摘要 :
Die Rupturen der Adduktoren, des M. rectus femoris und des M. biceps femoris sind Verletzungen beim Sportler, die eine schnelle und sichere Diagnosestellung erfordern. Die Therapie der rein muskulären Verletzungen ist überwiegen...
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Die Rupturen der Adduktoren, des M. rectus femoris und des M. biceps femoris sind Verletzungen beim Sportler, die eine schnelle und sichere Diagnosestellung erfordern. Die Therapie der rein muskulären Verletzungen ist überwiegend konservativ, bei Abrissfrakturen an den Insertionen oder kompletten sehnigen Rupturen muss in Abhängigkeit vom funktionellen Ausfall und der Dislokation oder Retraktion der Sehnenansätze häufiger eine operative Therapie indiziert werden.
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Coseismic surface ruptures during desctructive earthquakes (1999 Kocaeli-Diizce, Turkey and 1999 Chi-Chi, Taiwan) have caused devastating effects on buildings and infrastructures. Surface rupture remains a complicated phenomenon i...
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Coseismic surface ruptures during desctructive earthquakes (1999 Kocaeli-Diizce, Turkey and 1999 Chi-Chi, Taiwan) have caused devastating effects on buildings and infrastructures. Surface rupture remains a complicated phenomenon involving variable movements along near surface traces of both primary and secondary faults. The surface rupture patterns observed in nature, the rupture zone width and the magnitude of the surface rupture displacements, depend on the type of faulting, the earthquake magnitude, the complexities of fault geometry, as well as on the thickness and nature of the materials above bedrock. Surface rupture hazard assessment for determining the width of the surface rupture and rupture displacements magnitudes for civil engineering design needs to be site specific and incorporate various geological and geotechnical investigations. The current research on laboratory and numerical simulations to evaluate the impact of surface rupture on structure foundations is promising. However, it may be misleading to conclude that such models are sufficient to simulate the surface rupture complexities as observed in nature.
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摘要 :
We report a patient with traumatic aortic rupture
and preoperatively unrecognized complete disrup-
tion of the bronchus for the left lower lobe. Preop-
erative state was complicated by inadequate oxygen-
ation due to total atelect...
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We report a patient with traumatic aortic rupture
and preoperatively unrecognized complete disrup-
tion of the bronchus for the left lower lobe. Preop-
erative state was complicated by inadequate oxygen-
ation due to total atelectasis of the unventilated
collapsed left lower lobe with consequent significant
shunting of the unoxygenated blood. The patient had
no massive pneumothorax because the intact peri-
bronchial tissue and pleura covered the injured
place, preventing important air leakage. The suspi-
cion of possible concomitant tracheobronchial injury
and early diagnostic bronchoscopy are important in
patients with aortic rupture after blunt chest trauma.
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Les ruptures négligées du tendon calcanéen posent un problème chirurgical difficile en raison de la rétraction tendineuse et de la perte de substance créée. Le but de cette étude est d’évaluer l’intérêt du lambeau en ...
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Les ruptures négligées du tendon calcanéen posent un problème chirurgical difficile en raison de la rétraction tendineuse et de la perte de substance créée. Le but de cette étude est d’évaluer l’intérêt du lambeau en VY d’Abraham dans le traitement de ces ruptures négligées du tendon calcanéen. C’est une étude rétrospective effectuée sur une durée de quatre ans, entre juillet 2005 et juillet 2009, portant sur 16 ruptures négligées du tendon calcanéen. L’âge moyen de nos patients est de 40 ans (30 à 54 ans). Sur le plan étiologique, il s’agissait essentiellement d’accident de sport (12 cas). Le délai moyen entre l’accident initial et la prise en charge était de dix semaines, avec des extrêmes entre 4 à 16 semaines. Le diagnostic de rupture a toujours été confirmé par le seul examen clinique. L’intervention a été menée en décubitus ventral, par une voie d’abord para-achilléenne médiale. La perte de substance moyenne était estimée à 6 cm(5 à 10 cm). La mobilisation du lambeau en VYa permis de combler la perte de substance. Un renforcement a toujours été effectué par le tendon du muscle plantaire grêle. Une contention par plâtre avec décharge pendant six semaines (en équin pendant les trois premières semaines, cheville à angle droit pendant les trois dernières) a suivi l’intervention. Ensuite, la rééducation fonctionnelle a été entreprise. Les résultats ont été évalués selon des critères fonctionnels et cliniques. Les résultats globaux ont été excellents dans deux cas (12,5 %), bons dans 12 cas (75 %) et mauvais dans deux cas (12,5 %). Le traitement des ruptures négligées du tendon calcanéen est difficile du fait de la grande perte de substance souvent constatée. Le lambeau en VY d’Abrahamapporte des résultats fonctionnels encourageants.
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Ascending thoracic aortic aneurysms (ATAAs) are focal dilatations in the aorta that are prone to rupture or dissection. To accurately evaluate the rupture risk, one must know the local mechanical conditions at the rupture site and...
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Ascending thoracic aortic aneurysms (ATAAs) are focal dilatations in the aorta that are prone to rupture or dissection. To accurately evaluate the rupture risk, one must know the local mechanical conditions at the rupture site and understand how rupture is triggered in a layered fibrous media. A challenge facing experimental studies of ATAA rupture is that the ATAA tissue is highly heterogeneous; experimental protocols that operate under the premise of tissue homogeneity will have difficulty delineating the location conditions. In this work, we employed a previously established pointwise identification method to characterize wall stress, strain, and property distributions to a sub-millimeter resolution. Based on the acquired field data, we obtained the local mechanical properties at the rupture site in nine ATAA tissue samples. The rupture stress, ultimate strain, energy density, and the toughness of the tested samples were also reported. Our results show that the direction of the rupture is aligned with the direction of maximum stiffness, indicating that higher stiffness is not always related to higher strength. It was also found that the rupture generally occurs at a location of highest stored energy. As a higher stiffness and higher strain energy indicate a larger recruitment of collagen fibers in the tissue at the location and along the direction of rupture, the recruitment of collagen fibers in the deformation of the tissue is probably essential in ATAA rupture.
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摘要 :AbstractObjectiveWe aimed to evaluate the clinical outcomes after surgical repair of patellar tendon rupture (PTR) and compare the evolution of 2?types of rupture (acute and chronic) after the same rehabilitation protocol.M...
展开AbstractObjectiveWe aimed to evaluate the clinical outcomes after surgical repair of patellar tendon rupture (PTR) and compare the evolution of 2?types of rupture (acute and chronic) after the same rehabilitation protocol.MethodsThis was a prospective cohort study of patients with PTR treated between January?2006 and January?2014 in the department of trauma surgery, Ibn Rochd university hospital, Casablanca.ResultsWe evaluated 25?patients (21?men) after a median follow-up of 75?months (range 29–120). The mean age was 34.7±8.59?years. Overall, 17?patients had acute rupture and 8?chronic rupture. Fifteen healthy volunteers (13?men) were recruited as a control group. Mean Knee Society Score (KSS) knee score was significantly higher after than before surgery (82.28±12.297 vs 20.64±7.6; P<0.0001) as was KSS function score (88.40±17.483 vs 23.40±8.98; P<0.0001). Pain measured on a visual analog scale was significantly lower after than before surgery (1.96±1.24 vs 6.60±1.26; P<0.0001). ROM and KSS knee and function scores were significantly lower on the operated than non-operated side after surgery. For both types of PTR, only knee extensor muscle strength was significantly lower on the operated than non-operated side and as compared with healthy volunteer knees.ConclusionsSurgical repair of PTR with reinforcement and an early rehabilitation program demonstrate good results after a long follow-up. However, chronic PTR may need longer or a different rehabilitation protocol of the knee-extensor apparatus. ]]>
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摘要 :
Distal rupture of the biceps tendon can be disabling to active individuals. Many methods have been described to address acute and chronic ruptures surgically. Successful surgical management of these ruptures requires attention to ...
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Distal rupture of the biceps tendon can be disabling to active individuals. Many methods have been described to address acute and chronic ruptures surgically. Successful surgical management of these ruptures requires attention to the possible complications of nerve injury and heterotopic bone formation. Single-incision techniques utilizing multiple suture anchors may facilitate surgical repair and reconstruction without sacrificing fixation strength. The authors' experience with this technique has provided reliable surgical outcomes and patient satisfaction.
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Acquired cystic kidney disease (ACKD) is a complication of end-stage renal disease, the prevalence of which is related to dialysis duration; incidence of ACKD and associated conditions (neoplasia, hemorrhage) have decreased with i...
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Acquired cystic kidney disease (ACKD) is a complication of end-stage renal disease, the prevalence of which is related to dialysis duration; incidence of ACKD and associated conditions (neoplasia, hemorrhage) have decreased with improvements in renal transplantation and with the ageing of the dialysis population. This report regards spontaneous kidney rupture in a 57-year old patient, on home hemodialysis for 11 years, with ACKD for 5 years. At the end of a dialysis session, the patient reported sudden onset of colicky flank pain, followed by macrohematuria. Pain remitted with low doses of pain relievers, leaving dull flank discomfort. The patient self diagnosed a renal colic, and called the hospital two days later. At referral, two large hemorrhagic renal masses (7 and 2.8 cm) were found at ultrasound and CT scan. At surgery, kidney rupture was diagnosed. This case highlights the life threatening complications associated with ACKD, and underlines that massive renal hemorrhage may occur with relativelyminor symptoms.
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