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Orthopaedics & Traumatology, Surgery &... Dec 2015Obesity is a major public health issue, as incidence is rising in all developed countries, although the proportion is lower in Europe than in the U.S. Over and above the... (Review)
Review
UNLABELLED
Obesity is a major public health issue, as incidence is rising in all developed countries, although the proportion is lower in Europe than in the U.S. Over and above the metabolic consequences and increased risk of diabetes, cardiovascular pathology and certain forms of cancer, the present study focuses on osteoarticular risk, and in particular on pathologies manageable by arthroscopy. It also analyzes results and complications specific to arthroscopy in these indications. Meniscal and ligamentous pathologies of the knee, rotator-cuff pathology in the shoulder and tendon pathology in the elbow were not significantly elevated, although a trend emerged. In contrast, there was significant elevation of Achilles and plantar aponeurosis pathology. In terms of postoperative complications, thromboembolic risk was elevated, but there were not significantly more complications specific to arthroscopy. Finally, subjective results were comparable to those for non-obese patients.
LEVEL OF EVIDENCE
Review.
Topics: Achilles Tendon; Arthroscopy; Elbow Joint; Humans; Menisci, Tibial; Obesity; Rotator Cuff; Rotator Cuff Injuries; Tendinopathy; Tibial Meniscus Injuries
PubMed: 26552647
DOI: 10.1016/j.otsr.2015.09.001 -
Knee Surgery, Sports Traumatology,... Dec 2017Adductor longus injuries are complex. The conflict between views in the recent literature and various nineteenth-century anatomy books regarding symphyseal and...
PURPOSE
Adductor longus injuries are complex. The conflict between views in the recent literature and various nineteenth-century anatomy books regarding symphyseal and perisymphyseal anatomy can lead to difficulties in MRI interpretation and treatment decisions. The aim of the study is to systematically investigate the pyramidalis muscle and its anatomical connections with adductor longus and rectus abdominis, to elucidate injury patterns occurring with adductor avulsions.
METHODS
A layered dissection of the soft tissues of the anterior symphyseal area was performed on seven fresh-frozen male cadavers. The dimensions of the pyramidalis muscle were measured and anatomical connections with adductor longus, rectus abdominis and aponeuroses examined.
RESULTS
The pyramidalis is the only abdominal muscle anterior to the pubic bone and was found bilaterally in all specimens. It arises from the pubic crest and anterior pubic ligament and attaches to the linea alba on the medial border. The proximal adductor longus attaches to the pubic crest and anterior pubic ligament. The anterior pubic ligament is also a fascial anchor point connecting the lower anterior abdominal aponeurosis and fascia lata. The rectus abdominis, however, is not attached to the adductor longus; its lateral tendon attaches to the cranial border of the pubis; and its slender internal tendon attaches inferiorly to the symphysis with fascia lata and gracilis.
CONCLUSION
The study demonstrates a strong direct connection between the pyramidalis muscle and adductor longus tendon via the anterior pubic ligament, and it introduces the new anatomical concept of the pyramidalis-anterior pubic ligament-adductor longus complex (PLAC). Knowledge of these anatomical relationships should be employed to aid in image interpretation and treatment planning with proximal adductor avulsions. In particular, MRI imaging should be employed for all proximal adductor longus avulsions to assess the integrity of the PLAC.
Topics: Aged; Cadaver; Groin; Humans; Ligaments, Articular; Male; Middle Aged; Pubic Symphysis; Rectus Abdominis
PubMed: 28866812
DOI: 10.1007/s00167-017-4688-2 -
International Journal of Environmental... Nov 2021The hamstring muscles are described as forming part of myofascial chains or meridians, and the superficial back line (SBL) is one such chain. Good hamstring flexibility... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The hamstring muscles are described as forming part of myofascial chains or meridians, and the superficial back line (SBL) is one such chain. Good hamstring flexibility is fundamental to sporting performance and is associated with prevention of injuries of these muscles. The aim of this study was to measure the effect of self-myofascial release (SMR) on hamstring flexibility and determine which segment of the SBL resulted in the greatest increase in flexibility.
METHODS
94 volunteers were randomly assigned to a control group or to one of the five intervention groups. In the intervention groups, SMR was applied to one of the five segments of the SBL (plantar fascia, posterior part of the sural fascia, posterior part of the crural fascia, lumbar fascia or epicranial aponeurosis) for 10 min. The analyzed variables were hamstring flexibility at 30 s, 2, 5, and 10 min, and dorsiflexion range of motion before and after the intervention.
RESULTS
Hamstring flexibility and ankle dorsiflexion improved when SMR was performed on any of the SBL segments. The segments with the greatest effect were the posterior part of the sural fascia when the intervention was brief (30 s to 2 min) or the posterior part of the crural fascia when the intervention was longer (5 or 10 min). In general, 50% of the flexibility gain was obtained during the first 2 min of SMR.
CONCLUSIONS
The SBL may be considered a functional structure, and SMR to any of the segments can improve hamstring flexibility and ankle dorsiflexion.
Topics: Hamstring Muscles; Humans; Massage; Muscle, Skeletal; Myofascial Release Therapy; Range of Motion, Articular
PubMed: 34886078
DOI: 10.3390/ijerph182312356 -
Orthopaedics & Traumatology, Surgery &... Feb 2022Calcaneal osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot deformity. It has static, architectural and dynamic effects,... (Review)
Review
Calcaneal osteotomy is an extra-articular procedure used for conservative surgical treatment of hindfoot deformity. It has static, architectural and dynamic effects, reorienting the tuberosity action point of the digastric muscle formation of the sural triceps and plantar aponeurosis. Calcaneal osteotomies vary in location, form and displacement, but can be categorized as tuberosity osteotomy, acting on talar position, and cervical osteotomy, acting on Chopart joint-line orientation. We here describe the 3 main calcaneal osteotomies we use for hindfoot deformity: talar varus/valgus, valgus flatfoot, and midfoot abductus/adductus. In each case, we describe our technique, resulting from our responses to the difficulties we have had to deal with: medializing osteotomy: performed percutaneously to limit skin complications, and easily associated to cervical calcaneal osteotomy to manage valgus flatfoot; Hintermann cervical adduction osteotomy: providing excellent angular correction, while conserving a medial cortical hinge; lateralizingosteotomy: performed on a medial approach, to enhance translation capacity and prevent the acute tarsal tunnel syndrome with which we have been otherwise confronted. Correcting foot deformities involves complex, multi-dimensional, multi-tissue surgery that is risky as it concerns a segment with terminal vascularization. The present three techniques need to be mastered, as they are usually associated to other tendon and/or ligament reconstruction procedures, and tourniquet time is limited. LEVEL OF EVIDENCE: V; expert opinion.
Topics: Calcaneus; Flatfoot; Foot; Humans; Osteotomy; Plastic Surgery Procedures; Tendons
PubMed: 34687951
DOI: 10.1016/j.otsr.2021.103121 -
Journal of Applied Physiology... May 2019This review, the first in a series of minireviews on the passive mechanical properties of skeletal muscles, seeks to summarize what is known about the muscle... (Review)
Review
This review, the first in a series of minireviews on the passive mechanical properties of skeletal muscles, seeks to summarize what is known about the muscle deformations that allow relaxed muscles to lengthen and shorten. Most obviously, when a muscle lengthens, muscle fascicles elongate, but this is not the only mechanism by which muscles change their length. In pennate muscles, elongation of muscle fascicles is accompanied by changes in pennation and changes in fascicle curvature, both of which may contribute to changes in muscle length. The contributions of these mechanisms to change in muscle length are usually small under passive conditions. In very pennate muscles with long aponeuroses, fascicle shear could contribute substantially to changes in muscle length. Tendons experience moderate axial strains even under passive loads, and, because tendons are often much longer than muscle fibers, even moderate tendon strains may contribute substantially to changes in muscle length. Data obtained with new imaging techniques suggest that muscle fascicle and aponeurosis strains are highly nonuniform, but this is yet to be confirmed. The development, validation, and interpretation of continuum muscle models informed by rigorous measurements of muscle architecture and material properties should provide further insights into the mechanisms that allow relaxed muscles to lengthen and shorten.
Topics: Aponeurosis; Humans; Muscle Contraction; Muscle, Skeletal; Tendons
PubMed: 30571291
DOI: 10.1152/japplphysiol.00673.2018 -
Indian Journal of Plastic Surgery :... Dec 2023Bulldog scalp syndrome or cutis verticis gyrata (CVG) is a rare cutaneous disorder with an incidence of just 0.026 to 1 per 100,000 population and cosmetic problems...
Bulldog scalp syndrome or cutis verticis gyrata (CVG) is a rare cutaneous disorder with an incidence of just 0.026 to 1 per 100,000 population and cosmetic problems should not be ignored as they can affect the quality of life of patients in social and psychological aspects. In CVG the scalp thickens to form folds resembling sulci and gyri just as the skin fold of bulldog. It is a clinical diagnosis with various etiologies. It is classified as primary essential or nonessential and secondary CVG. It can manifest with symptoms ranging from mild to severe intensity. Cosmetic problems are the major concern that can affect patients' social and psychological health. If the folds are heavy, they can cause mass symptoms. Thus, surgery remains the definitive treatment option for improving the cosmetic appearance. Both our cases have different etiologies, however, were managed surgically with removal of skin folds (gyrae) and scoring of aponeuroses of the scalp followed by stretching of the scalp and closure to improve appearance. The surgical team as well as patients were satisfied with the appearance of the scalp after healing. CVG though a rare disease with various etiologies is a benign condition with good prognosis with no reports of malignant transformation so far.
PubMed: 38105879
DOI: 10.1055/s-0043-1776897