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Sample records for ankle arthroscopy distraction

  1. Distraction-free ankle arthroscopy for anterolateral impingement.

    PubMed

    Rouvillain, Jean Louis; Daoud, Wael; Donica, Adrian; Garron, Emmanuel; Uzel, André Pierre

    2014-08-01

    The origin of chronic pain after external ankle sprain is better known with arthroscopy's contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement." But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected? This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than 6 months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction. Average patient follow-up was 22 months (12-92 months). All patients had a good Kitaoka score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at 6 months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement. In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates. Level of evidence Retrospective cohort study, Level IV. PMID:24220747

  2. Ankle arthroscopy

    MedlinePlus

    Ankle surgery; Arthroscopy - ankle; Surgery - ankle - arthroscopy; Surgery - ankle - arthroscopic ... You will likely receive general anesthesia before this surgery. This means you will be asleep and unable ...

  3. Editorial Commentary: Ankle Arthroscopy: Correct Portals and Distraction Are the Keys to Success.

    PubMed

    Ferkel, Richard D

    2016-07-01

    Access to all areas of the ankle during arthroscopy is always problematic. The use of the correct portals and distraction increases access in both the supine and prone positions. Noninvasive distraction up to 30 pounds is safe and effective to perform arthroscopy in the supine position, and avoids the potential complications of pin distraction. PMID:27373182

  4. Pseudoaneurysm of peroneal artery after ankle arthroscopy

    PubMed Central

    Battisti, Daniela; Oliva, Francesco; Tarantino, Umberto; Nicola, Maffulli

    2014-01-01

    Summary Background: ankle arthroscopy increased its role in the diagnosis and treatment of pathology of the ankle since 1970s. Although the benefits are well established, ankle arthroscopy is associated with a definite risk of complications, especially neurological. The incidence rate of vascular complication after anterior ankle arthroscopy has been reported. Methods: we review the literature on vascular complications after anterior ankle arthroscopy especially pseudoaneurysm and a case report of a peronal artery pseudoaneurysm was reported. Conclusion: vascular complications after an anterior ankle arthroscopy are extremely rare but orthopaedic surgeons should be wary of this chance. Among vascular complications after an anterior ankle arthroscopy, peroneal artery pseudoaneurysm to our knowledge never has been described until now. PMID:25332946

  5. Extended indications for foot and ankle arthroscopy.

    PubMed

    Hsu, Andrew R; Gross, Christopher E; Lee, Simon; Carreira, Dominic S

    2014-01-01

    Advances in foot and ankle arthroscopy have allowed surgeons to diagnose and treat a broadening array of disorders that were previously limited to open procedures. Arthroscopy of the posterior ankle, subtalar joint, and first metatarsophalangeal joint and tendoscopy can be used to address common foot and ankle ailments, with the potential benefits of decreased pain, fast recovery, and low complication rates. Posterior ankle and subtalar arthroscopy can be used to manage impingement, arthrofibrosis, synovitis, arthritis, fractures, and osteochondral defects. First metatarsophalangeal joint arthroscopy can address osteophytes, chronic synovitis, osteochondral defects, and degenerative joint disease. Tendoscopy is a minimally invasive alternative for evaluation and débridement of the Achilles, posterior tibial, flexor hallucis longus, and peroneal tendons. PMID:24382875

  6. Small joint arthroscopy in foot and ankle.

    PubMed

    Lui, Tun Hing; Yuen, Chi Pan

    2015-03-01

    The clinical application of small joint arthroscopies (metatarsophalangeal joint, Lisfranc joint, Chopart joint, and interphlangeal joint) in the foot has seen significant advancements in the past decades. This article reviews the clinical indications, technical details, outcomes, and potential complications of small joint arthroscopies of the foot. PMID:25726488

  7. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal.

    PubMed

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  8. Iatrogenic posterior tibial nerve division during a combined anterior ankle arthroscopy with an additional posterolateral portal

    PubMed Central

    Abdul-Jabar, Hani B; Bhamra, Jagmeet; Quick, Tom J; Fox, Michael

    2016-01-01

    Ankle arthroscopy is an important diagnostic and therapeutic technique in the management of ankle disorders. Nowadays ankle arthroscopy provides good to excellent results (up to 90%) in the treatment of certain intra-articular disorders. Due to the superficial location of ankle joint and the abundance of overlying neurovascular structures, complications reported in ankle arthroscopy are greater than those reported in other joints. We present the first reported case of a complete division of the posterior tibial nerve during an anterior ankle arthroscopy combined with an additional posterolateral portal. This was due to a poorly controlled use of the arthroscopic instruments. PMID:27197613

  9. Use of Cannulated Instruments to Localize the Portals in Anterior Ankle Arthroscopy: A Technique Tip.

    PubMed

    Needleman, Richard L

    2016-01-01

    The use of cannulated instruments under fluoroscopy can improve the localization of the anteromedial and posterolateral portals for use in ankle arthroscopy. This technique is valuable for the less-experienced ankle arthroscopist, in resident education, and for the experienced arthroscopist when surface anatomy palpation and visualization is less than ideal due to soft tissue edema and obesity. PMID:26947000

  10. Anterior Tibial Artery Pseudoaneurysm following Ankle Arthroscopy in a Hemophiliac Patient.

    PubMed

    Chamseddin, Khalil H; Kirkwood, Melissa L

    2016-07-01

    Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We present the second case of anterior tibial artery pseudoaneurysm formation secondary to ankle arthroscopy in a hemophiliac patient and suggest that these individuals are at higher risk for developing complications associated with arterial injury. Furthermore, potential risk factors include port placement, anatomic variation of the vessels, and nature of the arthroscopic procedure. We recommend steps to prevent complications in hemophiliac patients. PMID:27174350

  11. Intra-articular Lesions in Chronic Lateral Ankle Instability: Comparison of Arthroscopy with Magnetic Resonance Imaging Findings

    PubMed Central

    Kim, Hyoung Soo; Chung, Soo Tai; Yoo, Jeong Hyun; Park, Jai Hyung; Kim, Joo Hak; Hyung, Jae Won

    2012-01-01

    Background Chronic lateral ankle instability often accompanies intra-articular lesions, and arthroscopy is often useful in diagnosis and treatment of intra-articular lesions. Methods Preoperative magnetic resonance imaging (MRI) examinations and arthroscopic findings were reviewed retrospectively and compared in 65 patients who underwent surgery for chronic lateral ankle instability from January 2006 to January 2010. MR images obtained were assessed by two radiologists, and the inter- and intra-observer reliability was calculated. American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores were evaluated. Results Abnormalities of the anterior talofibular ligament (ATFL) were found in all 65 (100%) cases. In arthroscopy examinations, 33 (51%) cases had talar cartilage lesions, and 3 (5%) cases had 'tram-track' cartilage lesion. Additionally, 39 (60%) cases of synovitis, 9 (14%) cases of anterior impingement syndrome caused by osteophyte, 14 (22%) cases of impingement syndrome caused by fibrotic band and tissue were found. Sensitivity of MRI examination for each abnormality was: ATFL, 60%; osteochondral lesion of talus (OLT), 46%; syndesmosis injury, 21%; synovitis, 21%; anterior impingement syndrome caused by osteophyte, 22%. Paired intra-observer reliability was measured by a kappa statistic of 0.787 (95% confidence interval [CI], 0.641 to 0.864) for ATFL injury, 0.818 (95% CI, 0.743 to 0.908) for OLT, 0.713 (95% CI, 0.605 to 0.821) for synovitis, and 0.739 (95% CI, 0.642 to 0.817) for impingement. Paired inter-observer reliability was measured by a kappa statistic of 0.381 (95% CI, 0.241 to 0.463) for ATFL injury, 0.613 (95% CI, 0.541 to 0.721) for OLT, 0.324 (95% CI, 0.217 to 0.441) for synovitis, and 0.394 (95% CI, 0.249 to 0.471) for impingement. Mean AOFAS score increased from 64.5 to 87.92 (p < 0.001) when there was no intra-articular lesion, from 61.07 to 89.04 (p < 0.001) in patients who had one intra-articular lesion, and from

  12. Deltoid Ligament and Tibiofibular Syndesmosis Injury in Chronic Lateral Ankle Instability: Magnetic Resonance Imaging Evaluation at 3T and Comparison with Arthroscopy

    PubMed Central

    Chun, Ka-Young; Lee, Seok Hoon; Kim, Jin Su; Young, Ki Won; Jeong, Min-Sun; Kim, Dae-Jung

    2015-01-01

    Objective To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). Materials and Methods Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. Results On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. Conclusion Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential. PMID:26356649

  13. Editorial Commentary: Does Early Arthroscopy of Subtle Instability in High Ankle Sprains Hasten Return to Play in Elite Athletes?

    PubMed

    Feldman, Michael D

    2016-04-01

    Anterior inferior tibial fibular ligament tenderness to palpation, a positive squeeze test, and a positive external rotation test correlate well with syndesmosis instability after high ankle sprain. However, it is still unknown whether subtle unstable high ankle sprains (grade IIB) could heal satisfactorily with nonoperative treatment and whether their recovery would be prolonged compared with operative treatment. PMID:27039685

  14. Wrist arthroscopy

    MedlinePlus

    Wrist surgery; Arthroscopy - wrist; Surgery - wrist - arthroscopy; Surgery - wrist - arthroscopic; Carpal tunnel release ... You will likely receive general anesthesia before this surgery. This means you will be asleep and unable ...

  15. Instrumentation in Arthroscopy.

    PubMed

    Barp, Eric A; Erickson, John G; Reese, Eric R

    2016-10-01

    In recent years, arthroscopic procedures of the foot and ankle have seen a significant increase in both indications and popularity. Furthermore, technological advances in video quality, fluid management, and other arthroscopy-specific instruments continue to make arthroscopic procedures more effective with reproducible outcomes. As surgeons continue to use this approach, it is important that they have a complete understanding of the instrumentation available to them, including their indications and limitations. PMID:27599434

  16. Distraction arthroplasty.

    PubMed

    Morse, Kenneth R; Flemister, A Samuel; Baumhauer, Judith F; DiGiovanni, Benedict F

    2007-03-01

    Few joint-preserving surgical options exist for the patient who has ankle arthritis refractory to conservative measures. Therefore, continuous effort is afforded to the development of additional treatment options for such patients. Distraction arthroplasty has been proposed as one of these options for the patient in whom fusion or joint replacement is not appropriate. Although the mechanism of action remains unknown, the reports of several researchers support the potential beneficial effects that can be obtained from joint distraction arthroplasty in the severely osteoarthritic ankle. Furthermore, the studies published to date suggest that these effects may not only persist for years but also improve as time progresses during the first several years after treatment. Although additional laboratory studies are needed to understand the biochemical and biomechanical effects of distraction, additional prospective clinical studies are also needed to further understand its efficacy and appropriate patient population. The data thus far suggests that joint distraction arthroplasty may be a viable alternative treatment to arthrodesis and replacement for the young patient who has a congruent, painful, mobile, arthritic ankle joint. PMID:17350509

  17. [Hip arthroscopy].

    PubMed

    Gollwitzer, H; Banke, I J; Schauwecker, J

    2016-02-01

    Hip arthroscopy represents an important component in the treatment of diseases of the hip joint and is nowadays an indispensible tool in modern hip-preserving surgery. This article provides a review of the basic technical principles, typical indications and complications of hip arthroscopy. Furthermore, current developments as well as possibilities and limitations of the arthroscopic technique are reviewed. PMID:26781702

  18. [Complications of hip arthroscopies].

    PubMed

    Dienst, M; Grün, U

    2008-11-01

    Surgical complications of hip arthroscopies are rare in the hands of experienced hip arthroscopists. However, when performed by beginners and in more demanding situations such as marginal distraction of the head and socket and technically advanced procedures, the risk increases. This report describes possible complications which may happen during positioning and traction, portal placement, and diagnostic and therapeutic procedures. Possible causes of soft tissue lesions of the portal area, perineum and foot, intra-articular lesions of the labrum and cartilage, direct and traction-related indirect neurovascular lesions, and other rare complications are analyzed. PMID:18854972

  19. Hip arthroscopy

    MedlinePlus

    Johnson D, Weiss WM. Basic arthroscopic principles. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ... 11. Sanchez VMI, Meza AO. Hip arthroscopy. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ...

  20. Small Joint Arthroscopy in the Foot.

    PubMed

    Reeves, Christopher L; Shane, Amber M; Payne, Trevor; Cavins, Zac

    2016-10-01

    Arthroscopy has advanced in the foot and ankle realm, leading to new innovative techniques designed toward treatment of small joint abnormality. A range of abnormalities that are currently widespread for arthroscopic treatment in larger joints continues to be translated to congruent modalities in the small joints. Small joint arthroscopy offers relief from foot ailments with a noninvasive element afforded by arthroscopy. Early studies have found comparable results from arthroscopic soft tissue procedures as well as arthrodesis of the small joints when compared with the standard open approach. PMID:27599441

  1. Laser arthroscopy.

    PubMed

    Sherk, H H; Lane, G J; Black, J D

    1992-09-01

    Lasers have become widely used in several medical and surgical disciplines. In ophthalmology and plastic surgery, their use has permitted the development of therapeutic modalities that would have been otherwise impossible. In such specialties as gynecology and general surgery, lasers provide advantages that make certain procedures more convenient and easier to perform. In contrast, orthopaedic surgeons have, to date, been slow to accept these devices into the therapeutic armamentarium. The purpose of this paper is to describe the status of laser use in the orthopaedic subspecialty of arthroscopy. PMID:1437258

  2. Trends in Wrist Arthroscopy

    PubMed Central

    Obdeijn, Miryam C.; Tuijthof, Gabrielle J. M.; van der Horst, Chantal M. A. M.; Mathoulin, Christophe; Liverneaux, Philippe

    2013-01-01

    Background Wrist arthroscopy plays a role in both the diagnosis and the treatment of wrist pathology. It has evolved in the last three decades. Questions The present status of wrist arthroscopy was investigated by answering the following questions: -What is its current position in the treatment wrist pathologies according to the literature? -What is its current position according to hand surgeons? Methods Analysis of the number of publications on wrist arthroscopy was performed and compared with the number of publications on other arthroscopy topics to assess the current position of wrist arthroscopy. The members of the EWAS (European Wrist Arthroscopy Society) and the members of eight national hand surgery societies were questioned on wrist arthroscopy in daily practice. Results From 1975 till now, 925 papers on wrist arthroscopy were found. The publications on wrist arthroscopy increased from an average of 8/year (1986) to 26/year (2012). More than half (56.9%) of the respondents of the EWAS perform fewer than 5 wrist arthroscopies per month, and only 7 (10.8%) indicate the performance of more than 10 wrist arthroscopies per month. Seventy-four percent of the orthopedic hand surgeons perform wrist arthroscopy (in 48.5% for therapeutic indications) against 36.8% of plastic surgery hand surgeons (in 23.1% for therapeutic indications). Conclusion Wrist arthroscopy has taken up a place in the armamentarium of the hand surgeon. The place of wrist arthroscopy in daily practice is related to the background of the hand surgeon. PMID:24436823

  3. Ankle replacement

    MedlinePlus

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

  4. [Arthroscopic surgery of the ankle].

    PubMed

    Bojanić, Ivan; Franić, Miljenko; Ivković, Alan

    2007-05-01

    Arthroscopic surgery of the ankle has become indispensable method in the armamentarium of the modern orthopaedic surgeon. Technological advancement and thorough understanding of the anatomy have resulted in improved ability to perform arthroscopy of the ankle. The method is minimally invasive and it allows the direct visualization of intra-articular structures without arthrotomy or malleolar osteotomy. Anterior or posterior approach may be used, and various indications have become generally accepted: anterior soft tissue or bony impingement, loose bodies, osteochondral defects, synovitis (rheumatoid arthritis, infective arthritis, and hemophilic arthropathy), posterior impingement syndrome, posttraumatic conditions, osteoarthritis (arthrosis), ankle arthrodesis, tumor-like lesions (synovial osteochondromatosis, pigmented villonodular synovitis) and many combinations of these pathological entities. In this paper we will discuss technique, indications, complications and future perspective of the ankle arthroscopy. In addition we will review the most recent literature data regarding this appealing technique. PMID:17695197

  5. Distracted Driving

    MedlinePlus

    ... combines all three types of distraction. 3 How big is the problem? Deaths In 2013, 3,154 ... European countries. More A CDC study analyzed 2011 data on distracted driving, including talking on a cell ...

  6. Knee arthroscopy - discharge

    MedlinePlus

    ... knee arthroscopy). You may have been checked for: Torn meniscus. Meniscus is cartilage that cushions the space ... Surgery is done to repair or remove it. Torn or damaged anterior cruciate ligament (ACL) or posterior ...

  7. Metatarsal phalangeal joint arthroscopy.

    PubMed

    Shonka, T E

    1991-01-01

    An overview of metatarsophalangeal joint (MPJ) arthroscopy is presented. Indications, technique, and perioperative management are discussed. The author believes it is the operative treatment of choice for various pathology encountered in this joint. PMID:2002183

  8. Knee arthroscopy - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100117.htm Knee arthroscopy - series To use the sharing features on ... 5 out of 5 Normal anatomy Overview The knee is a complex joint made up of the ...

  9. Thromboembolism Following Shoulder Arthroscopy

    PubMed Central

    Schick, Cameron W.; Westermann, Robert W.; Gao, Yubo; Abboud, Joseph A.; Wolf, Brian R.

    2014-01-01

    Background: Thromboembolism following shoulder arthroscopy is considered an uncommon complication, with fewer than 50 cases reported in the literature. Arthroscopy of the shoulder is one of the most commonly performed orthopaedic procedures, with low associated risks. Purpose: To identify potential risk factors for the development of venous thromboembolism (VTE) following shoulder arthroscopy and to determine the overall incidence of this complication. Study Design: Case-control study; Level of evidence, 3. Methods: A retrospective case-control review was performed of patients who developed symptomatic deep venous thrombosis (DVT) or pulmonary embolism (PE) following shoulder arthroscopy. Multiple surgeons from across North America were queried. For every case of DVT or PE identified, 2 control cases of shoulder arthroscopy were analyzed. The incidence of DVT/PE following shoulder arthroscopy was determined. A univariate analysis and a multivariate logistic regression model were conducted to identify any potential risk factors for the development of VTE following shoulder arthroscopy. Results: A total of 17 surgeons participated in this study and had performed a total of 15,033 cases of shoulder arthroscopy from September 2002 through August 2011. Eleven of the 17 participating surgeons had had a patient with a VTE complication during this time frame. The incidence of VTE in the 15,033 cases was 0.15%; 22 patients of the 15,033 patients had a DVT (n = 15) and/or PE (n = 8). Forty-four control cases were also analyzed. Univariate and multivariate analyses were performed. No significant risk factors were identified other than patient positioning. All cases and controls were positioned in the beach-chair position for surgery. Conclusion: The results of this study show that although rare, VTE occurs following shoulder arthroscopy at a rate of 0.15%. The variables analyzed in the cases of VTE compared with the control cases did not show any significant risk factors. All

  10. Advances in wrist arthroscopy.

    PubMed

    Wolf, Jennifer Moriatis; Dukas, Alex; Pensak, Michael

    2012-11-01

    Since its introduction more than three decades ago, wrist arthroscopy has continually evolved. The procedure has a wide list of indications, including diagnostic and management applications. The scope of practice for the wrist arthroscopic surgeon includes management of triangulofibrocartilage complex pathology, evaluation and management of carpal instability, assistance in fracture reduction of the radius and scaphoid, treatment of trapeziometacarpal synovitis and arthritis, distal ulnar and carpal bone excisions, and salvage procedures. In addition, innovations such as new portals and smaller arthroscopes have expanded the applications of wrist arthroscopy. PMID:23118138

  11. Hip Arthroscopy: A Brief History.

    PubMed

    Kandil, Abdurrahman; Safran, Marc R

    2016-07-01

    Hip arthroscopy is a fast-growing and evolving field. Like knee and shoulder arthroscopy, hip arthroscopy began as a diagnostic procedure and then progressed to biopsy and resection of abnormalities. Subsequently, it has evolved to repair of various tissues and treatment of underlying causes. As the understanding of the hip joint and its associated pathophysiology grows, indications will continue to expand for this diagnostic and therapeutic modality. This article outlines the historic developments of hip arthroscopy, including advancements in instrumentation and techniques from the days of the first hip arthroscopies to the present day. PMID:27343387

  12. Distracted driving

    MedlinePlus

    ... stay safe with a cell phone in the car. ... for Disease Control and Prevention Injury Prevention & Control. Motor Vehicle Safety. www.cdc.gov/motorvehiclesafety/distracted_driving . Accessed May ...

  13. HIP ARTHROSCOPY IN ATHLETES

    PubMed Central

    Polesello, Giancarlo Cavalli; Keiske Ono, Nelson; Bellan, Davi Gabriel; Honda, Emerson Kiyoshi; Guimarães, Rodrigo Pereira; Junior, Walter Riccioli; Do Val Sella, Guilherme

    2015-01-01

    To confirm the therapeutic importance of hip arthroplasty in athletes whose pain precludes sportive function of the hip joint, being able to minimize it to the extent of helping on the return of sports practice at satisfactory levels. Methods: 49 athlete patients (51 hips) submitted to hip arthroscopy complaining of pain and inability to practice sports were assessed. Follow-up time ranged from 12 to 74 months (mean: 39.0 months). Preoperatively, pain site, severity according to Facial Expression Scale (FES) and the degree of disability using the modified Harris Hip Score (HHS) were assessed. Different diagnoses were provided, which led to the indication of arthroscopy, such as femoralacetabular impact, acetabular lip injury not secondary to femoral-acetabular impact, etc. Postoperatively, the patients were assessed by using the same methods as used at baseline and by the subjective analysis of return to sports activities. Results: Based on pre-and postoperative HHS and FES, the statistical analysis showed significance between values. We found some improvement in all cases and return to sports activities at a satisfactory level in most of the cases. Conclusion: As a result of our study, we confirm that arthroscopy in athletes with local hip injuries is an effective technique, able to promote the return to sports practice in most of the cases, without pain, and with an effective joint function, provided well indicated. PMID:26998449

  14. COMPLICATIONS IN HIP ARTHROSCOPY

    PubMed Central

    Contreras, Marcos Emílio Kuschnaroff; Hoffmann, Rafael Barreiros; de Araújo, Lúcio Cappelli Toledo; Dani, William Sotau; José Berral, Francisco

    2015-01-01

    Objectives: To determine the prevalence of complications in a series of consecutive cases of hip arthroscopy; to assess the progression of the sample through a learning curve; and to recognize the causes of complications in arthroscopic hip operations. Method: 150 consecutive cases that underwent hip arthroscopy between May 2004 and December 2008 were evaluated. The complications encountered were classified in three ways: organic system affected, severity and groups of 50 consecutive cases. The data were analyzed by means of descriptive statistics and Fisher's exact test. Results: We observed 15 complications in this study (10%): ten were neurological, two were osteoarticular, one was vascular-ischemic and two were cutaneous. In the classification of severity, three were classified as major, 12 as intermediate and none as minor. The incidence of complications over the course of the learning curve did not present any statistically significant difference (p = 0.16). Conclusions: Hip arthroscopy is a surgical procedure that involves low morbidity, but which presents complications in some cases. These complications are frequently neurological and transitory, and mainly occur because of joint traction. The complication rate did not decrease with progression of our sample. PMID:27022521

  15. Current concepts in wrist arthroscopy.

    PubMed

    Chloros, George D; Wiesler, Ethan R; Poehling, Gary G

    2008-03-01

    The purpose of this article is to review the recent literature on arthroscopic treatment of distal radius fractures (DRFs), triangular fibrocartilage complex injuries, intercarpal ligament injuries, and ganglion cysts, including the use of electrothermal devices. A major advantage of arthroscopy in the treatment of DRFs is the accurate assessment of the status of the articular surfaces and the detection of concomitant injuries. Nonrandomized studies of arthroscopically assisted reduction of DRFs show satisfactory results, but there is only 1 prospective randomized study showing the benefits of arthroscopy compared with open reduction-internal fixation. Wrist arthroscopy plays an important role as part of the treatment for DRFs; however, the treatment for each practitioner and each patient needs to be individualized. Wrist arthroscopy is the gold standard in the diagnosis and treatment of triangular fibrocartilage complex injuries. Type 1A injuries may be successfully treated with debridement, whereas the repair of type 1B, 1C, and 1D injuries gives satisfactory results. For type 2 injuries, the arthroscopic wafer procedure is equally effective as ulnar shortening osteotomy but is associated with fewer complications in the ulnar positive wrist. With interosseous ligament injuries, arthroscopic visualization provides critical diagnostic value. Debridement and pinning in the acute setting of complete ligament tears are promising and proven. In the chronic patient, arthroscopy can guide reconstructive options based on cartilage integrity. The preliminary results of wrist arthroscopy using electrothermal devices are encouraging; however, complications have been reported, and therefore, their use is controversial. In dorsal wrist ganglia, arthroscopy has shown excellent results, a lower rate of recurrence, and no incidence of scapholunate interosseous ligament instability compared with open ganglionectomy. Arthroscopy in the treatment of volar wrist ganglia has yielded

  16. Deadly distractions.

    PubMed

    Zuzek, Crystal

    2013-04-01

    In 2011, the National Transportation Safety Board urged all states to ban the use of portable electronic devices while driving, including hand-held and hands-free devices. Texting while driving concerns several Texas legislators, who have filed bills, backed by the Texas Medical Association, to ban the practice. TMA physicians recognize that the use of hand-held and hands-free devices and other factors associated with distracted driving affect their patients' safety. PMID:23546834

  17. Imaging of Common Arthroscopic Pathology of the Ankle.

    PubMed

    Grambart, Sean T

    2016-10-01

    Arthroscopy of the ankle is used in the treatment and diagnosis of a spectrum of intra-articular pathology including soft tissue and osseous impingement, osteochondral lesions, arthrofibrosis, and synovitis. To help identify the correct pathology, imaging techniques are often used to aid the surgeon in diagnosing pathology and determining best treatment options. This article discusses the use of imaging in various ankle pathologies. PMID:27599435

  18. Heterotopic ossification after hip arthroscopy

    PubMed Central

    Amar, Eyal; Sharfman, Zachary T.; Rath, Ehud

    2015-01-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy. PMID:27011859

  19. Heterotopic ossification after hip arthroscopy.

    PubMed

    Amar, Eyal; Sharfman, Zachary T; Rath, Ehud

    2015-12-01

    Heterotopic ossification (HO) after hip arthroscopy is the abnormal formation of mature lamellar bone within extra skeletal soft tissues. HO may lead to pain, impaired range of motion and possibly revision surgery. There has been a substantial amount of recent research on the pathophysiology, prophylaxis and treatment of HO associated with open and arthroscopic hip surgery. This article reviews the literature on the aforementioned topics with a focus on their application in hip arthroscopy. PMID:27011859

  20. Ankle Problems

    MedlinePlus

    ... intense you're unable to walk on the ankle? Yes You may have a FRACTURE or a severe SPRAIN. Don't walk on the injured foot. Raise the leg and place ice on the swollen area. See your doctor promptly. No ... but you're still able to walk on the ankle? Yes You may have a SPRAINED ANKLE, or ...

  1. Ankle sprain (image)

    MedlinePlus

    An ankle sprain is a common injury to the ankle. The most common way the ankle is injured is when ... swelling, inflammation, and bruising around the ankle. An ankle sprain injury may take a few weeks to many ...

  2. Ankle Sprains

    MedlinePlus

    ... What's the Treatment for a Sprained Ankle? More Serious Sprains en español Esguinces de tobillo As a field hockey player, Jill was used to twisting her ankle. She'd always been able to walk it off and get back in the game. But one day she stepped on another player's ...

  3. Ankle impingement.

    PubMed

    Lavery, Kyle P; McHale, Kevin J; Rossy, William H; Theodore, George

    2016-01-01

    Ankle impingement is a syndrome that encompasses a wide range of anterior and posterior joint pathology involving both osseous and soft tissue abnormalities. In this review, the etiology, pathoanatomy, diagnostic workup, and treatment options for both anterior and posterior ankle impingement syndromes are discussed. PMID:27608626

  4. Sprained Ankles

    MedlinePlus

    ... Body I think my child has sprained her ankle. How can I tell for sure? Sprains are injuries to the ligaments that connect bones ... away before the ligament is injured. Types of Sprains In young children, the ankle is the most commonly sprained joint, followed by ...

  5. Current innovations in wrist arthroscopy.

    PubMed

    Slutsky, David J

    2012-09-01

    It has become clear that the stability of the scapholunate joint does not depend wholly on the scapholunate interosseous ligament, but rather on both primary and secondary stabilizers, which form a scapholunate ligament complex. Each case of scapholunate instability is unique and should be treated with tissue-specific repairs, which may partly explain why one procedure cannot successfully restore joint stability in every case. Wrist arthroscopy has a pivotal role in both the assessment and treatment of the scapholunate ligament complex derangements. Tears of the foveal attachment of the triangular fibrocartilaginous complex can be an underdiagnosed cause of distal radioulnar joint instability, because the foveal fibers cannot be visualized using the standard radiocarpal arthroscopy portals. Distal radioulnar joint arthroscopy allows for direct visualization and assessment of these fibers, which in turn has spawned a number of open and arthroscopic repair methods. Wrist arthroscopy has gained wider acceptance as a method to fine-tune articular reduction during open and percutaneous fixation of distal radius fractures, and simplifies intra-articular osteotomies for malunion. It can facilitate percutaneous bone grafting of scaphoid nonunions and has a role in the diagnosis and treatment of associated soft tissue lesions. These and other recent developments will be discussed in the following article. PMID:22916867

  6. New advances in wrist arthroscopy.

    PubMed

    Bain, Gregory I; Munt, Justin; Turner, Perry C

    2008-03-01

    Wrist arthroscopy is a commonly used procedure that has undergone many modifications and improvements since it was first described. The advent of new portals (both dorsal and volar) means that the wrist joint can be viewed from virtually any perspective ("box concept"). Indications for wrist arthroscopy have continued to expand and include diagnostic and reparative procedures and, more recently, reconstructive, soft-tissue, and bony procedures. Arthroscopic grading of Kienböck's disease better describes articular damage compared with plain radiographs and can help guide surgical treatment options. Triangular fibrocartilage complex injury diagnosis, classification, and treatment can be performed arthroscopically, including distal ulna resection (wafer procedure). Assessment of fracture reduction of the distal radius and scaphoid is superior to that obtained with fluoroscopy, with the advantage of being able to look for associated soft-tissue and chondral injuries. Arthroscopic assessment of intercarpal ligament injuries and instability is now considered the gold standard by many authors. Arthroscopy can also aid us in the management of post-traumatic capsular contraction, resection of ganglia, and the relatively rare isolated ulna styloid impaction. Complications of wrist arthroscopy are relatively uncommon. With the ever-expanding list of indications and procedures that can be performed with this technique, it exists as an essential diagnostic and therapeutic tool for the orthopaedic surgeon. PMID:18308189

  7. [Diagnostic arthroscopy and arthroscopic surgery: experiences with 500 knee arthroscopies].

    PubMed

    Glinz, W

    1979-05-01

    A diagnosis by clinical examination and arthrography was not possible in 160 out of 500 arthroscopically examined patients, most of them with post-traumatic knee disorders. In 157 cases the clinical diagnosis was wrong, and in another 58 cases incomplete. Only in 89 patients (18%) arthroscopy proved the clinical diagnosis to be correct. At arthroscopy, a meniscal injury was found in 156 patients (medial meniscus 57, lateral meniscus 64, both menisci 8). With regard to the menisci a previous arthrography was found correct only in 103 out of 213 cases, i.e. in 48%. Lesions of the articular cartilage were present in 210 patients, although they were expected clinically in only one third of these cases. Normal intraarticular structures were found in 95 examinations. The arthroscopic examination was insufficient three times because of a protruding fat pad, and wrong in 2 patients in whom an arthroscopically diagnosed meniscal tear could not be found at arthrotomy. The morbidity of arthroscopy is small. Only complications: A local allergic reaction because of a wound spray in four cases, bronchial asthma following general anesthesia in two patients. No infection occurred. Several therapeutic procedures may be carried out through the arthroscope. So loose bodies were removed from the joint in 39 and partial meniscectomy performed in 13 patients, all of them being treated as out-patients. PMID:468577

  8. Ankle replacement

    MedlinePlus

    ... to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. A piece of plastic is then inserted between the two metal parts. Screws maybe placed to stabilize your ankle. The surgeon ...

  9. Learning to Ignore Distracters

    PubMed Central

    Rozek, Ellen; Kemper, Susan; McDowd, Joan

    2011-01-01

    Eyetracking has indicated that older and young adults process distracters similarly when reading single sentences. The present study extended this approach by presenting short paragraphs sentence by sentence. Eyetracking measures included reading times per word, and the duration of the first fixation and total fixations to the distracters and target words. Comprehension was tested following each paragraph and recognition of distracters and target words was assessed. The results indicated that young adults were able to learn to ignore the distracters as they read through the paragraphs whereas older adults were less successful at learning to ignore the distracters. PMID:22004518

  10. Ankle sprain - Series (image)

    MedlinePlus

    The ankle joint connects the foot with the leg. The ankle joint allows the foot to move upward and ... outward motion. Muscles, tendons, and ligaments surround the ankle providing the stability the ankle joint needs for ...

  11. Arthroscopy Authors Seek Innovative International Readers.

    PubMed

    Lubowitz, James H; Provencher, Matthew T; Rossi, Michael J; Brand, Jefferson C; Schmidt, Melissa B

    2016-08-01

    Arthroscopy and Arthroscopy Techniques attract authors as a result of our large, innovative, and global audience. In addition, the journals attract authors because of our robust and rapid review process, our wide indexing and search availability, and our openness to diverse article types including Technical Notes with video. PMID:27495852

  12. Accuracy of clinical diagnosis in knee arthroscopy.

    PubMed Central

    Brooks, Stuart; Morgan, Mamdouh

    2002-01-01

    A prospective study of 238 patients was performed in a district general hospital to assess current diagnostic accuracy rates and to ascertain the use and the effectiveness of magnetic resonance imaging (MRI) scanning in reducing the number of negative arthroscopies. The pre-operative diagnosis of patients listed for knee arthroscopy was medial meniscus tear 94 (40%) and osteoarthritis 59 (25%). MRI scans were requested in 57 patients (24%) with medial meniscus tear representing 65% (37 patients). The correlation study was done between pre-operative diagnosis, MRI and arthroscopic diagnosis. Clinical diagnosis was as accurate as the MRI with 79% agreement between the preoperative diagnosis and arthroscopy compared to 77% agreement between MRI scan and arthroscopy. There was no evidence, in this study, that MRI scan can reduce the number of negative arthroscopies. Four normal MRI scans had positive arthroscopic diagnosis (two torn medial meniscus, one torn lateral meniscus and one chondromalacia patella). Out of 240 arthroscopies, there were only 10 normal knees (negative arthroscopy) representing 4% of the total number of knee arthroscopies; one patient of those 10 cases had MRI scan with ACL rupture diagnosis. Images Figure 1 Figure 2 PMID:12215031

  13. Hip Arthroscopy: Tales From the Crypt.

    PubMed

    Matsuda, Dean K; Philippon, Marc J; Safran, Marc R; Sampson, Thomas G

    2016-01-01

    Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented. PMID:27049210

  14. Role of simulation in arthroscopy training.

    PubMed

    Madan, Simerjit Singh; Pai, Dinker R

    2014-04-01

    Arthroscopy uses a completely different skill set compared with open orthopedic surgery. Hitherto, arthroscopy had not been given enough emphasis in the core orthopedic curricula. Simulation has been seen as an excellent way to teach the skills required in arthroscopy. The simulators used for arthroscopy training can be broadly classified into physical simulators such as cadavers, animals, models and box trainers, virtual-reality simulators, and hybrid simulators that combine virtual-reality simulation with physical components that allow real tactile feedback. The advantages and disadvantages of each of these types have been described in this article. The factors that determine skill acquisition using these simulators have been highlighted. In conclusion, simulation seems to be a valuable tool for arthroscopy training, although further studies are needed to state whether this translates into better operative skill on real patients. PMID:24096921

  15. Hip Arthroscopy in The Athlete

    PubMed Central

    2007-01-01

    Sports related injuries to the hip have received relatively little attention, in the part because the clinical assessment, imaging studies, and surgical techniques are less sophisticated. The evolution of hip arthroscopy has offered a less invasive technique that allows for recognition and treatment of hip pathologies that previously went unrecognized. The success of hip arthoscopy is dependent on proper patient selection based on the patient's history and diagnosis. The purpose of this clinical commentary is to outline mechanisms of injury and specific lesions that can be addresses using hip arthoscopy. PMID:21509141

  16. Adhesive capsulitis of the ankle (frozen ankle).

    PubMed

    van Moppes, F I; van den Hoogenband, C R; Greep, J M

    1979-09-01

    Adhesive capsulitis or "frozen ankle" is a syndrome resulting from repeated ankle sprains, or perhaps following immobilization after trauma. Ankle arthrography is a useful and safe diagnostic procedure in this syndrome. Typical arthrographic features are described together with case histories of two patients with frozen ankle. We suggest that early mobilization of the patient following trauma is particularly important in preventing the development of a forzen ankle syndrome. PMID:508071

  17. Postoperative pectoral swelling after shoulder arthroscopy

    PubMed Central

    ERCIN, ERSIN; BILGILI, MUSTAFA GOKHAN; ONES, HALIL NADIR; KURAL, CEMAL

    2015-01-01

    Fluid extravasation is possibly the most common complication of shoulder arthroscopy. Shoulder arthroscopy can lead to major increases in the compartment pressure of adjacent muscles and this phenomenon is significant when an infusion pump is used. This article describes a case of pectoral swelling due to fluid extravasation after shoulder arthroscopy. A 24-year-old male underwent an arthroscopic Bankart repair for recurrent shoulder dislocation. The surgery was performed in the beach chair position and lasted two hours. At the end of the procedure, the patient was found to have left pectoral swelling. A chest radiography showed no abnormality. Pectoral swelling due to fluid extravasation after shoulder arthroscopy has not previously been documented. PMID:26889473

  18. Wrist arthroscopy: principles and clinical applications.

    PubMed

    Gupta, R; Bozentka, D J; Osterman, A L

    2001-01-01

    With the development of better and smaller equipment, arthroscopy of the wrist offers the same benefits achievable with arthroscopy of the knee, shoulder, or elbow - not only diagnostic information but also a therapeutic option. Standardized techniques of performing wrist arthroscopy have been developed to evaluate the treat various wrist disorders, such as lesions of the triangular fibrocartilage complex, intra-articular distal radius fractures, and scaphoid fractures. Arthroscopy is now performed in the treatment of dorsal-wrist ganglion cysts and interosseous ligament disruptions, as well as for bone incisions, such as radial styloidectomy, distal ulnar excision (wafer procedure), and proximal-row carpectomy. Compared with other techniques, arthroscopic procedures, such as repair of the triangular fibrocartilage complex, demonstrate better results and improved localization of the injury with a low complication rate. In addition, arthroscopic procedures involve lesssurgical dissection, less postoperative pain, a shorter recovery time, and an earlier return to work for the patient. PMID:11421577

  19. Nonfatal air embolism during shoulder arthroscopy.

    PubMed

    Pandey, Vivek; Varghese, Elsa; Rao, Madhu; Srinivasan, Nataraj M; Mathew, Neethu; Acharya, Kiran K V; Rao, P Sripathi

    2013-06-01

    An air embolism is a rare but potentially fatal complication of shoulder arthroscopy. In this article, we report the case of a patient who developed a nonfatal air embolism during shoulder arthroscopy for an acute bony Bankart lesion and a greater tuberosity avulsion fracture. The venous air embolism occurred immediately after the joint was insufflated with air for diagnostic air arthroscopy. The diagnosis was based on a drop in end-tidal carbon dioxide and blood pressure and presence of mill wheel (waterwheel) murmur over the right heart. Supportive treatment was initiated immediately. The patient recovered fully and had no further complications of air embolism. This patient's case emphasizes the importance of being aware that air embolisms can occur during shoulder arthroscopy performed for acute intra-articular fractures of the shoulder. Monitoring end tidal carbon dioxide can be very useful in early detection of air embolisms. PMID:23805421

  20. ARTHROSCOPY OF THE SCAPULOTHORACIC JOINT: CASE REPORTS

    PubMed Central

    Andreoli, Carlos Vicente; Ejnisman, Benno; Pochini, Alberto de Castro; Monteiro, Gustavo Cará; Cohen, Moisés; Faloppa, Flávio

    2015-01-01

    Scapulothoracic arthroscopy is a procedure presenting restricted indications, for resecting free bodies, benign tumors, bursitis, and snaping scapula. The authors report four cases of scapulothoracic joint arthroscopy; in the first case, only a benign tumor (osteochondroma) could be visualized; in the second case, arthroscopic resection of an osteochondroma was found; in the third case, arthroscopic bursectomy due to scapulothoracic bursitis, and; in the fourth case, bursectomy and partial superomedial arthroscopic scapulectomy due to snaping scapula. PMID:27022519

  1. Distractions in Everyday Driving

    MedlinePlus

    ... about one hour and 15 minutes in their vehicles every day? Unfortunately, people often treat this as ... easy access to information, entertainment, and communications, in-vehicle distractions are increasing – as is the temptation to ...

  2. Hip arthroscopy in obese, a successful combination?

    PubMed

    Bech, N H; Kodde, I F; Dusseldorp, F; Druyts, P A M C; Jansen, S P L; Haverkamp, D

    2016-04-01

    Discussion persists about the outcome and results of hip arthroscopy in obese patients. Hip arthroscopy gained popularity over time. A current discussion is if obese patients can reach similar results after surgery compared with non-obese. To our knowledge, this is the first systematic review of literature about hip arthroscopy and obesity. We searched the Pubmed/Medline databases for literature and included three studies that compared the outcome of hip arthroscopy between different BMI groups. We extracted and pooled the data. For continues data a weighted mean difference was calculated, for dichotomous variables a weighted odds ratio (OR) was calculated using Review Software Manager. Heterogeneity of the included studies was calculated using I(2) statistics. Data were extracted from two studies. In the Obese group, there was significant more conversion to total hip replacement or resurfacing hip replacement (OR = 2.21, 95% CI 1.07-4.56) and more re-arthroscopy (OR = 4.68, 95% CI 1.41-15.45). Any reoperation occurred more often in the obese group (OR = 2.87, 95% CI 1.53-5.38). In the Non Arthritic Hip Score obese scored lower than the non-Obese group [10.9 (-14,6 to 7.1)]. For the modified Harris Hip Score the score is - 6,6, according to the MCID this difference is clinically relevant. For both scores obese show lower outcomes but similar improvement after hip arthroscopy. Regarding a higher chance of needing a re-operation and lower subjective outcome scores obesity appears to have a negative influence on the outcome of hip arthroscopy. PMID:27026817

  3. Hip arthroscopy in obese, a successful combination?

    PubMed Central

    Bech, N. H.; Kodde, I. F.; Dusseldorp, F.; Druyts, P. A. M. C.; Jansen, S. P. L.; Haverkamp, D.

    2016-01-01

    Discussion persists about the outcome and results of hip arthroscopy in obese patients. Hip arthroscopy gained popularity over time. A current discussion is if obese patients can reach similar results after surgery compared with non-obese. To our knowledge, this is the first systematic review of literature about hip arthroscopy and obesity. We searched the Pubmed/Medline databases for literature and included three studies that compared the outcome of hip arthroscopy between different BMI groups. We extracted and pooled the data. For continues data a weighted mean difference was calculated, for dichotomous variables a weighted odds ratio (OR) was calculated using Review Software Manager. Heterogeneity of the included studies was calculated using I2 statistics. Data were extracted from two studies. In the Obese group, there was significant more conversion to total hip replacement or resurfacing hip replacement (OR = 2.21, 95% CI 1.07–4.56) and more re-arthroscopy (OR = 4.68, 95% CI 1.41–15.45). Any reoperation occurred more often in the obese group (OR = 2.87, 95% CI 1.53–5.38). In the Non Arthritic Hip Score obese scored lower than the non-Obese group [10.9 (−14,6 to 7.1)]. For the modified Harris Hip Score the score is − 6,6, according to the MCID this difference is clinically relevant. For both scores obese show lower outcomes but similar improvement after hip arthroscopy. Regarding a higher chance of needing a re-operation and lower subjective outcome scores obesity appears to have a negative influence on the outcome of hip arthroscopy. PMID:27026817

  4. Electronic gaming as pain distraction.

    PubMed

    Jameson, Eleanor; Trevena, Judy; Swain, Nic

    2011-01-01

    The current study investigated whether active distraction reduces participants' experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2°C) water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system) and passive (television) distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants' expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control. PMID:21369538

  5. Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement

    PubMed Central

    Matsuda, Dean K.; Gupta, Nikhil; Hanami, Dylan

    2014-01-01

    Pincer femoroacetabular impingement occurs in focal or global forms, the latter having more generalized and typically more extreme acetabular overcoverage. Severe global deformities are often treated with open surgical dislocation of the hip. Arthroscopic technical challenges relate to difficulties with hip distraction; central-compartment access; and instrument navigation, acetabuloplasty, and chondrolabral surgery of the posterior acetabulum. Techniques addressing these challenges are introduced permitting dual-portal hip arthroscopy with central-compartment access, subtotal acetabuloplasty, and circumferential chondrolabral surgery. The modified midanterior portal in combination with a zone-specific sequence of acetabular rim reduction monitored with fluoroscopic templating enables precision subtotal acetabuloplasty. Guidelines for acetabular rim reduction include the following suggested radiographic endpoints: postoperative center-edge angle of 35°, a neutral posterior wall sign, and an anterior margin ratio of 0.5. Arthroscopic zone-specific chondrophobic rim preparation and circumferential labral reparative and reconstructive techniques and tools permit the arthroscopic treatment of these challenging deformities. PMID:24904760

  6. Posterior approach for arthroscopic treatment of posterolateral impingement syndrome of the ankle in a top-level field hockey player.

    PubMed

    Lohrer, Heinz; Arentz, Sabine

    2004-04-01

    A case history of a 25-year-old field hockey player, a member of the German National Field Hockey Team, is presented. The patient could not remember any specific ankle injury, but since the World Indoor Championship in February 2003, he experienced significant but diffuse pain around the posterior ankle, especially while loading the forefoot in hockey training and competition. For 2 months, the patient was unable to run. Conservative treatment failed, and surgery was performed. Posterior ankle arthroscopy revealed a frayed posterior intermalleolar ligament and meniscoid-like scar tissue at the posterolateral ankle, indicating a posterolateral soft tissue ankle impingement syndrome. A concomitant inflammation of the posterolateral ankle and subtalar synovium was present. After arthroscopic resection and early functional aftertreatment, the patient returned to full high-level sports ability within 2 months. PMID:15067292

  7. Neonatal Mandibular Distraction Osteogenesis

    PubMed Central

    Flores, Roberto L.

    2014-01-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue–lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  8. Neonatal mandibular distraction osteogenesis.

    PubMed

    Flores, Roberto L

    2014-11-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue-lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  9. Diagnosing syndesmotic instability in ankle fractures

    PubMed Central

    van den Bekerom, Michel PJ

    2011-01-01

    The precise diagnosis of distal tibiofibular syndesmotic ligament injury is challenging and a distinction should be made between syndesmotic ligament disruption and real syndesmotic instability. This article summarizes the available evidence in the light of the author’s opinion. Pre-operative radiographic assessment, standard radiographs, computed tomography scanning and magnetic resonance imaging are of limited value in detecting syndesmotic instability in acute ankle fractures but can be helpful in planning. Intra-operative stress testing, in the sagittal, coronal or exorotation direction, is more reliable in the diagnosis of syndesmotic instability of rotational ankle fractures. The Hook or Cotton test is more reliable than the exorotation stress test. The lateral view is more reliable than the AP mortise view because of the larger displacement in this direction. When the Hook test is used the force should be applied in the sagittal direction. A force of 100 N applied to the fibula seems to be appropriate. In the case of an unstable joint requiring syndesmotic stabilisation, the tibiofibular clear space would exceed 5 mm on the lateral stress test. When the surgeon is able to perform an ankle arthroscopy this technique is useful to detect syndesmotic injury and can guide anatomic reduction of the syndesmosis. Many guidelines formulated in this article are based on biomechanical and cadaveric studies and clinical correlation has to be established. PMID:22474636

  10. What causes auditory distraction?

    PubMed

    Macken, William J; Phelps, Fiona G; Jones, Dylan M

    2009-02-01

    The role of separating task-relevant from task-irrelevant aspects of the environment is typically assigned to the executive functioning of working memory. However, pervasive aspects of auditory distraction have been shown to be unrelated to working memory capacity in a range of studies of individual differences. We measured individual differences in global pattern matching and deliberate recoding of auditory sequences, and showed that, although deliberate processing was related to short-term memory performance, it did not predict the extent to which that performance was disrupted by task-irrelevant sound. Individual differences in global sequence processing were, however, positively related to the degree to which auditory distraction occurred. We argue that much auditory distraction, rather than being a negative function of working memory capacity, is in fact a positive function of the acuity of obligatory auditory processing. PMID:19145024

  11. The value of wrist arthroscopy. An evaluation of 129 cases.

    PubMed

    De Smet, L; Dauwe, D; Fortems, Y; Zachee, B; Fabry, G

    1996-04-01

    In order to evaluate diagnostic and therapeutic wrist arthroscopy we analyzed 129 arthroscopies with a follow-up of at least 6 months. Seventy-seven arthroscopies were performed for therapeutic purposes; 52 arthroscopies were diagnostic. There were diagnostic benefits in 55 arthroscopies (42.5%), therapeutic benefits in 29 arthroscopies (22.5%), combined diagnostic and therapeutic benefits in 39 (30%) and no benefits in six (5%). In 65 cases of the therapeutic group (with preoperative diagnosis) the authors found that the arthroscopy had been worthwhile. For the diagnostic group without a preoperative diagnosis, an arthroscopic diagnosis was made in 44 cases. Complications occurred in two patients: one tendon incision over a Kirschner wire in the therapeutic group and one superficial infection in the diagnostic group. PMID:8732403

  12. Ankle sprain - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100209.htm Ankle sprain - Series To use the sharing features on ... 4 out of 4 Normal anatomy Overview The ankle joint connects the foot with the leg. The ...

  13. Arthroscopic Ankle Arthrodesis.

    PubMed

    Hutchinson, Byron

    2016-10-01

    Arthroscopic ankle arthrodesis is a cost-effective option for many patients with posttraumatic arthritis of the ankle joint. Rehabilitation is generally quicker than conventional open techniques, and rates of fusion are comparable or better than traditional open techniques. Unless the arthroscopic surgeon has considerable experience, the best results are seen in patients with very little deformity in the ankle joint. PMID:27599442

  14. Ankle Injuries and Disorders

    MedlinePlus

    Your ankle bone and the ends of your two lower leg bones make up the ankle joint. Your ligaments, which connect bones to one ... muscles and tendons move it. The most common ankle problems are sprains and fractures. A sprain is ...

  15. Assessment of Ankle Injuries

    ERIC Educational Resources Information Center

    Mai, Nicholas; Cooper, Leslie

    2009-01-01

    School nurses are faced with the challenge of identifying and treating ankle injuries in the school setting. There is little information guiding the assessment and treatment of these children when an injury occurs. It is essential for school nurses to understand ankle anatomy, pathophysiology of the acute ankle injury, general and orthopedic…

  16. The use of navigation forces for assessment of wrist arthroscopy skills level.

    PubMed

    Obdeijn, Miryam C; van Baalen, Sophie J; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J M

    2014-05-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy?What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level?Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3-4 portal and the hook through the 6R portal, and visualization of the hook in the center of the imageNavigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarksThe second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance. PMID:25077049

  17. The Use of Navigation Forces for Assessment of Wrist Arthroscopy Skills Level

    PubMed Central

    Obdeijn, Miryam C.; van Baalen, Sophie J.; Horeman, Tim; Liverneaux, Philippe; Tuijthof, Gabrielle J. M.

    2014-01-01

    Purpose To provide an efficient learning process, feedback on performance is crucial. In skills laboratories, it is possible to measure the skills and progression of skills of the trainees objectively. This requires metrics that represent the learning curve of the trainee, which were investigated for wrist arthroscopy. The research questions were: What are the forces used by novices during wrist arthroscopy? What aspects of these navigation forces are discriminative for the wrist arthroscopy skills level? Methods A cadaver wrist was mounted in a custom-made distraction device mounted in front of a force platform (ForceTrap). Eleven novices were invited to perform two tasks on the wrist: Insertion of the scope through the 3–4 portal and the hook through the 6R portal, and visualization of the hook in the center of the image Navigation through the wrist from radial to ulnar with probing and visualization of five predefined landmarks The second task was repeated 10 times. The absolute force (F abs) and the direction of force were measured. The angle α is defined in the vertical plane, and the angle β in the horizontal plane. Results The median F abs used by novices remained below the force threshold as defined from the expert data (7.3 N). However, the direction of the applied forces by novices in both planes was not consistent with expert data and showed a wider range. Also, there was no improvement after more trials. Conclusion Our study suggests by the absence of a learning curve for the novices and a significant difference between novices and experts that novices can benefit from feedback on the magnitude and direction of forces to improve their performance. PMID:25077049

  18. Major vascular injuries complicating knee arthroscopy

    PubMed Central

    Bancu, Serban; Muresan, Mircea; Sala, Daniela

    2015-01-01

    Starting with a case report, we made a detailed review of the literature, with the purpose of identifying and analyzing the type of iatrogenic vascular lesion following knee arthroscopy and the method of vascular repair. A PubMed literature search was undertaken to locate all reported cases of major vascular iatrogenic injuries during arthroscopic knee procedures. We identified 39 papers which report a total of 62 cases of major iatrogenic popliteal lesions after knee arthroscopy, between 1985 and 2014. The type of arthroscopic intervention performed, the type of iatrogenic vascular lesion encountered, the time passed until its discovery and treatment, the method of vascular reconstruction, and the postoperative course are presented. Postarthroscopy vascular complications are infrequent but potentially disastrous for the condition of the affected inferior limb. An early diagnosis and reintervention are mandatory for a good postoperative outcome. PMID:26240627

  19. New methods in arthroscopy: preliminary investigations.

    PubMed Central

    Frizziero, L; Zizzi, F; Leghissa, R; Ferruzzi, A

    1986-01-01

    The microhysteroscope, which affords direct in vivo observation of otherwise inaccessible surfaces, can be used to great advantage in arthroscopy. Although conventional arthroscopy can distinguish between 'inflammatory' and 'reactive' (post-traumatic) synovial changes, the microendoscope offers the possibility of more precise differentiation. Synovial membranes, joint cartilage, and menisci were studied at four different magnifications, including microscopic observation of vitally stained cells. Frankly pathological synovia (e.g., rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis) were compared and distinguished from examples of less florid synovial changes. The fibrocartilaginous structure of the menisci and secondary undulations and tertiary depression of joint cartilage become visible in vivo with the microendoscope; these may well point to early damage to these structures. The authors believe that the three dimensional images at the magnifications provided by this microendoscope go some way towards bridging the gap between the conventional arthroscope, the light microscope, and the scanning electron microscope. This report presents preliminary findings with this new technique. Images PMID:3740979

  20. [Arthroscopy-assisted management of wrist fractures].

    PubMed

    Deiler, S; Häberle, S; Quentmeier, P; Biberthaler, P; Ahrens, P

    2013-04-01

    Distal radius fractures are the most common fractures in humans and early surgical intervention with modern plating systems is becoming increasingly more established to avoid secondary dislocation. Even fractures with slight dislocations are adequately stabilized and the affinity for surgical intervention and plating procedures is applied to secure these simple fractures. In this aspect the surgical indications are significantly dependent on X-ray examination results. Further diagnostics with respect to ligamentous and soft tissue injury are the exception although the impact energy which creates osseus fractures is sufficient by far to destroy functional soft tissue, cartilage and ligaments. The ongoing development of wrist arthroscopy enables new possibilities especially concerning concomitant articular involvement of distal radius fractures. Arthroscopy-assisted reduction and stabilization as well as minimally invasive soft tissue repair and loose body removal seem to be adequate methods to improve the surgical treatment of distal radius fractures. PMID:23515646

  1. Routine Complete Capsular Closure During Hip Arthroscopy

    PubMed Central

    Harris, Joshua D.; Slikker, William; Gupta, Anil K.; McCormick, Frank M.; Nho, Shane J.

    2013-01-01

    The utility of hip arthroscopy has recently progressed beyond diagnostic to therapeutic purposes addressing central and peripheral compartment pathologies. Capsulotomy provides freedom of visualization and instrumentation. The contribution to hip stability of both dynamic and static hip structures is not fully understood. However, both basic science biomechanical and clinical outcome studies have exhibited a relevant role of the capsule in hip stability. Though rare, iatrogenic post-arthroscopy subluxation and dislocation have been reported. Therefore many surgeons have cautioned against aggressive capsulotomy or capsulectomy without repair, because of the potential for precipitation of iatrogenic hip instability. We typically perform a “T” capsulotomy and recommend complete capsular closure in conjunction with labral repair and osseous femoral and acetabular treatment. A safe, efficient, and effective method to accomplish complete capsular closure is presented to reduce iatrogenic postoperative hip instability. PMID:23875156

  2. Distracted Biking: An Observational Study.

    PubMed

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

  3. Severe refractory hypertension during shoulder arthroscopy

    PubMed Central

    Abrons, RO; Ellis, SE

    2016-01-01

    The use of epinephrine-containing saline irrigating solutions during arthroscopic shoulder surgery gained popularity after it was reported that the addition of epinephrine reduced bleeding and improved visualization without adverse cardiovascular effects. We share a case of a patient undergoing shoulder arthroscopy who received a standard intra-articular infusion of epinephrine-containing normal saline (1 mcg/mL) and experienced severe hemodynamic consequences. PMID:27051380

  4. Arthroscopy Journal Prizes Are Major Decisions.

    PubMed

    Lubowitz, James H; Brand, Jefferson C; Provencher, Matthew T; Rossi, Michael J

    2016-01-01

    According to the Harvard Business Review, the optimal number of people in a decision-making group is no more than 8. Thus, it is no surprise that 18 Arthroscopy journal associate editors had difficulty making a major decision. In the end, 18 editors did successfully select the 2015 winner of the Best Comparative Study Prize. All studies have limitations, but from a statistical standpoint, the editors believe that the conclusions of the winning study are likely correct. PMID:26743401

  5. Hanger-lifting procedure in knee arthroscopy.

    PubMed

    Maeno, Shinichi; Hashimoto, Daijo; Otani, Toshiro; Masumoto, Ko; Matsumoto, Hideo; Enomoto, Hiroyuki; Niki, Yasuo; Yuzawa, Itsuki; Fukui, Yasuyuki; Ishikawa, Masayuki; Fujita, Nobuyuki; Okubo, Masashi

    2008-12-01

    We propose a unique arthroscopic technique, the "hanger-lifting procedure." Unlike conventional arthroscopy, the space in which the arthroscope is placed is not a joint space filled with water but a subcutaneous space filled with air. The space is kept lifted by a semi-loop-shaped hanger and a retraction system by use of a wire. In general, arthroscopes are unable to be applied outside the joint because of the lack of a cavity. However, this method can provide extra-articular visualization of the knee in addition to standard intra-articular visualization. This approach is useful for lateral release of the knee extensor and bipartite patellae, allowing direct vision from both outside and inside the joint. One possible complication is subcutaneous effusion or interstitial edema. Compressive dressings should be applied to prevent subcutaneous effusion after surgery. However, the combination of conventional arthroscopy by use of saline solution and the hanger-lifting technique by use of air arthroscopy can provide an excellent view inside and outside the joint. This technique may continue to evolve, and although some points in the technique can be improved, this method is useful in joint surgeries. PMID:19038715

  6. Basic Hip Arthroscopy: Supine Patient Positioning and Dynamic Fluoroscopic Evaluation

    PubMed Central

    Mannava, Sandeep; Howse, Elizabeth A.; Stone, Austin V.; Stubbs, Allston J.

    2015-01-01

    Hip arthroscopy serves as both a diagnostic and therapeutic tool for the management of various conditions that afflict the hip. This article reviews the basics of hip arthroscopy by demonstrating supine patient positioning, fluoroscopic evaluation of the hip under anesthesia, and sterile preparation and draping. Careful attention to detail during the operating theater setup ensures adequate access to the various compartments of the hip to facilitate the diagnosis of disease and treatment with minimally invasive arthroscopy. Furthermore, having a routine method for patient positioning and operative setup improves patient safety, as well as operative efficiency, as the operative team becomes familiar with the surgeon's standard approach to hip arthroscopy cases. PMID:26759783

  7. The sprained ankle.

    PubMed

    Puffer, J C

    2001-01-01

    The sprained ankle is the most common musculoskeletal injury seen by physicians caring for active youngsters and adults. It accounts for approximately one fourth of all sports-related injuries and is commonly seen in athletes participating in basketball, soccer, or football. It has been shown that one third of West Point cadets suffer an ankle sprain during their 4 years at the military academy. While diagnosis and management of the sprained ankle is usually straightforward, several serious injuries can masquerade as an ankle sprain, and it is important for the clinician to recognize these to prevent long-term morbidity. In this article the basic anatomy of the ankle, mechanisms by which the ankle is injured, and the differential diagnosis of the acutely injured ankle are reviewed. Appropriate evaluation of the injured ankle and the criteria that should be utilized for determining the necessity of radiographs are discussed as well as management of the acutely sprained ankle and the role of prevention in reducing the risk of ankle injury. PMID:11464730

  8. Distraction subtalar arthrodesis.

    PubMed

    Jackson, J Benjamin; Jacobson, Lance; Banerjee, Rahul; Nickisch, Florian

    2015-06-01

    There is a high potential for disability following calcaneal fracture. This potential exists whether a patient is treated with conservative or operative management. Subfibular impingement and irritation of the peroneal tendon and sural nerve may also be present. Posttraumatic arthritis of the subtalar joint can occur. In patients with symptomatic calcaneal malunion, systematic evaluation is required to determine the source of pain. Nonsurgical treatment may be effective. One surgical treatment option is subtalar distraction arthrodesis. High rates of successful arthrodesis and patient satisfaction have been reported with this surgical option in correctly selected patients. PMID:26043248

  9. Foot, leg, and ankle swelling

    MedlinePlus

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  10. Ankle Sprains. A Round Table.

    ERIC Educational Resources Information Center

    Physician and Sportsmedicine, 1986

    1986-01-01

    Types of ankle sprains, surgical versus nonsurgical treatment, tape versus brace for support, rehabilitation, exercise, and prevention of ankle sprains are discussed by a panel of experts. An acute ankle taping technique is illustrated. (MT)

  11. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... News, Videos & Podcasts » Articles » Text Size Print Bookmark Ankle Fractures Often Not Diagnosed Long-term Complications Result from Poor Recovery Mistaking an ankle fracture for an ankle sprain has serious consequences ...

  12. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    PubMed Central

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion. PMID:26060592

  13. Neural Basis of Visual Distraction

    ERIC Educational Resources Information Center

    Kim, So-Yeon; Hopfinger, Joseph B.

    2010-01-01

    The ability to maintain focus and avoid distraction by goal-irrelevant stimuli is critical for performing many tasks and may be a key deficit in attention-related problems. Recent studies have demonstrated that irrelevant stimuli that are consciously perceived may be filtered out on a neural level and not cause the distraction triggered by…

  14. How to Care for a Sprained Ankle

    MedlinePlus

    ... Sprained Ankle How to Care for a Sprained Ankle Page Content Ankle sprains are very common injuries. ... Grade I, II or III. Treating your Sprained Ankle Treating your sprained ankle properly may prevent chronic ...

  15. [Front Block distraction].

    PubMed

    Esnault, Olivier

    2015-03-01

    The contribution of the segmental osteotomies in the ortho-surgical protocols is no longer to demonstrate and found a new lease of life thanks to the combination with the bone distraction techniques. The osteotomy of Köle, initially described to close infraclusies, and then used to level very marked curves of Spee has more recently been used to correct anterior crowding. This support is therefore aimed at patients with an incisor and canine Class 2 but molar Class 1 with an isolated mandibular footprint. With minimal orthodontic preparation we can create in two weeks bilateral diastemas that will then be used to align the incisivocanin crowding without stripping or bicuspid extractions. Dental orthodontic movements can be resumed one month after the end of the distraction. This technique is therefore likely to avoid bicuspid extraction and replace some sagittal osteotomy advancement by correction of the overjet. It also helps to correct a incisors labial or lingual tipping playing on differential activation of the cylinders and the distractor. This segmental surgery can be combined with Le Fort 1 surgeries with correction of the transverse and associated meanings, but in a second time, to a mandibular advancement and/or a genioplasty. PMID:25888045

  16. The distracted driver.

    PubMed

    Peters, G A; Peters, B J

    2001-03-01

    A serious health problem is developing from automobile collisions caused by distracted drivers. This is a result of the rapid proliferation of portable cellular telephones and personal organisers used while driving, the development of more sophisticated entertainment systems and instrument panel controls, the advent of navigation and television displays in vehicles and promises of sophisticated wireless e-mail, FAX and Internet services in the vehicle. Preoccupation with electronic gadgets may also degrade human driving performance. Many drivers however, sincerely believe they have the talent to do several things at the same time, such as hold and look at a cellular telephone in one hand and drive with a beverage container in the other hand whilst at the same time, exercise their personal skills. Obviously, they believe that they do not need two hands on the steering wheel and two eyes on the road. This is a unique situation requiring intensive health promotion as distracted or 'offensive driving' may be habit forming and difficult to change, any significant design remedies will be slow to arrive and may be circumvented, and the regulatory laws have proved difficult or impossible to enforce. This special need may require research to determine the most effective techniques for health promotion. PMID:11329694

  17. Subtalar arthroscopy using a 2.4-mm zero-degree arthroscope: indication, technical experience, and results.

    PubMed

    Siddiqui, Mashfiqul A; Chong, Keen Wai; Yeo, William; Rao, Mohana S; Rikhraj, Inderjeet S

    2010-08-01

    The subtalar joint is complex. With the advent of smaller diameter arthroscopes, subtalar arthroscopy has become an important diagnostic and therapeutic tool for subtalar joint disorders. The objective of this study was to evaluate the outcome of patients who underwent arthroscopy for subtalar joint disorders using a 2.4-mm zero-degree arthroscope. In this prospective study, 6 patients who underwent subtalar arthroscopy from September 2008 to January 2009 in the authors' institution were included. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scores were recorded preoperatively and at 3 and 6 months postoperatively. Mean +/- SD age was 45.5 +/- 16.2 years (range, 27.5-63.2). Postoperative diagnosis included arthrofibrosis, osteoarthritis, and osteochondral disease of the subtalar joint. Mean +/- SD AOFAS scores improved from 49.67 +/- 18.83 (range, 22-76) to 67.33 +/- 14.92 (range, 53-91) at 3 months (P = .03) and 75 +/- 19.74 (range, 54-100) at 6 months (P = .004). Subtalar arthroscopy using the 2.4-mm zero-degree arthroscope shows promising results in the diagnosis and treatment of subtalar pathologies. Patients have a significant improvement in their AOFAS hindfoot scores as early as 3 months and continue to improve subsequently. Usage of the zero-degree arthroscope allows the "instrumentation hand" to maneuver more easily in space and perform the operative procedure without getting in the way of the "camera hand." It can also save on inventory costs for centers that already have the zero-degree arthroscope. The role of specialized imaging is still unclear. Diagnosis of sinus tarsi syndrome should be historical with direct visualization of the joint revealing exact etiology. PMID:20530192

  18. Hip arthroscopy for the management of trauma: a literature review

    PubMed Central

    Newman, Justin T.; Saroki, Adriana J.; Philippon, Marc J.

    2015-01-01

    The first descriptions of the use of hip arthroscopy for traumatic injuries were presented in 1980. One paper described arthroscopy for the removal of a bullet fragment while others reported using hip arthroscopy to remove fragments following total hip arthroplasty. With the application of traction and modification of arthroscopic instruments, hip arthroscopy has become a useful tool in treating trauma to the hip. Most of the literature describes traumatic hip dislocation. Several studies have documented the successful use of arthroscopy for removal of loose bodies, but it has also been used to treat labral tears, chondral defects and acetabular rim fractures. Complications reported include fluid extravasation, the lowering of the patient's body temperature using cool saline irrigation and further injury due to unrecognized concomitant pathology. PMID:27011845

  19. Return to Play Following Hip Arthroscopy.

    PubMed

    Lee, Simon; Kuhn, Andrew; Draovitch, Pete; Bedi, Asheesh

    2016-10-01

    Femoroacetabular impingement may be particularly disabling to the high-demand athlete, especially those with significant cutting and pivoting requirements. If nonoperative treatment fails to adequately alleviate symptoms or sufficiently restore function in the athlete, hip arthroscopy can lead to improved pain, improved range of motion, and high rates of return to play with proper postoperative rehabilitation. The rate of return to previous level of competition is also high with accurate diagnosis and well-executed correction of deformity. A clear understanding of the etiology, diagnosis, management, and outcomes is essential for clinicians to optimally help patients to return to play. PMID:27543404

  20. Fluid Extravasation Related to Hip Arthroscopy

    PubMed Central

    Hinzpeter, Jaime; Barrientos, Cristián; Barahona, Maximiliano; Diaz, Jorge; Zamorano, Alvaro; Salazar, Alfonso; Catalan, Jaime

    2015-01-01

    Background: Complications related to hip arthroscopy are rare, with a current rate of <2%. Some complications are related to fluid extravasation, which has been associated with life-threatening conditions such as abdominal compartment syndrome, cardiopulmonary arrest, hypothermia, and atelectasis. Purpose: To identify risk factors for fluid volume extravasation in hip arthroscopy and to determine the relationship between anatomical location on computed tomography (CT) and extravasated volume. Study Design: Case series; Level of evidence, 4. Methods: We performed a prospective cohort study of 40 consecutive arthroscopies for femoroacetabular impingement. Patient demographics and procedures performed (ie, acetabuloplasty and its size, femoral osteoplasty, and psoas tenotomy) were recorded. The extravasated volume was estimated by the difference between the infused volume and the intraoperatively collected volume. Within 12 hours after the procedure, the pelvis was scanned by CT. We created a 3-stage radiological classification based on progressive involvement of anatomical structures attributed to liquid extravasation. Statistical analyses were performed with a 95% CI and a significance level of 5%. Results: No relevant clinical symptoms related to fluid extravasation were recorded. The mean extravasated volume was 3.06 L at a rate of 1.05 L/h, corresponding to nearly 10% of the infused volume. There was a trend toward greater extravasated volume with longer operative time and longer time in the peripheral compartment (without axial traction); however, there was no statistical significance. The anatomical classification on CT imaging was directly related to the extravasated volume and compromised the thigh, gluteus, and retroperitoneum and intraperitoneal spaces. There was a 6-fold greater probability of female patients having an advanced stage extravasation on CT classification. Conclusion: In our series, 10% of the infused volume was extravasated in uncomplicated

  1. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases. PMID:16224109

  2. Isolated Pulmonary Embolism following Shoulder Arthroscopy

    PubMed Central

    Goldhaber, Nicole H.; Lee, Christopher S.

    2014-01-01

    Pulmonary embolism (PE) following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT) angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis. PMID:25548699

  3. Distracted Driving Raises Crash Risk

    MedlinePlus

    ... Raises Crash Risk Video technology and in-vehicle sensors showed that distracted driving, especially among new drivers, ... whenever the cars were moving. A suite of sensors recorded acceleration, sudden braking or swerving, and other ...

  4. Context effects on auditory distraction

    PubMed Central

    Chen, Sufen; Sussman, Elyse S.

    2014-01-01

    The purpose of the study was to test the hypothesis that sound context modulates the magnitude of auditory distraction, indexed by behavioral and electrophysiological measures. Participants were asked to identify tone duration, while irrelevant changes occurred in tone frequency, tone intensity, and harmonic structure. Frequency deviants were randomly intermixed with standards (Uni-Condition), with intensity deviants (Bi-Condition), and with both intensity and complex deviants (Tri-Condition). Only in the Tri-Condition did the auditory distraction effect reflect the magnitude difference among the frequency and intensity deviants. The mixture of the different types of deviants in the Tri-Condition modulated the perceived level of distraction, demonstrating that the sound context can modulate the effect of deviance level on processing irrelevant acoustic changes in the environment. These findings thus indicate that perceptual contrast plays a role in change detection processes that leads to auditory distraction. PMID:23886958

  5. Revision Wrist Arthroscopy after Failed Primary Arthroscopic Treatment

    PubMed Central

    Jang, Eugene; Danoff, Jonathan R.; Rajfer, Rebecca A.; Rosenwasser, Melvin P.

    2014-01-01

    Background The etiologies and outcomes of cases of failed therapeutic wrist arthroscopy have not been well-described to date. Purpose The purposes of this study were to identify common preventable patterns of failure in wrist arthroscopy and to report outcomes of a series of revision arthroscopy cases. Patients and Methods Retrospective review of 237 wrist arthroscopies revealed 21 patients with a prior arthroscopy for the same symptoms, of which 16 were assessed by questionnaires and physical exam for this study. Results Six of sixteen patients (38%) had unrecognized dynamic ulnar impaction after débridement of triangular fibrocartilage complex (TFCC) tears, which resolved with arthroscopic wafer resection. Five (31%) had persistent distal radioulnar joint (DRUJ) instability after initial treatment of TFCC tears, requiring arthroscopic repair at revision. Four (25%) experienced diffuse dorsal wrist pain initially diagnosed as TFCC tears, but dynamic scapholunate ligament injuries were found and addressed with radiofrequency (RF) shrinkage at reoperation. Two (13%) required further resection of the radial styloid, after initial débridement was insufficient to correct radioscaphoid impingement. At a mean of 4.8 years after repeat arthroscopy (range, 1.5–13.4 years), this cohort had significant improvements in pain and satisfaction with outcomes after revision arthroscopy. Conclusions The most common indications for repeat wrist arthroscopy were ligamentous instability (of the DRUJ or scapholunate ligament) and osteoarthritis (from dynamic ulnar impaction or radioscaphoid impingement). Although revision wrist arthroscopy may yield acceptable outcomes, careful assessment of stability and cartilage wear at index procedure is crucial. Level of Evidence: Level IV Therapeutic. PMID:24533243

  6. Leading to distraction: Driver distraction, lead car, and road environment.

    PubMed

    Kountouriotis, G K; Merat, N

    2016-04-01

    Driver distraction is strongly associated with crashes and near-misses, and despite the attention this topic has received in recent years, the effect of different types of distracting task on driving performance remains unclear. In the case of non-visual distractions, such as talking on the phone or other engaging verbal tasks that do not require a visual input, a common finding is reduced lateral variability in steering and gaze patterns where participants concentrate their gaze towards the centre of the road and their steering control is less variable. In the experiments presented here, we examined whether this finding is more pronounced in the presence of a lead car (which may provide a focus point for gaze) and whether the behaviour of the lead car has any influence on the driver's steering control. In addition, both visual and non-visual distraction tasks were used, and their effect on different road environments (straight and curved roadways) was assessed. Visual distraction was found to increase variability in both gaze patterns and steering control, non-visual distraction reduced gaze and steering variability in conditions without a lead car; in the conditions where a lead car was present there was no significant difference from baseline. The lateral behaviour of the lead car did not have an effect on steering performance, a finding which indicates that a lead car may not necessarily be used as an information point. Finally, the effects of driver distraction were different for straight and curved roadways, indicating a stronger influence of the road environment in steering than previously thought. PMID:26785327

  7. Ankle fracture - aftercare

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this ... Sit with your foot elevated higher than your knee at least 4 times a day Apply an ...

  8. The epidemic of distraction.

    PubMed

    Weksler, Marc E; Weksler, Babette B

    2012-01-01

    Multitasking is a rapidly growing phenomenon affecting all segments of the population but is rarely as successful as its proponents believe. The use of mobile electronic devices contributes importantly to multitasking and cognitive overload. Although personal electronic devices provide many benefits, their adverse effects are frequently overlooked. Personal observation and a review of the scientific literature supports the view that overuse or misuse of personal electronic devices promotes cognitive overload, impairs multitasking and lowers performance at all ages but particularly in the elderly. This phenomenon appears to be rapidly increasing and threatens to become a tsunami as spreading electronic waves cause an 'epidemic of distraction'. Mobile electronic devices often bring benefits to their users in terms of rapid access to information. However, there is a dark side to the increasing addiction to these devices that challenges the health and well-being of the entire population, targeting, in particular, the aged and infirm. New approaches to information gathering can foster creativity if cognitive overload is avoided. PMID:22572729

  9. Effects of irrigation fluid in shoulder arthroscopy

    PubMed Central

    Gupta, Surbhi; Manjuladevi, M; Vasudeva Upadhyaya, KS; Kutappa, AM; Amaravathi, Rajkumar; Arpana, J

    2016-01-01

    Background and Aims: Extravasation of irrigation fluid used in shoulder arthroscopy can lead to life-threatening airway and systemic complications. This study was conducted to assess the effect of irrigation fluid absorption on measurable anthropometric parameters and to identify whether these parameters predict airway/respiratory compromise. Methods: Thirty six American Society of Anaesthesiologists physical status one or two patients aged 15–60 years undergoing shoulder arthroscopy under general anaesthesia were recruited. Measured variables preoperatively (baseline) and at the end of surgery were neck, chest, midarm and midthigh circumferences, weight, haemoglobin and serum sodium. Temperature, endotracheal tube cuff pressure, airway pressure, duration of surgery, amount of irrigation fluid and intravenous fluid used were also noted. Measured parameters were correlated with the duration of surgery and the amount of irrigation fluid used. Results: Postoperatively, the changes in variables showed a significant increase in the mean values (cm) for neck, chest, midarm and midthigh circumference (mean ± standard deviation: 2.35 ± 1.9, P < 0.001; 2.9 ± 3.88 cm, P < 0.001; 3.28 ± 2.44, P < 0.001 and 0.39 ± 0.71, P = 0.002, respectively) and weight (kg) (1.17 ± 1.24, P < 0.001). The post-operative haemoglobin (g/dL) levels decreased significantly (0.89 ± 1.23, P < 0.001) as compared to the baseline. No significant change was found in the serum sodium levels (P = 0.92). No patient experienced airway/respiratory compromise. Conclusion: Regional and systemic absorption of irrigation fluid in arthroscopic shoulder surgery is reflected in the degree of change in the measured anthropometric variables. However, this change was not significant enough to cause airway/respiratory compromise. PMID:27053783

  10. Ankle injuries in basketball players.

    PubMed

    Leanderson, J; Nemeth, G; Eriksson, E

    1993-01-01

    We carried out a retrospective study of the frequency of ankle sprains in basketball players. A questionnaire about previous ankle injuries, time off after such injuries, current ankle problems, personal data, number of practice hours and the use of prophylactic measures was sent out to 102 basketball players in a second division league in Sweden. Ninety-six players answered. 92% of them had suffered an ankle sprain while playing basketball, and of these 83% reported repeated sprains of one ankle. In the last two seasons, 78% of the players had injured at least one ankle. The injury frequency in the investigation was 5.5 ankle injuries per 1000 activity hours. 22% of the players used some kind of prophylactic support of their ankle joints. Because of the great number of ankle sprains and the disability in terms of time away from sports that they cause, prevention of these injuries is essential. PMID:8536029

  11. Indications for arthroscopy in mon- and polyarticular arthritis.

    PubMed Central

    Bots, R A; Boerbooms, A M

    1979-01-01

    In many cases clinical and laboratory data and x-rays are insufficient to diagnose the aetiology of synovitis in gonarthritis and to plan adequate treatment. The efficacy of arthroscopy in the management of the knee lesion was studied in mon- and polyarthritis. A classification of 'very useful', 'useful' and 'not useful' was used. On the basis of results reported here we outline the indications for arthroscopy in mon- and polyarthritis. PMID:496448

  12. [The evolution of surgical arthroscopy in Israel and worldwide].

    PubMed

    Haviv, Barak; Bronak, Shlomo; Thein, Rafael

    2015-04-01

    Arthroscopy is a minimal invasive surgical technique to treat joint disorders with the use of fiber optics for indirect vision and small surgical tools. The first endoscopic direct inspection of the knee joint was documented at the beginning of the 20th century; however, the clinical practice of arthroscopy started only fifty years later. The "historical fathers" of surgical arthroscopy were Kenji Takagi from Japan and Eugen Bircher from Switzerland. The arthroscopes had become safer and more dependable since the 1970's with the introduction of fiber optics, while vision became easier with the invention of television. Subsequently, in the 1980's and 90's instruments were refined and arthroscopy evolved from a diagnostic to a therapeutic tool with the advantages of minimal approach, few complications and short rehabilitation. The beginning of knee arthroscopy in Israel followed the development in North America in the1970's. Within a few years, knee arthroscopy in Israel had also evolved to be therapeutic rather than diagnostic and was specifically used for partial meniscectomies. Currently, arthroscopic surgery, particularly of the knee and shoulder, has become common practice worldwide. Arthroscopic procedures constitute more than a third of all orthopedic procedures performed at the Israeli Assuta private hospitals. With the development of various technologies, it is anticipated that arthroscopic techniques will further evolve and play an ever greater role in diagnosing and treating joint pathology. PMID:26065225

  13. Distraction Osteogenesis Update: Introduction of Multidirectional Cranial Distraction Osteogenesis.

    PubMed

    Gomi, Akira; Sunaga, Ataru; Kamochi, Hideaki; Oguma, Hirofumi; Sugawara, Yasushi

    2016-05-01

    In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique. PMID:27226854

  14. Distraction Osteogenesis Update: Introduction of Multidirectional Cranial Distraction Osteogenesis

    PubMed Central

    Sunaga, Ataru; Kamochi, Hideaki; Oguma, Hirofumi; Sugawara, Yasushi

    2016-01-01

    In this review, we discuss in detail our current procedure for treating craniosynostosis using multidirectional cranial distraction osteogenesis (MCDO). The MCDO method allows all phenotypes of skull deformity to be reshaped by distraction osteogenesis, except in patients who are 5 months of age or younger and patients with posterior cranial vault problems. We report the results of clinical data of 36 children with craniosynostosis who underwent MCDO between 2005 and 2014 in our institute. This method has the following benefits, such as a high flexibility of reshaping, shorter treatment period and less invasive secondary intervention. We also discuss the other distraction osteogenesis techniques that are used to treat craniosynostosis and compare them with MCDO. The preferred procedure for correction of craniosynostosis may depend on the patient's age, the extent of deformity, and the extent of correction achievable by surgery. We can arrange the combinations of various methods according to the advantage and disadvantage of each technique. PMID:27226854

  15. Osteochondral repair in hemophilic ankle arthropathy: from current options to future perspectives

    PubMed Central

    BUDA, ROBERTO; CAVALLO, MARCO; CASTAGNINI, FRANCESCO; FERRANTI, ENRICO; NATALI, SIMONE; GIANNINI, SANDRO

    2015-01-01

    Young hemophilic patients are frequently affected by ankle arthropathy. At the end stage of the disease, the current treatments are arthrodesis and arthroplasty, which have significant drawbacks. Validated procedures capable of slowing down or even arresting the progression towards the end stage are currently lacking. This review aims to discuss the rationale for and feasibility of applying, in mild hemophilic ankle arthropathy, the main techniques currently used to treat osteochondral defects, focusing in particular on ankle distraction, chondrocyte implantation, mesenchymal stem cell transplantation, allograft transplantation and the use of growth factors. To date, ankle distraction is the only procedure that has been successfully used in hemophilic ankle arthropathy. The use of mesenchymal stem cells have recently been evaluated as feasible for osteochondral repair in hemophilic patients. There may be a rationale for the use of growth factors if they are combined with the previous techniques, which could be useful to arrest the progression of the degeneration or delay end-stage procedures. PMID:26904526

  16. Callus stimulation in distraction osteogenesis.

    PubMed

    Mofid, Mehrdad M; Inoue, Nozomu; Atabey, Atay; Marti, Guy; Chao, Edmund Y S; Manson, Paul N; Vander Kolk, Craig A

    2002-04-15

    Distraction osteogenesis has been described as in vivo tissue engineering. The ability to stimulate this process for the repair of bony defects or lengthening of congenitally shortened facial structures is likely to significantly impact the field of craniofacial surgery. The purpose of this study was to determine whether mechanical stimulation of the distracted rabbit mandible would accelerate the maturation of the bony callus when applied during the early consolidation period. Twenty adult New Zealand White rabbits underwent unilateral mandibular osteotomy. A uni-directional internal distractor device (Synthes, Paoli, Pa.) was positioned along a plane perpendicular to the line of osteotomy. After a 7-day latency period, distraction was commenced at a rate of 1.0 mm/day for 12 days in all animals. In a control group of 10 rabbits, a consolidation period of 8 weeks was observed before they were killed. In the experimental group of 10 rabbits, daily alternate compression and distraction of 1 mm (sequential compression and distraction) was performed for 3 weeks followed by a 5-week period of rigid fixation. Each animal received a dose of a fluorescent label at three different time points during the study: at the end of the distraction period, 3 weeks after the completion of the distraction phase, and 3 days before it was killed. All animals were killed 8 weeks after the completion of the distraction phase. Undecalcified histologic analysis and 3-point bending tests to failure were performed on the extracted mandibles. The results of the experimental and control groups were compared. Four animals in the control group and three animals in the experimental group were excluded from the study because of screw loosening resulting in distractor dislodgment or because of infection. On histologic analysis, cortical thickness at the center of the callus was found to be significantly greater in the experimental group compared with the control group when normalized to the

  17. Doctor, I sprained my ankle.

    PubMed

    How, Choon How; Tan, Ken Jin

    2014-10-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long‑term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle's range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  18. Complications of distraction osteogenesis in short first metatarsals.

    PubMed

    Oh, Chang Wug; Satish, B R J; Lee, Sung-Tae; Song, Hae-Ryong

    2004-01-01

    The authors analyzed the results and complications of metatarsal lengthening in short first metatarsals by distraction osteogenesis. There were 13 first metatarsal lengthenings in eight patients. Mean age was 18.8 years and the average percentage of lengthening was 49.2%. The average healing index was 72.4 days/cm. The major complication was cavus foot, which was noticed in four feet. All great toes showed some loss of motion at metatarsophalangeal (MP) joint. Other complications were hallux valgus, angulation of the metatarsals, and pin tract infection each in two feet. The functional score according to the American Orthopedic Foot and Ankle Society (AOFAS) hallux MP joint, interphalangeal joint scale was excellent in 11 and good in 2. All patients were satisfied with the procedure. To avoid potential complications such as MP joint subluxation, cavus foot, and hallux valgus, the first metatarsal lengthening should not exceed 50% of the original length. PMID:15502575

  19. How to Tape an Ankle

    MedlinePlus

    ... Decide If You Need to See an Orthopaedic Foot and Ankle Specialist How to Care for a Sprained Ankle How to Be Non-weightbearing After Surgery Footwear All Site Content AOFAS / FootCareMD / How To... / Foot Injury / How to Tape an Ankle How to ...

  20. Ulnar impaction syndrome: Managed by wrist arthroscopy

    PubMed Central

    Hao, Jiajie; Xu, Zhijie; Zhao, Zhigang

    2016-01-01

    Background: The development of handicraft industry and increase of various such works that need a large amount of repeated wrist ulnar deviation strength, the incidence of ulnar impaction syndrome (UIS) is increasing, but the traditional simple ulnar shortening osteotomy has more complications. This study aimed to explore the early diagnostic criteria of UIS and its wrist arthroscopic treatment experience. Materials and Methods: 9 UIS patients were enrolled in this study. According to magnetic resonance imaging, X-ray and endoscopic features, the diagnostic criteria of UIS were summarized and the individualized treatment schedule was made. If the ulnar positive variance was less than 4 mm, the arthroscopic wafer resection was performed. If the ulnar positive variance was more than 4 mm, the arthroscopic resection of injury and degenerative triangular fibrocartilage complex and ulnar osteotomy were conducted. Results: In all patients, the wound healed without any complications. All patients returned to normal life and work, with no ulnar wrist pain again. One patient had wrist weakness. There was a significant difference of the wrist activity between the last followup and before operation (P < 0.05). According to the modified wrist function scoring system of Green and O’Brien, there were 6 cases of excellent, 2 cases of good and 1 case of appropriate and the overall excellent and good rate was 92.3%. Conclusion: In the treatment of UIS, the arthroscopy can improve the diagnosis rate, optimize the treatment plan, shorten the treatment cycle, with good treatment results. PMID:27053807

  1. Glanzmann's Thrombasthenia Diagnosed following Knee Arthroscopy

    PubMed Central

    Zvijac, John E.; Ammus, Sharhabil S.; Aran, Fernando; Kiebzak, Gary M.

    2015-01-01

    A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann's thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults. PMID:26000186

  2. Elbow arthroscopy: treatment of the thrower's elbow.

    PubMed

    O'Holleran, James D; Altchek, David W

    2006-01-01

    The athlete's elbow has been described as one of the last frontiers in orthopaedic sports medicine. It has been considered separately from other athletic injuries because of the unique constellation of pathology that results from repetitive overhead throwing. Tremendous gains in understanding the complex interplay between the dynamic and static stabilizers of the athlete's elbow have occurred over the past decade. The desire to treat these injuries in a minimally invasive manner has driven the development of techniques and instrumentation for elbow arthroscopy, a successful and essential technique in the treatment of the thrower's elbow. Medial collateral ligament injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans of the capitellum have all been described as consequences of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can each be present in conjunction with these conditions or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these conditions to form a comprehensive differential diagnosis for an athlete with elbow pain. The surgeon treating the athlete's elbow should be comfortable with both open and arthroscopic treatments. An understanding of the anatomy and biomechanics of the thrower's elbow is essential for good patient care. The preoperative evaluation should focus on a thorough history and physical examination, as well as specific diagnostic imaging modalities. PMID:16958443

  3. Arthroscopic ankle arthrodesis.

    PubMed

    Elmlund, Anna O; Winson, Ian G

    2015-03-01

    Arthroscopic ankle arthrodesis is a good option for the treatment of end-stage ankle arthritis. The surgical technique involving the use of a standard 4.5-mm arthroscope is described. Standard anteromedial and anterolateral portals are used. Joint surfaces except the lateral gutter are prepared to point bleeding with motorized burr, abraider, and curettes. Rigid fixation is achieved with cannulated screws. The postoperative regime includes 12 weeks protection, staged from non-weight bearing through partial to full weight bearing. Advantages compared with the open procedure include shorter hospital stay and shorter time to union with similar or better union rates. PMID:25726484

  4. Ankle Arthroscopic Reconstruction of Lateral Ligaments (Ankle Anti-ROLL)

    PubMed Central

    Takao, Masato; Glazebrook, Mark; Stone, James; Guillo, Stéphane

    2015-01-01

    Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all–inside-out manner that is likely safe for patients and minimally invasive. PMID:26900560

  5. Validation of a simulator for temporomandibular joint arthroscopy.

    PubMed

    Monje Gil, F; Hernandez Vila, C; Moyano Cuevas, J L; Lyra, M; Pagador, J B; Sanchez Margallo, F M

    2016-07-01

    The traditional method of surgical training has followed the 'observe, practice, and teach' model, which is useful for open surgery, but is insufficient for minimally invasive surgery. This study presents the validation of a new simulator designed for TMJ arthroscopy training. A group of 10 senior maxillofacial surgeons performed an arthroscopy procedure using the simulator. They then completed a questionnaire analyzing the realism of the simulator, its utility, and the educational quality of the audiovisual software. The mean age of the 10 surgeons was 42.6 years, and they had performed a mean 151 arthroscopies. With regard to the realism of the simulator, 80% reported that it was of an appropriate size and design and 70% referred to the very realistic positions and relationships between the internal structures. Regarding its educational potential, 80% reported the simulator to be very useful for acquiring the basic skills and to acquire the sensation of depth during access to the TMJ. Finally, 90% reported the prototype to be very useful for TMJ arthroscopy training. These preliminary results showed a high degree of approval. The general opinion of the group of experts was that the experience was rewarding and inspiring, and that the prototype has the educational potential for the achievement of basic TMJ arthroscopy skills. PMID:26850940

  6. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    PubMed

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments. PMID:26412207

  7. Doctor, I sprained my ankle

    PubMed Central

    How, Choon How; Tan, Ken Jin

    2014-01-01

    Ankle sprains constitute the majority of ankle injuries, and result in pain, limited mobility/exercise and loss of school/work days. Ankle sprains involve at least one of the ankle ligaments and range from a micro tear to complete tear of the ligament or group of ligaments. The most common mechanism of ankle sprains is inversion stress of a plantar-flexed foot, while the most frequently injured ligament is the anterior talofibular ligament. The attending clinician needs to stratify the risk of fracture through history-taking and physical examination, manage the pain, assess long-term complications and provide certification for rest and recovery. The Ottawa ankle rules may be useful. Graduated exercises to maintain the ankle’s range of motion should be started early, after the resolution of initial pain and swelling. The risk of recurrent ankle injuries is often a combination of both mechanical and functional disabilities. PMID:25631892

  8. [Tuberculosis of ankle].

    PubMed

    Rubio Barbón, S; Rodríguez Cocina, B; Suárez del Villar Acebal, R; Calvo Rodríguez, C E; Villar López, A; Escalada Rodríguez, P; Torreblanca Gil, A

    2004-09-01

    The authors present a case of tuberculous arthritis of ankle with sinovial fluid and sputum aspirate Lowenstein positive (M. tuberculosis) in a patient non inmunocomprometid and review the clinical, diagnosis and treatment aspects of this entity, and show the difficult diagnosis in cases of radiology normal or low suspect. PMID:15476422

  9. Ankle syndesmosis injuries.

    PubMed

    Peña, Fernando A; Coetzee, J Chris

    2006-03-01

    Physician awareness of ankle syndesmosis injuries is improving. The anatomy involved and the mechanism of injury are extremely relevant for the understanding and treatment of this type of injury. Examination under anesthesia may confirm the syndesmosis instability. Based on those findings, stabilization is the recommended approach. PMID:16564452

  10. Arthroscopically assisted reduction of type 1A ankle Fractures in Children: Case Report

    PubMed Central

    Al-Aubaidi, Zaid

    2013-01-01

    Introduction: The risk of growth arrest following paediatric ankle fractures type 1 A is very high. Therefore all attempts should be done to anatomically reduce this kind of fracture. The advances in ankle arthroscopy have brought the possibility to reduce these fractures under direct vision, without the need of capsulotomy. The purpose of this paper is to stress the importance of the use of arthroscopically assisted reduction of type 1 A fractures. Case Report: We describe two cases with SH type IV fractures of the distal medial tibia, one treated with open reduction and percutaneous screw fixation and the other treated with arthroscopically assisted reduction and percutaneous screw fixation. The first case ended with severe growth disturbance, while the second gave a very good result. Conclusion: The use of arthroscopically assisted reduction of type 1 A fractures should be considered to ensure anatomical reduction. PMID:27298899

  11. Hip arthroscopy in the setting of hip dysplasia

    PubMed Central

    Yeung, M.; Kowalczuk, M.; Simunovic, N.

    2016-01-01

    Objective Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. Methods A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed. Results The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty. Conclusion The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies. Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225–231. DOI: 10.1302/2046-3758.56.2000533. PMID:27313136

  12. Avoiding Failure in Hip Arthroscopy: Complications, Pearls, and Pitfalls.

    PubMed

    Burrus, Matthew Tyrrell; Cowan, James B; Bedi, Asheesh

    2016-07-01

    Although most patients have successful outcomes after hip arthroscopy, a minority of patients experience complications that may impact their recovery and long-term benefit. As most of these complications can be minimized by appropriate surgical technique, many tips have been recommended. Additionally, the reasons behind clinical failure postoperatively have been scrutinized, which include, most commonly, incomplete correction of osseous pathomorphology, underappreciated preexisting hip osteoarthritis, and/or an incorrect preoperative diagnosis. Meticulous preoperative planning, evaluation of advanced imaging studies, and proper patient selection will help to reduce the number of postoperative failures and increase the chance of a successful outcome following hip arthroscopy. PMID:27343398

  13. Knee arthropathy in ochronosis: diagnosis by arthroscopy with ultrastructural features.

    PubMed

    Lurie, D P; Musil, G

    1984-02-01

    Knee arthroscopy in a patient with undiagnosed chronic monoarticular arthritis revealed dark pigmentation of the snyovium; synovial biopsy revealed histologic and ultrastructural features characteristic of ochronosis. Synovial fluid (SF) was non-inflammatory, without pigmented shards of cartilage; calcium pyrophosphate dihydrate crystals were absent in both the SF and biopsy specimen. Homogentisic acid was detectable in the urine by thin layer chromatography, and asymptomatic spondylosis with intervertebral disc calcification was found. The negative family history, lack of mucocutaneous pigmentation and failure of the urine to spontaneously darken obscured the diagnosis, which was easily made by arthroscopy. PMID:6699824

  14. The role of hip arthroscopy in the management of osteonecrosis

    PubMed Central

    Papavasiliou, A.; Yercan, H. S.; Koukoulias, N.

    2014-01-01

    Hip arthroscopy has emerged as a diagnostic and therapeutic tool in the management of osteonecrosis (ON) of the femoral head. Direct visualization of the joint, aids the staging of the disease, while mechanical symptoms and pain can be alleviated by addressing the often coexisting intra-articular pathology (labral tears, chondral delamination, loose bodies and synovitis) thereby improving the clinical outcome in some patients. The article explores the role and possible value of hip arthroscopy as a surgical technique in the treatment of hip ON. PMID:27011804

  15. Knee arthroscopy after yttrium or osmic acid injection

    SciTech Connect

    Guaydier-Souquieres, C.; Beguin, J.; Ollivier, D.; Loyau, G.

    1989-01-01

    This study presents the macroscopic and histologic results of 35 knee arthroscopies performed on patients with rheumatoid arthritis, some months after an yttrium or osmic acid intraarticular injection. The procedure was most often performed after a failure of the injection or a relapse of synovitis. Arthroscopy provides an understanding of the cause of synoviorthesis failure--insufficient action of the product on the synovitis or its poor diffusion, fibri-nonecrotic deposits, or cartilaginous lesions--and may be used both diagnostically and therapeutically.

  16. Dual ACL Ganglion Cysts: Significance of Detailed Arthroscopy

    PubMed Central

    Singla, Amit; Nag, H. L.; Meena, Sanjay; Lohiya, Ramprakash; Agarwal, Abhinav

    2014-01-01

    Intra-articular ganglion cysts of the knee joint are rare and most frequently are an incidental finding on MRI and arthroscopy. Most of the previous studies have reported a single ganglion cyst in the knee. There have been previous reports of more than one cyst in the same knee but not in the same structure within the knee. We are reporting a case of dual ACL (anterior cruciate ligament) ganglion cysts one of which was missed on radiological examination but later detected during arthroscopy. To the best of our knowledge, no such case has been reported in the indexed English literature till date. PMID:25400962

  17. How Concentration Shields Against Distraction

    PubMed Central

    Marsh, John E.

    2015-01-01

    In this article, we outline our view of how concentration shields against distraction. We argue that higher levels of concentration make people less susceptible to distraction for two reasons. One reason is that the undesired processing of the background environment is reduced. For example, when people play a difficult video game, as opposed to an easy game, they are less likely to notice what people in the background are saying. The other reason is that the locus of attention becomes more steadfast. For example, when people are watching an entertaining episode of their favorite television series, as opposed to a less absorbing show, attention is less likely to be diverted away from the screen by a ringing telephone. The theoretical underpinnings of this perspective, and potential implications for applied settings, are addressed. PMID:26300594

  18. [Ankle braces prevent ligament injuries].

    PubMed

    Karlsson, Jon

    2002-09-01

    The Cochrane collaboration has performed a meta-analysis of all studies found on the prevention of ankle ligament injuries, frequent in sports like soccer, European handball and basketball. Interventions include the use of modified footwear and associated supports, training programmes and health education. Five randomized trials totalling 3,954 participants were included. With the exception of ankle disc training, all prophylactic interventions entailed the application of an external ankle support in the form of a semi-rigid orthosis, air-cast or high top shoes. The studies showed a significant reduction in the number of ankle sprains in individuals allocated to external ankle support. This reduction was greater for those with a previous history of ankle sprains. PMID:12362747

  19. Hip arthroscopy: a report on a cohort of orthopaedic surgeons

    PubMed Central

    Byrd, J. W. Thomas; Jones, Kay S.; Chin, Paul C.

    2016-01-01

    Successful hip arthroscopy depends on proper patient selection and reasonable patient expectations. The purpose of this study is to report the results of hip arthroscopy in orthopaedic surgeons who represent the most informed cohort. This report is based on a retrospective review of prospectively collected data among 24 orthopaedic surgeons (1 bilateral). Follow-up averaged 48 months (range 12–120 months). They were all males with an average age of 45 years (range 30–64 years). All improved with an average of 18 points (preoperative 75; post-operative 93); although one underwent repeat arthroscopy and one was converted to total hip arthroplasty at 54 months. There were numerous diagnoses and procedures performed and one complication (acute coronary artery occlusion). They resumed seeing patients at an average of 1.6 weeks (range 2 days–4 weeks) and operating at an average of 3.1 weeks (range 6 days–8 weeks). This report spans three decades, thus representing a heterogeneous population in terms of diagnoses and treatment. Nonetheless, successful results are noted. As a cohort, orthopaedic surgeons possess the greatest insight into hip arthroscopy, but as patients, often they must modulate their expectations in order to match the understanding of the realities of the procedure. PMID:27583146

  20. Endoscopic Removal of a Scapular Osteophyte Using Scapulothoracic Arthroscopy

    PubMed Central

    Lycke, Christian; Theopold, Jan-Dirk; Marquass, Bastian; von Dercks, Nikolaus; Hepp, Pierre

    2016-01-01

    This article describes the removal of a scapular osteophyte from the subscapular space by scapulothoracic arthroscopy. The endoscopic technique allows a gentle approach to the subscapular space without causing a large amount of surgical trauma and therefore leads to good cosmetic and functional results. PMID:27073768

  1. Late rupture of extensor pollicis longus after wrist arthroscopy.

    PubMed

    Fortems, Y; Mawhinney, I; Lawrence, T; Trial, I A; Stanley, J K

    1995-06-01

    The first cases of impending rupture of the extensor pollicis longus after wrist arthroscopy are reported and the etiology is compared with extensor pollicis longus ruptures after nondisplaced or minimally displaced Colles fractures. Both cases were treated with extensor indices proprius to extensor pollicis longus transfer with good clinical results. PMID:7632309

  2. Update on acute ankle sprains.

    PubMed

    Tiemstra, Jeffrey D

    2012-06-15

    Ankle sprains are a common problem seen by primary care physicians, especially among teenagers and young adults. Most ankle sprains are inversion injuries to the lateral ankle ligaments, although high sprains representing damage to the tibiofibular syndesmosis are becoming increasingly recognized. Physicians should apply the Ottawa ankle rules to determine whether radiography is needed. According to the Ottawa criteria, radiography is indicated if there is pain in the malleolar or midfoot zone, and either bone tenderness over an area of potential fracture (i.e., lateral malleolus, medial malleolus, base of fifth metatarsal, or navicular bone) or an inability to bear weight for four steps immediately after the injury and in the emergency department or physician's office. Patients with ankle sprain should use cryotherapy for the first three to seven days to reduce pain and improve recovery time. Patients should wear a lace-up ankle support or an air stirrup brace combined with an elastic compression wrap to reduce swelling and pain, speed recovery, and protect the injured ligaments as they become more mobile. Early mobilization speeds healing and reduces pain more effectively than prolonged rest. Pain control options for patients with ankle sprain include nonsteroidal anti-inflammatory drugs, acetaminophen, and mild opioids. Because a previous ankle sprain is the greatest risk factor for an acute ankle sprain, recovering patients should be counseled on prevention strategies. Ankle braces and supports, ankle taping, a focused neuromuscular training program, and regular sport-specific warm-up exercises can protect against ankle injuries, and should be considered for patients returning to sports or other high-risk activities. PMID:22962897

  3. What Is a Foot and Ankle Surgeon?

    MedlinePlus

    ... Text Size Print Bookmark What is a Foot & Ankle Surgeon? Foot and ankle surgeons are the surgical specialists of the podiatric ... every age. What education has a foot and ankle surgeon received? After completing undergraduate education, the foot ...

  4. Distracted by Your Mind? Individual Differences in Distractibility Predict Mind Wandering

    ERIC Educational Resources Information Center

    Forster, Sophie; Lavie, Nilli

    2014-01-01

    Attention may be distracted from its intended focus both by stimuli in the external environment and by internally generated task-unrelated thoughts during mind wandering. However, previous attention research has focused almost exclusively on distraction by external stimuli, and the extent to which mind wandering relates to external distraction is…

  5. Predicting Visual Distraction Using Driving Performance Data

    PubMed Central

    Kircher, Katja; Ahlstrom, Christer

    2010-01-01

    Behavioral variables are often used as performance indicators (PIs) of visual or internal distraction induced by secondary tasks. The objective of this study is to investigate whether visual distraction can be predicted by driving performance PIs in a naturalistic setting. Visual distraction is here defined by a gaze based real-time distraction detection algorithm called AttenD. Seven drivers used an instrumented vehicle for one month each in a small scale field operational test. For each of the visual distraction events detected by AttenD, seven PIs such as steering wheel reversal rate and throttle hold were calculated. Corresponding data were also calculated for time periods during which the drivers were classified as attentive. For each PI, means between distracted and attentive states were calculated using t-tests for different time-window sizes (2 – 40 s), and the window width with the smallest resulting p-value was selected as optimal. Based on the optimized PIs, logistic regression was used to predict whether the drivers were attentive or distracted. The logistic regression resulted in predictions which were 76 % correct (sensitivity = 77 % and specificity = 76 %). The conclusion is that there is a relationship between behavioral variables and visual distraction, but the relationship is not strong enough to accurately predict visual driver distraction. Instead, behavioral PIs are probably best suited as complementary to eye tracking based algorithms in order to make them more accurate and robust. PMID:21050615

  6. Acute ankle sprain: an update.

    PubMed

    Ivins, Douglas

    2006-11-15

    Acute ankle injury, a common musculoskeletal injury, can cause ankle sprains. Some evidence suggests that previous injuries or limited joint flexibility may contribute to ankle sprains. The initial assessment of an acute ankle injury should include questions about the timing and mechanism of the injury. The Ottawa Ankle and Foot Rules provide clinical guidelines for excluding a fracture in adults and children and determining if radiography is indicated at the time of injury. Reexamination three to five days after injury, when pain and swelling have improved, may help with the diagnosis. Therapy for ankle sprains focuses on controlling pain and swelling. PRICE (Protection, Rest, Ice, Compression, and Elevation) is a well-established protocol for the treatment of ankle injury. There is some evidence that applying ice and using nonsteroidal antiinflammatory drugs improves healing and speeds recovery. Functional rehabilitation (e.g., motion restoration and strengthening exercises) is preferred over immobilization. Superiority of surgical repair versus functional rehabilitation for severe lateral ligament rupture is controversial. Treatment using semirigid supports is superior to using elastic bandages. Support devices provide some protection against future ankle sprains, particularly in persons with a history of recurrent sprains. Ankle disk or proprioceptive neuromuscular facilitation exercise regimens also may be helpful, although the literature supporting this is limited. PMID:17137000

  7. Hip Arthroscopy in the Presence of Acetabular Dysplasia

    PubMed Central

    Jayasekera, Narlaka; Aprato, Alessandro; Villar, Richard N

    2015-01-01

    Purpose : Hip arthroscopy is a well established therapeutic intervention for an increasing number of painful hip conditions. Developmental dysplasia of the hip (DDH) is commonly associated with intra-articular hip pathology. However, some surgeons perceive patients with hip dysplasia as poor candidates for hip arthroscopy. Our aim was to describe early outcomes of arthroscopic treatment for patients with DDH, who also had femoroacetabular impingement (FAI) treated when necessary, and to compare these outcomes against a control group of patients without DDH. Methods : Prospective case-control study of 68 consecutive hip arthroscopy patients assessed with a modified Harris Hip Score (mHHS) preoperatively and at six weeks, six months, and one year after surgery. Presence of DDH was determined using a standard anteroposterior (AP) pelvic radiograph to measure the centre-edge angle (CEA) of Wiberg, with a CEA < 20º used as threshold for diagnosis of DDH. Results : 12 patients (eight female and four male) with acetabular dysplasia and mean CEA of 15.4º (9º to 19º). The control, nondysplastic group comprised 54 patients (23 females and 31 males) with a mean CEA of 33.1º (22º to 45º). All patients in the dysplastic group had a labral tear and 11 (91.7%) had associated femoral cam impingement lesion addressed at arthroscopy. Our study demonstrates a significant (p=0.02) improvement in outcome in the dysplastic group at one year using the mHHS. Conclusion : Hip arthroscopy in the presence of DDH is effective in relieving pain for at least one year after surgery although does not address underlying acetabular abnormality. PMID:26069512

  8. 77 FR 61048 - Distracted Driving Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... grant program, 77 FR 51610 (Aug. 24, 2012), which established an application deadline of October 9, 2012... National Highway Traffic Safety Administration Distracted Driving Grant Program AGENCY: National Highway... Transportation (DOT) announced the availability of funding authorized for distracted driving grants on August...

  9. Distractions in the School Science Laboratory

    ERIC Educational Resources Information Center

    Hamza, Karim M.

    2013-01-01

    In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, I…

  10. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    ERIC Educational Resources Information Center

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  11. Editorial Commentary: Love My Surgeon, Love My Surgery: Patient Satisfaction Matters After Hip Arthroscopy.

    PubMed

    Krych, Aaron J

    2016-08-01

    Patient satisfaction following hip arthroscopy is currently underreported and lacks uniformity when published. While current patient reported outcomes are important, they may not reflect overall patient satisfaction because it is complex and multifactorial. However, assessment and documentation of patient satisfaction following hip arthroscopy is critical to demonstrating value and quality. Therefore, it is of pressing importance that the hip arthroscopy community develops an accurate score that is consistent, valid, and reliable. PMID:27495866

  12. Psoas tunnel perforation-an unreported complication of hip arthroscopy.

    PubMed

    Degen, Ryan M; O'Sullivan, Eilish; Sink, Ernest L; Kelly, Bryan T

    2015-10-01

    The utilization of hip arthroscopy is rapidly increasing due to improved arthroscopic techniques and training, better recognition of pathology responsible for non-arthritic hip pain and an increasing desire for minimally invasive procedures. With increasing rates of arthroscopy, associated complications are also being recognized. We present a series of six patients who experienced psoas tunnel perforation during anchor insertion from the distal anterolateral portal during labral repair. All patients underwent prior hip arthroscopy and labral repair and presented with persistent symptoms at least partly attributable to magnetic resonance imaging (MRI)-documented psoas tunnel perforation. Their clinical records, operative notes and intra-operative photographs were reviewed. All patients presented with persistent pain, both with an anterior impingement test and resisted hip flexion. MRI imaging demonstrated medial cortical perforation with anchors visualized in the psoas tunnel, adjacent to the iliopsoas muscle. Four patients have undergone revision hip arthroscopy, whereas two have undergone periacetabular osteotomies. All patients had prominent anchors in the psoas tunnel removed at the time of surgery, with varying degrees of concomitant pathology appropriately treated during the revision procedure. Care must be utilized during medial anchor placement to avoid psoas tunnel perforation. Although this complication alone was not the sole cause for revision in each case, it may have contributed to their poor outcome and should be avoided in future cases. This can be accomplished by using a smaller anchor, inserting the anchor from the mid-anterior portal and checking the drill hole with a nitinol wire prior to anchor insertion. PMID:27011849

  13. What Factors Influence Long-term Survivorship After Hip Arthroscopy?

    PubMed Central

    Jarrett, Bryan T.; Ojeifo, Olumide; Lee, Jo Ann; Bragdon, Charles R.

    2010-01-01

    Background Hip arthroscopy is an evolving procedure. One small study suggested that a low modified Harris hip score and arthritis at the time of surgery were predictors of poor prognosis. Questions/purposes We therefore intended to confirm those findings with a large patient cohort to (1) determine the long-term nonarthritic hip score; (2) determine survivorship; (3) identify risk factors that increase the likelihood of THA; and (4) use those factors to create a usable risk assessment algorithm. Patients and Methods We retrospectively reviewed 324 patients (340 hips) who underwent arthroscopy for pain and/or catching. Of these, 106 patients (111 hips or 33%) had a minimum followup of 10 years (mean, 13 years; range, 10–20 years). The average age was 39 years (± 13) with 47 men and 59 women. We recorded patient age, gender, acetabular and femoral Outerbridge grade at surgery, and the presence of a labral tear. Followup consisted of a nonarthritic hip score or the date of a subsequent THA. We determined survivorship with the end point of THA for the acetabular and femoral Outerbridge grades. Results Overall survivorship among the 111 hips was 63% at 10 years. The average nonarthritic hip score for non-THA patients was 87.3 (± 12.1). Survivorship was greater for acetabular and femoral Outerbridge grades normal through II. Age at arthroscopy and Outerbridge grades independently predicted eventual THA. Gender and the presence of a labral tear did not influence long-term survivorship. Conclusions The long-term survivorship of labral tears with low-grade cartilage damage indicates hip arthroscopy is reasonable for treating labral tears. Level of Evidence Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:20872105

  14. The role of arthroscopy for treatment of perilunate injuries.

    PubMed

    Herzberg, Guillaume; Burnier, Marion; Marc, Antoine; Merlini, Lorenzo; Izem, Yadar

    2015-05-01

    Background Open reduction with internal fixation (ORIF) is currently the gold standard treatment of acute perilunate injuries (PLIs). Less invasive surgery, including arthroscopic techniques, has recently emerged in the hope that results similar to those of ORIF could be obtained with less tissue disturbance. Our purpose was to review retrospectively a series of selected PLIs treated with arthroscopic assistance over the past 10 years. Materials and Methods Between 2004 and 2014, a total of 135 acute PLIs were surgically treated in our unit. A total of 27 patients were treated with arthroscopic assistance, among whom 18 were reviewed clinically and radiologically. Description of Technique After an initial closed gross reduction, radio- and midcarpal arthroscopy were performed to clean up the debris and assess the cartilaginous, bony, and ligamentous damage. In 22 cases arthroscopy was followed by either radiolunate and lunotriquetral pinning, scapholunate ligament repair, and SL joint pinning or ORIF of a scaphoid fracture through a mini-invasive dorsal approach. In the remaining six cases, fixation of the ligamentous and/or bony injuries was done using arthroscopy alone. Results Arthroscopic findings are presented as well as the clinical results in a subgroup of patients. At final follow-up, visual analog scale (VAS) pain was rated 18/100 on average (minimum 0, maximum 50). If we consider only the patients without reflex sympathetic dystrophy (RSD; n = 14), the average active wrist flexion-extension was 87° (58% of the normal contralateral side) and the average grip strength was 30 kg (71% of the normal contralateral side). Conclusions Although no statistical comparisons were made, we found that the results were similar to those of ORIF. The results of our study suggest that the use of arthroscopy to treat selected PLIs may be a reliable adjunct either alone or in combination with a dorsal mini-open approach. PMID:25945294

  15. Psoas tunnel perforation—an unreported complication of hip arthroscopy

    PubMed Central

    Degen, Ryan M.; O’Sullivan, Eilish; Sink, Ernest L.; Kelly, Bryan T.

    2015-01-01

    The utilization of hip arthroscopy is rapidly increasing due to improved arthroscopic techniques and training, better recognition of pathology responsible for non-arthritic hip pain and an increasing desire for minimally invasive procedures. With increasing rates of arthroscopy, associated complications are also being recognized. We present a series of six patients who experienced psoas tunnel perforation during anchor insertion from the distal anterolateral portal during labral repair. All patients underwent prior hip arthroscopy and labral repair and presented with persistent symptoms at least partly attributable to magnetic resonance imaging (MRI)-documented psoas tunnel perforation. Their clinical records, operative notes and intra-operative photographs were reviewed. All patients presented with persistent pain, both with an anterior impingement test and resisted hip flexion. MRI imaging demonstrated medial cortical perforation with anchors visualized in the psoas tunnel, adjacent to the iliopsoas muscle. Four patients have undergone revision hip arthroscopy, whereas two have undergone periacetabular osteotomies. All patients had prominent anchors in the psoas tunnel removed at the time of surgery, with varying degrees of concomitant pathology appropriately treated during the revision procedure. Care must be utilized during medial anchor placement to avoid psoas tunnel perforation. Although this complication alone was not the sole cause for revision in each case, it may have contributed to their poor outcome and should be avoided in future cases. This can be accomplished by using a smaller anchor, inserting the anchor from the mid-anterior portal and checking the drill hole with a nitinol wire prior to anchor insertion. PMID:27011849

  16. Augmented Reality-Based Navigation System for Wrist Arthroscopy: Feasibility

    PubMed Central

    Zemirline, Ahmed; Agnus, Vincent; Soler, Luc; Mathoulin, Christophe L.; Liverneaux, Philippe A.; Obdeijn, Miryam

    2013-01-01

    Purpose In video surgery, and more specifically in arthroscopy, one of the major problems is positioning the camera and instruments within the anatomic environment. The concept of computer-guided video surgery has already been used in ear, nose, and throat (ENT), gynecology, and even in hip arthroscopy. These systems, however, rely on optical or mechanical sensors, which turn out to be restricting and cumbersome. The aim of our study was to develop and evaluate the accuracy of a navigation system based on electromagnetic sensors in video surgery. Methods We used an electromagnetic localization device (Aurora, Northern Digital Inc., Ontario, Canada) to track the movements in space of both the camera and the instruments. We have developed a dedicated application in the Python language, using the VTK library for the graphic display and the OpenCV library for camera calibration. Results A prototype has been designed and evaluated for wrist arthroscopy. It allows display of the theoretical position of instruments onto the arthroscopic view with useful accuracy. Discussion The augmented reality view represents valuable assistance when surgeons want to position the arthroscope or locate their instruments. It makes the maneuver more intuitive, increases comfort, saves time, and enhances concentration. PMID:24436832

  17. Single-Portal Arthroscopy: Report of a New Technique

    PubMed Central

    Cooper, Daniel E.; Fouts, Brian

    2013-01-01

    A new technique of single-portal arthroscopy using new instrumentation for arthroscopic knee surgery is reported. The procedure is intended for “targeted” surgery to address limited pathology. The arthroscope, cutters, and biters are all introduced into the joint through 1 portal. The technique is generally applicable to knee arthroscopy for isolated conditions and potentially useful in treating other joints. A 2.9-mm-diameter, light-sensitive, high-definition, 20-cm-long arthroscope is inserted through a 4.6-mm cannula. This arthroscope-cannula combination yields fluid flow mechanics similar to a standard 4-mm arthroscope in a 5.8-mm cannula. A Parallel Portal Cannula (PPC) (Stryker Endoscopy) is applied to the arthroscope cannula, producing a “double-barrel” system for entry into the joint. The PPC allows for sliding and rotational freedom along the axis of the arthroscope cannula but also locks in place once a desired position is achieved. PPC devices are available in zero-length, short (25-mm), and long (55-mm) sizes. Cutters that are bent in the mid shaft are available in 3.5- and 4-mm diameters. The instrumentation system allows both viewing with the arthroscope and passage of working cutters and biters through a single 9- to 10-mm portal. Potential advantages of single-portal arthroscopy include decreased patient morbidity and recovery time while still allowing for adequate treatment of limited knee pathology. PMID:24265996

  18. Perioperative pain management in hip arthroscopy; what options are there?

    PubMed

    Bech, N H; Hulst, A H; Spuijbroek, J A; van Leuken, L L A; Haverkamp, D

    2016-08-01

    Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed. There are several types of pain regimens that can mostly be divided in two groups: local anesthetics and nerve blocks. Included studies show a rather large variation in reported visual analogue scale scores, post anesthesia care unit admission time and opioid usage. There are several anesthetic options available for hip arthroscopy. Different studies use different dosages, anesthetic regimens and different protocols; this partly explains the differences between studies with similar techniques. Peripheral nerve blocks seems promising but regarding current literature no clear recommendation can be made about what the best perioperative pain management option is, an overview of all reported techniques is given. PMID:27583156

  19. Perioperative pain management in hip arthroscopy; what options are there?

    PubMed Central

    Bech, N. H.; Hulst, A. H.; Spuijbroek, J. A.; van Leuken, L. L. A.; Haverkamp, D.

    2016-01-01

    Hip arthroscopy is a fast growing orthopedic field of expertise. As in any field of surgery adequate postoperative pain management regimes are of utmost importance. The purpose of this review is to provide an overview of current knowledge on anesthetic options for perioperative pain management for hip arthroscopy. We searched the Pubmed/Medline and Embase database for literature and included 10 studies for our analysis. Because of the variety of pain scales and different ways of measured pain no meta-analysis could be performed and a descriptive review is performed. There are several types of pain regimens that can mostly be divided in two groups: local anesthetics and nerve blocks. Included studies show a rather large variation in reported visual analogue scale scores, post anesthesia care unit admission time and opioid usage. There are several anesthetic options available for hip arthroscopy. Different studies use different dosages, anesthetic regimens and different protocols; this partly explains the differences between studies with similar techniques. Peripheral nerve blocks seems promising but regarding current literature no clear recommendation can be made about what the best perioperative pain management option is, an overview of all reported techniques is given. PMID:27583156

  20. Capsular Management in Hip Arthroscopy: An Anatomic, Biomechanical, and Technical Review

    PubMed Central

    Kuhns, Benjamin D.; Weber, Alexander E.; Levy, David M.; Bedi, Asheesh; Mather, Richard C.; Salata, Michael J.; Nho, Shane J.

    2016-01-01

    Hip arthroscopy has become an increasingly utilized surgical technique for the treatment of the young, active patients with hip pain. The clinical outcomes of hip arthroscopy in this patient population have been largely successful; however, there is increasing interest in the contribution of hip capsule in postoperative clinical and functional outcomes. The structure and function of the normal hip capsule will be reviewed. Capsular contributions to hip stability will be discussed in the setting of hip arthroscopy with an emphasis on diagnosis-based considerations. Lastly, clinical outcomes following hip arthroscopy will be discussed as they relate to capsular management. PMID:26973840

  1. Vertical Alveolar Ridge Augmentation by Distraction Osteogenesis

    PubMed Central

    Kumar, N. Nanda; Ravindran, C.

    2015-01-01

    Introduction Compromised alveolar ridge in vertical and horizontal dimension is a common finding in patients visiting practitioners for dental prosthesis. Various treatment modalities are available for correction of deficient ridges among which alveolar distraction osteogenesis is one. Aim To study the efficacy of alveolar distraction osteogenesis in augmentation of alveolar ridges deficient in vertical dimension. Materials and Methods Ten patients aged 16 to 46 years with deficient alveolar ridge underwent ridge augmentation in 11 alveolar segments using the distraction osteogenesis method. For each patient a custom made distraction device was fabricated. The device was indigenously manufactured with SS-316 (ISO 3506). Results The vertical bone gain reached more than 10mm without the use of bone transplantation. Certain complications like incorrect vector of distraction, paresthesia, pain and loss of transport segment were encountered during the course of the study. Conclusion Alveolar vertical distraction osteogenesis is a reliable and predictable technique for both hard and soft tissue genesis. Implant placement is feasible with primary stability in neogenerated bone at the level of the distracted areas. PMID:26816991

  2. Distractions in the School Science Laboratory

    NASA Astrophysics Data System (ADS)

    Hamza, Karim M.

    2013-08-01

    In this article, I make a case for the potential educative worth of distractions for learning science in the school laboratory. Distractions are operationalized as experiences lying outside the main purpose of the laboratory activity, thereby diverting students' attention from that purpose. Through a practical epistemology analysis, I examined in close detail the conversations of three groups of high school students trying to explain how a real galvanic cell works. The three groups experienced the same two distractions, (1) a nonworking light-emitting diode and (2) negative readings on a voltmeter. The analysis reveals how one of the groups, through a series of contingencies, successively made the two distractions continuous with the main purpose of the activity. In the remaining two groups, no such continuity was established. The results show that (a) experiences initially being distracting, perplexing, and confusing may indeed acquire significance for the students' possibilities of coping with the main purpose of the activity but that (b) the outcome is highly contingent on the particular experiences drawn upon by the students to cope with the distractions. Consequently, I discuss ways in which teachers may turn distractions encountered in laboratory activities into educative experiences for more than a few lucky students.

  3. Arthroscopic Repair of Ankle Instability.

    PubMed

    Sorensen, Matthew D; Baca, John; Arbuckle, Keith

    2016-10-01

    Arthroscopic lateral ankle stabilization procedures have been described for many years. New technological advances and a deeper understanding of the pathobiomechanics involved in chronic lateral ankle instability have allowed an expansion of arthroscopic approaches to this common pathology. As experience is gained and outcomes within the patient profile are understood, the authors feel that the arthroscopic approach to lateral ankle stabilization may prove superior to traditional methods secondary to the risk and traditional complications that are mitigated within minimally invasive arthroscopic approaches. Additionally, the arthroscopic approach may allow a quicker return to ballistic sport and decrease time for rehabilitation. PMID:27599440

  4. The effects of distraction on metacognition and metacognition on distraction: evidence from recognition memory

    PubMed Central

    Beaman, C. Philip; Hanczakowski, Maciej; Jones, Dylan M.

    2014-01-01

    The effects of auditory distraction in memory tasks have, to date, been examined with procedures that minimize participants’ control over their own memory processes. Surprisingly little attention has been paid to metacognitive control factors which might affect memory performance. In this study, we investigate the effects of auditory distraction on metacognitive control of memory, examining the effects of auditory distraction in recognition tasks utilizing the metacognitive framework of Koriat and Goldsmith (1996), to determine whether strategic regulation of memory accuracy is impacted by auditory distraction. Results replicated previous findings in showing that auditory distraction impairs memory performance in tasks minimizing participants’ metacognitive control (forced-report test). However, the results revealed also that when metacognitive control is allowed (free-report tests), auditory distraction impacts upon a range of metacognitive indices. In the present study, auditory distraction undermined accuracy of metacognitive monitoring (resolution), reduced confidence in responses provided and, correspondingly, increased participants’ propensity to withhold responses in free-report recognition. Crucially, changes in metacognitive processes were related to impairment in free-report recognition performance, as the use of the “don’t know” option under distraction led to a reduction in the number of correct responses volunteered in free-report tests. Overall, the present results show how auditory distraction exerts its influence on memory performance via both memory and metamemory processes. PMID:24860543

  5. Reflections of distraction in memory: transfer of previous distraction improves recall in younger and older adults.

    PubMed

    Thomas, Ruthann C; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval. PMID:21843024

  6. Assessment of distraction from erotic stimuli by nonerotic interference.

    PubMed

    Anderson, Alex B; Hamilton, Lisa Dawn

    2015-01-01

    Distraction from erotic cues during sexual encounters is a major contributor to sexual difficulties in men and women. Being able to assess distraction in studies of sexual arousal will help clarify underlying contributions to sexual problems. The current study aimed to identify the most accurate assessment of distraction from erotic cues in healthy men (n = 29) and women (n = 38). Participants were assigned to a no distraction, low distraction, or high distraction condition. Distraction was induced using an auditory distraction task presented during the viewing of an erotic video. Attention to erotic cues was assessed using three methods: a written quiz, a visual quiz, and a self-reported distraction measure. Genital and psychological sexual responses were also measured. Self-reported distraction and written quiz scores most accurately represented the level of distraction present, while self-reported distraction also corresponded with a decrease in genital arousal. Findings support the usefulness of self-report measures in conjunction with a brief quiz on the erotic material as the most accurate and sensitive ways to simply measure experimentally-induced distraction. Insight into distraction assessment techniques will enable evaluation of naturally occurring distraction in patients suffering from sexual problems. PMID:24611908

  7. Foot, leg, and ankle swelling

    MedlinePlus

    ... feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... 51. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Phys . 2013;88( ...

  8. Ankle Fractures Often Not Diagnosed

    MedlinePlus

    ... side of the ankle. This condition often... Barefoot Running Barefoot running is running while barefoot, without wearing any shoes on the feet. Running in thin-soled, flexible shoes is related but ...

  9. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability.

    PubMed

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-07-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  10. Effects of ankle balance taping with kinesiology tape for a patient with chronic ankle instability

    PubMed Central

    Kim, Byeong-Jo; Lee, Jung-Hoon; Kim, Chang-Tae; Lee, Sun-Min

    2015-01-01

    [Purpose] To report the effects of ankle balance taping for a patient with chronic ankle instability (CAI). [Subject] A 33-year-old man with a 10 year history of chronic ankle stability. [Methods] ABT with kinesiology tape was performed for 2 months (average, 16 h/day) around the right ankle. [Results] At the end of two months, no ankle instability was noted when ascending and descending the stairs, jumping, turning, operating the pedals while driving, and lifting heavy objects. [Conclusion] The repeated use of kinesiology tape in ankle balance taping may be an effective treatment for recovering the ankle stability of patients with chronic ankle instability. PMID:26311206

  11. Special considerations in distracted driving with teens.

    PubMed

    Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne

    2014-01-01

    Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens' attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228

  12. Special Considerations in Distracted Driving with Teens

    PubMed Central

    Durbin, Dennis R; McGehee, Daniel V; Fisher, Donald; McCartt, Anne

    2014-01-01

    Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens’ attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction. PMID:24776228

  13. Distraction from emotional information reduces biased judgements.

    PubMed

    Lench, Heather C; Bench, Shane W; Davis, Elizabeth L

    2016-06-01

    Biases arising from emotional processes are some of the most robust behavioural effects in the social sciences. The goal of this investigation was to examine the extent to which the emotion regulation strategy of distraction could reduce biases in judgement known to result from emotional information. Study 1 explored lay views regarding whether distraction is an effective strategy to improve decision-making and revealed that participants did not endorse this strategy. Studies 2-5 focused on several established, robust biases that result from emotional information: loss aversion, desirability bias, risk aversion and optimistic bias. Participants were prompted to divert attention away from their feelings while making judgements, and in each study this distraction strategy resulted in reduced bias in judgement relative to control conditions. The findings provide evidence that distraction can improve choice across several situations that typically elicit robustly biased responses, even though participants are not aware of the effectiveness of this strategy. PMID:25787937

  14. Temperament, Distraction, and Learning in Toddlerhood

    PubMed Central

    Dixon, Wallace E.; Salley, Brenda J.; Clements, Andrea D.

    2006-01-01

    The word and non-word learning abilities of toddlers were tested under various conditions of environmental distraction, and evaluated with respect to children’s temperamental attentional focus. Thirty-nine children and their mothers visited the lab at child age 21-months, where children were exposed to fast-mapping word learning trials and nonlinguistic sequential learning trials. It was found that both word and nonword-learning was adversely affected by the presentation of environmental distractions. But it was also found that the effect of the distractions sometimes depended on children’s level of attentional focus. Specifically, children high in attentional focus were less affected by environmental distractions than children low in attentional focus when attempting to learn from a model, whereas children low in attentional focus demonstrated little learning from the model. Translationally, these results may be of use to child health-care providers investigating possible sources of cognitive and language delay. PMID:17138290

  15. The Biobasis for Distraction and Dyslexia.

    ERIC Educational Resources Information Center

    Buckley, Robert E.

    1981-01-01

    The article examines the neurological basis for hyperactivity/distraction and dyslexia. Overlapping symptoms are listed, nutritional and organic basis for hyperkinesis considered, and visual and motoric factors in dyslexia discussed. (CL)

  16. Sustained Efficacy of Virtual Reality Distraction

    PubMed Central

    Rutter, Charles E.; Dahlquist, Lynnda M.; Weiss, Karen E.

    2011-01-01

    The current study tested whether the effectiveness of distraction using virtual reality (VR) technology in reducing cold pressor pain would maintain over the course of eight weekly exposures. Twenty-eight adults, 18 to 23 years of age, underwent one baseline cold pressor trial and one VR distraction trial in randomized order each week. VR distraction led to significant increases in pain threshold and pain tolerance, and significant decreases in pain intensity, time spent thinking about pain, and self-reported anxiety, relative to baseline. Repeated exposure did not appear to affect the benefits of VR. Implications for the long-term use of VR distraction as a non-pharmacological analgesic are discussed. PMID:19231295

  17. Establishing the Attention-Distractibility Trait.

    PubMed

    Forster, Sophie; Lavie, Nilli

    2016-02-01

    Failures to focus attention will affect any task engagement (e.g., at work, in the classroom, when driving). At the clinical end, distractibility is a diagnostic criterion of attention-deficit/hyperactivity disorder (ADHD). In this study, we examined whether the inability to maintain attentional focus varies in the overall population in the form of an attention-distractibility trait. To test this idea, we administered an ADHD diagnostic tool to a sample of healthy participants and assessed the relationship between ADHD symptoms and task distraction. ADHD symptom summary scores were significantly positively associated with distractor interference in letter-search and name-classification tasks (as measured by reaction time), as long as the distractors were irrelevant (cartoon images) rather than relevant (i.e., compatible or incompatible with target names). Higher perceptual load during a task eliminated distraction irrespective of ADHD score. These findings suggest the existence of an attention-distractibility trait that confers vulnerability to irrelevant distraction, which can be remedied by increasing the level of perceptual load during the task. PMID:26667659

  18. Accuracy of double-contrast arthrography and arthroscopy of the knee joint

    SciTech Connect

    Thijn, C.J.P.

    1982-06-01

    Only in the diagnosis of medial meniscal lesions is double contrast arthrography superior to arthroscopy, provided that arthroscopy is carried out only from the anterolateral side (94% against 81% positive correlations). The rates in diagnosing lateral meniscal lesions are respectively 90% and 94.5%, in patellar chondropathy 55% and 99.5% respectively, and in diagnosting cruciate ligament lesions 69% and 97% respectively.

  19. Single-Portal Arthroscopy of the Central Compartment of the Hip

    PubMed Central

    Mannava, Sandeep; Howse, Elizabeth A.; Kelsey, Thomas J.; Barnes, Ryan H.; Antunes, Andre; Stubbs, Allston J.

    2015-01-01

    Since hip arthroscopy has become a standard of orthopaedic practice, the indications have continued to expand as it has proved to be a helpful diagnostic, as well as therapeutic, tool. Access to the hip joint, however, remains challenging for the orthopaedic surgeon who does not routinely perform hip arthroscopy. We present a single-portal arthroscopic technique, showing the feasibility of single-portal arthroscopic access to the hip joint, as well as describing basic indications and instrumentation for single-portal hip arthroscopy. Single-portal hip arthroscopy is ideal for the patient who needs to undergo diagnostic hip arthroscopy or for treatment in patients with simple hip pathology (e.g., removal of loose bodies or debridement). PMID:26258043

  20. Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults

    ERIC Educational Resources Information Center

    Thomas, Ruthann C.; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting…

  1. Day case arthroscopy and arthroscopic surgery of the knee.

    PubMed Central

    Allum, R. L.; Ribbans, W. J.

    1987-01-01

    A Day Case Unit was opened at Wexham Park Hospital in October 1985 and this paper describes the first year's experience in arthroscopy and arthroscopic surgery. Ninety nine knees in 96 patients were examined. The predominant diagnoses were lesions of the medial meniscus (33%), ruptures of the anterior cruciate ligament (30%) and lesions of the lateral meniscus (20%). Fourteen knees (14%) were normal. There was one postoperative infection, 3 patients had troublesome effusions and one patient developed a synovial fistula. Two patients required overnight admission. The waiting list was reduced from 14.7 weeks to 3.0 weeks. The advantages and limitations of this technique is discussed. PMID:3674684

  2. The Modified Mid-Anterior Portal for Hip Arthroscopy

    PubMed Central

    Matsuda, Dean K.; Villamor, Angel

    2014-01-01

    The modified mid-anterior portal is a utilitarian hip arthroscopy working portal that permits dual-portal comprehensive surgery for femoroacetabular impingement and related chondrolabral procedures without the need for interportal exchange. Its distal location facilitates labral reparative and reconstructive procedures while minimizing iatrogenic acetabular chondral damage. The relatively lateral location permits instrument navigation not only along the anterosuperior acetabular rim and anterolateral proximal femur typically required for acetabuloplasty and femoroplasty but even to the posterior regions of the hip in cases of global pincer femoroacetabular impingement and posterior extensions of cam morphology and the anteromedial proximal femur while avoiding direct injury to the lateral femoral cutaneous nerve. PMID:25276606

  3. CO2 laser arthroscopy-through the arthroscope

    NASA Astrophysics Data System (ADS)

    Garrick, James G.

    1990-06-01

    Orthopedists have been among the last of the specialists to utilize lasers in surgery. Even today, laser usage in orthopedics is almost exclusively limited to arthroscopy procedures. Although other types of lasers have been approved for use in orthopedics, nearly all laser-assisted arthroscopic procedures have involved the carbon dioxide laser in the knee. These techniques involve skills and problems not previously encountered. In an attempt to simplify the usage and circumvent some of the problems, we describe a means of laser energy delivery through the arthroscope.

  4. Hip arthroscopy and osteoarthritis: Where are the limits and indications?

    PubMed Central

    Mella, Claudio; Villalón, Ignacio E.; Núñez, Álvaro; Paccot, Daniel; Díaz-Ledezma, Claudio

    2015-01-01

    The use of hip arthroscopy, as a surgical technique, has increased significantly over the past ten years. The procedure has shown good and excellent results in symptom relief and function improvement for patients with femoro-acetabular impingement (FAI) and concurrent chondro-labral lesions. It is also a reliable method to correct the characteristic pathomorphologic alteration of FAI. However, surgical results are less successful among patients with advanced articular damage and secondary hip osteoarthritis. The aim of this article is to present some clinical and imagenological tools to discriminate the good candidates for arthroscopic FAI treatment from those who are not, due to extensive articular damage. PMID:27163082

  5. Arthroscopic-assisted fibular synthesis and syndesmotic stabilization of a complex unstable ankle injury.

    PubMed

    Salvi, Andrea Emilio; Metelli, Giovanni Pietro; Bettinsoli, Rosita; Hacking, Steven Adam

    2009-03-01

    Traditional treatment of complex ankle fracture consists of open reduction and internal fixation. Nevertheless, this treatment can delay fracture healing and cause prolonged oedema. The surgeon should consider necessity of early recovery when treating athletes, especially football players. In this light, it was decided to perform an arthroscopy-assisted percutaneous minimal osteosynthesis of a fibular fracture together with a syndesmotic disruption in order to permit the patient, a 24-year-old male, to resume quicker and easier full sport activities. The outcome was good and allowed patient to play soccer since 6 months following surgery. The complete and detailed articular evaluation provided by the arthroscope permitted to manage carefully a complex articular traumatism, avoiding the necessity of plating the fracture and improving a rapid full recovery of the joint function. PMID:18368413

  6. The origin of the ankle

    NASA Astrophysics Data System (ADS)

    Codino, Antonio; Plouin, Francois

    2007-03-01

    The differential intensity of cosmic radiation shows a sequence of depressions referred to as knees in a large energy band above 1015eV. The global depression entailed in the complete spectrum with respect to the extrapolated intensity based on low energy data, amounts to a maximum factor of 8, occurring at 5×10eV, where flux measurements exhibit a relative minimum, referred to as the ankle. It is demonstrated by a full simulation of cosmic ray trajectories in the Galaxy that the intensity minimum around the ankle energy is primarily due to the nuclear interactions of the cosmic ions with the interstellar matter and to the galactic magnetic field. Ankles signal the onset energies of the rectilinear propagation in the Milky Way at Earth, being for example, 4×10eV for helium and 6×10eV for iron. The ankle, in spite of its notable importance at Earth, is a local perturbation of the universal spectrum which, between the knee and the ankle, decreases by a round factor 109 regaining its unperturbed status above 1019eV.

  7. Posterior Ankle Structure Injury During Total Ankle Replacement.

    PubMed

    Reb, Christopher W; McAlister, Jeffrey E; Hyer, Christopher F; Berlet, Gregory C

    2016-01-01

    Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system. Ten fresh-frozen adult cadaveric below-the-knee specimens were positioned in the intraoperative positioning frame of an approved total ankle replacement system and adjusted to achieve proper foot alignment using fluoroscopic imaging. The relationship between the tibial cutting guide pins and the posterior neurovascular and tendon structures was measured using digital calipers. High rates of posterior structural injury were found. Nearly all proximal-medial pins encountered a posteromedial neurovascular structure, most commonly the tibial nerve. The distal-medial pins mainly encountered posteromedial tendinous structures, in particular, the flexor digitorum longus tendon. The proximal lateral pins were highly likely to encounter the Achilles tendon and the sural nerve. Our results support our hypothesis that the tibial neurovascular structures are at the greatest risk when preparing for and completing the bony resection, particularly with the medial and proximal cuts. Posterior ankle soft tissue structure injuries can occur during implantation but currently with unknown frequency and undetermined significance. Further study of posterior structural injuries could result in a more informed approach to post-total ankle replacement complications and management. PMID:27291681

  8. American Orthopaedic Foot and Ankle Society

    MedlinePlus

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  9. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... Size Print Bookmark Osteoarthritis of the Foot and Ankle What Is Osteoarthritis? Osteoarthritis is a condition characterized ... is also often found in the midfoot and ankle. Causes Osteoarthritis is considered a “wear and tear” ...

  10. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain

    PubMed Central

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  11. Effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.

    PubMed

    Lee, Sun-Min; Lee, Jung-Hoon

    2016-01-01

    [Purpose] The aim of this study was to report the effects of ankle eversion taping using kinesiology tape on ankle inversion sprain. [Subject] The subject was a 21-year-old woman with Grade 2 ankle inversion sprain. [Methods] Ankle eversion taping was applied to the sprained left ankle using kinesiology tape for 4 weeks (average, 15 h/day). [Results] Ankle instability and pain were reduced, and functional dynamic balance was improved after ankle eversion taping for 4 weeks. The Cumberland Ankle Instability Tool score and reach distances in the Y-Balance and lunge tests were increased. [Conclusion] Repeated ankle eversion taping may be an effective treatment intervention for ankle inversion sprain. PMID:27064668

  12. Happiness increases distraction by auditory deviant stimuli.

    PubMed

    Pacheco-Unguetti, Antonia Pilar; Parmentier, Fabrice B R

    2016-08-01

    Rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards) capture attention and impair behavioural performance in an ongoing visual task. Recent evidence indicates that this effect is increased by sadness in a task involving neutral stimuli. We tested the hypothesis that such effect may not be limited to negative emotions but reflect a general depletion of attentional resources by examining whether a positive emotion (happiness) would increase deviance distraction too. Prior to performing an auditory-visual oddball task, happiness or a neutral mood was induced in participants by means of the exposure to music and the recollection of an autobiographical event. Results from the oddball task showed significantly larger deviance distraction following the induction of happiness. Interestingly, the small amount of distraction typically observed on the standard trial following a deviant trial (post-deviance distraction) was not increased by happiness. We speculate that happiness might interfere with the disengagement of attention from the deviant sound back towards the target stimulus (through the depletion of cognitive resources and/or mind wandering) but help subsequent cognitive control to recover from distraction. PMID:26302716

  13. Subperiosteal Hematoma of the Ankle

    PubMed Central

    Hui, S H; Lui, T H

    2016-01-01

    Introduction: Periosteal reaction has a long list of differential diagnoses ranging from trauma, infection, metabolic disease to malignancy. The morphology of periosteal reaction shown in imaging studies helps to narrow down the list of differential diagnoses. Case report: A 25 year old gentleman had an inversion injury to his left ankle. He complained of lateral ankle and posterior heel pain and swelling after the injury. Radiograph of his left ankle revealed solid, smooth periosteal reaction at posterior aspect of left distal tibia. MRI showed periosteal reaction at the corresponding site, which was better demonstrated in CT scan. Follow up MRI and CT showed maturation of the new bone formation at the site of periosteal reaction. Findings were compatible with subperiosteal hematoma formation from injury, which ossified with time. Conclusion: Smooth, thick periosteal reaction favours benign process, while interrupted pattern is an alarming feature for more aggressive causes. PMID:27299131

  14. The Incidence of Ankle Sprains in Orienteering.

    ERIC Educational Resources Information Center

    Ekstrand, Jan; And Others

    1990-01-01

    Investigates relationship between ankle sprains and participation time in competitive orienteering. Examined 15,474 competitors in races in the Swedish O-ringen 5-day event in 1987. Injuries requiring medical attention were analyzed, showing 137 (23.9 percent) ankle sprains. Injury incidence was 8.4/10,000 hours. Incidence of ankle sprains was…

  15. Lateral ankle sprains and instability problems.

    PubMed

    Liu, S H; Jason, W J

    1994-10-01

    The lateral ankle complex is the most frequently injured single structure in athletes, consisting of 38% to 45% of all injuries. One-sixth of all sports injury loss time is from ankle sprains. In North America, ankle inversion sprains are considered "de rigeur" for basketball participation. PMID:7805107

  16. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... Print Bookmark Sports Injuries to the Foot and Ankle Depending on the sport, your feet and ankles can certainly take a beating from repetitive play. ... communities: Copyright © 2016 | American College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. | Privacy Statement | Disclaimer | ...

  17. The Interfering Effect of Distracting Stimuli on the Infant's Memory

    ERIC Educational Resources Information Center

    McCall, Robert B.; And Others

    1977-01-01

    Infants 3 1/2 months of age were assessed for the possible role of the dissimilarity of the distracting stimulus to the originally learned standard in a modified familiarization-distraction-test paradigm. (Author/JMB)

  18. Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find?

    PubMed Central

    Bergkvist, Dan; Dahlberg, Leif E; Neuman, Paul; Englund, Martin

    2016-01-01

    Background and purpose Several randomized controlled trials have not shown any added benefit of arthroscopy over placebo surgery or physiotherapy in middle-aged patients with knee symptoms without trauma. We studied the characteristics of the knee arthroscopies performed in southern Sweden. Patients and methods From the orthopedic surgical records from 2007–2009 in the Skåne region of Sweden (with a population of 1.2 million), we retrieved ICD-10 diagnostic codes and selected all 4,096 arthroscopies that were diagnosed peroperatively with code M23.2 (derangement of meniscus due to old tear or injury) or code M17 (knee osteoarthritis). We extracted information on cartilage and meniscus status at arthroscopy, and we also randomly sampled 502 of these patients from the regional archive of radiology and analyzed the preoperative prevalence of radiographic or magnetic resonance imaging (MRI)-defined osteoarthritis. Results 2,165 (53%) of the 4,096 arthroscopies had the diagnostic code M23.2 or M17. In this subgroup, 1,375 cases (64%) had typical findings consistent with degenerative meniscal tear (i.e. that correspond to a degenerative meniscal tear in at least a third of all arthroscopies). Of the randomly sampled patients, the preoperative prevalence of radiological knee osteoarthritis was 46%. Interpretation There is a discrepancy between evidence-based medicine treatment guidelines and clinical practice regarding the amount of knee arthroscopies performed in patients with symptoms of degenerative knee disease. PMID:26012547

  19. Distracted driving: prevalence, problems, and prevention.

    PubMed

    Overton, Tiffany L; Rives, Terry E; Hecht, Carrie; Shafi, Shahid; Gandhi, Rajesh R

    2015-01-01

    While the number of motor vehicle crashes has declined over the years, crashes resulting from distracted driving are increasing in the United States resulting in significant morbidity and mortality. The national public seems to be aware of the dangers associated with using technology while driving, but continues to engage in this dangerous behaviour, and may be unaware of or underestimate the impact of cell phone use on their own driving performance. Problems associated with distracted driving are not limited to novice or teenage drivers; multifaceted universal prevention efforts aimed at impacting large segments of the population may have the greatest impact. Legislation limiting drivers' cell phone use has had little impact, possibly due to low regulation and enforcement. Behaviour change programmes, improved vehicle safety, and public awareness campaigns have been developed as potential preventive efforts to reduce accidents caused by distracted drivers. PMID:24499372

  20. Distraction can reduce age-related forgetting.

    PubMed

    Biss, Renée K; Ngo, K W Joan; Hasher, Lynn; Campbell, Karen L; Rowe, Gillian

    2013-04-01

    In three experiments, we assessed whether older adults' generally greater tendency to process distracting information can be used to minimize widely reported age-related differences in forgetting. Younger and older adults studied and recalled a list of words on an initial test and again on a surprise test after a 15-min delay. In the middle (Experiments 1a and 2) or at the end (Experiment 3) of the delay, participants completed a 1-back task in which half of the studied words appeared as distractors. Across all experiments, older adults reliably forgot unrepeated words; however, older adults rarely or never forgot the words that had appeared as distractors, whereas younger adults forgot words in both categories. Exposure to distraction may serve as a rehearsal episode for older adults, and thus as a method by which general distractibility may be co-opted to boost memory. PMID:23426890

  1. Intervention randomized controlled trials involving wrist and shoulder arthroscopy: a systematic review

    PubMed Central

    2014-01-01

    Background Although arthroscopy of upper extremity joints was initially a diagnostic tool, it is increasingly used for therapeutic interventions. Randomized controlled trials (RCTs) are considered the gold standard for assessing treatment efficacy. We aimed to review the literature for intervention RCTs involving wrist and shoulder arthroscopy. Methods We performed a systematic review for RCTs in which at least one arm was an intervention performed through wrist arthroscopy or shoulder arthroscopy. PubMed and Cochrane Library databases were searched up to December 2012. Two researchers reviewed each article and recorded the condition treated, randomization method, number of randomized participants, time of randomization, outcomes measures, blinding, and description of dropouts and withdrawals. We used the modified Jadad scale that considers the randomization method, blinding, and dropouts/withdrawals; score 0 (lowest quality) to 5 (highest quality). The scores for the wrist and shoulder RCTs were compared with the Mann–Whitney test. Results The first references to both wrist and shoulder arthroscopy appeared in the late 1970s. The search found 4 wrist arthroscopy intervention RCTs (Kienböck’s disease, dorsal wrist ganglia, volar wrist ganglia, and distal radius fracture; first 3 compared arthroscopic with open surgery). The median number of participants was 45. The search found 50 shoulder arthroscopy intervention RCTs (rotator cuff tears 22, instability 14, impingement 9, and other conditions 5). Of these, 31 compared different arthroscopic treatments, 12 compared arthroscopic with open treatment, and 7 compared arthroscopic with nonoperative treatment. The median number of participants was 60. The median modified Jadad score for the wrist RCTs was 0.5 (range 0–1) and for the shoulder RCTs 3.0 (range 0–5) (p = 0.012). Conclusion Despite the increasing use of wrist arthroscopy in the treatment of various wrist disorders the efficacy of arthroscopically

  2. Sadness increases distraction by auditory deviant stimuli.

    PubMed

    Pacheco-Unguetti, Antonia P; Parmentier, Fabrice B R

    2014-02-01

    Research shows that attention is ineluctably captured away from a focal visual task by rare and unexpected changes (deviants) in an otherwise repeated stream of task-irrelevant auditory distractors (standards). The fundamental cognitive mechanisms underlying this effect have been the object of an increasing number of studies but their sensitivity to mood and emotions remains relatively unexplored despite suggestion of greater distractibility in negative emotional contexts. In this study, we examined the effect of sadness, a widespread form of emotional distress and a symptom of many disorders, on distraction by deviant sounds. Participants received either a sadness induction or a neutral mood induction by means of a mixed procedure based on music and autobiographical recall prior to taking part in an auditory-visual oddball task in which they categorized visual digits while ignoring task-irrelevant sounds. The results showed that although all participants exhibited significantly longer response times in the visual categorization task following the presentation of rare and unexpected deviant sounds relative to that of the standard sound, this distraction effect was significantly greater in participants who had received the sadness induction (a twofold increase). The residual distraction on the subsequent trial (postdeviance distraction) was equivalent in both groups, suggesting that sadness interfered with the disengagement of attention from the deviant sound and back toward the target stimulus. We propose that this disengagement impairment reflected the monopolization of cognitive resources by sadness and/or associated ruminations. Our findings suggest that sadness can increase distraction even when distractors are emotionally neutral. PMID:24098923

  3. The use of hip arthroscopy in the management of the pediatric hip

    PubMed Central

    Roy, Dennis R.

    2016-01-01

    Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist’s has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip. PMID:27583144

  4. The use of hip arthroscopy in the management of the pediatric hip.

    PubMed

    Roy, Dennis R

    2016-07-01

    Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist's has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip. PMID:27583144

  5. The Effects of Distraction on Cognitive Task Performance during Toddlerhood

    ERIC Educational Resources Information Center

    Wyss, Nancy M.; Kannass, Kathleen N.; Haden, Catherine A.

    2013-01-01

    We investigated the effects of distraction on attention and task performance during toddlerhood. Thirty toddlers (24- to 26-month-olds) completed different tasks (2 of each: categorization, problem solving, memory, free play) in one of two conditions: No Distraction or Distraction. The results revealed that the distractor had varying effects on…

  6. Distractibility in Learning Disabled Children: The Role of Measurement Artifact.

    ERIC Educational Resources Information Center

    Harvey, Philip D.; And Others

    Two digit span distraction tasks were used to compare performance of 32 learning disabled (LD) and 32 normal children (mean ages 16 and 15 years). On the first set of tasks, where the neutral and distraction conditions were matched for their ability to discriminate between groups, no differential distraction effect was found. The second task's…

  7. Expecting ankle tilts and wearing an ankle brace influence joint control in an imitated ankle sprain mechanism during walking.

    PubMed

    Gehring, Dominic; Wissler, Sabrina; Lohrer, Heinz; Nauck, Tanja; Gollhofer, Albert

    2014-03-01

    A thorough understanding of the functional aspects of ankle joint control is essential to developing effective injury prevention. It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24° inversion and 15° plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (-7%) and velocity (-4%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (-14%) and velocity (-11%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. PMID:24365326

  8. Foot and ankle problems in dancers.

    PubMed

    Kadel, Nancy

    2014-11-01

    The dancer's foot and ankle are subjected to high forces and unusual stresses in training and performance. Injuries are common in dancers, and the foot and ankle are particularly vulnerable. Ankle sprains, ankle impingement syndromes, flexor hallucis longus tendonitis, cuboid subluxation, stress fractures, midfoot injuries, heel pain, and first metatarsophalangeal joint problems including hallux valgus, hallux rigidus, and sesamoid injuries will be reviewed. This article will discuss these common foot and ankle problems in dancers and give typical clinical presentation and diagnostic and treatment recommendations. PMID:25442161

  9. Distinguishing ankle and knee articular cartilage.

    PubMed

    Cole, Ada A; Margulis, Arkady; Kuettner, Klaus E

    2003-06-01

    Degenerative changes in the tall and femoral distal cartilages of more than 2,000 tissue donors were graded based on the appearance of articular cartilage and osteophytes. In the ankle and the knee the degenerative changes increased with age; however, the rate of degeneration in the ankle was slower than in the knee. The degenerative changes in the ankle were more severe in men than in women, were predominantly bilateral, and seemed to be correlated with weight. The slower rate of change in the ankle may be caused, in part, by the biochemical and biomechanical tissue properties that distinguish ankle cartilage from that of the knee. PMID:12911243

  10. Anatomy of the ankle ligaments: a pictorial essay.

    PubMed

    Golanó, Pau; Vega, Jordi; de Leeuw, Peter A J; Malagelada, Francesc; Manzanares, M Cristina; Götzens, Víctor; van Dijk, C Niek

    2016-04-01

    Understanding the anatomy of the ankle ligaments is important for correct diagnosis and treatment. Ankle ligament injury is the most frequent cause of acute ankle pain. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. In this pictorial essay, the ligaments around the ankle are grouped, depending on their anatomic orientation, and each of the ankle ligaments is discussed in detail. PMID:27052302

  11. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player.

    PubMed

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-07-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  12. Ankle inversion taping using kinesiology tape for treating medial ankle sprain in an amateur soccer player

    PubMed Central

    Lee, Sun-Min; Lee, Jung-Hoon

    2015-01-01

    [Purpose] The purpose of this study was to report the effects of ankle inversion taping using kinesiology tape in a patient with a medial ankle sprain. [Subject] A 28-year-old amateur soccer player suffered a Grade 2 medial ankle sprain during a match. [Methods] Ankle inversion taping was applied to the sprained ankle every day for 2 months. [Results] His symptoms were reduced after ankle inversion taping application for 2 months. The self-reported function score, the reach distances in the Star Excursion Balance Test, and the weight-bearing ankle dorsiflexion were increased. [Conclusion] This study showed that ankle inversion taping using kinesiology tape may be an effective therapy for a patient with a medial ankle sprain. PMID:26311991

  13. Syndesmotic ankle sprains in athletes.

    PubMed

    Williams, Glenn N; Jones, Morgan H; Amendola, Annunziato

    2007-07-01

    Ankle sprains are among the most common athletic injuries and represent a significant source of persistent pain and disability. Despite the high incidence of ankle sprains in athletes, syndesmosis injuries have historically been underdiagnosed, and assessment in terms of severity and optimal treatment has not been determined. More recently, a heightened awareness in sports medicine has resulted in more frequent diagnoses of syndesmosis injuries. However, there is a low level of evidence and a paucity of literature on this topic compared with lateral ankle sprains. As a result, no clear guidelines are available to help the clinician assess the severity of injury, choose an imaging modality to visualize the injury, make a decision in terms of operative versus nonoperative treatment, or decide when the athlete may return to play. Increased knowledge and understanding of these injuries by clinicians and researchers are essential to improve the prevention, diagnosis, and treatment of this significant condition. This review will discuss the anatomy, mechanism of injury, diagnosis, and treatment of syndesmosis sprains of the ankle while identifying controversies in management and topics for future research. PMID:17519439

  14. Hip Arthroscopy for Synovial Chondromatosis: Tips and Tricks.

    PubMed

    Rath, Ehud; Amar, Eyal; Doron, Ran; Matsuda, Dean K

    2014-12-01

    Hip arthroscopy is an important diagnostic and therapeutic tool in the management of synovial chondromatosis. Removal of osteochondral fragments (OCFs) from the central and peripheral compartments is crucial for the relief of mechanical symptoms and subsequent joint destruction. Direct access to the central compartment is often limited because of the ball-and-socket morphology and limitation of traction. We present our surgical technique for removing OCFs and a new method for the removal of a large loose body using a nitinol stone retrieval basket. The technique facilitates removal of difficult-to-access fragments from the central compartment. Moreover, this technique allows removal of far-medial OCFs from the peripheral compartment. PMID:25685679

  15. [Minimally invasive treatment of tibial plateau fracture under arthroscopy monitoring].

    PubMed

    Chen, Lixin; Ma, Shaoyun; Li, Xianpeng

    2014-05-01

    Twenty six patients with fracture of tibial plateau was under arthroscopy assisted reduction, the joint surface of bone graft, and USES the steel plate fixation treatment. Average surgery time was 65 min (70-120 min), average fracture healing time was 15 weeks (12-17 weeks), joint surface anatomical reattachment rate was 92.9%. Using break knee function criteria evaluation of curative effect: 18 cases great 6 cases wed, 2 cases ok, fine rate was 92.3%. No infection, deep venous thrombosis and small leg fascia chamber syndrome and other complications. Conclusion is that treatment of tibial plateau fractures under arthroscope has advantages of small trauma, check intuitively and reset accurately, functional recovery of patients are satisfied, the treatment has certain clinical application value. PMID:25241526

  16. Arthroscopy Assisted Percutaneous Fixation of Ideberg Type Iii Glenoid Fractures

    PubMed Central

    Acharya, Prashant; Arora, Bakul; Pinto, Nelson

    2015-01-01

    Introduction: Intra-articular glenoid fractures are extremely rare and may be associated with other injuries. Traditionally open reduction and internal fixation has been recommended in displaced intra-articular glenoid fractures. However open reduction is difficult and it may not be possible to address the associated intra-articular soft tissue injuries. A few reports of arthroscopic assisted fixation of these fractures have been recently published. We are reporting a case of Ideberg type 3 glenoid fracture and its treatment. Case Report: We are presenting our case where a 52 year old man presented with Type 3 intra-articular glenoid fracture. The fracture was fixed percutaneously under simultaneous arthroscopic and fluoroscopic guidance. Conclusion: Intra-articular glenoid fractures are uncommon and difficult to treat. Arthroscopy assisted percutaneous fixation technique can be a valuable adjunct for the surgeon in dealing with not only the fracture but also the associated soft-tissue injuries. PMID:27299041

  17. Percutaneous screw fixation of acetabular fractures: applicability of hip arthroscopy.

    PubMed

    Yang, Jae-Hyuk; Chouhan, Devendra Kumar; Oh, Kwang-Jun

    2010-11-01

    Percutaneous screw fixation of the anterior column of the acetabulum has been a challenging task because of its unique anatomy and a risk of intra-articular penetration. Evidence is lacking for any tools to provide visual scrutiny of fracture reduction and intra-articular screw penetration. We report 2 cases of fracture of the acetabulum that developed in young female athletes, in which the anterior column was fixed with a percutaneous screw by use of hip arthroscopy as an assisting tool for intra-articular observation. In our experience this method was found to be promising in terms of anatomic reduction of the fracture site, avoiding articular penetration during screw insertion, with additional advantages of joint debridement, lavage, and reduction in radiation exposure. PMID:20888169

  18. The Neural Bases of Distraction and Reappraisal

    ERIC Educational Resources Information Center

    McRae, Kateri; Hughes, Brent; Chopra, Sita; Gabrieli, John D. E.; Gross, James J.; Ochsner, Kevin N.

    2010-01-01

    Distraction and reappraisal are two commonly used forms of cognitive emotion regulation. Functional neuroimaging studies have shown that each one depends upon interactions between pFC, interpreted as implementing cognitive control, and limbic regions, interpreted as mediating emotional responses. However, no study has directly compared distraction…

  19. Reward, Distraction, and the Overjustification Effect

    ERIC Educational Resources Information Center

    Smith, Timothy W.; Pittman, Thane S.

    1978-01-01

    This study tests two differing hypotheses: the competing response hypothesis, which states that both reward and non-reward distractions produce decreases in interest which weaken over repeated trials, and the attribution/overjustification hypothesis, which maintains that rewards produce a decrease in interest that does not weaken over trials.…

  20. 77 FR 51610 - Distracted Driving Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-24

    ... National Highway Traffic Safety Administration Distracted Driving Grant Program AGENCY: Department of... amount of $17.525 million in Federal fiscal year (FY) 2013 funds to provide grants to States for enacting... limitation that may be established in appropriations law. Therefore, the amount available for the grants...

  1. Angiogenesis and mineralization during distraction osteogenesis.

    PubMed Central

    Choi, In Ho; Chung, Chin Youb; Cho, Tae-Joon; Yoo, Won Joon

    2002-01-01

    Distraction osteogenesis is currently a standard method of bone lengthening. It is a viable method for the treatment of short extremities as well as extensive bone defects, because large amounts of bone can be regenerated in the distraction gap. Mechanical stimulation by distraction induces biological responses of skeletal regeneration that is accomplished by a cascade of biologic processes that may include differentiation of pluripotential tissue, angiogenesis, mineralization, and remodeling. There are complex interactions between bone-forming osteoblasts and other cells present within the bone microenvironment, particularly vascular endothelial cells that may be pivotal members of a complex interactive communication network in bone. Regenerate bone forms by three modes of ossification, which include intramembranous, enchondral, and transchondroid ossifications, although intramembraneous bone formation is the predominant mechanism of ossification. In this review we discussed the coupling between angiogenesis and mineralization, the biological and mechanical factors affecting them, the cellular and molecular events occurring during distraction osteogenesis, and the emerging modalities to accelerate regenerate bone healing and remodeling. PMID:12172035

  2. Interference from audio distracters during speechreading

    NASA Astrophysics Data System (ADS)

    Brungart, Douglas S.; Simpson, Brian D.

    2005-12-01

    Although many audio-visual speech experiments have focused on situations where the presence of an incongruent visual speech signal influences the perceived utterance heard by an observer, there are also documented examples of a related effect in which the presence of an incongruent audio speech signal influences the perceived utterance seen by an observer. This study examined the effects that different distracting audio signals had on performance in a color and number keyword speechreading task. When the distracting sound was noise, time-reversed speech, or continuous speech, it had no effect on speechreading. However, when the distracting audio signal consisted of speech that started at the same time as the visual stimulus, speechreading performance was substantially degraded. This degradation did not depend on the semantic similarity between the target and masker speech, but it was substantially reduced when the onset of the audio speech was shifted relative to that of the visual stimulus. Overall, these results suggest that visual speech perception is impaired by the presence of a simultaneous mismatched audio speech signal, but that other types of audio distracters have little effect on speechreading performance.

  3. Dynamics of Driver Distraction: The process of engaging and disengaging

    PubMed Central

    Lee, John D.

    2014-01-01

    Driver distraction research has a long history, spanning nearly 50 years, but intensifying over the last decade. The dominant paradigm guiding this research defines distraction in terms of excessive workload and limited attentional resources. This approach largely ignores how drivers come to engage in these tasks and under what conditions they engage and disengage from driving—the dynamics of distraction. The dynamics of distraction identifies breakdowns of interruption management as an important contributor to distraction, leading to describe distraction in terms of failures of task timing, switching, and prioritization. The dynamics of distraction also identifies disengagement in driving (e.g., mind wandering) as a substantial challenge that secondary tasks might exacerbate or mitigate. Increasing vehicle automation accentuates the need to consider these dynamics of distraction. Automation offers drivers more opportunity to engage in distractions and disengage from driving, and can surprise drivers by unexpectedly requiring drivers to quickly re-engage in driving—placing greater importance of interruption management expertise. This review describes distraction in terms of breakdowns in interruption management and problems of engagement, and summarizes how contingency, conditioning, and consequence traps lead to problems of engaging and disengaging in driving and distractions. PMID:24776224

  4. Virtual Reality: A Distraction Intervention for Chemotherapy

    PubMed Central

    Schneider, Susan M.; Hood, Linda E.

    2007-01-01

    Purpose/Objectives To explore virtual reality (VR) as a distraction intervention to relieve symptom distress in adults receiving chemotherapy treatments for breast, colon, and lung cancer. Design Crossover design in which participants served as their own control. Setting Outpatient clinic at a comprehensive cancer center in the southeastern United States. Sample 123 adults receiving initial chemotherapy treatments. Methods Participants were randomly assigned to receive the VR distraction intervention during one chemotherapy treatment and then received no intervention (control) during an alternate matched chemotherapy treatment. The Adapted Symptom Distress Scale–2, Revised Piper Fatigue Scale, and State Anxiety Inventory were used to measure symptom distress. The Presence Questionnaire and an open-ended questionnaire were used to evaluate the subjects’ VR experience. The influence of type of cancer, age, and gender on symptom outcomes was explored. Mixed models were used to test for differences in levels of symptom distress. Main Research Variables Virtual reality and symptom distress. Findings Patients had an altered perception of time (p < 0.001) when using VR, which validates the distracting capacity of the intervention. Evaluation of the intervention indicated that patients believed the head-mounted device was easy to use, they experienced no cybersickness, and 82% would use VR again. However, analysis demonstrated no significant differences in symptom distress immediately or two days following chemotherapy treatments. Conclusions Patients stated that using VR made the treatment seem shorter and that chemotherapy treatments with VR were better than treatments without the distraction intervention. However, positive experiences did not result in a decrease in symptom distress. The findings support the idea that using VR can help to make chemotherapy treatments more tolerable, but clinicians should not assume that use of VR will improve chemotherapy

  5. Total ankle replacement. The results in 200 ankles.

    PubMed

    Wood, P L R; Deakin, S

    2003-04-01

    Between 1993 and 2000 we implanted 200 cementless, mobile-bearing STAR total ankle replacements. None was lost to follow-up for reasons other than the death of a patient. The mean follow-up was for 46 months (24 to 101). A complication requiring further surgery developed in eight ankles and 14 were revised or fused. The cumulative survival rate at five years was 92.7% (95% CI 86.6 to 98.8) with time to decision to revision or fusion as an endpoint. The most frequent complications were delayed wound healing and fracture of a malleolus. These became less common with experience of the operation. The radiological appearance of the interface of the tibial implant was significantly related to its operative fit and to the type of bioactive coating. PMID:12729104

  6. A systematic review on ankle injury and ankle sprain in sports.

    PubMed

    Fong, Daniel Tik-Pui; Hong, Youlian; Chan, Lap-Ki; Yung, Patrick Shu-Hang; Chan, Kai-Ming

    2007-01-01

    This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201,600 patients were included, with 32,509 ankle injuries. Ankle injury information was available from 14,098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports. PMID:17190537

  7. What are the current indications for use of radiofrequency devices in hip arthroscopy? A systematic review

    PubMed Central

    Suarez-Ahedo, Carlos; Pavan Vemula, S.; Stake, Christine E.; Finley, Zachary A.; Martin, Timothy J.; Gui, Chengcheng; Domb, Benjamin G.

    2015-01-01

    The role of radiofrequency energy (RFE) devices has been minimally studied in hip arthroscopy. The purpose of this study was to determine the role of RFE devices in hip arthroscopy through a systematic review of the literature. We searched the PubMed database using the following Medical Subject Heading terms: hip arthroscopy, hip radiofrequency, thermal capsulorrhaphy, thermal chondroplasty and radiofrequency debridement. Two authors independently reviewed the literature and included articles based on predetermined inclusion criteria. We excluded review, technique and experimental articles. After title and abstract review, we selected 293 articles for full-text review. Ten articles met the inclusion and exclusion criteria. For the included articles, a total of 305 hips underwent arthroscopy with concomitant RFE treatment at a mean age of 25.7 years. Eight articles presented patient-reported outcome (PRO) instruments, one study did not report an outcome instrument but utilized an evaluation of postoperative range of motion (ROM) and 1 year magnetic resonance image (MRI) and computed tomography (CT) imaging. The remaining article measured only the ROM pre- and postoperatively. Only one of the articles reviewed reported complications. Current evidence on the safety and indications for use of RFE devices in hip arthroscopy is insufficient. The literature shows mixed results regarding its use in hip arthroscopy. Although the use of thermal energy is not without risk, if used judiciously and appropriate precautions are taken to avoid damage to adjacent tissues, those devices can be useful for the treatment of certain intra-articular hip pathologies arthroscopically. PMID:27011856

  8. Subtalar Joint Distraction Arthrodesis to Correct Calcaneal Valgus in Pediatric Patients with Tarsal Coalition: A Case Series.

    PubMed

    Schwartz, Jaclyn M; Kihm, Carl A; Camasta, Craig A

    2015-01-01

    Subtalar joint middle facet coalitions commonly present in children who have a painful, rigid, pes planovalgus foot type. The middle facet coalition allows rearfoot forces to be distributed medially through the coalition, and this can result in arthritis or lateral tarsal wedging. The senior author has used a wedged bone graft distraction subtalar joint arthrodesis to correct calcaneal valgus and restore the talar height in these patients. The tight, press-fit nature of the tricortical iliac crest allograft provides stability and can negate the need for internal fixation. We retrospectively reviewed 9 pediatric subtalar joint distraction arthrodesis procedures performed on 8 patients during a 6-year period. All patients began weightbearing at 6 weeks after surgery. All patients had osseous union, and no complications developed that required a second surgery. The clinical outcomes, assessed at a mean of 25.5 (range, 6.3 to 75.8) months postoperatively, were satisfactory. The mean American Orthopaedic Foot and Ankle Society score was 90.1 (range, 79 to 94), on a 94-point scale. The wedged distraction arthrodesis technique has not been previously described for correction of pediatric patients with lateral tarsal wedging, but it is an effective option and yields successful outcomes. PMID:25704449

  9. The prognosis of ankle sprains.

    PubMed

    de Bie, R A; de Vet, H C; van den Wildenberg, F A; Lenssen, T; Knipschild, P G

    1997-05-01

    We developed a new diagnostic tool for predicting the severity of ankle sprains just after injury. Since hard data obtained by diagnostic imaging techniques are still imperfect, we decided to use data from individual medical history and signs and symptoms that are part of the admission routine. During a three month-period data were collected on thirty-five patients with lateral ankle sprains who visited the first aid department of the University Hospital of Maastricht. Assessments took place at admission and at two and four weeks after injury. Assessors were the first-aid physician, a physiotherapist and the patient. Dependent variables were healed ankle in two and four weeks. Predicting variables were the data obtained at admission by the physician, the physiotherapist and the patient. The ability to predict outcome after two and four weeks was determined in a bivariate analysis, followed by logistic modelling. Accurate prediction of recovery time at admission appeared to be possible. Best two weeks predictor was the modified function score, an accuracy of 97% was achieved. Four weeks prediction was most accurate when function score was used together with the report mark from the doctor and the palpation score (accuracy of 81%). PMID:9231846

  10. Outcome of ankle arthrodesis in posttraumatic arthritis

    PubMed Central

    Gowda, BS Narayana; Kumar, J Mohan

    2012-01-01

    Background: Ankle arthrodesis is still a gold standard salvage procedure for the management of ankle arthritis. There are several functional and mechanical benefits of ankle arthrodesis, which make it a viable surgical procedure in the management of ankle arthritis. The functional outcomes following ankle arthrodesis are not very well known. The purpose of this study was to perform a clinical and radiographic evaluation of ankle arthrodesis in posttraumatic arthritis performed using Charnley's compression device. Materials and Methods: Between January 2006 and December 2009 a functional assessment of 15 patients (10 males and 5 females) who had undergone ankle arthrodesis for posttraumatic arthritis and/or avascular necrosis (AVN) talus (n=6), malunited bimalleolar fracture (n=4), distal tibial plafond fractures (n=3), medial malleoli nonunion (n=2). All the patients were assessed clinically and radiologically after an average followup of 2 years 8 months (range 1–5.7 years). Results: All patients had sound ankylosis and no complications related to the surgery. Scoring the patients with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, we found that 11 of the 15 had excellent results, two had good, and two showed fair results. They were all returned to their preinjury activities. Conclusion: We conclude that, the ankle arthrodesis can still be considered as a standard procedure in ankle arthritis. On the basis of these results, patients should be counseled that an ankle fusion will help to relieve pain and to improve overall function. Still, one should keep in mind that it is a salvage procedure that will cause persistent alterations in gait with a potential for deterioration due to the development of subtalar arthritis. PMID:22719119

  11. Find an Orthopaedic Foot and Ankle MD/DO

    MedlinePlus

    ... AOFAS / FootCareMD / Find a Surgeon Find an Orthopaedic Foot & Ankle Surgeon Page Content The Orthopaedic Distinction Who are Orthopaedic Foot & Ankle Surgeons? Orthopaedic foot and ankle surgeons are ...

  12. Total Ankle Arthroplasty: An Imaging Overview

    PubMed Central

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  13. Surgical treatment of the arthritic varus ankle.

    PubMed

    Easley, Mark E

    2012-12-01

    Within the past several years, the arthritic varus ankle has been addressed extensively in Foot and Ankle Clinics, with numerous excellent reviews by particularly knowledgeable authors. To support these outstanding contributions, this article provides a practical approach to this challenging constellation of foot and ankle abnormalities. Varus ankle arthritis exists on a continuum that prompts the treating surgeon to be familiar with a spectrum of surgical solutions, including joint-sparing realignment, arthroplasty, and arthrodesis. Each of these treatment options is addressed with several expanded case examples and supports the management approaches with the available pertinent literature. PMID:23158376

  14. Which ankle fractures require syndesmotic stabilization?

    PubMed

    van den Bekerom, Michel P J; Lamme, Bas; Hogervorst, Mike; Bolhuis, Hugo W

    2007-01-01

    Syndesmotic ruptures associated with ankle fractures are most commonly caused by external rotation of the foot, eversion of the talus within the ankle mortise, and excessive dorsiflexion. The distal tibiofibular syndesmosis consists of the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, and interosseous ligament, and it is essential for stability of the ankle mortise. Despite the numerous biomechanical and clinical studies pertaining to ankle fractures, there are no uniform recommendations regarding the use of the syndesmotic screw for specific injury patterns and fracture types. The objective of this review was to formulate recommendations for clinical practice related to the use of syndesmotic screw placement. PMID:17980843

  15. The relationship between lateral ankle sprain and ankle tendinitis in ballet dancers.

    PubMed

    Ritter, Stephanie; Moore, Marjorie

    2008-01-01

    The lateral ligament complex of the ankle is the most frequently injured structure in the body. Although most simple ankle sprains do not result in long-term disability, a significant number do not completely resolve, leading to residual symptoms that may persist for years. The most commonly reported symptoms, particularly among athletes, include instability, re-injury, and tendinitis. Ballet dancers are a combination of artist and high-performance athlete; consequently, they are subjected to the same types of injuries as other athletes, including lateral ankle sprains and their sequelae. Furthermore, ballet dancers perform in unusual positions such as en pointe, which places the ankle in extreme plantar flexion, requiring stabilization by surrounding muscles. Dancers' extraordinary performance demands place them at risk for other ankle injuries as well, including inflammation ofseveral tendons, especially the peroneals. This report reviews the relevant literature to characterize the scope of lateral ankle sprains and sequelae, discuss the importance of the peroneal muscles in ankle stability, and explore a relationship between lateral ankle sprain and ankle tendinitis in ballet dancers. Informal interviews were conducted with physical therapists who specialize in treating ballet dancers, providing a clinical context for this report. An extensive review of the literature was conducted, including electronic databases, reference lists from papers, and relevant reference texts. Numerous studies have investigated ankle sprains and residual complaints; nearly all report that lateral ankle sprains commonly lead to chronic ankle instability. Studies exploring ankle stability have demonstrated that the peroneal muscles play a crucial role in ankle stabilization; EMG studies confirm they are the first to contract during ankle inversion stress. The dancer's need for exceptional ankle stabilization may lead to peroneal overuse and tendinitis. Studies have linked peroneal

  16. Distractibility in Learning-Disabled Children: The Role of Measurement Artifact.

    ERIC Educational Resources Information Center

    Harvey, Philip D.; And Others

    1984-01-01

    Two-digit span tasks compared the distraction performance of 32 learning disabled (LD) high schoolers and non LD Ss. No differential distraction effect was found on the first set (matching nondistraction and distraction conditions). In set two, (distraction condition was designed to be more discriminating), a differential distraction effect was…

  17. Biomechanical patterns of text-message distraction.

    PubMed

    Le, Peter; Hwang, Jaejin; Grawe, Sarah; Li, Jing; Snyder, Alison; Lee, Christina; Marras, William S

    2015-01-01

    The objective of this study was to identify biomechanical measures that can distinguish texting distraction in a laboratory-simulated driving environment. The goal would be to use this information to provide an intervention for risky driving behaviour. Sixteen subjects participated in this study. Three independent variables were tested: task (texting, visual targeting, weighted and non-weighted movements), task direction (front and side) and task distance (close and far). Dependent variables consisted of biomechanical moments, head displacement and the length of time to complete each task. Results revealed that the time to complete each task was higher for texting compared to other tasks. Peak moments during texting were only distinguishable from visual targeting. Peak head displacement and cumulative biomechanical exposure measures indicated that texting can be distinguished from other tasks. Therefore, it may be useful to take into account both temporal and biomechanical measures when considering warning systems to detect texting distraction. PMID:25867196

  18. Sharing the responsibility for driver distraction across road transport systems: a systems approach to the management of distracted driving.

    PubMed

    Young, Kristie L; Salmon, Paul M

    2015-01-01

    Distracted driving is acknowledged universally as a large and growing road safety problem. Compounding the problem is that distracted driving is a complex, multifaceted issue influenced by a multitude of factors, organisations and individuals. As such, management of the problem is not straightforward. Numerous countermeasures have been developed and implemented across the globe. The vast majority of these measures have derived from the traditional reductionist, driver-centric approach to distraction and have failed to fully reflect the complex mix of actors and components that give rise to drivers becoming distracted. An alternative approach that is gaining momentum in road safety is the systems approach, which considers all components of the system and their interactions as an integrated whole. In this paper, we review the current knowledge base on driver distraction and argue that the systems approach is not currently being realised in practice. Adopting a more holistic, systems approach to distracted driving will not only improve existing knowledge and interventions from the traditional approach, but will enhance our understanding and management of distraction by considering the complex relationships and interactions of the multiple actors and the myriad sources, enablers and interventions that make up the distracted driving system. It is only by recognising and understanding how all of the system components work together to enable distraction to occur, that we can start to work on solutions to help mitigate the occurrence and consequences of distracted driving. PMID:24767853

  19. EFFECTIVENESS OF ULTRASONOGRAPHY IN DIAGNOSING CHRONIC LATERAL ANKLE INSTABILITY:A SYSTEMATIC REVIEW

    PubMed Central

    Bakowski, Jordan; Dew, Stephanie; Greenwald, Bridget; Hyde, Eryn; Webber, Nicole

    2016-01-01

    Background Chronic ankle instability (CAI) is a condition that often develops after repeated ankle sprains, increasing the suceptability of the ankle to move into excessive inversion when walking on unstable surfaces. Treatment for CAI costs approximately three billion health care dollars annually. Currently, common diagnostic tools used to identify ankle instability are arthroscopy, imaging, manual laxity testing, and self-reported questionnaires. Purpose The purpose of this systematic review was to investigate the effectiveness of ultrasonography in diagnosing CAI, in comparison with other diagnostic tools. Methods Search limits: articles published between the years 2000-2015, and articles that were peer reviewed and published in the English language. Databases searched: CINAHL, PubMed, Medline, Medline Plus, Science Direct, OVID, Cochrane, and EBSCO. Titles and abstracts of the 1,420 articles were screened for the inclusion criteria by two independent raters, with discrepancies solved by a third rater. The modified 14-point Quality Assessment of Diagnostic Accuracy Studies (QUADAS) scale was used to assess methodological quality of included articles. Results Six high quality articles were included in this systematic review, as indicated by high scores on the QUADAS scale, ranging from 10 to 13. Sensitivity of US ranged from: 84.6 % -100%, specificity of US ranged from: 90.9% − 100% and accuracy ranged from: 87% − 90.9%. Discussion The results of the included studies suggest that US is able to accurately differentiate between the grades of ankle sprains and between a lax ligament, torn ligament, thick ligament, absorbed ligament and a non-union avulsion fracture. These findings indicate that US is a reliable method for diagnosing CAI, and that US is able to classify the degree of instability. Conclusion Researchers found that US is effective, reliable, and accurate in the diagnosis of CAI. Clinical Implications US would allow for earlier diagnosis, which

  20. [An experimental study of a new bidirectional distraction appliance].

    PubMed

    Lucas, R; Gounot, N; Cresseaux, P; Breton, P; Freidel, M; Ferez, C; Roger, T; Genevois, J P

    1998-07-01

    The goals of mandibular distraction are to restore a normal length but also a normal shape to the hypoplastic mandible. These two goals are related to the elongation vector which is itself related to the location of the cortictomy and of the device. Other factors influence this elongation vector. So it is impossible to precisely predict the elongation vector. With the monodirectional distraction device no modification can be made during the distraction time. With a bidirectional distraction device offering the possibility to modulate the angulation between the two elongation rods it is possible to adjust the elongation vector during distraction. Precise distraction gap modeling is possible. This is particularly important to correct anterior open-bite. This device was tested on animals (pigs). PMID:9697234

  1. Strategies for preventing distractions and interruptions in the OR.

    PubMed

    Clark, Gregory J

    2013-06-01

    Stakeholders in the automotive industry, airline industry, and anesthesia profession have identified critical periods of time in which distractions and interruptions of normal processes can have devastating effects. Just as reducing distractions improves safety in an automobile or airplane cockpit, limiting distractions and interruptions during critical times in the perioperative setting can increase patient safety. We assessed perioperative nurses and identified what they perceived as critical phases of nursing care. We also worked with our anesthesia partners to address their concerns about interruptions during the administration of nerve blocks. The perioperative nurses at our hospital initiated strategies to reduce distractions or interruptions to their practice at critical points, and, in collaboration with surgical committee members, we developed strategies to reduce or eliminate distractions for anesthesia professionals during the preoperative administration of nerve blocks and to eliminate distractions for the RN circulator and scrub person during the final counts. PMID:23722034

  2. ARTHROSCOPY FOR TREATMENT OF REFRACTORY CALCIFIC TENDONITIS OF THE SHOULDER

    PubMed Central

    Fernandes, Marcos Rassi; Fernandes, Rui José

    2015-01-01

    Objective: To evaluate the results from arthroscopic treatment in patients with calcific tendonitis of the shoulder. Methods: Between September 2001 and June 2006, 55 patients with calcific tendonitis of the shoulder that was resistant to conservative treatment were evaluated, with follow-up of 12 to 70 months. The mean age was 42 years, ranging from 30 to 64 years; 44 patients were female (80%). There were 37 right shoulders, and 63.63% of the cases were on the dominant side. Pain was the main symptom, and the mean time between onset of symptoms and arthroscopy was 38 months (range: five to 120 months). The tendon affected was the supraspinatus in 42 cases, the infraspinatus in 11 cases and an association between these in two cases. Acromioplasty was carried out in 12 patients (21.82%) and subacromial bursectomy was performed in all cases. Results: According to the UCLA criteria, 46 cases were excellent and six were good, making a total of 52 satisfactory results (94.54%). Conclusion: Arthroscopic treatment of calcific tendonitis of the shoulder appears to be an effective method, with high rates of satisfactory results. Associated acromioplasty is not necessary. PMID:27019839

  3. Method for Automated Bone Shape Correction within Bone Distraction Procedure

    NASA Astrophysics Data System (ADS)

    Blynskiy, F. Yu

    2016-01-01

    The method for automated bone shape correction within bone distraction procedure is presented. High precision deformation angle measurement is provided by the software for X- Ray images processing. Special BDC v.1.0.1. application is designed. The purpose of the BDC is modeling of the bone geometry structure to calculate the appropriate distraction forces. The correction procedure control is realized by the hardware of the distraction system.

  4. Predictors of Length of Career Following Hip Arthroscopy for Femoroacetabular Impingement in Professional Hockey Players

    PubMed Central

    Menge, Travis; Briggs, Karen K.; Philippon, Marc J.

    2016-01-01

    Objectives: Previous studies have shown that professional hockey players return to sport at a high rate following hip arthroscopy. The average length of a National Hockey League (NHL) career has been reported to be 5.5 years, and it is unknown how long players continue to play after hip arthroscopy. The purpose of this study was 1) to determine predictors of length of career in players following hip arthroscopy for treatment of symptomatic femoroacetabular impingement (FAI), and 2) investigate the rate of those who continue to play professional hockey a minimum of 5 years after hip arthroscopy. Methods: Seventy professional hockey players underwent hip arthroscopy for FAI between 2005 and 2010 by a single surgeon. Data was retrieved from NHL.com regarding the duration of each player’s professional career. In addition, position played, draft position, age at time of surgery, and surgical details were also used in data analysis. Results: Our cohort included thirteen players that were centers, 15 defensemen, 20 goalies, and 22 wings. The average overall draft number was 57 (range 1 to 228), and average age at surgery was 27 years (range 17 to 38). Forty of the 70 athletes (57%) continued to play professionally a minimum of 5 years after hip arthroscopy. As of the most recent 2015 season, the average NHL length of career was 13 years (range 8 to 23 years), with an average of 6.9 years played following hip arthroscopy. Therre was no different in length of career and years played when goalies were compared to other players(p=0.760). Length of career and years played after arthroscopy correlated with age at surgery (r=0.799 and r=-0.408). Players who played 5 or more years after arthroscopy were significantly younger than those who did not (25 vs. 30 years, p=0.001). Sixty-five players (93%) had labral repair and 5 (7%) had labral reconstruction. There were no differences in length of career or years played after arthroscopy based on type of labral treatment (p=0

  5. Subtractive fuzzy classifier based driver distraction levels classification using EEG.

    PubMed

    Wali, Mousa Kadhim; Murugappan, Murugappan; Ahmad, Badlishah

    2013-09-01

    [Purpose] In earlier studies of driver distraction, researchers classified distraction into two levels (not distracted, and distracted). This study classified four levels of distraction (neutral, low, medium, high). [Subjects and Methods] Fifty Asian subjects (n=50, 43 males, 7 females), age range 20-35 years, who were free from any disease, participated in this study. Wireless EEG signals were recorded by 14 electrodes during four types of distraction stimuli (Global Position Systems (GPS), music player, short message service (SMS), and mental tasks). We derived the amplitude spectrum of three different frequency bands, theta, alpha, and beta of EEG. Then, based on fusion of discrete wavelet packet transforms and fast fourier transform yield, we extracted two features (power spectral density, spectral centroid frequency) of different wavelets (db4, db8, sym8, and coif5). Mean ± SD was calculated and analysis of variance (ANOVA) was performed. A fuzzy inference system classifier was applied to different wavelets using the two extracted features. [Results] The results indicate that the two features of sym8 posses highly significant discrimination across the four levels of distraction, and the best average accuracy achieved by the subtractive fuzzy classifier was 79.21% using the power spectral density feature extracted using the sym8 wavelet. [Conclusion] These findings suggest that EEG signals can be used to monitor distraction level intensity in order to alert drivers to high levels of distraction. PMID:24259914

  6. Speech-Language Dissociations, Distractibility, and Childhood Stuttering

    PubMed Central

    Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.

    2015-01-01

    Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations). PMID:26126203

  7. ALCOHOL AND DISTRACTION INTERACT TO IMPAIR DRIVING PERFORMANCE

    PubMed Central

    Harrison, Emily L. R.; Fillmore, Mark T.

    2011-01-01

    Background Recognition of the risks associated with alcohol intoxication and driver distraction has led to a wealth of simulated driving research aimed at studying the adverse effects of each of these factors. Research on driving has moved beyond the individual, separate examination of these factors to the examination of potential interactions between alcohol intoxication and driver distraction. In many driving situations, distractions are commonplace and might have little or no disruptive influence on primary driving functions. Yet, such distractions might become disruptive to a driver who is intoxicated. Methods The present study examined the interactive impairing effects of alcohol intoxication and driver distraction on simulated driving performance in 40 young adult drivers using a divided attention task as a distracter activity. The interactive influence of alcohol and distraction was tested by having drivers perform the driving task under four different conditions: 0.65 g/kg alcohol; 0.65 g/kg alcohol + divided attention; placebo; and placebo + divided attention. Results As hypothesized, divided attention had no impairing effect on driving performance in sober drivers. However, under alcohol, divided attention exacerbated the impairing effects of alcohol on driving precision. Conclusions Alcohol and distraction continue to be appropriate targets for research into ways to reduce the rates of driving-related fatalities and injuries. Greater consideration of how alcohol and distraction interact to impair aspects of driving performance can further efforts to create prevention and intervention measures to protect drivers, particularly young adults. PMID:21277119

  8. Ankle and Other Signatures in Uhecr

    NASA Astrophysics Data System (ADS)

    Berezinsky, Veniamin

    2015-03-01

    The interaction signatures of UHE protons propagating through CMB are discussed. Much attention is given to ankle, which starting from 1963 is usually interpreted as a feature of transition from galactic to extragalactic cosmic rays. We argue here that this interpretation is now excluded. It gives more credit to alternative explanation of the ankle as an intrinsic part of the pair-production dip.

  9. Basketball injuries of the foot and ankle.

    PubMed

    McDermott, E P

    1993-04-01

    Foot and ankle injuries in basketball are discussed in three unrelated categories in this article. This includes a practical differential diagnosis of ankle sprains, acute conditions of the mid and hindfoot, overuse syndromes of nerve entrapment, fascial strain, synovitis, joint subluxation, and inflammation resulting from repetitive stress. The diagnosis and treatment of tendon inflammation of the extrinsic foot musculature is also reviewed. PMID:8097679

  10. Diagnosis and treatment of chronic ankle pain.

    PubMed

    Wukich, Dane K; Tuason, Dominick A

    2011-01-01

    The differential diagnosis for chronic ankle pain is quite broad. Ankle pain can be caused by intra-articular or extra-articular pathology and may be a result of a traumatic or nontraumatic event. A detailed patient history and physical examination, coupled with judicious selection of the appropriate imaging modalities, are vital in making an accurate diagnosis and providing effective treatment. Chronic ankle pain can affect all age groups, ranging from young athletes to elderly patients with degenerative joint and soft-tissue disorders. It has been estimated that 23,000 ankle sprains occur each day in the United States, representing approximately 1 sprain per 10,000 people per day. Because nearly one in five ankle injuries result in chronic symptoms, orthopaedic surgeons are likely to see patients with chronic ankle pain. Many patients with chronic ankle pain do not recall any history of trauma. Reviewing the management of the various disorders that can cause chronic ankle pain will help orthopaedic surgeons provide the best treatment for their patients. PMID:21553785