may improve the patient compliance. This exhaustive search led to the discovery of a better antifungal agent, known as “Tavaborole.” A systematic literature search was carried out using databases such as PubMed, Cochrane Reviews, Google Scholar, etc. Detailed information about onychomycosis and tavaborole was gathered. Tavaborole is the first oxaborole antifungal agent approved by FDA in July 2014. It is marketed under the trade name “Kerydin.” It acts by inhibiting protein synthesis in the fungus. It inhibits an enzyme known as cytosolic leucyl-transfer RNA synthetase, or LeuRS, which plays a key role in fungal essential protein synthesis. Dermatitis at the site of topical application, erythema, exfoliation and ingrowing toe nail has been reported in 1% of subjects. Tavaborole may offer a promising role in the treatment of onychomycosis and may compell podiatrists to offer its use in onychomycosis. The present study describes about chemical nature, mechanism of action and two completed phase 3 clinical trial findings of Tavaborole.

  8. "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.

  9. The role of rivers in ancient societies, or how man transformed the alluvial landscapes of Khuzestan (SW Iran)

    Science.gov (United States)

    Walstra, J.; Heyvaert, V.; Verkinderen, P.

    2012-04-01

    For many thousands of years the alluvial plains of Khuzestan (SW Iran) have been subject to intensive settlement and agriculture. Ancient societies depended on the position of major rivers for their economic survival and hence, there is ample evidence of human activities trying to control the distribution of water. Throughout the plains ancient irrigation and settlement patterns are visible, although traces are rapidly disappearing due to expanding modern land use. Aim of this study is to unlock and integrate the rich information on landscape and archaeology, which only survives through the available historical imagery and some limited archaeological surveys. A GIS-based geomorphological mapping procedure was developed, using a variety of imagery, including historical aerial photographs, CORONA, Landsat and SPOT images. In addition, supported by the evidence from previous geological field surveys, archaeological elements were identified, mapped and included in a GIS database. The resulting map layers display the positions of successive palaeochannel belts and extensive irrigation networks, together indicating a complex alluvial history characterized by avulsions and significant human impact. As shown in several case-studies, integrating information from multiple disciplines provides valuable insights in the complex landscape evolution of this region, both from geological and historical perspectives. Remote sensing and GIS are essential tools in such a research context. The presented work was undertaken within the framework of the Interuniversity Attraction Pole "Greater Mesopotamia: Reconstruction of its Environment and History" (IAP 6/34), funded by the Belgian Science Policy.

  10. Analysis of injuries to the proximal diagnostic - Diagnostic difficulties, visualisation techniques

    International Nuclear Information System (INIS)

    Fractures of the proximal tibia involve the lateral condyle in 75-80% of cases. Intercondylar eminence fractures and avulsion injuries involve the tibial side of the attachment of the cruciate ligaments. The aim of this study was an analysis of injuries to the proximal tibia. In our opinion the best diagnostic method was CT investigation made according to a specified protocol and analyzed with radiographic images in two projections. MR was an additional method in problematic and complicated cases, such as subtle fractures of the tibial plateau with cartilage damage or when the CT was not diagnostic. A radiologist and an orthopedic surgeon analyzed the radiographic, CT, and MR images of 23 patients from both the technical and the diagnostic aspect. Partial fracture of the tibial plateau was diagnosed in 12 cases, including fractures of the lateral condyle in 11 cases, and isolated fractures of the lateral condyle in 4 cases. Fracture of the medial condyle was diagnosed in 1 case. Isolated avulsional fractures of the intercondylar eminentia were diagnosed in 2 cases. Multi fragmentary fractures of the tibial plateau and metaphysis were diagnosed in 6 cases. (author)

  11. 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.

  12. 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

  13. Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report.

    Science.gov (United States)

    Mibu, Akira; Nishigami, Tomohiko; Tanaka, Katsuyoshi; Osumi, Michihiro; Tanabe, Akihito

    2016-04-01

    A 43-year-old man had deafferentation pain in his right upper extremity secondary to brachial plexus avulsion from a traffic accident 23 years previously. On our initial examination, he had severe tingling pain with numbness in the right fingers rated 10 on the numerical rating scale. The body perception of the affected third and fourth fingers was distorted in the flexed position. Although he performed traditional mirror therapy (TMT) for 4 weeks in the same methods as seen in previous studies, he could not obtain willed motor imagery and pain-alleviation effect. Therefore, we modified the task of TMT: Graded mirror therapy (GMT). GMT consisted of five stages: (1) observation of the mirror reflection of the unaffected side without imagining any movements of the affected side; (2) observation of the mirror reflection of the third and fourth fingers changing shape gradually adjusted from a flexed position to a extended position; (3) observation of the mirror reflection of passive movement; (4) motor imagery of affected fingers with observation of the mirror reflection (similar to TMT); (5) motor imagery of affected fingers without mirror. Each task was performed for 3 to 4 weeks. As a result, pain intensity during mirror therapy gradually decreased and finally disappeared. The body perception of the affected fingers also improved, and he could imagine the movement of the fingers with or without mirror. We suggested that GMT starting from the observation task without motor imagery may effectively decrease deafferentation pain compared to TMT. PMID:26914841

  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, 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)

  15. 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)

  16. Channel Morphological Changes in the Yuba River, California, in the Post-Hydraulic Mining Period

    Science.gov (United States)

    Ghoshal, S.; James, A.; Singer, M.; Aalto, R.

    2007-12-01

    Hydraulic gold mining in the Sierra Nevada of California (1853-1884) produced large volumes of sediment from upland placer gravels. The prevailing belief has been that piedmont storage of this sediment is volumetrically negligible or inactive. This study tests the hypothesis that large deposits of historical sediment remaining in the bed, banks and terraces of the lower Yuba River have been remobilized by floods and that erosion has continued over the past few decades. Remote sensing and GIS analyses of topographic and planimetric data from historical maps, surveys, aerial photographs, and LiDAR data document historic changes and the timing of sediment erosion and deposition within the channel and floodplain system. Planimetric and volumetric measurements of channel enlargement, lateral migration, avulsions, and channel filling provide magnitudes of erosion and deposition of historic sediments in the lower Yuba River. In 1906, the California Debris Commission produced a detailed large-scale topographic map of the lower Yuba floodplain showing it as a multi-thread channel system. The paleochannel scars remain evident on air photos, LiDAR images, and in the field. Differencing of topographic data derived from the 1906 topographic maps and 1999 LiDAR data provide volumetric measures of substantial channel morphologic changes including channel shifting, filling, and evolution towards a single- thread channel system. These measures identify processes and rates of sediment production relevant to broader issues of flood hazards in the region.

  17. Bone and soft tissue tumors of hip and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Bloem, Johan L., E-mail: j.l.bloem@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands); Reidsma, Inge I., E-mail: i.i.reidsma@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands)

    2012-12-15

    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  18. Karolinska institutet 200-year anniversary. Symposium on traumatic injuries in the nervous system: injuries to the spinal cord and peripheral nervous system - injuries and repair, pain problems, lesions to brachial plexus.

    Science.gov (United States)

    Sköld, Mattias K; Svensson, Mikael; Tsao, Jack; Hultgren, Thomas; Landegren, Thomas; Carlstedt, Thomas; Cullheim, Staffan

    2011-01-01

    The Karolinska Institutet 200-year anniversary symposium on injuries to the spinal cord and peripheral nervous system gathered expertise in the spinal cord, spinal nerve, and peripheral nerve injury field spanning from molecular prerequisites for nerve regeneration to clinical methods in nerve repair and rehabilitation. The topics presented at the meeting covered findings on adult neural stem cells that when transplanted to the hypoglossal nucleus in the rat could integrate with its host and promote neuron survival. Studies on vascularization after intraspinal replantation of ventral nerve roots and microarray studies in ventral root replantation as a tool for mapping of biological patterns typical for neuronal regeneration were discussed. Different immune molecules in neurons and glia and their very specific roles in synapse plasticity after injury were presented. Novel strategies in repair of injured peripheral nerves with ethyl-cyanoacrylate adhesive showed functional recovery comparable to that of conventional epineural sutures. Various aspects on surgical techniques which are available to improve function of the limb, once the nerve regeneration after brachial plexus lesions and repair has reached its limit were presented. Moreover, neurogenic pain after amputation and its treatment with mirror therapy were shown to be followed by dramatic decrease in phantom limb pain. Finally clinical experiences on surgical techniques to repair avulsed spinal nerve root and the motoric as well as sensoric regain of function were presented. PMID:21629875

  19. Traumatic globe luxation associated with orbital fracture in a child: a case report and literature review.

    Science.gov (United States)

    Amaral, Márcio Bruno Figueiredo; Carvalho, Matheus Furtado; Ferreira, André Baptista; Mesquita, Ricardo Alves

    2015-03-01

    Orbital fracture associated with traumatic globe luxation is rare, as it generally requires trauma with high energy for this to occur. The present case report focused on a child who had been hit by a motorcycle, leading to a globe luxation of the left eye and fractures of the superolateral orbital walls. The patient presented initial cosmetic and psychological benefits from the repositioning of the intact globe and the reduction of the orbital fractures. However, a subsequent evisceration of the globe was required due to persistent proptosis and pain. An ocular prosthesis was also implanted, thus recovering the patient's aesthetics. Thirty-four well-documented cases of traumatic globe luxation could be found in the English literature since 1970. The mean age of patients presenting traumatic globe luxation was 29.5 years. The male gender proved to be more prevalent, with traffic collisions representing the most common accident etiology. Direct orbital trauma with fractures of medial and floor walls displacing the globe into the maxillary sinus represented the most common injury mechanism (38.2 %), followed by an elongated object entering the orbit (26.5 %). Optical nerve avulsion is the most serious complication seen in association with traumatic globe luxation, with the repositioning of the initial globe, with no enucleation or evisceration, representing the main form of management. PMID:25861192

  20. 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.

  1. Particulates from Hydrophilic-Coated Guiding Sheaths Embolize to the Brain

    Science.gov (United States)

    Stanley, James R.L.; Tzafriri, Abraham R.; Regan, Kathryn; LaRochelle, Alan; Wong, Gee; Zani, Brett G.; Markham, Peter M.; Bailey, Lynn; Spognardi, Anna; Kopia, Gregory A.; Edelman, Elazer R.

    2015-01-01

    Aims We sought to evaluate the incidence of embolic material in porcine brain following vascular interventions using hydrophilic-coated sheaths. Methods and results A new self-expanding stent and delivery system (SDS) were deployed through a hydrophilic-coated (Cook® Flexor Ansel) Guiding Sheath into iliac and/or carotid arteries of 23 anesthetized Yucatan miniswine. Animals were euthanized at 3, 30, 90 and 180 days and brains were removed for histological analysis. In an additional single control animal, the guiding sheath was advanced but no SDS was deployed. Advancement of the coated guiding sheath with or without the SDS was associated with frequent foreign material in the arterioles of the brain. The embolic material was amorphous, non-refractile, non-crystalline, and non-birefringent and typically lightly basophilic with a slight stippled appearance on hematoxylin and eosin (H&E) stain. Material was observed at all time points involving 54% of all study animals (ie, test and control) and in vitro after incubation in 0.9% saline. Conclusions The hydrophilic coating on a clinically used guiding sheath readily avulses and embolizes to the brain during deployment in a porcine model. Further documentation of this effect and monitoring in clinical scenarios is warranted. PMID:25735934

  2. Deep brain stimulation for chronic pain.

    Science.gov (United States)

    Boccard, Sandra G J; Pereira, Erlick A C; Aziz, Tipu Z

    2015-10-01

    Deep brain stimulation (DBS) is a neurosurgical intervention popularised in movement disorders such as Parkinson's disease, and also reported to improve symptoms of epilepsy, Tourette's syndrome, obsessive compulsive disorders and cluster headache. Since the 1950s, DBS has been used as a treatment to relieve intractable pain of several aetiologies including post stroke pain, phantom limb pain, facial pain and brachial plexus avulsion. Several patient series have shown benefits in stimulating various brain areas, including the sensory thalamus (ventral posterior lateral and medial), the periaqueductal and periventricular grey, or, more recently, the anterior cingulate cortex. However, this technique remains "off label" in the USA as it does not have Federal Drug Administration approval. Consequently, only a small number of surgeons report DBS for pain using current technology and techniques and few regions approve it. Randomised, blinded and controlled clinical trials that may use novel trial methodologies are desirable to evaluate the efficacy of DBS in patients who are refractory to other therapies. New imaging techniques, including tractography, may help optimise electrode placement and clinical outcome. PMID:26122383

  3. 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

  4. The osteo-anconeus flap. An approach for total elbow arthroplasty.

    Science.gov (United States)

    Wolfe, S W; Ranawat, C S

    1990-06-01

    Twenty-seven consecutive primary total elbow arthroplasties were done with a technique that preserved the continuity of the attachment of the triceps brachii muscle with a wafer of bone from the reflected extra-articular portion of the olecranon and with the lateral fascia of muscles of the forearm. During closure, the wafer was reattached to the broad cancellous surface of the olecranon with sutures through the bone. The elbows were immobilized for an average of sixteen days postoperatively. The patients who were available for follow-up were re-examined at an average of 3.9 years, and the strength of the triceps muscle was checked. No extensor lag or avulsion of the triceps occurred, and mild extensor weakness was seen in only two elbows. No patient had early or late drainage of the wound or infection. The average range of motion compared favorably with that in other reported series. This osteo-anconeus posterior approach is advocated for total elbow arthroplasty because it provides rapid and wide exposure, it is associated with a low rate of complications related to the wound, and it preserves the strength of the triceps. PMID:2355029

  5. Fractured rheumatoid elbow: treatment with Souter elbow arthroplasty--a clinical and radiologic midterm follow-up study.

    Science.gov (United States)

    Ikävalko, M; Lehto, M U

    2001-01-01

    We report the results in 26 patients who had 32 preoperative fractures treated with Souter elbow arthroplasty. All were rheumatoid patients with a mean disease duration of 29.7 years (range, 10 to 43). Six of the fractures were of the olecranon and 26 of the distal humerus. The time interval between fracture and arthroplasty was 9 months (mean; range, 0 to 48). Fragments were not excised, and osteosynthesis was performed. The follow-up was 2.6 years (mean; range, 0.5 to 8), when 20 of the fractures had united and 12 had not. K-wire fixation, either alone or in combination with cerclage or PDS suture, and bone grafting led to satisfactory results. Union was verified in 14 of 17 cases treated with this technique. There were no severe early complications. Six patients had late complications. In 3 cases, loosening of the humeral component was observed radiologically. One patient had a hematogenous deep infection 4 years after the operation, and 2 patients had avulsion rupture of the triceps tendon. Fracture in the badly destroyed elbow can be more reasonably treated with an arthroplasty than with an attempt of osteosynthesis before arthroplasty. If excision of the fragments is avoided, original, or near original, anatomy of the elbow joint can be better restored and acceptable outcome obtained with elbow arthroplasty. PMID:11408908

  6. EndoVascular Laser Therapy (EVLT of Varicose Veins

    Directory of Open Access Journals (Sweden)

    S. Akhlaghpour

    2005-08-01

    Full Text Available Introduction & Background: Tens of millions of people – up to 40% of women and 25% of men – suffer from lower limb varicose veins. Several risk factors are also identified including genetics, gender, age, obesity, hor-mones, pregnancy, and occupation. Sclerotheraphy is commonly used to treat small varicose veins. Medium-sized and large varicose veins can be removed by a surgical procedure called Stab avulsion or phlebectomy. EVLT is a new alternative surgical method for varicose veins. Patients & Methods: Using 980nm and 940nm diode laser with a 600micron bare-tipped fiber endoluminally under ultrasound and Doppler monitoring, we treated 43 patients in Noor Vein Clinic, Tehran, Iran. Results: The procedure was well tolerated by all patients with just a local anesthesia. No major complications were encountered. We noticed that 980nm and 940nm are the perfect wave lengths causing less post-operational discomfort for patients with enhanced recovery time due to fewer traumas to the adjacent tissues. One small size skin burn and local paresthesia were observed. Conclusion: We concluded that EVLT with diode laser is a safe, fast, and effective method with low recurrence rate.

  7. Analysis of the transport of sediment by the Suncook River in Epsom, Pembroke, and Allenstown, New Hampshire, after the May 2006 flood

    Science.gov (United States)

    Flynn, Robert H.

    2011-01-01

    in the model with the Laursen (Copeland) sediment-transport function best describing the sediment load, transport behavior, and changes in streambed elevation for the specified spatial and temporal conditions of the 400-day calibration period. Simulation results from the model and field-collected sediment data indicate that, downstream of the avulsion channel, for the average daily mean flow during the study period, approximately 100 to 400 tons per day of sediment (varying with daily mean flow) was moving past the Short Falls Road Bridge over the Suncook River in Epsom, while approximately 0.05 to 0.5 tons per day of sediment was moving past the Route 28 bridge in Pembroke and Allenstown, and approximately 1 to 10 tons per day was moving past the Route 3 bridge in Pembroke and Allenstown. Changes in water-surface elevation that the model predicted for the end of water year 2010 to be a result of changes in streambed elevation ranged from a mean increase of 0.20 feet (ft) for the 50-percent annual exceedence-probability flood (2-year recurrence-interval flood) due to an average thalweg increase of 0.88 ft between the Short Falls Road Bridge and the Buck Street Dams in Pembroke and Allenstown to a mean decrease of 0.41 ft for the 50-percent annual exceedence-probability flood due to an average thalweg decrease of 0.49 ft above the avulsion in Epsom. An analysis of shear stress (force created by a fluid acting on sediment particles) was undertaken to determine potential areas of erosion and deposition. Based on the median grain size (d50) and shear stress analysis, the study found that in general, for floods greater than the 50-percent annual exceedence probability flood, the shear stress in the streambed is greater than the critical shear stress in much of the river study reach. The result is an expectation of streambed-sediment movement and erosion even at high exceedence-probability events, pending although the stream ultimately attains equilibrium through stream

  8. MR imaging of posterior cruciate ligament injury

    International Nuclear Information System (INIS)

    There is increasing awareness of the clinical importance of early detection and treatment of posterior cruciate ligament(PCL) injury. We evaluate the usefulness of Magnetic resonance(MR) imaging in the diagnosis of PCL injury. We retrospectively analysed the MR images of 140 cases with clinically suspected knee injury. Arthroscopic or surgical correlation was available in 63 cases. We observed the finding and extent of PCL injury and other associated abnormalities. The frequency of anterior and posterior meniscofemoral ligament was evaluated. Eleven PCL injuries were observed, six midsubstance tears, two tibial attachment tears, two femoral attachment tear, one laxity. The sensitivity, specificity and accuracy of MR imaging diagnosis are 100%, 98.1%, 98.4%. MR findings of PCL injury are discontinuity and focal mass formation, irregular increased signal intensity, detachment or redundancy of the ligament with avulsed bony fragment. In all cases of injured PCL, other associated abnormalities of adjacent structures were observed. Accessory anterior and posterior meniscofemoral ligaments were observed in 67.4%(87/129). MR imaging is useful in evaluation of presence or absence of PCL injury, accurate extent of PCL injury and other important associated abnormalities of adjacent structures

  9. Minimally invasive surgery for Achilles tendon pathologies

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2010-07-01

    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University, Rome, ItalyAbstract: Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.Keywords: tendinopathy, rupture, percutanous repair, less invasive

  10. 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

  11. Clinical utility of tomosynthesis in suspected scaphoid fracture. A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats [Lund University, Skaane University Hospital, Center for Medical Imaging and Physiology, Lund (Sweden); Boerjesson, Annika M.; Goethlin, Jan H. [Sahlgrenska University Hospital, Department of Radiology, Moelndal (Sweden)

    2011-07-15

    Radiography alone will not detect all scaphoid fractures. There is a reported prevalence between 9 and 33% of occult scaphoid fractures. The evidence-based literature suggests that magnetic resonance imaging (MRI) is the most suitable secondary imaging modality due to the ability to evaluate the bone marrow directly and to also identify other injuries. However, there is no consensus on the choice of follow-up imaging strategy - computed tomography, MRI, or bone scan - across different institutions. Tomosynthesis is a new digital tomographic method creating multiple thin tomographic sections. The purpose of this study was to evaluate the clinical utility of tomosynthesis in suspected occult fracture. Thirty-five patients with a clinically suspected occult scaphoid fracture after initial normal radiography were imaged with repeat radiography and tomosynthesis scan 2 weeks after trauma. Repeat radiography revealed one previously undetected scaphoid tubercle avulsion and one scaphoid waist fracture, confirmed by tomosynthesis. Tomosynthesis revealed two additional scaphoid waist fractures. In total, three initially occult scaphoid waist fractures were detected (9%). No additional fractures were detected in the remaining 32 patients during a 1-year follow-up. Tomosynthesis can demonstrate occult scaphoid fractures not visible at radiography. (orig.)

  12. Evaluation of milnacipran, in comparison with amitriptyline, on cold and mechanical allodynia in a rat model of neuropathic pain.

    Science.gov (United States)

    Berrocoso, Esther; Mico, Juan-Antonio; Vitton, Olivier; Ladure, Philippe; Newman-Tancredi, Adrian; Depoortère, Ronan; Bardin, Laurent

    2011-03-25

    Milnacipran, a serotonin/norepinephrine reuptake inhibitor (SNRI), has shown efficacy against several chronic pain conditions, including fibromyalgia. Here, we evaluated, in rats, its anti-allodynic effects following acute or sub-chronic treatment in a model of neuropathic pain (chronic constriction injury, CCI, of the sciatic nerve). Amitriptyline, a tricyclic antidepressant active pre-clinically and clinically against neuropathic pains, was added as a comparison compound. Upon acute i.p. administration, milnacipran was potently efficacious in the CCI model. It significantly reduced thermal allodynia in the cold (4°C) plate test (MED=2.5mg/kg), and attenuated mechanical allodynia in the von Frey filaments test (MED=10mg/kg). Given sub-chronically (7day, b.i.d.), milnacipran was effective at 10mg/kgi.p. in both tests. Acute amitriptyline (10mg/kgi.p.) was efficacious against mechanical, but less so against cold allodynia; under sub-chronic conditions, it was only active against mechanical allodynia. These data show that milnacipran is as efficacious as the reference compound amitriptyline in a pre-clinical model of injury-induced neuropathy, and demonstrate for the first time that it is active acutely and sub-chronically against cold allodynia. They also suggest that milnacipran has the potential to alleviate allodynia associated with nerve compression-induced neuropathic pain in the clinic (for example following discal hernia, avulsion or cancer-induced tissue damage). PMID:21277295

  13. MR arthrogram findings of luxatio erecta in a pediatric patient - arthroscopic confirmation and review of the literature

    International Nuclear Information System (INIS)

    Luxatio erecta or inferior glenohumeral dislocation is a rare type of shoulder dislocation, accounting for less than 1 % of all reported shoulder dislocations. We describe a 15-year-old male who presented with luxatio erecta following an injury to his shoulder that resulted from a mountain biking accident. Clinically, the patient had shoulder pain and fixed abduction of the arm. Radiographs confirmed the diagnosis of luxatio erecta. A magnetic resonance arthrogram (MRA) performed 9 days after presentation demonstrated both a greater tuberosity fracture and avulsion of the anterior and posterior inferior glenohumeral ligaments from their humeral attachment. The MR findings were confirmed on arthroscopy. The bone and soft tissue injury pattern seen in our patient clearly supports the described mechanism of injury for luxatio erecta and lends credence to the theory that a fracture of the greater tuberosity spares injury to the rotator cuff, especially in children. A review of the literature failed to reveal any prior description of the MRI or MRA findings of luxatio erecta in a pediatric patient or any publication with arthroscopic confirmation of the MR findings. (orig.)

  14. Remote therapeutic effect of early nerve transposition in treatment of obstetric al brachial plexus palsy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To report a method and remote therape utic effect of early nerve transposition in treatment of obstetrical brachial pl exus palsy.   Methods: From May 1995 to August 1996, 12 patients who had no r ecovery of biceps 3 months after birth were treated with nerve transposition. Ei ght had neuroma at the upper trunk and 4 had rupture or avulsion of the upper tr unk. Mallet test was used to evaluate the results.   Results: The follow-up of 40-52 months showed that excellent and good recovery in functions was found in 75% of the patients and the excellen t rate of phrenic nerve and accessory nerve transposition was 83.3% and 6 6.7% respectively. A complete recovery in shoulder and elbow joint function wa s in 3 patients and Mallet Ⅳ was in 6 patients.   Conclusions: Satisfactory outcome can be obtained by using earl y nerve transposition in treating obstetrical brachial plexus.Paralysis, obstetric; Peripheral nerves; Nerve trans position

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. MR evaluation of brachial plexus injuries

    International Nuclear Information System (INIS)

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

  20. The value of spiral CT scan on fracture of ankle joint and tarsal bones

    International Nuclear Information System (INIS)

    Objective: To study the value of spiral CT scan on the fracture of ankle joint and tarsal bones. Methods: 43 cases with the fracture of ankle joint and tarsal bones were collected and analyzed. All the cases were examined by plain film radiography and spiral CT thin slice scan. Multi-planar reformation (MPR), surface shaded display (SSD) and other techniques of image post-processing were performed in 35 cases of them. Results: Spiral CT scan could demonstrate more fractures than plain film radiography in 28 cases(65.1%). There are 15 cases (34.9%) which are normal in plain film radiography but abnormal in Spiral CT scan. Spiral CT could demonstrate the different length, width, direction and number of linear low density shadow. SSD and MPR were performed again in the cases with avulsion fracture and fragmental fracture to demonstrate the fracture direction and the shape, size and location of fragments more clearly. Conclusion: Spiral CT thin slice scan with image post-processing techniques can play an important role in fracture of ankle joint and tarsal bones. (authors)