Plate Injury Research Articles

Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain

ObjectiveLumbar degenerative spinal ailments are the most important causes for chronic low back pain. Modic changes (MC) are vertebral bone marrow signal intensity changes seen on MRI, commonly in association with degenerative disc disease (DDD). Despite being widely studied, majority of issues concerning MC are still controversial. The current narrative, evidence-based review comprehensively discusses the various aspects related to MC. Literature searchAn elaborate search was made using keywords “Modic changes”, “lumbar Modic changes”, “Modic changes in lumbar spine”, and “vertebral Endplate Spinal Changes”, on pubmed and google (scholar.google.com) databases on the 3rd of March 2020. We identified crucial questions regarding Modic changes and included relevant articles pertaining to these topics for this narrative review. ResultsThe initial search using the keywords “Modic changes”, “lumbar Modic changes”, “Modic changes in lumbar spine”, and “vertebral Endplate Spinal Changes” on pubmed yielded a total of 568, 412, 394 and 216 articles on “pubmed” database, respectively. A similar search using the aforementioned keywords yielded a total of 3650, 3548, 3726 and 21570 articles on “google scholar” database. The initial screening involved exclusion of duplicate articles, articles unrelated to MC, animal or other non-clinical studies, and articles in non-English literature based on abstracts or the titles of articles. This initial screening resulted in the identification of 405 articles. Full manuscripts were obtained for all these selected articles and thoroughly scrutinised at the second stage of article selection. All articles not concerning Modic changes, not pertaining to concerned questions, articles concerning other degenerative phenomena, articles discussing cervical or thoracic MC, case reports or animal studies, articles in non-English language and duplicate articles were excluded. Review articles, randomised controlled trials and level 1 studies were given preference. Overall, 69 articles were included in this review. ConclusionModic change (MC) is a dynamic phenomenon and its true etiology is still not definitely known. Disc/end plate injury, occult discitis and autoimmune reactions seem to trigger an inflammatory cascade, which leads to their development. Male sex, older age, diabetes mellitus, genetic factors, smoking, obesity, spinal deformities, higher occupational loads and DDD are known risk factors. There is no conclusive evidence on the causative role of MC in chronic low back pain (LBP) or any influence on the long term outcome in patients with LBP or lumbar disc herniations (LDH). Patients with MC have been reported to have less satisfactory outcome following conservative treatment or discectomy, although the evidence is still unclear.

Top-Ten Tips for Imaging Groin Injury in Athletes.

Athletic groin injury remains a challenging prospect for sports clinicians and radiologists because of the closely related anatomical structures and overlapping clinical presentations. Recent consensus work designated four causative clinical entities, with the adductor/rectus aponeurosis and pubic symphysis capsule emphasized as key areas. This article highlights these key aspects of athletic groin injury with tips on anatomy, potential abnormalities, acronyms, and imaging appearances in this complex but common and potentially incapacitating entity. Many clinical and radiologic terms are in use such as cleft, enthesitis, plate injury, or defect that can cause confusion, and thus anatomical descriptions are preferable.Detailed clinical assessment is necessary but remains challenging because of the nonspecific presentations. Imaging, and in particular magnetic resonance imaging, plays an essential role in the evaluation process. But only when the two are used in combination can an accurate diagnosis be reached because several studies in asymptomatic athletes show that reactive changes are common.

Treatment with peter-williams intramedullary nail on children with humerus deformity due to osteogenesis imperfecta

Objective To evaluate the therapeutic effect with peter-williams intramedullary nail on children with humerus deformity due to osteogenesis imperfecta. Methods Data of 9 patients with humerus deformity due to osteogenesis imperfecta were retrospectively analyzed from Jun. 2009 to Dec.2012.There were 7 males and 2 females, aged from 6 years to 10 years and 7 months(average 8 years and 3 months). There were 7 unilateral humerus deformity and 2 bilateral humerus deformity with severe radius and ulna deformity.The humerus fracture frequency was from 4 to 13 times(average, 7.9 times)There were 2-3 deformity points in 9 patients(average 2.09 deformity points). The deformity angle ranged from 20°-100°(average 57.3°). The Constant-Murley scores were 16-24 scores(average 20.44). According to revised Sillence classifications, there were 6 cases of Type Ⅲ and 3 cases of Type Ⅳ.Eleven humerus of 9 patients were osteotomied and fixed with peter-williams intramedullary nail. Results All of 9 children were followed up for 12-66 months(average 22 months). The bone healing time were 8-12 weeks(average 9.5 weeks). Parents of 9 children were satisfied with surgical operation effect and deformity correction.The Constant-Murley scores ranged from preoperative average of (20.44±2.79) points(16-24 points) to postoperative average of (35.56±2.60) points(30-38 points) at the latest follow-up of patients, there was a statistically significant in score before and after treatment(t=0.20, P<0.05). Number 4 patient, one patient was found suffering from dorsal thumb numbness postoperatively after 3 days back stretching limitation.Considering the radial nerve stretching injury, treatment with neurotrophic drug for 3 months, symptoms disappeared.There was no infection, or osteomyelitis, no vascular damages.Epiphyseal plate injury or premature closure and affecting growth were not found in all of the patients at the latest follow-up examination. Conclusions Treatment with osteotomy and peter-williams intramedullary nail fixation on children with humerus deformity due to osteogenesis imperfecta is advantaged.It gets less damages, no intruding shoulder joint, less bleeding.The greatest degree of correction of the deformity can be achieved, and the shoulder joint function and the quality of life can be improved. Key words: Osteogenesis imperfecta; Peter-williams intramedullary nail; Humerus deformity

Turf Toe: Soft Tissue and Osteocartilaginous Injury to the First Metatarsophalangeal Joint

The use of artificial turf in the United States has created a dramatic increase in first metatarsophalangeal joint dorsiflexion injuries. Turf toe has been reported to occur in athletes who participate in sporting activities. An injury to the plantar capsular ligamentous complex can result in acute and chronic pain, resulting in time lost from sports participation for a short- or long-term period. Classification of this injury is based on clinical findings and imaging studies, including plain radiographs and magnetic resonance imaging. The early recognition of this injury is crucial to successful treatment. Nonoperative treatment may often suffice for incomplete injuries; however, surgery may be warranted for a complete plantar plate disruption or injury to one or both sesamoids. In the high-performance or elite athlete, a turf toe or severe dorsiflexion injury can be disabling, and can threaten an athlete's career if not treated properly.

Volar plate and collateral ligament injuries of the proximal interphalangeal joint

Volar plate and collateral ligament injuries of the proximal interphalangeal joint

FRACTURES AND DISLOCATIONS. CLOSED MANAGEMENT. VOLS. 1 AND 2. John F. Connolly. Philadelphia, W. B. Saunders, 1995. $138.00, 1588 pp.

This two-volume single-author work was written by an internationally known expert in the closed management of fractures. In his introduction, Connolly appropriately acknowledges Sarmiento's major contributions to the field as well as Clawson's influence on his career. The book is divided into a large section on “Principles,” followed by a chapter entitled “Pediatric/Epiphyseal Plate Injury” and then by chapters on regional anatomy. The format is attractive, with a two-column design. An outline format is used on one side, and line drawings are presented in the opposite column. …