Database: Ovid medline(R) Search Strategy



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<36>

Unique Identifier

12015803

Authors


Ranalli DN. Demas PN.

Institution

Department of Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. dnr4@pitt.edu

Title


Orofacial injuries from sport: preventive measures for sports medicine. [Review] [26 refs]

Source


Sports Medicine. 32(7):409-18, 2002.

Abstract


Individuals worldwide are participating in an expanding arena of vigorous physical activities as well as competitive sports at all levels. The healthful benefits of such activities are unfortunately associated with injury risks that include orofacial soft- and hard-tissue trauma. This article describes the scope and emergency management of sports-related orofacial traumatic injuries that may be encountered by physicians in the field of sports medicine. Since most of these injuries are preventable with the use of protective equipment, specific recommendations are provided for the use of properly fitted mouthguards. [References: 26]

Database: Ovid MEDLINE(R) <1966 to January Week 4 2004>

Search Strategy:

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1 exp Soft Tissue Injuries/rh, th [Rehabilitation, Therapy] (175)

2 exp ankle/ or exp ankle joint/ (8800)

3 ankle.af. or 2 (19689)

4 1 and 3 (10)

5 exp soft tissue injuries/ (1204)

6 (physical therapy or physiotherapy).af. (27292)

7 5 and 6 (32)

8 3 and 7 (3)

9 4 or 8 (11)

10 limit 9 to english (10)

11 5 and 3 (89)

12 exp *soft tissue injuries/ and 11 (47)

13 limit 12 to english (34)

14 from 13 keep 1-34 (34)

15 10 or 13 (40)

16 from 15 keep 1-40 (40)


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<1>

Unique Identifier

7604725

Authors


Vlastou C.

Institution

Diagnostic and Therapeutic Center of Athens, Hygeia Hospital, Greece.

Title


Alternatives in soft tissue reconstruction of the ankle and foot.

Source


Acta Orthopaedica Scandinavica. Supplementum. 264:27-30, 1995 Jun.

Abstract


Reconstruction of soft tissue defects of the ankle and foot still presents a challenge. This is related to both the lack of large soft tissue flaps in this part of the body suitable for transfer to adjacent injured areas and to of the unique characteristics of the soft tissues of the sole of the foot. Microsurgery has solved some of these problems with the transfer of soft tissue from more distal areas. Several small arterialized and sometimes innervated flaps from the intrinsic tissues of the foot are also available for reconstruction of defects of limited size. The present report assesses 49 flaps, 15 local and 34 microsurgical transfers which were performed in 46 patients. The results suggest that there are several effective alternatives for coverage of soft tissue defects of the ankle and foot.

<2>

Unique Identifier

12567051

Authors


Kuo YR. Kuo MH. Chou WC. Liu YT. Lutz BS. Jeng SF.

Institution

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.

Title


One-stage reconstruction of soft tissue and Achilles tendon defects using a composite free anterolateral thigh flap with vascularized fascia lata: clinical experience and functional assessment.

Source


Annals of Plastic Surgery. 50(2):149-55, 2003 Feb.

Abstract


The combined loss of the Achilles tendon with overlying soft tissue is a reconstructive challenge. To achieve acceptable rehabilitation, such patients need skin coverage including functional repair of the Achilles tendon. This article presents four such patients who were treated successfully by means of an anterolateral thigh (ALT) composite flap with vascularized fascia lata. The size of the ALT flaps ranged from 10 to 16 cm in length and 6 to 9 cm in width. All flaps included vascularized fascia lata, which was rolled to serve as vascularized tendon graft (range 8 x 6 cm to 10 x 8 cm) for reconstruction of the Achilles tendon defect. Flap success rate was 100%. All patients could walk and climb stairs without support; however, mild difficulty when running was reported. Functional outcome of the recipient ankle and donor thigh morbidity were investigated by using a kinetic dynamometer comparing reconstructed sides with the healthy contralateral limbs. This assessment was performed in two patients at 2 years postoperatively. In the reconstructed ankles, isokinetic concentric measurements of dorsiflexion and plantar flexion showed a deficit of 30% and 40%, respectively. Functional evaluation of quadriceps femoris muscle contraction forces after free ALT composite flap harvest showed a 10% to 25% deficit. However, there were no difficulties in daily ambulating. In summary, the free composite ALT flap with vascularized fascia lata provides an alternative option for Achilles tendon reconstruction in complex defects.

<3>

Unique Identifier

7639487

Authors


Woods JM 4th. Shack RB. Hagan KF.

Institution

Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-3631, USA.

Title


Free temporoparietal fascia flap in reconstruction of the lower extremity.

Source


Annals of Plastic Surgery. 34(5):501-6, 1995 May.

Abstract


Twenty-one patients with open wounds of the non-weight-bearing foot or the ankle underwent coverage with a free temporoparietal fascia flap and split-thickness skin graft. Our indications for this thin, well-vascularized flap included osteomyelitis and exposed tendon, bone, or fixation hardware. The pliability of the flap allowed superior restoration of natural anatomical contours. Only one flap was completely lost (95.2% overall success). There were four cases (20%) of partial flap loss, none of which required flap revision or a new flap. Four patients (19%) experienced transient donor-site alopecia, and one patient suffered transient palsy of the temporal branch of the facial nerve. One patient (4.7%) had an area of persistent scar alopecia in the temporal scalp after a donor-site hematoma that required revision under local anesthesia. Follow-up was available on 95% of the patients and averaged 20 months (range, 1-54 months). All patients resumed weight-bearing ambulation within 1 month from operation using unmodified footwear. The free TPF flap is a reliable coverage option, with long-term durability and minimal donor-site morbidity, for relatively superficial wounds of the distal lower extremity.

<4>

Unique Identifier

10724085

Authors


Nyland J. Snouse SL. Anderson M. Kelly T. Sterling JC.

Institution

United States Olympic Committee, 1996 Paralympic Games, Sports Medicine Staff, Colorado Springs, CO, USA.

Title


Soft tissue injuries to USA paralympians at the 1996 summer games.

Source


Archives of Physical Medicine & Rehabilitation. 81(3):368-73, 2000 Mar.

Abstract


OBJECTIVE: To report the soft tissue injuries sustained by the members of four disabled sports organizations (DSOs) who competed as the USA Team at the 1996 Paralympic Games. SETTING: 1996 Paralympic Games, Atlanta, Georgia. METHODS: Soft tissue (strain, sprain, tendonitis, bursitis, or contusion) injury frequencies sustained by Disabled Sports USA (DSUSA, n = 66), the United States Association for Blind Athletes (USABA, n = 53), the United States Cerebral Palsy Athletic Association (USCPAA, n = 56), and Wheelchair Sports USA (WSUSA, n = 129) athletes were compared by body region with chi-square tests (p<.05) and standardized residual assessment. RESULTS: A total of 254 soft tissue injuries (67% acute onset, 170/254) were sustained by the participant DSO members. Statistical design limitations and poor USCPAA athlete homogeneity prompted their exclusion from group comparisons (descriptive results are reported). The most common injury regions for specific DSOs were shoulder (26%), hip-thigh (14%), and ankle (12%) for DSUSA; hip-thigh (21%), cervicothoracic region (19%), and shoulder (17%) for USABA; lumbar region (14%), foot-toe (13%), and ankle (9%) for USCPAA; and shoulder (18%), arm-elbow (12%), forearm-wrist (12%), and lumbar region (9%) for USUSA. Chi-square residual analysis showed that the USABA athletes contributed more to cervicothoracic and lower leg region injury frequencies than DSUSA or WSUSA athletes. The WSUSA athletes contributed more to elbow-arm and forearm-wrist region injury frequencies than DSUSA or USABA athletes. The DSUSA athletes contributed more to ankle region injury frequencies than USABA or WSUSA athletes. CONCLUSIONS: Differences in soft tissue injury frequency among athletes of differing DSOs suggest that the competitive use of adaptive or assistive devices, in combination with sport-specific stressors and the athletes' disabilities, is related to the development of predictable soft tissue injury patterns. The decreased incidence of shoulder injury among WSUSA athletes suggests that the injury prevention advice provided by previous studies is being implemented among athletes at this competitive level. The increased incidence of ankle injuries among DSUSA athletes suggests lower extremity load imbalances (prosthetic vs. uninvolved) during running. The increased incidence of lower leg injuries among USABA athletes suggests "overuse" injury patterns typical of nondisabled runners, or inadvertent contacts (contused shins), whereas the increased incidence of cervicothoracic injuries suggests injuries related to falls, "near falls," or sudden directional changes prompted by guidance aids.

<5>

Unique Identifier

9276064

Authors


Egol KA. Parisien JS.

Institution

Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York, New York, USA.

Title


Impingement syndrome of the ankle caused by a medial meniscoid lesion. [Review] [10 refs]

Source


Arthroscopy. 13(4):522-5, 1997 Aug.

Abstract


Meniscoid lesion of the ankle is a well-described condition involving the anterolateral aspect of the ankle joint. To our knowledge, there are no reports of this condition involving the medial aspect of the ankle in the literature. We present the case of a 27-year-old man with a chronic deltoid ligament rupture who had developed anteromedial impingement syndrome of the ankle. The patient was treated with an arthroscopic debridement of the lesion and experienced a complete recovery. [References: 10]

<6>

Unique Identifier

9276057

Authors


DeBerardino TM. Arciero RA. Taylor DC.

Institution

Orthopaedic Surgery Service, United States Miliatry Academy, West Point, New York, USA.

Title


Arthroscopic treatment of soft-tissue impingement of the ankle in athletes.

Source


Arthroscopy. 13(4):492-8, 1997 Aug.

Abstract


Sixty ankle arthroscopies were performed on patients with chronic soft-tissue impingement of the ankle after an ankle sprain between January 1989 and January 1994. Preoperative examination findings featured tenderness localized to the anterolateral aspect of the ankle, no instability, and, with the exception of 2 patients, normal radiographs. A preoperative bone scan was performed on 34 patients and was positive in each case but was not specific. Arthroscopy was performed an average of 23 months after injury. Results were determined by using a new ankle rating score. Hypertrophic synovium, synovitis, or fibrous adhesions were arthroscopically visualized and resected in all cases. The average follow-up was 27 months (range, 6 to 64 months). Thirty-one patients underwent complete evaluation and 29 were evaluated over the telephone. There were 51 excellent, 7 good, 1 fair, and 1 poor results. The diagnosis of chronic soft-tissue impingement of the ankle can be made from an appropriate history, thorough physical examination, and plain radiographs. Ankle arthroscopy with resection of impinging hypertrophic synovium or fibrous bands occurring after an ankle sprain was effective in alleviating pain in athletes.

<7>

Unique Identifier

9731397

Authors


Porta DJ. Kress TA. Fuller PM. Snider JN.

Institution

Biology Department, Bellarmine College, Louisville, KY 40205, USA.

Title


Fractures of experimentally traumatized embalmed versus unembalmed cadaver legs.

Source


Biomedical Sciences Instrumentation. 33:423-8, 1997.

Abstract


Intact legs from six geriatric cadavers were fractured in a self-controlled study aimed at documenting the effects of embalming on both the soft and hard tissues of cadaver specimens subjected to biomechanical impact research. Upon bequeathal, one leg was removed and frozen while the other remained with the cadaver for embalming. The embalmed legs were amputated later and pre-test radiographs were made. For testing, a rod was inserted in the upright leg such that simulated upper body mass could be applied. A 50 kg cart propelled by a pneumatic accelerator to 7.5 m/s struck the anterior leg midway between the knee and ankle. The cart was headed by an instrumented steel pipe (4.75 cm dia.) coupled to a transducer which relayed impact force data to a Hewlett Packard 3562 A signal analyzer. Testing was captured on standard VHS video (30 frames/s) and 16 mm Color High Speed Film (1,000 frames/s). Post-test analyses included radiographs and thorough dissection. Peak forces were comparable for matched pairs. The unembalmed legs showed greater soft tissue damage (muscle and skin) but generally less bone fragmentation than their embalmed counterparts. Neurovascular components were virtually unharmed in most legs.

<8>

Unique Identifier

9613408

Authors


Dujon DG. Khan UD. Aslam S.

Institution

Department of Plastic Surgery, Northern General Hospital, Sheffield, UK.

Title


Bipedicle flaps: simple solutions for difficult problems in the extremities.

Source


British Journal of Plastic Surgery. 50(8):641-5, 1997 Dec.

Abstract


Bipedicle flaps have been used to provide good quality soft tissue cover for defects in many anatomical sites. The indications for the use of this flap have not been well defined and with the advent of more complex modes of tissue transfer this simple technique is often overlooked. We have found it to be a safe and expedient method of providing cover for difficult defects on the extremities. We present a series of 9 flaps raised on 7 patients over a 12-month period and discuss the indications and refinements in flap design.

<9>

Unique Identifier

10786865

Authors


Cromwell F. Walsh J. Gormley J.

Institution

Trinity College School of Physiotherapy, Trinity Centre for the Health Sciences, St James's Hospital, Dublin, Republic of Ireland.

Title


A pilot study examining injuries in elite gaelic footballers.

Source


British Journal of Sports Medicine. 34(2):104-8, 2000 Apr.

Abstract


OBJECTIVES: To quantify injuries in elite gaelic footballers and to determine the nature, sites, and outcome of injuries and the possible risk factors involved. METHODS: Information on injuries was collected from six elite gaelic football teams by a questionnaire. The footballers were asked to recall injuries over the preceding six month period. RESULTS: A total of 88 out of 107 subjects sustained injuries over the study period. Ninety five injuries were recorded, giving an incidence rate of 1.78 injuries per subject per year, of which 35% were recurring. It was found that 35% of injuries were sustained during training sessions. Lower body injuries predominated (77%), the ankle being the most commonly injured anatomic site. Most injuries were soft tissue in nature: muscle, 33%; ligament, 32%; tendon, 16%. The most common situations giving rise to injuries were collision (22%) and twist/turn (19%). Foul play only accounted for about 6% of injuries. Mean time off play as a result of injury was 17.3 days, and hospital admission was necessary for 15% of the injuries. CONCLUSION: Despite the limitations of a retrospective of this nature, the study provides useful and important information on injuries in gaelic footballers.

<10>

Unique Identifier

7670974

Authors


Ogilvie-Harris DJ. Gilbart M.

Institution

Department of Orthopaedic Surgery, University of Toronto, Ontario, Canada.

Title


Treatment modalities for soft tissue injuries of the ankle: a critical review.

Source


Clinical Journal of Sport Medicine. 5(3):175-86, 1995 Jul.

Abstract


We reviewed the English language medical literature on soft tissue injuries of the ankle published between 1966 and 1993. There were 150 articles reviewed of which 84 dealt substantially with ankle soft tissue injuries. The papers were analyzed for quality and it was found that there were significant weaknesses throughout the literature. This related particularly to randomization, blinded assessment, and outcome measures. The results of the treatment of 32,025 patients were reported in 84 studies. We were unable to gather sufficient data from these studies to perform a statistical analysis of the different forms of treatment. Our conclusions were that nonsteroidal antiinflammatory drugs shortened the time period to recovery and were associated with less pain. Active mobilization appeared to be the treatment of choice. Studies also showed that cryotherapy was of benefit and diapulse may be helpful. There was insufficient evidence to conclude that enzyme treatment, topical gels, ultrasound or diathermy, joint aspiration of injection were of benefit. Overall the literature would substantiate active mobilization following ankle sprains with judicious early use of nonsteroidal antiinflammatory drugs and the use of cryotherapy and diapulse in the treatment of ankle injuries. Our study suggests further investigations need to be carried out into the effectiveness and outcomes following alternative forms of therapy for ankle injuries.

<11>

Unique Identifier

10853156

Authors


Watson JT. Moed BR. Karges DE. Cramer KE.

Institution

Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, MI, USA.

Title


Pilon fractures. Treatment protocol based on severity of soft tissue injury.

Source


Clinical Orthopaedics & Related Research. (375):78-90, 2000 Jun.

Abstract


One hundred seven pilon fractures in 107 patients were treated according to a staged prospective protocol. All pilon fractures were stabilized immediately by the application of calcaneal traction. Open fractures or fractures in patients with multiple injuries were stabilized with traveling traction that was applied in the operating room. A distraction computed tomography scan was obtained before definitive treatment. Treatment groups were based on the degree of soft tissue compromise. Forty-one patients with Tscherne Grade 0 or Grade I injuries underwent open reduction and internal fixation (open plating) using contemporary techniques and low-profile implants. Sixty-four patients with Tscherne Grade II and Grade III closed injuries and all patients with open fractures underwent definitive treatment with limited open reduction and stabilization using small wire circular external fixators. Clinical and radiographic evaluations were performed at an average 4.9 years after injury. For all fracture types (AO classification), 81% of the patients who were treated with external fixation and 75% of the patients who were treated with open plating had good or excellent results. For severe fracture patterns (Type C), patients in both groups had significantly poorer results than patients with Types A and B fractures. The patients in the open plating group had a significantly higher rate of nonunion, malunion, and severe wound complications compared with the patients who received external fixation for Type C fracture patterns. Because of the increased incidence of bony and soft tissue complications when treating open or closed Type C fractures, use of limited exposures and stabilization with small wire circular external fixators is recommended.

<12>

Unique Identifier

8769456

Authors


Gaudinez RF. Mallik AR. Szporn M.

Institution

Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, New Haven, CT, USA.

Title


Hybrid external fixation in tibial plafond fractures.

Source


Clinical Orthopaedics & Related Research. (329):223-32, 1996 Aug.

Abstract


Fourteen patients with Ruedi/Allgower types II and III distal tibia fractures received indirect reduction followed by application of a Monticelli-Spinelli hybrid external fixation system. All 14 patients were available for followup. A stability similar to that of an open reduction and internal Fixation was noted. The mean time to union was 13 weeks. There were no nonunions. One patient experienced malunion in 7 degrees varus. Superficial pin tract infections occurred in 8 pins (3 patients), and all resolved with aggressive pin care and a short course of orally administered antibiotics. Through postoperative tomography, 1 pin was found to be within the ankle joint and was removed. There were no deep infections. The subjective and objective results were classified according to Ovadia and Beals. On the basis of these early results, by limiting additional trauma to the soft and bony tissues and allowing early ankle range of motion, indirect reduction and application of a hybrid external fixator is useful, particularly if the fracture fragments are so comminuted that anatomic reduction cannot be expected despite surgical intervention.

<13>

Unique Identifier

12123146

Authors


Kerr R.

Institution

Department of Radiology, Orthopaedic Hospital, 2400 South Flower Street, Los Angeles, CA 90007, USA. Rkerr@laoh.ucla.edu

Title


MRI of soft tissue disorders of the ankle. [Review] [32 refs]

Source


Clinics in Podiatric Medicine & Surgery. 19(2):285-307, 2002 Apr.

Abstract


In summary, MRI has become the dominant imaging modality for assessing soft tissue disorders of the ankle. It is useful in evaluating patients with acute or chronic ankle pain or instability, and for diagnosis and staging of soft tissue mass lesions. MRI often provides information that is essential to treatment planning of a variety of traumatic, degenerative, and neoplastic lesions. [References: 32]

<14>

Unique Identifier

7954216

Authors


Lamy C. Stienstra JJ.

Institution

Evergreen Foot and Ankle Clinic, Vancouver, Washington.

Title


Complications in ankle arthroscopy. [Review] [29 refs]

Source


Clinics in Podiatric Medicine & Surgery. 11(3):523-39, 1994 Jul.

Abstract


The advantages of arthroscopy are limited soft tissue injury and a microsurgical approach to manipulation of tissue. The benefits of this approach can be enjoyed by the patient and physician as earlier return to function and activity. Surgical ankle arthroscopy, like any other invasive ankle procedure, has complications. When it is compared to ankle arthrotomy, diminished morbidity and earlier return to function are usually realized for almost all procedures. Complications range from relatively inconsequential surface injury to substantial and morbid injury to fatal events. As with any surgery, the complications possible from arthroscopy must be weighted against the advantages of performing these procedures. Avoiding preventable complications is important to the success of ankle arthroscopy. The use of appropriate technique and the arthroscopist's experience can play a significant role in reducing the incidence of complications. Experience has been shown to reduce the frequency of complications. Appropriate technique appears to be particularly important in portal development and instrument manipulation. The portal creation maneuver is the source of many encountered complications. The learning curve for arthroscopic technique is steep. An inexperienced arthroscopist should expect complications. With appropriate indications and skills, the benefits of ankle arthroscopy are great. As with all invasive procedures, risks can never be eliminated. Maximizing and enhancing technique and controlling risk factors allow ankle arthroscopy the greatest potential for success with the least potential for complications. [References: 29]
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