Several of these fibers may be part of the formation of the tunnel for the flexor hallucis longus tendon. In addition, a band of strands merge with the posterior intermalleolar ligament . The posterior intermalleolar tendon has been the focus of current studies as a result of its contribution in the posterior soft tissue impingement disorder at the ankle joint[17, 27]. Its high frequency in incidence in radiological, and anatomical studies contrast extensively, extending from 19% up to 100% [24, 27, 30]. Springer ( ) noted that in cadaveric dissection the intermalleolar ligament was found consistently.
She reports of increasing lumbar pain, described as aching, burning and stabbing that radiates into the bilateral lower extremities with paresthesias and numbness. Her pain level is an 8/10. The pain is more prominent in the left upper extremity. She did undergo the bilateral L4-5, L5-S1 facet block which she reports was 75% beneficial in decreasing the deep stiffness aching sensation.
Consisting of bracing, cold modalities, and controlled stress to work out the alignment of the collagen fibers. It is also said by professionals today, to try and avoid immobilization of the knee, as it can contribute to the knee becoming very stiff, and the collagen fibers in the ligament not healing as properly. But also stated, isolated grade III MCL injuries, are claimed to be rare and should be treated the same as a grade II injury. (N. Reha Tandogan, Asim Kavaalp) In conclusion, surgical MCL repair vs non-surgical should be treated accordingly. It has to do with clinical findings of the injury.
DISCUSSION Lumbar Spine Anatomy The lumbar spine refers to the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades, and connects with the thoracic spine at the top and extends downward to the sacral spine. "Lumbar" is derived from the Latin word "lumbus," meaning lion, and the lumbar spine earns its name. It is built for both power and flexibility - lifting, twisting, and bending. The lumbar spine has several distinguishing characteristics: The lower the vertebra is in the spinal column, the more weight it must bear.
284). It is suggested the operation be a “Weaver-Dunn procedure using Dacron tape or autologous hamstring tendon to restore CC ligament function” (Bradley & Elkousy, 2003, p. 284). In type V injuries, the treatment is operative because “these injuries have significant disruption of the deltotrapezial fascia with pronounced superior displacement of the distal clavicle” (Bradley & Elkousy, 2003, p. 284). Although type VI injuries are rare, “they are treated with open reduction and internal fixation techniques” (Bradley & Elkousy, 2003, p. 285). No matter what type of separation occurs, stability needs to be provided by both the CC and AC ligaments to restore proper stabilization (Provencher & Romeo, 2012, p.
Dr. Wilson notes that examinations revealed moderate to severe palpation tenderness noted in the cervico-thoracic and lumbosacral paraspinal musculature with muscle hypertonicity, taut tender fibers and associated active trigger points. Range of motion was limited with muscle guarding and spasm. Joint fixation hypomobility noted in the upper spinal segments. Examination for altered spinal motion revealed an increase of segmental fixation at T1-T11. An evaluation of the musculature revealed a marked spasticity in the suboccipital muscles bilaterally, cervical paraspinal muscles bilaterally, upper thoracic muscles bilaterally, mid thoracic muscles bilaterally, lower thoracic muscles bilaterally and lumbar paraspinal muscles bilaterally.
The resected femoral head demonstrated a flattened widespread surface with a flap of articular cartilage and subchondral bone, and the cut section showed a subchondral fracture line parallel to the articular surface (Figure 4A). Histological examination showed repair tissue comprising of marked fracture callus and vascular rich granulation tissue on both sides of the fracture line (Figure 4B). There was no evidence of antecedent osteonecrosis. Histopathologic findings demonstrated that the collapse of his femoral head was caused by a subchondral fracture resulting from acetabular fracture. Figure 4 Histological findings show a subchondral fracture of the femoral head and no evidence of antecedent osteonecrosis.
Adolescents present with pain and tenderness over the medial border of the foot,aggravated by running or jumping sports or rubbing footwear.Clinical examination reveals a cornuate prominence on the medial side of the navicular,which may be tender and show pressure from footwear.An x-ray will confirm the presence of an ossicle at the medial border of the navicular(controversy whether a stress fracture, or a separate centre of ossification).Treatment is an arch support and modification of footwear. Acute pain, aggravated byweight bearing may require six weeks of cast immobilisation. Rarely excision of the lesionwith tightening of the tibialis posterior tendon is required. Osteochondroses These are idiopathic disorders of enchondral ossification which occur during the years of rapid growth. Trauma may influence their development, particularly from sport.
The Patellofemoral and knee joints would be open, but she has small bone spurs projecting from the patella, going posteriorly towards the femur and superiorly from the tibia towards the femur. The patient is under rotated because the lateral condyle is not completely superimposed over the medial condyle of the femur. The medial condyle is the one that appears “smaller” because it is closest to the image receptor. The lateral condyle is more posterior than the medial so the patient needs to be rotated more. The knee joint is not in the center of the collimated field.
Repeat __________ times. Complete this exercise __________ times per day. Exercise C: Ankle Plantar Flexion 1 Sit with your right / left leg crossed over your opposite knee. 2 Use your opposite hand to pull the top of your foot and toes toward you. You should feel a gentle stretch on the top of your foot and ankle.