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Pseudotumoural soft tissue lesions of the foot and ankle: a pictorial review
Erik Van Hul,Filip Vanhoenacker,Pieter Van Dyck,Arthur De Schepper,Paul M. Parizel
Insights into Imaging , 2011, DOI: 10.1007/s13244-011-0087-2
Abstract: In the foot and ankle region, benign neoplasms and pseudotumoural soft tissue lesions are significantly more frequent than malignant tumours. The pseudotumoural lesions constitute a heterogeneous group, with highly varied aetiology and histopathology. This article reviews the imaging features of the most common pseudotumours of the soft tissues in the foot and ankle. Although the imaging characteristics of several of the lesions discussed are non-specific, combining them with lesion location and clinical features allows the radiologist to suggest a specific diagnosis in most cases.
Negative pressure wound therapy for soft tissue injuries around the foot and ankle
Hyun-Joo Lee, Joon-Woo Kim, Chang-Wug Oh, Woo-Kie Min, Oog-Jin Shon, Jong-Keon Oh, Byung-Chul Park, Joo-Chul Ihn
Journal of Orthopaedic Surgery and Research , 2009, DOI: 10.1186/1749-799x-4-14
Abstract: Using a NPWT device, 16 patients were prospectively treated for soft tissue injuries around the foot and ankle. Mean patient age was 32.8 years (range, 3–67 years). All patients had suffered an acute trauma, due to a traffic accident, a fall, or a crush injury, and all had wounds with underlying tendon or bone exposure. Necrotic tissues were debrided before applying NPWT. Dressings were changed every 3 or 4 days and treatment was continued for 18.4 days on average (range, 11–29 days).Exposed tendons and bone were successfully covered with healthy granulation tissue in all cases except one. The sizes of soft tissue defects reduced from 56.4 cm2 to 42.9 cm2 after NPWT (mean decrease of 24%). In 15 of the 16 cases, coverage with granulation tissue was achieved and followed by a skin graft. A free flap was needed to cover exposed bone and tendon in one case. No major complication occurred that was directly attributable to treatment. In terms of minor complications, two patients suffered scar contracture of grafted skin.NPWT was found to facilitate the rapid formation of healthy granulation tissue on open wounds in the foot and ankle region, and thus, to shorten healing time and minimize secondary soft tissue defect coverage procedures.Tendon and/or bone exposure commonly occurs in the foot and ankle region after acute trauma [1]. The conventional treatment method used for these uncovered, open wounds in the foot and ankle is skin grafting after the formation of healthy granulation tissue by wet dressing [2]. However, the duration of treatment may be prolonged, and patients may experience severe pain during dressing changes [3]. Furthermore, it is difficult to form healthy granulation tissue by simple wet dressing, when a tendon, bone, or implant is exposed. Accordingly, free flap surgery is often required, which requires substantial effort and introduces the issue of donor site morbidity [4].Negative pressure wound therapy (NPWT) was first described by Argenta and Moryk
A Study of Design and Implementation Techniques of Active Soft Orthotic Ankle Foot  [PDF]
Ganesh K. Yenurkar, Swapnili P. Karmore
International Journal of Advanced Computer Research , 2012,
Abstract: This paper reports on the mechanical design of anactive soft orthotic implementation for AFP,which is powered by the pneumatic artificialmuscles. Ankle foot orthosis makes aneuromuscular patient’s having gait pattern morerehabilitate like that of an unaffected person, butthe devices can also be associated withcompensations of their own. And some patientswith a normal gate pattern are not necessary forits functionality. In this paper our study focuseson the rehabilitation performance based on theankle foot orthotic device.
Three-Dimensional Matrix-Induced Autologous Chondrocytes Implantation for Osteochondral Lesions of the Talus: Midterm Results  [PDF]
B. Magnan,E. Samaila,M. Bondi,E. Vecchini,G. M. Micheloni,P. Bartolozzi
Advances in Orthopedics , 2012, DOI: 10.1155/2012/942174
Abstract: Introduction. We evaluate the midterm results of thirty patients who underwent autologous chondrocytes implantation for talus osteochondral lesions treatment. Materials and Methods. From 2002 to 2009, 30 ankles with a mean lesion size of 2,36?cm2 were treated. We evaluated patients using American Orthopaedic Foot and Ankle Surgery and Coughlin score, Van Dijk scale, recovering time, and Musculoskeletal Outcomes Data Evaluation and Management System. Results. The mean AOFAS score varied from 36.9 to 83.9 at follow-up. Average of Van Dijk scale was 141.1. Coughlin score was excellent/good in 24 patients. MOCART score varied from 6.3 to 3.8. Discussion. This matrix is easy to handle conformable to the lesion and apply by arthroscopy. No correlation between MRI imaging and clinical results is found. Conclusions. Our results, compared with those reported in literature with other surgical procedures, show no superiority evidence for our technique compared to the others regarding the size of the lesions. 1. Introduction Ankle sprain is the most common trauma in sports, and an osteochondral lesion occurs, in up to 50% of an acute ankle trauma [1, 2]. Every day 1 out of 10000 people undergoes to an ankle injury, and in sports practice, this incidence becomes 5,23 out of 10000 [3–5]. The incidence of these lesions is more frequent in male (70%), with an average age ranging between 20 and 30 years, and is bilateral in 10% of cases [6]. The symptoms are impaired function, limited range of motion, stiffness, ankle pain even after a mild traumatic event, or chronic ankle pain [7, 8]. There are also no traumatic causes of osteochondral talus lesions: chronic instability, endocrine or metabolic factors, joint malalignment, idiopathic avascular necrosis particularly dumping growth age, degenerative joint diseases, systemic vasculopathies, and genetic predisposition [9–16]. Osteochondral lesions were classified by Berndt and Harty [17] in 1959 (X-ray classification), modified by Loomer et al. [18] in 1993 (CT scan classification), but many other classifications have been developed, including the arthroscopic outerbridge classification that is commonly used in clinical practice [19–24]. Only the MRI can assess the cartilage damage and other soft tissue lesions [25–27]. The aim of this study was to evaluate the midterm results of a series of patients who have undergone autologous chondrocytes implantation for the treatment of osteochondral lesions of the talus with MACI (Matrix-induced Autologous Chondrocytes Implantation) technique. Conservative treatments for
Audit of Diabetic Soft Tissue Infection and Foot Disease in Accra
E Asumanu, R Ametepi, CT Koney
West African Journal of Medicine , 2010,
Abstract: BACKGROUND: Soft tissue infection and foot disease are well known complications among diabetes mellitus patients. With an increasing prevalence of diabetes mellitus in Africa, management of these complications is expected to become a major problem. OBJECTIVE: To audit the surgical management of diabetic soft tissue infection and foot disease over a two-year period in Accra, Ghana. METHODS: A prospective study of all patients admitted to the General Surgical Unit of the 37 Military Hospital between May 2005 and April 2007 was conducted. Diabetic patients with soft tissue infections and foot disease were selected for study. Doppler studies using a monopolar 8 MHz Nicolet vascular probe was used in assessing the ankle to brachial pressure index (ABPI). Patients were managed based on admitting diagnosis and outcomes were noted. RESULTS: Eighty (8.3%) of 966 surgical patients had diabetes mellitus and soft tissue infection or foot disease. The peak age of presentation of diabetics with soft tissue infection or foot disease was 50–59 years. Diabetic foot disease (53.0%) was the commonest followed by cellulitis of the leg and other soft tissue infections. Overall amputation rate was 33.3% while mortality was 8.8%. CONCLUSION: Foot infections, cellulitis, abscesses and gangrene are the common surgical complications of diabetes mellitus patients in Ghana. Abscess of the hand is the commonest non-foot soft tissue surgical complication and had good outcomes. Overall, females presented earlier and had better outcomes than males.
Generation of subject-specific, dynamic, multisegment ankle and foot models to improve orthotic design: a feasibility study
Michiel Oosterwaal, Scott Telfer, S?ren T?rholm, Sylvain Carbes, Lodewijk W van Rhijn, Ross Macduff, Kenneth Meijer, Jim Woodburn
BMC Musculoskeletal Disorders , 2011, DOI: 10.1186/1471-2474-12-256
Abstract: Functional and anatomical datasets will be collected in a multicentre study from 10 healthy participants and 15 patients requiring orthotic devices. The patient group will include individuals with metarsalgia, flexible flat foot and drop foot.Each participant will undergo a clinical foot function assessment, 3D surface scans of the foot under different loading conditions, and detailed gait analysis including kinematic, kinetic, muscle activity and plantar pressure measurements in both barefoot and shod conditions. Following this each participant will undergo computed tomography (CT) imaging of their foot and ankle under a range of loads and positions while plantar pressures are recorded. A further subgroup of participants will undergo magnetic resonance imaging (MRI) of the foot and ankle.Imaging data will be segmented to derive the geometry of the bones and the orientation of the joint axes. Insertion points of muscles and ligaments will be determined from the MRI and CT-scans and soft tissue material properties computed from the loaded CT data in combination with the plantar pressure measurements. Gait analysis data will be used to drive the models and in combination with the 3D surface scans for scaling purposes. Predicted plantar pressures and muscle activation patterns predicted from the models will be compared to determine the validity of the models.This protocol will lead to the generation of unique datasets which will be used to develop linked inverse dynamic and forward dynamic biomechanical foot models. These models may be beneficial in predicting the effect of and thus improving the efficacy of orthotic devices for the foot and ankle.It has been estimated that almost 200 million people in Europe have disabling foot or ankle pain and that this figure will rise with aging societies and the associated increase in prevalence of chronic long term conditions [1-5]. Foot pain can cause loss of function, discomfort, and a general lowering of the patient's quality
Pseudotumoural soft tissue lesions of the hand and wrist: a pictorial review
Filip M. Vanhoenacker,Michiel Eyselbergs,Erik Van Hul,Pieter Van Dyck,Arthur M. De Schepper
Insights into Imaging , 2011, DOI: 10.1007/s13244-011-0076-5
Abstract: Mimickers of soft tissue tumours in the hand and wrist are more frequent than true neoplastic lesions. Pseudotumours belong to a large and heterogeneous group of disorders, varying from normal anatomical variants, cystic lesions, post-traumatic lesions, skin lesions, inflammatory and infectious lesions, non-neoplastic vascular lesions, metabolic disorders (crystal deposition disease and amyloidosis) and miscellaneous disorders. Although the imaging approach to pseudotumoural lesions is often very similar to the approach to “true” soft tissue tumoral counterparts, further management of these lesions is different. Biopsy should be performed only in doubtful cases, when the diagnosis is unclear. Therefore, the radiologist plays a pivotal role in the diagnosis of these lesions. Awareness of the normal anatomy and existence and common imaging presentation of these diseases, in combination with relevant clinical findings (clinical history, age, location and skin changes), enables the radiologist to make the correct diagnosis in most cases, thereby limiting the need for invasive procedures.
Functional Outcome in Limb-Salvage Surgery for Soft Tissue Tumours of the Foot and Ankle  [cached]
Nigel R. Colterjohn,Aileen M. Davis,Brian O'Sullivan,Charles N. Catton
Sarcoma , 1997, DOI: 10.1080/13577149778326
MR Imaging of Ankle Impingement Syndromes
Seyed Hassan Mostafavi
Iranian Journal of Radiology , 2010,
Abstract: Ankle impingement syndromes are characterized by painful friction of joint tissues. This is both the cause and the effect of altered joint biomechanics. The leading causes of impingement lesions are posttraumatic ankle injuries, usually ankle sprains, resulting in chronic ankle pain. "nBased on anatomic and clinical viewpoints, there are five types of ankle impingement syndromes:"n1. Anterolateral"n2. Anterior"n3. Anteromedial"n4. Posteromedial"n5. Posterior"nCareful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. MR imaging and MR arthrography are the most useful imaging methods for detecting the osseous and soft-tissue abnormalities present in these syndromes and for ruling out other potential causes of chronic ankle pain. "nThis presentation summarizes the MR imaging, and MR arthrography findings of ankle impingement syndromes.
Prevalence of oral soft tissue lesions in Vidisha
Ravi Mehrotra, Shaji Thomas, Preeti Nair, Shruti Pandya, Mamta Singh, Niraj S Nigam, Pankaj Shukla
BMC Research Notes , 2010, DOI: 10.1186/1756-0500-3-23
Abstract: 8.4 percent of the population studied had one or more oral lesions, associated with prosthetic use, trauma and tobacco consumption. With reference to the habit of tobacco use, 635(21%) were smokers, 1272(42%) tobacco chewers, 341(11%) smokers and chewers, while 1464(48%) neither smoked nor chewed. 256 patients were found to have significant mucosal lesions. Of these, 216 cases agreed to undergo scalpel biopsy confirmation. 88 had leukoplakia, 21 had oral submucous fibrosis, 9 showed smoker's melanosis, 6 patients had lichen planus, 17 had dysplasia, 2 patients had squamous cell carcinoma while there was 1 patient each with lichenoid reaction, angina bullosa hemorrhagica, allergic stomatitis and nutritional stomatitis.The findings in this population reveal a high prevalence of oral soft tissue lesions and a rampant misuse of variety of addictive substances in the community. Close follow up and systematic evaluation is required in this population. There is an urgent need for awareness programs involving the community health workers, dentists and allied medical professionals.Oral malignancies are the sixth most common cancer around the globe [1]. Oral mucosal lesions could be due to infection (bacterial, viral, fungal), local trauma and or irritation (traumatic keratosis, irritational fibroma, burns), systemic disease (metabolic or immunological), or related to lifestyle factors such as the usage of tobacco, areca nut, betel quid, or alcohol.For planning of national or regional oral health promotion programs as well as to prevent and treat oral health problems, baseline data about magnitude of the problem is required. India has a vast geographic area, divided into states, which differ with regard to their socioeconomic, educational, cultural and behavioural traditions. These factors may affect the oral health status. Hence to obtain nationwide representative data, a nationwide study is required. A more practical alternative is to develop regional databases and review d
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