43 research outputs found

    Modern Aspects of Diagnosis and Treatment of Ligament Injuries of the Lateral Column of the Ankle Joint // Съвременни аспекти на диагностиката и лечението при лигаментарни увреди на латералната колона на глезенната става

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    Независимо от високата честота на заболеваемост, голямата концентрация на структури в областта на глезенната става затруднява диагностиката и лечението. Темата на дисертационният труд акцентира върху лигаментарните увреди на латералната колона, поради честите пропуски в диагностиката, а от там и на неадекватни подходи в лечението. Нашите цели са свързани с изследване на сонографията и стрес рентгенографията като диагностични методики и изследването на някои оперативни интервенции в отговор на стремежа за по – цялостно и пълно възстановяване и сравняването им в краткосрочен, средносрочен и дългосрочен план спрямо останалите конвенционални подходи при диагностиката и лечението на увредите на латералния лигаментарен комплекс на глезенната става.Despite the high incidence of morbidity, the large concentration of structures in the ankle joint makes it difficult for diagnosis and treatment. This thesis focuses on the ligament damage to the lateral column due to frequent gaps in diagnosis resulting in inadequate treatment approaches. Our goals relate to the study of sonography and stress radiography as diagnostic methods and survey of some surgical interventions in response to the quest for full and complete recovery. We scrutinize them in the short, medium and long term compared to other conventional approaches in diagnosis and treatment of the injured lateral ligament complex of the ankle joint

    Ligamentous Lisfranc injuries: analysis of CT findings under weightbearing.

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    PURPOSE The aim of this study was to investigate the influence of different ligamentous Lisfranc injuries on computed tomography (CT) findings under weight-bearing and to emphasize the indications for surgical treatment of their various types. METHODS Sixteen human cadaveric lower limbs were placed in weight-bearing radiolucent frame for CT scanning. All intact specimens were initially scanned, and then, dorsal approach was used for sequential ligaments cutting of: (1) the dorsal and the interosseous (Lisfranc) ligaments between medical cuneiform (MC) and metatarsal 2 (MT2); (2) the plantar ligament between the MC and MT3; (3) the plantar ligament between MC and MT2. Based on sequential CT scans, the distances MT1-MT2, MC-T2, as well as the alignment and dorsal displacement of MT2 were measured. RESULTS Slight increase in the distances MT1-MT2 and MC-MT2 was observed after the disruption of the dorsal and the interosseous ligaments. Further increase in MT1-MT2 and MC-MT2 distances was registered after the disruption of the ligament between MC and MT3. The largest distances MT1-MT2 and MC-MT2 were measured after the final plantar ligament cut between MC and MT2. CONCLUSIONS Unequivocal instability is observed with simultaneous transection of the Lisfranc ligament with both plantar ligaments. On CT used as diagnostic tool, plantar injuries at the basis of the second and the third metatarsal are indirect signs of violation of the ligaments and represent an indication for surgical treatment. When using magnetic resonance imaging as diagnostic tool, a ruptured Lisfranc ligament alone without dislocation does not necessarily need surgical intervention

    On the states in the development of old bulgarian/old slavonic homiliar – facts and hypotheses

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    The article deals with some problems of formation of a Slavic Homiliar and translating a Sermon for Nativity of Virgin Mary – N 21 of Codex Suprasliensis – a text created in Preslav in the middle of the 10th c. – and relationship of this text in the development of the Slavic Homiliar. Recently scholars have been speaking in an ever more convincing manner of “early” and “late” Preslav. The author believes that when trying to find the states of this development, this direction should be followed

    Latent Semantic Analysis for German literature

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    The paper presents the results of experiments of usage of LSA for analysis of textual data. The method is explained in brief and special attention is pointed on its potential for comparison and investigation of German literature texts. Two hypotheses are tested: 1) the texts by the same author are alike and can be distinguished from the ones by different person; 2) the prose and poetry can be automatically discovered

    Hoffa Fracture in Childhood

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    Introduction: Coronal fractures of the femoral condyle, first described by Hoffa in 1904, are an uncommon clinical entity typically seen in adults after higher-energy trauma. These fractures appear to be even more uncommon in children. A young boy presented after sustaining a twisting injury to his left knee. He presented shortly thereafter to the emergency room with a swollen, painful left knee and inability to bear weight. Physical examination revealed a diffusely tender knee with a moderate-sized effusion. He reported significant pain with any type or range of motion. Anterior and lateral radiographs of the knee revealed a hemarthrosis with a minimally displaced fracture to the lateral femoral condyle. Computed tomography scan revealed a minimally displaced coronal shear fracture of the lateral femoral condyle. The patient was placed in a bulky soft dressing and knee immobilizer, and underwent open reduction and internal fixation. Hoffa fractures are a unique and uncommon clinical entity that has a different personality than other intra articular fractures of the knee in children. In contrast to adults, these fractures appear to be associated with lower-energy mechanisms in skeletally immature patients.Materials and Methods: The patient underwent surgical treatment. It was made with open reduction internal fixation done with 2 screws using anterior approach.Results: After undergoing rehabilitation,  the patient recovered full mobility and functionality of the joint for a period of 30 to 35 days. Conclusion: Hoffa fracture in childhood needs to be treated surgically with open reduction internal fixation in most of the cases by using cannulated screws or Herbert screw

    Adams Procedure - a Method of Repair for Post-Traumatic DRUJ Instability

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    Introduction: The triangular fibrocartilage complex (TFCC) is a ligamentous and cartilaginous structure that suspends the distal radius and the ulnar carpus from the distal ulna. It consists of a triangular fibrocartilage disc, radioulnar ligaments (RUL) and ulnocarpal ligaments (UCL) and is considered the main stabilizer of the distal radioulnar joint. The etiology of TFCC injuries consists of falls onto pronated hyperextended wrist, forced rotational movements or they are in association with distal forearm fractures. Patients report trauma followed by ulnar-side wrist pain, swelling, sound of clicking during supination or pronation and later on - loss of grip strength. Two specific classifications are used. The Palmer classification gives accurate anatomical location of the lesion while the five-graded Atzei-EWAS classification is used to determine the severity of the rupture. Stabilization of the distal radioulnar joint with reconstruction of distal radioulnar ligaments as outlined by Adams is indicated if a refixation of the triangular fibrocartilage complex is no longer possible and there are no present arthrotic changes.Materials and Methods: Ten patients with distal radioulnar joint instability caused by 4th grade TFCC tears were diagnosed and admitted to the Clinic of Orthopedics and Traumatology in St. Anna University Hospital, Varna for the interval 2013-2017. The procedure of Adams was the surgical method of choice for all of them.Results: MAYO wrist score was used for evaluation of the patients` pre- and postoperative conditions. The results showed restored stability, relieved symptoms and attained near-physiological levels of pronation and supination after the surgical procedure.Conclusion: TFCC injuries are not to be treated lightly as they trouble the mechanics of the DRUJ. Surgical treatment is considered superior to the conservative, and the Adams procedure is an effective method of approach towards the 4th grade tears

    Lateral ankle ligament complex sprain - epidemiology in Varna region population

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    Introduction: Ankle sprains are very common injury, not only in sport, but also in everyday life.  This pattern has been studied in athletic cohorts, but little is known of its epidemiology in the general population. We have not found accounts of the epidemiology rate for ankle sprain in Bulgarian population specifically in Varna region after 1990. Because of this, we have used in a long term, a retrospective epidemiological database to determine the incidence for ankle sprains admitted in the Emergency trauma center - University Hospital St. Anna, Varna, Bulgaria.Methods: We performed a retrospective statistical processing of patients who have passed through the Emergency trauma center in 01.01.2014-31.12.2014. Incidence rate ratios were then calculated with respect to age, sex, and involvement of the medial or lateral ankle aspect.Results: During the study period, an estimated 1267 ankle sprains occurred among a population of 475 074 (2011) in Varna region. The epidemiological rate for this period is 2.46 ‰.  Gender distribution - male/female ratio was 1.2/1 (♂  609, ♀ 560). Lateral ankle ligament complex sprains were 92.26% (1 169 cases) of all ankle sprains.Conclusion: Ankle sprains occur with high frequency and significantly affect the lateral ligament complex. The injury occurs not only during sports but in everyday life. Ankle sprains are often misdiagnosed and undertreated, resulting in chronic pain, muscular weakness and instability. This common trauma leads to serious economic consequences because it requires a long term recovery followed by physical therapy

    Cultural and Educational Processes among the Bulgarians in the USSR (the 1920s)

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    У статті на основі документальних джерел досліджено процес так званого болгарського культурно-освітнього відродження у контексті впровадженої більшовицькою владою політики коренізації. Зокрема, відтворено процес формування системи болгарських культурно-освітніх закладів — мережі шкіл, технікумів і бібліотек. Особливу увагу приділено закладам політичної просвіти й професійно-технічним осередкам — Преславському педагогічному технікуму та Преславській агрошколі.On the basis of documentary sources the author has studied the process of so-called Bulgarian cultural and educational revival in the context of Bolshevik regime’s indigenization policy. In particular, it is reproduced the formation of the system of Bulgarian cultural and educational institutions — a system of schools, colleges and libraries. Special attention is paid to the institutions of political education and vocational cells — Preslav Teachers College and Preslav agricultural school

    PANcakes Team: A Composite System of Genre-Agnostic Features For Author Profiling Notebook for PAN at CLEF 2016

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    Abstract We present the system we built for participating in the PAN-2016 Author Profiling Tas
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