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Partial tendon tear as unusual cause of trigger finger. a case report
Full text linkWe report a case of post-traumatic trigger finger due to a partial longitudinal tear of the flexor digitorum superficialis. The suspect came from the clinical history and the young age of the patient. It was successfully treated with tendon flap suture and pulley A1 release
Patient specific instrument in total knee arthroplasty
No full textIn this book, the complete development of an external intelligent knee prosthesis created by the Mechatronics Research Group (MRG) was presented. This project brought out several advances in the prosthetic field which the authors discuss in detail. The second chapter examines the use of finite element modeling for understanding knee prosthesis biomechanics, fundamental to answering clinical question in the field. Also looked at are the basic characteristics of knee prostheses that must be complied with in order to provide a safe and biomechanical performance to its users during walking. Other chapters present the main results from a project whose main focus was to evaluate the tibial inserts wear and to obtain the possibility to control the total knee prosthesis (TKPs) wear process; whether screening and decolonization (S&D) is effective in reducing the rate of postoperative infection after elective knee joint arthroplasty and whether it's cost-effective; and finally, a review of the current literature, as well as some personal experiences, on assessing the reliability of patient specific instrument system in total knee arthroplasty (TKA)
Is it really necessary to restore radial anatomic parameters after distal radius fractures?
No full textEvaluation of the accuracy of a patient-specific instrumentation
Full text linkPatient-specific instruments (PSI) has been introduced with the aim to reduce the overall costs of the implants, minimizing the size and number of instruments required, and also reducing surgery time. The aim of this study was to perform a review of the current literature, as well as to report about our personal experience, to assess reliability and accuracy of patient specific instrument system in total knee arthroplasty (TKA). A literature review was conducted of PSI system reviewing articles related to coronal alignment, clinical knee and function scores, cost, patient satisfaction and complications. Studies have reported incidences of coronal alignment ≥3° from neutral in TKAs performed with patient-specific cutting guides ranging from 6% to 31%. PSI seem not to be able to result in the same degree of accuracy as for the CAS system, while comparing well with standard manual technique with respect to component positioning and overall lower axis, in particular in the sagittal plane. In cases in which custom-made cutting jigs were used, we recommend performing an accurate control of the alignment before and after any cuts and in any further step of the procedure, in order to avoid possible outliers
The influence of playing surface on injury risk in italian elite rugby players
Full text linkBackground: There is a growing interest in the use of artificial turf surfaces in rugby. In particu- lar, artificial surfaces may be an useful means of increasing participation in the sport by allowing greater usage of a given pitch, especially in re- gions where natural turf pitches are difficult to maintain.
Methods: The incidence of site, nature, cause, and severity of training and match injuries was prospectively recorded in two professional teams (one equipped with World Rugby certified third generation artificial turf and the other with natural grass over the 2014-2015 season).
Results: A total of 23,840 minutes of exposure was displayed for the whole sample, 1,440 min- utes during matches and 22,400 during training sessions.
We recorded 37 (48%) traumatic injuries and 39 (52%) overuse injuries. For traumatic injuries, we
Corresponding author: did not find significant differences in the overall risk injury between grass and artificial turf con- sidering match exposure and training sessions. For overuse injuries, there were significant differ- ences in the overall risk injury between grass and artificial turf considering match exposure (p=0.03) and training sessions (p=0.02).
Conclusion: In elite Italian rugby players, artificial turf seems to be safe in regards to traumatic in- jury while it seems to be a risk factor for overuse injuries
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Extra-articular tenodesis combined with an anterior cruciate ligament reconstruction in acute anterior cruciate ligament tear in elite female football players
Full text linkPURPOSE: The growing popularity of elite soccer among female participants has led to increased incidents of anterior cruciate ligament (ACL) ruptures. Many authors underline a positive glide after ACL reconstruction (ACLR), especially in women. In fact, an isolated intra-articular ACLR may be inadequate to control rotational instability after a combined injury of the ACL and the peripheral structures of the knee. Extra-articular procedures are sometimes used in primary cases displaying excessive antero-lateral rotatory instability. The purpose of this case series was to report subjective and objective outcomes after combined ACL and lateral extra-articular tenodesis (LET) with a minimum 4-year follow-up in a selected high-risk population of elite female football players.
METHODS: Between January 2007 and December 2010, 16 elite Italian female football players were included in the study. All patients underwent the same surgical technique: anatomical ACLR with autogenous semitendinosus and gracilis tendons. After the intra-articular reconstruction was performed, an additional extra-articular MacIntosh modified Coker-Arnold procedure was carried out. Patients were assessed pre- and post-operatively with the subjective and objective International Knee Documentation Committee (IKDC) evaluation form, Tegner activity scale (TAS) and Lysholm score. Joint laxity was assessed with KT-1000 by measuring the side-to-side (S/S) differences in displacement at manual maximum (mm) testing.
RESULTS: At a mean follow-up of 72.6 ± 8.1 months, two independent examiners reviewed all players. All of the patients had a fully recovered range of motion. Lachman test was negative in all patients (100 %). The evaluation of joint laxity and clinical evaluation showed a statistically significant improvement. No patients experienced complication or a re-rupture.
DISCUSSION: The rationale of combining extra-articular procedures with ACLR is to restrict the internal rotation of the reconstructed knee, taking advantage of its long lever arm and thus providing more stability in the rotational axis and preventing the ACL graft from undergoing further excessive strain.
CONCLUSIONS: The combination of an LET with ACLR in elite female football players demonstrated excellent results in terms of subjective scales, post-operative residual laxity and re-rupture rate with no complication, and a complete return to sport activity
Denervation-related changes in acetylcholine receptor density and distribution in the rat flexor digitorum sublimis muscle
No full textReorganization of the muscle endplate structures is an important parameter for the study of posttraumatic neuromuscular recovery. The aim of this study was to investigate the changes and the distribution of the acetylcholine receptors (AChRs) in flexor digitorum sublimis muscle after 30 days of denervation in the rat forelimb experimental model. In young male rats, the median and ulnar nerves of the right forelimb were surgically transected and a 1-cm-long segment was removed to avoid spontaneous regeneration. Along the postoperative, the presence of complete functional loss was assessed by the grasping test. After 30 days, rats were sacrificed and flexor digitorum sublimis muscles of both limbs were explanted. The muscles were analysed by light microscopy, to assess the degree of muscle atrophy, and by immunofluorescence after rodhamine-conjugated alpha-bungarotoxin incubation to investigate the reorganization of endplates. The occurrence of muscle denervation was established, prior to sacrifice, by complete loss of the grip function. Light microscopy showed that 30-day denervation is sufficient to induce severe muscle fiber atrophy. Fluorescence analysis at low resolution showed that background fluorescence was higher in denervated muscles possibly because of the presence of extrajunctional AChR. At higher resolution, the endplates were clearly visible as ribbon-like structures. In control fibres, AChR formed a compact and bright structure while in denervated samples it appeared more diffuse and dimmer. Quantitative analysis showed that endplate area was larger in denervated muscles than in control samples. A corresponding decrease in fluorescence intensity was observed after subtracting the basal fluorescence. In conclusion, results of the present study demonstrate that 30 days of denervation induce severe atrophy in rat flexor digitorum sublimis muscle that is accompanied by significant changes in acetylcholine receptor density and distribution. These results also suggest that the rat median nerve denervation experimental model can be an excellent approach for the study of the progression of endplate re-organization after muscle denervation, and reinnervation, considering also its relatively low impact on animal well being in comparison to other experimental models
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