PubMed · 8732621
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O Dearlove, A Sharples. 1996. Cannulation in an odd place.. https://doi.org/10.1111/j.1460-9592.1996.tb00440.x
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In a previous paper it was shown that muscle nociceptive discharge depressed the activity of interneurones mediating group I non-reciprocal inhibition (or Ib interneurones) in humans [A. Rossi, B. Decchi, Changes in Ib heteronymous inhibition to soleus motoneurons during cutaneous and muscle nociceptive stimulation in humans, Brain Res. 774 (1997) 55-61.]. However, since nociceptive discharge depressed the size of the soleus H-reflex (by which Ib inhibition was tested) the question arises as to whether modification of motoneurone membrane conductance per se could depress the size of Ib inhibitory post-synaptic potentials. The results of the present study suggest that the contribution of motoneurone hyperpolarization to Ib disinhibition is negligible and that muscle nociceptive discharge actually depresses the activity of these pathways.
Diseases of the hindfoot are associated with considerable functional impairment and therefore may hamper patients' movements during gait considerably. Because of biomechanical overload, articular structures, tendons and ligaments are prone to early degenerative changes during the course of rheumatic diseases as visible with plain film radiography, sonography (US), or magnetic resonance imaging (MRI). Findings may occur as arthritis of major joints or in the form of fibroostitis and bursitis of the os calcis. Despite the progressive course of rheumatic diseases and characteristic imaging findings, high variability of X-ray signs may occur. Plain film radiograms and high-resolution ultrasonography play a key role in imaging rheumatic diseases of the hindfoot. MRI supports imaging diagnosis in selected cases. The principal goals of diagnostic imaging are precise and reproducible documentation of morphologic abnormalities and differentiated analysis for planning proper conservative or surgical treatment.
This study describes how an optimal single hinge axis position can be established for the application of articulated external fixation to the ankle joint. By deliberately introducing various amounts of relative mal-alignment between the optimal talocrural joint axis and the actual fixator hinge axis, it was possible to measure the corresponding amounts of additional resistance to joint motion. In a cadaveric study of six ankle specimens, we determined the instant axis of rotation of the talocrural joint from 3-D kinematic data. acquired by an electromagnetic motion tracking system. For each specimen, an optimal fixator hinge position was calculated from these motion data. Compared to the intact natural joint, aligning the fixator along the optimized axis position caused a moderate increase in energy (0.14 J) needed to rotate the ankle through a prescribed plantar/dorsiflexion range. However, malpositioning the hinge by 10 mm caused more than five times that amount of increase in motion resistance. While articulated external fixation with limited internal fixation can establish a favorable environment for the repair of severe injuries such as tibial pilon fractures, the large additional resistance to motion accompanying a malpositioned fixator axis suggests the development of untoward intra-articular forces that could act to disturb fragment alignment.