China
Africa
Explore chapters and articles related to this topic
Congenital Radio-Ulnar Synostosis
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
Nicholas Peterson, Christopher Prior, Selvadurai Nayagam
Surgery is needed only in a few cases and usually for a fixed over-pronation of the hand. The optimal position to achieve will depend on whether the condition is unilateral or bilateral and whether the treated hand is dominant. Specific recommendations on the final hand position are less useful than a careful consideration of the specific functional problems the presenting fixed hand position causes the patient and working out the optimum position that will allow those disabilities to be overcome.
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
Imagine a client over-pronating, with collapsed arches and knees rolling in as they run. A biomechanical approach labels ‘over-pronation’ as a dysfunction that needs to be corrected. ‘Flat feet’ are often identified as a cause of biomechanical stress leading to lower limb pain. Patients with flat feet are often prescribed orthotic inserts.
Biomechanics of the foot and ankle
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Sheraz S Malik, Shahbaz S Malik
The posterior tibial tendon is the key to performing a heel rise at push-off. It has a broad insertion on the navicular, tarsal bones and metatarsals. It acts to rotate navicular medially over the head of talus, which adducts transverse tarsal joint and inverts the heel. Hence, the posterior tibial tendon action initiates heel rise and brings the hindfoot in varus position, and the powerful Achilles tendon then takes over and holds the heel in inverted position. In posterior tibial tendon dysfunction the foot remains in a position of excessive pronation during weight-bearing, leading to adult-acquired flatfoot deformity. As the tendon loses function, increased stress is placed on supporting structures of medial longitudinal arch. The subsequent rupture of spring ligament and then failure of talonavicular joint results in collapse of the longitudinal arch and progressive abduction of the forefoot through transverse tarsal joint and progressive valgus deformity of the subtalar joint.16
Effect of COVID-19 on the incidence of postintubation laryngeal lesions
Published in Baylor University Medical Center Proceedings, 2023
Madison Buras, Nicole DeSisto, Randall Holdgraf
As previously mentioned, studies have shown that COVID-positive patients have increased risk factors for tissue damage. However, because increased risk of vocal fold injury in our study was associated directly with pronation rather than COVID infection, early laryngoscopy may be generalized to patients who undergo pronation therapy for other reasons. Pronation describes the act of placing a ventilated patient face down. It is not an uncommon maneuver, and in a multicenter randomized controlled trial by Guérin et al, it was shown to decrease the mortality of patients with acute respiratory distress syndrome from 32.8% to 16% in a 28-day period.13 Benefits from the prone position have been well described by many studies. These benefits include mobilizing secretions from the posterior lung fields, which allows for increased alveolar recruitment in those regions, thereby improving ventilation.14 However, pronation therapy has risks. Repositioning the patient can cause the endotracheal tube to shift or dislodge. Movement of the endotracheal tube and the increased pressure that pronation causes on areas such as the posterior commissure can increase the risk of laryngeal trauma. According to the American Thoracic Society, the benefits of pronation therapy outweigh the potential adverse events, so it recommends that patients with acute respiratory distress syndrome be positioned face down for 12 to 16 hours a day.14
Improving the recognition of cervical arterial dissection in clinical practice: investigation of a five criteria diagnostic support tool
Published in Physiotherapy Theory and Practice, 2023
Lucy C. Thomas, Trent Seth, Andrew Der, Ken Ho, Lene Eide, Stine Roenaas, Julia Treleaven
Physical screening was performed to assess for presence of any neurological signs that could be related to CeAD. Horner’s syndrome; unilateral ptosis (drooping eyelid) or miosis (constricted pupil) was assessed by visual inspection of the participant’s eyes. Balance was assessed in quiet tandem stance in bare feet with eyes closed. A positive test was identified as the inability to maintain this position for 30 seconds but was repeated with the eyes open if the participant could not achieve this. Coordination was evaluated by tandem gait over two meters. As gait assessment might not be possible in a patient group, it was also assessed by observable dysdiadochokinesia in a rhythmical alternating forearm pronation and supination test and observable overshoot or undershoot in the finger to nose test (Blumenfeld, 2014).
Comparison between radial and focused types of extracorporeal shock-wave therapy in plantar calcaneal spur: A randomized sham-controlled trial
Published in The Physician and Sportsmedicine, 2023
Volkan Şah, Şeyhmus Kaplan, Sezai Özkan, Cihan Adanaş, Murat Toprak
Plantar calcaneal spur (PCS), an abnormal bony outgrowth arising from the calcaneal tuberosity, is a common disorder associated with heel pain [1,2]. Its prevalence in the young to middle-aged subjects varies between 11% and 21% across various ethnicities, but increases significantly with aging and in the presence of heel pain and osteoarthritis, up to 55–81% [1]. In addition, obesity, degraded foot biomechanics such as pes planus and foot pronation, repetitive trauma and sport activities, degenerative processes, and inflammatory disorders are risk factors for PCS formation [1,2]. Although there is no standard therapy for PCS, non-surgical treatments, such as nonsteroidal anti-inflammatory medication, local injection of corticosteroids, extracorporeal shock waves, heel pads, stretching exercises, and physical therapy are usually applied. Considering that old and obesity rates will be even higher in the future, PCS also may be a bigger problem.