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Lateral Hernias
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
A small number of lumbar hernias have been acquired following trauma, usually blunt rather penetrating, in which either the lateral flank muscles are avulsed from the iliac crest (Figure 15.3) or the thoraco-dorsal fascia disrupted (Figure 15.4). These hernias do not emerge through the anatomical lumbar triangles as described earlier. Avulsion injury repair involves re-attaching the muscles to the ileum and this can be extremely difficult because, in the first week after the injury, the muscles may be torn, oedematous and difficult to handle. Tears in the thoraco-dorsal fascia may be easier to repair but such traumatic hernias are often associated with other injuries, so early repair is not a surgical priority. Delayed repair may also be difficult, however, as muscle contractures may prevent re-approximation of the tissues without undue tension.
Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Type I. The FDP tendon ruptures along with both vincula but with no fracture; hence, the tendon retracts into the palm and presents as a tender lump. Early repair (within 10 days) is needed as the vincular and synovial supplies have been disrupted. It is the most severe type of avulsion injury.
Pregnancy and Childbirth and the Effect on the Pelvic Floor
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Philip Toozs-Hobson, Aneta Obloza, Sara Webb
Figure 58.8 typicAl bilAterAl Avulsion injury seen in primipArous pAtient (forceps) As seen in the AxiAl plAne (right imAge). The defects Are indicAted by *. (reproduced from GAmble, J.A. And Creedy, D.K., Birth, 27, 256, 2000. With permission And courtesy of H.P. Dietz.)
The Roles of Injury Type, Injury Level and Amputation Type in the Need for Revision Surgery after Replantation: Retrospective Clinical Outcome with 296 Finger Replantation
Published in Journal of Investigative Surgery, 2022
Burak Sercan Erçin, Burak Ergün Tatar, Musa Kemal Keleş, Fatih Kabakaş
The type of injury (crush and avulsion) was determined according to the definitions presented by Dec et al. Crush injury is direct crushing of tissue with a heavy object. Avulsion injury is rapid cutting and rupture of the digit due to being pulled during injury.8 Amputation levels were determined as described by Sebastin et al. Zone 1 proximal–between the flexor digitorum profundus (FDP), zone 1 distal–distal to FDP insertion at the roof of the nail bed and FDS insertion, and zone 2–proximal to flexor digitorum superficialis (FDS) insertion9 (Figure 1).
Iliac crest avulsion fracture and staged return to play: a case report in youth soccer
Published in Science and Medicine in Football, 2019
Olivier Materne, Al Haddad Hani, Robertson Duncan
Different mechanisms have been described for iliac crest avulsion injury. The most prevalent (19.7%) mechanism in youth soccer is an acute forceful sudden muscle contraction, such as kicking (Rossi and Dragoni 2001). The problem may also present as an overuse-type injury, or as a heavy fall directly on to the iliac crest, typically referred to as a “Hip Pointer” (Ogden 2000). We suspect this case as a combination of the above two first aetiologies: a progressive asymptomatic physeal overuse from the recurrent sports-specific stress (during the month preceding the injury onset), in conjunction with a rapid powerful sports-specific movement. The aggregate effect is to overwhelm a weakened physis, resulting in acute catastrophic injury. In a player with multiple sequential apophyseal injuries, the causes are typically multifactorial, and attract controversy (Segawa et al. 2001). Muscle shortness has been a suggested risk factor (de Lucena et al. 2011). However, the hyper-laxity and great overall flexibility of the player mitigates this potential factor in our case. Also, repetitive-movement patterns are seen as a common precursor to apophyseal injuries. These types of injuries happen commonly during the period of the second ossification centre appearance. And variations between individual athletes differing ability to absorb these mechanical stresses suggests genetic components – as demonstrated in other pathologies (Collins 2010). It has been suggested that in some cases there is an abnormal response of the endochondral ossification centre and cartilage to high physical loads (Segawa et al. 2001; Doral et al. 2005). In line with similarly described clinical cases, apophysitis at early age of a growing young player is an excellent opportunity to consider future injury risk in other unfused growth cartilage. This can mean being more alert to proactive and optimal management of loads and symptoms – ideally preventing significant injuries around the anatomy of the growth plate at vulnerable moments of player’s maturation timeline.
Clinical significance of cervical MRI in brachial plexus birth injury
Published in Acta Orthopaedica, 2019
Petra Grahn, Tiina Pöyhiä, Antti Sommarhem, Yrjänä Nietosvaara
Sensitivity and specificity for the MRI findings in comparison with the intraoperative findings as well as PMC in relation to root avulsion injury on MRI were calculated. The 95% confidence intervals (CI) were calculated using Wilson score intervals. Linear regression models were fitted for GSA difference and model assumptions were visually assessed.