SEARCH · PubMed Health

Results for “LIGAMENTS, ARTICULAR”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources

PubMed1997

Superior detachment of a glenoid labrum variant resembling an incomplete discoid meniscus in a wheelchair ambulator.

Symptoms of instability and painful clunking in the shoulder were found associated with superior detachment of an incomplete discoid glenoid labrum and biceps origin in a 25-year-old woman. The patient was paraplegic below the T4 level secondary to resection of a spinal cord astrocytoma at age of 17. Symptoms began after 3 years of wheelchair use and repetitive transfer injuries. On arthroscopic examination, only the central surface of the articular glenoid cartilage was visible because of labral coverage. The entire labrum was meniscoid without distinguishable variation. The superior labrum was in continuity with the root of the biceps tendon; however, the superior biceps-labral complex was completely stripped away from the underlying glenoid. The anterior, posterior and inferior labrum was firmly attached peripherally about the glenoid. An arthroscopic staple was used to reattach the biceps root and superior labrum to bone. At 6 year follow-up, the functional result was satisfactory.

Adult↗

PubMed1996

[Magnetic resonance imaging of the knee joint after trauma with intra-articular accentuation].

Two male adolescents with direct trauma to the knee and haemarthrosis were followed up with MR imaging (MAI). No fractures were detected on plain films and both patients had extensive bone marrow lesions in MRI. The lesions were located within the metaphysis and the lateral tibial and femoral condyle respectively. In one patient MRI demonstrated additional soft tissue lesions of the femoral muscles. One patient had almost no clinical symptoms, while the other patient suffered from severe pain, inability to walk, and delayed recovery. The present report emphasizes the potential of MRI for the detection of occult injuries of bone and soft tissue, and calls for prospective studies of their clinical significance.

Adolescent↗

PubMed1989

[Fractures of the distal end of the radius].

Attitudes to the treatment of distal radial fracture are now more critical than previously, especially where intraarticular fracture is concerned. Inadequate primary reduction and such complications as redislocation or dystrophic problems lead to poor results. Quantification of fracture instability is becoming increasingly important in fracture classification, determination of the indications for the different treatment modalities and management. Accurate anatomical reduction also improves later function. The quality of alignment attained during the treatment depends on the quality of reduction. Closed reduction by means of traction should be achieved by pulling on fingers I, II and IV. The radial dislocation should be corrected first and then the dorsal dislocation; a cast applied to the lower arm is sufficient for immobilization. Primary surgery is indicated more urgently and the type of surgery in more detail, for example, when there are steps in the articular surface or when there is more than one factor in instability. Pin fixation should be applied sooner and more frequently with either primary or early secondary indications. Plate fixation is mostly achieved from the volar surface; it is indicated in flexion fractures and sometimes in extension fractures, but only in combination with rigid screw fixation with or without bone grafting. We are finding increasingly more indications for external fixation, not only in the case of open fractures with soft tissue damage but also with multiple fragments or comminuted fractures, sometimes in combination with bone grafting.

Bone Nails↗

PubMed1988

Intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints.

When displaced or unstable, intra-articular fractures of the metacarpophalangeal and proximal interphalangeal joints represent difficult management problems. The best results can be achieved only with near-anatomic restoration of the joint surfaces and early active motion exercises. These principles dictate the use of rigid internal fixation by means that are not compromised by the exercise program. Not all of these serious injuries, regardless of how they are treated, will do well. Salvage procedures represent considerable functional compromise. Therefore, the most reliable techniques must be used in the initial treatment of these uncommon injuries.

Bone Screws↗

PubMed1988

Epiphyseal injuries in the small joints of the hand.

The principles followed in treatment of epiphyseal injuries of the hand are essentially the same as those used in treating epiphyseal injuries elsewhere in the child. Special patience is required in treating the patients, and methods of immobilization must be modified appropriately for the active child. A knowledge of the mechanism of injury and potential effects on the growth potential of the digit are important in determining treatment and counseling parents on possible growth disturbance and later deformity. The epiphyses of the proximal phalanges of the fingers and the thumb metacarpal are the most frequently injured. Salter Type I and II fractures frequently demonstrate remarkable remodeling potential, whereas intra-articular Salter III and IV fractures often require surgical repair and may be more frequently associated with later problems of growth and post-traumatic arthritis. The physician should establish a trusting relationship with the child and his or her parents in order to provide comforting reassurance, facilitate treatment and compliance, and promote an understanding of the possible outcomes associated with injuries of the vulnerable growth plate. When these principles are followed appropriately, the long-term follow-up of these children provides for a very satisfying and rewarding experience for the physician and family.

Casts, Surgical↗

PubMed2006

Dynamic assist splinting for attenuated sagittal bands in the rheumatoid hand.

The extensor mechanism of the hand is complex, requiring effective functioning of all involved structures, including the sagittal bands. The sagittal bands function to maintain the extensor tendons in midline and to limit their distal excursion. Injury to the sagittal bands or sagittal band attenuation can cause instability and ulnar displacement/subluxation of the extensor tendons into the valleys between the digits and lead to a subsequent loss of active finger extension at the metacarpophalangeal joints. Secondary conditions may also develop, such as swan-neck deformity, as is frequently observed in the rheumatoid arthritis population. To prevent or reduce an extension lag and secondary changes and to maintain the functional use of the hand, a dynamic metacarpophalangeal extension assist splint is necessary. This splint enables extension at the metacarpophalangeal joints, thus enabling the functional use of the hand. This article reviews the biomechanics of the sagittal bands and the corrections that enable finger extension at the metacarpophalangeal joints, thus preventing secondary conditions.

Arthritis, Rheumatoid↗

PubMed2003

Therapeutic effects of Hominis placenta injection into an acupuncture point on the inflammatory responses in subchondral bone region of adjuvant-induced polyarthritic rat.

Rheumatoid arthritis (RA) is characterized by chronic inflammation of the synovial membrane in the joint, which leads to the progressive destruction of articular cartilage, ligament and bone. Several cytokines such as tumor necrosis factor alpha (TNF-alpha), interleukin 1beta (IL-1beta), and interleukin 6 (IL-6) have been implicated in the pathological mechanisms of synovial tissue proliferation, joint destruction and programmed cell death in rheumatoid joint. In the Korean traditional medicine, Hominis placenta (HP) as an herbal component of herb-acupuncture has been widely used to treat chronic inflammatory diseases such as RA. To study the therapeutic effects of HP injection into the ST36 acupoint (HP herb-acupuncture) on the inflammatory responses of a subchondral region of rheumatoid joint, the polyarthritis-induced Sprague-Dawley (SD) rat was developed as a rheumatoid arthritis model by the intradermal injection of dried cells of Mycobacterium tuberculosis emulsified in squalene to the base of tail. After the onset stage (11 d after adjuvant injection) of polyarthritis, a fixed volume of HP extract was daily injected to Zusanli (ST36) acupoint on the rat's leg for 2 weeks. The body weight, paw volume of the knee joint and articular index were exploited as an assessment method addressing arthritic symptoms, and the expression profiles of TNF-alpha, IL-1beta and IL-6 at the subchondral bone of the joint were analyzed using an immunohistochemistry. After the treatment of arthritic rats with HP, the body weights and paw volumes of arthritic rats were almost restored to the levels of normal rats whereas the evaluation by the articular index was not remarkable. The TNF-alpha, IL-1beta and IL-6 positive cells in the immunohistological sections of subchondral bone region of the joint significantly decreased in HP-treated (ST36 acupoint) arthritic group as compared with those in non-treated or HP-treated (non-acupoint) ones, which was coincident with the behavioral studies. In conclusion, the HP herb-acupuncture was found to be effective to alleviate the arthritic symptoms in adjuvant-induced arthritis rats as regards the body weight, joint appearance and the expression profiles of inflammatory cytokines.

Acupuncture Points↗

PubMed1994

Treatment of complex intra-articular distal radius fractures.

Techniques for reduction and fixation of intra-articular distal radius fractures have improved in recent years such that fractures that were once thought doomed to a poor result may now be successfully treated operatively. This article explores open, semi-open, and arthroscopically assisted techniques for reduction and fixation of complex distal radius fractures. The reader should gain an appreciation of which fractures can benefit from operative treatment and which techniques may be most useful for specific fracture types. A number of fixation techniques are described, and familiarity with diverse methods will aid the surgeon in complex cases.

Arthroplasty↗

PubMed1995

Sonographic evaluation of lipohemarthrosis: clinical and in vitro study.

The purpose of this study is to evaluate the role of sonography in diagnosing lipohemarthrosis. Sonography was performed on seven patients with intra-articular fractures of the knee, shoulder, and hip. An in vitro mixture of fat and blood was examined as the gold standard. In the patients scanned a few minutes after immobilization, a two-band appearance of joint effusion was present, representing a fat-blood level. One patient scanned 3 hours after immobilization showed a three-band appearance of joint effusion, corresponding to the layers of fat, serum and red blood cells. Results of this study indicate a high reliability of ultrasonography in detecting lipohemarthrosis.

Adipose Tissue↗

PubMed2006

Arthroscopic surgery for degenerative rupture of the ligamentum teres femoris.

We performed arthroscopic debridement for degenerative rupture of the ligamentum teres femoris in a patient and obtained good results. A 78-year-old woman suddenly developed intense load-bearing pain from the left lumbar to gluteal region, and giving way, without a definitive cause. At presentation, the range of motion of the left hip joint for external rotation was 0 degrees, showing restricted motion. When passive internal rotation was applied at 90 degrees of flexion, intense pain in the left gluteal region was induced. At the initial radiographic examination, there were no abnormal findings in the left hip joint. However, arthroscopic findings showed degeneration in the articular cartilage and labrum but no tear. In addition, degenerative rupture of the ligamentum teres femoris was observed and it was entrapped in the posterior joint space. Using a bipolar radiofrequency scalpel, the entrapped stump of the ligamentum teres was vaporized and excised. The restriction in external rotation of the hip joint observable even under anesthesia was resolved immediately after surgery. Two years after surgery, the patient had regained her preoperative walking ability with the aid of a T cane, and radiographic examination showed no coxarthrosis changes. This case indicates that coxalgia caused by degenerative rupture of the ligamentum teres femoris is also a good indication for arthroscopic debridement.

Aged↗

PubMed1991

[Adult non-insulin-dependent diabetic: limitation of articular mobility and soft tissue involvement].

Periarticular involvement and joint mobility were investigated in 100 non insulin dependent diabetic patients, compared to 100 healthy control subjects of similar age and sex. Periarticular involvement was much more common in diabetics (p < 0.01) including limitation of joint mobility (hands) (40% vs 9%), Dupuytren (29% vs 2%), palmar synovitis (59% vs 7%) and capsulitis (16% vs 1%). Diabetic patients with limitation of joint mobility had more neuropathy (80% vs 56%), retinitis proliferans (35% vs 17%) and alterations of the skin of the hands, compared to diabetics without limitation of joint mobility. Diabetes should be investigated in subjects with periarticular manifestations such as those described in this paper. Also, a more advanced stage of diabetes may be suspected in diabetics with such manifestations.

Adult↗

PubMedDate not supplied

Postosteonecrotic osteoarthritis-like disorder of the femoral head of rats.

The femoral heads of 15 rats were studied histologically 3 months after the induction of ischaemic necrosis by incising the cervical periosteum and cutting the ligamentum teres. The epiphyses consisted of immature disorganized subchondral and trabecular bone. The inter-trabecular spaces contained fibrous or haematopoietic tissue. Residual necrotic bone was rare. There was marked osteoblastic and osteoclastic activity. The articular aspect of the heads showed a spectrum of changes, ranging from cartilaginous degeneration with fibrillation and loss of glycosaminoglycans to an eburnated and polished bony surface. In seven rats, transphyseal bridges connected the epiphyseal and metaphyseal bony trabeculae to each other. It is suggested that the postnecrotic reparative processes, including the resorption of the necrotic debris and its replacement by newly formed, weak bone, led to an osteoarthritis-like disorder. This healing pattern of the necrotic femoral head was reminiscent of the progressive remodelling that occurs in rings in femoral capital osteonecrosis of adult human patients and in Perthes's disease of children.

Animals↗

PubMed2006

Enthesitis.

Enthesitis is a distinctive pathological feature of spondyloarthritis and may involve synovial joints, cartilaginous joints, syndesmoses and extra-articular entheses. This review focuses on peripheral extra-articular enthesitis, which is a clinical hallmark of spondyloarthritis. The entheses of the lower limbs are more frequently involved than those of the upper limbs, and heel enthesitis is the most frequent. Entheseal pain may be mild or moderate as well as severe and disabling. Peripheral enthesitis may be observed in all forms of spondyloarthritis, including the undifferentiated forms, and may, for a prolonged period, be the only longstanding clinical manifestation of the B27-associated disease process. The conceptual understanding of spondyloarthritis and the ability to image sites of skeletal inflammation accurately, i.e. ultrasound and magnetic resonance imaging, confirm that enthesitis is the primary lesion of spondyloarthritis. This advance has been occurring simultaneously with the therapeutic advances in spondyloarthritis due to the introduction of anti-tumour necrosis factor-alpha agents.

Fascia↗

PubMed1977

[Long-term radiological and clinical observations following surgery for tibio-fibular syndesmosis after fractures of the upper ankle joint (author's transl)].

Forty-two patients treated surgically for tibio-fibular syndesmosis were observed radiologically and clinically for a period of five years; the lesions followed fracture-dislocations type B, type C and following intra-articular fractures. Surgery consisted, as usual, of bone reconstruction and, where necessary, of transfixation of the syndesmosis with a horizontal screw introduced 2 cm. above the syndesmosis at a 30 degree angle to the frontal plane (15 cases). A new classification of the severity of subsequent arthrosis, as seen radiologically, was introduced and its correlation with clinical findings were determined. There was good agreement between the degree of arthrosis and functional results. The earliest signs of posttraumatic arthrosis following an incompletely treated lesion can be seen within the first year following the injury. An arthrosis of severity O due to sclerosis is of no, or only little, significance; it does not share the poor prognosis of severity grades I to III which, once they have developed, always show further deterioration.

Ankle Injuries↗

PubMed1993

Current concepts in ankle arthroscopy.

Ankle arthroscopy has rapidly become an important diagnostic and therapeutic procedure. Currently, indications for operative arthroscopy include transchondral talar dome fractures, acute articular fractures with hemarthrosis, posttraumatic synovitis, loose bodies, inflammatory synovitis, degenerative joint disease, and soft tissue impingement. Diagnostic arthroscopy is indicated for the patient with a chronically painful, symptomatic ankle when nonoperative treatment has failed and other measures have failed to produce a diagnosis. Three standard portals are used for routine ankle arthroscopy and allow a systematic examination of the joint. Mechanical distraction may be required to visualize the entire joint, the tight ankle, the ankle with posterior lesions, or to allow operative instruments to be introduced. The use of lasers in arthroscopy has yet to be clearly defined. The small size of the laser is an advantage in the ankle, but cost remains a disadvantage. Advances in technique and equipment will continue to expand the indications for this procedure.

Ankle Injuries↗

PubMed1998

Enthesiopathy: clinical manifestations, imaging and treatment.

Enthesitis is a distinctive pathological feature of spondyloarthropathy and may involve synovial joints, cartilaginous joints, syndesmoses and extra-articular entheses. This review focuses on peripheral extra-articular enthesitis which is a clinical hallmark of spondyloarthropathy. The entheses of the lower limbs are more frequently involved than those of the upper limbs, and heel enthesitis is the most frequent. Entheseal pain may be mild or moderate as well as severe and disabling. Peripheral enthesitis may be observed in all forms of spondyloarthropathy, including the undifferentiated ones, and may for a long time be the only long-standing clinical manifestation of the B27-associated disease process. Various imaging methods have been suggested for studying peripheral enthesitis. Ultrasonography and magnetic resonance imaging are the most useful because they may show alterations of the structures involved. Therapy of peripheral enthesitis consists of NSAIDs, orthoses and physical therapy. Steroid injections, second line drugs such as sulphasalazine and radiotherapy are reserved for more severe cases.

Adult↗

PubMed1991

Lateral retinaculum release in adolescent patellofemoral disorders: its relationship to peripheral nerve injury in the lateral retinaculum.

Adolescent patellofemoral disorders which are associated with recognizable change in the articular cartilage of the patella are called chondromalacia patellae. This is a clinical syndrome characterized by persistent retropatellar pain, but not always associated with histopathological changes of the articular cartilage. When lateral retinacular release is performed in such patients, pain is frequently eased even though lateral release does not always cause an appreciable change in patellofemoral contact pressure. This suggests that pain, at times, may emanate from the peripatellar retinacular supports themselves. Thirty-five knees of 22 patients suffering from anterior knee pain (with or without an unstable patella) were investigated histologically. Pathological changes in nerves were graded on a 0 to 3 + scale of severity. There was severe degenerative neuropathy in nine knees, moderate change in nine, and slight change in 11; the remaining six knees were normal. Histological investigation of the resected lateral retinaculum suggested that pain originated in the lateral retinaculum in many patients, and that degenerative changes in the nerves of the lateral retinaculum may be an important cause of pain in patients with patellofemoral disorders.

Adolescent↗

PubMedDate not supplied

Ligaments of the ankle: normal anatomy with MR arthrography.

PURPOSE: Our purpose was to define the normal MR arthrographic anatomy of ankle ligaments. METHOD: Prior to injection of intraarticular gadolinium in cadaveric ankle joints, proton density and T2-weighted images were obtained to assess the integrity of the ligaments and tendons as well as the amount of preexisting joint effusion. Following injection of 10 ml of contrast agent (gadopentetate dimeglumine 1:250, Omnipaqe 300, Knox gelatin 50%, and methylene blue), T1-weighted images with fat saturation in axial, oblique axial, coronal, and sagittal planes were obtained in neutral, dorsiflexion, and plantar flexion positions. Specimens were sectioned, allowing anatomic and MR correlation. RESULTS: Contrast agent outlining anterior and posterior aspects of the anterior talofibular ligament and posterior talofibular ligament (PTAF) was a normal finding, related to anterior and posterior recesses of the ankle joint that extend out beyond these ligaments in an anteroposterior direction above the level of the ligaments. Intraarticular contrast material allowed resolution of superficial and deep components of the posterior tibiofibular ligament. Both were seen separately from PTAF with dorsiflexion. Posterior intermalleolar ligament was not present in our specimens. Visualization of calcaneofibular ligament was much improved by contrast material outlining the articular aspect of the ligament. Visualization of the syndesmotic ligamentous complex also was improved by contrast material outlining the articular side of the ligaments and separating them from adjacent bone. Superiorly, the distribution of contrast agent was limited by the interosseous ligament. Visualization of the medial collateral ligaments was not improved by the presence of the intraarticular contrast material. CONCLUSION: MR arthrography of the ankle allows improved visualization and evaluation of the lateral and syndesmotic ligamentous complex.

Ankle Joint↗