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Musculoskeletal system
Published in David A Lisle, Imaging for Students, 2012
Avulsion fractures occur due to distraction forces at muscle, tendon and ligament insertions. Avulsion fractures are particularly common around the pelvis in athletes, such as the ischial tuberosity (hamstring origin) (Fig. 8.7) and anterior inferior iliac spine (rectus femoris origin). Avulsion fractures also occur in children at major ligament insertions, such as the insertion of the cruciate ligaments into the upper tibia. In children, the softer bone is more easily broken than the tougher ligament, whereas in adults the ligaments will tend to tear leaving the bony insertions intact.
Case Study: The Conservative Management of a Complex Mid Foot Injury in an Elite Professional Footballer
Published in Research in Sports Medicine, 2021
David Rhodes, Mark Leather, Russell Parker
Radiographs are mandatory for a suspected LFI with initial evaluation of non-weight-bearing (NWB) anteroposterior, 30 degrees internal oblique, and lateral images of the injured foot (Lewis & Anderson, 2016; Mulcahy, 2018). Magnetic resonance imaging (MRI) and a subsequent computed tomography (CT) scan to identify subtle findings associated with LFI (Hatem, 2008; Preidler et al., 1999) were arranged and reviewed by two radiologists detailing different findings. Initial reporting identified avulsion fracture immediately medial to the base of the 2nd MT with associated oedema, thickening and poor definition of the Lisfranc ligament. The follow up described no LFI or acute fracture, an acute osseous stress response in the lateral cuneiform (Figure 2) and associated chronic fibrosis coalition across the plantar joint margin of the 3rd TMTJ (Figure 3). Highlighting, the importance of patient presentation, clinical assessment and appropriate imaging (Eleftheriou et al., 2013; Keiserman et al., 2003; Sherief et al., 2007). Subtle LFI may not be identified via NWB radiographs due to osseous overlap at the TMTJ and possible spontaneous reduction after trauma therefore important to obtain weight-bearing films if possible (Llopis et al., 2016; Myerson et al., 1986; Raikin et al., 2009).
Evaluation of geometrically personalized THUMS pedestrian model response against sedan–pedestrian PMHS impact test data
Published in Traffic Injury Prevention, 2018
Huipeng Chen, David Poulard, Jason Forman, Jeff Crandall, Matthew B. Panzer
Using the DM, the morphed model did not predict skull fracture (consistent with the tests) but Baseline2 did, mainly due to the stiffer head impact location. Both models underestimated the number of rib fractures (Morphed2: 2, Baseline2: 0, PMHS2: 9). Morphed2 captured a fracture of the left scapula as in experiments but Baseline2 did not. Both models predicted pelvic fracture consistent with the experiments. No femur or tibia shaft fracture was predicted by the morphed model, consistent with the experiments, but Baseline1 predicted bilateral femur fractures. Both models overestimated the PMHS right knee ligament ruptures. Comminuted and avulsion fracture on the left fibula head and tibia plateau of the PMHS were not observed in the simulations, but high ligament strains were observed at similar locations for both models. Both models overestimated the ankle injury risks and predicted a left fibula fracture close to the ankle impact location that was not reported in the experiments.