Leg Injuries Research Articles

Leg Injury

Leg Injury

Leg Injury – Soccer

Leg Injury – Soccer

Leg Injury - Basketball Player

Leg Injury - Basketball Player

History Of Leg Injury Is Not Related To Indices Of Ankle Health In Female Gymnasts

History Of Leg Injury Is Not Related To Indices Of Ankle Health In Female Gymnasts

Achilles Tendon Softness and Thickness in Patients With Hypercholesterolemia.

BackgroundHypercholesterolemia is a condition where blood levels of cholesterol are high. It is of two types: The first type is familial hypercholesterolemia, which is hereditary, and the second one is due to diseases like diabetes, thyroid, etc. Achilles tendon xanthomas are noted in both types of hypercholesterolemia, which can be used as an indicator that predicts early cardiovascular disease. The aim of the study is to estimate the Achilles tendon thickness (ATT) and softness among hypercholesterolemia patients and to find the correlation between ATT and total cholesterol.MethodologyA hospital-based cross-sectional, analytical study was done in a tertiary care hospital, Salem, for eight months. Patients of age over 18 years of both sexes who came for screening of total cholesterol in the outpatient department were included in the study. Those patients with a history of previous leg injury involving the Achilles tendon were excluded from the study. A pre-structured questionnaire was used to collect the data, and analysis was done using Statistical Package for the Social Sciences (SPSS) v20 (IBM Corp., Armonk, NY). The analysts performed the Pearson correlation test to determine the correlation between two continuous variables. A p-value of less than 0.05 was used to indicate statistical significance.ResultsIn this study, there are 40 participants in the normal group and about 60 participants in the secondary hypercholesterolemia group. The mean ATT value among males and females was 9.3 and 6.1 mm, respectively. A positive correlation was noted between the ATT and total cholesterol value (p-value = 0.0001).ConclusionThe thickness and softness of the Achilles tendon are positively correlated with the serum total cholesterol level. Males are the group where this correlation is most significant. As a result, men have a higher risk of developing Achilles tendon thickening than women. The thickness of the Achilles tendon can therefore be one of the early signs of high cholesterol levels. The clinician can utilize this indicator to evaluate early abnormal cardiac illness.

THE ROOSTER IN THE SALTIV CULTURE

ІIn 2016, the Slobozhanska Early Medieval Archaeological Expedition has excavated the complex 16 — a pit-cellar, quite typical for sites of the forest-steppe variant of the Saltiv culture in the Siverskyi Dinets basin. The small material is also quite typical for the Saltiv population. The pottery is represented by two fragments of pithos and a fragment of an amphora handle with a neck. The kitchenware from the assemblage was a hand-made: touched up on a potter’s wheel and shaped by hand. The handle and walls of the jars of good quality were also found.
 The compact find of five bones of roosters tarsometatarsus from the filling of the assemblage attracts attention. This paper attempts to analyze this unique find. The role and significance of the bird in the Saltiv culture is also analyzed.
 The birds were of normal size, the length of the bones differs from the roosters from earlier sites as well as from some modern outbred roosters by less than 1 cm. Signs that they were fighting roosters (as a result of fights, the birds get leg injuries which remain the marks on the bones) are visible. The small number of finds of chickens in general at the sites of the Saltiv culture does not allow us to claim that they were used in the economy.
 Currently, this is only the second find of tarsometatarsi of roosters at the sites of the Saltiv culture (the first one comes from the so-called ritual assemblage from Mayaki). In the scientific literature, accordingly, there have been no attempts to interpret such cases. Taking into account the historiographic review of the problems of interpretation of roosters in general from archaeological sites, we come to the conclusion that the tarsometatarsus of roosters could be a symbol (amulets) of bravery and militancy, respectively, most likely, of warriors. And the act of burying this symbol (amulets) can be an act of taking away the powers of a warrior.

Injury profiles and epidemiology of single vehicle motorcycle fatalities in Tamil Nadu, India, 2009-2017

This article investigates single-vehicle motorcycle crashes and crash risk where a rider is killed or injured in Tamil Nadu, India. Hospital data linked with police-reported crash data, including demographic information, injury characteristics, and environmental and road characteristics, were analysed for all single-vehicle motorcycle crashes between January 2009 and December 2017. A total of 16,541 single-vehicle motorcycle crashes resulted in injuries (fatal, serious, and minor injury) during the period, among which 7,447 were fatal crashes. The majority of fatal crashes involved male motorcyclists aged between 26 and 64 years (5,287). Those aged 18 and 25 years (1,897) were the next most frequent group of fatally injured motorcyclists. Among the fatal injured motorcyclists, 66.6% were wearing a helmet. When reported, 33.8% of motorcyclists did not have a valid driving licence at the time of the incident. Motorcyclists injured most commonly sustained head injuries (51.3%), followed by multiple injuries (20.1%), leg injuries (3.3%), and hand injuries (3.2%). Logistic regression results suggest that specific road characteristics and environmental factors increase the probability of fatal crashes: urban roads, express highways, multiple lane roads, night time, absence of median divider, cross and T-junctions, junctions with four arms, under-aged (<18 years) riders, not holding a valid licence and non-use of helmets. Appropriate countermeasures to mitigate motorcyclist trauma are recommended.

인간 진화에 따른 다리 근육 및 발 결합조직의 변화 개관

Purpose: The purpose of this study is to review important changes in studies on plantaris, peroneus tertius, and plantar aponeurosis according to human evolution.BR Method: For this overview study, we searched papers published in Pubmed by 2021. The keywords of the search engine were leg muscle, evolution, plantaris, peroneus tertius, plantar aponeurosis, and plantar fascia. Research papers related to primates were excluded from this study. A total of 22 papers, including 8 papers related to the plantaris, 9 papers related to the peroneus tertius, and 5 papers related to the plantar aponeurosis were accepted and analyzed for this overview.BR Results: Plantaris is a vestigial muscle but has recently been shown to be a useful graft for the lateral ankle ligament and hand tendon. Peroneus tertius is a human-specific muscle that serves to parallelize the sole of the foot to the ground for adaptation to bipedal gait and its final evolution seems not to be finished yet. Plantar aponeurosis has been shown to be an adaptation to evolved human bipedal walking while providing a unique windlass mechanism in cooperation with longitudinal arch.BR Conclusion: In conclusion, plantaris, peroneus tertius, and plantar aponeurosis have undergone important changes along with human bipedalism evolution and are closely related to modern leg and foot injuries. Therefore, this aspect should be considered carefully when diagnosing and treating related leg and foot injuries.

Performance of wild animals with "broken" traits: Movement patterns in nature of moose with leg injuries.

Organismal traits are presumed to be well suited for performance in the tasks required for survival, growth, and reproduction. Major injuries to such traits should therefore compromise performance and prevent success in the natural world; yet some injured animals can survive for long periods of time and contribute to future generations. We here examine 3 years of camera trap observations along a remote trail through old‐growth forest in northern British Columbia, Canada. The most common observations were of moose (2966), wolves (476), and brown bears (224). The moose overwhelmingly moved in one direction along the trail in the late fall and early winter and in the other direction in the spring. This movement was clustered/contagious, with days on which many moose traveled often being interspersed with days on which few moose traveled. On the video recordings, we identified 12 injured moose, representing 1.4% of all moose observations. Seven injuries were to the carpus, three were to the antebrachium, and two were to the tarsus—and they are hypothesized to reflect damage to ligaments, tendons, and perhaps bones. The injured moose were limping in all cases, sometimes severely; and yet they did not differ noticeably from uninjured moose in the direction, date, contagiousness, or speed of movement along the trail. We discuss the potential relevance of these findings for the action of natural selection in the evolution of organismal traits important for performance.

Body Composition Asymmetries in University Ice Hockey Players and Their Implications for Lower Back Pain and Leg Injury.

Resta, T, Frenette, S, Rizk, A, and Fortin, M. Body composition asymmetries in university ice hockey players and their implications for lower back pain and leg injury. J Strength Cond Res 36(10): 2830-2836, 2022-Right to left asymmetries in body composition have been examined across many sports, suggesting possible implications for lower back pain (LBP) and decreased level of performance. However, we are not aware of any study that has examined the presence and implications of morphological asymmetries in ice hockey players. The purpose of this study was to (a) investigate body composition asymmetries in female and male university-level ice hockey players and (b) examine whether the degree of body composition asymmetry is associated with the history of LBP and lower-limb injury (LLI). A total of 32 players (female = 18, male = 14) were included in this cross-sectional study (e.g., university research center setting). Dual-energy X-ray absorptiometry (DEXA) was used to acquire body composition measurements. The parameters of interest included bone mass, lean body mass, and fat mass, for the right and left sides and body segments (e.g., arm, leg, trunk, and total), separately. The history of LBP and LLI was obtained using a self-reported demographic questionnaire. The statistical significance for the study was set at p < 0.05. Our findings revealed significant side-to-side asymmetry in arm and total bone mass in females, with higher values on the right side. Both males and females also had significantly greater trunk lean body mass on the left side. With the exception of greater arm bone mass asymmetry being associated with LBP in the past 3 months, there was no other significant association between the degree of asymmetry with LBP and LLI. This study provides novel data regarding the presence of asymmetry in body composition in university-level ice hockey players. Monitoring body composition in athletes provides information that can be used by athletic trainers and strength and conditioning coaches to develop injury prevention, performance optimization, and targeted rehabilitation programs.

Design of a Physical Therapy Device for Lower Leg Recovery

Currently, some physical therapy requires another person to assist in exercises that rehabilitate patients with leg injuries such as sprains and fractures. In this paper, we propose a device that can help strengthen muscles that have weakened due to injury without the help of another person. The device is portable and can be used in a home setting, and the amount of resistance it provides can be adjusted by the patient. We suggest a design that aids patients in lower leg rehabilitation and can adjust for the patient’s preference in exercise type and intensity.

Comparison of pre-high school and high school football quarterback injuries

ABSTRACT Objective To compare the common injuries of pre-high school American football quarterbacks (Pre-HS QBs) and high school American football quarterbacks (HS QBs) within the last 15 years. Methods A retrospective chart review was performed at a sports medicine clinic at a tertiary-level pediatric medical center. Pediatric and adolescent American football quarterback patients who sustained sports-related injuries were extracted. Injury status (acute vs. overuse), injured anatomic locations, injury types, and surgical status were compared by Pre-HS QBs (<14 years old) and HS QBs (14–18 years old). Results A total of 121 injuries were found in 118 male Pre-HS QBs (mean age: 12.4 ± 1.6), while 302 injuries were observed in 256 male HS QBs (mean age: 15.8 ± 1.4). Overall, nearly two-third (2/3) of injuries were acute (64.3%) while a little over one-third (1/3) of injuries were overuse in nature (35.7%), and there were no differences between Pre-HS and HS QBs (58.7% vs. 66.7%, p = 0.114). The top 3 injured anatomic locations for Pre-HS QBs were elbow (20.7%), shoulder (18.2%), and head/neck (14.0%). For HS QBs, the top 3 injured anatomic locations were shoulder (24.5%), knee (17.5%), and head/neck (15.2%). There were significant differences in proportion of elbow (20.7% vs. 10.6%, p = 0.006), hip/trunk/upper leg (10.7% vs. 3.3%, p = 0.002), and knee injuries (9.1% vs. 17.5%, p = 0.028) between Pre-HS and HS QBs. Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (60.3% vs. 46.3%, p = 0.009) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (14.2% vs. 5.8%, p = 0.015). Conclusions QB-associated injuries were distinctively different between Pre-HS and HS QBs. Future studies are warranted to investigate relatively high proportions of elbow injuries as well as bony/cartilaginous/labral injuries found in Pre-HS QBs.

Physical Education Teaching Based on Human Model Design and Computer Simulation of Human Two-Dimensional Moving Image

The traditional gait analysis is mainly used in the research of joint dynamics and electromyography, which is helpful to develop a medical feedback system. The system judges the leg injury by analyzing the patient’s gait, so as to provide effective treatment. In order to study how computer technology can be more appropriately introduced into physical education, this paper puts forward a new design method of manikin. The application of some key implementation technologies of computer simulation of two-dimensional motion images of human body is conducive to the scientization of physical education teaching and training. The experiment analyzes the daily movement of human body. MEMS technology is a technology to obtain human inertial data by simulating human motion with one or more computers. By integrating the collected data, different characteristics can be obtained. Then, classify these feature processing algorithms, and finally, identify the actions performed by the human body. Finally, the advantages of this recognition method in recognition accuracy are verified.

A review of the first wave of lower limb amputees from the Great March of Return in Gaza: Taking stock and preparing for the task ahead

AimBallistic injuries during the Great March of Return (GMR) protests in Gaza have resulted in young, civilian amputees. This article defines this unique population, their injuries and clinical variables that impacted on amputation. MethodA multidisciplinary team (MDT) assessed 103 lower limb amputees (104 stumps). Individualized prescriptions of care were formulated and applied for both stump and prosthesis management.The cohort's health state was assessed at screening by applying the EQ-5D-L5 questionnaire. The EQ-5D-L5 will be repeated on completion of the prescription of care. ResultsThe population is predominantly young, male, suffering unilateral amputation with an equal ratio of above knee (AKA) to below knee (BKA) amputations. 18% were amputated immediately and 82% with delay. Most amputations occur within 15 days of gunshot wound (GSW).All tissue elements were affected by the severe, ballistic injury. Division, gapping and tissue loss consolidated the decision for amputation rather than limb salvage. Knee zone injury was common, influencing the high numbers AKAs.Primary injury ramified beyond the amputated leg: 38% have contralateral leg injuries. 20% had physiological challenges requiring Intensive care unit (ICU) admissions. Infection was reported in 49% of amputees with 12% reporting acute sepsis. Psychologically, 49% reported severe, or extreme, anxiety and depression.AKAs were associated with greater morbidity: amputees are significantly younger, have more proximal vascular injuries, receive delayed amputations and experience longer time intervals to stump healing. ICU care and contralateral leg injuries were more frequent.One third of amputees used their prostheses’, one third did not and one third do not have a prosthesis yet. The limiting factor for repair was supply of materials. 11% of amputees needed no adjustment to stump or prosthesis. Surgical stump revision was recommended in 26% of stumps and prosthetic management in 41%. A further 22%, subject to the success or failure of prescribed prosthetic adjustment, could require stump revision. ConclusionYouth, proximal injury, high numbers of AKA, psychosocial issues and the need for stump and prosthetic support define this group of amputees. Unifying expertise within a National MDT will promote continuity of care necessary for decades to come.The ultimate aim is an evidence-based amputee care system in Gaza, with lower limb specialists promoting best outcomes, judicious allocation of funds and maximising amputee quality of life.

Collisions with another person while skiing and snowboarding: A 13-year national registry analysis

IntroductionInterindividual collisions while skiing or snowboarding occur regularly, they can be associated with severe injuries. ObjectiveTo elucidate causes of accidents, injury patterns and potential risk factors for injury severity in interindividual collisions of skiers and snowboarders. Material and MethodsRetrospective analysis of the Austrian Registry for Mountain Accidents within a 13-year timeframe (2005–2018) with regard to on- or off-piste collisions of skiers and snowboarders. ResultsA total of 30,503 collisions, involving 52,430 (85.9%) skiers and 8,576 (14.1%) snowboarders were analysed. Denominators are lacking, since total numbers of skiers and snowboarders were not available. Compared to skiers, snowboarders were younger (23 vs. 42 years; p<0.001), predominantly male (77.4% vs. 61.0%; p<0.001) and less often severely injured (46.8% vs. 26.2%; p<0.001). Most accidents occurred on slopes (>95%). Collisions involving two snowboarders occurred proportionally more often in terrain parks (4.1% of 1,664 injured snowboarders; p<0.001) and while one victim was standing or sitting (9.7%; p<0.001). Contusions/strains/sprains were most prevalent (>23%), as were head injuries (>12%). In skiers, chest, shoulder, hip, thigh and knee injuries occurred more often, leading to fractures, dislocations, concussions and internal injuries more frequently. In snowboarders, spine/back, elbow, forearm, wrist and lower leg injuries were more prevalent. Female gender and standing or sitting prior to the accident was a risk factor for being more severely injured in collisions involving i) two skiers (OR: 4.02 (3.79–4.26) and 3.91 (3.26–4.68)), ii) a skier and a snowboarder (OR: 4.50 (3.95–5.14) and 11.49 (8.04–16.41)) or iii) two snowboarders (OR: 2.85 (2.12–3.84) and 12.47 (6.17–25.20)). Wearing a helmet increased the risk when two skiers collided (OR: 1.10 (1.03–1.17)). In skier vs. snowboarder collisions, the skier had a higher risk of being injured more severely (OR: 7.93 (6.98–9.01)). ConclusionsIn interindividual collisions of skiers and snowboarders, injury patterns and preceding causes differ substantially. Skiers are more likely to be severely injured. Awareness of an increased risk of injury should be raised particularly while standing or sitting on the slope.

Emergency Traumatology at the N.V. Sklifosovsky Research Institute for Emergency Medicine: History and Modernity

The purpose of this work was to study the history of the development of traumatology-orthopedics at the N.V. Sklifosovsky Research Institute for Emergency Medicine.Traumatology as an independent discipline began to form at the N.V. Sklifosovsky Research Institute for Emergency Medicine during the reign of Professor S.S. Yudin (chief surgeon since 1928), who invited the famous Argentinean traumatologist-orthopedist Professor Lelio Zeno to work at the institute.In 1932, the trauma department of the N.V. Sklifosovsky Research Institute for Emergency Medicine was headed by Professor V.V. Gorinevskaya. She organized a 100-bed trauma clinic for the treatment of injuries to the head, spine, limbs, chest and abdominal cavity. She is rightfully considered one of the founders of trauma science in the USSR.With the development of traumatology and orthopedics as an independent specialty in 1961, two clinics were formed at the institute. The first trauma clinic was run by Dr. med. sciences professor I.I. Sokolov. The second clinic was headed by Dr. med. Sci. P.N. Petrov.In 1971, Dr. med. Professor, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Medical and Technical Sciences of the Russian Federation V.P. Okhotsky was appointed the head of the traumatological service of the institute and the chief traumatologist of Moscow (from 1971 to 2001). With his active participation in Moscow, the reorganization of outpatient care was completed, work was widely launched on the medical aspects of the prevention of road traffic injuries and the introduction into practice of the most rational methods of diagnosis and treatment of patients with injuries of the musculoskeletal system. In the N.V. Sklifosovsky Research Institute for Emergency Medicine A.G. Suvalyan introduced the method of intramedullary osteosynthesis of long tubular bones (humerus, femur and tibia). Under the guidance of prof. V.P. Okhotsky the dissertation researches of A.G. Suvalyan, M.A. Suvalyan and S.S. Myakota were carried out. The expediency of early surgical intervention on the extremities in case of combined traumatic brain injury and multiple trauma of the extremities has also been proven, new functional methods of treatment of diaphyseal fractures of the shoulder, lower leg, spine and intra-articular injuries have been developed.In close scientific cooperation with scientists from other clinics of the institute, a comprehensive method of treating open injuries of the limbs has been developed (dissertation researches of I.F. Byalik, I.Yu. Klyukvin, O.P. Filippov, M.V. Zvezdina, R.S. Titov). Much scientific work has been carried out to improve the diagnosis and treatment of intra-articular injuries of the knee joint (dissertation researches by M.A. Malygina, O.P. Filippov, A.Yu. Vasa).From 2001 to 2016 the head of the department of emergency traumatology of the musculoskeletal system was a student of prof. V.P. Okhotsky – Dr. med. sciences, Professor, Academician of the Academy of Medical and Technical Sciences of the Russian Federation I.Yu. Klyukvin. Since 2016 the department is headed by Dr. med. sciences Alexey M. Fine.The scientific developments of the employees of the Department of Emergency Traumatology have a practical orientation. Every year, the department’s employees successfully perform more than 2500 surgical interventions using advanced low-traumatic techniques, making extensive use of the achievements of biotechnology.

Calf Strain in Athletes.

Calf strain is a common condition. In high-performance athletes, calf strain contributes to a substantial absence from competition. Player age and history of a calf strain or other leg injury are the strongest risk factors for calf strain injury and reinjury. Although the diagnosis is often clinical, magnetic resonance imaging and ultrasound are valuable to confirm the location of the strain and the grade of injury. Nonoperative treatment is effective for most calf strain injuries. Operative management, although rarely indicated, may be appropriate for severe cases with grade-III rupture or complications. Further investigation is necessary to elucidate the benefits of blood flow restriction therapy, deep water running, lower-body positive pressure therapy, platelet-rich plasma, and stem cell therapy for calf strain rehabilitation.

Acute shine compartment syndrome: epidemiology, etiology, pathophysiology, anatomy, diagnostics, treatment, complications and outputs: literature review

Vytautas Matiulevič1 1Vilnius University, Faculty of Medicine, Vilnius, Lithuania, Abstract Background. Compartment syndrome is an acute condition that requires urgent care. Patients with traumatic leg injuries need to be considerately monitored since complications associated with late diagnosis and treatment lead to irreversible consequences. Aim of the study. Summarize the latest studies and provide information on the relevance, clinical signs, diagnostic and treatment features of compartment syndrome. Materials and methods. The review of the literature was conducted using the PubMed, ScienceDirect, and ClinicalKey databases. The literature research was conducted using predetermined keywords: acute compartment syndrome, fasciotomy, diagnosis and treatment of compartment syndrome, acute extremity compartment syndrome. Exclusion criteria were applied to articles related to crush syndrome. More than 20 publications were analyzed. Results. Most of the clinical signs of compartment syndrome are nonspecific. Fasciotomy should be performed after suspicion of compartment syndrome and measuring the differential pressure < 30 mm Hg. Conclusions. The most common cause of calf compartment syndrome is tibial fractures. Patient complaints are nonspecific. Pain, non-manageable with NSAIDs, and muscle tension are usually present. Diagnosis is based on patient complaints, physical examination, and measurement of differential pressure. Fasciotomy is recommended when the differential pressure is < 30 mm Hg. This is the only effective treatment for compartment syndrome. There are 2 calf fasciotomy techniques: single incision and two incisions. The surgeon chooses the technique based on his experience and the condition of the patient as the results are similar. Untreated, patients develop soft tissue necrosis, resulting in muscle weakness, pain, nerve damage, cosmetic defects, and venous insufficiency. Keywords: acute compartment syndrome, fasciotomy, diagnosis, treatment.

EFFECT OF BALANCE TRAINING ON ATHLETES WITH FUNCTIONAL ANKLE INSTABILITY OF ANKLE JOINT

Introduction: The ankle is an amazing structure because it helps transfer vertical to horizontal weight bearing and rarely deteriorates over the course of a life time.This study aims to find out the prevalence of functional ankle instability in athletes and to determine the effect of posturography training on balance in athletes with functional ankle joint instability. Material and Methods: This study was conducted in two phases. In the first phase after obtaining the informed consent, a descriptive study was conducted among 453 students from the Department of Physical Education and were included in the study to determine the prevalence of functional ankle instability (FAI). The study participants were distributed with Modified Ankle Instability Instrument questionnaire with brief explanation about the questionnaire and the prevalence of FAI was studied. Modified ankle instability instrument has high reliability,feasible and has appropriate way to obtain information on the presence of instability symptoms.21It contains 11 yes/no type questions.9 questions focus on ankle injury,last 2 questions focus on knee for exclusion purpose.12 questionnaires were found to be incomplete and the remaining 441 completed questionnaires were taken for data analysis.Among the 441 questionnaires,207 was excluded as they have knee and leg injuries.With the remaining 234, 43 athletes have FAI with the prevalence of 18.4%.From them, 39 athletes entered phase II and were given balance training using a commercially available device, Posturograph-the Biodex Balance Stability System (BSS) (Biodex, Inc., Shirley, New York). Results: The prevalence of FAI was 18.4% in the present study.The most common age group of the present study was 21-25 years(52.2%). Male participants (58.5%) were outnumbered female participants(41.5%). Most of the athletes had normal BMI.Underweight population was 20.4% and overweight was 5.9%. The common events participated by the athletes of the present study were football (25.85%),basketball (14.51%) and volley ball (12.24%).Of the total 441 participants ,207 (46.9%) had associated knee and leg injuries and hence was not taken for analysis.There is no association found between FAI in relation to gender game - wise as demonstrated in the above table.There was significant association observed between FAI and BMI for football and hockey players ( = 6.195, p =0.045).There is significant difference in anterior reach distance,posteromedial and posterolateral reach distance between affected and normal ankle at baseline (p &lt;0.05) Conclusion: The present study results showed that balance training with posturograph effectively improved the functional ankle instability in athletes and also enhances the stability of the normal ankle. In addition, the balance training may increase patients interest and participation rate in treatment more than existing therapy methods.

Evaluation of the plantaris tendon: cadaver anatomy study with ultrasonographic and clinical correlation with tennis leg injury in 759 calves.

The role of the plantaris muscle (PM) in the literature is not clear. The objectives of this study were as follows: (1) to study PM at the interface between the medial gastrocnemius and soleus muscle in a cadaveric series, (2) to compare anatomic results with ultrasound (US) in the general population, and (3) to identify the potential role of the PM in the genesis of tennis leg (TL) injury. First, a cadaveric study was undertaken on six cadavers for descriptive and functional PM anatomy. Second, US evaluation was carried out for 670 calves in 335 subjects with no suspicion of a clinical tear in the thigh or calf muscle (group 1) and for 89 calves in 89 patients with tear symptoms (group 2). Study criteria were the presence or absence of PM tendon and the width measurement if present. The PM was present in all cadavers. Traction on the tendon showed its "limited" mobility due to the connective tissue adherence mentioned with no apparent gliding of PM, promoting TL injury. In US, 37 PM were absent (4.35%) in 23 subjects. PM tendon width measurement of group 1 and group 2 was, respectively, 3.93 + / - 1.10mm and 3.96 + / - 1.10mm. No statistically significant differences between width measurements were found according to side (P = 0.74) or group (P = 0.69). Significant differences in width were only found between genders in group 1 (P = 0.014). PM were absent in 4.35% population. The contraction of PM can promote tennis leg injury by increasing the shear forces at the level of the distal inter-aponeurotic region.