1,721,102 research outputs found
Misdiagnosed iuxta-articular osteoid osteoma of the calcaneus following an injury.
No full textThe diagnosis of osteoid osteoma, in usual localizations, is generally simple. In iuxta-articular localizations
this tumor may be unrecognized and the diagnosis delayed. Injury has been sometimes correlated
with the onset of symptoms and this can make the diagnosis even more difficult.We present a case of osteoid
osteoma of the calcaneus iuxta-articular to the subtalar joint in a 17-year-old basketball player. He had
a history of initial injury, ankle sprain during training, followed by pain and swelling. He was initially treated
for lateral ligament lesion of the ankle with unsatisfactory results. After acute trauma the pain changed
becoming chronic and mostly nocturnal disappearing when rofecoxib was taken. Standard x-ray didn’t show
the lesion.Nuclear Magnetic Resonance (NMR) and scintigraphic results were not well interpreted but these
clinical changes and Computed Tomography (CT) images supported the diagnosis of osteoid osteoma. The
complete resection of the bone lesion resolved all the symptoms and the histological report confirmed the
suspected diagnosis
DELAYED DIAGNOSIS OF ISOLATED CORACOID PROCESS FRACTURES: RESULTS OF 9 CASES TREATED CONSERVATIVELY
No full textBackground and aim: Isolated coracoid process fractures are more frequent than what has formerly
been believed. Delayed diagnosis or misdiagnosis are not infrequent as it is difficult to notice this injury
using routine radiographic projections of the shoulder. In any event, more specific views are prescribed only
when a fracture is suspected. The purpose of this study is to assess the outcomes of 9 cases of isolated coracoids
fractures treated conservatively after being undiagnosed and discuss the reasons of these delayed diagnoses.
Materials and Methods: Between January 1984 and June 2011, 9 out of 19 isolated coracoid fractures
received a delayed diagnosis. There were 7 type I fractures and 2 type II. All patients were treated conservatively.
Results: All fractures, except one, consolidated. The delay of the diagnosis was greater in type II lesions
rather than in type I. Differences in clinical outcomes between affected and healthy side were minimal.
Delayed diagnosis was overseen by the physician in 8 cases whereas in 1 case the patient underestimated the
trauma and left the injury untreated. Conclusions: An isolated coracoid fracture should always be suspected
after receiving a direct blow on the shoulder or after sustaining a forceful traction of the upper arm. In these
events, specific radiographic projections should be performed in order to visualise the entire length of the
coracoid process and to avoid oversight, delayed diagnosis or misdiagnosis. In isolated type I undisplaced
fractures and in the majority of type II fractures, conservative treatment is indicated
POST-TRAUMATIC INFECTED NECROSIS OF THE ASTRAGALUS TREATED BY TIBIOTALOCALCANEAL ARTHRODESIS: DESCRIPTION OF A CLINICAL CASE.
No full text
Osteosintesi con placca volare a stabilità angolare nelle fratture del polso. "Volar fixed-angle plate fixation for wrist fractures".
No full textCryoultrasound therapy and tendonitis in athletes: a comparative evaluation versus laser CO2 and t.e.ca.r.therapy
No full textAim of this study is to compare the different kinds of tendonitis in athletes using cryoultrasound
therapy, lasertherapy CO2 and t.e.ca.r. therapy ( transfert energetic capacitive and resistive ). Forty five athletes
were selected; they were all affected by severe insertional tendonitis of the Achilles tendon (15 of them),
of the patellar tendon (15 of them) and of the epicondylar region (15 of them) during the last two months.
They were divided into three groups. The first group underwent a treatment of 12 lasertherapy CO2 sessions,
the second group 12 cryoultrasound therapy sessions and the last group 12 t.e.ca.r. therapy sessions. Each patient
was registered by an independent observer according to the pain before (initial V.A.S.) and after treatment
(final V.A.S.) using the analogic visual range from 0 (lack of pain) to 10 (unbearable pain) and the indicator
of efficacy (difference between initial V.A.S. and final V.A.S. / initial V.A.S.x 100). The obtained results
were expressed as a difference between the two V.A.S. values and as a parameter of effectiveness (value
ranging from 0 to 100) in order to correlate the initial condition of the patients with the performed physiotherapic
treatment. The obtained V.A.S. score was submitted to statistic evaluation by analysis of variance
through repeated measures, taking into consideration a value of p<0,05. Possible differences among the group
of patients were shown by analysis of variance through one single way by comparison among groups. Every
patient benefited from the treatment. Analyzing the initial and final V.A.S. values in the three groups, statistically
significant variations emerged (p<0,05). A meaningful difference resulted among the different kinds
of treatment; a marked difference was noticed between laser CO2 and cryoultrasound therapy (p<0,01). No
statistically significant differences were observed between t.e.ca.r. and laser CO2 therapy or between t.e.ca.r.
and cryoultrasound therapy. It must be admitted that the mean difference between initial and final V.A.S. is
higher in the Cryoultrasound group (7,40), than in the Laser group (6,33) compared to t.e.ca.r. group (6,74).
This result would explain a higher range of effectiveness in the Cryoultrasound group (85) compared to the
laser CO2 (71,9 ) and t.e.ca.r. group (77,3). It can be asserted that cryoultrasound is a useful instrument for
the physician working in the sports field. It offers advantages in comparison with laser CO2. It does not show
significant differences with t.e.ca.r. therapy, although it shows a better mean range of effectiveness
L’epitrocleite del lanciatore nel gioco del baseball
No full textAim. Aim of this study is to evaluate the efficaciousness of a programm aiming to prevent relapse of epitrocleytis. This overuse pathology being caused by repeated microtraumas on articular parts of the elbow during constant throwing in baseball game. Methods. Eighty-six baseball players, playing in professional and semiprofessional teams in the area of Parma underwent a screening. Nineteen pitchers were selected, the age varied from 18 to 25 years, who had lamented in the previous twelve months at least two episodes of testified epitrocleytis, none the less at the moment of selection they did not show any painful symptom. An isokinetic test was effected in order to verify the peak torque and power of pronator-supinator muscles, it showed an increase of peak torque and power of pronator muscles. It was well adviced a therapeutical programm to restablish singularly the deficitarious muscles by global reinforcement muscular exercises and specifically isotonic with weights and theraband. Results. The isokinetic test effected after six months from therapeutical preventive treatment underlined a variation statistically meaningful with a medium increase of the peak torque value of 24% and power of 19% for supinator muscles with an angular speed of 90°/sec.; respectively of 26% and 20.6% with angular speed of 180°/sec. A balanced equilibrium between pronator-supinator muscles was successfully achieved. No elbow pathology was present after two years treatment. Conclusion. The muscular unbalance may provoke pathologies in structures musculo tendinous and capsule-ligamentous in baseball game. The improvement of muscular balance resulted by the adviced treatment showed by isokinetic test, has positively influenced the biomechanic of the movement and we believe that was a relevant factor in preventing the frequent relapses. In all those sports in which throwing is particularly elicited, it was necessary a harmonic balance in the muscular structure in particular of pronator and supinator muscles; all this may be achieved by a suitable preventive exercise
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