Fourth Metatarsal Base Stress Fractures in Athletes: A Case Series.
Fourth Metatarsal Base Stress Fractures in Athletes: A Case Series.
Filed under: Rehab Centers
Foot Ankle Int. 2013 Feb 5;
Rongstad KM, Tueting J, Rongstad M, Garrels K, Meis R
Background:Metatarsal stress fractures account for approximately 28% of all stress fractures reported in the literature. Second and third metatarsal stress fractures are most common, followed by fractures of the fourth and fifth metatarsal. Reports in the literature suggest that proximal fourth metatarsal stress fractures have the same propensity for delayed healing and nonunion as do fifth metatarsal stress fractures. There is a paucity of literature on operative management of fourth metatarsal fractures. This study reports the results of operative management of fourth metatarsal stress fractures in athletes.Methods:A retrospective review with prospectively collected data was undertaken to evaluate utility of operative care of fourth metatarsal stress fractures in an athletic population desiring early return to sports. Eleven athletes over a 13-year period were enrolled with proximal fourth metatarsal stress fractures. The American Orthopaedic Foot & Ankle Society (AOFAS) Midfoot scores were obtained pre- and postoperatively. Midfoot alignment, including the presence or absence of metatarsus adductus, radiographic time to healing, and time to return to sports were also recorded.Results:All patients were treated with operative open reduction and internal plate fixation with calcaneal autograft. Four of the 11 patients had metatarsus adductus. All had evidence of radiographic healing prior to return to activity, all returned to sports at an average of 12 weeks post surgery, and all would choose surgery again given the same injury. The AOFAS Midfoot scale improved from an average of 55 preoperatively to 94 postoperatively (P < .001)Conclusion:Our study suggests that operative repair of fourth metatarsal stress fractures hastens time of healing and return to sports in athletes. It also supports the theory that there is a correlation between metatarsus adductus lateral metatarsal stress fractures.Level of Evidence:Level IV, retrospective case series. HubMed – rehab
Prosthetic rehabilitation of partial ear loss with custom-made acrylic attachment and long-term soft liner.
Filed under: Rehab Centers
Prosthet Orthot Int. 2013 Feb 5;
Chand P, Agrawal KK, Bhalla G, Singh K, Jurel SK, Goel P, Singh SV
Background:The craniofacial implants are used for retaining the prostheses although these are costly and often require complex laboratory procedures. The aim of this case report is to describe a case of successful rehabilitation of partial ear loss with long-term soft liner and mechanically retained by custom-made heat-cured acrylic attachment.Case Description and Methods:A female patient underwent a scalp avulsion injury and lost major portion of her hair and upper part of the left ear till the antitragus. A partial auricular prosthesis was fabricated, and mechanical retention was achieved through custom-made heat-cured acrylic attachment engaged in anatomic undercuts of remained ear.Findings and Outcomes:Permanent soft liner provided a life-like appearance and consistency to the prosthetic ear and bonded to custom-made heat-cured acrylic attachment through chemical cross-linking.Conclusion:Patient accepted the prosthesis satisfactorily without any social and psychological embracement. This technique simplified the clinical and laboratory procedures and reduced the cost of the prosthesis.Clinical relevanceThe use of permanent soft liner is esthetically acceptable and can cross-link with acrylic resin to allow the bonding between the custom-made acrylic retentive element and the prosthesis.
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Do personality traits matter when choosing a group therapy for early psychosis?
Filed under: Rehab Centers
Psychol Psychother. 2013 Mar; 86(1): 19-32
Beauchamp MC, Lecomte T, Lecomte C, Leclerc C, Corbière M
Objectives. This study aimed at determining the predictive value of personality traits, based on the Five Factor Model (FFM) of personality, on therapeutic outcomes according to specific group treatments for first episode psychosis: cognitive-behavioural therapy (CBT) or skills training for symptom management (SM). Methods. Individuals experiencing early psychosis were recruited to participate in a randomized- controlled trial (RCT). Participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO-FFI) and outcome measures of symptomatology (BPRS-E) and coping strategies (CCS). Pearson correlation analyses were conducted on 78 individuals and linear regression analyses on 66. Results. Links were found between personality traits, symptoms, and coping outcome measures, according to specific group treatments. Personality traits were particularly linked to therapeutic changes in active coping strategies, with Conscientiousness accounting for 14% of the variance in the CBT group, Extraversion accounting for 41% of the variance in the SM group, and Openness to experience accounting for 22% of the variance in the control group. Conclusions. Individual differences in personality traits for people experiencing early psychosis should be considered when offering psychosocial treatments, since it appears that those with specific traits might benefit more than others in specific group interventions, particularly for interventions that do not solely aim at improving symptoms.
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Electrocardiography in Conscious Releasable Andean Condors (Vultur gryphus): Reference Panel and Unusual Findings.
Filed under: Rehab Centers
Zoo Biol. 2013 Feb 5;
Wiemeyer GM, Lambertucci SA, Bianchini LT, Belerenian G
Electrocardiography is a useful tool when included in healthcare protocols and is increasingly utilized for monitoring wild birds. However, the lack of reference data for many species is limiting the clinical value of this technique. In this study 26 Andean condors (Vultur gryphus) coming from rehabilitation and captive breeding programs were examined to determine electrocardiographic references prior to being released. Standard bipolar (I, II, and III) and augmented unipolar limb (aVR, aVL, and aVF) leads were recorded with birds under physical restraint. Five beats were analyzed on Lead II at 50?mm/sec and 1?cm?=?1?mV to determine QRS complex morphology, cardiac rhythm, heart rate, P, PR, R, S, QRS, T, QT, and ST amplitude and/or duration. P and T wave configuration was determined for all leads, and Mean Electrical Axis (MEA) in the frontal plane was determined using leads I and III. Cardiac rhythm corresponded to regular sinus rhythm in 42% of the birds, with a relevant rate of sinus arrhythmia in 58%, and rS as the most common pattern (42%) for QRS complex in lead II. We found an influence of age and heart rate but not of sex on several ECG waves and intervals. Relevant ECG findings for studied Andean condors include a high rate of T(a) , R’, and U wave detection. Waves T(a) and R’ were considered non-pathological, while the significance of U waves remains unclear. Our results provide a useful reference to improve clinical interpretation of full electrocardiographic examination in Andean condors. Zoo Biol. XX:XX-XX, 2013. © 2013 Wiley Periodicals Inc. Zoo Biol. XX:XX-XX, 2013. © 2013 Wiley Periodicals Inc.
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