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At least 163 records · Page 9Linked to original sources

Ankle sprains and other soft tissue injuries.

Lateral ankle sprains are the most frequently encountered injuries in sports. In the evaluation of lateral ankle injury, one should consider all soft tissue structures (i.e., peroneal tendons, ligaments of the ankle, subtalar joints, around the lateral ankle). The treatment of most ankle sprains has evolved from immobilization to functional rehabilitation. Many patients with ankle sprains return to their previous activities. A few patients are left with pain and residual instability after conservative treatment; thus, the question of when to operate on acute severe ankle sprain remains controversial. The other challenge physicians face is the problem of persistent lateral ankle pain after sprain. This condition may be due to intra-articular or extra-articular pathology (i.e., soft tissue lateral ankle impingement, osteochondral lesion, or partial peroneal tendon tear). Diagnosis can be made with careful history, physical examination, and appropriate ancillary studies. Only proper diagnosis can lead to uncompromised, undelayed patient care.

Ankle Injuries↗

Early prognostic factors for duration on temporary total benefits in the first year among workers with compensated occupational soft tissue injuries.

AIMS: To develop a model of prognosis for time receiving workers' compensation wage replacement benefits in the first year. METHODS: A prospective cohort of 907 injured workers off work because of soft tissue injuries was followed for one year through structured telephone interviews and administrative data sources. Workers were recruited at workers' compensation claim registration. Only those still off work at four weeks post-registration were included in the analysis. Data from several domains (demographics, clinical factors, workplace factors, recovery expectations) were collected at approximately two weeks and a subset again at four weeks. Outcome was duration on total temporary wage replacement benefits. Variable selection was carried out in two steps using content experts and backward elimination with the Cox model. RESULTS: Body region specific functional status, change in pain, workplace offers of arrangements for return to work, and recovery expectations were independently predictive of time on benefits. Change in pain and workplace offers interacted, so the largest mutual association occurred for those whose pain was getting worse-that is, reduction in median duration from 112.5 to 32.5 days. Across observed values, widely different recovery profiles of groups of workers resulted; for example, at four months, only one third of the highest risk group had gone off benefits while over 95% of the lowest risk group had done so. CONCLUSIONS: Focus on a relatively small set of prognostic factors should enable occupational health practitioners to triage injured workers within the first month and concentrate on those requiring additional assistance to return to work.

Accidents, Occupational↗

Endoscopic correction of eyebrow asymmetry in associated forehead soft-tissue injuries.

Supported by anatomical principles, a subgaleal endoscopically assisted selective myotomy of the forehead and glabellar muscles was used to achieve eyebrow symmetry in patients with unilateral facial nerve palsy and associated forehead soft-tissue injuries. Selective myotomy equalizes the agonist-antagonist muscle relationship on both sides of the forehead, thereby allowing the untouched muscle to exert its activity without opponent restriction. Selective myotomy allows for the management of the muscles' group action as well as individual manipulation of each muscle in accordance with its participation in the eyebrow deformity.

Adult↗

Soft-tissue injuries of the hand and wrist in racquet sports.

Participants in racquet sports are prone to a host of soft-tissue injuries to their hands and wrists owing to the direct impact of the handle as well as the repetitive stretching that occurs as the wrist is forcefully whipped into extremes of position. Tendinitis can occur in all tendons but is most common in the first dorsal compartment, flexor carpi ulnaris, flexor carpi radialis, and extensor carpi ulnaris. Ligamentous tears can produce instability patterns that, if unrecognized, can become chronic disabilities. Vessels and nerves can be compromised by repetitive blunt trauma to the structures themselves or by entrapment by surrounding structures. Prompt diagnosis will allow for the appropriate treatment and eliminate the need for vague terms such as "wrist sprain." The goal of early recognition and treatment is to allow the player to get back to the court and prevent the development of chronic discomfort or permanent impairment.

Athletic Injuries↗

Efficacy of a proprietary ibuprofen gel in soft tissue injuries: a randomised, double-blind, placebo-controlled study.

The efficacy of a novel, proprietary topical formulation of ibuprofen 5% gel (Ibugel) was evaluated in a placebo-controlled study in patients with soft tissue injuries. Patients received either active gel (n=40) or placebo gel (n=41) for a maximum of seven days. Pain and interference with physical activity were assessed daily using visual analogue scales. There was a significant difference (p<0.001) in favour of active treatment for the time to achieve clinically meaningful reduction in pain. By day 7, 75% of patients in the active gel group had a clinically meaningful reduction of pain compared with 39% of patients who received placebo. Despite differences between study centres, the data for interference with physical activity also showed an advantage for active treatment. By day 7, 79% of patients in the active gel group had a clinically meaningful reduction in interference with physical activity, compared with 44% of patients who received placebo.

Administration, Topical↗

Methods for mitigating soft-tissue injury after subcutaneous injection of water soluble contrast media.

RATIONALE AND OBJECTIVES: Water soluble contrast media may cause tissue injury by extravasation during intravenous injection during various radiologic examinations. The authors attempted to find out what kind of management could mitigate tissue injury when extravasation of water soluble contrast media occurs. METHODS: Sodium and meglumine ioxithalamate was injected subcutaneously into 240 hind feet of 120 rats that were divided into six groups according to the methods of experimental management. Experimental managements included the following: no further management (control), injection of distilled water, injection of normal saline, injection of hydrocortisone, hot water application, and cold water application. Gross morphologic changes in each group were compared with those in the control group. RESULTS: Only the saline injection group showed statistically significant decrease of tissue injury compared with the control group. CONCLUSIONS: Saline injection lessens the degree of soft-tissue injury at contrast media extravasation sites in rats.

Animals↗

[Soft tissue injuries of the neck].

Thirty five patients were examined. All had soft tissue spinal cord injury and were not treated in a hospital. Complete diagnostic and therapeutical protocol was carried out only for 13 patients. The goal was to compare their initial condition with condition after the control examination after the therapy. Results showed that 8 patients (23%) suffered from pain in the neck, 25 (72%) had limited neck mobility, and 17 (49%) manifested neurological symptoms. Signs of osteochondrosis at isolated spinal levels and dyscoligamental instability were noted in one fifth of the observed patients. In 24 patients (69%) the condition was defined as "serious". Although soft tissue spinal cord injuries are considered as "light" injuries, they can cause serious consequences that reduce the quality of patient's life due to inadequate treatment. From that point of view, a serious approach to diagnosis and treatment is necessary.

Adolescent↗

[Management of soft tissue injury in III B open tibial fractures: are local muscle flaps still up-to-date?].

Local muscle flaps for covering pretibial defects have been widely replaced due to the establishment of microsurgical procedures. The intention of the following study is to examine the results of soft tissue covering using local muscle flaps and to find out if its application is still indicated. At our level 1 trauma center 21 patients with III B open tibial fractures were treated with a local muscle flap to repair the soft tissue injury in the proximal and medial part of the lower leg. At the late follow-up after the average of 29 months all soft tissue defects and fractures were healed. Except of slight swelling under full weight stress no obstruction of blood circulation could be verified. 14 patients rated their functional outcome as good to excellent. In view of our results we consider local muscle flaps a suitable alternative to the free myoplasty for situations in which a more elaborate surgery is not feasible in due time, e. g. patients with acute brain edema, organ failure or lack of compliance.

Adolescent↗

Soft tissue injury in resistance welding.

Electrical resistance welding is commonly used in industries where light sheet metal is bonded. The process uses a combination of heat and pressure to form the weld, which frequently results in the production of high-velocity metal-fragment projectiles. The process is described and case studies are presented to illustrate the nature of the injuries which occasionally result from these missiles. The difficulties in preventing these injuries and potential approaches for doing so are discussed.

Accident Prevention↗

Treatment of soft tissue injuries to the dorsum of the metacarpophalangeal joint (Boxer's knuckle).

We retrospectively reviewed the surgical treatment for 16 cases of traumatic soft tissue injury to the metacarpophalangeal joint (Boxer's knuckle). A history of trauma was present in all cases and there was an associated extensor tendon dislocation in seven cases. Eight cases were initially treated conservatively, but their symptoms persisted. Intraoperative findings included rupture of the extensor hood or joint capsule in all cases. Surgical closure of the rupture of the joint capsule resulted in a successful outcome in all cases. We consider that conservative treatment of this injury may not be effective when the joint capsule of the metacarpophalangeal joint is ruptured. We recommend arthrography of the metacarpophalangeal joint to assist in the decision as to whether to proceed with surgical or conservative treatment.

Adolescent↗

Soft tissue injuries of the tarsus.

Contrast radiography provides a clear survey of the size, shape, and location of extratendovaginal fluid-filled cavities, distended bursa, and tendon sheaths and demonstrates intersynovial communication. Ultrasonography effectively demonstrates Achilles tendon injury, slippage of the SDFT off the summit of the calcaneus, assorted ligamentous injuries, and cystic or solid extratendovaginal masses. It will also demonstrate distended bursae and tendon sheaths, but it is not as effective in demonstrating a synovial herniation, or a narrow synovial fistula. Contrast radiography may prove to be the imaging modality of choice for examination of fluctuating swellings, whereas ultrasonography is preferred for the assessment of firm swellings. Routine radiographic evaluation in the clinical assessment of soft tissue injuries in the hock region continues to play an invaluable diagnostic role.

Animals↗

Comparative efficacy of a proprietary topical ibuprofen gel and oral ibuprofen in acute soft tissue injuries: a randomized, double-blind study.

The efficacy of a novel, proprietary topical formulation of ibuprofen 5% gel (Ibugel) and ibuprofen 400 mg tablets (1200 mg daily) was compared in a double-blind, double-dummy, parallel group study in patients with acute soft tissue injuries. Patients received either active gel plus placebo tablets (n = 50) or active tablets plus placebo gel (n = 50) for at least 7 days. The gel was applied and one tablet was taken three times daily. The two treatments showed similar efficacy. There were no significant differences between the groups for either the primary efficacy endpoint, the median time for the injury to be rated as 'completely better' by the patients (>14 days active gel, 13.5 days active tablets; P = 0.59), or for other efficacy measures including the times to clinically significant relief from pain at rest or on movement and swelling. In summary, ibuprofen gel shows similar efficacy to oral ibuprofen 400 mg and may offer improved tolerability.

Administration, Cutaneous↗

Soft-tissue injury of the neck in a hospital based material.

In a study from northern Sweden, 139 patients with a history of a soft-tissue injury of the neck were studied. The incidence was 1 per 1000 inhabitants. Male patients in the age group 20-29 years were most commonly injured. Traffic accidents constituted the major group with 96 (69%) and falls with 24 (17%). Forty-one cases received sickness benefit for a median time of 16 days for males and 25 days for females. Five persons were on sick-leave for over a year. The calculated total cost of treatment and sickness insurance benefit was about 0.9 million SEK/year.

Adolescent↗

Eye motility dysfunction after soft-tissue injury of the cervical spine. A controlled, prospective study of 38 patients.

We investigated eye motility prospectively in 40 patients with a soft-tissue injury of the cervical spine. The initial oculomotor test, performed within 3 months, was pathologic in 8 patients. The follow-up test in 38 patients, on average 15 months after the accident, remained pathologic in the 8 patients and 5 additional patients had changed from normal to pathologic test results. At follow-up, all the 13 patients with oculomotor dysfunction had persisting symptoms, while 5 of the 25 cases with normal test results still were symptomatic.

Adolescent↗

Portable thermogram technique for topically applied benzydamine cream in acute soft-tissue injuries.

A double-blind, parallel trial was undertaken with 3% benzydamine cream compared with a matching placebo, on patients suffering acute soft-tissue injuries. 21 patients received active material and 22 received placebo material. Patients applied the cream lightly 6 times a day for 6 days. Assessments were made (by the same physician) on days 0, 2, 4 and 6, and signs and symptoms were graded as "absent", "slight", "moderate" or "severe". Thermograms were taken on day 0 and day 6. The results showed significant relief of spontaneous pain, significant reduction in tenderness on pressure and in swelling on days 2, 4 and 6 of the trial, and a significant reduction in functional impairment on days 4 and 6, in the patients who had received the 3% benzydamine cream.

Administration, Topical↗

Suturing technique in facial soft tissue injuries.

This article has presented suturing techniques and instrumentation and suggestions that we have found to be helpful in the management of facial soft tissue injuries. The reader is encouraged to practice suture and knot tying techniques on fresh pigfeet, which are readily accessible and inexpensive and approximate the characteristics of human skin.

Debridement↗

Soft tissue injuries to face and neck: early assessment and repair.

The principles of assessment and repair of soft tissue trauma of the face are outlined. The importance of an adequate preoperative evaluation is emphasized. Recognizing lesions in the deep vital structures is extremely important in the initial approach to these patients. The postoperative care and the best management of the sequelae are described.

Facial Injuries↗