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Sample records for adolescent hallux valgus

  1. Hallux valgus.

    PubMed

    Hecht, Paul J; Lin, Timothy J

    2014-03-01

    Hallux valgus is a common foot problem whose cause and progression is multifactorial, complex, and poorly known. Hallux valgus shows a predilection toward women. It is a progressive disorder with no treatment known to slow or stop progression. Surgery is indicated in healthy individuals when nonoperative measures fail. Adverse effects of surgery include infection and recurrence. Many procedures have been described, including soft tissue and bony reconstruction of the first ray. The procedure that is indicated depends on the severity of the deformity. PMID:24559871

  2. Scarf-Akin osteotomy for hallux valgus in juvenile and adolescent patients.

    PubMed

    Agrawal, Yuvraj; Bajaj, Sunil K; Flowers, Mark J

    2015-11-01

    Hallux valgus (HV) has been reported to affect 22-36% of adolescents, with a recurrence rate of around 30-40%. Operative treatment may be indicated in symptomatic deformities where conservative management has failed to halt progression of the deformity. There remains genuine concern with respect to high complication rates including recurrence and stiffness of the metatarsophalangeal joint following operative treatment in adolescents. We report the clinical, functional and radiological outcomes of the Scarf-Akin procedure in the treatment of juvenile and adolescent HV. A review of single surgeon series was carried out of all children who underwent Scarf and Akin osteotomies as a combined procedure for HV between February 2001 and 2010. The preoperative and postoperative intermetatarsal angle (IMA1-2), hallux valgus angle, distal metatarsal articular angle and ratio of the length of first metatarsal to that of the second metatarsal were determined. The American Orthopaedic Foot and Ankle Score was used for functional assessment. Twenty-nine patients (47 feet) underwent Scarf-Akin osteotomies for moderate to severe HV. The average age of the patients at surgery was 11.7 years. The 6-week postoperative radiographs confirmed a significant improvement in the IMA, hallux valgus angle and distal metatarsal articular angle, in all the 47 feet, but 10 patients (14 feet, 29.8%) reported recurrence of hallux valgus at subsequent reviews. The radiological recurrence rate in our series was 29.8%, with 21.3% of patients symptomatic enough to require a revision operation. We report a high recurrence rate in hallux valgus operation in children and hence recommend postponement of correction until skeletal maturity. PMID:26237662

  3. [Hallux valgus--an atavism?].

    PubMed

    Klaue, K

    2004-07-01

    In biology, atavism is generally understood as a biological phenomenon which brings to sight a recurrent phenotypic character which was lost for extinct generations. Phylogenic evolution of homo sapiens demonstrates today that the first plantar ray in tetrapods has always been a very stable ray and the lateral foot experienced a progressive adduction to the talo-metatarsal axis, together with a remodeling of the lateral column of the foot and a progressive valgus of the calcaneus beneath the talus. The foot appears as a strongly modified extremity, starting at a prehensile foot organ, common to our ancestors. In homo sapiens, the hand became a very mobile, less loaded organ, while the foot became a rather less mobile, but more loaded organ. The first ray, distal to Lisfranc's ligament, has no ligamentous structure holding it to the second ray. Stability is thus precarious and controlled by extrinsic and intrinsic muscles. Passive mobility of the tarso-metatarsal joints has been studied in vitro and in vivo. A relationship between unstable or hypermobile first ray and relevant Hallux valgus deformity has been demonstrated. Factors which facilitate the deformity are a long hallux and a functional equinus of the foot. Clinical pathology includes metatarsalgia, hammer toes, together with metatarsus primus varus and shortened gastrocnemii. Logical treatment of relevant and painful deformity includes tarso-metatarsal fusion with or without fusion to the second metatarsus. Osteotomies seem less secure in severe cases on the long run. In conclusion, Hallux valgus cannot be considered as an atavism because clinical history and findings do not correspond to the archaic prehensile foot and its evolution, but rather do correspond to a weak spot on a (still) fragile, often overloaded, phylogenetically young organ. PMID:15354748

  4. Percutaneous Surgery for Severe Hallux Valgus.

    PubMed

    Vernois, Joel; Redfern, David J

    2016-09-01

    Severe hallux valgus is a challenge to treat. If the basal osteotomy is a well known surgery for severe deformity, the chevron osteotomy is usually used in mild to moderate deformity. With a accurent fixation the chevron can also be used in severe deformity. Both techniques can be performed percutaneously and offer reliable techniques. PMID:27524702

  5. Revisional hallux abducto valgus surgery using tricorrectional bunionectomy.

    PubMed

    Selner, Allen J; Selner, Marc D; Cyr, Robert P; Noiwangmuang, Wanlop

    2004-01-01

    We present a radiographic analysis of 91 failed hallux abducto valgus surgeries. Patients were categorized by type of postoperative complication: hallux varus, hallux limitus, or recurrent hallux abducto valgus deformities. All deformities were radiographically evaluated preoperatively and after correction using tricorrectional bunionectomy. Analysis of the surgical revisions showed improvement in radiographic parameters, including the intermetatarsal angle, hallux abductus angle, proximal articular set angle, and tibial sesamoid position. We conclude that tricorrectional bunionectomy is a versatile procedure that can be used when addressing a residual deformity after failed hallux abducto valgus surgery. PMID:15265991

  6. Radiographic correlates of hallux valgus severity in older people

    PubMed Central

    2010-01-01

    Background The severity of hallux valgus is easily appreciated by its clinical appearance, however x-ray measurements are also frequently used to evaluate the condition, particularly if surgery is being considered. There have been few large studies that have assessed the validity of these x-ray observations across a wide spectrum of the deformity. In addition, no studies have specifically focused on older people where the progression of the disorder has largely ceased. Therefore, this study aimed to explore relationships between relevant x-ray observations with respect to hallux valgus severity in older people. Methods This study utilised 402 x-rays of 201 participants (74 men and 127 women) aged 65 to 94 years. All participants were graded using the Manchester Scale - a simple, validated system to grade the severity of hallux valgus - prior to radiographic assessment. A total of 19 hallux valgus-related x-ray observations were performed on each set of x-rays. These measurements were then correlated with the Manchester Scale scores. Results Strong, positive correlations were identified between the severity of hallux valgus and the hallux abductus angle, the proximal articular set angle, the sesamoid position and congruency of the first metatarsophalangeal joint. As hallux valgus severity increased, so did the frequency of radiographic osteoarthritis of the first metatarsophalangeal joint and a round first metatarsal head. A strong linear relationship between increased relative length of the first metatarsal and increased severity of hallux valgus was also observed. Conclusions Strong associations are evident between the clinical appearance of hallux valgus and a number of hallux valgus-related x-ray observations indicative of structural deformity and joint degeneration. As it is unlikely that metatarsal length increases as a result of hallux valgus deformity, increased length of the first metatarsal relative to the second metatarsal may be a contributing factor to

  7. Length of the first metatarsal and hallux in hallux valgus in the initial stage

    PubMed Central

    Polo, Juan; Rebollo, Jesús

    2007-01-01

    The aim of this study was to confirm whether the length of the first metatarsal and the length of the hallux are greater than normal in the initial phase of the hallux valgus deformity. In a sample of 152 radiographs (98 of normal feet and 54 of incipient hallux valgus feet), the length of the first metatarsal and the hallux was measured according to methods previously described. Comparisons were made between normal and hallux valgus feet, and between male and female feet. The results show significant differences between the two groups in the first metatarsal (P  <  0.0001) and hallux (P < 0.001). In the male feet, these differences are more marked (when comparing the length of the hallux between the female hallux valgus feet and the female normal feet, P > 0.05). This indicates that in men with hallux valgus, the excess in length of the first metatarso-digital segment is greater than in women that develop this deformity, at least in its initial phase. According to these results, the size of the first metatarso-digital segment could be involved in the development of the hallux valgus deformity. PMID:17375298

  8. Treatment of hallux valgus in China.

    PubMed

    Chen, B X

    1992-04-01

    This is a review of the treatment of hallux valgus based on the paper material submitted to the First and Second Sino-American Conferences on Foot Disorders held in Beijing in 1987 and 1990. The data consisted of 676 cases (979 feet) from 10 major hospitals in China. There were 122 men and 554 women, giving a male to female ratio of 1:45. Sixty-nine (10%) cases had a family history of hallux valgus and 120 cases (18%) were associated with hammer toe deformity. The age ranged from 16-85 years with an average of 42. Among the 412 female cases (78.5%) at the age of 20-35, 339 (82.3%) had the history of wearing high heeled and narrow tipped shoes. Osteoarthritis changes of the first M-P joint were seen in 31 cases, all above the age of 60. 615 cases (90.9%) were treated surgically for pain relief and only 25 cases (3.7%) at the age of 20-30 had the deformity corrected for cosmetic purpose. The surgical procedures employed were bunionectomy (Silver's operation, 39 feet), Keller's operation (344 feet), McBride's operation (239 feet) and a variety of osteotomies of the first metatarsal (295 feet). Joplin and Lapidus operations were used by one author in 5 and 2 cases respectively. Overall excellent and good results were obtained in 609 cases (90%) during the follow-up of 1-14 years. PMID:1618018

  9. The effectiveness of distal soft tissue procedures in hallux valgus

    PubMed Central

    Ozturk, Hasan; Agus, Haluk; Altay, Taskin; Hancerli, Ozgur

    2008-01-01

    Background Hallux valgus is a common disorder affecting mostly women population. Distal soft tissue procedure in the treatment of hallux valgus is one of the main operative techniques described. The aim of this study is to evaluate the outcomes of McBride’s distal soft tissue procedure in hallux valgus cases. Materials and methods This study includes 30 patients (27 women) having 31 hallux valgus, who were treated between 1999 and 2004. Modified McBride’s distal soft tissue procedure was carried out in all cases. Pain status of the cases was recorded by using VAS, clinical assessment described by Bonney and Macnab, and American Orthopaedic Foot and Ankle Society’s (AOFAS) score at the last follow up. Results The mean hallux valgus and intermetatarsal angles decreased from 31.4° and 13.8° to 13.5° and 10.5°, respectively, with an average follow-up period of 54.4 months. AOFAS’s score displayed significant improvement from 57 to 87. The mean VAS showed a significant decrease from 8.75 preoperatively to 2.1 at the last follow-up. According to Bonney and Macnab criteria, only one case was accepted as poor result due to 5° hallux varus. Conclusions McBride’s distal soft tissue procedure yields high rate of satisfaction for mild to moderate hallux valgus with no bony complications related to osteotomy. PMID:19384606

  10. Bilateral Hallux Valgus: A Utility Outcome Score Assessment.

    PubMed

    Makhdom, Asim M; Sinno, Hani; Aldebeyan, Sultan; Cota, Adam; Hamdy, Reggie Charles; Alzahrani, Mohammad; Janelle, Chantal

    2016-01-01

    Hallux valgus is the most common forefoot problem in adults. Although it can cause considerable disability and affect the quality of life of those affected, many patients seek medical attention because of cosmetic concerns. Our aim was to objectively measure the perceived health burden of living with bilateral hallux valgus. Previously validated utility outcome measures, including the visual analog scale, time trade-off, and standard gamble tests, were used to quantify the health burden for single-eye blindness, double-eye blindness, and bilateral hallux valgus in 103 healthy subjects using an online survey. The Student t test and linear regression analysis were used for statistical analysis. The mean visual analog scale, time trade-off, and standard gamble scores for bilateral hallux valgus were 0.86 ± 1.6, 0.95 ± 0.5, and 0.95 ± 0.14, respectively. These were significantly greater than the utility scores for single-eye and double-eye blindness (p < .05). Age, gender, race, income, and education were not statistically significant independent predictors of the utility scores for hallux valgus. In conclusion, we have objectively demonstrated the effect of living with bilateral hallux valgus deformities. Our sample population reported being willing to undergo a procedure with a 5% mortality rate and sacrifice 1.8 years of life to attain perfect health and avoid the bilateral hallux valgus health state. Our findings will guide us in counseling our patients and understanding how they perceive their foot deformity. PMID:27289218

  11. Roger A. Mann Award. Juvenile hallux valgus: etiology and treatment.

    PubMed

    Coughlin, M J

    1995-11-01

    In an 11-year retrospective study of 45 patients (60 feet) with juvenile hallux valgus, a multiprocedural approach was used to surgically correct the deformity. A Chevron osteotomy or McBride procedure was used for mild deformities, a distal soft tissue procedure with proximal first metatarsal osteotomy was used for moderate and severe deformities with MTP subluxation, and a double osteotomy (extra-articular correction) was used for moderate and severe deformities with an increased distal metatarsal articular angle (DMAA). The average hallux valgus correction was 17.2 degrees and the average correction of the 1-2 intermetatarsal angle was 5.3 degrees. Good and excellent results were obtained in 92% of cases using a multiprocedural approach. Eighty-eight percent of patients were female and 40% of deformities occurred at age 10 or younger. Early onset was characterized by increased deformity and an increased DMAA. Maternal transmission was noted in 72% of patients. An increased distal metatarsal articular angle was noted in 48% of cases. With subluxation of the first MTP joint, the average DMAA was 7.9 degrees. With a congruent joint, the average DMAA was 15.3 degrees. In patients where hallux valgus occurred at age 10 or younger, the DMAA was increased. First metatarsal length was compared with second metatarsal length. While the incidence of a long first metatarsal was similar to that in the normal population (30%), the DMAA was 15.8 degrees for a long first metatarsal and 6.0 degrees for a short first metatarsal. An increased DMAA may be the defining characteristic of juvenile hallux valgus. The success of surgical correction of a juvenile hallux valgus deformity is intimately associated with the magnitude of the DMAA. Moderate and severe pes planus occurred in 17% of cases, which was no different than the incidence in the normal population. No recurrences occurred in the presence of pes planus. Pes planus was not thought to have an affect on occurrence or

  12. The SCARF osteotomy for the correction of hallux valgus deformities.

    PubMed

    Kristen, K H; Berger, C; Stelzig, S; Thalhammer, E; Posch, M; Engel, A

    2002-03-01

    The authors report their experience with a modified SCARF osteotomy with three years follow-up. Correction of moderate to severe hallux valgus deformities was achieved using a Z step osteotomy cut to realign the first metatarsal bone. A retrospective analysis was undertaken in 89 consecutive patients (111 feet). Results were analyzed by clinical examination, a questionnaire including the AOFAS forefoot score, and plain roentgenograms. Hallux valgus and intermetatarsal angle improved at mean 19.1 degrees and 6.6 degrees, respectively. Mean forefoot score improved from 50.1 to 91 points out of 100 possible points. Satisfactory healing time was expressed by an average return back to work of 5.8 weeks and back to sport of 8.3 weeks. Persistence or recurrence of hallux valgus was seen in seven patients (6%). The complication rate was 5.4% including superficial wound infection, traumatic dislocation of the distal fragment, and hallux limitus. The presented technique provides predictable correction of moderate to severe hallux valgus deformities. PMID:11934064

  13. The association between hallux valgus and proximal joint alignment in young female dancers.

    PubMed

    Steinberg, N; Siev-Ner, I; Zeev, A; Dar, G

    2015-01-01

    Very little is known about the relationship between proximal joint alignment and hallux valgus among young dancers. This study sought to determine the extent to which spinal and lower extremity alignments are involved in hallux valgus, and to identify predicting variables for its development in young dancers. A group of 1336 young female dancers aged 8-16 years, and 226 control participants of the same age cohort were screened for the presence of hallux valgus, body physique characteristics, joint range of motion, and anatomical anomalies. Hallux valgus was common in the 2 young female populations studied. Among the dancers, 40.0% had bilateral hallux valgus and 7.3% unilateral. Among the controls, 32.3% had bilateral and 1.8% unilateral hallux valgus (χ2=8.27, df=1, p=0.004). Following logistic regression analysis, age (OR=1.028, 95% CI=0.968-1.091), genu varum (OR=1.514; CI=1.139-2.013) and scoliosis (OR=2.089; CI=1.113-3.921) were found to be significant predicting factors for hallux valgus in the dancer group, whereas in the control group, the predicting factors were age (OR=0.911, 95% CI=0.801-1.036) and ankle plantar flexion range of motion (OR=0.972; CI=0.951-0.992). In conclusion, it was found that spinal deformity, lower extremity alignment, and joint range of motion are strongly related to hallux valgus. PMID:25144433

  14. Hallux valgus in dancers: a closer look at dance technique and its impact on dancers' feet.

    PubMed

    Davenport, Kathleen L; Simmel, Liane; Kadel, Nancy

    2014-01-01

    Hallux valgus is a common deformity of the forefoot. There is no doubt that some dancers develop hallux valgus, but the question remains as to whether dancers are at greater risk than the general population for developing this deformity. Review of the literature reveals on-going debate regarding risk factors for hallux valgus, which may include increasing age, female gender, genetic predisposition, constrictive shoe wear, first ray hypermobility, foot architecture, tight Achilles tendon, and first metatarsal length. There is insufficient evidence to demonstrate conclusively that dancing, specifically pointe work, increases the prevalence or severity of hallux valgus; more research is needed. Treatment of hallux valgus in dancers should be conservative, with delay of surgical correction until retirement if possible. PMID:24844425

  15. Approach for measuring the angle of hallux valgus

    PubMed Central

    Zhou, Jin; Hlavacek, Petr; Xu, Bo; Chen, Wuyong

    2013-01-01

    Background: There is medium correlation between the current anthropometric method and the radiography in the angle of hallux valgus (AoH) measurement, so this study aimed at designing a reliable and more accurate approach to measure the AoH (AoH). Materials and Methods: Fifteen age, body weight, and height matched male students were included and those with foot disorders, deformities, or injuries were excluded from the study. The dorsal protrusions of the first metatarsal and the hallux were marked by palpating from three experienced observers; then their barefoot model in standing was collected by a three dimensional laser scanning system. The AoH was defined in the X-Y plane by the angle between the line joining the marks of centre of head and centre of base of metatarsal shaft and the one connecting the marks of the centre of metatarsal head and the hallux. The same procedure was repeated a week later. Besides, other measures based on the footprint, outline, and the radiography were also available for comparisons. Paired t-test, linear regression, and reliability analysis were applied for statistical analysis with significant level of 0.05 and 95% confidence interval. Results: There were no significant differences recorded between the new method and the radiographic method (P = 0.069). The AoH was superior to the methods of footprint and outline and it displayed a relative higher correlation with the radiographic method (r = 0.94, r2 = 0.89). Moreover both the inter and intraobserver reliabilities of this method were proved to be good. Conclusion: This new method can be used for hallux valgus inspection and evaluation. PMID:23798759

  16. Percutaneous Surgery for Mild to Moderate Hallux Valgus.

    PubMed

    Lam, Peter; Lee, Moses; Xing, Jerry; Di Nallo, Martin

    2016-09-01

    Patients who undergo percutaneous chevron-Akin osteotomies have less pain at follow-up, greater correction of hallux valgus angle, and a shorter operation time compared with open osteotomies. Stable fixation of the chevron osteotomy allows early full weight bearing and mobilization of the first metatarsophalangeal joint. This article describes the surgery technique, including reduction of the first metatarsal head after translation, accurate positioning of the proximal first metatarsal fixation screw, and removal of the dorsomedial prominence of the first metatarsal head. PMID:27524701

  17. Sliding oblique osteotomy for the treatment of hallux abducto valgus associated with functional hallux limitus.

    PubMed

    Lundeen, R O; Rose, J M

    2000-01-01

    This is a retrospective study of 27 patients (35 feet) with hallux abducto valgus associated with hallux limitus who underwent a sliding oblique osteotomy for surgical treatment between August 1997 and June 1998. Radiographic analysis and range-of-motion measurements were evaluated with an average follow-up of 65 days (range, 26-100). Preoperative criteria included < 45 degrees of dorsiflexion of the first metatarsophalangeal joint with weightbearing, no evidence of degenerative joint disease at the first metatarsocuneiform joint, and no previous surgical procedures on the first ray. The average preoperative intermetatarsal angle was 9 degrees, hallux abductus angle 17 degrees, and first metatarsal declination angle 15 degrees. The average postoperative intermetatarsal angle was 6.6 degrees, hallux abductus angle 10.3 degrees, and first metatarsal declination angle 21.7 degrees. Eighteen patients (22 feet) had a follow-up of over 6 weeks, and the first metatarsophalangeal joint was evaluated. The average gain in postoperative range of motion with weightbearing was 22.3 degrees. PMID:10862387

  18. Hallux valgus and hallux rigidus: a comparison of impact on health-related quality of life in patients presenting to foot surgeons in Australia

    PubMed Central

    Gilheany, Mark F; Landorf, Karl B; Robinson, Priscilla

    2008-01-01

    Background Hallux valgus and hallux rigidus are common foot conditions that lead to a deterioration in health status. Patients with significant pain or deformity from these conditions frequently resort to surgery. In this project, the foot health status of patients with hallux valgus and hallux rigidus presenting to foot surgeons in Australia was compared. Methods Foot health status was measured in 120 participants using the Foot Health Status Questionnaire (FHSQ), a validated 0 – 100 point health status instrument. All participants had presented for surgical advice regarding hallux valgus/rigidus. The mean age of participants was 48.0 years (SD ± 14.3, range 19 – 79). Results In the sample, 68% of participants were diagnosed with hallux valgus and 32% with hallux rigidus. Participants with hallux rigidus had greater levels of pain and functional limitation compared with hallux valgus. The mean difference for pain was 13.8 points (95% CI 4.6 to 22.9) and the mean difference for function was 15.0 points (95% CI 5.3 to 24.7). Both conditions result in similarly negative levels of impact on shoe fit and overall foot health. Conclusion This study found measurable differences in foot health status between hallux valgus and hallux rigidus in participants presenting for surgical consultation. While both appear to have a negative impact on health status, hallux rigidus has a more significant impact. PMID:19077213

  19. Hallux valgus and plantar pressure loading: the Framingham foot study

    PubMed Central

    2013-01-01

    Background Hallux valgus (HV), a common structural foot deformity, can cause foot pain and lead to limited mobility. The purpose of this study was to evaluate differences in plantar pressure and force during gait by HV status in a large population-based cohort of men and women. Methods A trained examiner performed a validated physical examination on participants’ feet and recorded the presence of hallux valgus and other specific foot disorders. Each foot was classified into one of four mutually exclusive groups based on the foot examination. Foot groups were: (i) HV only, (ii) HV and at least one additional foot disorder (FD), (iii) no HV but at least one other FD, and (iv) neither HV nor FD (referent). Biomechanical data for both feet were collected using Tekscan Matscan. Foot posture during quiet standing, using modified arch index (MAI), and foot function during gait, using center of pressure excursion index (CPEI), were calculated per foot. Further, walking scans were masked into eight sub-regions using Novel Automask, and peak pressure and maximum force exerted in each region were calculated. Results There were 3205 participants, contributing 6393 feet with complete foot exam data and valid biomechanical measurements. Participants with HV had lower hallucal loading and higher forces at lesser toes as well as higher MAI and lower CPEI values compared to the referent. Participants with HV and other FDs were also noted to have aberrant rearfoot forces and pressures. Conclusions These results suggest that HV alters foot loading patterns and pressure profiles. Future work should investigate how these changes affect the risk of other foot and lower extremity ailments. PMID:24138804

  20. Gait parameters associated with hallux valgus: a systematic review

    PubMed Central

    2013-01-01

    Background Hallux valgus (HV) has been linked to functional disability and increased falls risk in older adults. However, specific gait alterations in individuals with HV are unclear. This systematic review investigated gait parameters associated with HV in otherwise healthy adults. Methods Electronic databases (Medline, Embase, CINAHL) were searched to October 2011, including cross-sectional studies with clearly defined HV and non-HV comparison groups. Two investigators independently rated studies for methodological quality. Effect sizes (95% confidence intervals (CI)) were calculated as standardized mean differences (SMD) for continuous data and risk ratios (RR) for dichotomous data. Results Nine studies included a total of 589 participants. Three plantar pressure studies reported increased hallux loading (SMD 0.56 to 1.78) and medial forefoot loading (SMD 0.62 to 1.21), while one study found reduced first metatarsal loading (SMD −0.61, CI −1.19 to −0.03) in HV participants. HV participants demonstrated less ankle and rearfoot motion during terminal stance (SMD −0.81 to −0.63) and increased intrinsic muscle activity (RR 1.6, 1.1 to 2.2). Most studies reported no differences in spatio-temporal parameters; however, one study found reduced speed (SMD −0.73, -1.25 to −0.20), step length (SMD −0.66 to −0.59) and less stable gait patterns (SMD −0.86 to −0.78) in older adults with HV. Conclusions HV impacts on particular gait parameters, and further understanding of potentially modifiable factors is important for prevention and management of HV. Cause and effect relationships cannot be inferred from cross-sectional studies, thus prospective studies are warranted to elucidate the relationship between HV and functional disability. PMID:23497584

  1. First metatarsophalangeal arthroscopy in patients with post-traumatic hallux valgus.

    PubMed

    Lui, T H

    2015-12-01

    Post-traumatic hallux valgus is relatively rare and has been reported after rupture of the medial collateral ligament of the first metatarsophalangeal (MTP-1) joint; Lisfranc joint injury; turf toe injury; medial plantar nerve entrapment secondary to tibial fracture or first metatarsal fracture. Post-traumatic hallux valgus after medial collateral ligament injury has a high incidence of MTP-1 pathology. Detailed history and clinical examination can facilitate differentiation of the source(s) of the patient's symptoms and assist accurate formulation of the surgical plan. First, MTP arthroscopy is a feasible diagnostic and therapeutic tool to manage the MTP-1 joint pain in hallux valgus following injury to the MTP-1 joint. PMID:26362238

  2. Clinical usage and influence of radiographs in the assessment of hallux valgus.

    PubMed

    Malik, John; Mathieson, Ian

    2013-01-01

    It has been assumed that radiographs are consistently used in the preoperative evaluation of hallux valgus; however, little information is available to support this assumption. To investigate the frequency of use and clinical utility of radiographs in the assessment of hallux valgus, an online survey was completed by 28 podiatrists in UK departments of podiatric surgery. Radiographs were used in the assessment of hallux valgus in all departments. Of the 28 podiatrists, 61% viewed digital radiographs only, 7% film only, and 32%, a combination of both. Also, 71% routinely took measurements from the radiographs to inform procedure selection. Of those taking measurements, the first intermetatarsal angle was the only measurement used by all participants, followed by the sesamoid position, used by 90%. For those taking measurements, the measurements influenced procedure selection for most cases before surgery, with the procedure site within the first metatarsal moving more proximally as the first metatarsal angle increased. PMID:23415859

  3. Radiological Characteristics and Anatomical Risk Factors in the Evaluation of Hallux Valgus in Chinese Adults

    PubMed Central

    Xu, Hailin; Jin, Kaiji; Fu, Zhongguo; Ma, Mingtai; Liu, Zhongdi; An, Shuai; Jiang, Baoguo

    2015-01-01

    Background: There are no unified theories as to the anatomical changes that occur with hallux valgus, we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults. Methods: We reviewed 141 patients with hallux valgus (206 feet; 15 males, 126 females; mean age, 58.5 years). These patients attended Peking University People's Hospital from April 2008 to March 2014. All feet had intact radiological data, obtained using the Centricity RIS/PACS system. We measured hallux valgus angle (HVA), 1–2 intermetatarsal angle (IMA), proximal articular set angle (PASA), distal articular set angle, hallux interphalangeal angle, metatarsocuneiform angle, size of the medial eminence of the distal first metatarsal, tibial sesamoid position, and joint congruity of the first metatarsophalangeal joint (MTPJ). Results: We found positive correlations between the HVA and IMA (r = 0.279, P < 0.01) and HVA and PASA (r = 0.358, P < 0.01), but not for IMA and PASA (P > 0.05). Feet were divided into three groups based on HVA severity. IMA (P < 0.05) and PASA (P < 0.05) in the mild group were significantly lower than that in the moderate and severe groups, with no significant difference determined for IMA or PASA between the moderate and severe groups (P > 0.05). Feet were then grouped based on the shape of the first metatarsal head. Using this grouping, HVA was significant higher in the rounded shape (19.92°) than in a flat shape (17.66°). The size of the medial eminence of the distal first metatarsal was positively correlated with HVA (r = 0.185, P < 0.01). The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different. Conclusions: PASA enlargement is an adaptive change during early hallux valgus formation, and decompensation leads to subdislocation in the first MTPJ. A rounded first metatarsal head would thus predispose a

  4. Opening wedge osteotomies for correction of hallux valgus: a review of wedge plate fixation.

    PubMed

    Smith, W Bret; Hyer, Christopher F; DeCarbo, William T; Berlet, Gregory C; Lee, Thomas H

    2009-12-01

    Osteotomy of the proximal metatarsal for the correction of moderate to severe hallux valgus deformity is commonly performed. The purpose of this study is to review the early results of a technique for the correction of hallux valgus, an opening wedge osteotomy of the proximal first metatarsal with opening wedge plate fixation. A review was performed of the results of 47 patients (49 feet) who underwent correction of hallux valgus with proximal metatarsal opening wedge osteotomy. All osteotomies were secured with plate fixation on the medial side. Evaluation consisted of preoperative and postoperative radiographic as well as clinical evaluations. Mean corrections of 7 degrees were achieved for the 1-2 intermetatarsal angles. Fourteen complications occurred, 6 of which involved mild hardware irritation and did not affect outcome. Four nonunions or delayed unions were identified. The authors find the opening wedge osteotomy of the proximal first metatarsal to be a technically straightforward procedure for correcting moderate to severe hallux valgus. The correction obtained is comparable to other described techniques. PMID:20400425

  5. A retrospective study of 63 hallux valgus corrections using the osteodesis procedure.

    PubMed

    Wu, Daniel Yiang

    2015-01-01

    Osteotomy procedures have been the most popular approach to hallux valgus deformity correction. Soft tissue approaches have, in general, been regarded as ineffective for moderate and severe hallux valgus deformities. Osteodesis is a soft tissue technique that has been shown to be effective in the past but is still seldom practiced. In the present report, we describe a retrospective study of 63 hallux valgus feet in 36 patients who had undergone the osteodesis procedure. Their mean age was 46 ± 12 years, and the mean follow-up period was 25.4 ± 9.6 months. The surgical technique consisted of metatarsus primus varus deformity correction by intermetatarsal cerclage sutures and hallux valgus deformity correction by rebalancing the ligaments. The first metatarsophalangeal angle improved from a mean of 32.5° ± 7.6° preoperatively to 18.4° ± 7° postoperatively, the first intermetatarsal angle improved from 14.6° ± 2.6° to 6.8° ± 1.8°, and the American Orthopaedic Foot and Ankle Society score improved from 59 ± 14 to 93 ± 8 points. The rate of patient satisfaction after surgery was 92% (33 of 36 patients, 59 of 63 feet). The complications included a second metatarsal stress fracture in 3 feet (5%), metatarsophalangeal joint medial subluxation in 3 feet (5%), and metatarsophalangeal joint stiffness in 5 feet (8%). This soft tissue, nonosteotomy procedure was a safe technique that effectively corrected hallux valgus and metatarsus primus varus deformities of various severities without osteotomy or fusion. PMID:25435009

  6. Evaluation of Hallux Valgus Correction With Versus Without Akin Proximal Phalanx Osteotomy.

    PubMed

    Shibuya, Naohiro; Thorud, Jakob C; Martin, Lanster R; Plemmons, Britton S; Jupiter, Daniel C

    2016-01-01

    Although the efficacy of Akin proximal phalanx closing wedge osteotomy as a sole procedure for correction of hallux valgus deformity is questionable, when used in combination with other osseous corrective procedures, the procedure has been believed to be efficacious. However, a limited number of comparative studies have confirmed the value of this additional procedure. We identified patients who had undergone osseous hallux valgus correction with first metatarsal osteotomy or first tarsometatarsal joint arthrodesis with (n = 73) and without (n = 81) Akin osteotomy and evaluated their radiographic measurements at 3 points (preoperatively, within 3 months after surgery, and ≥6 months after surgery). We found that those people who had undergone the Akin procedure tended to have a larger hallux abduction angle and a more laterally deviated tibial sesamoid position preoperatively. Although the radiographic correction of the deformity was promising immediately after corrective surgery with the Akin osteotomy, maintenance of the correction was questionable in our cohort. The value of additional Akin osteotomy for correction of hallux valgus deformity is uncertain. PMID:27289220

  7. Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach.

    PubMed

    Glasoe, Ward M

    2016-07-01

    Synopsis Hallux valgus is a progressive deformity of the first metatarsophalangeal joint that changes the anatomy and biomechanics of the foot. To date, surgery is the only treatment to correct this deformity, though the recurrence rate is as high as 15%. This clinical commentary provides instruction in a strengthening approach for treatment of hallux valgus deformity, by addressing the moment actions of 5 muscles identified as having the ability to counter the hallux valgus process. Unlike surgery, muscle strengthening does not correct the deformity, but, instead, reduces the pain and associated gait impairments that affect the mobility of people who live with the disorder. This review is organized in 4 parts. Part 1 defines the terms of foot motion and posture. Part 2 details the anatomy and biomechanics, and describes how the foot is changed with deformity. Part 3 details the muscles targeted for strengthening; the intrinsics being the abductor hallucis, adductor hallucis, and the flexor hallucis brevis; the extrinsics being the tibialis posterior and fibularis longus. Part 4 instructs the exercise and reviews the related literature. Instructions are given for the short-foot, the toe-spread-out, and the heel-raise exercises. The routine may be performed by almost anyone at home and may be adopted into physical therapist practice, with intent to strengthen the foot muscles as an adjunct to almost any protocol of care, but especially for the treatment of hallux valgus deformity. J Orthop Sports Phys Ther 2016;46(7):596-605. Epub 6 Jun 2016. doi:10.2519/jospt.2016.6704. PMID:27266887

  8. Radiographic angles in hallux valgus: Comparison between protractor and iPhone measurements.

    PubMed

    Meng, Hong-Zheng; Zhang, Wei-Lin; Li, Xiu-Cheng; Yang, Mao-Wei

    2015-08-01

    Radiographic angles are used to assess the severity of hallux valgus deformity, make preoperative plans, evaluate outcomes after surgery, and compare results between different methods. Traditionally, hallux valgus angle (HVA) has been measured by using a protractor and a marker pen with hardcopy radiographs. The main objective of this study is to compare HVA measurements performed using a smartphone and a traditional protractor. The secondary objective was to compare the time taken between those two methods. Six observers measured major HVA on 20 radiographs of hallux valgus deformity with both a standard protractor and an Apple iPhone. Four of the observers repeated the measurements at least a week after the original measurements. The mean absolute difference between pairs of protractor and smartphone measurements was 3.2°. The 95% confidence intervals for intra-observer variability were ±3.1° for the smartphone measurement and ±3.2° for the protractor method. The 95% confidence intervals for inter-observer variability were ±9.1° for the smartphone measurement and ±9.6° for the protractor measurement. We conclude that the smartphone is equivalent to the protractor for the accuracy of HVA measurement. But, the time taken in smartphone measurement was also reduced. PMID:25763918

  9. Tensile Properties of the Deep Transverse Metatarsal Ligament in Hallux Valgus

    PubMed Central

    Abdalbary, Sahar Ahmed; Elshaarawy, Ehab A.A.; Khalid, Bahaa E.A.

    2016-01-01

    Abstract The deep transverse metatarsal ligament (DTML) connects the neighboring 2 metatarsal heads and is one of the stabilizers connecting the lateral sesamoid and second metatarsal head. In this study, we aimed to determine the tensile properties of the DTML in normal specimens and to compare these results with hallux valgus specimens. We hypothesized that the tensile properties of the DTML would be different between the 2 groups of specimens. The DTML in the first interspace was dissected from 12 fresh frozen human cadaveric specimens. Six cadavers had bilateral hallux valgus and the other 6 cadavers had normal feet. The initial length (L0) and cross-sectional area (A0) of the DTML were measured using a digital caliper, and tensile tests with load failure were performed using a material testing machine. There were significant between-groups differences in the initial length (L0) P = 0.009 and cross-sectional area (A0) of the DTML P = 0.007. There were also significant between-groups differences for maximum force (N) P = 0.004, maximum distance (mm) P = 0.005, maximum stress (N/mm2) P = 0.003, and maximum strain (%) P = 0.006. The DTML is an anatomical structure for which the tensile properties differ in hallux valgus. PMID:26937914

  10. Fact or fiction? Iatrogenic hallux abducto valgus secondary to tibial sesamoidectomy.

    PubMed

    Canales, Michael B; DeMore, Matthew; Bowen, Michael F; Ehredt, Duane J; Razzante, Mark C

    2015-01-01

    First ray function and hallux misalignment after isolated tibial sesamoidectomy have been topics of debate. Although sesamoidectomy has been proved to be effective in the relief of sesamoid pain, many foot and ankle surgeons remain hesitant to perform the procedure fearing a possible joint perturbation. To our knowledge, the present study is the first to evaluate both laboratory and clinical evidence of the association between isolated tibial sesamoidectomy and hallux abducto valgus deformity. The bench study consisted of 10 cadaveric limbs that were dissected and prepared for testing. Controlled valgus loads were applied before and after tibial sesamoidectomy. No significant difference was found in the joint position after sesamoidectomy in both the rectus (p = .36) and the dorsiflexed (p = .062) positions. The clinical evaluation consisted of a retrospective cohort of 5 females; all of whom underwent isolated tibial sesamoidectomy. The pre- and postoperative radiographs and self-reported pain scores (visual analog scale) were compared. None of the patients developed a postoperative hallux abducto valgus deformity. Neither the hallux abductus angle (p = .180) nor the intermetatarsal angle 1-2 (p = .180) changed significantly in the postoperative setting. The visual analog scale pain scores changed from a mean of 6.8 to 1, a significant difference (p = .042). Based on our observations and clinical experience, we believe that isolated tibial sesamoidectomy does not have a significant effect on the position of the first metatarsophalangeal joint when meticulous surgical technique is used to excise the sesamoid. Isolated tibial sesamoidectomy can provide substantial pain relief and appears to be a safe treatment for a variety of conditions affecting the tibial sesamoid. PMID:25441270

  11. [Dynamic plantar pressure distribution after percutaneous hallux valgus correction using the Reverdin-Isham osteotomy].

    PubMed

    Rodríguez-Reyes, Gerardo; López-Gavito, Eduardo; Pérez-Sanpablo, Alberto Isaac; Galván Duque-Gastélum, Carlos; Alvarez-Camacho, Michelín; Mendoza-Cruz, Felipe; Parra-Téllez, Patricia; Vázquez-Escamilla, Jesús; Quiñones-Urióstegui, Ivett

    2014-07-01

    Percutaneous surgical techniques are suitable for the correction of the hallux valgus deformity. Satisfactory aesthetic and functional results obtained with the Reverdin- Isham osteotomy have been reported. The aim of this study was to describe dynamic plantar pressure redistribution after the correction of the deformity using this technique. A sample of 20 feet with mild or moderate hallux valgus was conformed and surgically treated using the Reverdin-Isham osteotomy. Clinical, radiological, surface and pressure assessments were performed pre and postoperatively. Postoperative mean (± SD) values of the American Orthopaedic Foot and Ankle Society (AOFAS) score, metatarsophalangeal, first intermetatarsal and proximal articular sect angles were 95.7 (3.3), 15.5° (5.4), 9.5° (1.5) y 5.3° (3.0), respectively. A significant decrease was observed in surface values of both lateral (P = 0.003) and medial (P = 0.001) masks of the forefoot. Mean pressure values of the lateral forefoot region denoted a significant increase (P < 0.001) while the medial forefoot region showed no change (P = 0.137). There is evidence that this particular surgical technique promotes a new plantar pressure pattern in the foot that might significantly favour the increase of the pressure observed under the lesser metatarsal heads and might not induce meaningful changes in the mean pressure registered under the first metatarsal head and hallux. PMID:25264801

  12. Radiographic Relevance of the Distal Medial Cuneiform Angle in Hallux Valgus Assessment.

    PubMed

    Hatch, Daniel J; Smith, Abigail; Fowler, Troy

    2016-01-01

    The angle formed by the distal articular facet of the medial cuneiform has been evaluated and discussed by various investigators. However, no consistent method has been available to radiograph and measure this entity. The wide variability of the angle is not conducive to comparative analysis. Additionally, investigators have noted that the angles observed (obliquity) vary greatly because of changes in radiographic angle, foot position, rotation of the first ray, and declination of the first metatarsal. Recognizing that these variables exist, we propose a reproducible assessment using digital radiography and application of deformity of correction principles. Our results have indicated a mean distal medial cuneiform angle of 20.69° in normal feet, 23.51° with moderate hallux valgus, and 20.41° with severe hallux valgus deformity. The radiograph beam was kept at 15° from the coronal plane. An inverse relationship was found between the distal medial cuneiform angle and bunion severity. This was in contrast to our expected hypothesis. The overall angle of the first metatarsal-medial cuneiform did, however, correlate with the severity of the bunion deformity (p < .000). The obliquity values and intermetatarsal angles changed in direct relationship to the radiographic projection angle. This illustrates the importance of using standardized radiographic projection angles. We conclude that the 1-dimensional standard anteroposterior radiograph with assessment of the distal medial cuneiform angle cannot adequately demonstrate the pathologic features of hallux valgus. A better indicator appears to be the first metatarsal-medial cuneiform angle. This pathologic entity is a 3-dimensional one that incorporates the joint morphology of the first ray, triplane osseous positioning, and soft tissue imbalances. Perhaps, 3-dimensional computed tomography imaging will provide better insight into this entity. PMID:26359620

  13. Popliteal sciatic nerve block versus spinal anesthesia in hallux valgus surgery

    PubMed Central

    Jeon, Hyun-Jun; Lee, Jong Nam; Bae, Jun-Seok

    2013-01-01

    Background We compared clinical properties and patient satisfaction between spinal anesthesia and popliteal sciatic nerve block (PSNB) for hallux valgus surgery. Methods Forty patients undergoing hallux valgus surgery were divided into spinal group (spinal anesthesia with 2.5 ml of 0.5% bupivacaine [n = 20]) and PSNB group (PSNB with 30 ml of 0.75% ropivacaine mixed with 10 ml of normal saline solution using a nerve stimulator [n = 20]). The PSNB group used a patient-controlled-analgesia (PCA) pump for postoperative pain control. The quality and side effects were compared between the two groups. A questionnaire was used to evaluate patient satisfaction with the use of anesthetic techniques and postoperative pain control in the PSNB group. This study was assessed 3 days postoperatively by a blinded observer. Results Procedure time and time from anesthesia until start of sugery were significantly shorter in the spinal group than those in the PSNB group (P < 0.01). Anesthesia-related complications such as hypotension, bradycardia, shivering, nausea/vomitting, post-dural puncture headache (PDPH) and urinary retension were observed in 15%, 10%, 5%, 5%, 10%, and 20% of patients in the spinal group, respectively. PSNB was not associated with these complications. Patient satisfaction was slightly higher for PSNB than for spinal anesthesia. In the PSNB group, patient satisfaction with postoperative pain-control was 95% above ordinary satisfaction. Conclusions Despite the long duration of the procedure, PSNB is relatively safe, provides an adequate level of anesthesia, effectively controls postoperative pain and reduces side effects. Therefore, PSNB could be a potential anesthetic technique for hallux valgus surgery. PMID:23646241

  14. Footwear modification following hallux valgus surgery: The all-or-none phenomenon

    PubMed Central

    Robinson, Cal; Bhosale, Abhijit; Pillai, Anand

    2016-01-01

    AIM: To define footwear outcomes following hallux valgus surgery, focusing on patient return to comfortable and heeled footwear and patterns of post-operative footwear selection. METHODS: Surgical intervention is indicated for symptomatic cases of hallux valgus unresponsive to conservative methods, with favourable reported outcomes. The return to various types of footwear post-operatively is reflective of the degree of correction achieved, and corresponds to patient satisfaction. Patients are expected to return to comfortable footwear post-operatively without significant residual symptoms. Many female patients will additionally attempt to return to high-heeled, narrow toe box shoes. However, minimal evidence exists to guide their expectations. Sixty-five female hallux valgus patients that had undergone primary surgery between 2011 and 2013 were retrospectively identified using our hospital surgical database. Patients were reviewed using a footwear-specific outcome questionnaire at a mean 18.5 mo follow-up. RESULTS: Eighty-six percent of patients were able to return to comfortable footwear post-operatively with minimal discomfort. Of those intending to resume wearing heeled footwear, 62% were able to do so, with 77% of these patients wearing these as or more frequently than pre-operatively. No significant difference was observed between pre- and post-operative heel size. Mean time to return to heeled footwear was 21.4 wk post-operation. Cosmetic outcomes were very high and did not adversely impact footwear selection. CONCLUSION: We report high rates of return to both comfortable and heeled shoes in female patients following primary hallux valgus surgery. We observed an “all-or-none phenomenon” where patients rejected a return to heeled footwear unless able to tolerate them at the same frequency and heel size as pre-operatively. A minority of patients were unable to return to comfortable footwear post-operatively, which had adverse ramifications on their quality

  15. A New Mini-External Fixator for Treating Hallux Valgus: A Preclinical, Biomechanical Study.

    PubMed

    Erdil, Mehmet; Ceylan, Hasan Huseyin; Polat, Gokhan; Kara, Deniz; Bozdag, Ergun; Sunbuloglu, Emin

    2016-01-01

    Proximal metatarsal osteotomy is the most effective technique for correcting hallux valgus deformities, especially in metatarsus primus varus. However, these surgeries are technically demanding and prone to complications, such as nonunion, implant failure, and unexpected extension of the osteotomy to the tarsometatarsal joint. In a preclinical study, we evaluated the biomechanical properties of the fixator and compared it with compression screws for treating hallux valgus with a proximal metatarsal osteotomy. Of 18 metatarsal composite bone models proximally osteotomized, 9 were fixed with a headless compression screw and 9 with the mini-external fixator. A dorsal angulation of 10° and displacement of 10 mm were defined as the failure threshold values. Construct stiffness and the amount of interfragmentary angulation were calculated at various load cycles. All screw models failed before completing 1000 load cycles. In the fixator group, only 2 of 9 models (22.2%) failed before 1000 cycles, both between the 600th and 700th load cycles. The stability of fixation differed significantly between the groups (p < .001). The stability provided by the mini-external fixator was superior to that of compression screw fixation. Additional testing of the fixator is indicated. PMID:26190777

  16. Correlates of foot pain severity in adults with hallux valgus: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Hallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis. The link between structural HV deformity and foot pain is unclear. This study investigated possible explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of joint degeneration. Methods Participants were 60 adults (53 female) with HV aged 20 to 75 years. Participant demographics and a range of radiographic, clinical and functional measures were considered potential correlates of foot pain. Self-reported foot pain (visual analogue scales and a dichotomous definition) was considered the dependent variable. Multivariate modelling was used to determine which characteristics and measures explained pain, with univariate analyses first used to screen potential variables. Results Approximately 20 to 30% of the variance in foot pain associated with HV could be explained by patient characteristics such as poorer general health status, lower educational attainment and increased occupational physical activity levels, in combination with some dynamic physical characteristics such as hallux plantarflexion weakness and reduced force-time integral under the second metatarsal during gait. Neither increasing lateral deviation of the hallux (HV angle) nor presence of first metatarsophalangeal joint osteoarthritis was associated with foot pain. Conclusions This study shows that passive structural factors, including HV angle, do not appear to be significant correlates of foot pain intensity in HV. Our data demonstrate the importance of considering patient characteristics such as general health and physical activity levels when assessing foot pain associated with HV. PMID:25028598

  17. Hallux Valgus and Lesser Toe Deformities are Highly Heritable in Adult Men and Women: the Framingham Foot Study

    PubMed Central

    Hannan, Marian T.; Menz, Hylton B.; Jordan, Joanne M.; Cupples, L. Adrienne; Cheng, Chia-Ho; Hsu, Yi-Hsiang

    2013-01-01

    Objective To estimate heritability of three common disorders affecting the forefoot: hallux valgus, lesser toe deformities and plantar forefoot soft tissue atrophy in adult Caucasian men and women. Methods Between 2002-2008, a trained examiner used a validated foot exam to document presence of hallux valgus, lesser toe deformities and plantar soft tissue atrophy in 2,446 adults from the Framingham Foot Study. Among these, 1,370 participants with available pedigree structure were included. Heritability (h2) was estimated using pedigree structures by Sequential Oligogenic Linkage Analysis Routines (SOLAR) package. Results were adjusted for age, sex and BMI. Results Mean age of participants was 66 years (range 39 to 99 years) and 57% were female. Prevalence of hallux valgus, lesser toe deformities and plantar soft tissue atrophy was 31%, 29.6% and 28.4%, respectively. Significant h2 was found for hallux valgus (0.29 ~ 0.89, depending on age and sex) and lesser toe deformity (0.49 ~ 0.90 depending on age and sex). The h2 for lesser toe deformity in men and women aged 70+ years was 0.65 (p= 9×10−7). Significant h2 was found for plantar soft tissue atrophy in men and women aged 70+ years (h2 = 0.37; p=3.8×10−3). Conclusion To our knowledge, these are the first findings of heritability of foot disorders in humans, and they confirm the widely-held view that hallux valgus and lesser toe deformities are highly heritable in European-descent Caucasian men and women, underscoring the importance of future work to identify genetic determinants of the underlying genetic susceptibility to these common foot disorders. PMID:23696165

  18. [Analysis of stability and healing on minimally invasive osteotomy for the treatment of hallux valgus].

    PubMed

    Sun, Wei-dong; Wen, Jian-min

    2016-03-01

    To treat hallux valgus, minimally invasive osteotomy on 1st metatarsal neck,immobilization with "8-shape" bandagev was performed, and the effect was definited. The principles of osteotomy stability were analyzed from the osteotomy position, methods, direction and angle. The grinding drill was used to increase friction coefficient between the ends of osteotomy. Correct direction of osteotomy and suitable angle were the key point of stability. The immobilization with "8-shape" bandage complied with the principle of elastic fixation created the conditions for the slight movement of the osteotomy ends. Compared with internal fixation ,it was better on osteotomy healing,and the osteotomy ends were stable and healed with cartilage PMID:27149792

  19. Modified Wilson’s Osteotomy for Hallux Valgus Deformity. A New Approach

    PubMed Central

    Xarchas, Konstantinos C; Mavrolias, Dimitrios; Kyriakopoulos, Georgios

    2014-01-01

    We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson’s osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al., with the final outcome being satisfactory in all of the cases. This set of modifications introduced to the original Wilson’s osteotomy, proved to offer a stable, predictable and satisfactory outcome in all cases and we strongly recommend it. PMID:25352929

  20. Point-Connecting Measurements of the Hallux Valgus Deformity: A New Measurement and Its Clinical Application

    PubMed Central

    Seo, Jeong-Ho; Boedijono, Dimas

    2016-01-01

    Purpose The aim of this study was to investigate new point-connecting measurements for the hallux valgus angle (HVA) and the first intermetatarsal angle (IMA), which can reflect the degree of subluxation of the first metatarsophalangeal joint (MTPJ). Also, this study attempted to compare the validity of midline measurements and the new point-connecting measurements for the determination of HVA and IMA values. Materials and Methods Sixty feet of hallux valgus patients who underwent surgery between 2007 and 2011 were classified in terms of the severity of HVA, congruency of the first MTPJ, and type of chevron metatarsal osteotomy. On weight-bearing dorsal-plantar radiographs, HVA and IMA values were measured and compared preoperatively and postoperatively using both the conventional and new methods. Results Compared with midline measurements, point-connecting measurements showed higher inter- and intra-observer reliability for preoperative HVA/IMA and similar or higher inter- and intra-observer reliability for postoperative HVA/IMA. Patients who underwent distal chevron metatarsal osteotomy (DCMO) had higher intraclass correlation coefficient for inter- and intra-observer reliability for pre- and post-operative HVA and IMA measured by the point-connecting method compared with the midline method. All differences in the preoperative HVAs and IMAs determined by both the midline method and point-connecting methods were significant between the deviated group and subluxated groups (p=0.001). Conclusion The point-connecting method for measuring HVA and IMA in the subluxated first MTPJ may better reflect the severity of a HV deformity with higher reliability than the midline method, and is more useful in patients with DCMO than in patients with proximal chevron metatarsal osteotomy. PMID:26996576

  1. Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

    PubMed

    Choi, Gi Won; Kim, Hak Jun; Kim, Taik Seon; Chun, Sung Kwang; Kim, Tae Wan; Lee, Yong In; Kim, Kyoung Ho

    2016-01-01

    Distal metatarsal osteotomy and the modified McBride procedure have each been used for the treatment of mild to moderate hallux valgus. However, few studies have compared the results of these 2 procedures for mild to moderate hallux valgus. The purpose of the present study was to compare the results of distal chevron osteotomy and the modified McBride procedure for treatment of mild to moderate hallux valgus according to the severity of the deformity. We analyzed the data from 45 patients (49.5%; 48 feet [49.0%]), who had undergone an isolated modified McBride procedure (McBride group), and 46 patients (50.5%; 50 feet [51.0%]), who had a distal chevron osteotomy (chevron group). We subdivided each group into those with mild and moderate deformity and compared the clinical and radiologic outcomes between the groups in relation to the severity of the deformity. The improvements in the American Orthopaedic Foot and Ankle Society scale score and the visual analog scale for pain were significantly better for the chevron group for both mild and moderate deformity. The chevron group experienced significantly greater correction in the hallux valgus angle and intermetatarsal angle for both mild and moderate deformity. The chevron group experienced a significantly greater decrease in the grade of sesamoid displacement for patients with moderate deformity. The McBride group had a greater risk of recurrence than did the chevron group for moderate deformity (odds ratio 14.00, 95% confidence interval 3.91 to 50.06, p < .001). The results of the present study have demonstrated the superiority of the distal chevron osteotomy over the modified McBride procedure for mild to moderate deformity. For patients with moderate deformity, the McBride group had a greater risk of hallux valgus recurrence than did the distal chevron group. Therefore, we recommend distal chevron osteotomy rather than a modified McBride procedure for the treatment of mild and moderate hallux valgus. PMID

  2. A comparison of hallux valgus angles assessed with computerised plantar pressure measurements, clinical examination and radiography in patients with diabetes

    PubMed Central

    2014-01-01

    Background Hallux valgus deformity is a common musculoskeletal foot disorder with a prevalence of 3.5% in adolescents to 35.7% in adults aged over 65 years. Radiographic measurements of hallux valgus angles (HVA) are considered to be the most reproducible and accurate assessment of HVA. However, in European countries, many podiatrists do not have direct access to radiographic facilities. Therefore, alternative measurements are desired. Such measurements are computerised plantar pressure measurement and clinical goniometry. The purpose of this study was to establish the agreement of these techniques and radiographic assessments. Methods HVA was determined in one hundred and eighty six participants suffering from diabetes. Radiographic measurements of HVA were performed with standardised static weight bearing dorsoplantar foot radiographs. The clinical goniometry for HVA was measured with a universal goniometer. Computerised plantar pressure measurement for HVA was executed with the EMED SF-4® pressure platform and Novel-Ortho-Geometry software. The intra-class correlation coefficients (ICC) and levels of agreement were analysed using Bland & Altman plots. Results Comparison of radiographic measurements to clinical goniometry for HVA showed an intraclass correlation coefficient (ICC) of 0.81 (95% confidence interval, 0.76 to 0.86; p<0.001). Radiographic measurement versus computerised plantar pressure measurement showed an ICC of 0.59 (95% confidence interval, 0.49 to 0.68; p<0.001). In addition, clinical goniometry versus computerised plantar pressure measurement showed an ICC of 0.77 (95% confidence interval, 0.70 to 0.82; p<0.001). The systematic difference of the computerised plantar pressure measurement compared with radiographic measurement and clinical goniometry was 7.0 degrees (SD 6.8) and 5.2 degrees (SD 5.0), respectively. The systemic difference of radiographic measurements compared with clinical goniometry was 1.8 degrees (SD 5.0). Conclusions The

  3. Foot pain and functional limitation in healthy adults with hallux valgus: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Hallux valgus (HV) is a very common deformity of the first metatarsophalangeal joint that often requires surgical correction. However, the association between structural HV deformity and related foot pain and disability is unclear. Furthermore, no previous studies have investigated concerns about appearance and difficulty with footwear in a population with HV not seeking surgical correction. The aim of this cross-sectional study was to investigate foot pain, functional limitation, concern about appearance and difficulty with footwear in otherwise healthy adults with HV compared to controls. Methods Thirty volunteers with HV (radiographic HV angle >15 degrees) and 30 matched controls were recruited for this study (50 women, 10 men; mean age 44.4 years, range 20 to 76 years). Differences between groups were examined for self-reported foot pain and disability, satisfaction with appearance, footwear difficulty, and pressure-pain threshold at the first metatarsophalangeal joint. Functional measures included balance tests, walking performance, and hallux muscle strength (abduction and plantarflexion). Mean differences (MD) and 95% confidence intervals (CI) were calculated. Results All self-report measures showed that HV was associated with higher levels of foot pain and disability and significant concerns about appearance and footwear (p < 0.001). Lower pressure-pain threshold was measured at the medial first metatarsophalangeal joint in participants with HV (MD = −133.3 kPa, CI: -251.5 to −15.1). Participants with HV also showed reduced hallux plantarflexion strength (MD = −37.1 N, CI: -55.4 to −18.8) and abduction strength (MD = −9.8 N, CI: -15.6 to −4.0), and increased mediolateral sway when standing with both feet with eyes closed (MD = 0.34 cm, CI: 0.04 to 0.63). Conclusions These findings show that HV negatively impacts on self-reported foot pain and function, and concerns about foot appearance and footwear in otherwise healthy adults. There

  4. Traumeel S® for pain relief following hallux valgus surgery: a randomized controlled trial

    PubMed Central

    2010-01-01

    Background In spite of recent advances in post-operative pain relief, pain following orthopedic surgery remains an ongoing challenge for clinicians. We examined whether a well known and frequently prescribed homeopathic preparation could mitigate post-operative pain. Method We performed a randomized, double blind, placebo-controlled trial to evaluate the efficacy of the homeopathic preparation Traumeel S® in minimizing post-operative pain and analgesic consumption following surgical correction of hallux valgus. Eighty consecutive patients were randomized to receive either Traumeel tablets or an indistinguishable placebo, and took primary and rescue oral analgesics as needed. Maximum numerical pain scores at rest and consumption of oral analgesics were recorded on day of surgery and for 13 days following surgery. Results Traumeel was not found superior to placebo in minimizing pain or analgesic consumption over the 14 days of the trial, however a transient reduction in the daily maximum post-operative pain score favoring the Traumeel arm was observed on the day of surgery, a finding supported by a treatment-time interaction test (p = 0.04). Conclusions Traumeel was not superior to placebo in minimizing pain or analgesic consumption over the 14 days of the trial. A transient reduction in the daily maximum post-operative pain score on the day of surgery is of questionable clinical importance. Trial Registration This study was registered at ClinicalTrials.gov. # NCT00279513 PMID:20380750

  5. Effects of hallux valgus deformity on rear foot position, pain, function, and quality of life of women

    PubMed Central

    Coşkun, Gürsoy; Talu, Burcu; Bek, Nilgün; Bayramlar, Kezban Yigiter

    2016-01-01

    [Purpose] To investigate the relationship between hallux valgus (HV) deformity and the position of rearfoot joints, and its effects on the quality of life, pain, and related functional status of women with bilateral hallux valgus (HV). [Subjects and Methods] The subjects were 27 right-dominant women. Demographic data, HV angle, weight-bearing and non-weight-bearing subtalar pronation (SP), and navicular height were recorded. Visual Analog Pain Scale, Foot Function Index (FFI), and the American Orthopaedic Foot and Ankle Society (AOFAS) first metatarsophalangeal- interphalangeal (MTP-IP) and AOFAS Mid foot (MF) Scales, and SF-36 were also used. [Results] HV angle, weight-bearing SP, and pain intensity of the left foot were higher. HV angle of left foot was correlated with all sub-scales of FFI, the pain parameter of AOFAS MTP-IP, and pain and total scores of AOFAS-MF Scale. HV angle of the left foot correlated with physical role, pain, and social function sub-domains of SF-36. Right HV angles were correlated with right foot pain and non-weight-bearing SP. [Conclusion] Increasing HV angle and pathomechanical changes in the rear foot are correlated, resulting in increasing pain and thus decreasing functional status as well as decreasing quality of life. Although all the participants were right-dominant, their left foot problems were more prominent. PMID:27134358

  6. Effects of hallux valgus deformity on rear foot position, pain, function, and quality of life of women.

    PubMed

    Coşkun, Gürsoy; Talu, Burcu; Bek, Nilgün; Bayramlar, Kezban Yigiter

    2016-03-01

    [Purpose] To investigate the relationship between hallux valgus (HV) deformity and the position of rearfoot joints, and its effects on the quality of life, pain, and related functional status of women with bilateral hallux valgus (HV). [Subjects and Methods] The subjects were 27 right-dominant women. Demographic data, HV angle, weight-bearing and non-weight-bearing subtalar pronation (SP), and navicular height were recorded. Visual Analog Pain Scale, Foot Function Index (FFI), and the American Orthopaedic Foot and Ankle Society (AOFAS) first metatarsophalangeal- interphalangeal (MTP-IP) and AOFAS Mid foot (MF) Scales, and SF-36 were also used. [Results] HV angle, weight-bearing SP, and pain intensity of the left foot were higher. HV angle of left foot was correlated with all sub-scales of FFI, the pain parameter of AOFAS MTP-IP, and pain and total scores of AOFAS-MF Scale. HV angle of the left foot correlated with physical role, pain, and social function sub-domains of SF-36. Right HV angles were correlated with right foot pain and non-weight-bearing SP. [Conclusion] Increasing HV angle and pathomechanical changes in the rear foot are correlated, resulting in increasing pain and thus decreasing functional status as well as decreasing quality of life. Although all the participants were right-dominant, their left foot problems were more prominent. PMID:27134358

  7. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus

    PubMed Central

    López, Daniel López; Callejo González, Lucía; Iglesias, Marta Elena Losa; Canosa, Jesús Luis Saleta; Sanz, David Rodríguez; Lobo, Cesar Calvo; de Bengoa Vallejo, Ricardo Becerro

    2016-01-01

    Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health. The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (P<0.05) and there were no differences of physical activity (62.81 ± 24.6). Often, quality of life decreases in the elderly population based in large part on their foot health. There is a progressive reduction in health in general and foot health with increasing severity of hallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender. PMID:26816663

  8. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus.

    PubMed

    López, Daniel López; Callejo González, Lucía; Losa Iglesias, Marta Elena; Canosa, Jesús Luis Saleta; Sanz, David Rodríguez; Lobo, Cesar Calvo; Becerro de Bengoa Vallejo, Ricardo

    2016-01-01

    Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health. The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (P<0.05) and there were no differences of physical activity (62.81 ± 24.6). Often, quality of life decreases in the elderly population based in large part on their foot health. There is a progressive reduction in health in general and foot health with increasing severity of hallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender. PMID:26816663

  9. Functional restoration and risk of non-union of the first metatarsocuneiform arthrodesis for hallux valgus: A finite element approach.

    PubMed

    Wai-Chi Wong, Duo; Wang, Yan; Zhang, Ming; Kam-Lun Leung, Aaron

    2015-09-18

    First metatarsocuneiform arthrodesis is one of the surgical interventions to correct hallux valgus, especially those with hypermobile first ray. There is lacking of biomechanical investigations to assess this operation. The objective of this study was to explore the functional restoration and the risk of non-union after the surgery via finite element analysis. A three-dimensional foot model was constructed from a female aged 28 via magnetic resonance imaging. Thirty bones and encapsulated bulk tissue were modeled. Walking stance was simulated by the gait analysis data of the same participant. Parts of the first metatarsal and cuneiform were resected and the bone graft was assigned with the same stiffness as adjacent bones to resemble the surgery of first metatarsocuneiform arthrodesis. The third principal stress of the first metatarsal at midstance (25% stance) and push off (60% stance) was increased by 76% and 139% respectively after the operation, while that of the second metatarsal was decreased by 14% and 66%. The operation reduced the medial deviation of the first metatarsal head by about 3.5mm during initial push off (60% stance). Besides, the bone graft could experience tensile stress inferiorly (26.51MPa). In conclusion, the increase of stress on the first metatarsal and the reduced medial excursion of the first metatarsal head after the simulated operation reflected that metatarsocuneiform arthrodesis could restore the load-bearing function of the first ray. However, inter-fragmentary compression could not be guaranteed. The appropriate course of hardware and non-weight-bearing protocol should be noted and further investigated. PMID:26243661

  10. Factors Associated with Hallux Valgus in a Community-Based Cross-Sectional Study of Adults with and without Osteoarthritis

    PubMed Central

    Golightly, Yvonne M.; Hannan, Marian T.; Dufour, Alyssa B.; Renner, Jordan B.; Jordan, Joanne M.

    2014-01-01

    Objective To determine whether hallux valgus (HV) was associated with potential risk factors including foot pain in a large, bi-racial cohort of older men and women. Methods We conducted a cross-sectional analysis of cohort members of the Johnston County Osteoarthritis Project of whom 1,502 had complete clinical and demographic data available (mean age 68 years, mean body mass index [BMI] 31.3 kg/m2, 68% women, 30% African American). The presence of HV was assessed visually using a validated examination. Multivariate logistic regression models with generalized estimating equations for the total sample and for each sex and race subgroup were used to examine the effect of age, BMI, foot pain, pes planus, and knee or hip radiographic osteoarthritis (OA) on HV. Results HV was present in 64% of the total sample (African American men=69%, African American women=70%, Caucasian men=54%, Caucasian women=65%). The association between HV and foot pain was elevated but not statistically significant (adjusted odds ratio [aOR] 1.21, 95% confidence interval 0.99, 1.47). Women, African American, older individuals, and those with pes planus or knee/hip OA had significantly higher odds of HV (aORs 1.17–1.48). Participants with higher BMI had lower odds of HV compared to those with normal BMI (aORs 0.54–0.72). Overall, patterns of associations were similar across subgroups. Conclusion HV was associated with female sex, African American race, older age, pes planus, and knee/hip OA and inversely associated with higher BMI. Early prevention and intervention approaches may be needed in high-risk groups; longitudinal studies would inform these approaches. PMID:25418024

  11. Bunions (Hallux Abducto Valgus)

    MedlinePlus

    ... Search by GPS Please enter a city or last name. Use your current position? {{ps.position.alert.message}} ... digit zip code. Please enter a city or last name. Search Where do you hurt? Interactive Foot Diagram ...

  12. Bunions (Hallux Abducto Valgus)

    MedlinePlus

    ... visible bump actually reflects changes in the bony framework of the front part of the foot. The ... or side of the foot. However, to fully evaluate the condition, the foot and ankle surgeon may ...

  13. Hallux metatarsophalangeal arthritis.

    PubMed

    Weinfeld, S B; Schon, L C

    1998-04-01

    Arthritis of the hallux metatarsophalangeal joint is a common disorder that affects shoewear, ambulation, and other activities of daily living. Etiologies include degenerative arthritis (hallux rigidus), crystal induced arthropathy (gout, pseudogout), rheumatoid arthritis, the seronegative spondyloathropathies, posttraumatic degeneration, and advanced hallux valgus. Accurate diagnosis and selection of the appropriate intervention depends on recognition of pertinent clinical and radiographic features. This study presents a synopsis of the senior author's (LCS) experience with 439 surgically treated patients with hallux metatarsophalangeal arthritis, focusing on origin and treatment. PMID:9584362

  14. EVALUATION OF THE INTERMETATARSAL ANGLE AFTER THE ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT FOR TREATMENT OF THE HALLUX VALGUS

    PubMed Central

    Costa, Marco Túlio; Neto, Douglas Lobato Lopes; Kojima, Fábio Henrique; Ferreira, Ricardo Cardenuto

    2015-01-01

    Objective: To evaluate the correction of the intermetatarsal angle after arthrodesis of the metatarsophalangeal joint of the hallux. We believe that varus deformity of the first metatarsal can be corrected after arthrodesis of the first metatarsophalangeal joint, without the need for proximal osteotomy. Methods: Forty-three feet of patients who had undergone arthrodesis of the first metatarsophalangeal joint between May 1997 and October 2009 were retrospectively analyzed by means of radiographs. The mean length of follow-up was 58 months. Measurements on the metatarsophalangeal angle, intermetatarsal angle and sesamoid dislocation were made using radiographs made before, immediately after and later on after the operation. Results: The mean metatarsophalangeal angle was 37.6 degrees preoperatively, 12.8 degrees immediately after the operation and 16.4 degrees later on after the operation. The mean intermetatarsal angle was 16 degrees preoperatively, 10 degrees immediately after the operation and 10.2 degrees later on after the operation. Regarding sesamoid dislocation, preoperative radiographs showed most feet to be classified as G3; immediately after the operation, most were classified as G2; and later on after the operation, most were G1. Conclusion: The intermetatarsal angle and sesamoid dislocation improved with arthrodesis of the first metatarsophalangeal joint, without the need for osteotomy at the base of the first metatarsal. PMID:27042648

  15. Genome-Wide Association Meta-Analyses to Identify Common Genetic Variants Associated with Hallux Valgus in Caucasian and African Americans

    PubMed Central

    Hsu, Yi-Hsiang; Liu, Youfang; Hannan, Marian T.; Maixner, William; Smith, Shad B.; Diatchenko, Luda; Golightly, Yvonne M.; Menz, Hylton B.; Kraus, Virginia B.; Doherty, Michael; Wilson, A.G.; Jordan, Joanne M.

    2016-01-01

    Objective Hallux valgus (HV) affects ~36% of Caucasian adults. Although considered highly heritable, the underlying genetic determinants are unclear. We conducted the first genome-wide association study (GWAS) aimed to identify genetic variants associated with HV. Methods HV was assessed in 3 Caucasian cohorts (n=2,263, n=915, and n=1,231 participants, respectively). In each cohort, a GWAS was conducted using 2.5M imputed single nucleotide polymorphisms (SNPs). Mixed-effect regression with the additive genetic model adjusted for age, sex, weight and within-family correlations was used for both sex-specific and combined analyses. To combine GWAS results across cohorts, fixed-effect inverse-variance meta-analyses were used. Following meta-analyses, top-associated findings were also examined in an African American cohort (n=327). Results The proportion of HV variance explained by genome-wide genotyped SNPs was 50% in men and 48% in women. A higher proportion of genetic determinants of HV was sex-specific. The most significantly associated SNP in men was rs9675316 located on chr17q23-a24 near the AXIN2 gene (p=5.46×10−7); the most significantly associated SNP in women was rs7996797 located on chr13q14.1-q14.2 near the ESD gene (p=7.21×10−7). Genome-wide significant SNP-by-sex interaction was found for SNP rs1563374 located on chr11p15.1 near the MRGPRX3 gene (interaction p-value =4.1×10−9). The association signals diminished when combining men and women. Conclusion Findings suggest that the potential pathophysiological mechanisms of HV are complex and strongly underlined by sex-specific interactions. The identified genetic variants imply contribution of biological pathways observed in osteoarthritis as well as new pathways, influencing skeletal development and inflammation. PMID:26337638

  16. Scarf versus chevron osteotomy for the correction of 1-2 intermetatarsal angle in hallux valgus: a systematic review and meta-analysis.

    PubMed

    Smith, Simon E; Landorf, Karl B; Butterworth, Paul A; Menz, Hylton B

    2012-01-01

    The chevron and scarf osteotomies are commonly used for the surgical management of hallux valgus (HV). However, there is debate as to whether one osteotomy provides more 1-2 intermetatarsal (1-2 IMA) correction than the other. The objective of this systematic review and meta-analysis was to compare the effectiveness of 3 types of first metatarsal osteotomy for reducing the 1-2 IMA in HV correction: the chevron osteotomy, the long plantar arm (modified) chevron osteotomy, and the scarf osteotomy. A systematic search for eligible studies was performed of the following databases: Medline, Embase (Ovid), CINAHL (EBSCO Host), and The Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Clinical Trials. Only English-language studies previous to May 2010 were included in the review. Additional hand and electronic content searches of relevant foot and orthopaedic journals were performed. Criteria for inclusion in this analysis included systematic reviews of randomized controlled trials, prospective and retrospective cohort studies, and case-control studies, as well as case-series studies involving the chevron, scarf, or long plantar arm chevron osteotomy of >20 participants with a minimum of 80% follow-up. Quality of evidence of the included studies was assessed with the Grading of Recommendations Assessment, Development and Evaluation system. All pooled analyses were based on a fixed effects model. There was a total of 1351 participants who underwent either a chevron (n = 1028), scarf (n = 300), or long plantar arm chevron osteotomy (n = 23). Only one study for the long plantar arm chevron group fitted the eligibility criteria for this review; however, it was not amenable to meta-analysis. The chevron osteotomy was associated with a mean reduction of 1-2 IMA from preoperative to postoperative of 5.33° (95% confidence interval, 5.12 to 5.54, p < .001), and the scarf osteotomy was associated with a mean reduction of 6.21° (95% confidence

  17. The correlation between calcaneal valgus angle and asymmetrical thoracic-lumbar rotation angles in patients with adolescent scoliosis.

    PubMed

    Park, Jaeyong; Lee, Sang Gil; Bae, Jongjin; Lee, Jung Chul

    2015-12-01

    [Purpose] This study aimed to provide a predictable evaluation method for the progression of scoliosis in adolescents based on quick and reliable measurements using the naked eye, such as the calcaneal valgus angle of the foot, which can be performed at public facilities such as schools. [Subjects and Methods] Idiopathic scoliosis patients with a Cobb's angle of 10° or more (96 females, 22 males) were included in this study. To identify relationships between factors, Pearson's product-moment correlation coefficient was computed. The degree of scoliosis was set as a dependent variable to predict thoracic and lumbar scoliosis using ankle angle and physique factors. Height, weight, and left and right calcaneal valgus angles were set as independent variables; thereafter, multiple regression analysis was performed. This study extracted variables at a significance level (α) of 0.05 by applying a stepwise method, and calculated a regression equation. [Results] Negative correlation (R=-0.266) was shown between lumbar lordosis and asymmetrical lumbar rotation angles. A correlation (R=0.281) was also demonstrated between left calcaneal valgus angles and asymmetrical thoracic rotation angles. [Conclusion] Prediction of scoliosis progress was revealed to be possible through ocular inspection of the calcaneus and Adams forward bending test and the use of a scoliometer. PMID:26834376

  18. Hallux rigidus

    PubMed Central

    Brantingham, James W.; Wood, Timothy G.

    2002-01-01

    Abstract Hallux rigidus is a common problem of the first metatarsophalangeal joint and is particularly common in the 31–69 year old age group. Loss of articular cartilage narrowing of joint space and formation of periarticular osteophytes are present and increase over time, often leading to palpable osteophyte formation. The authors suggest that a diagnosis of hallux rigidus be made if at least 4 of the following are present at the big toe: pain, stiffness, palpable exostosis, positive X-ray findings, positive axial grind test, occasional synovitis, decreased motion on motion palpation (particularly dorsiflexion). This case study follows a 36-year-old male professional tennis player over a 7 year period under various forms of management including orthopaedic, physical therapy and chiropractic care. Initial surgery provided some relief, subsequent physiotherapy did not significantly reduce the patient's pain while chiropractic manipulation and mobilization on two separate occasions provided marked reduction in pain scores. NSAID usage and “punching out” his shoes also provided some relief. There is a reasonable possibility that general foot and big toe mobilization and the Brantingham “protective” big toe manipulation may reduce the pain of hallux rigidus. A randomized-controlled study should be done to ascertain the efficacy of such a treatment protocol. PMID:19674557

  19. Hallux valgus—a case for a physiotherapist or only for a surgeon? Literature review

    PubMed Central

    Mortka, Kamila; Lisiński, Przemysław

    2015-01-01

    [Purpose] Hallux valgus is one of the most common deformations of the human foot, and it causes great difficulties for the patients. The aim of this paper was to review available medical literature in search of evidence which would justify implementation of physiotherapy, based on its effectiveness for patients with hallux valgus. [Subjects and Methods] The following databases were searched for applicable papers: PubMed, Google Scholar, Clinical Key and UpToDate. Full-text articles from the last 15 years were subjected to a review, which ultimately selected seven papers about hallux valgus therapy published over the past 12 years. These studies were grouped according to their design and level of evidence and classified depending on whether they concerned physiotherapy as postoperative therapy or as the only treatment. [Results] The studies included in the present analysis used the following interventions for patients with hallux valgus: exercise, manual therapy, gait training, taping and orthosis. All the studies showed beneficial effects and the most frequently observed results were reductions in pain and improvements in function. [Conclusion] The evidence found in the reviewed materials clearly indicates that patients with hallux valgus should not only be subject to surgical procedures but also undergo physiotherapeutic treatment. PMID:26644698

  20. Radiologic Patterning of Hallux Deformity in Rheumatoid Arthritis and Its Relationship to Flatfoot.

    PubMed

    Matsumoto, Takumi; Nakada, Izumi; Juji, Takuo; Nakamura, Ichiro; Ito, Katsumi

    2016-01-01

    Hallux deformities other than hallux valgus, especially those in the sagittal plane, have not yet been elucidated in the feet of patients with rheumatoid arthritis. The objectives of the present study were to classify rheumatoid arthritis hallux deformity in both the horizontal and the sagittal planes and investigate its relationship with flatfoot. Using a cross-sectional study design, we assessed patients with rheumatoid arthritis (527 feet in 274 patients) using radiographs and classified the deformity patterns of the great toes using cluster analysis. Of the 274 patients, the range of motion in the metatarsophalangeal joint was clinically investigated in 44 (16.1%) patients. The great toes could be divided into 5 clusters according to the characteristic configuration as follows: cluster I (normal type), cluster II (hallux valgus type), cluster III (boutonniere type), cluster IV (boutonniere with hallux valgus type), and cluster V (swan-neck type). Radiographic measurements revealed the characteristic deformities of each cluster, including splayed foot for cluster II; flat foot, metatarsal primus elevatus, and plantar displacement of the proximal phalanx for cluster III; and a mixture of these characteristics for cluster IV. Plantar displacement of the proximal phalanx, which was a specific characteristic of the boutonniere deformity, correlated significantly with the decreased dorsiflexion in the metatarsophalangeal joint. Our classification method revealed the relationship of hallux deformity in the sagittal plane to flatfoot and also demonstrated the usefulness of measuring basal phalanx displacement in predicting the range of motion of the metatarsophalangeal joint. PMID:27289217

  1. Cheilectomy for Hallux Rigidus.

    PubMed

    Razik, Aisha; Sott, A H

    2016-09-01

    Hallux rigidus is a degenerative condition leading to arthritis of the first metatarsophalangeal joint. Cheilectomy is a surgical procedure that is used in the treatment of hallux rigidus. It removes dorsal and dorsomedial or dorsolateral osteophytes, primarily relieving the impingement at the first metatarsophalangeal joint, which causes patients pain. The minimally invasive technique has proven to be an excellent technique to remove bony spurs to relieve symptoms with minimal surgical complications and fast recovery time. PMID:27524700

  2. Continuous passive motion as an alternative treatment for iatrogenic hallux limitus.

    PubMed

    Connor, J C; Berk, D M

    1994-01-01

    The use and effect of continuous passive motion (CPM) was evaluated for 10 patients suffering from iatrogenic hallux limitus. All patients had previous hallux valgus corrective surgery. After their initial evaluation, patients were instructed to begin CPM therapy at home for a minimum of 4 hr. a day and were instructed to increase range of motion (ROM) as tolerated. CPM was used for 4 weeks. ROM was measured on day 0, 28, 48, 90. There were significant increases in mean extension (p < 0.025) and mean flexion (p < 0.05). All patients reported a decrease in pain and stiffness of the first metatarsophalangeal joint. Seven of the 10 patients treated with CPM had increases in ROM. Three patients, all of whom had first metatarsal elevatus, required an additional surgical procedure. Patients suffering from iatrogenic hallux limitus with no associated first metatarsal elevatus can utilize CPM as a viable alternative to return to functional ROM. PMID:8019541

  3. Tendon insertion at the base of the proximal phalanx of the hallux: surgical implications.

    PubMed

    Becerro de Bengoa Vallejo, Ricardo; Losa Iglesias, Marta Elena; Jules, Kevin T

    2012-01-01

    Hallux valgus, limitus, and rigidus are conditions affecting the first metatarsophalangeal joint that can be treated by arthroplasty. Excessive arthroplasty can compromise the insertion of the tendons at the base of the proximal phalanx of the hallux, leading to first metatarsophalangeal joint plantarflexion weakness, cock-up toe deformity, and altered forefoot loading. The present study investigated the anatomic length of insertion of the medial and lateral flexor hallucis brevis, extensor hallucis brevis, abductor hallucis, and adductor hallucis tendons into the base of the hallux proximal phalanx and the amount of bone that can be safely resected without compromising the insertional limits. A total of 43 specimens (22 right and 21 left) from 22 embalmed cadavers (11 male and 11 female) were dissected. The insertion lengths of the 5 tendons were measured, along with the dimensions of the hallux proximal phalanx. No statistically significant differences were found in any proximal phalanx measurements or tendon insertion lengths according to side (p > .05). Significant differences were found between the genders in most dimensions of the hallux proximal phalanx (p < .05). The medial insertion site, where the medial flexor brevis tendon and distal abductor hallucis muscle join, was longer than the lateral site (p < .001). To preserve the tendon's insertion, hallux proximal phalanx resection should not exceed 3 mm. Resection of the tendons is ensured by removal of more than 7.88 mm and 9.37 mm in females and males, respectively. When performing hallux arthroplasty of the first metatarsophalangeal joint, we recommend calculating the length of the tendon insertions, instead of the length of the hallux proximal phalanx. PMID:22789484

  4. Unilobed Rotational Flap for Plantar Hallux Interphalangeal Joint Ulceration Complicated by Osteomyelitis.

    PubMed

    Boffeli, Troy J; Hyllengren, Shelby B

    2015-01-01

    Diabetes-related neuropathic ulcers located at the plantar aspect of the hallux interphalangeal joint are often chronic or recurrent and frequently become complicated by osteomyelitis. Once infected, treatment will typically involve hallux amputation. Although intended as a definitive procedure, amputation of the first toe is not desirable from a cosmetic or functional standpoint and often leads to transfer ulcers at adjacent locations of the foot. Reconstructive wound surgery, combined with limited bone resection, is possible if the infection is caught early before the local tissue and bone have become necrotic. In addition to neuropathy, biomechanical issues, including ankle equinus, hallux limitus, hallux extensus, and hallux valgus, predispose patients with diabetes mellitus to developing plantar hallux ulcers. We commonly employ a proximal based unilobed plantar rotational flap combined with hallux interphalangeal joint arthroplasty as an alternative to hallux amputation. We present a typical case with long-term follow-up to highlight our flap protocol, including patient selection criteria, flap design, surgical technique, bone resection and biopsy pearls, staging timeline, and a typical postoperative course. Periodic follow-up during the next 72 months for unrelated conditions allowed long-term monitoring with no recurrence of osteomyelitis or subsequent amputation. The foot remained ulcer free 6 years later. The benefits of this surgical approach include complete excision of the ulcer, adequate exposure for bone resection, early bone biopsy before the spread of infection or necrosis of local tissue, flap coverage with viable soft tissue, and partial offloading of mechanical pressure at the plantar interphalangeal joint. PMID:25681281

  5. Moberg Osteotomy for Hallux Rigidus.

    PubMed

    Warganich, Tibor; Harris, Thomas

    2015-09-01

    Hallux rigidus is a common cause of pain and decreased range of motion of the first metatarsophalangeal joint, notably with loss of dorsiflexion. Hallux rigidus is the second most common disorder affecting the great toe. The primary cause of hallux rigidus is thought to be a traumatic event, a culmination of microtrauma, or an alteration in kinematics leading to a loss of articular cartilage and dorsal osteophyte formation. Surgical treatments include Moberg osteotomy, also referred to as a proximal phalanx extension osteotomy. This article discusses current techniques, developments, complications, outcomes, and management of the Moberg osteotomy. PMID:26320558

  6. Hallux Rigidus: Relevant Anatomy and Pathophysiology.

    PubMed

    Lucas, Douglas E; Hunt, Kenneth J

    2015-09-01

    Hallux rigidus is a painful condition of the great toe characterized by restriction of the metatarsophalangeal joint arc of motion and progressive osteophyte formation. Precise cause of hallux rigidus remains under debate. Anatomic variations and historical, clinical, and radiographic findings have been implicated in the development and progression of hallux rigidus. Radiologic findings associated with hallux rigidus include metatarsal head osteochondral defects, altered metatarsal head morphology, and an elevated hallux interphalangeus angle measure. Associated historical findings include a positive family history and history of trauma to the joint. An understanding of relevant anatomy and pathophysiology is essential during the approach to hallux rigidus treatment. PMID:26320553

  7. Modified Youngswick procedure for hallux limitus.

    PubMed

    Radovic, Philip; Yadav-Shah, Ekta; Choe, Ki

    2007-01-01

    Multiple surgical procedures have been described for the correction of hallux limitus deformity. We describe a new modification of the Youngswick procedure for the surgical treatment of hallux limitus. Other procedures for hallux limitus correction are also discussed. This modified Youngswick procedure will provide a new approach to treating hallux limitus secondary to metatarsus primus elevatus when shortening of the first metatarsal is not indicated. PMID:17901350

  8. Functional hallux limitus: a review.

    PubMed

    Durrant, Beverley; Chockalingam, Nachiappan

    2009-01-01

    Functional hallux limitus is defined as a functional inability of the proximal phalanx of the hallux to extend on the first metatarsal head during gait. The theory concerning this anomaly and the altered gait characteristics that may result appears to have influenced the understanding of sagittal plane podiatric biomechanics. Although there is an increase in the body of evidence to support the proposed gait alterations, a detailed review suggests the need for further work. The aim of this article is to review the functional hallux limitus literature and its reported effects on gait. Furthermore, we explore some of the key and inherent problems with obtaining accurate data for joint motion measurement in the foot. With evidence-based practice now at the forefront of both clinical and academic practice, it is imperative to review the literature that underpins a particular commonly held or historical belief, in order to substantiate and validate subsequent diagnoses and treatments provided in light of this information. This is also true to advance the understanding of a particular anomaly or pathology and to inform so as to facilitate the provision of better care to patients. PMID:19448175

  9. Therapeutic Management of the Hallux Rigidus

    PubMed Central

    Aggarwal, Anoop; Kumar, Suraj; Kumar, Ratnesh

    2012-01-01

    Background. Hallux rigidus is a chronic, disabling condition of foot characterized by reduced great toe extension. The manual therapy approaches are described theoretically however their practical published evidence has not been analyzed well. Objective. Aim of the present paper was to systematically review the literature available for therapeutic management of the hallux rigidus by identifying and evaluating the randomized controlled trials (RCTs) and non-RCTs. Methods. To view the hallux rigidus and its rehabilitation, a webbased published literature search of Pubmed, Ovid Medline, Science direct, Cochrane Database, PEDro database, CINAHL was conducted for last 35 years in August 2010 using 4 specific keywords “hallux rigidus, physical therapy, chiropractic, and manual therapy” typed in exactly same manner in the search column of the databases. Result. the review finds that there is acute need of the quality studies and RCTs for the manual therapy, chiropractic, or physiotherapeutic management of the hallux rigidus. Conclusion. Review conclude that conservative programs for hallux rigidus consists of comprehensive intervention program that includes great toe mobilization, toe flexor strengthening, sesamoid bones mobilization and long MTP joint. The clinician should put an emphasis on the mobilization program with proper follow up along with comparative studies for rehabilitation of hallux rigidus. PMID:22991669

  10. Influence of Hallux Rigidus on Reamputation in Patients With Diabetes Mellitus After Partial Hallux Amputation.

    PubMed

    Oliver, Noah G; Attinger, Christopher E; Steinberg, John S; Evans, Karen K; Vieweger, David; Kim, Paul J

    2015-01-01

    Diabetic foot ulceration of the plantar hallux is a challenging condition and can require partial hallux amputation when complicated by infection. Lower extremity biomechanics play an important role in the development of hallux ulcers, and hallux rigidus (HR) could influence the outcomes after partial hallux amputation. We hypothesized that radiographic evidence of HR in patients with diabetes would be associated with greater ulcer recurrence and reamputation rates after partial hallux amputation. We performed a retrospective review of all patients with diabetes who had undergone a partial hallux amputation from January 2005 to December 2012. The subjects were divided into 2 cohorts according to the presence or absence of HR identified on preoperative radiographs. Baseline characteristics and outcomes were compared using a 2-sample Student's t test for continuous variables, and categorical variables were compared using the chi-square test for homogeneity and Fisher's exact test. A total of 52 patients were included, with 16 (31%) positive for radiographic evidence of HR at partial hallux amputation. Differences in the patient demographics and comorbidities were not significant between 2 cohorts with and without HR or reamputation. Reamputation was required in 5 subjects (31%) with HR and 2 (6%) without HR (p = .023). The average follow-up duration was 126 ± 89 weeks. Our results have demonstrated that the reamputation rate after partial hallux amputation is significantly greater in patients with than in those without radiographic evidence of HR. Surgeons should evaluate patients for HR when planning partial hallux amputation and use adjuvant methods of offloading when HR is evident to prevent recurrent ulceration and reamputation. PMID:26256297

  11. Functional hallux limitus and lesser-metatarsal overload.

    PubMed

    Clough, James G

    2005-01-01

    The implications of functional hallux limitus for lesser-metatarsal overload are discussed. A new method of treating functional hallux limitus is proposed, and three case histories are reviewed showing adequate resolution of symptoms using the proposed method of treatment. A proposed mechanism for the development of functional hallux limitus is discussed, and different methods of identification are illustrated. PMID:16291854

  12. Etiology, pathophysiology, and staging of hallux rigidus.

    PubMed

    Botek, Georgeanne; Anderson, Martha A

    2011-04-01

    The condition of hallux limitus is well understood and agreed on as visualized histologically and radiographically. But the historically described pathophysiology and anatomy that predisposes to hallux limitus has been challenged. Numerous investigators have proposed anatomic abnormalities of the foot as a primary cause of this condition, but perhaps trauma is the only unanimously agreed on cause. However, this accounts for only a small percentage of cases. To strive for better treatment outcomes, understanding the pathophysiology, assessing patient risk factors, and recognizing causative agents can better equip the foot and ankle surgeon in managing this condition. PMID:21669337

  13. Valgus osteotomy for hinge abduction.

    PubMed

    de Gheldere, Antoine; Eastwood, Deborah M

    2011-07-01

    Failure of the enlarged and deformed anterolateral portion of the femoral head to roll into the acetabulum during abduction alters hip joint mechanics. The resultant hinge abduction is associated with pain, and the patient often has restricted movement. A valgus osteotomy removes the deformed portion of the femoral head away from the weight-bearing area and ensures there is pain-free congruent range of movement around the weight-bearing position. The concomitant improvement in lever arm function and leg length results in a better gait pattern. In immature patients, abolition of hinge abduction allows the lateral acetabular ossification center to grow more normally. PMID:21742146

  14. Long arm decompression osteotomy for hallux limitus.

    PubMed

    Robinson, Stephen C; Frank, Ryan P

    2005-04-01

    This article presents a new osteotomy for stage I or II hallux limitus. The long arm decompression osteotomy can be used to shorten and plantarflex the first metatarsal. The indications, surgical technique, advantages, and disadvantages are described in detail. PMID:15833423

  15. Clinical Presentation and Management of Hallux Rigidus.

    PubMed

    Hamid, Kamran S; Parekh, Selene G

    2015-09-01

    Hallux rigidus is the most commonly occurring arthritic condition of the foot and is marked by pain, limited motion in the sagittal plane of the first metatarsophalangeal joint and varying degrees of functional impairment. In conjunction with clinical findings, radiographic grading helps guide therapeutic choices. Nonsurgical management with anti-inflammatory medications, corticosteroid injections, or shoewear and activity modifications can be successful in appropriately selected patients. Patients with more severe disease or refractory to conservative management may benefit from surgical intervention. Operative options range from joint-preserving procedures (eg, cheilectomy with or without associated osteotomies) to joint-altering procedures (eg, arthroplasty or arthrodesis). PMID:26320554

  16. The association of hallux limitus with the accessory navicular.

    PubMed

    Evans, R D Lee; Averett, Ryan; Sanders, Stephanie

    2002-06-01

    Hallux limitus is one of the most prevalent, debilitating disorders of the first metatarsophalangeal joint, and it has many proposed etiologies. This article reviews these etiologies, focusing primarily on the pes planus foot. The pes planus foot type is often associated with symptomatic hallux limitus and the accessory navicular. This article discusses this correlation, although a causal relationship has not been proven. The prevalence and classification of the accessory navicular are also discussed. Clinical cases involving symptomatic hallux limitus occurring concomitantly with an accessory navicular are reviewed, including radiographic findings, symptoms, and surgical treatment. PMID:12070237

  17. The use of osteotomies in the treatment of hallux limitus and hallux rigidus.

    PubMed

    Haddad, S L

    2000-09-01

    Though osteotomies for relief of hallux limitus and rigidus have been around since the earliest surgical corrections, no sound clinical studies have been performed to warrant their use over the standard accepted techniques of cheilectomy and arthrodesis. These operations are surely more technically demanding than such standard procedures, and involve significant increased risk and postoperative immobilization than cheilectomy alone. Sound theories such as metatarsus primus elevatus and excessive metatarsal length contributing to hallux rigidus have never been proven, and no accurate way to diagnose these structural deformities has been proposed. These operations are intriguing and some make clinical sense. It remains to be seen whether the orthopedic community will adopt them based on their merits. PMID:11232401

  18. A retrospective analysis of 772 patients with hallux limitus.

    PubMed

    Grady, John F; Axe, Timothy M; Zager, Emil J; Sheldon, Lori A

    2002-02-01

    In this retrospective analysis of 772 patients with symptomatic hallux limitus, 428 patients (55%) were successfully treated with conservative care alone; of these 428 patients, 362 (84%) were treated with orthoses. Corticosteroid injections and a change in shoes allowed 24 patients (6% of conservatively treated patients) and 42 patients (10%), respectively, to have less discomfort and return to previous activity levels. Overall, 47% of the patients in this analysis were successfully treated with orthoses. Surgical procedures were performed on 296 patients (38% of all patients) who did not respond to conservative care. In this analysis, 48 of the patients (6% of all patients) who did not respond to conservative care either refused surgery or were not surgical candidates. These data are intended to provide podiatric physicians with expected outcomes for conservative care of hallux limitus. The etiology, symptoms, conservative management, and surgical treatments of hallux limitus and hallux rigidus are also reviewed. PMID:11847262

  19. Muscle contribution to elbow joint valgus stability.

    PubMed

    Lin, Fang; Kohli, Navjot; Perlmutter, Sam; Lim, Dohyung; Nuber, Gordon W; Makhsous, Mohsen

    2007-01-01

    Repetitive valgus stress of the elbow can result in excessive strain or rupture of the native medial ulnar collateral ligament (MUCL). The flexor-pronator mass (FPM) may be particularly important for elbow valgus stability in overhead-throwing athletes. The aim of this study was to identify the relative contribution of each muscle of the FPM--that is, the flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), and pronator teres (PT)--and of the extensor-supinator mass, including the extensor carpi ulnaris (ECU), extensor digitorum communis (EDC), extensor carpi radialis longus and brevus, and brachioradialis, to elbow valgus stability at 45 degrees and 90 degrees of elbow flexion angles. Eight fresh-frozen elbow specimens (mean age at death, 73.75 +/- 14.07 years) were tested. With the skin and subcutaneous tissue removed but all muscles left intact, each individual muscle of the FPM and extensor-supinator mass was loaded at 3 levels of force. During loading, strain on the MUCL and the kinematics of the elbow were measured simultaneously. Kinematic measurements were later repeated when the MUCL was fully cut. At 45 degrees and 90 degrees of elbow flexion, individual loading of the FCU, FDS, and FCR caused significant relief to the MUCL whereas the PT produced no significant change. Furthermore, of these flexor muscles, the FCU provided the greatest MUCL relief at both 45 degrees and 90 degrees . In contrast, loading of the ECU at 45 degrees of elbow flexion produced a significant increase in MUCL strain. All FPM muscles caused significant elbow varus movement at both 45 degrees and 90 degrees when loaded individually. At 90 degrees , the FCU created more motion than both the FCR and PT but not the FDS, and the FDS created more motion than the PT. The EDC and ECU created significant valgus movement at 45 degrees and 90 degrees , which became insignificant when the MUCL was transected. Our study suggested that the FCU, FDS, and

  20. The effect of rearfoot eversion on maximal hallux dorsiflexion. A preliminary study.

    PubMed

    Harradine, P D; Bevan, L S

    2000-09-01

    Functional hallux limitus has been recently described as an etiologic factor in postural complaints. Eversion of the rearfoot has been theoretically linked to decreased hallux dorsiflexion, although there have been no scientific studies on this subject to date. This study was undertaken to investigate the relationship between rearfoot eversion and hallux dorsiflexion; the results show that hallux dorsiflexion is decreased with rearfoot eversion in a static setting. PMID:11021049

  1. Valgus torque in youth baseball pitchers: A biomechanical study.

    PubMed

    Sabick, Michelle B; Torry, Michael R; Lawton, Richard L; Hawkins, Richard J

    2004-01-01

    The purpose of this study was to determine the biomechanical and anthropometric factors contributing to elbow valgus torque during pitching. Video data of 14 youth pitchers throwing fastballs were used to calculate shoulder and elbow kinematics and kinetics. Peak elbow valgus torque averaged 18 Nm and occurred just before maximal shoulder external rotation. The magnitude of valgus torque was most closely correlated with the thrower's weight. When subject weight and height were controlled for, maximum shoulder abduction torque and maximum shoulder internal rotation torque were most strongly associated with elbow valgus torque, accounting for 85% of its variance (P <.001). When only kinematic variables were considered, maximum shoulder external rotation accounted for 33% of the variance in valgus torque. Given that the biomechanical variables correlated with peak valgus torque are not easily modifiable, limiting the number of innings pitched is likely the best way to reduce elbow injury in youth pitchers. PMID:15111908

  2. Valgus Extension Overload in Baseball Players.

    PubMed

    Paulino, Franklin E; Villacis, Diego C; Ahmad, Christopher S

    2016-01-01

    Repetitive throwing, such as in baseball pitching, applies massive stress on the elbow. This can often lead to a predictable constellation of elbow injuries, such as valgus extension overload syndrome (VEO). The following review of VEO provides an understanding of relevant anatomy, explanation of pathomechanics, key aspects to clinical evaluation, effective treatment options, and indications for surgery. In addition, we provide the senior author's (CSA) preferred arthroscopic technique for cases of VEO refractory to conservative management. PMID:26991567

  3. Resurfacing of the Metatarsal Head to Treat Advanced Hallux Rigidus.

    PubMed

    Kline, Alex J; Hasselman, Carl T

    2015-09-01

    Advanced stages of hallux rigidus are usually treated with various arthroplasties or arthrodesis. Recent results with resurfacing of the metatarsal head have shown promising results and outcomes similar or superior to those of arthrodesis. In this article, the authors show their preoperative decision making, surgical techniques, postoperative management, results, and a comparative literature review to identify metatarsal head resurfacing as an acceptable technique for the treatment of advanced hallux rigidus in active patients. Key points in this article are adequate soft tissue release, immediate rigid fixation of the components, and appropriate alignment of the components. PMID:26320559

  4. Impacted valgus fractures of the proximal humerus.

    PubMed

    Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; da Costa, Miguel Pereira

    2016-01-01

    Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature. PMID:27069878

  5. Impacted valgus fractures of the proximal humerus☆

    PubMed Central

    Ribeiro, Fabiano Rebouças; Takesian, Fernando Hovaguim; Bezerra, Luiz Eduardo Pimentel; Filho, Rômulo Brasil; Júnior, Antonio Carlos Tenor; da Costa, Miguel Pereira

    2016-01-01

    Impacted valgus fractures of the proximal humerus are considered to be a special type fracture, since impaction of the humeral head on the metaphysis with maintenance of the posteromedial periosteum improves the prognosis regarding occurrences of avascular necrosis. This characteristic can also facilitate the reduction maneuver and increase the consolidation rate of these fractures, even in more complex cases. The studies included were obtained by searching the Bireme, Medline, PubMed, Cochrane Library and Google Scholar databases for those published between 1991 and 2013. The objective of this study was to identify the most common definitions, classifications and treatment methods used for these fractures in the orthopedic medical literature. PMID:27069878

  6. A Post-Marketing Observational Study to Evaluate Primus™ FGT Implant at a Minimum of 5 Years Follow-up

    ClinicalTrials.gov

    2015-01-26

    Hallux Limitus or Hallux Rigidus; Rheumatoid Arthritis; Hallux Abducto Valgus Associated With Arthritis; Unstable or Painful Joint From Previous Surgery; Symptomatic Grade II or III Osteoarthritis; Geriatric Bunion

  7. Current surgical strategies for total arthroplasty in valgus knee

    PubMed Central

    Nikolopoulos, Dimitrios; Michos, Ioannis; Safos, George; Safos, Petros

    2015-01-01

    The majority of orthopaedic surgeons even currently agree that primary total arthroplasty in valgus knees with a deformity of more than ten degrees may prove challenging. The unique sets of bone and soft tissue abnormalities that must be addressed at the time of the operation make accurate axis restoration, component orientation and joint stability attainment a difficult task. Understanding the specific pathologic anatomic changes associated with the valgus knee is a prerequisite so as to select the proper surgical method, to optimize component position and restore soft-tissue balance. The purpose of this article is to review the valgus knee anatomical variations, to assess the best pre-operative planning and to evaluate how to choose the grade of constraint of the implant. It will also be underlying the up-to-date main approaches and surgical techniques be proposed in the English literature both for bone cuts and soft tissue management of valgus knees. PMID:26191494

  8. Management of hallux limitus with distraction of the first metatarsophalangeal joint.

    PubMed

    Talarico, Leonard M; Vito, George R; Goldstein, Larry; Perler, Adam D

    2005-01-01

    This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus. Both intrinsic and extrinsic muscular imbalances are reduced. Follow-up of 133 patients treated in this manner since 1997 demonstrates excellent long-term results. PMID:15778469

  9. Effects of hallux limitus on plantar foot pressure and foot kinematics during walking.

    PubMed

    Van Gheluwe, Bart; Dananberg, Howard J; Hagman, Friso; Vanstaen, Kerstin

    2006-01-01

    The effects of hallux limitus on plantar foot pressure and foot kinematics have received limited attention in the literature. Therefore, a study was conducted to assess the effects of limited first metatarsophalangeal joint mobility on plantar foot pressure. It was equally important to identify detection criteria based on plantar pressures and metatarsophalangeal joint kinematics, enabling differentiation between subjects affected by hallux limitus and people with normal hallux function. To further our understanding of the relation between midtarsal collapse and hallux limitus, kinematic variables relating to midtarsal pronation were also included in the study. Two populations of 19 subjects each, one with hallux limitus and the other free of functional abnormalities, were asked to walk at their preferred speed while plantar foot pressures were recorded along with three-dimensional foot kinematics. The presence of hallux limitus, structural or functional, caused peak plantar pressure under the hallux to build up significantly more and at a faster rate than under the first metatarsal head. Additional discriminators for hallux limitus were peak dorsiflexion of the first metatarsophalangeal joint, time to this peak value, peak pressure ratios of the first metatarsal head and the more lateral metatarsal heads, and time to maximal pressure under the fourth and fifth metatarsal heads. Finally, in approximately 20% of the subjects, with and without hallux limitus, midtarsal pronation occurred after heel lift, validating the claim that retrograde midtarsal pronation does occur. PMID:16988174

  10. Multiplanar phalangeal and metatarsal osteotomies for hallux rigidus.

    PubMed

    Freeman, Brian L; Hardy, Mark A

    2011-04-01

    Many articles have been published on the various treatments of hallux rigidus/limitus but few, if any, have focused solely on the osteotomies performed in the treatment of this disorder and provided a thorough review of the literature and critique of the procedures. Here, we describe the most commonly used, most widely accepted, and most effective osteotomies in the treatment of hallux limitus/rigidus. Along with this discussion are figures and tables to make the information accessible and user friendly. Among the procedures discussed are Keller arthroplasty, Keller interpositional arthroplasty, Bonney-Kessel, Mayo-Stone, Regnauld, Youngswick, Watermann, Watermann-Green, tricorrectional metatarsal osteotomy, sagittal V, LADO (long-arm decompression osteotomy), Drago, Lambrinudi (plantarflexory closing base wedge osteotomy), sagittal Scarf/sagittal Z, and Weil/Mau/distal oblique osteotomy. PMID:21669342

  11. Use of the Mini TightRope® for correction of hallux varus deformity.

    PubMed

    Gerbert, Joshua; Traynor, Colin; Blue, Kevin; Kim, Kevin

    2011-01-01

    The flexible form of acquired hallux varus has historically been treated with a number of applicable soft tissue procedures, most of which combine medial capsular release with adjunct procedures aimed at restoring the transverse plane balance of the digit. In this report, a surgical technique for correction of hallux varus that employs the use of an implanted button and suture device, namely the Mini TightRope(®), is described. Rather than relying on the patient's own soft tissues, this device applies tension to anchor the hallux in the proper alignment. The device is easily adjusted during the course of the surgery and readily enables accurate correction of the hallux in the transverse plane. The indications, technical execution, postoperative care, and potential complications related to our use of the Mini TightRope(®) for correction of hallux varus are described, and the case of an adult woman who underwent the procedure for correction of acquired hallux varus is presented. In the authors' experience, the Mini TightRope(®) is a viable option that mimics restoration of the lateral collateral ligaments of the first metatarsophalangeal joint, and we believe this technique to be superior to other soft tissue surgical procedures used to repair flexible hallux varus. PMID:21262578

  12. Hallux checkrein deformity resulting from the scarring of long flexor muscle belly - case report.

    PubMed

    Boszczyk, Andrzej; Zakrzewski, Piotr; Pomianowski, Stanisław

    2015-01-01

    A case of posttraumatic checkrein deformity of the hallux is presented. This deformity is most often caused by scarring of the muscle belly or tethering of the tendon. A 22-year old woman developed a hallux checkrein deformity after a bimaleolar fracture. Intraoperatively, a linear scar tethering the muscle belly to the posterior tibia was observed. Resection of the scar allowed for full flexor hallucis longus mobility. Full hallux range of motion as well as foot function was restored. The cause of the checkrein deformity in our patient was a scar tethering the flexor hallucis belly to the posterior tibia. PMID:25759157

  13. Sensitivity and specificity of the functional hallux limitus test to predict foot function.

    PubMed

    Payne, Craig; Chuter, Vivienne; Miller, Kathryn

    2002-05-01

    Functional hallux limitus is an underrecognized entity that generally does not produce symptoms but can result in a variety of compensatory mechanisms that can produce symptoms. Clinically, hallux limitus can be determined by assessing the range of motion available at the first metatarsophalangeal joint while the first ray is prevented from plantarflexing. The aim of this study was to determine the sensitivity and specificity of this clinical test to predict abnormal excessive midtarsal joint function during gait. A total of 86 feet were examined for functional hallux limitus and abnormal pronation of the midtarsal joint during late midstance. The test had a sensitivity of 0.72 and a specificity of 0.66, suggesting that clinicians should consider functional hallux limitus when there is late midstance pronation of the midtarsal joint during gait. PMID:12015407

  14. [Functional hallux limitus (Fhl): a new explanation for overuse pathologies].

    PubMed

    Vallotton, Jacques

    2014-12-01

    Functional Hallux limitus (Fhl) is still a misconceived and unappreciated clinical entity, being often diagnosed during a clinical examination or a podiatric assessment. In the presence of Fhl, the patient's gait necessitates the unwitting existence of complementary efforts on their part, thus resembling to the gait pattern of someone with elongated foot or feet. The consequences of this dysfunction affect all age groups and manifest themselves in the form of low back pain, impingement, sprain, joint incongruence, or overload tendon and fibro-osseous lesions. An elongated foot gait pattern increases the stress applied to bones and joints and subsequently disrupts equilibrium. The biomechanical changes induced by Fhl mandate a profound reconsideration of our way of thinking and analysis, hence a revision of our reference system. It is indeed a new paradigm shift. PMID:25626251

  15. Valgus osteotomy for nonunion and neglected neck of femur fractures

    PubMed Central

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-01-01

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure. PMID:27190758

  16. Valgus osteotomy for nonunion and neglected neck of femur fractures.

    PubMed

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-05-18

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure. PMID:27190758

  17. Lapidus arthrodesis plus osteochondral autograft transplantation in the management of hallux rigidus with an elevated first ray.

    PubMed

    Klos, Kajetan; Simons, Paul

    2014-04-01

    The range of joint-sparing treatments for advanced hallux rigidus is still very limited. The authors describe an osteochondral autograft transplantation technique combined with Lapidus arthrodesis as a novel method of obtaining a relatively symptom-free first metatarsophalangeal joint function in patients with hallux rigidus and first-ray elevation. PMID:24379451

  18. Plantar pressure and joint motion after the Youngswick procedure for hallux limitus.

    PubMed

    Bryant, Alan R; Tinley, Paul; Cole, Joan H

    2004-01-01

    The effects of the Youngswick osteotomy on plantar peak pressure distribution in the forefoot are presented for 17 patients (23 feet) with mild-to-moderate hallux limitus deformity and 23 control subjects (23 feet). During 2 years of follow-up, the operation produced a significant increase in the range of dorsiflexion of the first metatarsophalangeal joint in these patients, reaching near-normal values. Preoperative and postoperative measurements, using a pressure-distribution measurement system, show that peak pressure beneath the hallux and the first metatarsal head remained unchanged. However, peak pressure was significantly increased beneath the second metatarsal head and decreased beneath the fifth metatarsal head. These findings suggest that the foot functioned in a less inverted manner postoperatively. Compared with normal feet, hallux limitus feet demonstrated significantly higher peak pressure beneath the fourth metatarsal head preoperatively and postoperatively. PMID:14729987

  19. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    PubMed Central

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  20. Traumatic Hallux Varus Treated by Minimally Invasive Extensor Hallucis Brevis Tenodesis

    PubMed Central

    Cheung, C. N.; Lui, T. H.

    2015-01-01

    A case of traumatic hallux varus due to avulsion fracture of the lateral side of the base of proximal phalanx was reported. The lateral instability of the first metatarsophalangeal joint was believed to be due to the disruption of adductor hallucis function. It was successfully managed by minimally invasive extensor hallucis brevis tenodesis. PMID:26793399

  1. Congenital Hallux Varus with Polydactyly and Syndactyly-Correction in an Adult - A Case Report

    PubMed Central

    Patil, Sampat Dumbre; Parekh, Hemant; Patil, Vaishali Dumbre; Joshi, Kartikeya

    2014-01-01

    Introduction: Congenital hallux varus of secondary type is associated with polydactyly, syndactyly or other congenital deformities of the foot. Such congenital deformities can be addressed in childhood with soft tissue reconstructive procedures. In adulthood, treatment of these deformities is challenging because of soft tissue contractures and rigid bony deformities. To our knowledge, this is the first case report demonstrating the management of neglected secondary congenital hallux varus in adults. Case Report: We present here a case of a 23 years old male patient who presented to us with untreated congenital hallux varus of secondary type. Patient had an extra great toe (polydactyly) with syndactyly. We have treated this patient in two stages. First stage consisted of excision of the extra great toe and gradual correction of medial great toe. In second stage, metatarsophalangeal joint fusion was done. We have follow up of this case for more than 2.5 years. Conclusion: Severe neglected congenital deformities presenting in adulthood pose unique problems of soft tissue contractures and permanent bony deformities. Congenital neglected hallux varus with polydactyly and syndactyly is a rare deformity. Its correction was challenging as patient presented to us in adulthood. A staged approach of gradual soft tissue distraction and then metatarsophalangeal joint fusion has resulted in satisfactory aesthetic and functional outcome. PMID:27298963

  2. The effect of isolated valgus moments on ACL strain during single-leg landing: A simulation study

    PubMed Central

    Shin, Choongsoo S.; Chaudhari, Ajit M.; Andriacchi, Thomas P.

    2009-01-01

    Valgus moments on the knee joint during single-leg landing have been suggested as a risk factor for anterior cruciate ligament (ACL) injury. The purpose of this study was to test the influence of isolated valgus moment on ACL strain during single-leg landing. Physiologic levels of valgus moments from an in vivo study of single-leg landing were applied to a three-dimensional dynamic knee model, previously developed and tested for ACL strain measurement during simulated landing. The ACL strain, knee valgus angle, tibial rotation, and medial collateral ligament (MCL) strain were calculated and analyzed. The study shows that the peak ACL strain increased nonlinearly with increasing peak valgus moment. Subjects with naturally high valgus moments showed greater sensitivity for increased ACL strain with increased valgus moment, but ACL strain plateaus below reported ACL failure levels when the applied isolated valgus moment rises above the maximum values observed during normal cutting activities. In addition, the tibia was observed to rotate externally as the peak valgus moment increased due to bony and soft-tissue constraints. In conclusion, knee valgus moment increases peak ACL strain during single-leg landing. However, valgus moment alone may not be sufficient to induce an isolated ACL tear without concomitant damage to the MCL, because coupled tibial external rotation and increasing strain in the MCL prevent proportional increases in ACL strain at higher levels of valgus moment. Training that reduces the external valgus moment, however, can reduce the ACL strain and thus may help athletes reduce their overall ACL injury risk. PMID:19100550

  3. Varus-Valgus Alignment: Reduced Risk for Subsequent Cartilage Loss in the Less Loaded Compartment

    PubMed Central

    Moisio, Kirsten; Chang, Alison; Eckstein, Felix; Chmiel, Joan S.; Wirth, Wolfgang; Almagor, Orit; Prasad, Pottumarthi; Cahue, September; Kothari, Ami; Sharma, Leena

    2011-01-01

    Objective Varus-valgus alignment has been linked to subsequent osteoarthritis progression within the mechanically stressed (medial for varus, lateral for valgus) tibiofemoral compartment. Cartilage data from the off-loaded compartment are sparse. We hypothesized: neutral and valgus (vs. varus) knees each have reduced odds of cartilage loss in medial subregions; and neutral and varus (vs. valgus) knees each have reduced odds of lateral subregional loss. Methods Participants with knee osteoarthritis underwent knee magnetic resonance imaging at baseline and two years. Mean cartilage thickness was quantified within five tibial and three femoral subregions. We used logistic regression with generalized estimating equations to analyze the relationship between baseline alignment and two-year subregional cartilage loss, adjusting for age, gender, body mass index, and disease severity. Results A reduced risk of cartilage loss in medial subregions was associated with neutral (vs. varus) alignment (external tibial, central femoral, external femoral) and valgus (vs. varus) alignment (central tibial, external tibial, central femoral, external femoral). A reduced risk of cartilage loss in lateral subregions, was associated with neutral (vs. valgus) alignment (central tibial, internal tibial, posterior tibial) and varus (vs. valgus) alignment (central tibial, external tibial, posterior tibial, external femoral). Conclusion Neutral and valgus alignment were each associated with a reduction in the risk of subsequent cartilage loss in certain medial subregions, and neutral and varus with a reduction in the risk of cartilage loss in certain lateral subregions. These results support load redistribution as an in vivo mechanism of long-term alignment effect on cartilage loss in knee osteoarthritis. PMID:21225680

  4. Fabella Fractures after Total Knee Arthroplasty with Correction of Valgus Malalignment.

    PubMed

    Kwee, Thomas Christian; Heggelman, Ben; Gaasbeek, Robert; Nix, Maarten

    2016-01-01

    The incidence of fabella fractures is considered to be extremely low. This report presents two patients with femorotibial osteoarthritis and considerable preoperative valgus malalignment, who developed a fracture of the fabella (as demonstrated by radiography) after total knee arthroplasty with intraoperative correction of the valgus malalignment. Special attention should be paid to the fabella for not missing a fabella fracture in these patients. PMID:27340579

  5. Fabella Fractures after Total Knee Arthroplasty with Correction of Valgus Malalignment

    PubMed Central

    Heggelman, Ben; Gaasbeek, Robert; Nix, Maarten

    2016-01-01

    The incidence of fabella fractures is considered to be extremely low. This report presents two patients with femorotibial osteoarthritis and considerable preoperative valgus malalignment, who developed a fracture of the fabella (as demonstrated by radiography) after total knee arthroplasty with intraoperative correction of the valgus malalignment. Special attention should be paid to the fabella for not missing a fabella fracture in these patients. PMID:27340579

  6. The results of Grice Green subtalar arthrodesis of valgus foot in spina bifida

    PubMed Central

    Küçükdurmaz, Fatih; Ağır, İsmail; Saygı, Baransel; Bezer, Murat

    2012-01-01

    Background: Valgus foot is a common foot deformity in spina bifida. The most popular operation for the valgus deformity has been the Grice talocalcaneal blocking. It has not been studied primarily in children with spina bifida. We report a prospective series, we present the results of hind foot valgus deformity of children with spina bifida, using Grice talocalcaneal arthrodesis with a tricortical iliac bone graft. Materials and Methods: Between May 2000 and December 2003, 21 patients with bilateral (42 feet) valgus deformity of feet underwent surgery. There were 7 males and 14 females. The mean age of patients was 67.7 months (range 50–108 months). Results: The total number of feet that had nonunion was 11, in 7 of them the grafts were completely reabsorbed and the outcome of all these feet was unsatisfactory. Four feet had partial union of which three had unsatisfactory and one had satisfactory outcome. Sixteen feet had residual valgus deformity at the last followup visit, 10 patients had nonunion, and 6 had inadequate correction. Mean preoperative talocalcaneal and calcaneal pitch angles were 48.5° and 31.9°, respectively, which decreased to 38.5° and 29.1°, respectively, postoperatively. The decrease in talocalcaneal angle and calcaneal pitch was significant between preoperative and postoperative measurements (P<0.05). Conclusion: Grice subtalar arthrodesis technique is still a valuable option for valgus foot in patients with spina bifida. In this study, we found more encouraging results in older patients. PMID:22719122

  7. Gait style as an etiology to chronic postural pain. Part I. Functional hallux limitus.

    PubMed

    Dananberg, H J

    1993-08-01

    A common, but locally asymptomatic and therefore rarely recognized functional inability of the first metatarsophalangeal joint to dorsiflex strictly during gait is described. Normal motion is present in this joint during nonweight-bearing examination; therefore this is referred to as functional hallux limitus. Since this joint forms the pivot about which the entire body advances during each step, this disturbance in function, when repeated thousands of times on a daily basis, can alter foot and postural biomechanics. It can cause and perpetuate many chronic postural ailments, including lower back pain. When functional hallux limitus is specifically addressed in an orthotic treatment plan, 77% of long-term chronic postural pain patients exhibit 50% to 100% improvement in their overall condition, in spite of failing previous therapy on their specific site of pain and never exhibiting any foot symptomatology. PMID:8366431

  8. Lateral Stress Dorsiflexion View: A Case Series Demonstrating Clinical Utility in Midterm Hallux Limitus.

    PubMed

    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    The lateral hallux stress dorsiflexion view is part of our standard workup for midterm hallux limitus (HL)/hallux rigidus (HR). It provides a functional radiographic examination of the first metatarsal phalangeal joint. Midterm HL primarily involves degenerative changes in the upper one third of the metatarsal phalangeal joint involving formation of bone spurs, dorsal bone impingement, joint space narrowing with cartilage degeneration, and fragmentation of the bone spurs. The lateral hallux stress dorsiflexion view provides diagnostic information not visible on a standard weightbearing lateral view in patients with midterm HL/HR, including joint space narrowing on the dorsal third of the joint despite intact cartilage through the center one third of the joint, the extent of maximum first metatarsal phalangeal joint dorsiflexion, and direct visualization of dorsal bone spur impingement. This functional radiographic examination also appears to provide improved patient understanding regarding why their joint is stiff and painful. Improved patient understanding of their condition positively influences the shared decision making regarding the treatment objectives and options. The cases of 5 patients with stage II or III HL/HR are presented to depict the utility of this radiographic view, including objective measurement of maximum first metatarsal phalangeal joint dorsiflexion, confirmation of a bony block at the end range of dorsiflexion, the presence or absence of joint space narrowing at the dorsal third of the joint, evaluation of the excursion of the sesamoid apparatus, a tool to help the patient understand, an intraoperative assessment of procedure effectiveness, and a comparison of maximum dorsiflexion before and after surgery. PMID:25242208

  9. Long-term follow-up of the Green-Watermann osteotomy for hallux limitus.

    PubMed

    Dickerson, Jason B; Green, Richard; Green, Donald R

    2002-01-01

    The authors undertook a retrospective analysis of the long-term efficacy of the Green-Watermann procedure for the treatment of painful hallux limitus or rigidus. Questionnaires were sent to 80 consecutive patients who had such procedures performed between 1990 and 1999. Medical records and radiographs were reviewed for the 32 patients who completed the questionnaires, representing 40 Green-Watermann procedures. Twenty-four patients were able to return for clinical evaluation. The average length of follow-up was 4 years (range, 1 to 10 years). The questionnaires addressed pain before and after surgery, function after surgery, complications, and overall impression and satisfaction. Nearly all of the patients (30 of 32; 94%) reported that surgery had significantly relieved their hallux joint pain, and a slightly smaller proportion (28 of 32; 88%) felt that their chief complaints were at least 70% improved. Clinical evaluation revealed adequate range of motion at the first metatarsophalangeal joint. It is concluded that the Green-Watermann procedure is an effective treatment approach for hallux limitus and rigidus, resulting in a significant reduction in pain, an increase in function, and a high degree of patient satisfaction. PMID:12438500

  10. Comparison of Hallux Interphalangeal Joint Arthrodesis Fixation Techniques: A Retrospective Multicenter Study.

    PubMed

    Thorud, Jakob C; Jolley, Tyler; Shibuya, Naohiro; Lew, Eric; Britt, Matthew; Butterfield, Ted; Boike, Alan; Hardy, Mark; Brancheau, Steven P; Motley, Travis; Jupiter, Daniel C

    2016-01-01

    Few studies have investigated the complications that occur after hallux interphalangeal joint arthrodesis. The present study evaluated complications in 152 patients aged 18 to 80 years from 2005 to 2012 from 4 different academic institutions after hallux interphalangeal joint arthrodesis. Overall, 65.8% of the patients had ≥1 complication. Infections occurred in 16.5%, dehiscence in 12.5%, and reoperations in 27.0%. The clinical nonunion rate was ≥17.8%, and the radiographic nonunion rate was ≥13.8%. After logistic regression analysis, only the study site and peripheral neuropathy were associated with having ≥1 complication (p < .01 and p < .05, respectively). Single screw fixation compared with other fixation did not have a statistically significant influence on the postoperative complications. However, when fixation was expanded to 4 categories, single screw fixation had lower infection and reoperation rates than either crossed Kirschner wires or other fixation category but not compared with crossed screws on multivariate logistic regression analysis. Although additional studies are warranted, the findings from the present study might aid in both the prognosis of complications and the support of the use of a single screw over crossed Kirchner wire fixation in hallux interphalangeal joint arthrodesis. PMID:25960055

  11. Supracondylar Osteotomy in Valgus Knee: Angle Blade Plate Versus Locking Compression Plate

    PubMed Central

    Kazemi, Seyyed Morteza; Minaei, Reza; Safdari, Farshad; Keipourfard, Ali; Forghani, Rozhin; Mirzapourshafiei, Alemeh

    2016-01-01

    Background: There are few studies comparing the biomechanical properties of angled blade plate and locking compression plates in supracondylar osteotomy. In the current randomized study, we prospectively compared the clinical and radiological outcomes of supracondylar osteotomy using these two plates. Methods: Forty patients with valgus knee malalignment were randomly assigned to two equal numbered groups: angled blade plate and locking compression plates. All of the patients underwent medial closing wedge supracondylar osteotomy and were followed for one year. Before and after the operation the valgus angle and mechanical lateral distal femoral angle were compared between groups. Also, the rate of complications were compared. Results: After the operation, the mean valgus angle and mechanical lateral distal femoral angle improved significantly in the two groups (P<0.001). Although, the preoperative amount of the valgus angle and mechanical lateral distal femoral angle were the same, at the last visit the valgus angle (5.4±2.1 versus 3.1±1.8; P=0.032) and mechanical lateral distal femoral angle (87.6±2 versus 89.7±3.2; P=0.041) were significantly lower and higher in the angled blade plate group, respectively. Nonunion occurred in four patients (20%) in the locking compression plates group (P=0.35). Conclusion: Based on having a larger valgus angle and mechanical lateral distal femoral angle correction in the angled blade plate group and considerable rate of nonunion in the locking compression plate group, the authors recommend using the angled blade plate for fixation of medial closing wedge supracondylar osteotomy for patients with valgus malalignment. However, more long-term studies are required. PMID:26894215

  12. Stress distribution on a valgus knee prosthetic inclined interline -- a finite element analysis.

    PubMed

    Orban, H; Stan, G; Gruionu, L; Orban, C

    2013-01-01

    Total knee arthroplasty following valgus deformity is a challenging procedure due to the unique set of problems that must be addressed. The aim of this study is to determine, with a finite element analysis, the load distribution for an inclined valgus prosthetic balanced knee and to compare these results with those of a prosthetic balanced knee with an uninclined interline. Computational simulations, using finite element analysis, focused on a comparision between load intensity and distribution for these situations. We studied valgus inclination at 3 and 8 degrees. We noticed that for an inclination of 3 degrees, the forces are distributed almost symmetrically on both condyles, similar to the distribution of forces in the uninclined interline case. The maximum contact pressure is greater, increasing from 15 MPa to 19.3 MPa (28%). At 8 degrees of inclination, the contact patch moved anterolateraly on the tibia, meaning that the tibial condyles will be unequally loaded. The maximum contact pressure increases to 25 MPa (66%). These greater forces could lead to polyethylene wear and collapse. Additional tibial resection could be a useful method for balancing in severe valgus knee, when valgus inlination does not exceed 3 degrees. PMID:23464776

  13. The effects of a valgus collapse knee position on in vivo ACL elongation.

    PubMed

    Utturkar, G M; Irribarra, L A; Taylor, K A; Spritzer, C E; Taylor, D C; Garrett, W E; Defrate, Louis E

    2013-01-01

    There are conflicting data regarding what motions increase ACL injury risk. More specifically, the mechanical role of valgus collapse positions during ACL injury remains controversial. Our objective was to evaluate ACL elongation in a model that mimics knee movements thought to occur during ACL injury. Eight healthy male subjects were imaged using MR and biplanar fluoroscopy to measure the in vivo elongation of the ACL and its functional bundles during three static knee positions: full extension, 30° of flexion, and a position intended to mimic a valgus collapse position described in the literature. For this study, the valgus collapse position consisted of 30° of knee flexion, internal rotation of the hip, and 10° of external tibial rotation. ACL length decreased significantly from full extension (30.2 ± 2.6 mm) to 30° of flexion (27.1 ± 2.2 mm). ACL length further decreased in the valgus collapse position (25.6 ± 2.4 mm). Both functional bundles of the ACL followed similar trends with regards to decreases in length in each of the three positions. Since strain would follow patterns of ACL length, landing on an extended knee may be a more relevant risk factor for ACL injuries than the valgus collapse position in males. Future studies should evaluate the effects of dynamic motion patterns on in vivo ACL strains. PMID:22855117

  14. Three-dimensional reconstruction method for measuring the knee valgus angle of the femur in northern Chinese adults*

    PubMed Central

    Liu, Tong; Wang, Chen-yu; Xiao, Jian-lin; Zhu, Lan-yu; Li, Xue-zhou; Qin, Yan-guo; Gao, Zhong-li

    2014-01-01

    The purpose of this study was to establish a method for measuring the knee valgus angle from the anatomical and mechanical axes on three-dimensional reconstruction imaging models, and to use this method for estimating an average knee valgus angle value for northern Chinese adults. Computed tomographic angiography data in DICOM format for 128 normal femurs from 64 adult subjects were chosen for analysis. After the femur images were subjected to three-dimensional reconstruction, the deepest point in the intercondylar notch (point A), the midpoint of the medullary cavity 20 cm above the knee-joint line (point B), and the landmark of the femoral head rotation center (point C) were identified on each three-dimensional model. The knee valgus angle was defined as the angle enclosed by the distal femoral anatomical axis (line AB) and the femoral mechanical axis (line AC). The average (mean±SD) of knee valgus angle for the 128 femurs was 6.20°±1.20° (range, 3.05° to 10.64°). Significant positive correlations were found between the knee valgus angles of the right and left sides and between the knee valgus angle and age. During total knee arthroplasty, choosing a valgus cut angle of approximately 6° may achieve a good result in reestablishing the natural mechanical alignment of the lower extremity for patients of northern Chinese ethnicity. Larger valgus cut angles should be chosen for older patients. PMID:25091990

  15. Assessment of gait symmetry for Talus Valgus children based on experimental kinematic analysis

    NASA Astrophysics Data System (ADS)

    Toth-Tascau, Mirela; Pasca, Oana; Vigaru, Cosmina; Rusu, Lucian

    2013-10-01

    The general purpose of this study was to assess the gait symmetry for Talus Valgus deformity based on experimental kinematic analysis. As this foot condition generally occurs in children, the study is focused on two children having five years old, one being healthy, as control subject, and the second one having bilateral Talus Valgus deformity. Kinematic experimental analysis was conducted using Zebris CMS-HS Measuring System. The bilateral symmetry was analyzed using two methods: index of symmetry (SI) calculated for spatio-temporal parameters (stance phase, swing phase, and step length) and kinematic parameter (maximum value of dorsiflexion - plantar flexion angle in the ankle joint), and an unpaired t-test to compare the variation of means values of dorsiflexion - plantar flexion angle in ankle joint for both left and right side. The study evidenced a good bilateral symmetry in case of the control subject and quantified the asymmetry in case of subject with Talus Valgus deformity.

  16. The thrower's elbow: arthroscopic treatment of valgus extension overload syndrome.

    PubMed

    O'Holleran, James D; Altchek, David W

    2006-02-01

    Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems 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 problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications

  17. Stress shielding in the bony chain of leg in presence of varus or valgus knee

    PubMed Central

    Filardi, Vincenzo

    2015-01-01

    Aims The aim was to assess how the stress shielding can influence the integrity and resistance of bones in presence of a misalignment. Methods Three finite elements models have been developed: a normal one, and two varus and valgus knee ones. Results The obtained results reveal interesting consequences deriving by a wrong disposition of parts which compose the skeletal chain of the leg. Conclusion The most dangerous conditions occur in the contact interface between pelvis and hip of the femur, for the valgus knee configuration, and for the varus one, at the contact interface around the knee zone. PMID:25972702

  18. Extreme femoral valgus and patella dislocation following lateral plate fixation of a pediatric femur fracture.

    PubMed

    Ezzat, Ahmed; Iobst, Christopher

    2016-07-01

    A 15-year-old boy presented with a 35° femoral valgus deformity, leg-length discrepancy, painful retained hardware, and a lateral dislocation of the patella 4 years after undergoing lateral plate fixation of a distal femur fracture. Femoral valgus is a possible complication of lateral plate fixation in up to 30% of pediatric distal femur fractures. With this patient's unusual combination of deformities as an example, we suggest early hardware removal after fracture union to prevent the development of deformity. If plate removal is not chosen, then continued close monitoring of the patient is necessary until skeletal maturity. PMID:27243610

  19. Total knee arthroplasty in valgus knees using minimally invasive medial-subvastus approach

    PubMed Central

    Shah, Nilen Amulak; Jain, Nimesh Prakash

    2016-01-01

    Background: An ideal approach for valgus knees must provide adequate exposure with minimal complications due to approach per se. Median parapatellar approach is most commonly used approach in TKA including valgus knees. A medial subvastus approach is seldom used for valgus knees and has definite advantages of maintaining extensor mechanism integrity and minimal effect on patellar tracking. The present study was conducted to evaluate outcomes of total knee arthroplasty (TKA) and efficacy of subvastus approach in valgus knees in terms of early functional recovery, limb alignment and complications. Materials and Methods: We retrospectively reviewed 112 knees with valgus deformity between January 2006 and December 2011. All patients were assessed postoperatively for pain using Visual Analog Scale (VAS) and quadriceps recovery in form of time to active straight leg raising (SLR) and staircase competency and clinical outcomes using American Knee Society (AKS) score and radiographic evaluation with average followup of 40 months (range 24–84 months). Results: The mean VAS on postoperative day (POD) 1 and POD2 at rest was 2.73 and 2.39, respectively and after mobilization was 3.28 and 3.08, respectively (P < 0.001). The quadriceps recovery was very early and 92 (86.7%) patients were able to do active SLR by POD1 with mean time of 21.98 h while reciprocal gait and staircase competency was possible at 43.05 h. The AKS and function score showed significant improvement from preoperative mean score of 39 and 36 to 91 and 79 (P < 0.001), respectively, and the mean range of motion increased from 102° preoperatively to 119° at recent followup (P < 0.001). The mean tibiofemoral valgus was corrected from preoperative 16° (range 10°–35°) to 5° (range 3°–9°) valgus (P < 0.001). Conclusions: Mini-subvastus quadriceps approach provides adequate exposure and excellent early recovery for TKA in valgus knees, without increase in incidence of complications. PMID:26955174

  20. Minimally Invasive Arthrodesis of 1st Metatarsophalangeal Joint for Hallux Rigidus.

    PubMed

    Sott, A H

    2016-09-01

    First metatarsophalangeal joint arthrodesis plays a significant role in the management of symptomatic hallux rigidus/osteoarthritis of the 1st metatarsophalangeal joint. Several open and few percutaneous techniques have been described in the literature. This article describes and discusses a percutaneous technique that has been successfully used to achieve a pain-free stable and functional 1st metatarsophalangeal joint. All aspects of surgical indication and operative technique and details of patient-reported outcomes are presented with a referenced discussion. PMID:27524706

  1. The shape of the metatarsal head as a cause of hallux abductovalgus.

    PubMed

    Ferrari, Jill; Malone-Lee, James

    2002-03-01

    The curvature of the 1st metatarsal head was evaluated on 100 radiographs by calculating the functional angle of the joint surface. This measure of curvature varied positively with the degree of hallux abductovalgus (HAV). Using measures of correlation it was found that in males, the association was linear (r2=0.39, p<0.001). In females, a linear relationship was identified only after logarithmic transformation of the data (r2=0.25, p<0.001). Comparison of the functional angle between males and females showed a significant difference (t=-5.03, df=98, p<0.001). PMID:11934066

  2. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus.

    PubMed

    Ford, Kevin R; Nguyen, Anh-Dung; Dischiavi, Steven L; Hegedus, Eric J; Zuk, Emma F; Taylor, Jeffrey B

    2015-01-01

    Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions. PMID:26346471

  3. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus

    PubMed Central

    Ford, Kevin R; Nguyen, Anh-Dung; Dischiavi, Steven L; Hegedus, Eric J; Zuk, Emma F; Taylor, Jeffrey B

    2015-01-01

    Deficits in proximal hip strength or neuromuscular control may lead to dynamic lower extremity valgus. Measures of dynamic lower extremity valgus have been previously shown to relate to increased risk of several knee pathologies, specifically anterior cruciate ligament ruptures and patellofemoral pain. Therefore, hip-focused interventions have gained considerable attention and been successful in addressing these knee pathologies. The purpose of the review was to identify and discuss hip-focused exercise interventions that aim to address dynamic lower extremity valgus. Previous electromyography, kinematics, and kinetics research support the use of targeted hip exercises with non-weight-bearing, controlled weight-bearing, functional exercise, and, to a lesser extent, dynamic exercises in reducing dynamic lower extremity valgus. Further studies should be developed to identify and understand the mechanistic relationship between optimized biomechanics during sports and hip-focused neuromuscular exercise interventions. PMID:26346471

  4. Effects of rearfoot-controlling orthotic treatment on dorsiflexion of the hallux in feet with abnormal subtalar pronation: a preliminary report.

    PubMed

    Munuera, Pedro V; Domínguez, Gabriel; Palomo, Inmaculada C; Lafuente, Guillermo

    2006-01-01

    The aim of this study was to determine whether the treatment of abnormal subtalar pronation restores functional (as opposed to structural) limited dorsiflexion of the first metatarsophalangeal joint (functional hallux limitus). We studied 16 feet of eight individuals with abnormal subtalar pronation. Orthoses were made for all of the feet, and hallux dorsiflexion was measured during weightbearing. Each patient was unshod without the orthosis, unshod with the orthosis fitted on the same day, and unshod with the orthosis fitted approximately 5 months later. The results suggest that in functional hallux limitus caused by abnormal subtalar pronation, hallux dorsiflexion will gradually be restored by the use of foot orthoses to control the abnormal subtalar pronation. PMID:16868319

  5. First metatarsophalangeal joint replacement with total arthroplasty in the surgical treatment of the hallux rigidus.

    PubMed

    Valentini, Roberto; De Fabrizio, Giovanni; Piovan, Gianluca

    2014-01-01

    The hallux rigidus, especially in advanced stage, has always been a challenge as regards the surgical treatment. Over the years there have been various surgical techniques proposed with the aim of relieving pain, correcting deformity and maintain a certain degree of movement. For some years we have addressed the problem with the replacement metatarsophalangeal joint arthroplasty with Reflexion system. As far as our experience we have operated and monitored 25 patients (18 females and 7 males) of mean age 58.1 years, operated with this technique from June 2008 to June 2011. It reached an average ROM of 72° (extension and flexion 45° and 27°) with a good functional recovery in 8 patients, and this articulation was good (50° - 40°) in 12 patients and moderate in 5 with a articular range from 40°- 30°. The clinical results, according to our experience, appear to be favorable, as even patient satisfaction is complete. PMID:25409730

  6. [The Rubinstein-Taybi syndrome or a broad thumb-hallux syndrome].

    PubMed

    Hosek, J; Borková, A

    2008-01-01

    The Rubinstein-Taybi syndrome (broad thumb-hallux syndrome) is a rare congenital disease with prevalence 1:125,000 of life-born children. It is characterised by multiplex malformations, which includes growth and psychomotor retardation. Up to this date, over 1000 cases have been described in literature. This review is mainly focused on a description of symptoms, which occur in the syndrome mentioned above and serve as main diagnostic markers. Mutations in the CBP and the p300 genes have been associated with this disease as well. Therefore, substantial part is devoted to aetiology, where emphasis is put on a genetic origin of the Rubinstein-Taybi syndrome. Possibilities of this diagnose are mentioned at the end of the article. PMID:18401977

  7. Impaired varus-valgus proprioception and neuromuscular stabilization in medial knee osteoarthritis.

    PubMed

    Chang, Alison H; Lee, Song Joo; Zhao, Heng; Ren, Yupeng; Zhang, Li-Qun

    2014-01-22

    Impaired proprioception and poor muscular stabilization in the frontal plane may lead to knee instability during functional activities, a common complaint in persons with knee osteoarthritis (KOA). Understanding these frontal plane neuromechanical properties in KOA will help elucidate the factors contributing to knee instability and aid in the development of targeted intervention strategies. The objectives of the study were to compare knee varus-valgus proprioception, isometric muscle strength, and active muscular contribution to stability between persons with medial KOA and healthy controls. We evaluated knee frontal plane neuromechanical parameters in 14 participants with medial KOA and 14 age- and gender-matched controls, using a joint driving device (JDD) with a customized motor and a 6-axis force sensor. Analysis of covariance with BMI as a covariate was used to test the differences in varus-valgus neuromechanical parameters between these two groups. The KOA group had impaired varus proprioception acuity (1.08±0.59° vs. 0.69±0.49°, p<0.05), decreased normalized varus muscle strength (1.31±0.75% vs. 1.79±0.84% body weight, p<0.05), a trend toward decreased valgus strength (1.29±0.67% vs. 1.88±0.99%, p=0.054), and impaired ability to actively stabilize the knee in the frontal plane during external perturbation (4.67±2.86 vs. 8.26±5.95 Nm/degree, p<0.05). The knee frontal plane sensorimotor control system is compromised in persons with medial KOA. Our findings suggest varus-valgus control deficits in both the afferent input (proprioceptive acuity) and muscular effectors (muscle strength and capacity to stabilize the joint). PMID:24321442

  8. Impaired Varus-Valgus Proprioception and Neuromuscular Stabilization in Medial Knee Osteoarthritis

    PubMed Central

    Chang, Alison H.; Lee, Song Joo; Zhao, Heng; Ren, Yupeng; Zhang, Li-Qun

    2014-01-01

    Impaired proprioception and poor muscular stabilization in the frontal plane may lead to knee instability during functional activities, a common complaint in persons with knee osteoarthritis (KOA). Understanding these frontal plane neuromechanical properties in KOA will help elucidate the factors contributing to knee instability and aid in the development of targeted intervention strategies. The study objectives were to compare knee varus-valgus proprioception, isometric muscle strength, and active muscular contribution to stability between persons with medial KOA and healthy controls. We evaluated knee frontal plane neuromechanical parameters in 14 participants with medial KOA and 14 age- and gender-matched controls, using a joint driving device (JDD) with a customized motor and a 6-axis force sensor. Analysis of covariance with BMI as a covariate was used to test the differences in varus-valgus neuromechanical parameters between these two groups. The KOA group had impaired varus proprioception acuity (1.08 ± 0.59° vs. 0.69 ± 0.49°, p < 0.05), decreased normalized varus muscle strength (1.31 ± 0.75% vs. 1.79 ± 0.84% body weight, p < 0.05), a trend toward decreased valgus strength (1.29 ± 0.67% vs. 1.88 ± 0.99%, p = 0.054), and impaired ability to actively stabilize the knee in the frontal plane during external perturbation (4.67 ± 2.86 vs. 8.26 ± 5.95 Nm/degree, p < 0.05). The knee frontal plane sensorimotor control system is compromised in persons with medial KOA. Our findings suggest varus-valgus control deficits in both the afferent input (proprioceptive acuity) and muscular effectors (muscle strength and capacity to stabilize the joint). PMID:24321442

  9. Growth modulation with a medial malleolar screw for ankle valgus deformity

    PubMed Central

    Rupprecht, Martin; Spiro, Alexander S; Breyer, Sandra; Vettorazzi, Eik; Ridderbusch, Karsten; Stücker, Ralf

    2015-01-01

    Background and purpose Growth modulation with a medial malleolar screw is used to correct ankle valgus deformity in children with a wide spectrum of underlying etiologies. It is unclear whether the etiology of the deformity affects the angular correction rate with this procedure. Patients and methods 79 children (20 girls) with ankle valgus deformity had growth modulation by a medial malleolar screw (125 ankles). To be included, patients had to have undergone screw removal at the time of skeletal maturity or deformity correction, or a minimum follow-up of 18 months, and consistent radiographs preoperatively and at the time of screw removal and/or follow-up. The patients were assigned to 1 of 7 groups according to their underlying diagnoses. The lateral distal tibial angle (LDTA) was analyzed preoperatively, at screw removal, and at follow-up. Results Mean age at operation was 11.7 (7.4–16.5) years. The average lateral distal tibial angle normalized from 80° (67–85) preoperatively to 89° (73–97) at screw removal. The screws were removed after an average time of 18 (6–46) months, according to an average rate of correction of 0.65° (0.1–2.2) per month. No significant differences in the correction rate per month were found between the groups (p = 0.3). Interpretation Growth modulation with a medial malleolar screw is effective for the treatment of ankle valgus deformity in patients with a wide spectrum of underlying diagnoses. The individual etiology of the ankle valgus does not appear to affect the correction rate after growth modulation. Thus, the optimal timing of growth modulation mainly depends on the remaining individual growth and on the extent of the deformity. PMID:25909385

  10. Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS.

    PubMed

    Chen, Hang; Hu, Xiaochuan; Tang, Haochen; Yang, Guoyong; Xiang, Ming

    2015-01-01

    There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61-74) with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 11-34) months. The fractures united in an average of 7.2 (6-14) weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4 ± 4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed. PMID:26693491

  11. Distal oblique osteotomy of the first metatarsal for the correction of hallux limitus and rigidus deformity.

    PubMed

    Ronconi, P; Monachino, P; Baleanu, P M; Favilli, G

    2000-01-01

    The purpose of this study was to evaluate the effectiveness of the distal oblique osteotomy of the first metatarsal (a triplanar shortening decompression osteotomy) to correct stage I and II hallux rigidus. The osteotomy cut is performed from dorsal-distal to plantar-proximal with an angle ranging from 35 degrees to 45 degrees in the sagittal plane. The capital fragment is then displaced plantarly and proximally and fixed with two screws and the metatarsal head is remodeled. From January 1993 through December 1995, a total of 26 patients (21 females and 5 males) underwent 30 distal oblique osteotomies of the first metatarsal (22 unilateral and 4 bilateral). The mean age of the patients was 54 years and the mean follow-up was 21 months. Patient satisfaction and objective clinical and radiographic measurements were evaluated. Patients' satisfaction was measured postoperatively with a modification of the University of Maryland 100-Point Painful Foot Center Scoring System. The results were: 84% good to excellent; 7% fair; and 9% poor. Radiographic measurements included: intermetatarsal angle mean: preop = 12.2 degrees, postop = 8.6 degrees; proximal articular set angle mean: preop = 11.8 degrees; postop = 10.3 degrees. There was no evidence of avascular necrosis in any of the cases. Clinical findings were: dorsiflexion of the first metatarsophalangeal joint: preop = 22 degrees, postop = 45 degrees; plantarflexion of the first metatarsophalangeal joint: preop = 15 degrees, postop = 18 degrees; hallux purchase power: preop = 2.5, postop = 2.3; pain on the second and third metatarsophalangeal joints, associated with excessive pressure on the central metatarsal heads: preop--present in 10 patients, postop--present in 12 patients; forefoot supination angle: preop = 13 degrees, postop = 7 degrees. PMID:10862386

  12. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    PubMed

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-01-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist. PMID:26291149

  13. Hallux Rigidus

    MedlinePlus

    ... example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing ... Shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles ...

  14. Hallux Rigidus

    MedlinePlus

    ... Search by GPS Please enter a city or last name. Use your current position? {{ps.position.alert.message}} ... digit zip code. Please enter a city or last name. Search Where do you hurt? Interactive Foot Diagram ...

  15. Prostate cancer metastasis to the distal phalanx of the left hallux: The first confirmed case and literature review

    PubMed Central

    Sui, Xinbing; Hu, Yan; Zhang, Cheng; Pan, Hongming; Li, Da

    2016-01-01

    Prostate cancer is one of the most common carcinomas in Asia, as well as all over the world. The vast majority of prostate cancer patients present with bone metastases, which mainly involve the axial bones, with pain as the most common symptom. The present study reports the first case of prostate cancer metastasis to the hallux in a 73-year-old man who presented with pain and a swollen phalanx of the left hallux. This symptom developed gradually over a period of several months and could not be improved with the common treatments. Due to a pathological fracture, amputation of the left phalanx was performed. Notably, the immunohistochemical examinations of the surgical sample demonstrated the presence of a metastatic lesion from prostate cancer. The present study describes an unusual presentation involving phalangeal metastasis in a prostate cancer patient, and a systematic review of reported cases of rare metastatic events in prostate cancer is also discussed. PMID:27446396

  16. The Wilson bunion procedure modified for improved clinical results.

    PubMed

    Pittman, S R; Burns, D E

    1984-01-01

    The Wilson procedure for correction of hallux abducto valgus is modified for use in three specific clinical conditions. The modifications are outlined and demonstrated in the preoperative conditions of 1) juvenile hallux abducto valgus, 2) functional hallux limitus, and 3) postoperative metatarsus primus elevatus. The rationale and biomechanical considerations for the modified Wilson bunion procedure are discussed. PMID:6470430

  17. Asymmetric varus and valgus stability of the anatomic cadaver knee and the load sharing between collateral ligaments and bearing surfaces.

    PubMed

    Wang, Xiaonan; Malik, Aamer; Bartel, Donald L; Wickiewicz, Thomas L; Wright, Timothy

    2014-08-01

    Knee joint stability is important in maintaining normal joint motion during activities of daily living. Joint instability not only disrupts normal motion but also plays a crucial role in the initiation and progression of osteoarthritis. Our goal was to examine knee joint coronal plane stability under varus or valgus loading and to understand the relative contributions of the mechanisms that act to stabilize the knee in response to varus-valgus moments, namely, load distribution between the medial and lateral condyles and the ligaments. A robot testing system was used to determine joint stability in human cadaveric knees as described by the moment versus angular rotation behavior under varus and valgus loads at extension and at 30 deg and 90 deg of flexion. The anatomic knee joint was more stable in response to valgus than varus moments, and stability decreased with flexion angle. The primary mechanism for providing varus-valgus stability was the redistribution of the contact force on the articular surfaces from both condyles to a single condyle. Stretching of the collateral ligaments provided a secondary stabilizing mechanism after the lift-off of a condyle occurred. Compressive loads applied across the knee joint, such as would occur with the application of muscle forces, enhanced the ability of the articular surface to provide varus-valgus moment, and thus, helped stabilize the joint in the coronal plane. Coupled internal/external rotations and anteroposterior and medial-lateral translations were variable and in the case of the rotations were often as large as the varus-valgus rotations created by the applied moment. PMID:24828416

  18. Foot kinematics in walking on a level surface and on stairs in patients with hallux rigidus before and after cheilectomy

    PubMed Central

    2014-01-01

    Background Walking down stairs is a clinically relevant daily activity for older persons. The aim of this pilot study was to investigate the impact of cheilectomy on walking on level ground and on stairs. Methods 3D motion analysis of foot kinematics was performed in eight patients with hallux rigidus and 11 healthy control participants with a 12-camera system, using the Heidelberg foot measurement method before and one year after surgery. The clinical results were documented using the AOFAS Scale. Results The range of motion of the first metatarsophalangeal joint did not improve after the operation under any gait condition. Preoperatively, hallux dorsi-/plantarflexion in level walking was 11.9° lower in patients than in controls (p = 0.006), postoperatively 14.5° lower (p = 0.004). Comparing walking conditions in patients, hallux dorsi-/plantarflexion was significantly higher in level walking than in climbing stairs (difference up stairs – level: -8.1°, p = 0.018). The AOFAS Scale improved significantly from 56.9 ± 19.9 points (mean ± SD), preoperatively, to 75.9 ± 13.9 points, postoperatively (p = 0.027). Conclusions Cheilectomy is appropriate for reducing symptoms of hallux rigidus. However, neither a positive influence on the range of motion in walking on level ground and on stairs nor a functional improvement was observed in this group of patients. Trial registration NCT01804491 PMID:24524773

  19. Developing a 6-DOF robot to investigate multi-axis ACL injuries under valgus loading coupled with tibia internal rotation.

    PubMed

    Ren, Yupeng; Jacobs, Benjamin J; Nuber, Gordon W; Koh, Jason L; Zhang, Li-Qun

    2010-01-01

    Anterior cruciate ligament (ACL) injuries have become more common in recent years as more young people participate in risky sporting activities [1]. Most ACL injuries occur as a result of noncontact mechanisms. Previous in vitro studies of ACL strain have found significant increases in ACL strain primarily with anterior directed force on the tibia relative to the femur and with internal rotation and often with valgus torque [2,3]. However, there remains significant controversy over the mechanisms of ACL failure and the forces on the knee that lead to injury. Some studies have also shown that isolated valgus loading may not load the ACL strongly. The goal of this study was to investigate the mechanism underlying valgus-related ACL injuries. An improved understanding of ACL failure may lead to improved ACL injury prevention programs. A novel 6 degrees of freedom (DOF) knee driving robot was developed in this study with a unique multi-axis simultaneous torque/position control. It was found that pure valgus torque caused a torque that internally rotated the tibia and thus increased ACL strain markedly, which may be an important mechanism underlying the rather common seemingly valgus-related ACL injuries. PMID:21097089

  20. Optimizing whole-body kinematics to minimize valgus knee loading during sidestepping: implications for ACL injury risk.

    PubMed

    Donnelly, C J; Lloyd, D G; Elliott, B C; Reinbolt, J A

    2012-05-11

    The kinematic mechanisms associated with elevated externally applied valgus knee moments during non-contact sidestepping and subsequent anterior cruciate ligament (ACL) injury risk are not well understood. To address this issue, the residual reduction algorithm (RRA) in OpenSim was used to create nine subject-specific, full-body (37 degrees of freedom) torque-driven simulations of athletic males performing unplanned sidestep (UnSS) sport tasks. The RRA was used again to produce an optimized kinematic solution with reduced peak valgus knee torques during the weight acceptance phase of stance. Pre-to-post kinematic optimization, mean peak valgus knee moments were significantly reduced by 44.2 Nm (p=0.045). Nine of a possible 37 upper and lower body kinematic changes in all three planes of motion were consistently used during the RRA to decrease peak valgus knee moments. The generalized kinematic strategy used by all nine simulations to reduce peak valgus knee moments and subsequent ACL injury risk during UnSS was to redirect the whole-body center of mass medially, towards the desired direction of travel. PMID:22387123

  1. PROXIMAL FEMURAL VALGUS SUBTROCHANTERIC OSTEOTOMY FOR NON UNION OF TROCHANTERIC FRACTURES

    PubMed Central

    Silva, Paulo; Coelho, Danilo Lopes; Curi, Calim; de Oliveira, Leandro Alves; de Moraes, Frederico Barra; do Amaral, Rogério Andrade; Rebello, Percival Rosa

    2015-01-01

    Objectives: To evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. Methods: A retrospective study of cases series. From 1998 September to 2009 January, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the Ortophaedic And Traumatology service of the Hospital Geral de Goiania (HGG). The patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3rd months after the initial surgery. Results: Patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. The mean time from first surgery to osteotomy was six months. Bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. The mean hip varus angle was 1050 (1200 to 900). After surgery, the mean hip valgus angle was 1440 (1550 to 1350). We had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with DHS of 1500, with valgization to 1540. After six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. Conclusion: Valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb. PMID:27027080

  2. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara

    PubMed Central

    Khairy, Hosam Mohamed

    2016-01-01

    Background Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Methods Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. Results The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p < 0.001). Radiological results showed that all osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p < 0.001) at the final follow-up. The femoral neck shaft angle was improved from 93.7° to 129.9° (p < 0.001) at the final follow-up. Shortening of the affected limb was corrected from 2.8 cm to 1.3 cm (p < 0.001) at the last follow-up. No major serious complications were recorded in the present study. Conclusions Intertrochanteric valgus osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara

  3. Hallux rigidus: Joint preserving alternatives to arthrodesis - a review of the literature.

    PubMed

    Polzer, Hans; Polzer, Sigmund; Brumann, Mareen; Mutschler, Wolf; Regauer, Markus

    2014-01-18

    Hallux rigidus describes the osteoarthritis of the first metatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numerous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter. PMID:24649409

  4. Hallux rigidus: Joint preserving alternatives to arthrodesis - a review of the literature

    PubMed Central

    Polzer, Hans; Polzer, Sigmund; Brumann, Mareen; Mutschler, Wolf; Regauer, Markus

    2014-01-01

    Hallux rigidus describes the osteoarthritis of the first metatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numerous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter. PMID:24649409

  5. DISTAL FEMORAL VARUSING FOR OSTEOARTHRITIS OF VALGUS KNEE: A LONG-TERM FOLLOW-UP

    PubMed Central

    Andrade, Marco Antônio Percope de; Gomes, Davi Coutinho Fonseca Fernandes; Portugal, André Lopes; Silva, Guilherme Moreira de Abreu e

    2015-01-01

    Objective: Assess the long-term results of distal femoral varusing osteotomy and try to establish predictive criteria that could help on selecting patients to be submitted to this technique. Methods: Fifteen patients with lateral compartment osteoarthritis and valgus deformity of the knee were submitted to distal femoral “V” varusing osteotomy fixated with lateral plate, pursuing knee alignment at 0° on the anatomical axis. The mean follow-up period was 81.4 months, ranging from 43 to 132 months. The Knee Society Rating System protocol was employed. Additional assessed variables were the following: patient age, follow-up time, and postoperative anatomical angle. Results: 11 results were regarded as excellent or good (73%) and four as fair or poor (27%). Conclusion: Distal femoral “V” varusing osteotomy constitutes a good treatment alternative for patients with lateral compartment osteoarthritis and valgus knee. The following variables have not been confirmed: patient age at the time of surgery, follow-up time, and postoperative anatomical angle as predictive factors for the results. PMID:27022518

  6. Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

    PubMed

    Malcolm, Tennison L; Bederman, S Samuel; Schwarzkopf, Ran

    2016-01-01

    The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses. PMID:26730689

  7. Plantar pressure distribution in older people with osteoarthritis of the first metatarsophalangeal joint (hallux limitus/rigidus).

    PubMed

    Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B

    2008-12-01

    The purpose of this study was to evaluate differences in dynamic plantar pressure distribution between older people with and without radiographically confirmed osteoarthritis (OA) of the first metatarsophalangeal joint (first MPJ) of the foot. Dynamic plantar pressure recordings using the TekScan MatScan system were obtained during barefoot level walking in 40 older participants; 20 with radiographically confirmed OA of the first MPJ displaying less than 55 degrees of passive dorsiflexion, and 20 with no evidence of OA in the first MPJ displaying greater than 55 degrees of passive dorsiflexion. Group comparisons between the variables maximum force and peak pressure were made for seven different regions underneath the right foot (heel, midfoot, first MPJ, second MPJ, third to fifth MPJs, hallux, and lesser toes). Compared to the control group, participants with OA of the first MPJ exhibited 34% greater maximum force (7.9 +/- 2.5 vs. 5.9 +/- 1.7 kg, p = 0.005) and 23% higher peak pressure (1.6 +/- 0.3 vs. 1.3 +/- 0.3 kg/cm(2), p = 0.001) under the hallux. Similar results were also found under the lesser toes with 43% greater maximum force (5.0 +/- 1.9 vs. 3.5 +/- 1.4 kg; p = 0.006) and 29% higher peak pressure (0.9 +/- 0.2 vs. 0.7 +/- 0.2 kg/cm(2), p = 0.018). No significant differences were found to exist between groups for any other plantar region. These findings indicate that OA of the first MPJ is associated with significant changes in load-bearing function of the foot, which may contribute to the development of secondary pathological changes associated with the condition, such as plantar callus formation and hyperextension of the hallux interphalangeal joint. PMID:18634037

  8. Geometric pattern of the hominoid hallucal tarsometatarsal complex. Quantifying the degree of hallux abduction in early hominids

    NASA Astrophysics Data System (ADS)

    Berillon, Gilles

    1999-05-01

    The degree of hallux abduction in extant and fossil hominoids is analysed in terms of geometric relationships between the first metatarsal and the medial cuneiform and quantified by angular data, in relation to grasping ability and locomotor pattern. The 'australopithecine' pattern corresponds to an abducted first podal ray with some grasping abilities and seems to be derived from a ' Proconsul-like' pattern rather than a 'living African great ape-like' pattern. The Olduvai Hominid 8 condition closely resembles that of the modern human which corresponds to a full bipedalism.

  9. The Role of Varus and Valgus Alignment in the Initial Development of Knee Cartilage Damage by MRI: the MOST Study

    PubMed Central

    Sharma, Leena; Chmiel, Joan S.; Almagor, Orit; Felson, David; Guermazi, Ali; Roemer, Frank; Lewis, Cora E.; Segal, Neil; Torner, James; Cooke, T. Derek V.; Hietpas, Jean; Lynch, John; Nevitt, Michael

    2013-01-01

    Objective Varus and valgus alignment are associated with progression of knee osteoarthritis, but their role in incident disease is less certain. Radiographic measures of incident knee osteoarthritis may be capturing early progression rather than disease development. We tested the hypothesis: in knees with normal cartilage morphology by MRI, varus is associated with incident medial cartilage damage and valgus with incident lateral damage. Methods In MOST, a prospective study of persons at risk for or with knee osteoarthritis, baseline full-limb x-rays and baseline and 30-month MRIs were acquired. In knees with normal baseline cartilage morphology in all tibiofemoral subregions, we used logistic regression with GEE to examine the association between alignment and incident cartilage damage adjusting for age, gender, BMI, laxity, meniscal tear, and extrusion. Results Of 1881 knees, 293 from 256 persons met criteria. Varus vs. non-varus was associated with incident medial damage (adjusted OR 3.59, 95% CI: 1.59, 8.10), as was varus vs. neutral, with evidence of a dose effect (adjusted OR 1.38/1° varus, 95% CI: 1.19, 1.59). Findings held even excluding knees with medial meniscal damage. Valgus was not associated with incident lateral damage. Varus and valgus were associated with a reduced risk of incident lateral and medial damage, respectively. Conclusion In knees with normal cartilage morphology, varus was associated with incident cartilage damage in the medial compartment, and varus and valgus with a reduced risk of incident damage in the less loaded compartment. These results support that varus increases the risk for initial development of knee osteoarthritis. PMID:22550314

  10. The effects of 4 weeks of jump training on landing knee valgus and crossover hop performance in female basketball players.

    PubMed

    Herrington, Lee

    2010-12-01

    Female basketball players would appear particularly prone to knee injuries. These injuries have been associated with the nature of the sport, but more specifically with the particular movement strategies adopted. A valgus or abducted position of the knee on landing has been reported to be associated with a number of different knee injuries. Jump-training programs have been reported to improve both landing knee valgus and functional performance. The majority of the jump-training programs have been of 6 weeks' duration, 3 sessions per week often lasting up to 1 hour. For most sports coaches, team conditioners, and athletes, this duration and program length is not acceptable. The aim of this study was to assess if an abridged jump-training program could have similar effects to those previously reported. Fifteen female basketball players had their knee valgus angles assessed during 2 landing tasks, drop jump landing, and when undertaking a jump shot and along with crossover hop distance before and after a progressive jump-training program. The jump-training program lasted 4 weeks, 3 times per week, each session lasting 15 minutes. After training, crossover hop distance showed an average percentage improvement on distance jumped of 73.6% (p = 0.001); the drop jump knee valgus angle in the left leg on average was reduced by 9.8° (p = 0.002), right leg reduced by 12.3° (p = 0.0001); during the jump shot, the knee valgus angle in the left leg showed a mean reduction of 4.5° (p = 0.035), and the right leg was reduced by 4.3° (p = 0.01). The study undertaken achieved comparable results to those previously reported with an abridged program over considerably shortened session duration and training period. PMID:20664369

  11. A comparison of the biomechanical effects of valgus knee braces and lateral wedged insoles in patients with knee osteoarthritis.

    PubMed

    Jones, Richard K; Nester, Christopher J; Richards, Jim D; Kim, Winston Y; Johnson, David S; Jari, Sanjiv; Laxton, Philip; Tyson, Sarah F

    2013-03-01

    Increases in the external knee adduction moment (EKAM) have been associated with increased mechanical load at the knee and progression of knee osteoarthritis. Valgus knee braces and lateral wedged insoles are common approaches to reducing this loading; however no study has directly compared the biomechanical and clinical effects of these two treatments in patients with medial tibiofemoral osteoarthritis. A cross-over randomised design was used where each intervention was worn by 28 patients for a two week period. Pre- and post-intervention gait kinematic/kinetic data and clinical outcomes were collected to evaluate the biomechanical and clinical effects on the knee joint. The valgus knee brace and the lateral wedged insole significantly increased walking speed, reduced the early stance EKAM by 7% and 12%, and the knee adduction angular impulse by 8.6 and 16.1% respectively. The lateral wedged insole significantly reduced the early stance EKAM compared to the valgus knee brace (p=0.001). The valgus knee brace significantly reduced the knee varus angle compared to the baseline and lateral wedged insole. Improvements in pain and function subscales were comparable for the valgus knee brace and lateral wedged insole. There were no significant differences between the two treatments in any of the clinical outcomes; however the lateral wedged insoles demonstrated greater levels of acceptance by patients. This is the first study to biomechanically compare these two treatments, and demonstrates that given the potential role of knee loading in osteoarthritis progression, that both treatments reduce this but lateral wedge insoles appear to have a greater effect. PMID:22920242

  12. Clarification of functional differences between the hallux and lesser toes during the single leg stance: immediate effects of conditioning contraction of the toe plantar flexion muscles.

    PubMed

    Saeki, Junya; Tojima, Michio; Torii, Suguru

    2015-09-01

    [Purpose] The purpose of this study was to determine the functional differences of the plantar flexion muscles of the hallux and lesser toes during the single leg stance by comparing postural sway in different conditioning contraction interventions. [Subjects] Thirty-four healthy, young males and females participated in this study. [Methods] The front-back and right-left direction components of maximal displacement and postural sway velocity during the single leg stance were measured in various conditioning contraction interventions for the plantar flexion muscles of the hallux or lessor toes. [Results] The main findings of this study were as follows: 1) the front-back direction component of maximal displacement was reduced by conditioning contraction of the plantar flexion muscles of the hallux, and 2) the front-back direction component of the postural sway velocity was reduced by conditioning contraction of the plantar flexion muscles of the lesser toes during the single leg stance. [Conclusion] The plantar flexion muscles of the lesser toes control the postural sway velocity. Furthermore, the plantar flexion muscles of the hallux appear to control the amplitude of postural sway. PMID:26504272

  13. Valgus-Varus Deformity of the Intertarsal Joint in Broiler Chickens

    PubMed Central

    Julian, R. J.

    1984-01-01

    A lateral or medial angulation of the shaft of the distal tibiotarsal bone resulting in deviation of the lower part of the leg and frequently with bending of the proximal shaft of the tarsometatarsus is the most common leg deformity in broiler chickens. This lateral or medial deviation of the legs in broiler chickens, which has been described by many workers, deserves a specific name such as angular bone deformity or valgus-varus deformity of intertarsal joint, so that it may be separated from other varieties of lameness in broilers. ImagesFigure 1.Figure 2A.Figure 2B.Figure 3.Figure 4.Figures 5A and 5B.Figures 5A and 5B.Figures 6A and 6B.Figures 6A and 6B.Figures 7A and 7B.Figures 7A and 7B.Figure 8. PMID:17422417

  14. Valgus subsidence of the tibial component in cementless Oxford unicompartmental knee replacement

    PubMed Central

    Liddle, A. D.; Pandit, H. G.; Jenkins, C.; Lobenhoffer, P.; Jackson, W. F. M.; Dodd, C. A. F.; Murray, D. W.

    2014-01-01

    The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version. However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed. We present the clinical and radiological findings of these six patients and describe their natural history and the likely causes. Two underwent revision in the early post-operative period, and in four the implant stabilised and became well-fixed radiologically with a good functional outcome. This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients. Cite this article: Bone Joint J 2014;96-B:345–9. PMID:24589789

  15. Bilateral carpal valgus deformity in hand-reared cheetah cubs (Acinonyx jubatus).

    PubMed

    Bell, Katherine M; van Zyl, Malan; Ugarte, Claudia E; Hartman, Angela

    2011-01-01

    Four hand-reared cheetah cubs (Acinonyx jubatus) exhibited progressively severe bilateral valgus deformity of the carpi (CV) during the weaning period. Radiographs of the thoracic limbs suggested normal bone ossification, and serum chemistry was unremarkable. All affected cubs developed CV shortly after the onset of gastroenteritis, which was treated medically, and included use of a prescription diet. A sudden decrease in growth rate was associated with gastrointestinal disease. Before gastroenteritis and CV, affected cubs had higher growth rates than unaffected cubs, despite similar mean daily energy intake. Return to normal thoracic limb conformation was consequent to dietary manipulation (including a reduction in energy intake and vitamin and mineral supplementation), as well as decreased growth rates and recovery from gastroenteritis. The cause of the CV is likely to have been multi-factorial with potentially complex physiological interactions involved. PMID:21462246

  16. The Result of In Situ Pinning for Valgus Impacted Femoral Neck Fractures of Patients over 70 Years Old

    PubMed Central

    Kim, Yoon-Chung; Lee, Joo-Yup; Oh, Seungbae

    2014-01-01

    Purpose We aimed to evaluate the outcome of fixation with cannulated screws for valgus impacted femoral neck fractures in patients over 70 years of age. Materials and Methods We reviewed the outcome in 33 patients older than 70 years with valgus impacted femoral neck fractures who were treated with cannulated screws fixation from May 2007 to December 2010. These patients were followed for at least a year. We assessed the fixation failure rate, body mass index (BMI), bone mineral density (BMD) of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation. Results We identified six patients (18.2%) with failure. Two patients with subtrochanteric fractures through the screw insertion site and another patient with osteonecrosis were excluded from the fixation failure group. No difference was found in age, BMI, BMD of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation between failure and non-failure groups. Conclusion The failure rate of cannualted screw fixation for valgus impacted femoral neck fractures in the elderly patients was not low. Risk of failure should be considered in the management of these patients and accurate assessment for fracture type should be performed using computed tomogram and clinical evaluation.

  17. KINEMATIC ANALYSIS OF KNEE VALGUS DURING DROP VERTICAL JUMP AND FORWARD STEP-UP IN YOUNG BASKETBALL PLAYERS

    PubMed Central

    Maia, Marianna de Freitas; Farias, Déborah; Santana, Haroldo; Miranda, Humberto; Lima, Vicente; Herrington, Lee

    2016-01-01

    Purpose/Background Lower limb asymmetry between dominant and nondominant limbs is often associated with injuries. However, there is a lack of evidence about frontal plane projection angle (FPPA) of the knee joint (knee valgus) during drop vertical jump (DVJ) and forward step-up tasks (FSUP) in young basketball players. Therefore, the purpose of this study was to assess the FPPA (i.e., dynamic knee valgus) via 2D video analysis during DVJ and FSUP tasks in the dominant and nondominant limbs of young male basketball players. Methods Twenty seven young male basketball players (age 14.5 ± 1.3 y, height 161.1 ± 4.1 cm, weight 64.2 ± 10.2 kg) participated in this study. The participants were asked to perform a bilateral DVJ and unilateral FSUP tasks. Kinematic analysis of FPPA was completed via a two-dimensional (2D) examination in order to evaluate the knee valgus alignment during the beginning of the concentric phase of each task. Knee valgus alignment was computed considering the angle between the line formed between the markers at the anterior superior iliac spine and middle of the tibiofemoral joint and the line formed from the markers on the middle of the tibiofemoral joint to the middle of the ankle mortise. Paired t-tests were used to evaluate differences in tasks. Standard error of measurement (SEM) was calculated to establish random error scores. Results There was no difference in knee valgus angle during the DVJ task between dominant (20.2 ± 4.4 º) and nondominant legs (20 ± 4.1 º; p = 0.067). However, a significant difference was noted during FSUP between the non-dominant limb (18.7 ± 3.4 º) when compared to the dominant (21.7 ± 3.5 º; p = 0.001) limb. Conclusion Two dimensional kinematic analysis of knee FPPA may help coaches and other professionals to detect asymmetries between dominant and nondominant limbs, and to develop training programs with the goal of reducing overall lower extremity injury risk

  18. Biomechanical behavior of valgus foot in children with cerebral palsy: A comparative study.

    PubMed

    Guo, Junchao; Wang, Lizhen; Mo, Zhongjun; Chen, Wei; Fan, Yubo

    2015-09-18

    Valgus foot (VF) is the most common foot deformity in children with cerebral palsy (CP), which seriously affects the foot balance in standing and posture control in walking. Little information about the locus and stress of internal bones was available. To accurately describe the biomechanical behavior of the internal bones of VF in CP, we compared the locus and stress of internal bones between the normal foot (NF) and VF by finite element models. Compared with the NF, displacement of the talus and navicular drop in VF increased by 109% and 171% in vertical direction respectively, and the locus of talus had a tendency to clockwise rotation and downward movement in coronal plane. In addition, the abduction angle of forefoot in VF increased up to 10.3°, which was twice more than that in the NF. Moreover, the lateral metatarsophalangeal joints were upward tilted 6.3° comparing with touchdown posture of NF, and peak von Mises stress of the internal bones in VF model concentrated on the fourth metatarsal. The simulation showed that locus of the forefoot, downward rotation of talus head and navicular drop were meaningful to quantify the collapse of medial longitudinal arch. It would provide some suggestions to the rehabilitation treatments of the CP children's VF. PMID:26209085

  19. Valgus knee stress in lumbosacral myelomeningocele: a gait-analysis evaluation.

    PubMed

    Lim, R; Dias, L; Vankoski, S; Moore, C; Marinello, M; Sarwark, J

    1998-01-01

    Twenty-five independent community-ambulating patients with lumbosacral-level myelomeningocele (N = 50 limbs) underwent gait analysis. The limbs of these patients were divided into two groups based on thigh-foot angle (TFA): Group I (n = 20) had marked external tibial torsion, TFA > or = 20 degrees, and group II had TFA between 10 and 20 degrees. Ten limbs were excluded because of neutral or internal alignment. Twenty normal limbs with TFA = 10 degrees served as controls. An abnormal internal varus knee stress during stance was identified in all group I limbs and 12 (70%) of 20 limbs group II limbs compared with controls, which demonstrated an internal valgus stress. This internal varus moment was greater in group I limbs than in the abnormal limbs in group II (p < 0.05). Knee flexion was the only other parameter found to correlate with this stress and only in group I limbs. We conclude that (a) in this patient group, increased external tibial torsion is likely to result in an abnormal internal varus knee stress; (b) TFA > 20 degrees appears significantly to increase this stress; and (c) knee flexion is an important related parameter, but only in limbs with TFA between 10 and 20 degrees. We believe that this abnormal stress may predispose the knee to late arthrosis and that derotational osteotomies to normalize the TFA may prove to have a favorable long-term effect. PMID:9661845

  20. Chronic Bilateral Tibial Stress Fractures with Valgus Treated with Bilateral Intramedullary Nailing: A Case Report

    PubMed Central

    Dailey, Steven K; Archdeacon, Michael T.

    2014-01-01

    Introduction: Stress fractures are overuse injuries most commonly seen in athletes, military recruits, and individuals with endocrine abnormalities. It has been demonstrated that chronic cases of anterior tibial stress fractures refractory to conservative management respond well to intramedullary nailing. To our knowledge, only one report has been published concerning patients with bilateral tibial stress fractures treated with bilateral intramedullary nailing. All patients in the series were high-level athletes. We present the case of a non-athletic patient with chronic bilateral tibial stress fractures and associated deformity successfully treated with bilateral intramedullary nails. Case Report: A 23-year-old Caucasian female full-time student presented with chronic bilateral shin pain for approximately five years. She had failed an extensive regimen of conservative management. She was diagnosed with chronic bilateral tibial stress fractures based on history, physical examination, and radiologic findings. She subsequently underwent sequential intramedullary nailing of her tibiae. Both tibiae were in valgus alignment; however, this did not preclude nail placement. The nails deformed upon insertion into the sclerotic canals to conform to the deformation. Post operatively the tibiae united and patient was relieved of her symptoms. Conclusion: Bilateral intramedullary nailing of chronic bilateral tibial stress fractures should be considered as a treatment option for all patients, not just high-level athletes, who fail a trial of conservative management. Additionally, mild to moderate tibial malalignment does not necessarily preclude tibial nailing as the smaller nails placed in sclerotic canals will likely deform on insertion and conform to the canal. PMID:27298944

  1. First metatarsophalangeal joint arthrodesis versus proximal phalanx hemiarthroplasty for hallux rigidus: feasibility study for a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Osteoarthritis of the first metatarsophalangeal joint (hallux rigidus) leads to pain and poor function and mobility. Arthrodesis is the gold standard treatment for end-stage disease. Total joint arthroplasties have been attempted, but early loosening has been attributed to dorsally directed shear forces on the metatarsal component. Metallic proximal phalangeal hemiarthroplasty theoretically avoids this. Whilst early results are promising, no comparative trials exist comparing this to arthrodesis. Methods/Design The primary objectives are to determine the range of outcome scores between the two treatment arms (to inform a power calculation). Outcome measures will include the MOXFQ, AOFAS-Hallux and EuroQol EQ-5D-5 L. Secondary objectives are to determine the accrual rate, dropout rate and trial acceptability to both patients and surgeons. These data will allow the development of a larger trial with longer follow-up. This is a prospective randomised controlled single-centre study comparing proximal phalanx hemiarthroplasty (AnaToemic, Arthrex Ltd., Sheffield, UK) with arthrodesis (15 patients in each arm). Randomisation will be performed using a 1:1 allocation ratio in blocks of six. Patients meeting the eligibility criteria will be recruited from three foot and ankle consultant surgeon’s clinics (East Lancashire Hospitals NHS Trust). If agreeable, informed consent will be obtained before patients are randomised. The outcome measure scores will be completed pre-operatively and repeated at 6 weeks, 3 months and 12 months. A radiological review will be performed at 6 weeks and 12 months to determine rates of loosening (hemiarthroplasty) and union (arthrodesis). Data on length of stay, return to work, complications and re-operation rates will also be collected. The analysis will compare the change in outcome scores between treatment groups at all follow-up time points. Scores will be compared using a Student t-test, adjusting for scores at baseline

  2. Functional hallux limitus or rigidus caused by a tenodesis effect at the retrotalar pulley: description of the functional stretch test and the simple hoover cord maneuver that releases this tenodesis.

    PubMed

    Vallotton, Jacques; Echeverri, Santiago; Dobbelaere-Nicolas, Vinciane

    2010-01-01

    Functional hallux limitus is a loss of metatarsophalangeal joint extension during the second half of the single-support phase, when the weightbearing foot is in maximal dorsiflexion. Functionally, it constitutes a sagittal plane blockade during gait. As a result, the mechanical support and stability mechanisms of the foot are disrupted, with important consequences during gait. Functional hallux limitus is a frequent, though relatively unknown condition that clinicians may overlook when examining patients with complaints that are not limited to their feet, for they can also present other symptoms such as hip, knee and lower-back pain. The purpose of this article is to present a critical review of the literature on functional hallux limitus and to explain a previously described and simple diagnostic test (flexor hallucis longus stretch test) and a physiotherapeutic manipulation (the Hoover cord maneuver) that recovers the dorsiflexion of the hallux releasing the tenodesis effect at the retrotalar pulley, which according to our clinical experience is the main cause of functional hallux limitus. The latter, to the best of our knowledge, has never been described before. PMID:20479455

  3. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function☆

    PubMed Central

    Almeida, Gabriel Peixoto Leão; Silva, Ana Paula de Moura Campos Carvalho e; França, Fábio Jorge Renovato; Magalhães, Maurício Oliveira; Burke, Thomaz Nogueira; Marques, Amélia Pasqual

    2016-01-01

    Objective To investigate the relationship between the q-angle and anterior knee pain severity, functional capacity, dynamic knee valgus and hip abductor torque in women with patellofemoral pain syndrome (PFPS). Methods This study included 22 women with PFPS. The q-angle was assessed using goniometry: the participants were positioned in dorsal decubitus with the knee and hip extended, and the hip and foot in neutral rotation. Anterior knee pain severity was assessed using a visual analog scale, and functional capacity was assessed using the anterior knee pain scale. Dynamic valgus was evaluated using the frontal plane projection angle (FPPA) of the knee, which was recorded using a digital camera during step down, and hip abductor peak torque was recorded using a handheld dynamometer. Results The q-angle did not present any significant correlation with severity of knee pain (r = −0.29; p = 0.19), functional capacity (r = −0.08; p = 0.72), FPPA (r = −0.28; p = 0.19) or isometric peak torque of the abductor muscles (r = −0.21; p = 0.35). Conclusion The q-angle did not present any relationship with pain intensity, functional capacity, FPPA, or hip abductor peak torque in the patients with PFPS. PMID:27069887

  4. Adolescent development

    MedlinePlus

    Development - adolescent; Growth and development - adolescent ... During adolescence, children develop the ability to: Understand abstract ideas. These include grasping higher math concepts, and developing moral ...

  5. Adolescent development

    MedlinePlus

    Development - adolescent; Growth and development - adolescent ... rights and privileges. Establish and maintain satisfying relationships. Adolescents will learn to share intimacy without feeling worried ...

  6. Reliability and concurrent validity between two-dimensional and three-dimensional evaluations of knee valgus during drop jumps

    PubMed Central

    Ortiz, Alexis; Rosario-Canales, Martin; Rodríguez, Alejandro; Seda, Alexie; Figueroa, Carla; Venegas-Ríos, Heidi L

    2016-01-01

    Purpose The aim of this study was to establish the concurrent validity and reliability of four different two-dimensional (2D) video-based techniques for quantifying frontal plane knee kinematics during a 40 cm double-legged drop jump. Participants and methods A convenience sample of 16 healthy participants (nine males and seven females; age: [mean ± standard deviation] 25.5±2 years; body mass index: 24.33±2.98 kg/m2) participated in this investigation. A total of five trials during a 40 cm drop jump maneuver with a countermovement jump were used as the functional task. Four knee valgus measures, such as two different frontal plane projection angle measures, knee-to-ankle separation ratio (KASR), and knee separation distance (KSD), were measured using 2D and three-dimensional (3D) systems. To generalize to the greater population of possible evaluators, the testers performing the biomechanical analyses were three novice physical therapists. Intra- and intertester intraclass correlation coefficients (ICCs) were estimated for 2D analysis variables. ICCs were estimated for all measures between systems to determine concurrent validity of the 2D system. Results All four 2D measures showed good to excellent reliability (ICC: 0.89–0.99). KASR and KSD showed excellent correlation (ICC: 0.96; 95% CI: 0.82–0.98 and ICC: 0.94; 95% CI: 0.90–0.96, respectively) with the 3D system, while both methods of frontal plane projection angle showed poor to moderate correlation (ICC: 0–0.57) with the 3D system. Conclusion 2D KASR and KSD measures are cost effective, reliable, and highly correlated with the same measures using 3D techniques for the evaluation of knee valgus. PMID:27313480

  7. Common medial elbow injuries in the adolescent athlete.

    PubMed

    Leahy, Ian; Schorpion, Melissa; Ganley, Theodore

    2015-01-01

    Recently there has been increased year-round sports participation among children and adolescents with limited to no rest periods. This has led to increases in pediatric repetitive stress injuries, once considered a rarity. Whether in the throwing athlete or in the athlete that experiences repetitive axial loading; increased medial tension and overload syndromes can lead to stress reactions and fractures. This occurs in the developing athlete due to the bone being weaker than the surrounding tendons and ligaments. The medial elbow is a high stress area and is susceptible to many conditions including apophysitis , avulsion fractures and ulnar collateral ligament disruption. Valgus stress can cause injury to the medial elbow which can lead to increased lateral compression, Panner's disease and osteochondral lesions of the capitellum and olecranon. The purpose of this manuscript is to review common elbow disorders in the adolescent population, outline management and highlight important features of rehabilitation. PMID:25840494

  8. [Application of the pulsed low-frequency electrostatic field in the early rehabilitative treatment of patients following surgery for the correction of valgus deformation of the first toe].

    PubMed

    Razumov, A N; Li, A A; Kotenko, K V; Korchazhkina, N B; Orekhova, E M; Kazantsev, A B; Li, E A

    2010-01-01

    This paper describes the method and results of application of the pulsed low-frequency electrostatic field (PLFESF) to the lower extremities of the patients who underwent surgical treatment for the correction of valgus deformation of the first toe. The efficiency of the method used in the early period of rehabilitative treatment was estimated at 93.3% compared with 96.7% in the patients who were managed by the same therapy in combination with polyoxdonium. PMID:21086590

  9. Swanson's silastic implants in great toes.

    PubMed

    Sethu, A; D'Netto, D C; Ramakrishna, B

    1980-02-01

    This is a review of 77 partial replacement and interposition arthroplasties in which Silastic implants were used. The operations were carried out between 1971 and 1977 on the metatarsophalangeal joints of the great toes of 62 patients. Twenty-six of the operations were for painful hallux rigidus and 51 for hallux valgus. The patients were reviewed 12 to 92 months after operation, the average follow-up being 60 months. The analysis of results indicated that while the procedure may be suitable for hallux rigidus its use for hallux valgus is not fully satisfactory in the long run. PMID:7351441

  10. Least Possible Fixation Techniques of 4-Part Valgus Impacted Fractures of the Proximal Humerus: A Systematic Review

    PubMed Central

    Panagopoulos, Andreas; Tatani, Irini; Ntourantonis, Dimitrios; Seferlis, Ioannis; Kouzelis, Antonis; Tyllianakis, Minos

    2016-01-01

    The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. We systematically reviewed clinical studies assessing the benefits and harms of least possible fixation techniques (LPFT) for this unique fracture type. Such information would be potentially helpful in developing an evidence-based approach in the management of these complex injuries. We performed analytic searches of PubMed, Embase, Web of Science, Google Scholar and the Cochrane Library, restricting it to the years 1991-2014. Included studies had to describe outcomes and complications after primary osteosynthesis with any type of LPFT apart from plate-screws and intramedullary nailing. Eligibility criteria were also included English language, more than 5 cases, minimum follow up of one year and report of clinical outcome using at least one relevant score (Constant, Neer or ASES). Based on 292 database hits we identified 12 eligible studies including 190 four-part valgus impacted fractures in 188 patients. All eligible studies were case series composed of min 8 to max 45 patients per study. The gender distribution was 60% (112) female and 40% (76) male. The average age of the patients at the time of injury was 54.5 years. In 8/12 studies an open reduction was used for fracture fixation using different surgical techniques including KW, cerclage wires, cannulated screws and osteosutures. Closed reduction and percutaneous fixation was used in 4 studies. Mean follow-up time ranged from 24 to 69 months. A good functional outcome (constant score >80) was reported in 9/12 studies. The most common complication was avascular necrosis of the humeral head with an overall incidence of 11% (range, 0-26.3%). Total avascular necrosis (AVN) was found in 15/188 patients (7.9%) and was more common in percutaneous techniques and partial AVN in 6/188 (3

  11. Salter-Harris type III and IV displaced fracture of the hallux in young gymnasts: A series of four cases at 1-year follow-up.

    PubMed

    Perugia, Dario; Fabbri, Mattia; Guidi, Marco; Lepri, Marco; Masi, Vincenzo

    2014-12-01

    The purpose of this study was to describe four exceptional cases of Salter-Harris type III and IV fractures of the proximal phalanx of the hallux in young high-level gymnasts. All gymnasts underwent the same mechanism of injury of hyperadduction, which indicates a role of the abductor hallucis muscle in the genesis and displacement of these fractures. An open reduction and internal fixation was performed to achieve an anatomical reduction and avoid chronic disability. At 1-year follow-up, all patients had an excellent American Orthopaedic Foot and Ankle Society (AOFAS) score (100 points), and there was no shortening or angulation of the first ray and no evidence of degenerative joint disease on X-ray. Moreover, all the gymnasts had returned to pre-injury levels of sporting activity. To our knowledge, there are no previous studies that address these types of injuries and how they are handled in gymnasts. PMID:25457317

  12. 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

  13. [Physiological adolescence, pathological adolescence].

    PubMed

    Olié, Jean-Pierre; Gourion, David; Canceil, Olivier; Lôo, Henri

    2006-11-01

    The uncertainties of looming adulthood, nostalgia for childhood, and a general malaise explain the crisis of adolescence. Rebellion, conflict, occasional failure at school or in society, and at-risk behaviors are not always signs of future psychiatric illness. In contrast, the physician must be in a position to identify tell-tale signs such as dysmorphophobia, existential anxiety, a feeling of emptiness, and school or social breakdown. Most psychiatric disorders that begin in adolescence are only diagnosed several years after onset. Yet early diagnosis is of utmost importance, as treatment becomes less effective and the long-term prognosis worsens with time. Suicide is the second cause of death during adolescence. All signs of suicidal behavior require hospitalization and evaluation in a psychiatric unit. Antidepressants may be necessary in adolescence. The recent controversy concerning a possible increase in the suicidal risk during antidepressant treatment should not mask the fact that the real public health issue is depression, and not antidepressants. Eating disorders are especially frequent among adolescent girls; it is important to identify psychiatric comorbidities such as schizophrenia, depression and obsessive-compulsive disorders, and to assess the vital risk. Illicit drug and alcohol consumption are frequent during adolescence; for example, close to half of all French adolescents have tried cannabis at least once. Once again, it is important to detect psychiatric comorbidities in substance-abusing adolescents. Phobia is an underdiagnosed anxiety disorder among adolescents; it may become chronic if proper treatment is not implemented, leading to suffering and disability. Finally, two major psychiatric disorders--schizophrenia and bipolar disorder--generally begin in adolescence. Treatment efficacy and the long-term prognosis both depend on early diagnosis. Treatment must be tailored to the individual patient. "Borderline" states are over

  14. Corrigendum.

    PubMed

    2016-04-01

    Loh B, Chen JY, Yew AKS, et al. Prevalence of metatarsus adductus in symptomatic hallux valgus and its influence on functional outcome.Foot Ankle Int.2015;36(11):1316-1321. (Original DOI:10.1177/1071100715595618). PMID:27032765

  15. A numerical simulation approach to studying anterior cruciate ligament strains and internal forces among young recreational women performing valgus inducing stop-jump activities.

    PubMed

    Kar, Julia; Quesada, Peter M

    2012-08-01

    Anterior cruciate ligament (ACL) injuries are commonly incurred by recreational and professional women athletes during non-contact jumping maneuvers in sports like basketball and volleyball, where incidences of ACL injury is more frequent to females compared to males. What remains a numerical challenge is in vivo calculation of ACL strain and internal force. This study investigated effects of increasing stop-jump height on neuromuscular and bio-mechanical properties of knee and ACL, when performed by young female recreational athletes. The underlying hypothesis is increasing stop-jump (platform) height increases knee valgus angles and external moments which also increases ACL strain and internal force. Using numerical analysis tools comprised of Inverse Kinematics, Computed Muscle Control and Forward Dynamics, a novel approach is presented for computing ACL strain and internal force based on (1) knee joint kinematics and (2) optimization of muscle activation, with ACL insertion into musculoskeletal model. Results showed increases in knee valgus external moments and angles with increasing stop-jump height. Increase in stop-jump height from 30 to 50 cm lead to increase in average peak valgus external moment from 40.5 ± 3.2 to 43.2 ± 3.7 Nm which was co-incidental with increase in average peak ACL strain, from 9.3 ± 3.1 to 13.7 ± 1.1%, and average peak ACL internal force, from 1056.1 ± 71.4 to 1165.4 ± 123.8 N for the right side with comparable increases in the left. In effect this study demonstrates a technique for estimating dynamic changes to knee and ACL variables by conducting musculoskeletal simulation on motion analysis data, collected from actual stop-jump tasks performed by young recreational women athletes. PMID:22527014

  16. Correction of static axial alignment in children with knee varus or valgus deformities through guided growth: Does it also correct dynamic frontal plane moments during walking?

    PubMed

    Böhm, Harald; Stief, Felix; Sander, Klaus; Hösl, Matthias; Döderlein, Leonhard

    2015-09-01

    Malaligned knees are predisposed to the development and progression of unicompartmental degenerations because of the excessive load placed on one side of the knee. Therefore, guided growth in skeletally immature patients is recommended. Indication for correction of varus/valgus deformities are based on static weight bearing radiographs. However, the dynamic knee abduction moment during walking showed only a weak correlation to malalignment determined by static radiographs. Therefore, the aim of the study was to measure the effects of guided growth on the normalization of frontal plane knee joint moments during walking. 15 legs of 8 patients (11-15 years) with idiopathic axial varus or valgus malalignment were analyzed. 16 typically developed peers served as controls. Instrumented gait analysis and clinical assessment were performed the day before implantation and explantation of eight-plates. Correlation between static mechanical tibiofemoral axis angle (MAA) and dynamic frontal plane knee joint moments and their change by guided growth were performed. The changes in dynamic knee moment in the frontal plane following guided growth showed high and significant correlation to the changes in static MAA (R=0.97, p<0.001). Contrary to the correlation of the changes, there was no correlation between static and dynamic measures in both sessions. In consequence two patients that had a natural knee moment before treatment showed a more pathological one after treatment. In conclusion, the changes in the dynamic load situation during walking can be predicted from the changes in static alignment. If pre-surgical gait analysis reveals a natural load situation, despite a static varus or valgus deformity, the intervention must be critically discussed. PMID:26159802

  17. Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.

    PubMed

    Oravakangas, Rami; Leppilahti, Juhana; Laine, Vesa; Niinimäki, Tuukka

    2016-01-01

    Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation. PMID:26905255

  18. [Adolescent pregnancy].

    PubMed

    Fatichi, B

    1991-10-01

    This exploration of adolescent pregnancy focuses on adolescents whose pregnancies are undesired. The physical and psychic transformations of puberty and adolescence may be experienced differently in different social contexts. The prolongation of school attendance in Western societies means that most adolescents remain financially dependent on their parents. But greater sexual freedom in the society at large has been reflected in an increase in early sexual activity among adolescents. Wider use of contraception has not completely eliminated prenatal pregnancy among adolescents. Adolescent pregnancies have actually declined in France as a proportion of all pregnancies carried to term, from 4% to 1.5-2% in the past 10 or 15 years. But in 1986, 42.5% of all induced abortions were performed on adolescents. Among causes of unwanted pregnancy in adolescents are their frequent inability to believe that they may be at risk of pregnancy, or that pregnancy can result from the 1st sexual intercourse. The episodic nature of sexual relations, the lack of ready availability of contraception, and specific shortcomings of different methods are factors in the frequent failure of adolescents to protect themselves against undesired pregnancy. Adolescents may become pregnant out of loneliness or to prove that they are women, or as a result of incest or prostitution. Adolescents who seek abortions are those who have discovered and acknowledged their pregnancies before the 12th week and had the courage to inform their parents and obtain legal permission for the abortion. Pregnancy terminations are more frequent in more advantaged societal sectors with more structured family life. The moral shock and sense of failure associated with abortion are often deeply felt by adolescents. Their experience is greatly influenced by the attitudes of those around them. Adolescents who carry their pregnancies to term are those who have not sought abortion in the 1st 12 weeks. Often they refuse to admit

  19. Counseling adolescents.

    PubMed

    Yamuna, Srinivasan

    2013-11-01

    Skills for counseling adolescents are acquired over a period of time by all practitioners of adolescent health. Though the principles of counseling remain the same the process of counseling an adolescent differs considerably from that of a child or an adult. Adolescents are in their transition between childhood and adulthood with physical, emotional and social challenges to face. The maturity level of each adolescent differs and that decides the pace and contents of each session. The counselor sets the context in a non judgmental manner so that the adolescent feels the ease and eagerness to self disclose. Privacy and confidentiality are two key issues that have to be taken care of during counseling. PMID:23888379

  20. Efficacy of intra-articular hyaluronan (Synvisc®) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial

    PubMed Central

    Munteanu, Shannon E; Menz, Hylton B; Zammit, Gerard V; Landorf, Karl B; Handley, Christopher J; ElZarka, Ayman; DeLuca, Jason

    2009-01-01

    Background Osteoarthritis of the first metatarsophalangeal joint (MPJ) of the foot, termed hallux limitus, is common and painful. Numerous non-surgical interventions have been proposed for this disorder, however there is limited evidence for their efficacy. Intra-articular injections of hyaluronan have shown beneficial effects in case-series and clinical trials for the treatment of osteoarthritis of the first metatarsophalangeal joint. However, no study has evaluated the efficacy of this form of treatment using a randomised placebo controlled trial. This article describes the design of a randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc®) to reduce pain and improve function in people with hallux limitus. Methods One hundred and fifty community-dwelling men and women aged 18 years and over with hallux limitus (who satisfy inclusion and exclusion criteria) will be recruited. Participants will be randomised, using a computer-generated random number sequence, to receive a single intra-articular injection of up to 1 ml hyaluronan (Synvisc®) or sterile saline (placebo) into the first MPJ. The injections will be performed by an interventional radiologist using fluoroscopy to ensure accurate deposition of the hyaluronan in the joint. Participants will be given the option of a second and final intra-articular injection (of Synvisc® or sterile saline according to the treatment group they are in) either 1 or 3 months post-treatment if there is no improvement in pain and the participant has not experienced severe adverse effects after the first injection. The primary outcome measures will be the pain and function subscales of the Foot Health Status Questionnaire. The secondary outcome measures will be pain at the first MPJ (during walking and at rest), stiffness at the first MPJ, passive non-weightbearing dorsiflexion of the first MPJ, plantar flexion strength of the toe-flexors of the hallux, global satisfaction with the

  1. Kibbutz Adolescents.

    ERIC Educational Resources Information Center

    Mazor, Aviva, Ed.

    1993-01-01

    This special issue on adolescence in the Israeli kibbutz contains a series of seven papers that seek to advance thought and research regarding the relationship between a communal way of life and individual developmental processes in adolescence and early adulthood. The articles represent a transitional era as the kibbutz evolves. (SLD)

  2. Adolescent Literacy

    ERIC Educational Resources Information Center

    Ippolito, Jacy, Ed.; Steele, Jennifer L., Ed.; Samson, Jennifer F., Ed.

    2012-01-01

    "Adolescent Literacy" initially appeared as a special issue of the "Harvard Educational Review". It explores key issues and debates in the adolescent literacy crisis, the popular use of cognitive strategies, and disciplinary and content-area literacy. Also examined are alternative forms of literacy, afterschool interventions, new instruction…

  3. Adolescent Neurodevelopment

    PubMed Central

    Spear, Linda Patia

    2012-01-01

    Purpose The purpose of this paper is to outline notable alterations occurring in the adolescent brain, and consider potential ramifications of these developmental transformations for public policy and programs involving adolescents. Methods Developmental changes in the adolescent brain obtained from human imaging work are reviewed, along with results of basic science studies. Results Adolescent brain transformations include both progressive and regressive changes that are regionally specific and serve to refine brain functional connectivity. Along with still maturing inhibitory control systems that can be overcome under emotional circumstances, the adolescent brain is associated with sometimes elevated activation of reward-relevant brain regions, whereas sensitivity to aversive stimuli may be attenuated. At this time, the developmental shift from greater brain plasticity early in life to the relative stability of the mature brain is still tilted more towards plasticity than seen in adulthood, perhaps providing an opportunity for some experience-influenced sculpting of the adolescent brain. Conclusions Normal developmental transformations in brain reward/aversive systems, areas critical for inhibitory control, and regions activated by emotional, exciting and stressful stimuli may promote some normative degree of adolescent risk-taking. These findings have a number of potential implications for public policies and programs focused on adolescent health and well-being. PMID:23332574

  4. Adolescent suicide.

    PubMed

    1996-01-01

    In the introduction to this report our committee, with its focus on adolescent development, expressed its concern that adolescent suicidal behavior represented a grave crisis in the adolescent, a crisis not only in the development of the adolescent but one that endangers the existence of the adolescent. The possibility of a fatal outcome is abhorrent to us as physicians and psychiatrists, as it is to all those entrusted with the care and development of our fellow human beings. Consequently, we explored the ways in which developmental and other forces lead to adolescent suicide and the measures that can be taken to prevent it. We first considered the historical and cross-cultural aspects of suicidal behaviors. Societal and cultural stresses arise from parental attitudes, beliefs, expectations, and childrearing practices that evolve from the social and economic needs in each culture. If unbalanced by growth-sustaining supports, they may compromise or constrict the existential adaptive ability of the developing adolescent and place the adolescent at risk for suicide. Research into vulnerability in adolescence has revealed gender, ethnic, and geographic differences in the dimension of the problem and has indicated the social, psychological, and biological conditions that increase the likelihood that adolescents will resort to suicidal behaviors. Research is still needed to distinguish those adolescents who commit suicide from those adolescents with similar conditions who do not. Research has only begun to explore the ways in which the interaction of specific individual dynamics, precipitating events, and personal characteristics result in an adolescent's attempt of suicide. We discussed the strengths that adolescents acquire, but we emphasized the weaknesses that ensue as adolescents are faced with the impact of the thrust of their own biological, psychological, and social development with the forces inherent in their cultures. Adolescents progress through this period

  5. Greater Hip Extension but Not Hip Abduction Explosive Strength Is Associated With Lesser Hip Adduction and Knee Valgus Motion During a Single-Leg Jump-Cut

    PubMed Central

    Cronin, Baker; Johnson, Samuel T.; Chang, Eunwook; Pollard, Christine D.; Norcross, Marc F.

    2016-01-01

    Background: The relationships between hip abductor and extensor strength and frontal plane hip and knee motions that are associated with anterior cruciate ligament injury risk are equivocal. However, previous research on these relationships has evaluated relatively low-level movement tasks and peak torque rather than a time-critical strength measure such as the rate of torque development (RTD). Hypothesis: Females with greater hip abduction and extension RTD would exhibit lesser frontal plane hip and knee motion during a single-leg jump-cutting task. Study Design: Descriptive laboratory study. Methods: Forty recreationally active females performed maximal isometric contractions and single-leg jump-cuts. From recorded torque data, hip extension and abduction RTD was calculated from torque onset to 200 ms after onset. Three-dimensional motion analysis was used to quantify frontal plane hip and knee kinematics during the movement task. For each RTD measure, jump-cut biomechanics were compared between participants in the highest (high) and lowest (low) RTD tertiles. Results: No differences in frontal plane hip and knee kinematics were identified between high and low hip abduction RTD groups. However, those in the high hip extension RTD group exhibited lower hip adduction (high, 3.8° ± 3.0°; low, 6.5° ± 3.0°; P = .019) and knee valgus (high, –2.5° ± 2.3°; low, –4.4° ± 3.2°; P = .046) displacements during the jump-cut. Conclusion: In movements such as cutting that are performed with the hip in a relatively abducted and flexed position, the ability of the gluteus medius to control hip adduction may be compromised. However, the gluteus maximus, functioning as a hip abductor, may take on a pivotal role in controlling hip adduction and knee valgus motion during these types of tasks. Clinical Relevance: Training with a specific emphasis on increasing explosive strength of the hip extensors may be a means through which to improve frontal plane hip and knee

  6. Stages of Adolescence

    MedlinePlus

    ... Español Text Size Email Print Share Stages of Adolescence Page Content Article Body Adolescence, these years from puberty to adulthood, may be roughly divided into three stages: early adolescence, generally ages eleven to fourteen; middle adolescence, ages ...

  7. Adolescent Prostitution.

    ERIC Educational Resources Information Center

    Schaffer, Bernie; DeBlassie, Richard R.

    1984-01-01

    Explores the conditions which lead to teenagers' becoming prostitutes, including alienation, abuse, lack of education and employment, and family problems. Discusses the role of the justice system and institutions and the need for improving adolescents' self-image. (JAC)

  8. Adolescent Sexuality.

    ERIC Educational Resources Information Center

    Sharpe, Thomasina H.

    2003-01-01

    This article offers a medical and psychosocial perspective of adolescent sexual development. Sub-types of sexual development are discussed as well as treatment implications for allied health providers. (Contains 38 references.) (Author)

  9. [Adolescence: viewpoints from adolescent psychiatry].

    PubMed

    Bürgin, D; von Klitzing, K

    1994-05-01

    Adolescence is a phase of human development which is marked by a high vulnerability due to the ongoing psycho-physiological transformations. The regulation of the self-esteem is especially in danger in youngsters who went into adolescence with a marked burden of conflicts or who lived in families with disturbed intrafamilial dynamics. To be present as a partner and not to find the solutions for the adolescents' conflicts, to accept their questioning of what is established and to recognize their movements of reconciliation are the quite complex demands put on to the world of the adults. Adolescents urge us to a review of our own adolescence, to a balancing of hate and love, openness and rigidity, and to dialectic movements between disintegration and reintegration as well as between the generations. Any help, be it on the physical, the social or the psychic level, should be directed toward a restitution of the intrapsychic, intrafamilial or intergenerational balance; sociocultural factors have also always to be respected. The helpers--especially in a culture with rapid change--are often confronted with their own adolescence, which took place a generation before and mostly under totally different conditions. PMID:8016759

  10. Treating Children and Adolescents

    MedlinePlus

    ... Children and Adolescents Go Back Treating Children and Adolescents Email Print + Share For the most part, the ... tailored, based upon the child's weight. Children and adolescents are moving through a period of physical and ...

  11. [Adolescent sexuality].

    PubMed

    Calero, Juan del Rey

    2010-01-01

    The social Adolescent features are insecurity, narcissism, eroticism, more impetuosity than reason. 1/3 of adolescents have risk behaviour for health. The pregnancy rate in adolescent are 9/1,000 (11,720, the abort about 50 %). The total abort (2009) were 114,480. Increase the rate of 8,4 (1990) to 14,6/ 1,000 (2009). The sexual education fails. The consulting about contraceptives get pregnancy of the OR 3,2, condom OR 2,7. The adolescent are influenced in his matter: oeer have 70-75 % of influence, mother 30-40 %, father 15 %, for yhe environment and education Cyberspace access to information: 33 % exposed to unwanted sexual materials, 1 in 7 solicited sexual online. The argument have 4 central topic: Morality and Responsibility, Desire (responsibility vs gratification), Danger (fear related to pregnancy and STD/VIH), and Victimization. The prevention of STD: so called safe sex, delayed, and abstinence, Prevention HPV vaccine. The information is not enough, are necessary personal integral formation in values as self control, abstinence, mutual respect, responsibility, reasonable decisions. PMID:21877398

  12. Adolescent Suicide.

    ERIC Educational Resources Information Center

    Ray, Lynda Y.; Johnson, Norbert

    1983-01-01

    Explores the causes and symptoms of adolescent suicide including depression, loss of parent, alienation from family, and a mystical concept of death. Treatment procedures with unsuccessful suicide attempters and their parents are described and prevention strategies are discussed which involve teachers and counselors as well as parents. (JAC)

  13. Unmotivated Adolescents.

    ERIC Educational Resources Information Center

    Smith, Jill; Diller, Howard

    This book examines the characteristics and educational needs of unmotivated adolescents. It suggests that many of these students suffer from low self-esteem and are learning disabled and/or have an attention deficit disorder with hyperactivity. It offers a definition of learning disabilities that emphasizes the presence of significant differences…

  14. Adolescent gynecology.

    PubMed

    Sanfilippo, Joseph S; Lara-Torre, Eduardo

    2009-04-01

    Given new developments in the field of adolescent reproductive health, this review focuses on highlighting new guidelines and practice patterns in evaluation and management of adolescent gynecologic problems. First, understanding the proper techniques for the initial examination is key to establishing a long-term relationship with this age group. Reservations about the first gynecologic examination are common, and the practitioner's goal is foremost to make the patient as comfortable as possible. Preventive health in this patient population is key, and practitioners should become comfortable with providing education about topics as diverse as sexuality, eating disorders, and dating violence. Furthermore, the frequency with which teenagers report sexual activity and the high unintended pregnancy rate in this age group makes counseling regarding effective contraception essential. Additionally, practitioners are encouraged to take the opportunity to discuss the availability of the human papillomavirus (HPV) vaccine with adolescents. In 2007, adolescents were designated as a special population, given the frequency with which they acquire and clear mild HPV-related cervical dysplasia. More conservative treatment in this population is generally favored. During their transition through puberty, disorders of menstruation become the most common complaint requiring the attention of the gynecologist. Most commonly, anovulation serves as the cause behind such abnormal bleeding. Polycystic ovarian syndrome can develop in early puberty and carry its consequences into adulthood. Infertility, diabetes, and hirsutism mark the most important components of the syndrome and require age-appropriate management. Finally, the consequences of endometriosis on the future fertility of adolescents have brought early intervention to light. Recognition and prompt treatment are advocated to prevent the future implications of this disease. PMID:19305342

  15. Salvaging of a failed Lapidus procedure by the soft tissue osteodesis procedure: A six-year follow-up case report.

    PubMed

    Wu, Daniel Y

    2016-06-01

    Soft tissue approach to hallux valgus deformity correction has not been popular due to concerns of its effectiveness. Osteodesis procedure is a soft tissue technique that has been reported with favorable results, especially its long term deformity recurrence rate was very low. Recurrence complication after Lapidus procedure has seldom been reported and its remedial surgery not much discussed yet. Soft tissue approach has never been recommended or reported for salvaging failed hallux valgus surgery. This case report is a failed Lapidus procedure due to symptomatic recurrence of deformity that was successfully salvaged by osteodesis procedure and followed up for six years to ensure no late symptoms and deformity recurrence. PMID:26341948

  16. Adolescent Attitudes about Rape.

    ERIC Educational Resources Information Center

    Kershner, Ruth

    1996-01-01

    A very significant problem in society is adolescent rape victimization and the growing number of adolescent perpetrators. This paper examines adolescent attitudes about rape in order to develop curricular materials. It is found that adolescents exhibit conservative attitudes about gender roles, general rape myths, and victim issues. (Author)

  17. Counsellors' Perceptions of Adolescence.

    ERIC Educational Resources Information Center

    Tatar, Moshe

    2001-01-01

    Investigates the perceptions Israeli secondary-school counselors have of adolescence. Results reveal that, in general, counselors have a favorable view of adolescents and do not perceive adolescence as a "difficult stage." Counselors also believe that they are perceived positively by their adolescent students. Identifies five types of adolescents…

  18. Adolescent attraction to cults.

    PubMed

    Hunter, E

    1998-01-01

    This article details the reasons behind adolescents' attraction to cults. It is recommended that parents, teachers, and counselors familiarize themselves with the warning signs. Suggestions are offered on how to make adolescents less vulnerable to cult overtures. PMID:9831888

  19. Post-Adolescent Issues

    MedlinePlus

    Search COPING & HEALING CARING FOR A CHILD: POST-ADOLESCENT ISSUES As your child reaches adulthood, there will ... intake. New issues that you and your post adolescent child may want to discus together with his/ ...

  20. Adolescent and School Health

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Adolescent and School Health Note: Javascript is disabled or ... behaviors now JAMA Viewpoint: Lesbian, Gay, and Bisexual Adolescents New MMWR Article Learn What State and Local ...

  1. Adolescence and Mythology

    ERIC Educational Resources Information Center

    Anastasopoulos, Dimitris; Soumaki, Eugenia; Anagnostopoulos, Dimitris

    2010-01-01

    The article begins with a brief exploration of the various aspects of adolescent's psychic qualities as these are described in Greek mythology. It is argued that myths are an integral part of the way that adolescence is perceived and myths play an important role in adolescents' psychic and external world, as well as in their mythological thinking.…

  2. Preventing Adolescent Suicide.

    ERIC Educational Resources Information Center

    Capuzzi, David

    The adolescent at risk for suicidal preoccupation and behavior has become an increasing concern for schools and communities. This paper presents some of the causes of teen suicide, things adults should know about adolescent suicide prevention, and what can be done to help such youth. The transition to adolescence is a complex time when many values…

  3. Life Satisfaction of Adolescents.

    ERIC Educational Resources Information Center

    Torgoff, Irving; And Others

    The feelings and perceptions of adolescents, apart from objective indices, warrent attention from those who are concerned with adolescent development and psychological stress. There is a need for a reliable baseline measure of adolescent subjective well-being, as manifested by self-reports of life satisfaction, to which future measurements can be…

  4. Adolescent Attachment and Psychopathology.

    ERIC Educational Resources Information Center

    Rosenstein, Diana S.; Horowitz, Harvey A.

    1996-01-01

    In relationships among attachment classification, psychopathology, and personality, traits were examined in a group of 60 psychiatrically hospitalized adolescents. Attachment was examined in 27 adolescent-mother pairs. Both adolescent and maternal attachment status were overwhelmingly insecure and were highly concordant. Results support a model of…

  5. Demystifying the Adolescent Brain

    ERIC Educational Resources Information Center

    Steinberg, Laurence

    2011-01-01

    Understanding the nature of brain development in adolescence helps explain why adolescents can vacillate so often between mature and immature behavior. Early and middle adolescence, in particular, are times of heightened vulnerability to risky and reckless behavior because the brain's reward center is easily aroused, but the systems that control…

  6. Adolescents and the Media.

    ERIC Educational Resources Information Center

    Strasburgber, Victor C., Ed.; Comstock, George A., Ed.

    1993-01-01

    In the 1990s, the media represent the single most easily modifiable influence on children and adolescents. This series of articles offers medically oriented practitioners a review of current research on the influence of the media on children and adolescents. The 13 articles are: (1) "Children, Adolescents, and the Media: Five Crucial Issues"…

  7. The Adolescent Patient.

    ERIC Educational Resources Information Center

    Daniel, William A., Jr.

    Written to orient the physician and paramedical personnel to the adolescent patient, the book provides information concerning the changes of adolescence, and age-related problems and illnesses. Part 1 discusses the essence of adolescence by describing physical, mental, and emotional growth and development. Part 2, the major section, consists of 21…

  8. Update on Adolescent Immunizations.

    PubMed

    Schreier, Rebecca; Halady, Tasia; Bishop, Nina; Chatterjee, Archana

    2016-02-01

    Timely and complete adolescent vaccination remains an elusive public health goal. Three infections for which routine adolescent vaccination is recommended in the U.S. are pertussis, meningococcal disease and human papillomavirus (HPV). These infections and the Tdap, meningococcal and HPV vaccines recommended for adolescents are reviewed in this article. PMID:26999915

  9. 2007 Maryland Adolescent Survey

    ERIC Educational Resources Information Center

    Maryland State Department of Education, 2008

    2008-01-01

    Periodically, Maryland's sixth, eighth, tenth, and twelfth graders are surveyed to determine the nature, extent, and trend of alcohol, tobacco, and other drug (ATOD) use among adolescents. The "2007 Maryland Adolescent Survey (MAS)" presents the latest findings regarding ATOD use by Maryland's adolescents and compares State and local findings with…

  10. Parent-Adolescent Conflict in Early Adolescence

    ERIC Educational Resources Information Center

    Allison, Barbara N.; Schultz, Jerelyn B.

    2004-01-01

    This study explored parent-adolescent conflict during the early years of adolescence (ages 11 to 14). The responses of 357 youths in Grades 6, 7, and 8 to the Issues Checklist (Prinz, Foster, Kent, & O'Leary, 1979) revealed frequent conflicts with parents over a sizable number of issues during this period, peaking in Grade 7 between parents and…

  11. Health for Adolescents and Youth.

    ERIC Educational Resources Information Center

    Deschamps, Jean-Pierre; And Others

    1989-01-01

    This report discusses the health of adolescents and youth in the tropics. The report is divided into five sections. The first section defines adolescence, youth, the duration of adolescence, the age group and its problems, and societies in adolescence. The second section discusses adolescence in relation to society and culture and focuses on the…

  12. Contraception for adolescents.

    PubMed

    Ott, Mary A; Sucato, Gina S

    2014-10-01

    A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians' long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions. PMID:25266435

  13. Search the Foot and Ankle: Interactive Foot Diagram

    MedlinePlus

    ... Text Size Print Bookmark Search the Foot and Ankle Foot conditions in this region: Bunions (Hallux Valgus) » ... Injuries » Posterior Tibial Tendon Dysfunction (PTTD) » Tarsal Coalition » Ankle Fractures » Ankle Sprain » Chronic Ankle Instability » Equinus » Gout » ...

  14. 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

  15. Victimization of obese adolescents.

    PubMed

    Robinson, Sabrina

    2006-08-01

    Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and teasing as a result of being overweight or obese. The victimization may be overt or relational. Obese adolescents are at risk of victimization, because their peers view them as different and undesirable. Although peer victimization occurs commonly among adolescents, obese adolescents are more susceptible than their average-weight peers. Because school nurses are often the first line of defense for obese adolescents, they are in an excellent position to identify forms of peer victimization and be prepared to intervene with the victims. School nurses can potentially preserve the psychosocial integrity of obese adolescents by promoting healthy peer interactions and experiences. PMID:16856773

  16. Adolescents with Down syndrome.

    PubMed

    Merrick, Joav; Kandel, Isack; Vardi, Gideon

    2004-01-01

    Adolescence is a period of transition that can create stress for both adolescents and parents. Adolescents with Down syndrome (DS) go through the same stages as other adolescents, but due to lack of cognitive and behavioral factors they and their parents may find this period particularly challenging. This paper reviews several studies, especially from the United Kingdom, of groups of adolescents with Down syndrome and their controls followed from childhood, through adolescence into adulthood. There are special medical problems for this population that require annual medical examinations and surveillance, but the focus has shifted from health problems to social maturation, developing independence, and transition from school to employment or work activity. Medical transition from a pediatric to family physician provider is mentioned with recommendations as to how that transition can be made as smooth as possible. PMID:15148854

  17. Contraception for adolescents.

    PubMed

    2014-10-01

    Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report. PMID:25266430

  18. Adolescent childbearing.

    PubMed

    Vernon, M

    1991-05-01

    The concern for the consequences of adolescent pregnancy are discussed. Childbirth among unmarried teenagers results in a higher incidence of low birth weight babies, a higher infant mortality and morbidity rate, a higher percentage of childbirth complications, a decreased likelihood of completing school, a higher risk of unemployment and welfare dependency, limited vocational opportunities, larger families, and vulnerability to psychological problems and distress. In 1988, 66% of all births to teens occurred outside of marriage. Out of wedlock live births to teens 14 years rose from 80.8% in 1970 to 92.5% in 1986, and for teens 15-19 years, 29.5% to 60.8%. 70% have a repeat pregnancy within the 1st year following their 1st childbirth. 50% have a 2nd child within 3 years. Most 2nd pregnancies occur in teenagers who are not using effective contractive methods, and the pregnancy is frequently unplanned and unwanted. The factors affecting the rate of 2nd pregnancy are age, race, marital status, education, and economic status. Teenage mothers tend to come from disadvantaged backgrounds, and childbearing compounds the poverty. Aid to families with dependent children 50% of payments were to teen mothers for the birth of their 1st child. Teen fathers are usually low income providers. The public costs are high. Some teen fathers abandon their children after birth, but many are interested in supporting their child. Specific programs to help prepare fathers are needed. Teenage mothers are stressed by child care arrangements, living arrangements, employment, school, relationships with peers, relationships with parents, housework and errands, health, finances, job counseling, community services, and child care information. Parents play an important role in guiding sexual involvement and early childbearing, and need to understand why teens get pregnant and to keep channels of communication open. Teens are influenced by media, peer pressure, lack of self-esteem, unhappiness

  19. Adolescent pregnancy options.

    PubMed

    Resnick, M D

    1992-09-01

    The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions. PMID:1434557

  20. Nutrition in the adolescent.

    PubMed

    Wahl, R

    1999-02-01

    This article reviews the nutritional requirements of puberty and the clinical assessment of nutritional status, and discusses the nutritional risks imposed by vegetarian diets, pregnancy, and athletic involvement. Energy (calories) and protein are essential in pubertal development. Adolescent females require approximately 2200 calories/day, whereas male adolescents require 2500-3000 calories/day. Additional intake requirements include fat, calcium, iron, zinc, vitamins, and fiber. The clinical assessment of nutritional status begins with obtaining a good diet history of the patient and this could be offered by the body mass index. Nutritional deficiencies and poor eating habits established during adolescence can have long-term consequences, including delayed sexual maturation, loss of final adult height, osteoporosis, hyperlipidemia, and obesity. As for vegetarian adolescents, nutritional risks include lack of iodine, vitamin B12, vitamin D, and some essential fatty acids. In addition, substances in some grains reduce gut absorption, thus increasing mineral deficiencies. Pregnancy may also be a risk factor for poor nutrition during adolescence. A pregnant adolescent has different nutritional needs because she is still growing. Among adolescent athletes many are turning to nutritional supplements in an attempt to improve athletic performance. A balanced, varied diet provides adequate calories and nutrition to meet the needs of most adolescents. They also have greater water needs than do adult athletes. Details on adolescent health concerns are further discussed in this article. PMID:10036686

  1. [Childhood and adolescent depression].

    PubMed

    Mikami, Katsunaka; Matsumoto, Hideo

    2007-09-01

    Depression is a common, chronic and recurrent disorder in children and adolescents. This article reviewed the epidemiology, clinical characteristics, natural course and treatment (pharmacological and psychotherapeutic treatment) of major depressive disorder (MDD) in children and adolescents. Several randomized controlled trials have shown that the selective serotonin reuptake inhibitors (SSRIs), in particular fluoxetine, and psychotherapeutic treatments such as cognitive behavioral therapy and interpersonal therapy are efficacious in children and adolescents with MDD. However, in Japan only three SSRIs (fluvoxamine, paroxetine and sertraline) are currently available, and few clinicians are trained to deliver psychotherapeutic treatment. Further clinical researches on the treatment to children and adolescents with MDD are needed in Japan. PMID:17876994

  2. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. PMID:26598305

  3. Conflict Resolution in Parent-Adolescent Relationships and Adolescent Delinquency

    ERIC Educational Resources Information Center

    Van Doorn, Muriel D.; Branje, Susan J. T.; Meeus, Wim H. J.

    2008-01-01

    This study examines the relation between conflict resolution styles in parent-adolescent relationships and adolescent delinquency. Questionnaires about conflict resolution styles were completed by 284 early adolescents (mean age 13.3) and their parents. Adolescents also completed a questionnaire on delinquency. Hierarchical regression analyses…

  4. [Contraception in adolescents].

    PubMed

    1992-12-01

    The proportion of women aged 15-19 in Colombia who are mothers declined from 14% in 1985 to 10% in 1990, but the actual number of cases increased due to population growth. Some 1,780,000 adolescents who have had children or are pregnant require family planning services. An additional, unknown number of adolescent pregnancies are terminated by abortion. It is estimated that 95% of adolescent pregnancies diagnosed or followed by PROFAMILIA's center for young people were unwanted. Reasons for making family planning services available to adolescents include the ever young age at initiation of sexual activity, the very low rates of contraceptive usage among sexually active adolescents, the lack of information of adolescents concerning reproduction and contraception, and their fear and guilt surrounding their sexual activity and contraceptive usage. Obstetrical services appear reluctant to furnish adolescent mothers with information on contraception, and the pharmacists and their employees who provide such information may not be aware of contraindications for this age group or whether adolescents are adequately instructed in use of the method. The rising age at marriage increases the span of time that adolescents are at risk of unwanted pregnancy. Adolescents who are well informed about sexuality and contraception and trained in decision making, self-esteem, and responsible parenthood are likely to postpone sexual activity. Information on contraception and family planning services needs to be made available to adolescents in a way that will actually motivate use. Information on sex and contraception should be made available at puberty and should include the form of use, contraindications, and advantages and disadvantages of all methods appropriate to adolescents. Orientation and assistance in selecting the best method should be individually tailored and should be provided in schools or other places accessible to young people, in a language they can understand. Rhythm and

  5. Sexual Health for America's Adolescents.

    ERIC Educational Resources Information Center

    Haffner, Debra W.

    1996-01-01

    The National Commission on Adolescent Sexual Health developed a professional consensus statement about adolescent sexual health. Its report for policymakers recommends that adults face the facts about adolescent sexuality and that public policies on adolescent sexual health be based on appropriate knowledge, accurate data, current theory, ongoing…

  6. Classifying Adolescent Perfectionists

    ERIC Educational Resources Information Center

    Rice, Kenneth G.; Ashby, Jeffrey S.; Gilman, Rich

    2011-01-01

    A large school-based sample of 9th-grade adolescents (N = 875) completed the Almost Perfect Scale-Revised (APS-R; Slaney, Mobley, Trippi, Ashby, & Johnson, 1996). Decision rules and cut-scores were developed and replicated that classify adolescents as one of two kinds of perfectionists (adaptive or maladaptive) or as nonperfectionists. A…

  7. Adolescent Steroid Use.

    ERIC Educational Resources Information Center

    Office of Inspector General (DHHS), Washington, DC.

    The study focused on non-medical steroid use by adolescents according to data obtained from the National Institute on Drug Abuse, professional literature, 30 key informants knowledgeable in steroid issues, and 72 current or former steroid users. The findings indicated: (1) over 250,000 adolescents, primarily males, used or have used steroids, and…

  8. Diagnosing ADHD in Adolescence

    ERIC Educational Resources Information Center

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  9. Gender and Adolescent Development

    ERIC Educational Resources Information Center

    Perry, David G.; Pauletti, Rachel E.

    2011-01-01

    This article summarizes and critiques recent trends in research and theory on the role of gender in adolescent development. First, gender differences in key areas of adolescent functioning are reviewed. Second, research on 3 constructs that are especially relevant to the investigation of within-gender individual differences in gender…

  10. Key Data on Adolescence.

    ERIC Educational Resources Information Center

    Coleman, John

    In order to counteract widespread stereotyping of adolescents and to provide a historical perspective on the lives of youth in Great Britain, this report compiles statistical data in six areas regarding adolescents and youth. Chapter 1, "Population, Families and Households," presents information on the population of the United Kingdom including…

  11. Cigars, Cigarettes, and Adolescents

    ERIC Educational Resources Information Center

    Brooks, Ashley; Larkin, Elizabeth M. Gaier; Kishore, Sonal; Frank, Scott

    2008-01-01

    Objective: To examine public health implications of adolescent use of cigars only, cigarettes only, and both cigarettes and cigars. Methods: A cross-sectional health risk survey was administered to a random sample of 4486 high school students in a Midwestern county. Results: More adolescents reported using both cigarettes and cigars (10.6%) than…

  12. Preventing Adolescent Suicide.

    ERIC Educational Resources Information Center

    Capuzzi, Dave; Golden, Larry

    This book deals with the realities of adolescent suicide. It consists of 15 chapters organized under 5 major headings: The Problem of Adolescent Suicide (chapters 1 and 2); A Profile of the Attempter (chapters 3-6); Assessing Lethality (chapters 7 and 8); Prevention and Intervention (chapters 9-14); and Legal Issues (chapter 15). Individual…

  13. Motivating Young Adolescents

    ERIC Educational Resources Information Center

    Wormeli, Rick

    2014-01-01

    This author acknowledges that teachers agree that "adolescents aren't always interested in the topics adults consider important for them to learn." It is easy for adults who have forgotten the wonder and uncertainty of the adolescent years to declare that students today are more uninterested in school and undisciplined in life than…

  14. The Adolescent Brain

    ERIC Educational Resources Information Center

    Casey, B. J.; Getz, Sarah; Galvan, Adriana

    2008-01-01

    Adolescence is a developmental period characterized by suboptimal decisions and actions that give rise to an increased incidence of unintentional injuries and violence, alcohol and drug abuse, unintended pregnancy and sexually transmitted diseases. Traditional neurobiological and cognitive explanations for adolescent behavior have failed to…

  15. Advances in Adolescent Psychology.

    ERIC Educational Resources Information Center

    Violato, Claudio; Travis, Leroy

    Adolescence is a multiplicity of events, experiences, behavior, people, and cultural meanings. This book attempts to provide detailed and in-depth analysis of the central issues related to adolescent psychology, while taking this multiplicity into account. A comprehensive representation of the topic is provided through integration of historical,…

  16. Responding to Adolescent Suicide.

    ERIC Educational Resources Information Center

    Phi Delta Kappa Educational Foundation, Bloomington, IN.

    This publication is designed to help educators deal with the problems that arise after an adolescent's suicide. It recommends that teachers should be able to detect differences in students' responses to emotional problems. Following a preface and a brief review of the extent of the problem, the first chapter discusses which adolescents are…

  17. The Changing Adolescent Brain

    ERIC Educational Resources Information Center

    White, Aaron M.

    2005-01-01

    Adolescence is the transition from childhood to adulthood, a period during which an individual acquires the skills necessary to survive on his or her own, away from parents or other caregivers. Adolescence can be a very confusing time. They experience changes in sleep, diet, mood, weight and attitude and a decreased pleasure from daily activities.…

  18. Early Adolescent Ego Development.

    ERIC Educational Resources Information Center

    James, Michael A.

    1980-01-01

    Presented are the theoretical characteristics of social identity in early adolescence (ages 10 to 15). It is suggested that no longer is identity thought to begin with adolescence, but may have its beginnings in the preteen years. The article draws heavily on Eriksonian concepts. (Editor/KC)

  19. Adolescent Attraction to Cults.

    ERIC Educational Resources Information Center

    Hunter, Eagan

    1998-01-01

    Details the reasons behind adolescents' attraction to cults. and distinguishes functions of cults and the term "cult." Identifies various cults, and describes the process of involvement. Notes that in the absence of authentic, stabilizing standards, some youth are especially vulnerable. Provides recommendations for adults working with adolescents.…

  20. [Adolescent sexuality in Peru].

    PubMed

    Loli, A; Aramburu, C; Paxman, J M

    1987-01-01

    22% of the population of Peru, or 4.25 million individuals, is between the ages of 11 and 19 years. A survey was performed on a sample of 6,000 adolescents living in Lima, Cajamarca, Huarez, and Supe. Surveys were performed in a variety of locations, including school classrooms, maternity wards, schools, and work places. The questionnaire was constructed based on a format that had been tested in Nigeria; questions dealt with socioeconomic background, sex behavior, contraceptive behavior, pregnancy history, and health practices and knowledge. 60% of the adolescents were women and 40% were men. 41% had had at least 1 sexual experience; among 18-year-olds, this % rose to 55. Only 10% were in stable union. Married adolescents tended to have begun sexual relations sooner in life. Early sexual relations were more common among men than among women, and more common among non-religious adolescents than among Catholics. Fewer than 12% of the adolescents had at 1 time used contraceptives. Contraceptive use was more prevalent among adolescents from wealthier socioeconomic groups, and more prevalent in Lima than in other regions surveyed. Of adolescents using contraceptives, 38% used condoms, 24% used oral contraceptives, and 15% used rhythm methods. Most adolescents who did not use contraceptives failed to do so because of lack of knowledge. Almost 1/4 of the young women had had a pregnancy. 18.5 of these had abortions, usually in a hospital. The importance of supporting educational prevention programs is underlined. PMID:12269059

  1. Hispanic Adolescent Fertility.

    ERIC Educational Resources Information Center

    Darabi, Katherine F.; And Others

    1986-01-01

    Discusses fertility of Hispanic adolescents in the United States. Summarizes what is known about sexuality, contraception, pregnancy, and childbearing among male and female Hispanics of various countries of origin. Indicates Hispanic adolescent birthrates fall between those of non-Hispanic Whites and Blacks, but there is considerable within-group…

  2. Wellness Factors among Adolescents.

    ERIC Educational Resources Information Center

    Sleet, David A.; Dane, J. K.

    1985-01-01

    Content for wellness-learning games aimed at youth was derived from the professional judgment of an advisory panel composed of experts in preventive medicine, health education, and adolescent development using a Delphi-like series of structured inquiries. Thirty-nine attributes considered important in the development of healthy adolescents were…

  3. Adolescence and Body Image.

    ERIC Educational Resources Information Center

    Weinshenker, Naomi

    2002-01-01

    Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…

  4. Adolescence Education Newsletter, 2000.

    ERIC Educational Resources Information Center

    Villanueva, Carmelita L., Ed.; Padilla, Teresita M., Ed.

    2000-01-01

    This document comprises the two 2000 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  5. Adolescence Education Newsletter, 2002.

    ERIC Educational Resources Information Center

    Villanueva, Carmelita L., Ed.; Espada-Carlos, Lichelle Dara, Ed.

    2002-01-01

    This document consists of the two 2002 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue includes news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  6. Adolescence Education Newsletter, 2001.

    ERIC Educational Resources Information Center

    Villanueva, Carmelita L., Ed.; Espada-Carlos, Lichelle Dara, Ed.

    2001-01-01

    This document comprises the two 2001 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent health and education, as well as Web links and publications on the…

  7. Adolescence Education Newsletter, 1999.

    ERIC Educational Resources Information Center

    Villanueva, Carmelita L., Ed.; Padilla, Teresita M., Ed.

    1999-01-01

    This document comprises the two 1999 issues of a UNESCO newsletter addressing topics related to adolescent well-being in the Asia-Pacific region, particularly reproductive and sexual health. Each issue contains news from the region on various initiatives related to adolescent heath and education, as well as Web links and publications on the…

  8. Inside the Adolescent Brain

    ERIC Educational Resources Information Center

    Drury, Stacy S.

    2009-01-01

    Dr. Jay Giedd says that the main alterations in the adolescent brain are the inverted U-shaped developmental trajectories with late childhood/early teen peaks for gray matter volume among others. Giedd adds that the adolescent brain is vulnerable to substances that artificially modulate dopamine levels since its reward system is in a state of flux.

  9. Smoking and adolescent health.

    PubMed

    Park, Sang-Hee

    2011-10-01

    With the Westernization and opening of our society, adolescents' smoking is increasing and being popularized. Many adolescents start smoking at an early age out of curiosity and venturesomeness, and earlier start of smoking makes it more difficult to quit smoking. Adolescents' habitual smoking not only becomes a gateway to all kinds of substance abuse but also causes various health problems including upper respiratory infection, immature lung development, reduced maximum vital capacity, and lung cancer. Therefore, it is quite important to prevent adolescents from smoking. The lowering of adolescents' smoking rate cannot be achieved only through social restrictions such as stereotyped education on the harms of smoking and ID checking. In order to lower adolescents' smoking rate substantially, each area of society should develop standardized programs and make related efforts. As adolescents' smoking is highly influenced by home environment or school life, it is necessary to make efforts in effective education and social reinforcement in school, to establish related norms, and to execute preventive education using peer groups. When these efforts are spread throughout society in cooperation with homes and communities, they will be helpful to protect adolescents' health and improve their quality of life. PMID:22232621

  10. School Phobia in Adolescence

    ERIC Educational Resources Information Center

    Goldberg, Charles

    1977-01-01

    The symptoms of school phobia were found to be student withdrawal, unwillingness of the student to leave the mother, being either the oldest child of the family or the last one left at home, and having an impulsive, violent, sadistic philandering father. Five adolescents are examined in detail and a proposal is made that adolescence is a time…

  11. Fluency Variation in Adolescents

    ERIC Educational Resources Information Center

    De Andrade, Claudia Regina Furquim; Martins, Vanessa De Oliveira

    2007-01-01

    The Speech Fluency Profile of fluent adolescent speakers of Brazilian Portuguese, were examined with respect to gender and neurolinguistic variations. Speech samples of 130 male and female adolescents, aged between 12;0 and 17;11 years were gathered. They were analysed according to type of speech disruption; speech rate; and frequency of speech…

  12. Evolving Science in Adolescence

    PubMed Central

    Dodge, Kenneth A.; Albert, Dustin

    2012-01-01

    Ellis et al. bring an evolutionary perspective to bear on adolescent risky behavioral development, clinical practice, and public policy. They offer important insights that: 1) some risky behaviors may be adaptive for the individual and the species by being hard-wired due to fitness benefits; and 2) interventions might be more successful if they move with, rather than against, the natural tendencies of an adolescent. Ellis et al. criticize the field of developmental psychopathology, but we see the two fields as complementary. Their position would be enhanced by integrating it with contemporary perspectives on dynamic cascades through which normative behavior turns into genuinely maladaptive outcomes, dual processes in adolescent neural development, and adolescent decision-making. Finally, they rightly note that innovation is needed in interventions and policies toward adolescent problem behavior. PMID:22545848

  13. Adolescent bulimia nervosa.

    PubMed

    Hoste, Renee Rienecke; Labuschagne, Zandre; Le Grange, Daniel

    2012-08-01

    Onset of bulimia nervosa (BN) typically occurs in adolescence and is frequently accompanied by medical and psychiatric sequelae that may have detrimental effects on adolescent development. Potentially serious medical consequences and high comorbid rates of mood disorders and suicidality underscore the need for early recognition and effective treatments. Research among adolescents with BN has lagged behind that of adults, although evidence is accumulating to support the efficacy of family-based interventions and cognitive behavioral treatments that are adapted for use with adolescent populations. The aim of the current article is to provide an overview of recent research on epidemiology, risk factors, diagnostic issues, and treatment interventions focusing on adolescent BN, and to highlight areas for future research. PMID:22614677

  14. Androgenetic alopecia in adolescents.

    PubMed

    Price, Vera H

    2003-02-01

    Androgenetic alopecia (AGA), or hereditary hair thinning, is a common and unwelcome cause of hair loss in men and women. AGA also occurs in adolescents, though its prevalence in this younger population is not known. Physical appearance is extremely important to most adolescents, and early onset of hair loss can have a definite negative effect on self-image and self-esteem. Minoxidil topical solution is widely used by adults for hair loss, but its use by adolescents has not been systematically evaluated. This article provides an overview of AGA and presents new information on the prevalence and age at onset of hereditary hair thinning in adolescents. In addition, data are presented on the efficacy and proper use of minoxidil topical solution in adolescent boys and girls. PMID:12635889

  15. Depression in adolescence

    PubMed Central

    Thapar, Anita; Collishaw, Stephan; Pine, Daniel S; Thapar, Ajay K

    2012-01-01

    Unipolar depressive disorder in adolescence is common worldwide but often unrecognised. The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%. The burden is highest in low-income and middle-income countries. Depression is associated with sub stantial present and future morbidity, and heightens suicide risk. The strongest risk factors for depression in adolescents are a family history of depression and exposure to psychosocial stress. Inherited risks, developmental factors, sex hormones, and psychosocial adversity interact to increase risk through hormonal factors and associated perturbed neural pathways. Although many similarities between depression in adolescence and depression in adulthood exist, in adolescents the use of antidepressants is of concern and opinions about clinical management are divided. Effective treatments are available, but choices are dependent on depression severity and available resources. Prevention strategies targeted at high-risk groups are promising. PMID:22305766

  16. Adolescent pregnancy and loss.

    PubMed

    Bright, P D

    1987-01-01

    Adolescents have a perinatal and infant mortality rate two times as high as that found in the adult population, and yet few have investigated the characteristics of adolescent grief over pregnancy loss. The mourning response of adolescents appears to differ from that of older females: adult signs of depression are either nonexistent or fleeting. Adolescents who are having difficulties moving away from dependence on their mothers may become pregnant in order to demonstrate a semblance of adulthood and also to circumvent the depression common to this phase of development. When reproductive loss occurs, two outcomes often are seen: mother-daughter conflict concerning independence accelerates, which, in turn, provides the impetus for re-impregnation soon afterward. Since pregnancy interferes with mourning, the adolescent may not be able to bond with subsequent children, thus continuing the mother-child conflict into another generation. PMID:3649521

  17. Adolescence and body image.

    PubMed

    Weinshenker, Naomi

    2002-05-01

    Concerns about body image range from a normal desire to look attractive to a pathological concern with thinness or physical perfection. Today, more than ever, adolescents in America are prone to body image distortions and dissatisfaction. The reasons for this are multi-determined and include the influence of the media and cultural expectations, as well as a discrepancy between an adolescent's own physical characteristics and the expectations of his or her social environment. Adolescents with severe body image distortions are vulnerable to developing serious psychiatric disorders that can have life-threatening consequences. Schools can help by providing guidance and information in a time of uncertainty. PMID:12046161

  18. Graffiti and adolescent personality.

    PubMed

    Peretti, P O; Carter, R; McClinton, B

    1977-01-01

    Graffiti has been studied for many years from many viewpoints. They have been used to explain accounts of people, styles of life, and assumed relationships. The present paper reports an attempt to analyze graffiti as outward manifestations of adolescent personality. Results suggested that different forms of graffiti could be interpreted from five characterizations of early adolescent personality: sexual maturity, self-identity, idealism, iconoclasm, and rebelliousness. Significant differences were found between boys and girls in numbers of inscriptions for each category. Further, the graffiti were analyzed in relation to early adolescent stages of development. PMID:868627

  19. [Adolescent behavioral disorders].

    PubMed

    Karila, Laurent; Larrar, Michael; Ferreri, Mélanie

    2014-04-01

    Adolescence is a period of physical and mental transition between childhood and adulthood, two supposedly quieter periods. Puberty and social pressures generate painful psychic conflicts even for a subject without particular problem. Behavioral disorders of adolescents are numerous and heterogeneous. It is oppositional defiant disorder, conduct disorder, hyperactive disorder with attention deficit which often begin during childhood to evolve negatively in adolescence. Eating disorders, addictive disorders, self-mutilation and scarification are also found. Therapeutic management should be multimodal and involve different actors in the health, education and social areas. PMID:24855786

  20. Adolescent Development and Sexuality. Adolescent Decisions Curriculum.

    ERIC Educational Resources Information Center

    Brion-Meisels, Steven; And Others

    This teacher's manual is one volume in a six volume curriculum for the secondary level, designed to provide a systematic, group-oriented approach to decision-making in areas crucial to adolescent development: sexuality and social relationships, drug (substance) use and abuse, work, juvenile law, and people and government. An introductory section…

  1. Nutritional concerns during adolescence.

    PubMed

    Marino, D D; King, J C

    1980-02-01

    Adolescent food habits often run counter to the special nutritional needs of this age group. Suggestions for nutrient supplements are offered, with particular emphasis on fulfilling the unique needs of the obese, athletic, or pregnant teenager. PMID:6445537

  2. [Adolescent health in numbers].

    PubMed

    2008-01-01

    Adolescent health is not a priority to public health services. The physical, psychological and social changes lived by youngsters expose these individuals to several health risks and events that are determinant to their actual and future health status. The main health problems in adolescents are infectious respiratory and gastrointestinal diseases but traumatisms are very important in males. Female adolescents demand services related to their reproductive life and link to early and not desired pregnancies. Another important health problem is overweight and obesity in both sexes. The main causes of death in this age group are malignant tumors, specially leukemias, and accidents. We do not have information related to health risks like addictions and mental health. Data show how important adolescents health should be to the public health sector specially because it will be more easy to tackle their health risks and negative health life-styles at this age than further in their lives. PMID:18647579

  3. The Philosophy of Adolescence

    ERIC Educational Resources Information Center

    Feibleman, James K.

    1969-01-01

    The adolescent goes through various stages of physical and psychological development in the years between puberty and maturity. Finding his rightful place in society and refining his ideas about life are two experiences he undergoes during this period. (CK)

  4. The Fears of Adolescents

    ERIC Educational Resources Information Center

    Bamber, James H.

    1974-01-01

    This study investigated the self-reported fears and some personality characteristics of a sample of 1112 adolescents ranging in age from 12 to 18 years (attending grammar and secondary schools in Northern Ireland). (CS)

  5. Abortion in adolescence.

    PubMed

    Greydanus, D E; Railsback, L D

    1985-09-01

    This article reviews the difficult but complex subject of abortion in adolescents. Methods of abortion are outlined and additional aspects are presented: psychological effects, counseling issues, and legal parameters. It is our conclusion that intense efforts should be aimed at education of youth about sexuality and prevention of pregnancy, utilizing appropriate contraceptive services. When confronted with a youth having an unwanted pregnancy, all legal options need to be carefully explored: delivery, adoption, or abortion. The decision belongs to the youth and important individuals in her environment. Understanding developmental aspects of adolescence will help the clinician deal with the pregnant teenagers. If abortion is selected, a first trimester procedure is best. Finally, physicians are urged to be aware of the specific, ever changing legal dynamics concerning this subject which are present in their states. Abortion is a phenomenon which has become an emotional but undeniably important aspect of adolescent sexuality and adolescent health care, in this country and around the world. PMID:3916607

  6. [Adolescence and sexuality].

    PubMed

    Kjellberg, G

    2006-03-22

    Different pathological states occurring during adolescence, such as anorexia, bulimia and suicidal attempts are seen as possible manifestations of psychological defence mechanisms against the anxiety-provoking bodily changes of puberty and the necessary psychological transformations inherent to adolescence and sexual maturation. The changes of object of desire and some sexual risk behaviours are illustrated by clinical vignettes. Music is suggested to play a role in the mobilisation of emotions, bodily sensations and in the construction of an imaginary world and thus to be a factor--a part from biological and psycho-social ones--influencing the sexual behaviour of adolescents. Some communication techniques are suggested enabling access to adolescents on sexual matters - a domain of increasing public health importance. PMID:16615726

  7. Adolescent pregnancy (image)

    MedlinePlus

    Clear, specific information about sexual behavior and its consequences is frequently not provided to adolescents by their families, schools and communities. The "sex education" that many receive comes from misinformed or uninformed peers.

  8. Adolescents and oral contraceptives.

    PubMed

    Sanfilippo, J S

    1991-01-01

    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development

  9. [Choosing contraception for adolescents].

    PubMed

    Wemeau-jacquemont, C

    1985-02-01

    Earlier and more frequent sexual activity and the significant risk of pregnancy have increased the need for contraception among young adolescent girls. The problem for the physician is to choose a contraceptive method which will not affect future fertility or the psychological and biological maturity of adolescents. Condoms, diaphragms, and spermicides are quite effective if used correctly; they have no deleterious side effects, and they provide protection against sexually transmitted diseases. They appear to be well-adapted to the sporadic sexual activity of adolescents. The efficacy of combined oral contraceptives (OCs) is also high. Side effects depend on the synthetic estrogen component and are dose dependent. Absolute contraindications to OC use in women of any age include thromboembolic disease, cerebral vascular accidents, severe cardiac or hepatic disorders, breast or genital cancer, pregnancy, undiagnosed genital bleeding, and pituitary adenoma. Relative contraindications include hypertension, diabetes, hyperlipidemia, obesity, history of hepatitis, migraines, epilepsy, asthma, renal insufficiency, cystic breast disease, and mammary fibroadenomas. Combined OCs do not seem to interfere with subsequent maturation of the hypothalamopituitary axis. The frequency of ovulatory cycles in adolescents who have discontinued pill use is the same as that in adolescents who have never used pills. However, estrogens accelerate the process of maturation in the bones, so combined OCs should never be prescribed for girls who have not terminated their growth. Minidose OCs containing 30-45 mcg of ethinyl estradiol aggravate the relative hyperestrogenism of adolescents and are associated with menstrual problems, functional ovarian cysts, and breast problems. They should only be prescribed for adolescents with regular sexual activity, no less than 3 years following menarche, with regular ovulatory menstrual cycles and no history of breast disorders. Otherwise, a standard

  10. [Relations of the adolescent].

    PubMed

    Arballo Angulo, M A

    1990-01-01

    Adolescents often feel like sexual beings because of the physical and psychological changes produced by their hormones. Adolescents are sometimes disturbed by their newly occurring sexual fantasies and by lack of understanding from their parents of the changes they are experiencing. These factors together with social pressures of various kinds occasionally make the adolescent forget that decisions about how to behave sexually should be made by the individual, not by others. Adolescents should be able to evaluate personal relationships for their positive or destructive qualities. Decisions by adolescents about their sexual behavior and about when a personal relationship should become a sexual relationship are made more difficult by the conflicting social, group, and interpersonal pressures they face. In a good sexual relationship as in a good friendship, the 2 persons feel confident and behave honestly with each other. Neither dominates the other, and the relationship is pleasurable rather than negative for both. According to research, the 1st sexual relations of an adolescent often occur with an adult. Sex is usually unpremeditated and unplanned. Many adolescents are disappointed in their 1st sexual experiences, which may have occurred in unfavorable circumstances. The combination of inadequate sex education and knowledge of what to expect and unrealistically high expectations from movies or stories probably are principal causes of disappointment. Adolescents in the process of maturing from childhood into adulthood are not completely prepared psychologically or socioculturally for parenthood. In Mexico, 75% of 1st unions are believed to begin before the woman is 20 years old. Most adolescents who become pregnant do not use contraception. In 1976, only 16% of new family planning acceptors were believed to be 15-19 years old. The proportion of births to mothers under 18 was estimated to have increased from 3.1% in 1968-70 to 10% in 1976. Adolescent pregnancies

  11. Implants in adolescents

    PubMed Central

    Shah, Rohit A.; Mitra, Dipika K.; Rodrigues, Silvia V.; Pathare, Pragalbha N.; Podar, Rajesh S.; Vijayakar, Harshad N.

    2013-01-01

    Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature. PMID:24174743

  12. Adolescent fertility: worldwide concerns.

    PubMed

    Senderowitz, J; Paxman, J M

    1985-04-01

    There is growing concern over the adverse health, social, economic, and demographic effects of adolescent fertility. Morbidity and mortality rates ar significantly higher for teenage mothers and their infants, and early initiation of childbearing generally means truncated education, lower future family income, and larger completed family size. Adolescent fertility rates, which largely reflect marriage patterns, range from 4/1000 in Mauritania; in sub-Saharan Africa, virtually all rates are over 100. In most countries, adolescent fertility rates are declining due to rising age at marriage, increased educational and economic opportunities for young women, changes in social customs, increased use of contraception, and access to abortion. However, even if fertility rates were to decline dramatically among adolescent women in developing countries, their sheer numbers imply that their fertility will have a major impact on world population growth in the years ahead. The number of women in the world ages 15-19 years is expected to increase from 245 million in 1985 to over 320 million in the years 2020; 82% of these women live in developing countries. As a result of more and earlier premarital sexual activity, fostered by the lengthening gap between puberty and marriage, diminished parental and social controls, and increasing peer and media pressure to be sexually active, abortion and out-of-wedlock childbearing are increasing among teenagers in many developed and rapidly urbanizing developing countries. Laws and policies regarding sex education in the schools and access to family planning services by adolescents can either inhibit or support efforts to reduce adolescent fertility. Since contraceptive use is often sporadic and ineffective among adolescents, family planning services are crucial. Such programs should aim to reduce adolescents' dependence on abortion through preventive measures and increase awareness of the benefits of delayed sexual activity. Similarly, sex

  13. [Eczematous disorders in adolescents].

    PubMed

    Fölster-Holst, R

    2016-04-01

    Eczematous disorders in adolescence (definition WHO: the period between 10 and 20 years) are common and include mainly atopic dermatitis, contact eczema, and seborrheic dermatitis. They all share the similarity of inflammatory reactions which mainly affect the epidermis and can take a chronic course, depending on the underlying dermatosis. In the following article, the particularities of eczematous diseases in adolescents are discussed. PMID:26857132

  14. Colorectal cancer in adolescents.

    PubMed Central

    Shankar, A.; Renaut, A. J.; Whelan, J.; Taylor, I.

    1999-01-01

    Colorectal cancer, one of the most common malignancies among adults, is rare in adolescence. This low incidence coupled with non-specific symptoms and aggressive natural history leads to a poorer prognosis than in reported adult series. This article describes two cases of colorectal cancer in adolescents and reviews the literature regarding this rare condition. Earlier diagnosis and a greater understanding of the natural history may lead to improved treatment with concomitant improvements in survival. Images Figure 1 Figure 2 PMID:10364965

  15. Agreement among Adolescents, Parents, and Teachers on Adolescent Personality

    ERIC Educational Resources Information Center

    Laidra, Kaia; Allik, Juri; Harro, Maarike; Merenakk, Liis; Harro, Jaanus

    2006-01-01

    Agreement between adolescents, mothers, fathers, and teachers on adolescents' personality traits was investigated in a longitudinal study. The targets for personality ratings were the adolescents who participated in the European Youth Heart Study in Estonia. There were 593 participants in the first wave and 480 participants in the follow-up study…

  16. Parent-Adolescent Conflicts, Conflict Resolution Types, and Adolescent Adjustment

    ERIC Educational Resources Information Center

    Branje, Susan J. T.; van Doorn, Muriel; van der Valk, Inge; Meeus, Wim

    2009-01-01

    The current study examined the moderating role of conflict resolution on the association between parent-adolescent conflicts and adolescent problematic adjustment. Participants were 1313 Dutch early and middle adolescents who completed measures on conflict frequency, conflict resolution with parents, and internalizing and externalizing adjustment…

  17. Marital conflict and adolescent distress: the role of adolescent awareness.

    PubMed

    Harold, G T; Conger, R D

    1997-04-01

    The present longitudinal study (1989-1991) of seventh-grade adolescents (173 boys, 197 girls; M age = 12.7 in 1989) living in the rural Midwest examined the influence of children's awareness of marital conflict and reported level of parental hostility on symptoms of adolescent distress. The theoretical model guiding the research indirectly linked marital conflict to adolescent perceptions of parents' hostility through the mediating effects of parents' and observers' report of hostility toward the adolescent and through adolescent awareness of the frequency of interparental conflict. Controlling for earlier levels of psychological distress, we hypothesized a direct path between adolescent report of parent hostility and adolescent maladjustment. Maximum likelihood estimation of the proposed model showed that marital conflict was significantly related to parents' and observers' reports of parent hostility toward the adolescent and to adolescent awareness of conflict frequency. Both parent hostility and adolescent awareness of the frequency of marital conflicts were significantly related to adolescent perceptions of parent hostility. When controlled for earlier distress, adolescent report of parent hostility significantly predicted the later internalizing and externalizing symptoms of these teenagers. The model predicted externalizing problems for boys but not girls. Otherwise, there were no gender differences in the postulated causal processes. PMID:9180005

  18. Agreement between Parent and Adolescent Reports of Adolescent Substance Use

    ERIC Educational Resources Information Center

    McGillicuddy, Neil; Rychtarik, Robert G.; Morsheimer, Elizabeth T.; Burke-Storer, Michelle R.

    2007-01-01

    This study examined the correspondence between parent and adolescent reports of the adolescent's substance use in a population of parents concerned about, and experiencing problems resulting from, their teen's substance use. Seventy-five parents and their adolescents (76% not in treatment; 24% in treatment) were interviewed separately regarding…

  19. Comparisons between Thai Adolescent Voices and Thai Adolescent Health Literature

    ERIC Educational Resources Information Center

    Thongpriwan, Vipavee; McElmurry, Beverly J.

    2006-01-01

    Thai adolescents are hesitant to openly talk to adults; however, they are avid users of the Internet. In 2002, faculty of the Boromarajonani College of Nursing, Nopparat Vajira, Thailand, established a webboard to reach out to high school students for questions and answers on adolescent health. Adolescents pose health questions, which are answered…

  20. Adolescent and Pediatric Brain Tumors

    MedlinePlus

    ... abta.org Donate Now Menu Adolescent & Pediatric Brain Tumors Brain Tumors In Children Pediatric Brain Tumor Diagnosis Family ... or Complete our contact form Adolescent & Pediatric Brain Tumors Brain Tumors In Children Pediatric Brain Tumor Diagnosis Family ...

  1. Of Adolescent Cultures and Subcultures

    ERIC Educational Resources Information Center

    Deiulio, Anthony M.

    1978-01-01

    Discusses the characteristics of adolescent graffiti, analyzes recent trends in graffiti content, and argues that graffiti tend to reflect the same feelings and concerns uncovered by formal studies of adolescents conducted by sociologists and pollsters. (JG)

  2. On Variations in Adolescent Subcultures

    ERIC Educational Resources Information Center

    Kandel, Denise B.

    1978-01-01

    The attributes of adolescents involved in marihuana and nonmarihuana-using peer groups are described. Adolescent subcultures are highly differentiated and involvement with peers does not necessarily entail rejection and estrangement from parents. (Author/AM)

  3. Motivational Interviewing and Adolescent Psychopharmacology

    ERIC Educational Resources Information Center

    Dilallo, John J.; Weiss, Gony

    2009-01-01

    The use of motivational interviewing strategies in the practice of adolescent psychopharmacology is described. Motivational interviewing is an efficient and collaborative style of clinical interaction and this helps adolescent patients to integrate their psychiatric difficulties into a more resilient identity.

  4. Adolescent Pregnancy: A Medical Concern.

    ERIC Educational Resources Information Center

    Taborn, John M.

    1989-01-01

    Outlines the medical and social consequences of adolescent pregnancy, including maternal and infant mortality, and low birth weight. Discusses why pregnant adolescents do not seek prenatal care and implications for health providers. (FMW)

  5. FastStats: Adolescent Health

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Adolescent Health Recommend on Facebook Tweet Share Compartir Data are for the U.S. Health status Percent of adolescents 12-17 years of age who are in ...

  6. Scoliosis in Children and Adolescents

    MedlinePlus

    ... Questions and Answers about Scoliosis in Children and Adolescents This publication defines scoliosis and provides information about ... it is diagnosed and treated in children and adolescents. You may be interested in contacting one or ...

  7. Gay, Lesbian and Bisexual Adolescents

    MedlinePlus

    ... Guide Skip breadcrumb navigation Gay, Lesbian and Bisexual Adolescents Quick Links Facts For Families Guide Facts For ... is a demanding and challenging task for every adolescent. One important aspect is forming one's sexual identity. ...

  8. Adolescent test or procedure preparation

    MedlinePlus

    ... someone else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... effects the test may cause. Older adolescents may benefit from videos that show adolescents of the same ...

  9. Parent-Adolescent Sexual Communication.

    PubMed

    Harris, Allyssa L

    2016-01-01

    Risky sexual behavior among adolescents is a major public health concern with potentially long-lasting consequences, including pregnancy, sexually transmitted infections, and HIV/AIDS. Researchers have demonstrated that parent-adolescent sexual communication can mitigate adolescent risky sexual behaviors; the development of interventions that support this process are vital. This column examines a recent study that evaluated a parent-adolescent sexual communication intervention. PMID:27067937

  10. Effect of functional foot orthoses on first metatarsophalangeal joint dorsiflexion in stance and gait.

    PubMed

    Scherer, Paul R; Sanders, Jennifer; Eldredge, Denten E; Duffy, Susan J; Lee, Ryan Y

    2006-01-01

    Reduction in first metatarsophalangeal joint maximum degree of dorsiflexion with dorsiflexion of the first ray has been proposed to be the predominant cause of hallux abducto valgus and hallux rigidus. We sought to determine whether orthoses made from a cast with the first ray plantarflexed and a 4-mm medial skive could increase the maximum degree of dorsiflexion in patients with functional hallux limitus in stance and gait. Forty-eight feet of 27 subjects were casted for orthoses with the first ray plantarflexed and in the customary neutral rearfoot position with locked midtarsal joint. First metatarsophalangeal joint maximum dorsiflexion was measured with and without orthoses in stance, and subhallux pressure was measured with and without orthoses at heel-off. Changes in mean maximum dorsiflexion in stance and in mean maximum subhallux pressure in gait with orthoses were significant. We investigated the relationship between this increase in dorsiflexion and gender, shoe size, resting calcaneal stance position, and change in resting calcaneal stance position with the use of orthoses. These correlations were not statistically significant. The biomechanical implication of increasing limited first metatarsophalangeal joint dorsiflexion with orthoses is discussed and related to the clinical treatment of deformities, including hallux valgus and hallux rigidus. The use of orthoses to decrease subhallux pressure is also discussed. PMID:17114600

  11. Assessing Adolescents' Motivation to Read

    ERIC Educational Resources Information Center

    Pitcher, Sharon M.; Albright, Lettie K.; DeLaney, Carol J.; Walker, Nancy T.; Seunarinesingh, Krishna; Mogge, Stephen; Headley, Kathy N.; Ridgeway, Victoria Gentry; Peck, Sharon; Hunt, Rebecca; Dunston, Pamela J.

    2007-01-01

    A team of researchers revised the Motivation to Read Profile for use with adolescents. Instruments to assess adolescents' in- and out-of-school reading motivations were administered. A survey adapted for adolescents was administered to 384 teens at eight sites throughout the United States and Trinidad, and 100 students were interviewed using a…

  12. Child Maltreatment and Adolescent Development

    ERIC Educational Resources Information Center

    Trickett, Penelope K.; Negriff, Sonya; Ji, Juye; Peckins, Melissa

    2011-01-01

    Child abuse and neglect, often collectively called child maltreatment, are huge social problems affecting millions of children and adolescents in America. Adolescents are affected both by maltreatment which occurred during childhood with lingering effects and by maltreatment that continues into or begins in adolescence. Several decades of research…

  13. Adolescent Psychology around the World

    ERIC Educational Resources Information Center

    Arnett, Jeffrey Jensen, Ed.

    2011-01-01

    This book paints a portrait of adolescent psychology in 4 major regions: Africa/the Middle East, Asia, the Americas, and Europe. Featuring 24 revised and updated chapters from the "International Encyclopedia of Adolescence" (2007), readers are introduced to the way the majority of the world's adolescents actually live. Most contributors are…

  14. Pathways of Adolescent Suicidal Behavior.

    ERIC Educational Resources Information Center

    Munzer, Jane; And Others

    Suicide attempts and suicidal ideation among adolescents have been increasing faster than those for adults. This study addresses three questions on adolescent suicidal behavior: (1) Why do some adolescents with psychiatric disorders have a history of suicidal behaviors and some do not?; (2) How do intrapsychic and interpersonal underpinnings of…

  15. Popular Music in Early Adolescence.

    ERIC Educational Resources Information Center

    Christenson, Peter G.; Roberts, Donald F.

    This paper examines young adolescents' involvement with popular music and the health implications of that involvement. Initial discussion explores three central concepts: music media, adolescence, and mass media effects. A summary of research on music media in adolescence is offereed in two sections discussing exposure to, and gratifications and…

  16. Rorschach Evaluation of Adolescent Bulimics.

    ERIC Educational Resources Information Center

    Smith, Jane E.; And Others

    1991-01-01

    Used Rorschach Test to contrast 12 diagnosed female adolescent bulimics with 12 female adolescent controls. Bulimics averaged greater number of aggression responses. Data suggest that adolescent bulimics are more depressed, self-punitive, and negativistic than peers and that they have more disordered thoughts, inaccurate perceptions, and impaired…

  17. Depression in Children and Adolescents

    ERIC Educational Resources Information Center

    Davis, Noel M.

    2005-01-01

    During the past 20 years, depression has been recognized widely in children and adolescents. However, even with what is known today about depression, many children and adolescents remain undiagnosed. Early recognition is imperative to prevent further episodes that may continue into adulthood. Depression in children and adolescents affects social…

  18. The Relevance of Adolescent Literature.

    ERIC Educational Resources Information Center

    LaRocque, Geraldine E.

    1969-01-01

    Although summer writer's conferences have added adolescent literature to their programs and many professional educators have recommended a required course in adolescent literature for all high school English teachers, adolescent literature is still neglected, especially by English teachers. All students at some time in their literary growth enjoy…

  19. Eating Disorders in Adolescent Males

    ERIC Educational Resources Information Center

    Ray, Shannon L.

    2004-01-01

    Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…

  20. Anger Communication in Bicultural Adolescents

    ERIC Educational Resources Information Center

    Novin, Sheida; Rieffe, Carolien

    2012-01-01

    Little is known about bicultural adolescents' emotional competence. The aim of the present study was to examine anger communication by comparing thirty-eight 16-year-old Moroccan-Dutch adolescents with 40 Dutch and 40 Moroccan peers using hypothetical anger-eliciting vignettes. Findings show that although Moroccan and Dutch adolescents were…

  1. Adolescent Egocentrism: A Contemporary View

    ERIC Educational Resources Information Center

    Schwartz, Paul D.; Maynard, Amanda M.; Uzelac, Sarah M.

    2008-01-01

    This study sought to determine whether adolescent egocentrism is displayed during adolescence in the same patterns as when the constructs were first defined in 1967. We empirically revisited the constructs of personal fable and imaginary audience in contemporary adolescents, hypothesizing a decrease in egocentrism with increasing age. Adolescents…

  2. Latino Adolescents' Adjustment, Maternal Depressive Symptoms, and the Mother-Adolescent Relationship

    ERIC Educational Resources Information Center

    Corona, Rosalie; Lefkowitz, Eva S.; Sigman, Marian; Romo, Laura F.

    2005-01-01

    This study examined associations between adolescent behaviors, maternal depressive symptoms, and mother-adolescent relationships. Latina mothers and adolescents (111 dyads) completed questionnaires and participated in videotaped discussions. Mothers' depressive symptoms related to adolescents' internalizing and externalizing behaviors and family…

  3. Adolescent male health

    PubMed Central

    Westwood, Michael; Pinzon, Jorge

    2008-01-01

    Although adolescent males have as many health issues and concerns as adolescent females, they are much less likely to be seen in a clinical setting. This is related to both individual factors and the health care system itself, which is not always encouraging and set up to provide comprehensive male health care. Working with adolescent boys involves gaining the knowledge and skills to address concerns such as puberty and sexuality, substance use, violence, risk-taking behaviours and mental health issues. The ability to engage the young male patient is critical, and the professional must be comfortable in initiating conversation about a wide array of topics with the teen boy, who may be reluctant to discuss his concerns. It is important to take every opportunity with adolescent boys to talk about issues beyond the presenting complain, and let them know about confidential care. The physician can educate teens about the importance of regular checkups, and that they are welcome to contact the physician if they are experiencing any concerns about their health or well-being. Parents of preadolescent and adolescent boys should be educated on the value of regular health maintenance visits for their sons beginning in their early teen years. PMID:19119350

  4. ADOLESCENTS AND ALCOHOL

    PubMed Central

    Spear, Linda Patia

    2014-01-01

    The high levels of alcohol consumption characteristic of adolescence may be in part biologically based, given that elevated consumption levels are also evident during this developmental transition in other mammalian species as well. Studies conducted using a simple animal model of adolescence in the rat has shown adolescents to be more sensitive than adults to social facilitatory and rewarding effects of alcohol, but less sensitive to numerous alcohol effects that may serve as cues to limit intake. These age-specific alcohol sensitivities appear related to differential rates of development of neural systems underlying different alcohol effects as well as to an ontogenetic decline in rapid brain compensations to alcohol, termed “acute tolerance”. In contrast, these adolescent-typical sensitivities to alcohol do not appear to be notably influenced by pubertally-related increases in gonadal hormones. Although data are sparse, there are hints that similar alcohol sensitivities may also be seen in human adolescents, with this developmentally decreased sensitivity to alcohol’s intoxicating effects possibly exacerbated by genetic vulnerabilities also characterized by an insensitivity to alcohol intoxication, thereby perhaps permitting especially high levels of alcohol consumption among vulnerable youth. PMID:25309054

  5. The Adolescent Experience: European and American Adolescents in the 1990s. Research Monographs in Adolescence.

    ERIC Educational Resources Information Center

    Alsaker, Francoise D., Ed.; Flammer, August, Ed.

    Scholars are increasingly recognizing that adolescent development is best understood by acknowledging and examining adolescents' cultural, social, historical, and political contexts. The Euronet for Research on Adolescence in the Context of Social Change project, begun in 1991, is a collaborative effort among research teams from European countries…

  6. Adolescent Perceptions of Parental Behaviors, Adolescent Self-Esteem, and Adolescent Depressed Mood

    ERIC Educational Resources Information Center

    Plunkett, Scott W.; Henry, Carolyn S.; Robinson, Linda C.; Behnke, Andrew; Falcon, Pedro C., III

    2007-01-01

    Using symbolic interaction, we developed a research model that proposed adolescent perceptions of parental support and psychological control would be related to adolescent depressed mood directly and indirectly through self-esteem. We tested the model using self-report questionnaire data from 161 adolescents living with both of their biological…

  7. 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

  8. The versatility of the Lapidus arthrodesis.

    PubMed

    Blitz, Neal M

    2009-07-01

    Lapidus Arthrodesis is probably the most versatile procedure of the foot and ankle surgeon. The procedure was conceived initially for the surgical treatment of met primus adductus associated with hallux valgus, but has also been used for the treatment of a variety of other conditions including hallux limitus, revision bunion surgery, medial column stabilization, and others. Although the use of the Lapidus in bunion surgery is well supported in the literature, surgeons have been expanding its indications to manage a variety of disorders affecting the foot. As more surgeons continue to gain experience with the procedure, additional studies will emerge, further supporting its versatility in the realm of foot surgery. PMID:19505642

  9. [Family dynamics around the adolescent].

    PubMed

    Schmit, Gérard

    2005-05-31

    Family dynamics around the adolescent Adolescence modifies the family dynamics around the adolescent because adolescence comprises an unavoidable process of psychological separation between the subject and the parents of his childhood. On the adolescent side, the relations with his parents show a newer claim of recognition. On the parents' side, the mourning deals with several topics. The outcome of the crisis depends on the inner family control of anxiety and on the degree of differentiation of its members. Parents, grandparents and siblings have an important role to play in those transformations. PMID:16097251

  10. Improving adolescent maternal health.

    PubMed

    Baxter, C; Moodley, D

    2015-11-01

    Each year thousands of adolescent girls and young women in South Africa (SA) become pregnant and many die from complications related to pregnancy and childbirth. Although women of all ages are susceptible, girls<15 years of age are five times as likely, and those aged 15-19 years twice as likely, to die from complications related to childbirth than women in their 20s. In SA, non-pregnancy-related infections (e.g. HIV), obstetric haemorrhage and hypertension contributed to almost 70% of avoidable maternal deaths. In addition to the implementation of standardized preventive interventions to reduce obstetric haemorrhage and hypertension, better reproductive health services for adolescents, access to HIV care and treatment for women infected with HIV, and improved access to and uptake of long-acting reversible contraception are important ingredients for reducing maternal mortality among adolescents. PMID:26937508

  11. Reaching out to adolescents.

    PubMed

    1997-10-01

    The IEC Workshop for the Production of Video Scripts on Reproductive Health for Adolescents and Young Adults was held in Japan during August 18-23 as part of the UNFPA-supported Training and Development, Production and Utilization of IEC Materials with Special Focus on Reproductive Health for Adolescents and Young Adults project. Participants involved in promoting sexual and reproductive health for adolescents and young adults, and in charge of producing IEC materials for the age group, came from Bangladesh, China, India, Indonesia, Laos, Malaysia, Myanmar, Nepal, the Philippines, Sri Lanka, Thailand, and Vietnam to engage in a 4-day intensive development process of developing 3 prototype video scripts. The workshop was organized by JOICFP in collaboration with UNFPA, IPPF, the Japanese Ministry of Foreign Affairs, and the Japan Family Planning Association. An UNFPA observer was also in attendance. PMID:12292743

  12. Borderline personality disorder in adolescence.

    PubMed

    Kaess, Michael; Brunner, Romuald; Chanen, Andrew

    2014-10-01

    Borderline personality disorder (BPD) is a common and severe mental disorder that is associated with severe functional impairment and a high suicide rate. BPD is usually associated with other psychiatric and personality disorders, high burden on families and carers, continuing resource utilization, and high treatment costs. BPD has been a controversial diagnosis in adolescents, but this is no longer justified. Recent evidence demonstrates that BPD is as reliable and valid among adolescents as it is in adults and that adolescents with BPD can benefit from early intervention. Consequently, adolescent BPD is now recognized in psychiatric classification systems and in national treatment guidelines. This review aims to inform practitioners in the field of adolescent health about the nature of BPD in adolescence and the benefits of early detection and intervention. BPD diagnosis and treatment should be considered part of routine practice in adolescent mental health to improve these individuals' well-being and long-term prognosis. PMID:25246626

  13. [Pregnancy and adolescence today].

    PubMed

    Conceicao, I S

    1993-09-01

    The high rate of adolescent pregnancy has been a social, medical, and personal problem defying solution since the 1970s. Pregnancy in young women is the major cause of maternal mortality and morbidity, social inequality of adolescent mothers, the exacerbation of neuroses, and the great number of abandoned or maladjusted children in society. The principal element of profound social transformations currently taking place is the question of sexual activity and sexual roles. Adults educated in a conservative society question the results of this education, where sex is prohibited for women but it is obligatory for men. In the last three decades this repression has been contested by accepting sexuality as a natural individual right. As a consequence of this sociocultural transition, adolescents are not prepared to restrain their sexuality until they reach maturity. In the preceding decades, a social stimulus induced young people (especially women) to start premarital sex without being sufficiently prepared for the eventual consequences, such as sexually transmitted diseases and unwanted pregnancies. The feminist movement wants a new place in society. These changes are ill-defined and obscure and provoke anxiety and insecurity in the fulfillment of women's role. Adolescence is a phase of change of identity, and anxiety and uncertainty about the proper sexual role also contribute to emotional instability. Preparation for a profession requires a long time and dependency on the family postponing economic independence for marriage. This dichotomy promotes premarital sexual life. On the other hand, those who do not study find it difficult to get a job, which also involves adolescents in irresponsibility and disrespect for social values. Pregnancy is often the solution to this unproductivity by creating a condition that is socially recognized. These factors may explain the high rate of adolescent pregnancies, which is ten times higher than it was at the beginning of the century

  14. Targeting the adolescent male.

    PubMed

    Pitt, E

    1986-01-01

    The National Urban League regards too early parenting among adolescents as an issue requiring high level, active attention from all segments of the Black community. Poverty, single parent households and adolescent pregnancies are not exclusively female problems. The role that males play has been missing from too many studies of these phenomena. In light of the fact that most sexual activity is male initiated, and most sexual behavior is male influenced, it becomes clear that there will be no resolution of the problem of teenage pregnancy without directing greater attention to the male. The issue of male responsibility is skirted too often due to parental pride on the part of mothers and fathers when their male children seek sexual relations with female partners. It is viewed as a sign that they are developing sexually within the norm. This is especially true, in many instances, in female headed households where the mother is concerned that she may not be providing her son with an adequate male role model. Sexual activity by female adolescents, however, is generally not condoned. This confusing double standard is further compounded by the disjointed fashion in which American society responds to adolescent sexuality on the whole. Although the home should be the focal point, many parents reluctantly admit an inability to communicate effectively about sex with their pre-adolescent children. Thus, the school, church, community and social agencies have all been enlisted in this task. The National Urban League's initiative in this area is expected to have significant impact on the course of adolescent sexuality and reproductive responsibility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3745498

  15. [Variocele in adolescents].

    PubMed

    Kaminsky, A; Sperling, H

    2014-02-01

    Up to 20% of adolescents have a varicocele. Often a varicocele is an incidental finding during a physical examination. However, adolescents with a varicocele might suffer from pain or they may have noticed a difference in the volume of the testes. The diagnostic investigation of the ejaculate in adolescents is difficult because no age-dependent spermiogram standard values exist. Endocrinological tests are also difficult because of the physiological variability of testosterone and gonadotropins during adolescence. The difference in testes volume normalizes in half of the boys without any therapy during maturation. Most adolescents with a varicocele have a normal semen analysis. The sperm parameters are the most important factor for treatment decision making.If sperm concentration, motility, and morphology are normal, active surveillance with regular control examinations are recommended even if the volume of the testis is divergent. Pathologic sperm parameters should lead to an operative treatment. The microsurgical subinguinal technique is the method of choice due to the low complication and reoperation rates. The sperm concentration, morphology, and motility increase postoperatively as well as the volume of the testis. It is not clear whether the improved sperm parameters lead to improved spontaneous pregnancy rates later in life. Whether scrotal pain decreases after operative therapy is uncertain because of the subjectivity of pain.Until now there are only a few studies with small and very heterogeneous case numbers so that no clear recommendation for the treatment of a varicocele in adolescents can be made. The difficulty in the treatment decision-making is preventing reduced fertility, while avoiding overtreatment. PMID:24535204

  16. [Adolescence and AIDS].

    PubMed

    1991-01-01

    The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex

  17. [Sexual disorders in adolescents].

    PubMed

    Scheer, P J

    2014-02-01

    Numerous sexual disorders, which were previously in the foreground, have in fact disappeared due to our changing society. This broad field today includes repressed sexual disorders of adolescents who cannot or do not want to go along with the changes either for familial or personal reasons. Immigrant background, religious beliefs, and peer pressure may play a role here. As a dialog partner for adolescents, the competent physician must take into consideration the interplay of sexual desire, ethical beliefs, morals, and parental expectations, which requires interest, intuition, and tact. PMID:24535205

  18. ADHD and Adolescent Athletes

    PubMed Central

    Nazeer, Ahsan; Mansour, Miriam; Gross, Kathleen A.

    2014-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects the child and adolescent population. It is characterized by impairment in attention/concentration, hyperactivity, and impulsivity, all of which can impact performance of athletes. ADHD treatment within the athletic population is a unique challenge. The research in this field has been relatively limited. The National Collegiate Athletic Association and International Olympic Committee both regulate the use of psychostimulants for treatment of ADHD due to their performance-enhancing effects. In this article, authors have discussed the screening methods, pharmacological treatment, side effects, and behavioral approaches for the treatment of ADHD in adolescent athletes. PMID:24987666

  19. Creativity in adolescence.

    PubMed

    Rothenberg, A

    1990-09-01

    Findings from an empirical research project on creativity, including controlled experimental assessment, indicate that the development of creative capacity occurs primarily during the adolescent period. Defined as the production of entities that are both new and valuable, creativity necessarily involves two specific types of cognition designated as the janusian and homospatial processes. Although there are precursors to the development of creativity during earlier childhood, both the motivation and the capacity to create appear first in the adolescent period. Important motivational factors derive from adolescent conflicts and developmental tasks such as the impetus to solve and consolidate issues relating to identity, the return of oedipal conflicts, and the pressures toward autonomy and independence. Engaging in creative types of fields and outlets helps generally to establish coherent identity during adolescence and beyond; the beginnings of a specific creative identity in adolescence are a necessary foundation for creative motivation and ability to create throughout life. The return of the oedipal conflict at the onset of puberty motivates the dual compliance and competition of the creatively disposed adolescent with his or her same-sex parent. The pressures toward autonomy and independence provide the motivational and affective substrate for the development of the homospatial and janusian processes. The homospatial process arises from the vacillating and concomitant experiences of autonomy (or separation) and connectedness. In the creatively disposed adolescent, one who activates and uses cognition to express and explore affect, the creative aspect of those experiences begins to be manifested in the concomitant cognitive separation and connection involved in superimposition of mental images. The janusian process arises from the experiences of rebellious oppositionality and intense emotional ambivalence. The creative cognitive aspect of these experiences is

  20. Adolescent Contraception: An Overview

    PubMed Central

    Pavilanis, Alan V.

    1988-01-01

    Adolescents are sexual beings who are undergoing important biological and social changes. Physicians must recognize the need for contraception in their teenage patients and realize when teenagers are asking for contraception. In order to deal effectively with the question of birth control, the physician must be comfortable with the issues of adolescent development and sexuality, as well as with his of her own sexuality. The birth-control pill remains the contraceptive prescription of choice, but other methods of birth control are discussed as well. Physicians must also be prepared to validate a teenager's decision not to engage in intercourse. PMID:21253171

  1. Adolescent Varicoceles and Infertility.

    PubMed

    Casey, Jessica T; Misseri, Rosalia

    2015-12-01

    Varicoceles are associated with testicular atrophy and abnormal spermatogenesis. Varicocele-related testicular damage is thought to be progressive in nature. Adult varicoceles are common in men with infertility, and varicocele repair in this population has demonstrated improved semen parameters and paternity outcomes. However, without solid objective endpoints (reproducible semen analyses, paternity), the indications for adolescent varicocele repair remain controversial. Given the controversy surrounding adolescent varicocele management, it is not surprising that surveys of pediatric urologists have revealed a lack of consensus on diagnostic approaches, treatment decisions, and operative approaches. PMID:26568496

  2. Genetics Home Reference: adolescent idiopathic scoliosis

    MedlinePlus

    ... Understand Genetics Home Health Conditions adolescent idiopathic scoliosis adolescent idiopathic scoliosis Enable Javascript to view the expand/ ... boxes. Download PDF Open All Close All Description Adolescent idiopathic scoliosis is an abnormal curvature of the ...

  3. Eosinophilic Esophagitis in Pediatric and Adolescent Patients

    MedlinePlus

    ... and Adolescent Patients Eosinophilic Esophagitis in Pediatric and Adolescent Patients Basics Overview Eosinophilic esophagitis also known as ( ... children may have vomiting and abdominal pain, and adolescents may complain of the feeling of food getting ...

  4. Smoking cessation treatment for adolescents.

    PubMed

    Karpinski, Julie P; Timpe, Erin M; Lubsch, Lisa

    2010-10-01

    Cigarette smoking in the adolescent population remains a public health concern. A significant portion of the adolescent population currently uses tobacco. Nicotine is particularly addicting in adolescents, and quitting is difficult. The goals for adolescent cigarette smoking efforts must include both primary prevention and smoking cessation. Bupropion and nicotine replacement therapies-including nicotine patches, gum, and nasal spray-have been studied to a limited extent in the adolescent population. Varenicline has not been evaluated as a treatment modality in adolescents. Long-term quit rates in the pharmacotherapy trials have not been optimal; however, decreases in cigarettes smoked per day have been observed. Several evidencebased guidelines include recommendations for smoking cessation in adolescents that include counseling and pharmacotherapy. Pharmacotherapy may be instituted for some adolescents in addition to counseling and behavioral interventions. Therapy should be individualized, based on smoking patterns, patient preferences, and concomitant disease states. Smoking cessation support for parents should be instituted as well. The pharmacist can play a large role in helping the adolescent quit smoking. Further studies evaluating pharmacotherapy options for smoking cessation in adolescents are necessary. If pharmacotherapy is used, it should be individualized and combined with psychosocial and behavioral interventions. PMID:22477813

  5. Victimization of Obese Adolescents

    ERIC Educational Resources Information Center

    Robinson, Sabrina

    2006-01-01

    Peer victimization of obese adolescents has been associated with low self-esteem, body dissatisfaction, social isolation, marginalization, poor psychosocial adjustment, depression, eating disorders, and suicidal ideation and attempts, not to mention poor academic performance. Weight-based peer victimization is defined as unsolicited bullying and…

  6. Friendship Bonds in Adolescence.

    ERIC Educational Resources Information Center

    Tedesco, Lisa A.; Gaier, Eugene L.

    1988-01-01

    Assessed the major motifs of interpersonal relations, achievement, and physical development, influencing adolescent friendship formation. The interpersonal category was salient at all grade levels for both sexes and increased with time. A corresponding decrease for the achievement and physical attributes categories also emerged. Friendship…

  7. Eating Disordered Adolescent Males.

    ERIC Educational Resources Information Center

    Eliot, Alexandra O.; Baker, Christina Wood

    2001-01-01

    Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…

  8. Early Adolescent Helper Program.

    ERIC Educational Resources Information Center

    Harrington, Diane, Ed.

    1986-01-01

    Recognizing the need for more active learning experiences and appropriate after-school activities for 11- to 14-year-olds, the Early Adolescent Helper Program has designed and tested a model program. Seminars and internships prepare students for placement, which is frequently in child-care or senior centers. (JMM)

  9. Brief Interventions for Adolescents

    PubMed Central

    Winters, Ken C

    2016-01-01

    Public health concerns regarding adolescent alcohol and other drug involvement emphasize the need for continuing research to develop and evaluate preventive interventions for use in a variety of settings. This focus includes research on brief interventions. This short commentary piece provides an overview of the brief intervention literature and highlights future directions PMID:27182561

  10. The Emotionally Sensitive Adolescent.

    ERIC Educational Resources Information Center

    Shaughnessy, Michael F.; Lehtonen, Kimmo

    This paper provides a list of signs, symptoms, and indicators of emotionally sensitive adolescents includes clinging behavior, withdrawn behavior, shy/inhibited behavior, represses anger, poor reaction to criticism, makes self-disparaging statements, low self-esteem, "can't forgive self or others," ruined by a small critical comment, exploding…

  11. Evaluating Adolescent Catechesis

    ERIC Educational Resources Information Center

    Kaster, Jeffrey

    2011-01-01

    Systematic program evaluations of adolescent catechesis curricula are seldom completed and rarely published. This makes it very challenging to understand what is working and what is not. This case study describes the findings of a program evaluation of the Youth in Theology and Ministry curriculum of Saint John's School of Theology and Seminary in…

  12. Adolescents' Reasons for Smoking.

    ERIC Educational Resources Information Center

    Sarason, Irwin G.; And Others

    1992-01-01

    Reports a study of adolescents' motivations for smoking. Survey results indicated that curiosity, social norms, and pressures were the main reasons for beginning smoking and that pleasure, addiction, and desire were the main reasons for continuing; various gender differences surfaced. Suggestions are given for smoking prevention programs. (SM)

  13. Adolescent to Parent Violence.

    ERIC Educational Resources Information Center

    Cornell, Claire Pedrick; Gelles, Richard J.

    1982-01-01

    Examines the extent of violence toward parents by adolescent children in relation to: (1) sex and age of the child; (2) the likelihood that mothers, more than fathers, are victims of children's violence; (3) social factors that may influence child to parent violence; and (4) stress as a factor in family violence. (Author/MJL)

  14. Adolescent Communication Screen. Revised.

    ERIC Educational Resources Information Center

    Tisthammer, Patricia; And Others

    The Adolescent Communication Screen--a criterion-based instrument designed to provide speech-language clinicians a measure for screening the communication skills of students in grades 5 through 12--is described in this document. Included in the description are the instrument's subtests: vocabulary, temporal concepts, language comprehension,…

  15. Hypertension in adolescents.

    PubMed

    Aglony, Marlene; Acevedo, Monica; Ambrosio, Giuseppe

    2009-12-01

    In adults, hypertension has long been perceived as a public health problem. By contrast, its impact in childhood is far less appreciated. In fact, quite often, high blood pressure in children is not even diagnosed. Blood pressure is a vital sign that is routinely obtained during a physical examination of adults, but only very seldom in children. The diagnosis of hypertension in children is complicated because 'normal' blood pressure values vary with age, sex and height. As a consequence, almost 75% of the cases of arterial hypertension and 90% of the cases of prehypertension in children and adolescents are currently undiagnosed. Furthermore, adolescence hypertension is increasing in prevalence as the prevalence of pediatric obesity has increased. Ambulatory blood pressure monitoring is a useful method for risk evaluation in adolescents. In addition to being viewed as an important cardiovascular risk factor in adolescents, elevated blood pressure should prompt a thorough search for other modifiable risk factors that, if treated, might reduce teenagers' risk of developing cardiovascular disease in adulthood. Thus, assessing blood pressure values in children represents one of the most important measurable markers of cardiovascular risk later in life and a major step in preventive medicine. PMID:19954321

  16. Sexual Behavior of Adolescents.

    ERIC Educational Resources Information Center

    Wagner, Hilmar

    1978-01-01

    Confined to discussion of heterosexual activities, this article examines adolescent sexual behavior in terms of promiscuity; the search for a sexual behavior code; the impact of the media; and the influence of peer groups, religious identification, and the adult double standard. (JC)

  17. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  18. Gender dysphoria in adolescence.

    PubMed

    Leibowitz, Scott; de Vries, Annelou L C

    2016-01-01

    Adolescents presenting with gender-related concerns are increasingly seeking support from providers from a variety of disciplines within health care settings across the world. For those treating young people who meet the criteria for the DSM 5 diagnosis of gender dysphoria (GD), complex decisions in clinical care are common. Defining best practice with this population with respect to interventions that span mental health, physical, and surgical domains can be challenging, given a relative dearth of empirical data available; yet practice guidelines have emerged from different professional organizations which can aid with this. For this review paper, a broad literature search was performed to identify relevant studies pertaining to the care of adolescents with GD. In addition, an overview of trends in clinical practice, including shifts in conceptualization of how clinicians and patients define care that is considered affirming when working with this population, is described. This paper explores the characteristics of referral patterns to specialized clinics, provides a brief overview of gender identity development in adolescence, and then describes the phenomenology of known aetiological factors and co-occurring psychiatric issues in adolescents with GD. Additionally, clinical management considerations that detail assessment aims and common treatment interventions across disciplines will be explored. PMID:26828376

  19. Adolescents and Graffiti.

    ERIC Educational Resources Information Center

    Kan, Koon-Hwee

    2001-01-01

    Describes the different types of graffiti: (1) private forms of graffiti (doodling and latrinalia); and (2 public forms (gang graffiti, tags, and pieces). Uses teenage psychology to interpret adolescents' involvement in graffiti. Examines graffiti art in relation to its educational implications for secondary art education. (CMK)

  20. Moral Development in Adolescence

    ERIC Educational Resources Information Center

    Hart, Daniel; Carlo, Gustavo

    2005-01-01

    Themes in the papers in this special issue of the "JRA" on moral development are identified. We discuss the intersection of moral development research with policy concerns, the distinctive qualities of moral life in adolescence that warrant investigation, the multiple connotations of "moral", the methods typical of moral development research, and…

  1. Adolescent Program for Stutterers.

    ERIC Educational Resources Information Center

    Lepp, Daniel S.; Kiernan, Bonnie M.

    Written for speech-language clinicians in the school setting, the manual describes therapy techniques used in the Keystone Adolescent Program for Stutterers (KAPS). KAPS emphasizes the Airflow Technique, a self-regulatory approach consisting of two parts: (1) a quiet breathing in and out allowing the breath to flow out a distance before initiating…

  2. Popularity Contagion among Adolescents

    ERIC Educational Resources Information Center

    Marks, Peter E. L.; Cillessen, Antonius H. N.; Crick, Nicki R.

    2012-01-01

    This study aimed to support the theory of popularity contagion, which posits that popularity spreads among friends spontaneously and regardless of behavioral changes. Peer nominations of status and behavior were collected annually between 6th and 12th grades from a total of 1062 adolescents. Longitudinal hypotheses were mostly supported using path…

  3. Internet Addiction among Adolescence

    ERIC Educational Resources Information Center

    Sargin, Nurten

    2012-01-01

    Each innovation brings along many risks. One of the risks related with the Internet use is Internet addiction. The aim of this study is to examine Internet addiction in adolescence in terms of gender, Internet access at home and grades. The research design used was survey method. The study population consisted of second stage students attending…

  4. Psychopathological Development across Adolescence

    ERIC Educational Resources Information Center

    Rutter, Michael

    2007-01-01

    Daniel Offer's seminal writings in the 1960s led to a realization that normal adolescence was not characterized by turmoil and upheaval, the then prevailing view that derived from studies of clinical samples. In this paper, the research findings that have appeared over the last four decades are reviewed with respect to the overall features of…

  5. Adolescence and Formal Operations

    ERIC Educational Resources Information Center

    Blasi, A.; Hoeffel, E. C.

    1974-01-01

    Analyzes the relationship between the development of formal operations and the development of the adolescent personality, as hypothesized by Inhelder and Piaget. It is suggested that the concepts of possibility and reflectivity have a variety of meanings, and that once these meanings are examined, the logical foundation for the…

  6. Nutrient Requirements in Adolescence.

    ERIC Educational Resources Information Center

    McKigney, John I,; Munro, Hamish N.

    It is important to understand the nutrient requirements and the significance of nutrition both in pubescence and adolescence. The pubescent growth spurt is characterized by an increase in body size and a change in proportion of different tissues. Both of these factors are of great nutritional importance, since there is reason to believe that the…

  7. Common approaches for adolescents.

    PubMed

    1998-01-01

    A South-South program organized by JOICFP provided an excellent opportunity for the exchange of experiences in the field of adolescent reproductive health (RH) between Mexico and the Philippines. Alfonso Lopez Juarez, executive director, Mexican Foundation for Family Planning (MEXFAM), shared MEXFAM's experiences with field personnel and GO-NGO representatives related to JOICFP's RH-oriented project in the Philippines while in the country from November 16 to 21. The program was also effective for identifying common issues and effective approaches to adolescent health issues and communicating with youth on RH and sexual health. The exchange was supported by the Hoken Kaikan Foundation and organized by JOICFP in collaboration with UNFPA-Manila and the Commission on Population (POPCOM). Lopez shared some of the lessons of MEXFAM's decade-long Gente Joven IEC program on adolescent health with GO and NGO representatives at a forum held on November 18. The event was opened by Dr. Carmencita Reodica, secretary, Department of Health (DOH). He then moved to the project sites of Balayan and Malvar municipalities of Batangas Province, where he spoke with field staff and demonstrated MEXFAM's approach in classroom situations with young people. Lopez also observed various adolescent activities such as group work with peer facilitators. "I am pleased that we can share some applicable experiences and learn from each other's projects," commented Lopez. PMID:12348336

  8. Adolescent Prejudice Reduction Conference.

    ERIC Educational Resources Information Center

    Ketroser, Heidi

    1988-01-01

    Discusses the fifth annual Dr. Curtis C. Melnick Adolescent Prejudice Reduction Conference sponsored by the Greater Chicago (Illinois) Regional Office of the Anti-Defamation League of the B'nai B'rith. The day-long conference addressed issues of prejudice and allowed students and staff from various high schools to explore their concerns with…

  9. Adolescent suicide: an overview.

    PubMed

    Sudak, H S; Ford, A B; Rushforth, N B

    1984-07-01

    Etiological theories of suicide are reviewed from epidemiological, individual (both biological and psychological), and psychosocial perspectives. Cohort and population-model approaches as explanations for the two- to three-fold increase in completed suicide rates observed in adolescents and young adults over the past 25 years are presented. The results of the authors' study of suicides in adolescents and young adults in Cuyahoga County, Ohio, to test these hypotheses are summarized. This study revealed marked cohort differences in suicide rates and provided partial support for the "population-model" approach. Differences between suicide rates in adolescents and other age groups are discussed, as are data from some minority groups. The role of depression in adolescents and various studies of diagnostic approaches (e.g., structured diagnostic assessments, biological markers, clues during intensive psychotherapy or psychoanalysis, studies of high-risk diagnostic groups) are reviewed. Lastly, treatment employing individual, family, and group approaches to classical psychoanalytic or cognitive psychotherapy as well as the role of pharmacological treatments are considered. PMID:6385734

  10. Abortion among Adolescents.

    ERIC Educational Resources Information Center

    Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne

    2003-01-01

    Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…

  11. Adolescent Sociopaths. Revised.

    ERIC Educational Resources Information Center

    Chapple, Eliot D.

    Presented is the final report of a research project on the programed training and placement of nonpsychotic disturbed adolescents. Eleven chapters cover topics which include the following: psychiatry and the sociopaths and psychopaths; boys dealt with in the project; development of the programed interaction diagnostic interview; disturbances to…

  12. Adolescence: Season of Transition.

    ERIC Educational Resources Information Center

    Philibert, Paul J.

    1982-01-01

    Delineates Sigmund Freud's theories of symbolic relations, Jean Piaget's theories of cognitive development, and Eric Erickson's concept of identity crisis to analyze and explain the characteristics and phenomena of adolescent development. Suggests roles and tasks for teachers and parents in promoting healthy development. (WL)

  13. Adolescents in Therapeutic Communities.

    ERIC Educational Resources Information Center

    Mann-Feder, Varda R.

    1996-01-01

    Compares the course of change of two groups of conduct-disoriented adolescents in two theoretically distinct residential treatment programs. Despite an overall trend toward improvement in both groups, there was little significant difference between the rates of progress over time. Supports the need for qualitative research focusing on the…

  14. [Self care in adolescents].

    PubMed

    Rodríguez de la Parra, S; Carbelo Baquero, B

    1999-01-01

    The purpose of this work is to offer an analysis on the adolescence as stage of the life with some specific characteristics due to the transformations that happen so much at biological level as cognitive and psychosocial. During this period, the adolescent develops their autonomy and by so much starts their independence of the parents, some and other will experience situations that them will make be felt insecure in their/its performances until each one assume their new paper in the familiar environment and before itself. Parents and adolescent can need support and advice to obtain that this stage, in conflicting occasions, is developed normally, so that the adolescent become a capable adult about caring whether same and about others, with a life style that favor the integrated operation and the continued development. The family nurse can lend them the support and advice that need, since occupies a privileged place in the health equipment to guarantee the continuity of the assistance to the familiar group from the birth until the maturity. Basing us on the theory of the self-care developed by D. Orem, we will check the specific requirements of self-care of this stage of the vital cycle, of great transcendency for the step to the adult age. PMID:10514786

  15. [Adolescent psychosocial development].

    PubMed

    Gaete, Verónica

    2015-01-01

    It is increasingly necessary that pediatricians have greater knowledge of adolescent health. To begin with they should be familiar with the psychosocial development of this period, an issue which is imperative for the health care of the age group. With that purpose, this article reviews the normal adolescent psychosocial development. Adolescence is a stage that has been progressively prolonged, during which fast and big changes occur, that lead human beings to become biologically, psychologically and socially mature, and potentially able to live independently. Developmental tasks of this period are the establishment of identity and the achievement of autonomy. Although it is a process of high individual variability in terms of its beginning and end, the progression through stages, the synchrony of development between the various areas, and in other aspects, the psychosocial development of this period usually have common characteristics and a progressive pattern of 3 phases: early, middle and late adolescence. Psychological, cognitive, social, sexual and moral development of young people in each of them are described in this article. PMID:26342392

  16. Correlates of Adolescent Parenting.

    ERIC Educational Resources Information Center

    Reis, Janet S.; Herz, Elicia J.

    1987-01-01

    Studied correlates of teenage parenting in self-selected sample of 177 teenage parents. Parental race, punitive attitudes toward child rearing, and parental age were statistically significant predictors of total Home Observation for Measurement of the Environment scores. Older, white adolescent mothers with less punitive attitudes toward child…

  17. Controlling Adolescent Fertility.

    ERIC Educational Resources Information Center

    Rodman, Hyman

    1985-01-01

    Public concern over adolescent sexual and contraceptive behavior is increasing. One recommended policy response is for states to pass legislation giving minors the right to consent to reproductive health services. Such services are likely to benefit individuals, families, and society. (KH)

  18. Reading, Writing, and Adolescents.

    ERIC Educational Resources Information Center

    Fleming, Margaret, Ed.

    1983-01-01

    Noting that most junior high level curricula do not take into account students' rapid mental and physical changes, the articles in this focused journal issue recommend works and teaching strategies that harmonize with these student needs. The titles and their authors are as follows: (1) "Adolescent Development and the Growth of Writing Abilities"…

  19. The risks for late adolescence of early adolescent marijuana use.

    PubMed Central

    Brook, J S; Balka, E B; Whiteman, M

    1999-01-01

    OBJECTIVES: The purpose of this study was to assess the relation of early adolescent marijuana use to late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. METHODS: African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. RESULTS: Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. CONCLUSIONS: Early adolescent marijuana use is related to later adolescent problems that limit the acquisition of skills necessary for employment and heighten the risks of contracting HIV and abusing legal and illegal substances. Hence, assessments of and treatments for adolescent marijuana use need to be incorporated in clinical practice. PMID:10511838

  20. The adolescent. Athletics and development.

    PubMed

    Masland, R P

    1983-01-01

    An appreciation of adolescent growth and development is essential to the understanding of problems faced by the adolescent athlete. Early adolescence (ages 10-15 years) can be characterized as the body period. Physical growth is genetically determined and can be influenced by disease, injury, and nutrition. Early maturers are subject to adult expectations which may lead to either failure or excessive acclaim. Middle adolescence (ages 15-18 years) is the sexuality period, with special emphasis on gender identity. Friendships are critical, and athletics can be a focal point for showing love and affection without social fear. Late adolescence (ages 18-22 years) is the separation period. Young people with athletic skills leave home to face greater athletic and academic pressure and competition in college. Adjustment to this final adolescent period is achieved through learning to lose as well as win with grace and dignity. PMID:6833060

  1. Examination of the adolescent patient.

    PubMed

    Hampton, H L

    2000-03-01

    Adolescent patients need knowledge and motivation to practice a healthy lifestyle. The provider of adolescent health care is uniquely qualified to provide factual health information and practical advice. Enlisting parental support for confidential adolescent health services usually is not problematic when parents and health care providers share common goals and responsibility. The health care provider must develop rapport to foster high-risk health behavior disclosure and must promote health messages that are stronger than those received from peers, television, movies, and magazines. Adolescents who elect to abstain from sexual activity need as much support as sexually active patients. Depression, substance abuse, and eating disorders must be recognized and treated. Preventative health care services for adolescents can be optimized when office staff understand the special needs of these young women. The physician's concerns regarding the health of adolescent patients will be welcomed by patients, their parents, and the community. PMID:10693179

  2. Cannabis Use Disorder in Adolescence.

    PubMed

    Simpson, Annabelle K; Magid, Viktoriya

    2016-07-01

    Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population. PMID:27338965

  3. Liver disease in the adolescent.

    PubMed

    Mavis, Alisha M; Alonso, Estella M

    2015-02-01

    This article discusses common liver diseases in the adolescent. Briefly reviewed is the evaluation of the adolescent with new-onset liver enzyme elevation. Then the article discusses common liver diseases, such as nonalcoholic fatty liver disease, hepatitis, metabolic disease, biliary atresia, cystic fibrosis, and inherited disorders of cholestasis. Finally, a management approach to the adolescent with liver disease is outlined, noting the challenges that must be addressed to effectively care for not only liver disease in the adolescent but also the patient as a whole. PMID:25454303

  4. Update on Adolescent Bariatric Surgery.

    PubMed

    Desai, Nirav K; Wulkan, Mark L; Inge, Thomas H

    2016-09-01

    Childhood obesity remains a significant public health issue. Approximately 8% of adolescent girls and 7% of adolescent boys have severe (≥class 2) obesity. Adolescent severe obesity is associated with numerous comorbidities, and persists into adulthood. Bariatric surgery is the most effective treatment available, resulting in major weight loss and resolution of important comorbid conditions. Clinical practice guidelines for pediatric obesity treatment recommend consideration of surgery after failure of behavioral approaches. Careful screening and postoperative management of patients by a multidisciplinary team is required. Long-term studies are needed to assess the impact of adolescent bariatric surgery. PMID:27519138

  5. Family planning and adolescent pregnancy.

    PubMed

    Molina, Ramiro Cartes; Roca, Carolina Gonzalez; Zamorano, Jorge Sandoval; Araya, Electra Gonzales

    2010-04-01

    High adolescent fecundity principally affects developing countries. In spite of a decrease in the incidence of pregnancies in the developing countries over the past 13 years, the differences that exist with respect to developed countries turn adolescent fecundity into an indicator of the level of development of countries. The impact of adolescent pregnancy is evident in maternal and perinatal morbidity and mortality. Nonetheless, in addition to the age involved in precocious pregnancy, it also reflects previous conditions such as malnutrition, infectious diseases and deficiencies in the health care given to pregnant adolescents. The most important impact lies in the psychosocial area: it contributes to a loss of self-esteem, a destruction of life projects and the maintenance of the circle of poverty. This affects both adolescent mothers and fathers; the latter have been studied very little. Intervention with comprehensive health services and the maintenance of the education of adolescent mothers and fathers prevents repeat pregnancies. Evidence shows success in the prevention of the first pregnancy when the intervention includes comprehensive sexual education, the existence of preferential sexual and reproductive health services for adolescents, the handout of modern contraceptives gauged to the adolescence stage of the subjects and the existence of an information network. There is little research in contraception for adolescents, and for this reason, the indications given are projections of data obtained from adults. PMID:20167542

  6. Initiation into Adolescent Marijuana Use.

    ERIC Educational Resources Information Center

    Brook, Judith S.; And Others

    1980-01-01

    This longitudinal study examined the relationship of three domains (personality/attitudinal orientations, peer relationships, and family socialization factors) with initiation into adolescent marihuana use. (Author/DB)

  7. Adolescence: myths and misconceptions.

    PubMed

    Dhall, A

    1995-01-01

    Adolescence is the period of physical and psychological growth between childhood and adulthood. The author is a practicing obstetrician and gynecologist in New Delhi. Over the course of her medical career, she has identified many myths and misconceptions about adolescents and adolescence. With regard to male adolescents, masturbation-related myths may be the most frequently harbored. Male adolescents have a hormone-driven need to have sexual intercourse, frequently. Masturbation is a healthy, no-cost way to relieve sexual tension. There is neither need to pay a prostitute nor fear of contracting a sexually transmitted disease. A young man can masturbate virtually whenever he wants. Despite the guilt and misinformation implanted by adults that masturbation causes weakness, boys masturbate rather frequently. Also contrary to popular myth, the nocturnal emissions which may result in growing boys as a result of sexual excitement during a dream are completely normal and no reason for concern. Further, boys should not worry about penis size, for, when erect, they all work just fine. People grow at different rates. Menstruation starts when 17% of a woman's body weight is fat. The onset of menstruation may therefore start earlier in well-fed girls compared to in girls who are more lean. The frequency and duration of menses are not constant. Menstrual irregularity therefore does not necessarily mean that a young woman is pregnant or that professional medical treatment is required. Breasts, like penises, serve their intended function irrespective of size. The hymen is a membrane at the opening of the vagina. It may have a hole in the center or the side for the escape of menstrual blood. There are myths that an intact hymen is indicative of virginity, the hymen should be intact until marriage, and the first sexual experience should be painful for a woman. The hymen is elastic and even some prostitutes have been found to have intact hymens. The hymen also may tear due to a

  8. Adolescent-Mother Agreement about Adolescent Problem Behaviors: Direction and Predictors of Disagreement

    ERIC Educational Resources Information Center

    Barker, Erin T.; Bornstein, Marc H.; Putnick, Diane L.; Hendricks, Charlene; Suwalsky, Joan T. D.

    2007-01-01

    Correlations between adolescent and parent reports of adolescent problems are low in magnitude. In community samples adolescents tend to report "more" problems than parents and in clinical samples adolescents tend to report "fewer" problems than parents. Indices of agreement may be biased if some adolescents in a given sample report more problems…

  9. Maternal and Adolescent Temperament as Predictors of Maternal Affective Behavior during Mother-Adolescent Interactions

    ERIC Educational Resources Information Center

    Davenport, Emily; Yap, Marie B. H.; Simmons, Julian G.; Sheeber, Lisa B.; Allen, Nicholas B.

    2011-01-01

    This study examined maternal and early adolescent temperament dimensions as predictors of maternal emotional behavior during mother-adolescent interactions. The sample comprised 151 early adolescents (aged 11-13) and their mothers (aged 29-57). Adolescent- and mother-reports of adolescent temperament and self-reports of maternal temperament were…

  10. Adolescent Sexuality and Parent-Adolescent Processes: Promoting Healthy Teen Choices.

    ERIC Educational Resources Information Center

    Meschke, Laurie L.; Bartholomae, Suzanne; Zentall, Shannon R.

    2000-01-01

    Reports on trends in adolescent sexual health, the relation between parenting and adolescent sexual outcomes, and adolescent sexuality interventions. Discusses parenting efforts related to adolescent sexual behavior. Examines adolescent sexuality programs with a parent component. Review of 19 programs supports the incorporation of theory and the…

  11. Role of the Father-Adolescent Relationship in Shaping Adolescents Attitudes toward Divorce

    ERIC Educational Resources Information Center

    Risch, Sharon C.; Jodl, Kathleen M.; Eccles, Jaquelynne S.

    2004-01-01

    The quality of father-adolescent relationships, especially for non-traditional fathers, has been neglected in investigating adolescents beliefs. Closeness of father-adolescent relationships was examined as a predictor of adolescents attitudes toward divorce. A sample of European and African American adolescents N=300 reported on the quality of…

  12. Quality of Parent/Adolescent Attachment and Aggression in Young Adolescents.

    ERIC Educational Resources Information Center

    Simons, Kevin J.; Paternite, Carl E.; Shore, Cecilia

    2001-01-01

    Examined association between adolescents' perception of parent-adolescent attachment quality and adolescent aggression, as mediated by social cognition and self-esteem. Found that higher social cognition was associated with lower self-reported aggression when parent-adolescent attachments and adolescent self-esteem were controlled. When…

  13. Television and adolescent sexuality.

    PubMed

    Brown, J D; Childers, K W; Waszak, C S

    1990-01-01

    Existing studies of the sexual content of television programming and advertising and the effects of this content on adolescent viewers are reviewed. Content studies show that the frequency of sexual references have increased in the past decade and are increasingly explicit. Studies of the effects of this content, while scarce, suggest that adolescents who rely heavily on television for information about sexuality will have high standards of female beauty and will believe that premarital and extramarital intercourse with multiple partners is acceptable. They are unlikely to learn about the need for contraceptives as a form of protection against pregnancy or disease. Suggestions for future research and trends in television programming policies are explored. PMID:2307597

  14. Adolescents with gender dysphoria.

    PubMed

    Cohen-Kettenis, Peggy T; Klink, Daniel

    2015-06-01

    Young people with gender dysphoria are increasingly seen by pediatric endocrinologists. Mental health child specialists assess the adolescent and give advice about psychological or medical treatment. Provided they fulfill eligibility and readiness criteria, adolescents may receive pubertal suspension, consisting of using gonadotrophin-releasing hormone analogs, later followed by cross-sex hormones (sex steroids of the experienced gender). If they fulfill additional criteria, they may have various types of gender affirming surgery. Current issues involve safety aspects. Although generally considered safe in the short-term, the long-term effects regarding bone health and cardiovascular risks are still unknown. Therefore, vigilance is warranted during and long after completion of the last gender affirming surgeries. The timing of the various treatment steps is also under debate: instead of fixed age limits, the cognitive and emotional maturation, along with the physical development, are now often considered as more relevant. PMID:26051304

  15. Adolescent idiopathic scoliosis.

    PubMed

    Cheng, Jack C; Castelein, René M; Chu, Winnie C; Danielsson, Aina J; Dobbs, Matthew B; Grivas, Theodoros B; Gurnett, Christina A; Luk, Keith D; Moreau, Alain; Newton, Peter O; Stokes, Ian A; Weinstein, Stuart L; Burwell, R Geoffrey

    2015-01-01

    Adolescent idiopathic scoliosis (AIS) is the most common form of structural spinal deformities that have a radiological lateral Cobb angle - a measure of spinal curvature - of ≥10(°). AIS affects between 1% and 4% of adolescents in the early stages of puberty and is more common in young women than in young men. The condition occurs in otherwise healthy individuals and currently has no recognizable cause. In the past few decades, considerable progress has been made towards understanding the clinical patterns and the three-dimensional pathoanatomy of AIS. Advances in biomechanics and technology and their clinical application, supported by limited evidence-based research, have led to improvements in the safety and outcomes of surgical and non-surgical treatments. However, the definite aetiology and aetiopathogenetic mechanisms that underlie AIS are still unclear. Thus, at present, both the prevention of AIS and the treatment of its direct underlying cause are not possible. PMID:27188385

  16. [Adolescent eating disorders].

    PubMed

    Herpertz-Dahlmann, Beate; Hagenah, Ulrich; Vloet, Timo; Holtkamp, Kristian

    2005-04-01

    Anorexia and Bulimia nervosa are common psychiatric disorders in adolescent girls. In discrepancy to ICD-10 and DSM-IV we would propose the 10th BMI percentile as weight criterium for anorexia nervosa. Both disorders have a high somatic and psychiatric comorbidity; the most severe complication at long term follow-up is osteoporosis. The most prevalent psychiatric disorders are affective disorders, anxiety and obsessive-compulsive disorder and substance abuse. There is undoubtedly a genetic predisposition and a range of general and personal environmental risk factors. Treatment of adolescent eating disorders mostly requires a multimodal approach which consists of several components, e.g. weight rehabilitation, nutritional counselling, individual and family psychotherapy, and treatment of comorbid psychiatric disorders. PMID:15918539

  17. Features of Parent-Adolescent Relationships and Adolescents' Problem Behavior.

    ERIC Educational Resources Information Center

    Repinski, Daniel J.; Zook, Joan M.

    Seven features of adolescents' relationships with mothers and with fathers (time together per day, number of activities, degree of influence, subjective closeness, and frequency of experiencing positive, hostile, and sad emotions in the relationship) were used to predict adolescents' problem behavior and chemical use. Using a sample of 64 seventh-…

  18. Patterns of Parenting during Adolescence: Perceptions of Adolescents and Parents.

    ERIC Educational Resources Information Center

    Paulson, Sharon E.; Sputa, Cheryl L.

    1996-01-01

    Explores differences in maternal and paternal parenting styles and involvement, the differences between parents' and adolescents' perceptions of parenting style and involvement, and changes in parenting style and involvement between the adolescents' 9th and 12th grade years. Subjects were 244 ninth graders from the Southeast and Midwest. Discusses…

  19. The Millon Adolescent Personality Inventory Profiles of Depressed Adolescents.

    ERIC Educational Resources Information Center

    Ehrenberg, Marion F.; And Others

    1990-01-01

    Investigated personality styles, concerns, and behaviors of depressed adolescents using Millon Adolescent Personality Inventory (MAPI). Data from 332 high school students on Beck Depression Inventory and MAPI were reduced to 2 factors accounting for 65.1 percent of total variance, the first suggesting socially withdrawn, overtly recognizable…

  20. The status of adolescent medicine: building a global adolescent workforce.

    PubMed

    Lee, Lana; Upadhya, Krishna K; Matson, Pamela A; Adger, Hoover; Trent, Maria E

    2016-08-01

    Remarkable public health achievements to reduce infant and child mortality as well as improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10-24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history. However, there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that affect the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) define a global assessment of the health needs for adolescents around the world; 2) describe examples of current training programs and requirements in adolescent medicine; 3) identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery. PMID:26167974

  1. Older Adolescents' Positive Attitudes toward Younger Adolescents as Sexual Partners

    ERIC Educational Resources Information Center

    Hegna, Kristinn; Mossige, Svein; Wichstrom, Lars

    2004-01-01

    The prevalence of older adolescents' positive attitudes toward younger sexual partners was investigated through three measures of self-reported hypothetical likelihood of having sex with preadolescents and younger adolescents (LSA), using a school-based cluster sample of 710 Norwegian 18- to 19-year-olds attending nonvocational high schools in…

  2. Adolescent and Parent Perceptions of Media Influence on Adolescent Sexuality

    ERIC Educational Resources Information Center

    Werner-Wilson, Ronald Jay; Fitzharris, Jennifer Lynn; Morrissey, Kathleen M.

    2004-01-01

    Empirical evidence suggests that television and other media influence adolescents' attitudes and behaviors. Much of the research in this area is based on surveys in which adolescents are asked to rank the relative importance of a fixed set of factors such as parents, peers, and media. We reviewed data from focus groups conducted with adolescents…

  3. Significant Individuals in Adolescence: Adolescent and Adult Perspectives.

    ERIC Educational Resources Information Center

    Tatar, Moshe

    1998-01-01

    Examines attitudes of Israeli adolescents and midlife adults about significant adults in their past. Results indicate that most choose a parent as the most significant relative in their adolescence, and females choose mothers more than males do. Adults attribute more negative characteristics to their parents and are more likely to mention teachers…

  4. Editorial: Reducing adolescent suicide.

    PubMed

    Bloch, Michael H

    2016-07-01

    Suicide is currently the second leading cause of death in young people ages 10-19 (CDC, 2015). Current statistics suggest that in the US one in every seven youths has seriously considered or made a plan to commit suicide and one in every 13 youths has attempted suicide in the previous year (CDC, 2015). Suicide represents a - if not the - major public health problem in adolescents. PMID:27320365

  5. [School difficulties in adolescence].

    PubMed

    Schwarzenberg, T L; Buffone, M R; Scardia, C; Facente, C

    2002-12-01

    Loss, failure and desertion are those words, which better describe the most frequent difficulties incurred by teenagers, and their relation to the school environment, and indicate, as well, the lack of connection between individual aspirations and school achievements obtained. Despite the likelihood of school difficulties throughout the entire educational career, from the kindergarten to the college, we are able to recognize certain specific "disturbances" which come out during the adolescence, basically relating to the school experiences. School failure, school desertion and school abandonment are, in fact, issues mainly discussed in coincidence with the beginning of the adolescent age and the attending of the high school. The aetiopathogenesis of school discomfort is mostly determined by more than only one factor: psychological, physical, cognitive and environmental aspects, all together, contribute in various ways, to the rise and persisting of the above described problems. Suggesting a univocal characterization of the adolescent with school difficulties, is indeed a hard task, since school failure is not an exclusive feature of only one kind of personality or the expression of only one type of conflict. Once identified the individuals more subject to risk, and the warning signs of actual uneasiness, it is important therefore to intervene timely and in different ways in order to avoid the worsening or the excessive extension of the school difficulties and of their frequent and serious consequences on the teenagers' individual and domestic well-being. Such type of prevention definitely belongs to the Adolescent Medicine, and must be developed on different levels, by involving not only the teenagers, but also their families, the school, and the whole social environment in which the teenagers live and with which they interact. PMID:12388952

  6. Alcohol advertising and adolescents.

    PubMed

    Strasburger, Victor C

    2002-04-01

    Considerable research now exists that the media may exert a powerful influence on adolescents' drug-taking behavior. Teens view an average of 2,000 beer and wine ads per year in the US. In addition, television shows, movies, and music videos contain considerable amounts of alcohol use. This article will discuss the available research and offers suggestions to make the media healthier for teenagers. PMID:11993288

  7. Adolescent Russian roulette deaths.

    PubMed

    Collins, Kim A

    2010-03-01

    Adolescence, between the ages of 10 and 19 years, is a unique period both physically and emotionally. During this time of life, individuals are known to experiment and engage in risky behavior, sometimes with unforeseen morbidity and mortality. We also see suicide emerge as a manner of death in this age group. The most common method is gunshot wound and sometimes in the form of Russian roulette. Few studies have looked at deaths by Russian roulette, the victims, and scenarios. In particular, no study examines the adolescent victim of Russian roulette. To better understand and classify this entity, adolescent Russian roulette autopsy cases over a 20-year period were examined looking at the victims, scenarios, autopsy findings, cause and manner of death, and the weapons. All victims were males, ages 13 to 19 years, with a Black-to-White ratio of 1:1. No victim had a previous psychiatric history. Toxicology was positive for alcohol and/or marijuana in 50% of the victims. Friends were present when the victim shot himself which occurred in the home the majority of the time. In all but 1 case, premeditation of the game was involved as the victim provided the weapon for the roulette. The cause of death was gunshot wound to the head (6 to the right side, 1 to the mouth, 1 to the forehead), and the manner of death was suicide in 6 cases and accident in 2 cases. A review of the literature discusses the adolescent victim, suicide, and Russian roulette. PMID:20010290

  8. The Adolescent in Literature.

    ERIC Educational Resources Information Center

    Wacht, Francine G.

    This paper describes a one-semester high school course which introduces students to well-written contemporary novels in which the main character is an adolescent. Eight novels are read, and five of these are the core of the course: "The Catcher in the Rye,""A Separate Peace,""The Temple of Gold,""The Man Without a Face," and "Night." The students…

  9. Discrepancies between Parental and Adolescent Developmental Expectations.

    ERIC Educational Resources Information Center

    Dekovic, Maja

    Guided by a conceptual model linking discrepancies between parent and adolescent developmental expectations and adolescent adjustment and the quality of the parent-adolescent relationship, this study examined adolescent and parent beliefs about the age at which specific competencies should appear. Developmental timetables were grouped into…

  10. Creative Counseling Interventions for Grieving Adolescents

    ERIC Educational Resources Information Center

    Slyter, Marty

    2012-01-01

    This article provides information on adolescent developmental issues and developmentally appropriate interventions that can help mental health practitioners work with adolescents grieving a death loss. Specific areas that are initially covered include core adolescent developmental issues that must be understood, including adolescent developmental…

  11. Marital and Birth Expectations of Urban Adolescents.

    ERIC Educational Resources Information Center

    Smith, Edward A.; Zabin, Laurie S.

    1993-01-01

    Analyzes the responses of 1,344 African-American and 580 white female adolescents, and 852 African-American and 520 white male adolescents to questions regarding their perceived ideal ages for marriage and first birth. Findings reveal differences between white and African-American adolescents' responses. Comparisons suggest that the adolescents'…

  12. Self-Esteem in Deaf Adolescents.

    ERIC Educational Resources Information Center

    Yachnik, Michael

    1986-01-01

    Comparison of self-esteem ratings of deaf adolescents (N=56) by adolescents and both parents (56 hearing and 56 deaf parents) on the Self Description Questionnaire III showed that adolescents with deaf parents generally rated themselves higher than did adolescents with hearing parents of global, same sex, and opposite sex self-esteem. (CB)

  13. Assessment of Parental and Adolescent Verbal Interactions.

    ERIC Educational Resources Information Center

    Anderson, Rhydonia H.; And Others

    Verbal interactions between adolescents and their parents may affect adolescents' self-esteem and self-concept. The current development of an instrument, the Verbal Interaction Questionnaire (VIQ), was designed to measure adolescents' perceptions of their parents verbal interactions with them. Noting that the relationship between adolescents'…

  14. Metatarsus Primus Varus Correction.

    PubMed

    Sorensen, Matthew D; Gradisek, Brian; Cottom, James M

    2015-07-01

    We present a discussion on the use of proximal first-ray osteotomies in the surgical treatment for hallux valgus as a valid option compared with first-tarsometatarsal arthrodesis. Recent and historical literature tells us that stability of the first ray is a function of the alignment and reestablishment of retrograde stabilizing forces at the first tarsometatarsal joint. This realignment and stabilization may be accomplished with the use of distal soft tissue and proximal osteotomy procedures. PMID:26117572

  15. Sexual Knowledge among Norwegian Adolescents.

    ERIC Educational Resources Information Center

    Kraft, Pal

    1993-01-01

    Studied sexual knowledge among Norwegian adolescents (n=1,855) aged 17-19 years. Found knowledge gaps among adolescents on sexual physiology and anatomy, sexually transmitted diseases, and fecundation/contraception. Level of sexual knowledge was higher among girls than boys and increased with increasing age. Sexual knowledge did not predict…

  16. Re/Mediating Adolescent Literacies.

    ERIC Educational Resources Information Center

    Elkins, John, Ed.; Luke, Allan, Ed.

    Suggesting that teaching in New Times requires that educators read and re/mediate the social relations, the cultural knowledges, and the relationships of power between adolescents and their social, biological, and semiotic universes, this collection of essays offers new ways of seeing and talking about adolescents and their literacies. Most of the…

  17. Troubled Adolescents and HIV Infection.

    ERIC Educational Resources Information Center

    Woodruff, John O., Ed.; And Others

    This report on adolescents, Acquired Immune Deficiency Syndrome (AIDS), and Human Immune Virus (HIV) infection had its beginning in the Knowledge Development Workshop "Issues in the Prevention and Treatment of AIDS Among Adolescents with Serious Emotional Disturbance," held June 9-10, 1988 in the District of Columbia. These papers are included:…

  18. Aspects of Spirituality in Adolescents

    ERIC Educational Resources Information Center

    Bussing, Arndt; Foller-Mancini, Axel; Gidley, Jennifer; Heusser, Peter

    2010-01-01

    This paper analyses which aspects of spirituality are valued by adolescents, and how they are interconnected with youths' life satisfaction and "self-centeredness". The participants were 254 adolescents (11th grade) of four different high schools from west Germany. After re-validation of the 6-factorial student's version of the ASP questionnaire…

  19. Discrimination against Muslim American Adolescents

    ERIC Educational Resources Information Center

    Aroian, Karen J.

    2012-01-01

    Although there is ample evidence of discrimination toward Muslim Americans in general, there is limited information specific to Muslim American adolescents. The few existing studies specific to this age group suggest that Muslim American adolescents encounter much discrimination from teachers, school administrators, and classmates. This…

  20. Online Communication and Adolescent Relationships

    ERIC Educational Resources Information Center

    Subrahmanyam, Kaveri; Greenfield, Patricia

    2008-01-01

    Over the past decade, technology has become increasingly important in the lives of adolescents. As a group, adolescents are heavy users of newer electronic communication forms such as instant messaging, e-mail, and text messaging, as well as communication-oriented Internet sites such as blogs, social networking, and sites for sharing photos and…

  1. Cluster Analysis of Adolescent Blogs

    ERIC Educational Resources Information Center

    Liu, Eric Zhi-Feng; Lin, Chun-Hung; Chen, Feng-Yi; Peng, Ping-Chuan

    2012-01-01

    Emerging web applications and networking systems such as blogs have become popular, and they offer unique opportunities and environments for learners, especially for adolescent learners. This study attempts to explore the writing styles and genres used by adolescents in their blogs by employing content, factor, and cluster analyses. Factor…

  2. Multiple Dimensions of Adolescent Pregnancy.

    ERIC Educational Resources Information Center

    Stoddard, Ann H.

    1989-01-01

    Discusses what the Jacksonville (Florida) community is doing for teens to prevent pregnancy, help pregnant adolescents, and help adolescent parents. Discusses whether these activities are sufficient and effective. Suggests specific ways to improve programs and indicates that there are many factors to consider when attempting to deter teen…

  3. Adolescent Decision Making: An Overview

    ERIC Educational Resources Information Center

    Halpern-Felsher, Bonnie

    2009-01-01

    An important developmental task during adolescence is learning to make decisions, experiencing the related positive and negative consequences, and learning from these outcomes. However, a youth's ability to make competent decisions is sometimes called into question because adolescence is also often a time of engagement in risky behaviors. This…

  4. Self-Mutilation in Adolescents

    ERIC Educational Resources Information Center

    McDonald, Catherine

    2006-01-01

    Self-mutilation is not a new trend or phenomenon in adolescents. Self-mutilation can be divided into three categories: major, stereotypic, and moderate/superficial. Moderate/superficial self-mutilation is the most common type in adolescents and includes cutting, burning, and carving. School nurses are positioned to identify, to assist, and to…

  5. Cries for Help: Adolescent Suicide

    ERIC Educational Resources Information Center

    Miller, Mary Susan

    1977-01-01

    In order to understand the emotional state that leads a young person to self-destruction, it is important to look at what is considered a normal adolescence. Lists four factors that explain why adolescence is a time of great depression, four myths associated with the reasons for suicide, some factors that create situations for which suicide is the…

  6. Adolescent Literacy: More than Remediation

    ERIC Educational Resources Information Center

    Biancarosa, Gina

    2012-01-01

    The challenge of adolescent literacy involves more than providing remediation for students who have not mastered basic reading skills. To become successful learners, adolescents must master complex texts, understand the diverse literacy demands of the different content areas, and navigate digital texts. In this article, Biancarosa reviews what the…

  7. Birth Defects and Adolescent Pregnancies

    ERIC Educational Resources Information Center

    Walters, James

    1975-01-01

    Home economists who work with adolescents can help prepare them for responsible parenthood later in life by explaining the known causes of various birth defects; providing basic information about human genetics, prenatal nutrition, and drug and alcohol effects; and motivating adolescents to exercise increased responsibility in their sexual…

  8. Adolescent Behavior Change: A Review.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Educational Programs and Studies Information Service.

    This focus paper contains reprints of 11 articles intended to provide an overview of the key issues in the area of adolescent behavior change as it relates to Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) education. Included are: (1) "Preventing HIV Infection and AIDS in Children and Adolescents" (J.…

  9. Handbook of Adolescent Literacy Research

    ERIC Educational Resources Information Center

    Christenbury, Leila, Ed.; Bomer, Randy, Ed.; Smagorinsky, Peter, Ed.

    2009-01-01

    The first comprehensive research handbook of its kind, this volume showcases innovative approaches to understanding adolescent literacy learning in a variety of settings. Distinguished contributors examine how well adolescents are served by current instructional practices and highlight ways to translate research findings more effectively into…

  10. Best Practices for Adolescent ELLs

    ERIC Educational Resources Information Center

    Rance-Roney, Judith

    2009-01-01

    Adolescent English language learners present particular challenges for schools. The population of adolescent ELLs is diverse, and their educational needs are affected by differences in immigration status, quality of educational background, native language, cultural distance from U.S. culture, future plans, and economic status. The article offers…

  11. Neighborhood Poverty and Adolescent Development

    ERIC Educational Resources Information Center

    McBride Murry, Velma; Berkel, Cady; Gaylord-Harden, Noni K.; Copeland-Linder, Nikeea; Nation, Maury

    2011-01-01

    This article provides a comprehensive review of studies conducted over the past decade on the effects of neighborhood and poverty on adolescent normative and nonnormative development. Our review includes a summary of studies examining the associations between neighborhood poverty and adolescent identity development followed by a review of studies…

  12. Family Interaction in Early Adolescence.

    ERIC Educational Resources Information Center

    Steinberg, Laurence D.; Hill, John P.

    The verbal interaction of 31 middle class early adolescent boys and their parents was analyzed in order to provide information concerning adolescent autonomy. The boys were independently and reliably classified on the basis of age, physical maturity, and intellectual level. The taped interactions were coded for interruptions, talking times,…

  13. Adolescent Leisure across European Nations.

    ERIC Educational Resources Information Center

    Flammer, August; Schaffner, Brigitta

    2003-01-01

    Examined variations in adolescent time use within Europe and their relation to culture, focusing on organization of free time, most frequent leisure activities, and resulting emotional states. Found that European adolescents spent free time in a range of activities, including electronic media, computer games, playing musical instruments, reading,…

  14. Adolescent Motherhood and Postpartum Depression

    ERIC Educational Resources Information Center

    Birkeland, Robyn; Thompson, J. Kevin; Phares, Vicky

    2005-01-01

    Adolescent mothers undergo unique personal and social challenges that may contribute to postpartum functioning. In this exploratory investigation completed within a risk and resilience framework, 149 adolescent mothers, ages 15 to 19, who participated in school-based teen parents' programs, completed measures of parental stress (social isolation…

  15. Diabetes as Experienced by Adolescents.

    ERIC Educational Resources Information Center

    Meldman, Linda S.

    1987-01-01

    Explored adolescents' perspective of their diabetic management by interviewing 12 adolescent counselors-in-training at a diabetic youth camp. Interviews were analyzed using the constant comparative method; themes were further grouped into three categories: psychosocial, developmental, and clinical. A striking finding throughout the data was the…

  16. Counselor Response to Adolescent Suicide.

    ERIC Educational Resources Information Center

    Perrone, Philip A.

    1987-01-01

    Summarizes major research findings on adolescent suicide, presents a suicide chronology developed by Hawton (1986), and provides a selected list of references. Discusses five goals for counselor intervention with students at risk for suicide and explains how school personnel can work to prevent adolescent suicide. (NB)

  17. Supporting Adolescents Exposed to Disasters

    ERIC Educational Resources Information Center

    Jacobs, Anne K.; Vernberg, Eric; Lee, Stephanie J.

    2008-01-01

    Adolescents possess numerous strengths and vulnerabilities based on their unique stage of development. When youth experience a disaster, whether natural or human-caused, there are certain considerations to be taken into account when providing them with support. This article describes common adolescent reactions to the impact phase of disasters as…

  18. Postdivorce Father-Adolescent Closeness

    ERIC Educational Resources Information Center

    Scott, Mindy E.; Booth, Alan; King, Valarie; Johnson, David R.

    2007-01-01

    Research indicates that closeness of the father-child bond following parental divorce is associated with better outcomes for children and adolescents. Unlike other investigations, this study takes a long-term developmental approach to understanding stability and change in postdivorce father-adolescent relationship closeness. Drawing on Add Health…

  19. To Dance with the Adolescent.

    ERIC Educational Resources Information Center

    Schaefer, Larry

    1997-01-01

    Uses metaphor of the dance to suggest reciprocity, harmony, and a mutual exchange of leadership as key components of adolescent-adult relationships. Suggests that adolescents have high expectations of adult's character and competencies; therefore, teachers should elicit the highest values and behaviors from their students. (KDFB)

  20. Adolescents' Intentional Self-Mutilation

    ERIC Educational Resources Information Center

    Laskite, A.; Laskene, S.

    2011-01-01

    In Lithuania, suicide is among the top three causes of death; between twenty and thirty-three school-age children take their own lives every year, and the overwhelming majority of adolescents do not seek help in connection with situations that prompt them to engage in self-mutilation. Research indicates adolescents think that if more attention is…

  1. Evaluating Experiences in Adolescent Programs.

    ERIC Educational Resources Information Center

    Gebhardt-Seele, Peter

    1997-01-01

    Asserts that in developing Erdkinder, Montessori programs for adolescents, practitioners should use Montessori's principles of scientific pedagogy to establish methods for evaluating existing adolescent experiments. Suggests ways to apply criterion of normalization, and that "healing of deviations" comes from observing aspects like inner harmony…

  2. Stress Literacy in Australian Adolescents

    ERIC Educational Resources Information Center

    Varlow, Megan; Wuthrich, Viviana; Murrihy, Rachael; Remond, Louise; Tuqiri, Rebekka; van Kessel, Jacobine; Wheatley, Anna; Dedousis-Wallace, Anna; Kidman, Antony

    2009-01-01

    Stress literacy is a term that refers to knowledge about stress and stress management techniques. Levels of stress literacy were examined in more than nine hundred Australian adolescents by providing a short stress-management education session and assessing stress literacy using a pre-post survey design. It was found that while adolescents had a…

  3. Adolescence: A Time That Matters.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    Noting that there are an estimated 1.2 billion 10- to 19-year-olds in the world, this report examines the challenges faced by adolescents in both developing and developed nations. The report describes adolescence as a complex transition during which youth take on new responsibilities and experiment with independence. The importance of the…

  4. Residential Mobility and Adolescent Violence

    ERIC Educational Resources Information Center

    Haynie, Dana L.; South, Scott J.

    2005-01-01

    Using two waves of data from the National Longitudinal Study of Adolescent Health, this study examines the impact of recent residential mobility on adolescent violence. A unique focus of our analysis is an examination of the ability of various mechanisms, including parent-child relationships, psychological distress, experiences of victimization,…

  5. Impact of population on adolescents.

    PubMed

    1997-01-01

    Adolescents are often overlooked in the efforts of developing countries to reduce population growth rates by lowering fertility and to care for aging populations in those countries that have been successful in reducing fertility. The September issue of the Asia-Pacific Population Journal contains an article by Professor Gavin Jones of the Australian National University entitled "Population Dynamics and Their Impact on Adolescents in the ESCAP Region," which overcomes that gap in information on the population aged 10-24. It examines aspects such as the growth of the adolescent population, age at marriage, educational developments, labor force participation, unemployment, and fertility among adolescents. The article concludes with an examination of the effects of demographic and educational changes, poverty, globalization, and urbanization on adolescents, drawing out a number of implications for policy purposes. Stating that most of today's adolescents will be still alive at mid-century, the article observes that "this cohort will play a crucial role in national development in an increasingly interconnected and high-technology world. From this perspective, it is tragic to note that many of these adolescents will still lack access to secondary schools--and in some cases, even to primary schooling--and will suffer from avoidable health problems." It also points out that, because adolescents greatly outnumber the elderly, care should be taken to ensure that policies towards them are not neglected. PMID:12321306

  6. Minority Adolescent Stress and Coping

    ERIC Educational Resources Information Center

    Gonzales, Nancy A.; George, Preethy E.; Fernandez, Aida Cristina; Huerta, Violeta L.

    2005-01-01

    Many of the stressful life events and daily hassles of adolescence are similar for youths despite differences in cultural background or place of residence. However, adolescents from diverse cultural groups often encounter unique challenges that arise from the particular cultural-ecological niches they inhabit by virtue of their ethnic group…

  7. Increasing vegetable consumption in adolescents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studies have demonstrated that diets rich in vegetables may protect against many chronic diseases and overweight. Despite these benefits, consumption in children and adolescents is well below recommended levels. Finding methods to increase vegetable consumption in adolescents is important. Our objec...

  8. Adolescent Brain Development and Drugs

    ERIC Educational Resources Information Center

    Winters, Ken C.; Arria, Amelia

    2011-01-01

    Research now suggests that the human brain is still maturing during adolescence. The developing brain may help explain why adolescents sometimes make decisions that are risky and can lead to safety or health concerns, including unique vulnerabilities to drug abuse. This article explores how this new science may be put to use in our prevention and…

  9. Noise Exposures of Rural Adolescents

    ERIC Educational Resources Information Center

    Humann, Michael; Sanderson, Wayne; Flamme, Greg; Kelly, Kevin M.; Moore, Genna; Stromquist, Ann; Merchant, James A.

    2011-01-01

    Purpose: This project was conducted to characterize the noise exposure of adolescents living in rural and agricultural environments. Methods: From May to October, 25 adolescents ages 13 through 17, living either on a farm or a rural nonfarm, were enrolled in the study. Subjects received training on the correct operation and use of personal noise…

  10. Contraception and the Adolescent Diabetic.

    ERIC Educational Resources Information Center

    Fennoy, Ilene

    1989-01-01

    Data from a study of 11 teenage diabetics suggests that pregnancy among adolescent diabetics is more frequent than among the general population, at a time when diabetic control is poor because of psychosocial factors associated with adolescence. Current recommendations regarding contraception for diabetic women, focusing on barrier methods, are…

  11. Adolescent Attitudes towards Virtual Learning

    ERIC Educational Resources Information Center

    Pleau, Andrea R.

    2012-01-01

    This study was designed to examine adolescents' attitudes towards virtual schooling. Virtual schooling may be defined as any public or private organization that delivers instruction via the Internet. The rationale for this study is based on the increased number of adolescents opting to complete some or all of their secondary education through…

  12. Ego and Leadership among Adolescents

    ERIC Educational Resources Information Center

    Thangarajathi, S.

    2010-01-01

    The period of adolescence is designated as the period of storm and stress and age of revolt. This is considered as being one of the most difficult stage in the life of any individual. Thus adolescence is the most critical stage with a distinct phase of rapid physical, psychological and social behavioral changes and emotional disturbances. As Ego…

  13. [Pregnancy and motherhood in adolescence].

    PubMed

    Desaunay, Pierre; Perrin, Anne-Sophie; Gérardin, Priscille

    2016-01-01

    Adolescence and pregnancy are two periods which involve major psychological and identity changes. Teenage pregnancies are often considered to be a result of a confusion between these periods. The circumstances of teenage pregnancies and early motherhood are diverse and sit within the wider context of the psychopathology of adolescence, the heterogeneity of family configurations and evolutions in society. PMID:27444529

  14. Intuitive Risk Taking during Adolescence

    ERIC Educational Resources Information Center

    Holland, James D.; Klaczynski, Paul A.

    2009-01-01

    Adolescents frequently engage in risky behaviors that endanger both themselves and others. Critical to the development of effective interventions is an understanding of the processes adolescents go through when deciding to take risks. This article explores two information processing systems; a slow, deliberative, analytic system and a quick,…

  15. Parenting and Adolescents' Sexual Initiation

    ERIC Educational Resources Information Center

    Longmore, Monica A.; Eng, Abbey L.; Giordano, Peggy C.; Manning, Wendy D.

    2009-01-01

    This study draws on social control and social learning theories to examine the role of dating-specific attitudes and practices as predictors of adolescents' sexual initiation. We include attention to the adolescent's reaction to control attempts as a further means of assessing family dynamics (i.e., frequency of dating disagreements). The study…

  16. Adolescent Mothers Leaving Multigenerational Households

    ERIC Educational Resources Information Center

    Oberlander, Sarah E.; Shebl, Fatma M.; Magder, Laurence S.; Black, Maureen M.

    2009-01-01

    This study examined how the developmental processes of autonomy and relatedness are related to changes in the residential status of 181 first-time, adolescent, urban, low-income, African American mothers over the first 24 months postpartum. Although adolescent mothers were eager to live independently, few made a clear transition out of the…

  17. Origins of Adolescents' Autobiographical Memories

    ERIC Educational Resources Information Center

    Reese, Elaine; Jack, Fiona; White, Naomi

    2010-01-01

    Adolescents (N = 46; M = 12.46 years) who had previously participated in a longitudinal study of autobiographical memory development narrated their early childhood memories, interpreted life events, and completed a family history questionnaire and language assessment. Three distinct components of adolescent memory emerged: (1) age of earliest…

  18. Goals and Personality in Adolescents

    ERIC Educational Resources Information Center

    Sanz de Acedo Lizarraga, M. L.; Ugarte, M. D.; Lumbreras, M. Victoria; Sanz de Acedo Baquedano, M. T.

    2006-01-01

    The purpose of this study was to investigate the influence of personality factors in the value allotted by adolescents to various groups of goals. For this purpose, the "Cuestionario de Personalidad Situacional, CPS" (Situational Personality Questionnaire) and the "Cuestionario de Metas para Adolescentes, CMA" (Goals for Adolescents Questionnaire)…

  19. Korean American Adolescent Depression and Parenting

    PubMed Central

    Kim, Eunjung; Cain, Kevin C.

    2010-01-01

    PROBLEM Korean American adolescents tend to experience more mental health problems than adolescents in other ethnic groups. METHODS The goal of this study was to examine the association between Korean American parent-adolescent relationships and adolescents’ depressive symptoms in 56 families. FINDINGS Thirty-nine percent of adolescents reported elevated depressive symptoms. Adolescents’ perceived low maternal warmth and higher intergenerational acculturation conflicts with fathers were significant predictors for adolescent depressive symptoms. CONCLUSIONS The findings can be used to develop a family intervention program, the aim of which would be to decrease adolescent depressive symptoms by promoting parental warmth and decreasing parent-adolescent acculturation conflicts. PMID:18429840

  20. Adolescents' lived experience of epilepsy.

    PubMed

    Eklund, Pernilla Garmy; Sivberg, Bengt

    2003-02-01

    To improve the well-being of adolescents with epilepsy, research is needed on how adolescents cope. In this study, Lazarus' model of stress and coping and Antonovsky's Theory of Sense of Coherence were used as the theoretical framework. The aim was to describe the lived experience of adolescents with epilepsy and their coping skills. The participants were 13-19 years old with an epilepsy diagnosis but without mental retardation or cerebral palsy. The study was performed in southern Sweden at the pediatric department of a university hospital. Semistructured and open-ended interviews were conducted with 13 adolescents. The transcripts were analyzed with manifest and latent content analysis. All the adolescents had developed strategies to cope with the emotional strains caused by epilepsy. They experienced strains from the seizures, limitation of leisure activities, side effects of medication, and feelings of being different. The coping strategies described were finding support, being in control, and experimenting. PMID:12789720

  1. Sexually transmitted infections and adolescence.

    PubMed

    Ljubojević, Suzana; Lipozenčić, Jasna

    2010-01-01

    Sexually transmitted infections (STIs) remain a public health problem of major significance in most of the world. Adolescents make up about 20% of the world population, of whom 85% live in developing countries. They are at a greater risk of STIs because they frequently have unprotected intercourse, biologically may be more susceptible to infection, often are engaged in multiple monogamous relationships of limited duration, and face multiple obstacles in accessing confidential health care services. Young people who begin to have sexual intercourse in early or middle adolescence are more likely to develop an STI than those who postpone intercourse until later adolescence or adulthood. The most common STIs among adolescents are chlamydia, gonorrhea, human papillomavirus infection, and trichomoniasis. Unfortunately, lately the incidence of HIV/AIDS and syphilis among adolescents is growing. Comprehensive sex education programs in schools can increase STI knowledge and prevent risky sexual behaviors. Health care providers can promote STI prevention methods, including counseling about safe sex. PMID:21251451

  2. Emotional variability during mother-adolescent conflict interactions: longitudinal links to adolescent disclosure and maternal control.

    PubMed

    Van der Giessen, Daniëlle; Branje, Susan; Keijsers, Loes; Van Lier, Pol A C; Koot, Hans M; Meeus, Wim

    2014-01-01

    The aim of this study was to examine relations of emotional variability during mother-adolescent conflict interactions in early adolescence with adolescent disclosure and maternal control in early and late adolescence. Data were used from 92 mother-adolescent dyads (M age T1 = 13.05; 65.20% boys) that were videotaped at T1 while discussing a conflict. Emotional variability was derived from these conflict interactions. Mothers also completed questionnaires at the start of the study (T1) and five years later (T6) on adolescent disclosure and maternal control. Path analysis showed that more emotional variability during conflict interactions in early adolescence was associated with higher levels of adolescent disclosure in early adolescence and with relative decreases in maternal control from early to late adolescence. More emotional variability of mother-adolescent dyads serves an important function in adaptively dealing with relational challenges that arise during adolescence. PMID:24331301

  3. [The modified Lapidus arthrodesis].

    PubMed

    Trnka, H-J; Hofstätter, S

    2005-08-01

    For the correction of hallux valgus, as one of the most common deformities of the lower limbs, a modified Lapidus arthrodesis is applied at the base of the hallux. After using a lateral tissue technique with medial capsular reefing, a general arthrodesis of the tarsometatarsal 1 joint is carried out. An unstable hallux is the indication for a classic Lapidus arthrodesis. Before determination of the indication, an exact clinical x-ray examination should be made in the dorsoplanar position as well as laterally standing. Complications associated with the Lapidus arthrodesis are postoperative metatarsalgia and pseudoarthrosis. Advantages of this technique are, for example, a high correction potential and better healing, although the surgical technique and post-operative care are more time consuming than for other methods. PMID:16028050

  4. Maturation of the adolescent brain

    PubMed Central

    Arain, Mariam; Haque, Maliha; Johal, Lina; Mathur, Puja; Nel, Wynand; Rais, Afsha; Sandhu, Ranbir; Sharma, Sushil

    2013-01-01

    Adolescence is the developmental epoch during which children become adults – intellectually, physically, hormonally, and socially. Adolescence is a tumultuous time, full of changes and transformations. The pubertal transition to adulthood involves both gonadal and behavioral maturation. Magnetic resonance imaging studies have discovered that myelinogenesis, required for proper insulation and efficient neurocybernetics, continues from childhood and the brain’s region-specific neurocircuitry remains structurally and functionally vulnerable to impulsive sex, food, and sleep habits. The maturation of the adolescent brain is also influenced by heredity, environment, and sex hormones (estrogen, progesterone, and testosterone), which play a crucial role in myelination. Furthermore, glutamatergic neurotransmission predominates, whereas gamma-aminobutyric acid neurotransmission remains under construction, and this might be responsible for immature and impulsive behavior and neurobehavioral excitement during adolescent life. The adolescent population is highly vulnerable to driving under the influence of alcohol and social maladjustments due to an immature limbic system and prefrontal cortex. Synaptic plasticity and the release of neurotransmitters may also be influenced by environmental neurotoxins and drugs of abuse including cigarettes, caffeine, and alcohol during adolescence. Adolescents may become involved with offensive crimes, irresponsible behavior, unprotected sex, juvenile courts, or even prison. According to a report by the Centers for Disease Control and Prevention, the major cause of death among the teenage population is due to injury and violence related to sex and substance abuse. Prenatal neglect, cigarette smoking, and alcohol consumption may also significantly impact maturation of the adolescent brain. Pharmacological interventions to regulate adolescent behavior have been attempted with limited success. Since several factors, including age, sex

  5. Morphology of plantar interdigital neuroma: a comparative cadaveric study of elderly Finnish and Japanese individuals.

    PubMed

    Abe, Shinichi; Nakao, Tadashi; Yamane, Shigeki; Fukuda, Masayuki; Yamamoto, Masahito; Santti, Risto; Murakami, Gen

    2013-01-01

    To examine morphological differences in Morton's interdigital neuroma between two elderly human populations, we conducted comparative study using 40 Japanese (27 males, 13 females; mean age, 81.2 years) and 21 Finnish (6 males, 15 females; mean age, 80.5 years) cadavers. We defined the neuroma as a thickening of the nerve of at least two-fold relative to the non-pathological proximal part. The incidence of this neuroma was 25% (10/40) in the Japanese and 33.3% (7/21) in the Finnish cadavers. Moderate or severe hallux valgus (with an angle of more than 20 degrees) was seen in half of the 40 Japanese cadavers (7 males, 13 females), but was absent in the Finnish cadavers. Such hallux valgus was present in 7 (5 males, 2 females) of the 10 Japanese cadavers with neuroma. Moreover, in 2 Japanese cadavers, a paper-like, specialized type of neuroma was associated with the deformity. Pathogenesis of Morton's neuroma might be different between human populations with or without hallux valgus. PMID:23883772

  6. Ultrasonically Assisted Anchoring of Biodegradable Implants for Chevron Osteotomies – Clinical Evaluation of a Novel Fixation Method

    PubMed Central

    Olms, Kai; Randt, Thorsten; Reimers, Nils; Zander, Nils; Schulz, Arndt P.

    2014-01-01

    Reconstructive osteotomies for the treatment of Hallux valgus are among the most prevalent procedures in foot and ankle surgery. The combination of biodegradable materials with an innovative method for fixation by application of ultrasonic energy facilitates a new bonding method for fractures or osteotomies. As clinical experience is still limited, the aim of this study was to assess the safety and performance of the SonicPin system for fixation of Austin/Chevron osteotomies. Chevron osteotomy was performed on 30 patients for the treatment of Hallux valgus. The used SonicPins were made from polylactide and are selectively melted into the cancellous bone structure during insertion by ultrasonic energy. Patients were followed for one year, which included X-ray and MRI examinations as well as evaluation of life quality by EQ-5D (EuroQol). The MRI after three months showed adequate bone healing in all cases and no signs of foreign body reactions, which was again confirmed by MRI 12 months postoperatively. The bony healing after 12 months was uneventful without any signs of foreign body reactions. In summary, based on the low complication rate and the significant improvement in health related quality of life (EQ-5D) reported in this study, fixation of an Austin/Chevron osteotomy with a SonicPin for treatment of Hallux valgus can be considered to be safe and efficient over the short term. Level of Clinical Evidence: Therapeutic Level III. PMID:24851140

  7. The private adolescent: privacy needs of adolescents in hospitals.

    PubMed

    Hutton, Alison

    2002-02-01

    This report is based on an interpretative study that explored the meaning of space to adolescents in the hospital environment. Through designing their own adolescent ward and discussing their designs in an interview, participants articulated their spatial needs in the ward environment. This paper addresses the private space issues of the adolescent patient in the ward environment. Issues that are discussed include the use of the telephone, the bathroom, and the bedroom, and additional facilities needed to enhance privacy in the ward. PMID:11891498

  8. Reproductive health in adolescence.

    PubMed

    Friedman, H L

    1994-01-01

    The health and well-being of adolescents is closely intertwined with their physical, psychological and social development, but this is put at risk by sexual and reproductive health hazards which are increasing in much of the world. Changes in population growth and distribution, the rise of telecommunications, the increase in travel and a decline in the family, as well as a generally earlier start of menarche and later age of marriage are contributing to an increase in unprotected sexual relations before marriage. This, combined with risks from early marriage, result in too early or unwanted pregnancy and childbirth, induced abortion in hazardous circumstances and sexually transmitted diseases, including HIV infection leading to AIDS. With more than half the world's population below the age of 25, and 4 out of 5 young people living in developing countries with inadequate access to prevention and care, there is an urgent need for action. Young women are particularly vulnerable. Mortality and morbidity from early pregnancy whether ending in childbirth or abortion, is much higher for the younger adolescent. Young women, especially those who have less formal education, are more vulnerable to pressures for marriage, or sexual relations before marriage, often with older men. Young people generally lack adequate knowledge about their own development and information on how to get help. Those who could help are rarely trained for working with adolescents, and services which are generally designed for adults or children often deter young people from getting help when they most need it. Policy and legislation relating to sexual and reproductive health issues are often contradictory, and unclear or unenforced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8085368

  9. Narcolepsy in adolescents.

    PubMed

    Sullivan, Shannon S

    2010-12-01

    Narcolepsy is a disorder of children and adolescence, but until recently it was often not identified until adulthood, with a reported time from onset to diagnosis of about a decade. This disorder affects approximately 0.05% of the population and starts in childhood and adolescence about half of the time. With narcolepsy, the boundaries between wake, sleep, and dreams are blurred. The cardinal features of narcolepsy-cataplexy are daytime somnolence, cataplexy (sometimes occurring long after onset of sleepiness), sleep paralysis, and hypnagogic hallucinations. Weight gain, disturbed nocturnal sleep, and social/school functional changes are common; reactive substance use to maintain wakefulness during the day may also be seen. Males and females are equally affected. It is classically associated with HLA DQB1*0602, the most specific genetic marker for narcolepsy across all ethnic groups. CSF hypocretin has recently been found to be depleted in this disorder, and late-breaking data support that the disease is caused by autoimmune destruction of hypocretin-producing neurons in the hypothalamus. There is no known cure for narcolepsy. Therapies include behavioral/ scheduling modification, medications to combat daytime sleepiness and cataplexy, and treatment of concomitant disorders leading to daytime sleepiness. The differential diagnosis for this disorder should include other disorders of excessive daytime sleepiness with a proclivity toward onset in adolescence, such as delayed sleep phase syndrome, obstructive sleep apnea, and insufficient sleep time; substance use; and less commonly neurologic disorders such as Klein Levin syndrome, Prader-Willi syndrome, and others. Immunomodulator therapy and hypocretin replacement are proposed therapies that hold promise for the future. PMID:21302860

  10. ADOLESCENT ALCOHOL EXPOSURE: ARE THERE SEPARABLE VULNERABLE PERIODS WITHIN ADOLESCENCE?

    PubMed Central

    Spear, Linda Patia

    2015-01-01

    There are two key alcohol use patterns among human adolescents that confer increased vulnerability for later alcohol abuse/dependence, along with neurocognitive alterations: (a) early initiation of use during adolescence, and (b) high rates of binge drinking that are particularly prevalent late in adolescence. The central thesis of this review is that lasting neurobehavioral outcomes of these two adolescent exposure patterns may differ. Although it is difficult to disentangle consequences of early use from later binge drinking in human studies given the substantial overlap between groups, these two types of problematic adolescent use are differentially heritable and hence separable to some extent. Although few studies using animal models have manipulated alcohol exposure age, those studies that have have typically observed timing-specific exposure effects, with more marked (or at least different patterns of) lasting consequences evident after exposures during early-mid adolescence than late-adolescence/emerging adulthood, and effects often restricted to male rats in those few instances where sex differences have been explored. As one example, adult male rats exposed to ethanol during early-mid adolescence (postnatal days [P] 25-45) were found to be socially anxious and to retain adolescent-typical ethanol-induced social facilitation into adulthood, effects that were not evident after exposure during late-adolescence/emerging adulthood (P45-65); exposure at the later interval, however, induced lasting tolerance to ethanol's social inhibitory effects that was not evident after exposure early in adolescence. Females, in contrast, were little influenced by ethanol exposure at either interval. Exposure timing effects have likewise been reported following social isolation as well as after repeated exposure to other drugs such as nicotine (and cannabinoids), with effects often, although not always, more pronounced in males where studied. Consistent with these timing

  11. Adolescent alcohol exposure: Are there separable vulnerable periods within adolescence?

    PubMed

    Spear, Linda Patia

    2015-09-01

    There are two key alcohol use patterns among human adolescents that confer increased vulnerability for later alcohol abuse/dependence, along with neurocognitive alterations: (a) early initiation of use during adolescence, and (b) high rates of binge drinking that are particularly prevalent late in adolescence. The central thesis of this review is that lasting neurobehavioral outcomes of these two adolescent exposure patterns may differ. Although it is difficult to disentangle consequences of early use from later binge drinking in human studies given the substantial overlap between groups, these two types of problematic adolescent use are differentially heritable and hence separable to some extent. Although few studies using animal models have manipulated alcohol exposure age, those studies that have have typically observed timing-specific exposure effects, with more marked (or at least different patterns of) lasting consequences evident after exposures during early-mid adolescence than late-adolescence/emerging adulthood, and effects often restricted to male rats in those few instances where sex differences have been explored. As one example, adult male rats exposed to ethanol during early-mid adolescence (postnatal days [P] 25-45) were found to be socially anxious and to retain adolescent-typical ethanol-induced social facilitation into adulthood, effects that were not evident after exposure during late-adolescence/emerging adulthood (P45-65); exposure at the later interval, however, induced lasting tolerance to ethanol's social inhibitory effects that was not evident after exposure early in adolescence. Females, in contrast, were little influenced by ethanol exposure at either interval. Exposure timing effects have likewise been reported following social isolation as well as after repeated exposure to other drugs such as nicotine (and cannabinoids), with effects often, although not always, more pronounced in males where studied. Consistent with these timing

  12. [Feeding and adolescence].

    PubMed

    Dain, E

    2012-09-01

    Adolescence is a transition period during which young people face many changes. Their desire to assert and differentiate themselves is reflected even in their food choices. These choices may have impacts until their adult lives. Moreover the media affect them in contradictory ways from images of extreme thinnesses to enticing advertisements of calorie food. A lack of self-esteem may appear, and in case of fertile ground may cause either diet, either addiction, or eating disorder. A comforting family as well as empathetic physicians have a main role in the medical care. PMID:23091941

  13. Social networking and adolescents.

    PubMed

    Fuld, Gilbert L

    2009-04-01

    Online social networking is a 21st century innovation increasingly embraced by today's young people. It provides new opportunities for communication that expand an adolescent's world. Yet adults, often suspicious of new trends and technologies initially embraced by youth, often see these new environments as perilous places to visit. These fears have been accentuated by media hype, especially about sexual predators. How dangerous are they? Because the rush to go on these sites is a new phenomenon, research is as yet scant. This review explores current beliefs and knowledge about the dangers of social networking sites. PMID:19492691

  14. Adolescent sexual counseling.

    PubMed

    Shen, J T

    1982-05-01

    The physician provides a much-needed service to teenagers by counseling them regarding sexuality. A series of conferences during adolescence and use of questionnaires can facilitate discussion and point up potential problems. When the patient is confronted with a problem such as a need for contraception or an unwanted pregnancy, the physician should present all the options available and leave the final choice up to the patient. The physician is not obligated to participate in a solution that is counter to his or her moral values. PMID:7071042

  15. [Obesity, migration and adolescence].

    PubMed

    Chamay-Weber, Catherine; Shehu-Brovina, Shqipe; Narring, Françoise

    2012-06-13

    Weight management interventions during adolescence are challenging. Migration adds complexity to this problem, making migrant families more vulnerable. Teenagers confront families to new values transmitted by the host society: opulence, junk food, video games. Obesity should not be seen as a single issue of calories-excess, but must be considered as being part of a larger problem, which takes into account the context of the familial and societal life of the migrants. The caregivers must have an overall view of the situation to provide appropriate approaches to weight management. PMID:22787729

  16. Adolescents and child maltreatment.

    PubMed

    Beard, Joyce W

    2014-03-01

    Child maltreatment is a very complex medical and social problem. Many children have died as a result of child maltreatment; others are depressed, engaging in risky behaviors and substance abuse and running away from home. The purpose of this article is to provide an overview of child maltreatment in the United States. Characteristics and contributing factors of maltreatment are described, and health and behavior problems associated with maltreated adolescents will be reviewed. Additionally the role of the school nurse will be discussed. It is imperative that school nurses are aware of the significance of the problem and the effects that child maltreatment has on children as they mature into early adulthood. PMID:24707655

  17. Reward processing in adolescent rodents

    PubMed Central

    Simon, Nicholas W; Moghaddam, Bita

    2015-01-01

    Immaturities in adolescent reward processing are thought to contribute to poor decision making and increased susceptibility to develop addictive and psychiatric disorders. Very little is known; however, about how the adolescent brain processes reward. The current mechanistic theories of reward processing are derived from adult models. Here we review recent research focused on understanding of how the adolescent brain responds to rewards and reward-associated events. A critical aspect of this work is that age-related differences are evident in neuronal processing of reward-related events across multiple brain regions even when adolescent rats demonstrate behavior similar to adults. These include differences in reward processing between adolescent and adult rats in orbitofrontal cortex and dorsal striatum. Surprisingly, minimal age related differences are observed in ventral striatum, which has been a focal point of developmental studies. We go on to discuss the implications of these differences for behavioral traits affected in adolescence, such as impulsivity, risk-taking, and behavioral flexibility. Collectively, this work suggests that reward-evoked neural activity differs as a function of age and that regions such as the dorsal striatum that are not traditionally associated with affective processing in adults may be critical for reward processing and psychiatric vulnerability in adolescents. PMID:25524828

  18. Nicotine and the adolescent brain

    PubMed Central

    Yuan, Menglu; Cross, Sarah J; Loughlin, Sandra E; Leslie, Frances M

    2015-01-01

    Adolescence encompasses a sensitive developmental period of enhanced clinical vulnerability to nicotine, tobacco, and e-cigarettes. While there are sociocultural influences, data at preclinical and clinical levels indicate that this adolescent sensitivity has strong neurobiological underpinnings. Although definitions of adolescence vary, the hallmark of this period is a profound reorganization of brain regions necessary for mature cognitive and executive function, working memory, reward processing, emotional regulation, and motivated behavior. Regulating critical facets of brain maturation are nicotinic acetylcholine receptors (nAChRs). However, perturbations of cholinergic systems during this time with nicotine, via tobacco or e-cigarettes, have unique consequences on adolescent development. In this review, we highlight recent clinical and preclinical data examining the adolescent brain's distinct neurobiology and unique sensitivity to nicotine. First, we discuss what defines adolescence before reviewing normative structural and neurochemical alterations that persist until early adulthood, with an emphasis on dopaminergic systems. We review how acute exposure to nicotine impacts brain development and how drug responses differ from those seen in adults. Finally, we discuss the persistent alterations in neuronal signaling and cognitive function that result from chronic nicotine exposure, while highlighting a low dose, semi-chronic exposure paradigm that may better model adolescent tobacco use. We argue that nicotine exposure, increasingly occurring as a result of e-cigarette use, may induce epigenetic changes that sensitize the brain to other drugs and prime it for future substance abuse. PMID:26018031

  19. Imaging of the Adolescent Breast

    PubMed Central

    Jones, Katie N.

    2013-01-01

    The mainstay of breast imaging in the adolescent is ultrasonography. There is occasionally a need for additional imaging, particularly with magnetic resonance imaging (MRI). Imaging of the adolescent breast differs substantially from the adult in both the imaging modalities utilized and the relative likelihood of pathologies encountered. The majority of lesions in the adolescent are benign, but the presence of a breast lesion may cause anxiety to patients and their families due to the wide awareness of breast malignancy in the adult population. It is important to be aware of the imaging modalities available to image the adolescent breast to prevent unnecessary radiation exposure while answering the clinical question. The current recommendations for adolescent diagnostic and screening breast imaging will be reviewed. Benign breast lesions such as fibroadenomas, fibrocystic change, pseudoangiomatous stromal hyperplasia, gynecomastia, and posttraumatic or infectious lesions with their associated imaging findings and management will be outlined. Additionally, review of breast malignancies that can affect adolescents will provide the reader with features to distinguish benign from malignant processes in the adolescent based on imaging findings and clinical presentation. PMID:24872737

  20. Hepatitis B immunization in adolescents.

    PubMed

    Lawrence, M H; Goldstein, M A

    1995-10-01

    This article reviews the epidemiology of hepatitis B in the United States, previous vaccination strategy, and reasons for its failure and issues leading to the recommendation to vaccinate all adolescents. A review of specific hepatitis B virus risk behaviors of adolescents and barriers to vaccinating adolescents is covered. Strategies that favor successful completion of the immunization series are also examined. Hepatitis B infection is an important public health concern for adolescents. The previous vaccine strategy to immunize only individuals though to be at high risk was unsuccessful, especially because providers of care could not identify these individuals. Furthermore, many individuals thought not to be at high risk for infection were exposed through contacts which could not be identified. Challenges to immunization of adolescents include logistical issues, patient education, cost of the vaccine, and patient compliance. Several of these issues can be addressed by a school-based hepatitis B immunization program. The body of evidence and national policy is rapidly changing to support the recommendation that all adolescents receive the hepatitis B immunization series. The series would be most effective if administered during the middle-school years. A universal adolescent hepatitis B vaccination program would result in the most immediate health benefits and acceleration toward the eradication of hepatitis B in the United States. PMID:8580124

  1. Adolescent health in South America.

    PubMed

    Gaete, Veronica

    2016-08-01

    Since the 1950s, a significant amount of work has been done on behalf of the comprehensive health of young people in South America. This article focuses on the regional process of training health professionals to work with this age group. There are countries in which the growth of adolescent health training has been significant, others that have made progress but still have a narrower offer of teaching activities, and a few where only very basic and limited training is available. Latin American professional associations, scientific societies, and international organizations have also contributed to the education of the adolescent health work force. Although the training in the region has advanced in some countries to the point that there is specialization in adolescent medicine, much remains to be done. Certain regional conditions have contributed to the education of providers in adolescent care. The most important has been the existence of professionals who have been highly motivated to improve the health of young people. They have worked very hard and with great commitment to achieve this goal. There have also been important obstacles to educating professionals in adolescent care. Aside from the usual lack of funding, barriers have existed in the health care system and its providers, as well as the training entities and because of certain South American conditions. Finally, this article describes the regional adolescent medicine programs and the status of recognition of this specialty, and addresses the opportunities and challenges for adolescent health training. PMID:26115500

  2. Motivational interviewing in adolescent treatment.

    PubMed

    Naar-King, Sylvie

    2011-11-01

    This paper briefly reviews the research literature on motivational interviewing (MI) and behaviour change in adolescents and then discusses the implications of adolescent cognitive and social-emotional developmental processes for the relational and technical components of MI. Research suggests that MI is efficacious in improving substance use in adolescents. Research has been slower to emerge in other behaviours, but available randomized controlled trials suggest that MI has great promise for improving mental and physical health outcomes in this developmental period. The relational and technical components of MI are highly relevant for the adolescent developmental period, and studies have shown that these components are related to outcomes in this population. There are several ways to include MI in clinical interventions for adolescents, ranging from MI in brief settings to using MI as a platform from which all other treatments are offered. Future research is necessary to test the effects of MI in adolescent group settings and the full integration of MI into other adolescent treatment approaches. PMID:22114919

  3. Adolescent health in Asia: insights from India.

    PubMed

    Basker, Mona M

    2016-08-01

    Adolescents living in the Indian subcontinent form a significant proportion of the general population. India is home to 236 million adolescents, who make up one-fifth of the total population of India. Adolescent health is gradually considered an important issue by the government of India. Awareness is increasing about adolescent needs. Health care professionals in particular are becoming more interested in the specific needs of adolescent age. Adolescent medicine as a subspecialty of pediatrics has also gained importance gradually over the last decade. In a hospital setting, adolescent-specific needs are met, albeit not in a uniform manner in all the health centers. After having been trained in adolescent medicine in India and abroad, I present this paper as a bird's eye view of the practice of adolescent health and medicine in India. PMID:27447203

  4. [Intrafamiliar violence against pregnant adolescents].

    PubMed

    Monteiro, Claudete de Ferreira Souza; Costa, Neyla Shirlene Santos; Nascimento, Patrícia Samara Veras; de Aguiar, Yara Amorim

    2007-01-01

    The objective of this work is to describe how the adolescents had relationship with their relatives before and after the discovery of the pregnancy. Fifteen adolescents from a public maternity that were in the post-partum period participated fo the research. A semi-strcutred interview was used as instrument of data collection. Qualitative approach was used for data analysis. Results indicated that the adolescents had a good relationship, but when the pregnancy was revealed they became victims of violent acts by their parents and that dialogue about sexuality and contraception is still distant between parents and children. PMID:18041516

  5. Adolescent suicidal ideation.

    PubMed

    Field, T; Diego, M; Sanders, C E

    2001-01-01

    Adolescent suicidal ideation and its relationship to other variables was tapped by a self-report questionnaire administered to 88 high school seniors. Eighteen percent responded positively to the statement "sometimes I feel suicidal." Those who reported suicidal ideation were found to differ from those who did not on a number of variables, including family relationships (quality of relationship with mother, intimacy with parents, and closeness to siblings), family history of depression (maternal depression), peer relations (quality of peer relationships, popularity, and number of friends), emotional well-being (happiness, anger, and depression), drug use (cigarettes, marijuana, and cocaine), and grade point average. Stepwise regression indicated that happiness explained 46% of the variance in suicidal ideation, and number of friends, anger, and marijuana use explained an additional 20%, for a total of 66% of the variance. While 34% of the variance remained unexplained, it is suggested that the questions used to measure these four variables be included in global screenings to identify adolescents at risk for suicidal ideation. PMID:11572303

  6. Adolescents' experiences with uxoricide.

    PubMed

    Steeves, Richard H; Parker, Barbara; Laughon, Kathryn; Knopp, Andrea; Thompson, Mary E

    2011-01-01

    The purpose of this study was to describe the experiences of individuals who survived the loss of one or both parents through parental homicide or homicide/suicide as adolescents. Participants (N = 34) were aged between 12 and 19 years at the time of the death and were aged between 29 and 64 years at the time of the interview. Participants were interviewed twice and asked to tell the story of their lives. Data were analyzed in the hermeneutic phenomenological tradition using a stepwise process of developing categories and then a single complex theme. Common categories of participants' childhoods included abuse both before and after the uxoricide and vivid memories of the homicide. As adults, most participants reported difficulties with intimate relationships, legal problems, and substance use. Integrity was an overarching theme for these participants. Among those who had integrated the story of the homicide into their adult lives, some believed that they were doing well whereas others did not. Some participants had isolated the event and considered that they were doing well as a result. These findings are limited by the convenience sample but offer a rich portrait of the lives of individuals who experienced uxoricide as adolescents. Clinicians might be advised to tread carefully if individuals report that they have isolated rather than integrated the uxoricide into their adult lives. No evidence exists in support that either stance is preferable. PMID:21659301

  7. Adolescent parricide and psychopathy.

    PubMed

    Myers, Wade C; Vo, Eleanor Justen

    2012-08-01

    Most cases of juvenile parricide are believed to be the result of child abuse, yet the vast majority of abused children do not kill their parental abusers. This study explored the role of psychopathy in 10 adolescent parricide offenders tried in adult court who were referred for pretrial psychiatric evaluation. In addition, psychopathological findings, crime-related behaviors, and judicial outcomes are described. Diagnostic and Statistical Manual of Mental Disorders diagnoses, most commonly posttraumatic stress disorder, and chronic, severe child abuse were prevalent. Psychopathic traits were not found to have played a role in the traumatized youths' parricidal behavior. Killings occurred in the family homes, usually through a surprise attack with parent-owned firearms. There was an average of 1.7 victims per event, with fathers being the most likely victim. Bodies were commonly covered or wrapped and moved postmortem. Confessions were often incredible in quality. One half received sentences of 40+ years, and the modal sanction was a life sentence, despite 90% premorbidly described as good youth. Further studies of adolescent parricide are needed to better understand this unusual population. PMID:21628342

  8. Patterns of parenting during adolescence: perceptions of adolescents and parents.

    PubMed

    Paulson, S E; Sputa, C L

    1996-01-01

    The purposes of this study were (1) to explore differences in maternal and paternal parenting style and parental involvement, (2) to examine the differences between parents' and adolescents' perceptions of parenting style and parental involvement, and (3) to explore the changes in parenting style and parental involvement between the adolescents' ninth and twelfth grade years. Subjects were 244 ninth graders recruited from several school districts in the Southeast and Midwest. Thirty-one subjects participated in a small longitudinal study three years later when they were in the twelfth grade. Measures of maternal and parental demandingness, responsiveness, values toward achievement, involvement in schoolwork, and involvement in school functions, designed for this program of research, were obtained from both adolescents and their parents. Results showed that both adolescents and parents perceived mothers to be more involved in parenting than were fathers during both ninth and twelfth grades. Mothers and fathers were not found to be different regarding their values toward achievement. Additionally, both mothers and fathers perceived themselves to be higher on all aspects of parenting than their adolescents perceived them to be during both ninth and twelfth grades. In the longitudinal study, both adolescents and parents perceived levels of parenting to drop between ninth and twelfth grades, except values toward achievement which did not change. Implications for interpretation of existing research and for considerations of future research are discussed. PMID:8726896

  9. The effects of adolescent methamphetamine exposure

    PubMed Central

    Buck, Jordan M.; Siegel, Jessica A.

    2015-01-01

    Methamphetamine use among adolescents is a significant social and public health concern. Despite increased awareness of methamphetamine use among younger people, relatively little research has examined the effects of adolescent methamphetamine use compared to adult use. Thus, much remains to be learned about how methamphetamine alters adolescent brain function and behavior. In this article we review recent trends in adolescent methamphetamine use and data examining the effects of adolescent methamphetamine use on the dopaminergic system and behavior in humans and animal models. Future research is warranted to expand our understanding of the effects of adolescent methamphetamine exposure and how those effects differ from those seen in adults. PMID:25972781

  10. Eating Disorders in Adolescent Athletes.

    ERIC Educational Resources Information Center

    Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.

    2003-01-01

    Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)

  11. Concerns of Rural Adolescent Parents

    ERIC Educational Resources Information Center

    de Lissovoy, Vladimir

    1975-01-01

    Discusses problems in adolescent marriages: (1) economic struggles; (2) social interaction outside the marriage; and (3) child conception and rearing. Suggests that major changes must be made in social values and national policy regarding parenthood. (SDH)

  12. Adolescent sexuality and public policy.

    PubMed

    Olsen, J A; Jensen, L C; Greaves, P M

    1991-01-01

    In recent decades, various attempts have been made to determine the level of sexual activity among adolescents. This information has been used in the planning and evaluation of sex-related programs. However, there is a flaw in using only the initial estimates of the behavior--that a sexually active person is defined as one who has had sexual intercourse. This narrow definition distorts the perception of adolescent sexual behavior. Sexual activity can more accurately be designated by focusing on the actual frequency with which teenagers have sex. In this research report, adolescents were considered sexually active if they had had sex within the last four weeks. Using this definition, adolescents were found to be substantially less sexually active than has been previously reported. This finding was then used to look at various policy decisions in the areas of sex education, family planning, and sexually transmitted disease prevention. PMID:1927672

  13. Self-Injury in Adolescents

    MedlinePlus

    ... as depression, psychosis, Posttraumatic Stress Disorder (PTSD) and Bipolar Disorder. Additionally, some adolescents who engage in self-injury ... Comprehensive Psychiatric Evaluation Child Abuse - The Hidden Bruises Bipolar Disorder In Children And Teens If you find Facts ...

  14. Adherence to treatment in adolescents

    PubMed Central

    Taddeo, Danielle; Egedy, Maud; Frappier, Jean-Yves

    2008-01-01

    Health care professionals must be alert to the high prevalence of low adherence to treatment during adolescence. Low adherence increases morbidity and medical complications, contributes to poorer quality of life and an overuse of the health care system. Many different factors have an impact on adherence. However, critical factors to consider in teens are their developmental stage and challenges, emotional issues and family dysfunction. Direct and indirect methods have been described to assess adherence. Eliciting an adherence history is the most useful way for clinicians to evaluate adherence, and could be the beginning of a constructive dialogue with the adolescent. Interventions to improve adherence are multiple – managing mental health issues appropriately, building a strong relationship, customizing the treatment regimen if possible, empowering the adolescent to deal with adherence issues, providing information, ensuring family and peer support, and motivational enhancement therapy. Evaluation of adherence at regular intervals should be an important aspect of health care for adolescents. PMID:19119348

  15. Skin Diseases and the Adolescent

    ERIC Educational Resources Information Center

    Bauer, Marjorie

    1970-01-01

    Discusses such concerns as acne, syphilis, drug abuse, and tatoos. Indicates need for physician not only to treat skin diseases but to help adolescents to accept themselves and find constructive directions. (CJ)

  16. America's Adolescents: How Healthy Are They? Volume 1. Profiles of Adolescent Health Series.

    ERIC Educational Resources Information Center

    Gans, Janet E.; And Others

    Many adolescent health problems are linked with educational performance, family relationships, poverty, and the general lifestyles that adolescents experience in their communities. Although serious, chronic medical and psychiatric disorders affect about 6 percent of the adolescent population, many more adolescents are at risk for death and for…

  17. Adolescent Suicide. The Trauma of Adolescent Suicide. A Time for Special Leadership by Principals.

    ERIC Educational Resources Information Center

    Dempsey, Richard A.

    This monograph was written to help principals and other school personnel explore the issues of adolescent suicide and its prevention. Chapter 1 presents statistics on the incidence of adolescent suicides and suicide attempts. Chapter 2, Causes of Suicide, reviews developmental tasks of adolescence, lists several contributors to adolescent suicide,…

  18. Who's That Adolescent in Your Class?: Understanding the Psychosocial World of the Adolescent.

    ERIC Educational Resources Information Center

    Ehrlich, M. I.

    1982-01-01

    The psychosocial characteristics of adolescents are described in order to assist teachers in interacting more effectively with their students. Examination of students about the presence of pathology in adolescence reveals that the typical adolescent is not a stereotypically impulse-ridden, uncontrollable person. Many of an adolescent's…

  19. Reciprocal Effects between Parental Solicitation, Parental Control, Adolescent Disclosure, and Adolescent Delinquency

    ERIC Educational Resources Information Center

    Keijsers, Loes; Branje, Susan J. T.; VanderValk, Inge E.; Meeus, Wim

    2010-01-01

    This two-wave multi-informant study examined the bidirectional associations of parental control and solicitation with adolescent disclosure and delinquency. Participants were 289 adolescents (150 females and 139 males, modal age 14) and both parents. Parental solicitation and control did not predict adolescent delinquency, but adolescents'…

  20. Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

    ERIC Educational Resources Information Center

    Crowell, Sheila E.; Beauchaine, Theodore P.; Hsiao, Ray C.; Vasilev, Christina A.; Yaptangco, Mona; Linehan, Marsha M.; McCauley, Elizabeth

    2012-01-01

    Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report…

  1. Mother-Adolescent Relationship Quality and Autonomy as Predictors of Psychosocial Adjustment among African American Adolescents

    ERIC Educational Resources Information Center

    Bynum, Mia Smith; Kotchick, Beth A.

    2006-01-01

    This study investigated the role of mother-adolescent relationship quality and autonomy in the psychosocial outcomes in a sample of African American adolescents drawn from the National Longitudinal Study of Adolescent Health. The results indicated that positive mother-adolescent relationship quality and greater autonomy were associated with higher…

  2. Adolescent Marital Expectations and Romantic Experiences: Associations with Perceptions about Parental Conflict and Adolescent Attachment Security

    ERIC Educational Resources Information Center

    Steinberg, Sara J.; Davila, Joanne; Fincham, Frank

    2006-01-01

    This study tested associations between adolescent perceptions of interparental conflict, adolescent attachment security with parents, and adolescent marital expectations and romantic experiences. Participants were 96 early adolescent females from 2 parent families. Insecurity was examined as a mediator of the association between negative…

  3. Adolescents' Emotional Experiences of Mother-Adolescent Conflict Predict Internalizing and Externalizing Symptoms

    ERIC Educational Resources Information Center

    Gunlicks-Stoessel, Meredith L.; Powers, Sally I.

    2008-01-01

    Research on adolescent emotion has generally focused on expressions of emotion; however, there are reasons to believe that adolescents' experiences of emotion may be related to adolescent development in unique and important ways. This study examined the relation of adolescents' emotional experiences of conflict with their mothers to their…

  4. Differences Between Self-Concepts of Mennonite Adolescents and Public School Adolescents.

    ERIC Educational Resources Information Center

    Suzuki, Michael G.

    The purpose of the study was to find out if there were any significant differences between the self-concepts of Mennonite adolescents and public school adolescents. Twenty-five Mennonite adolescents and twenty-five public school adolescents, all of whom were twelfth-graders, were given a self-description inventory in which they were to answer sets…

  5. Cannabis and adolescent brain development.

    PubMed

    Lubman, Dan I; Cheetham, Ali; Yücel, Murat

    2015-04-01

    Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence. PMID:25460036

  6. Adolescent medicine in pediatric practice.

    PubMed

    Marks, A; Fisher, M; Lasker, S

    1990-03-01

    Adolescents report important unmet health care needs. This study directly assesses pediatricians' current practices pertinent to the primary care of adolescents. An anonymous questionnaire survey of general pediatricians was conducted in two suburban counties in New York State. Of the 101 respondents, 51% were older than age 50 and 88% were in private practice. The "average" pediatrician saw 28 patients in a 7-hour office day. Approximately 1 in 10 regularly saw patients with a sexuality-related concern, substance abuse problem, or anorexia nervosa. Fewer than half provided anticipatory guidance regarding sexuality, and only 14% questioned teens about depression. Respondents perceived factors related to fees, lack of time, lack of knowledge, and their image as obstacles to an expanded care of adolescents. Those with some training in adolescent medicine during residency were significantly more likely to provide care and anticipatory guidance related to sexuality and substance abuse. Thirty percent reported an interest in increasing their involvement with adolescents. We conclude that most of these pediatricians played a small role in meeting the health needs of adolescents. PMID:2318713

  7. Coping styles of pregnant adolescents.

    PubMed

    Myors, K; Johnson, M; Langdon, R

    2001-01-01

    This descriptive study examined the coping styles and specific strategies used by a group of pregnant adolescents attending an adolescent family support service. Seventy-one adolescents, with a mean age of 17 years, and a mean gestation of 25 weeks, completed the Revised Jalowiec Coping Scale (JCS-R). The findings demonstrated that the optimistic coping style (emotion-focused) was the most frequently used and most effective coping style for these young women. A confrontive coping style (problem-focused) was also used and found to be effective. A combination of problem-focused and emotion-focused styles is recommended, with an increased emphasis on problem-focused approaches. The focus by the adolescents on optimistic approaches is suggestive of a lack of understanding of the challenges that motherhood will place upon them, but is consistent with their age and developmental stage. A longitudinal study of coping styles and changes in style throughout pregnancy and early motherhood is recommended. Initial assessment and monitoring of coping styles of pregnant adolescents is proposed. This assessment would be the beginning point for a teaching program that highlights increased use of adaptive coping styles (problem-focused) with decreased use of maladaptive approaches, and includes emotion-focused styles. By expanding the repertoire of coping styles and strategies available to the adolescent, the public health nurse (PHN) prepares these vulnerable mothers for the challenges ahead. PMID:11251870

  8. [Human papillomavirus infection and adolescence].

    PubMed

    Sam Soto, Selene; de la Peña y Carranza, Alejandro Ortiz; Plascencia, Josefina Lira

    2011-04-01

    Infection with human papillomavirus has increased dramatically in recent years. The highest prevalence rates are among adolescents and young women, reflecting changes in sexual behavior associated with biological factors in adolescent development. Adolescents who begin sexual activity early are at greater risk of precursor lesions and cervical cancer. There are adolescents with special circumstances, where no early decision should be delayed cervical cytology and in whom it is important to initiate consultations and periodic reviews with a preventive approach. Cervical cancer can be avoided when the diagnosis and treatment of precursor lesions is early. Despite efforts at sex education based on "safe sex" with the correct use of condoms has not been able to reduce the incidence of infections with human papillomavirus in adolescents. While better than nothing, condom use is not 100% reliable. Studies show that consistent and correct use provides protection against the human papillomavirus only 70%. In Mexico, reported an overall ratio of actual use of condoms from 24.6%. It is clear that the physician who provides care for adolescents plays a fundamental role in sex education. The key to future prevention of cervical cancer and its precursor lesions could be the vaccination. PMID:21966809

  9. Adolescent health screening and counseling.

    PubMed

    Ham, Peter; Allen, Claudia

    2012-12-15

    Serious health problems, risky behavior, and poor health habits persist among adolescents despite access to medical care. Most adolescents do not seek advice about preventing leading causes of morbidity and mortality in their age group, and physicians often do not find ways to provide it. Although helping adolescents prevent unintended pregnancy, sexually transmitted infections, unintentional injuries, depression, suicide, and other problems is a community-wide effort, primary care physicians are well situated to discuss risks and offer interventions. Evidence supports routinely screening for obesity and depression, offering testing for human immunodeficiency virus infection, and screening for other sexually transmitted infections in some adolescents. Evidence validating the effectiveness of physician counseling about unintended pregnancy, gang violence, and substance abuse is scant. However, physicians should use empathic, personal messages to communicate with adolescents about these issues until studies prove the benefits of more specific methods. Effective communication with adolescents requires seeing the patient alone, tailoring the discussion to the individual patient, and understanding the role of the parents and of confidentiality. PMID:23316983

  10. Adolescent eating disorder: bulimia.

    PubMed

    Muuss, R E

    1986-01-01

    Bulimia, an eating disorder, recently has emerged as a major mental health problem, especially among adolescent females. The bulimic experiences periods of compulsive binge eating followed by purges to rid the body of unwanted calories. Binges are triggered by intense emotional experiences, such as loneliness, anger, rejection, or stress. Associated features of bulimia are secretiveness, depression, drug abuse, preoccupation with body image and sexual attractiveness, and an awareness that the behavior is abnormal. The physical side effects include dental problems, inflamed esophagus, EEG abnormalities, abdominal or urinary disturbances, and changes in blood sugar level. Cognitive disturbances related to binging and purging are perfectionistic, egocentric, and distorted thinking, misconceptions about nutritional requirements, unreasonable goals and expectations, and disturbed affect. Bulimics resist treatment; however, such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising. PMID:3461693

  11. Condom availability for adolescents.

    PubMed

    1996-06-01

    Although abstinence should be stressed as the certain way to prevent STDs and pregnancy, sexually active teens, male and female, must nonetheless be taught to use condoms properly, effectively, and consistently. The latex condom should be made widely available to young people. Ideally, young persons should have access to education and counseling when contraception is dispensed. However, condoms should be made easily available without any requirement for education. Condoms should be available not only through families, medical facilities, and commercial channels, but also through other appropriate and informed persons, without cost if possible, at sites where adolescents congregate. These sites may include schools, clubs, and other youth-serving agencies. A clear message from the medical community supporting condom use will enhance compliance. PMID:8803728

  12. The Positive Psychology of Youth and Adolescence.

    ERIC Educational Resources Information Center

    Rich, Grant Jewell

    2003-01-01

    Introduces this theme issue that explores the nature of adolescence and the positive psychology movement that focuses on positive aspects of adolescent development. Articles in this collection provide a window into the exploration of youth strengths. (SLD)

  13. Jungian Feminine Psychology and Adolescent Prostitutes.

    ERIC Educational Resources Information Center

    Newton-Ruddy, Lara; Handelsman, Mitchell M.

    1986-01-01

    Explores Jungian feminine psychology and its application in the treatment of adolescent prostitutes. Discusses Wolff's (1956) work on feminine functions and Leonard's (1982) work with father-daughter wounds. Explores techniques for applying these concepts with adolescent prostitutes. (Author)

  14. Eating Disorder Not Otherwise Specified in Adolescents

    ERIC Educational Resources Information Center

    Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel

    2008-01-01

    A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.

  15. American Academy of Child and Adolescent Psychiatry

    MedlinePlus

    ... on Children and Guns. Be CAPtivated - Child and Adolescent Psychiatry as a Career U.S. House Passes Mental ... More... AACAP Workforce Maps More... Delirium in Children & Adolescents More... Issues to Consider When Engaging Asian American ...

  16. Narratives of Friendship and Self in Adolescence

    ERIC Educational Resources Information Center

    Azmitia, Margarita; Ittel, Angela; Radmacher, Kimberley

    2005-01-01

    Gender and self-esteem provide lenses through which early and late adolescents construct their narratives of ideal and actual friendships. These narratives provide a unique window into the dynamics of adolescents' friendships during school transitions.

  17. Panic Disorder in Children and Adolescents

    MedlinePlus

    ... Skip breadcrumb navigation Panic Disorder In Children And Adolescents Quick Links Facts For Families Guide Facts For ... is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...

  18. Family Factors Related to Adolescent Autonomy.

    ERIC Educational Resources Information Center

    Pardeck, Jean A.; Pardeck, John T.

    1990-01-01

    Analyzes role that the family plays in the development of adolescent autonomy. Three family factors are analyzed in relation to the development of adolescent autonomy: parenting styles, family interaction, and transitions related to the family life cycle. (Author/NB)

  19. Trends in Psychopathology across the Adolescent Years: What Changes When Children become Adolescents, and When Adolescents become Adults?

    ERIC Educational Resources Information Center

    Costello, E. Jane; Copeland, William; Angold, Adrian

    2011-01-01

    Background: Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood. Methods: We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in…

  20. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018