DOCSLIB.ORG

Advanced Tsubo List

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Advanced Tsubo List LU/METAL 3-5A English Location Notes 6 cun lateral to the anterior midline, level LU-1 Center of gathering with the 1st ICS. Lung Bo Point At the cubital crease on the radial side of LU-5 Indentation in the stream the biceps brachii tendon. Child Point In depression at origin of styloid process of radius, 1.5 cun proximal to wrist crease, Luo (Connecting) LU-7 Broken Sequence lateral edge of radius Point At the wrist crease on the radial side of the Mother Point/ LU-9 Great stagnation radial artery. Source Point Young merchant (Sound of .1 cun posterior to the thumb nail on the LU-11 metal element) radial side. LI/METAL 5-7A English Location Notes .1 cun posterior to the corner of the nail on LI-1 Metal’s Note Yang the radial side of the index finger. On radial side of index finger, distal to LI-2 Second Interval metacarpophalangeal joint. Child Point In the middle of the 2nd metacarpal bone on LI-4 Meeting mountains the radial side. Source Point 3 cun proximal to the wrist crease, on a line Luo (Connecting) LI-6 Deviated Passage connecting LI-5 and LI-11 Point In the proximal forearm, 1.5 inches below the LI-10 Arm Three Miles cubital crease on the radial side At the lateral end of the transverse cubital crease midway between LU 5 and the lateral LI-11 Lake of energy on the corner epicondyle of the humerus. Mother Point On the radial side of the upper arm, 7 cun above LI 11 at the insertion of the deltoid LI-14 Upper & lower arm point muscle. Anterior and inferior to the acromion in a LI-15 Corner of the shoulder depression found with the arm abducted. In the nasolabial groove, level with the midpoint of the lateral border of the ala LI-20 Welcome smell nasi. ST/EARTH 7-9A English Location Notes Below the pupil, between the eyeball and ST-1 Receiving tears the infraorbital ridge. When looking straight ahead, vertically inferior to the pupil center, just inferior to ST-3 Great Crevice the cheekbone. Level with the tip of the Adam's Apple on the anterior border of the SCM muscle (where the pulse of the common cartoid ST-9 Welcome Human artery is felt). On the abdomen, 2 cun lateral to the ST-25 Center of borderline umbilicus (level with CV8) Bo Point of LI With knee flexed, 2 cun above the superior lateral border of the patella on the line ST-34 On the Hill connecting with the ASIS. 3 cun below ST 35, one finger width lateral ST-36 Leg Three Miles from the anterior border of the tibia. On the tibialis anterior muscle, level with midpoint between patella and lateral Luo (Connecting) ST-40 Abundant Flourishing malleolus, 2 cun lateral to tibia Point On anterior ankle joint, level with vertex of lateral malleolus, between tendons of extensor digitorum longus and hallucis ST-41 Release Stream longus Mother Point 1.3 cun distal to ST-41 at highest point on top of foot, in depression formed by 2nd ST-42 Rushing Yang and 3rd metatarsals and cuneiform bone. Source Point .1 cun posterior to the corner of the nail on ST-45 Evil’s Dissipation the lateral side of the 2nd toe. Child Point SP/EARTH 9-11A English Location Notes On the medial side of the big toe .1 cun SP-1 Inside white point posterior to the corner of the nail Medial side of big toe, distal and inferior to SP-2 Great Capital 1st metatarsophalangeal joint. Mother Point Proximal and inferior to head of first SP-3 Great Brightness metatarsal bone Source Point 1 cun posterior to SP-3, in depression distal and inferior to base of first Luo (Connecting) SP-4 Ancestor and Decendant metatarsal bone. Point In depression distal and inferior to medial SP-5 Metal’s Note Hill malleolus Child Point 3 cun directly above the tip of the medial malleoulus on the posterior border of the SP-6 Meeting point of 3 yin tibia. Between the posterior border of the tibia SP-9 Yin mountain pond and gastrocnemius muscle. 2" proximal to the superior border of the patella in the tender depression on the bulge of the vastus medialis muscle SP-10 Ocean of Blood (directly above SP9) On lateral side of the chest and on the mid-axillary line in the 6th inter-costal SP-21 Great Enveloping space. HT- ABSOLUTE FIRE 11A-1P English Location Notes In the center of the axilla on the radial side HT-1 First draining point of spring of the axillary artery. With the elbow flexed, between the ulnar end of the cubital crease and the medial HT-3 Young ocean epicondyle of the humerus. Luo (Connecting) HT-5 Communication’s Route 1 cun proximal to HT-7 Point At the wrist crease, on the radial side of the flexor carpi ulnaris tendon, between Child Point / HT-7 Gate of god the ulna and the pisiform bones. Source Point 1 cun posterior to the corner of the nail on HT-9 Little impact the radial side of the little finger. Mother Point SI- ABSOLUTE FIRE English Location Notes 1-3P .1 cun posterior to the corner of the nail on SI-1 Beginning of stream the ulnar side of the little finger. At the ulnar end of the distal palmar crease proximal to the 5th metacarpal phalangeal joint at the junction of the red SI-3 Rear groove & white skin. Mother Point On ulnar side of palm, in depression between 5th metacarpal bone and hamate SI-4 Wrist Bone and pisiform bones. Source Point On the ulnar end of the transverse wrist crease in a depression between the styloid process of the ulna and the triquetral SI-5 Yang valley bone. 5 cun proximal to wrist on line connecting Luo (Connecting) SI-7 Branch from the Main SI-5 and SI-8. Point Between the olecranon process of the ulna and the medial epicondyle of the SI-8 Small Sea humerus, found with the elbow flexed. Child Point On the scapula in a depression at the center of the infrascapular fossa, found at the junction of the upper and middle third between the lower scapular spine and the SI-11 Center of heaven inferior angle of the scapula. Anterior to the tragus and posterior to the condyloid process of the mandible, in a depression formed when the mouth is SI-19 Palace of hearing opened. BL-WATER 3-5P English Location Notes In a depression, .1 cun above the inner BL-1 Bright Light canthus of the eye. 1.3 cun lateral to GV 15, on the lateral BL-10 Pillar of Heaven aspect of the trapezius. BL-13-28 Review as Yu/Associated Points BL-40 Supporting Middle In the center of the popliteal crease 8 cun below UB 40 in a pointed depression below the gastrocnemius BL-57 In the Mountains when leg is stretched or heel is lifted. 7 cun directly above BL-60, on posterior Luo (Connecting) BL-58 Flying Yang border of fibula. Point In a depression between the tip of the BL-60 Kunlun Mountains external malleolus and the achilles tendon. Anterior and inferior to tuberosity of 5th BL-64 Central Bone metatarsal bone. Source Point Posterior and inferior to head of 5th BL-65 Restrained Bone metatarsal bone. Child Point .1 cun posterior to the corner of the nail on BL-67 Extreme Yin the lateral side of the little toe. Mother Point KD-WATER 5-7P English Location Notes On sole, in depression with foot in plantar flexion, at the junction of the anterior 1/3 and posterior 2/3 of line connecting base KD-1 Gushing spring of the 2nd and 3rd toes with the heel. Child Point In depression midway between the tip of the medial malleolus and the attachment KD-3 Great brook of the achilles tendon. Source Point Luo (Connecting) KD-4 Large Bell .5 cun inferior to KD-3 Point 2 cun above KD 3 on the anterior border KD-7 Returning Current of the achilles tendon. Mother Point On the medial side of the knee joint between the tendons of semitendinosis KD-10 Yin valley and semimembranosus. In a depression on the lower border of the KD-27 Transporting District clavicle, 2 cun lateral to the CV line. P- SUPPLEMEN TAL FIRE 7-9P English Location Notes P-1 Heaven's Pond 1 cun lateral to the nipple in the 4th ICS 2 cun above the wrist crease between the tendons of palmaris longus and flexor Luo (Connecting) P-6 Inner Gate carpi radialis. Point At midpoint of transverse wrist crease, between palmaris longus and carpi radialis Child Point / P-7 Big Mound tendons. Source Point At the center of the palm between the 2nd and 3rd metacarpal bones closer to the radial side of the 3rd, where the tip of the middle finger falls when a loose fist is P-8 Palace of Anxiety made. P-9 Middle Rushing In the center of the tip of the middle finger. Mother Point TH/SJ - SUPPLEMEN TAL FIRE 9-11P English Location Notes .1 cun posterior to the corner of the nail on TH-1 Exit of Rushing Energy the ulnar side of the ring finger. Back of hand, between 4th and 5th metacarpals, in depression proximal to TH-3 Middle Islet metacarpophalangeal joint. Mother Point At junction of ulna and carpal bones, in depression lateral to extensor digitorum TH-4 Yang’s Pool tendon.
Load more

Recommended publications
  • Ideal Medial Malleolar Screw Length Based on the Tibial Epiphyseal Scar Location in Weight Bearing CT’S Collin G
    Ideal Medial Malleolar Screw Length Based on the Tibial Epiphyseal Scar Location in Weight Bearing CT’s Collin G. Messerly DPM, Keegan A. Duelfer DPM, Troy J. Boffeli DPM, FACFAS, Tyler K. Sorensen, DPM Regions Hospital / HealthPartners Institute for Education and Research - Saint Paul, MN Figure 1. Zone of Dense Bone in Medial Malleolar ORIF Figure 4. Measuring Distal – Most 5% to Medial Malleolus Table 2. Distance Between Epiphyseal Scar & Distal – Most 5% of RESULTS STATEMENT OF PURPOSE The epiphyseal scar is located in the distal The medial malleolus to distal – most 5% mark Tibia 97 WB ankle CT scans evaluated in uninjured ankles Medial malleolar fractures are one of the most common fracture types metaphysis of the tibia, and can oftentimes be was measured on the coronal WB CT slice with Measurement of interest Male: Mean ± SD Female: Mean ± SD (mm) In males < 60 years old there was a 12.75 mm zone of increased bone the widest medial malleolus. Screw threads observed in the ankle joint and have been long fixated with two screws; easily visualized on X-ray and CT scan (red line). (mm) density, as compared to 13.66 mm in those ≥ 60 which was not statistically The distal – most 5% of the tibia (distal to the beyond this point will purchase less dense bone however, the bone density of the distal tibia has potential for poor screw significant. purchase due to compromised bone density. This is especially true in elderly black line) contains dense bone with marked in the medullary canal with potential to not have Epiphyseal Scar to Medial Malleolus 12.75 ± 2.91 9.39 ± 2.38 In females < 60 years old there was 9.39 mm zone of increased bone populations with osteoporotic bone.
    [Show full text]
  • Patellofemoral Syndrome: Evaluation & Management Scott Sevinsky MSPT
    Patellofemoral Syndrome: Evaluation & Management Scott Sevinsky MSPT What is Patellofemoral Syndrome? Patellofemoral syndrome (PFS) is a term commonly used to describe a condition where the patella ‘tracks’ or glides improperly between the femoral condyles. This improper tracking causes pain in the anterior knee and may lead to degenerative changes or dislocation of the knee cap. To be more precise the term ‘anterior knee pain’ is suggested to encompass all pain-related problems of the anterior part of the knee. By excluding anterior knee pain due to intra-articular pathology, peripatellar tendinitis or bursitis, plica syndromes, Sinding Larsen’s disease, Osgood Schlatter’s disease, neuromas and other rarely occurring pathologies it is suggested that remaining patients with a clinical presentation of anterior knee pain could be diagnosed with PFPS. The term ‘patellofemoral’ is used as no distinction can be made as to which specific structure of the patella or femur is affected. The term ‘chondromalacia patellae’, defined at the beginning of the 20th century to describe pathological changes of the retropatellar cartilage,7,8 was for half a century, used as a synonym for the syndrome of patellofemoral pain. However, several studies during the last 2 decades have shown a poor correlation between articular cartilage damage and the still not well-defined pain mechanism of retropatellar pain. Review of Knee Anatomy 1. Femur – thigh bone; longest bone in the body. · Lateral femoral condyle larger than medial condyle & projects farther anteriorly. · Medial femoral condyle longer anterior to posterior · Distal surfaces are convex · Intercondylar (trochlear) notch: groove in which the patella glides or ‘tracks’ 2.
    [Show full text]
  • Assessment, Management and Decision Making in the Treatment Of
    Pediatric Ankle Fractures Anthony I. Riccio, MD Texas Scottish Rite Hospital for Children Update 07/2016 Pediatric Ankle Fractures The Ankle is the 2nd most Common Site of Physeal Injury in Children 10-25% of all Physeal Injuries Occur About the Ankle Pediatric Ankle Fractures Primary Concerns Are: • Anatomic Restoration of Articular Surface • Restoration of Symmetric Ankle Mortise • Preservation of Physeal Growth • Minimize Iatrogenic Physeal Injury • Avoid Fixation Across Physis in Younger Children Salter Harris Classification Prognosis and Treatment of Pediatric Ankle Fractures is Often Dictated by the Salter Harris Classification of Physeal Fractures Type I and II Fractures: Often Amenable to Closed Tx / Lower Risk of Physeal Arrest Type III and IV: More Likely to Require Operative Tx / Higher Risk of Physeal Arrest Herring JA, ed. Tachdjian’s Pediatric Orthopaedics, 5th Ed. 2014. Elsevier. Philadelphia, PA. ISOLATED DISTAL FIBULA FRACTURES Distal Fibula Fractures • The Physis is Weaker than the Lateral Ankle Ligaments – Children Often Fracture the Distal Fibula but…. – …ligamentous Injuries are Not Uncommon • Mechanism of Injury = Inversion of a Supinated Foot • SH I and II Fractures are Most Common – SH I Fractures: Average Age = 10 Years – SH II Fractures: Average Age = 12 Years Distal Fibula Fractures Lateral Ankle Tenderness SH I Distal Fibula Fracture vs. Lateral Ligamentous Injury (Sprain) Distal Fibula Fractures • Sankar et al (JPO 2008) – 37 Children – All with Open Physes, Lateral Ankle Tenderness + Normal Films – 18%: Periosteal
    [Show full text]
  • Patella Problems
    Patella Problems Introduction The patella, or kneecap, can be the reason your knee hurts if it fails to function properly. Over time, wear and tear underneath the patella can also lead to degeneration of the cartilage behind the patella and cause pain, weakness and swelling of the knee joint. There are several different problems that affect the patella ­ and the groove that it runs through as the knee is bent. These problems can affect people of all ages. Anatomy The patella, or kneecap, is the moveable bone on the front of the knee. The patella is wrapped inside a large tendon that connects the large muscles on the front of the thigh, the quadriceps muscles, to the lower leg bone. This large tendon when combined with the patella, is called the quadriceps mechanism. The quadriceps mechanism is usually referred to as two separate tendons ­ the quadriceps tendon on top of the patella and the patellar tendon below the patella. The quadriceps mechanism allows you to straighten out the knee. The patella acts like a fulcrum to increase the force of the quadriceps muscle. The underside of the patella is covered with articular cartilage, the smooth covering of joint surfaces. This slippery surface helps the patella glide in a special groove of the thigh bone, or femur. Together the patella and the groove in the femur are called the patello­femoral mechanism. Causes Problems commonly develop when the patella suffers wear and tear. The underlying cartilage begins to degenerate, a condition sometimes referred to as chondromalacia patellae. Wear and tear can develop for several reasons.
    [Show full text]
  • About Your Knee
    OrthoInfo Basics About Your Knee What are the parts of the knee? Your knee is Your knee is made up of four main things: bones, cartilage, ligaments, the largest joint and tendons. in your body Bones. Three bones meet to form your knee joint: your thighbone and one of the (femur), shinbone (tibia), and kneecap (patella). Your patella sits in most complex. front of the joint and provides some protection. It is also vital Articular cartilage. The ends of your thighbone and shinbone are covered with articular cartilage. This slippery substance to movement. helps your knee bones glide smoothly across each other as you bend or straighten your leg. Because you use it so Two wedge-shaped pieces of meniscal cartilage act as much, it is vulnerable to Meniscus. “shock absorbers” between your thighbone and shinbone. Different injury. Because it is made from articular cartilage, the meniscus is tough and rubbery to help up of so many parts, cushion and stabilize the joint. When people talk about torn cartilage many different things in the knee, they are usually referring to torn meniscus. can go wrong. Knee pain or injury Femur is one of the most (thighbone) common reasons people Patella (kneecap) see their doctors. Most knee problems can be prevented or treated with simple measures, such as exercise or Articular cartilage training programs. Other problems require surgery Meniscus to correct. Tibia (shinbone) 1 OrthoInfo Basics — About Your Knee What are ligaments and tendons? Ligaments and tendons connect your thighbone Collateral ligaments. These are found on to the bones in your lower leg.
    [Show full text]
  • Physio Med Self Help for Anterior Knee Pain
    Physio Med Self Help 0113 229 1300 for Anterior Knee Pain There can be many causes of knee pain. Anterior knee pain or patella-femoral pain is pain that is felt under the knee cap (patella) at the front of the knee. The patella, or kneecap, can be a source of knee pain when it fails to function properly. Alignment or overuse problems of the patella can lead to wear and tear of the cartilage behind the patella. Patella-femoral pain syndrome (anterior knee pain) is a common knee problem that affects the patella and the groove that the patella slides in over the femur (thigh bone). The kneecap together with the lower end of the femur is considered to be the patella-femoral joint. Anatomy of the Area What is the patella, and what does it do? The patella (kneecap) is the moveable bone on the front of the knee. This unique bone is wrapped inside a tendon that connects the large muscles on the front of the thigh, the quadriceps muscles, to the lower leg bone. The large quadriceps tendon together with the patella and patellar ligament is called the extensor mechanism. Though we think of it as a single device, the extensor mechanism has two separate tendons, the quadriceps tendon on top of the patella, which connects the quadriceps muscle to the top of the patella, and the patellar tendon below the patella, which connects the lower portion of the patella to the shinbone (tibia). The tendon above the patella is called the suprapatella tendon and the tendon below the patella is called the infrapatella tendon.
    [Show full text]
  • Back of Leg I
    Back of Leg I Dr. Garima Sehgal Associate Professor “Only those who risk going too far, can possibly find King George’s Medical University out how far one can go.” UP, Lucknow — T.S. Elliot DISCLAIMER Presentation has been made only for educational purpose Images and data used in the presentation have been taken from various textbooks and other online resources Author of the presentation claims no ownership for this material Learning Objectives By the end of this teaching session on Back of leg – I all the MBBS 1st year students must be able to: • Enumerate the contents of superficial fascia of back of leg • Write a short note on small saphenous vein • Describe cutaneous innervation in the back of leg • Write a short note on sural nerve • Enumerate the boundaries of posterior compartment of leg • Enumerate the fascial compartments in back of leg & their contents • Write a short note on flexor retinaculum of leg- its attachments & structures passing underneath • Describe the origin, insertion nerve supply and actions of superficial muscles of the posterior compartment of leg Introduction- Back of Leg / Calf • Powerful superficial antigravity muscles • (gastrocnemius, soleus) • Muscles are large in size • Inserted into the heel • Raise the heel during walking Superficial fascia of Back of leg • Contains superficial veins- • small saphenous vein with its tributaries • part of course of great saphenous vein • Cutaneous nerves in the back of leg- 1. Saphenous nerve 2. Posterior division of medial cutaneous nerve of thigh 3. Posterior cutaneous
    [Show full text]
  • Anatomy of the Foot and Ankle
    Anatomy Of The Foot And Ankle Multimedia Health Education Disclaimer This movie is an educational resource only and should not be used to manage Orthopaedic Health. All decisions about management of the Foot and Ankle must be made in conjunction with your Physician or a licensed healthcare provider. Anatomy Of The Foot And Ankle Multimedia Health Education MULTIMEDIA HEALTH EDUCATION MANUAL TABLE OF CONTENTS SECTION CONTENT 1 . ANATOMY a. Ankle & Foot Anatomy b. Soft Tissue Anatomy 2 . BIOMECHANICS Anatomy Of The Foot And Ankle Multimedia Health Education Unit 1: Anatomy Introduction The foot and ankle in the human body work together to provide balance, stability, movement, and Propulsion. This complex anatomy consists of: 26 bones 33 joints Muscles Tendons Ligaments Blood vessels, nerves, and soft tissue In order to understand conditions that affect the foot and ankle, it is important to understand the normal anatomy of the foot and ankle. Ankle The ankle consists of three bones attached by muscles, tendons, and ligaments that connect the foot to the leg. In the lower leg are two bones called the tibia (shin bone) and the fibula. These bones articulate (connect) to the Talus or ankle bone at the tibiotalar joint (ankle joint) allowing the foot to move up and down. The bony protrusions that we can see and feel on the ankle are: Lateral Malleolus: this is the outer ankle bone formed by the distal end of the fibula. Medial Malleolus: this is the inner ankle bone formed by the distal end of the tibia. Tibia (shin bone) (Refer fig.1) Tibia
    [Show full text]
  • Supplementary Table 1: Description of All Clinical Tests Test Protocol
    Supplementary Table 1: Description of all clinical tests Test Protocol description Tibiofemoral • Palpate & mark tibial tuberosity & midpoint over the talus neck frontal plane • Ask participant to stand on footprint map with foot at 10° external rotation, feet shoulder width, looking alignment forward, 50% weightbearing • Place callipers of inclinometer in alignment with the the two landmarks • Record varus/valgus direction in degrees Herrington test • Participant supine on plinth, knee positioned and supported in 20° of knee flexion (to place the patella within the trochlea groove) • With knee in position, place a piece of 1” Leukotape (or similar) across the knee joint, and mark the medial and lateral epicondyles of the femur and mid-point of the patella. Be sure to make note of medial and lateral end of tape • Repeat 3 times, attaching tape to this document for measuring later 30 second chair • Shoes on, middle of chair, feet ~ shoulder width apart and slightly behind knees with feet flat on floor, stand test arms crossed on chest • Instructions “stand up keeping arms across chest, and ensure you stand completely up so hips and knees are fully extended; then sit completely back down, so that the bottom fully touches the seat, as many times as possible in 30 seconds,” • 1-2 practice repetitions for technique • One 30-second test trial • Record number of correctly performed full stands (if more than ½ of way up at end of the test, counted as a full stand) Repetitive single • Shoes on, seated on edge of plinth, foot placed with heel 10 cm forward from a plumb line at edge of leg rise test plinth, other leg held at side of body, arms across chest.
    [Show full text]
  • Two Cases of Combined Patellar Tendon Avulsion from the Tibia and Patella
    SICOT-J 2018, 4,17 © The Authors, published by EDP Sciences, 2018 https://doi.org/10.1051/sicotj/2018014 Available online at: www.sicot-j.org CASE REPORT Two cases of combined patellar tendon avulsion from the tibia and patella Viachaslau Bradko1,2,*, William T. Stoll1, Lee S. Haruno1, Scott B. Rosenfeld1,2, and Scott D. McKay1,2 1 Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA 2 Division of Orthopaedic Surgery, Texas Children’s Hospital, Houston, TX, USA Received 2 October 2017, Accepted 8 April 2018, Published online 23 May 2018 Abstract- -Avulsion fractures of the inferior pole of the patella and proximal tibial apophysis are independently rare injuries. They occur in children due to the relative weakness of the apophyseal cartilage compared to the ligaments and tendons. The combination of these two fractures, is exceedingly rare, with only a few previously described cases in the literature. Due to the infrequent presentation of this injury, careful examination and consideration of advanced imaging is important for diagnosis and preoperative planning. Here we present two cases of combined sleeve fractures of the inferior pole of the patella and tibial apophysis, with discussion of the pathophysiology, classification, identification and management of the injury. Key words: Knee injuries, Bifocal avulsion, Patella, Patella tendon, Tibial tuberosity. Introduction Case description Case 1 An intense muscle contraction may result in the rupture of a muscle or tendon, or an avulsion fracture. In A 13-year-old male runner with history of contralateral contrast to adults, children are more likely to suffer from (left) patellar dislocation developed pain and inability to avulsion fractures due to the relative weakness of their bear weight in his right lower extremity following an apohyseal cartilage compared to connective tissues such as awkward landing after jumping over a hurdle.
    [Show full text]
  • Management of Intra-Articular Fractures of the Calcaneus: Introducing a New Locking Plate
    Shafa Ortho J. 2018 November; 5(4):e7991. doi: 10.5812/soj.7991. Published online 2018 October 9. Letter Management of Intra-Articular Fractures of the Calcaneus: Introducing a New Locking Plate Bijan Valiollahi 1, * and Mostafa Salariyeh 1 1Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran *Corresponding author: Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran. Email: [email protected] Received 2016 October 31; Revised 2018 September 22; Accepted 2018 September 27. Keywords: Calcaneus Fracture, New Plate, Sinus Tarsal Approach Dear Editor, displaced intra-articular fractures involving the posterior Fracture of the calcaneus is usually a challenging prob- facet and is ideally performed within three weeks of in- lem for orthopedic surgeons and patients. Calcaneal frac- jury. Beyond this time, separation of the fragments be- tures are the most common of tarsal bone fractures, and comes more challenging. To achieve an adequate reduc- most of them are displaced intra-articular (nearly 75%) frac- tion, surgery must be performed after soft tissue swelling tures, usually resulting from falling or motor vehicle acci- diminishes (2). dents (1). Full diminishing of soft tissue edema is demonstrated Most patients with calcaneal fractures are usually by a positive wrinkle test, indicating that surgical interven- young men in their prime working years, which results in tion may be performed safely. For the extensile lateral ap- a significant loss of economic productivity. Although sur- proach, a good skin with positive wrinkle test is needed. gical techniques and fixation implants have generally im- Concerns about high wound complication rates in the ex- proved functional outcomes, there is vast controversy as to tensile lateral approach have prompted some to improve the management of these highly complex injuries.
    [Show full text]
  • Patellofemoral Syndrome (PFS)
    Scott Gudeman, MD 1260 Innovation Pkwy., Suite 100 Greenwood, IN 46143 317.884.5161 OrthoIndy.com ScottGudemanMD.com Patellofemoral Syndrome (PFS) Knee Anatomy The patella is a moveable bone in front of the knee wrapped inside a large tendon that connects the quadriceps (thigh) muscles to the tibia (lower leg bone). A healthy patella moves smoothly in a groove on the lower end of the femur. If the patella is moving incorrectly through this groove, Patellofemoral Syndrome (PFS) could form. Many muscle groups and ligaments control the triangular-shaped patella. The patella is coated on its bottom with a smooth covering called articular cartilage. The patella and the femur form a joint, called the patellofemoral joint, that is made up of muscles, soft tissue attachments and the groove where the patella rests. What is Patellofemoral Syndrome (PFS)? PFS is the medical name for a condition that causes pain in and around the kneecap. The patella (kneecap) is designed to move smoothly over a groove on the femur (thigh bone). When the patella is not moving or “tracking” properly over the femur, PFS can develop. This knee problem commonly appears in runners and athletes but non-athletes can also be affected. For the pediatric population, PFS can be jump-started during times of growth. PFS can strike at any age to any population. Causes of Patellofemoral Syndrome • Muscle imbalances in the quadriceps can cause the patella to move improperly through the groove in the femur. If one or more of the quadriceps muscles are weak, a muscle imbalance could occur. This imbalance pulls the patella off its track through the groove.
    [Show full text]