A Lisfranc (midfoot) injury is a significant injury that often has a prolonged recovery time. Fracture of the midfoot bones and/or disruption of the midfoot ligaments (Figure 1) leads to pain, swelling, and often an inability to weight-bear. During normal standing and walking the ligaments of the midfoot are subject to forces that are 2-3 times body weight.
What is lisfranc injury
The Lisfranc fracture is a fracture of the foot in which one or all of the metatarsals are displaced from the tarsus. It is named after 18th- and 19th-century surgeon and gynecologist Jacques Lisfranc de St. Martin. This type of injury classically occurred when a horseman fell while riding, having trapped his foot in the stirrup or fallen into a drain. At present, such an injury happens typically in activities such as windsurfing (where participants' feet are in foot straps that pass over the metatarsals), or when one steps into a hole and the foot twists heavily. Falling from a height of two or three stories can also cause this fracture. American football players occasionally get this injury, often when they have their foot pointing down and someone lands on their heel.
A Lisfranc injury is initially diagnosed based on the history and description of the athlete’s acute injury. Often an athletic trainer at the practice or competition may see the injury occur in real time and have an immediate suspicion for the injury. The athlete will describe the immediate onset of pain in the midfoot region. There may be difficulty or even an inability to put weight on the injured foot. Over the course of the ensuing day, swelling and bruising often occurs that when serious may even become evident on the bottom of the foot. On a physical exam, the injured athlete will be tender over Lisfranc’s joint and any others involved in the injury. In the most severe of injuries, those that involve a large direct crushing force to the foot, the swelling may be so severe that an emergent evaluation in an emergency room is necessary and possibly even immediate surgery. This is however extremely rare in the setting of athletic injuries.
Lisfranc injury recovery time
Most often the treatment of a Lisfranc injury is surgical, although some minor injuries can be treated conservatively. If there is minimal displacement of the bones, a stiff walking cast applied for approximately eight weeks is an appropriate alternative. However, the more common treatment is to secure the fractured and dislocated bones with either internal (screws) or external (pins) fixation.
Stable Lisfranc injuries that do not require surgery may cause an athlete to miss 2 months or more of their season. However, most athletes are able to successfully return at some point. Those injuries that are unstable, and require surgical repair, are serious injuries that almost always cause the injured athlete to miss the remainder of their season. It is also not uncommon for a high level athlete to not be able to return to the same level of athletic performance even in following seasons. Two well-known examples are Eric Rhett and Duce Staley both of whom had surgery for a serious Lisfranc injury and never successfully returned to their pre-injury form.
Women and Cardiovascular Disease Heart disease is the number one killer of both men and women. In the United States, heart attacks kill about 240,000 women a year; stroke takes another 88,000 women’s lives. That compares with about 43,000 women who die annually from breast cancer. In fact, nearly twice as many women die of CVD (Cardiovascular Disease) than all cancers combined.
While men do have more heart attacks and have them earlier in life, women have a much lower chance of surviving a heart attack. We understand the mechanism that cause CVD in men from years of male-oriented research. But only within the last decade have we moved toward a better understanding of how CVD manifests itself in women.
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Breast Cancer Treatment and Therapy Guidelines What about the follow-up after our primary and adjuvant treatment for breast cancer? We know from many good signs that most of the recurrences are found by patients, second most by physicians and almost never by routine tests. Therefore, the official recommendations for follow-up of asymptomatic individuals after primary therapy is that they have history and physicals about every four to six months and that they have annual mammographies. There are no films, scans, tumor markers that are indicated in the follow-up of asymptomatic individuals. So, we usually suggest a history and physical every three to six months and an annual mammography. This is something that is continually under review. It might change, but today, all of the studies that have been done have never been able to show survival benefit for intensive screening with radiographic and blood testing as opposed to just clinical follow-up of these patients.
Metastatic breast cancer. If breast cancer is found to have spread at the time of diagnosis or recurs later after local therapy, we have a situation which cannot be realistically considered to be a curable disease at this point. I think that is important. It is equally important however to recognize that the survival ratio with metastatic breast cancer is very, very variable. If you have metastatic lung cancer or inoperable pancreas cancer, most of these patients are dead in year. Certainly within 18 months. There is almost no survival at two years with a disease like that. Breast cancer is all over the board. The median survival from onset of metastases is probably on the order of two to three years but all of us have patients who have lived 10 years or more in very good physical condition after the development of metastatic disease. So, again looking at the clinical parameters of what the disease-free interval is, what sites are involved, whether the hormone receptors are positive, can help you project somewhat what is going to happen but is a situation with an extremely variable prognosis.
Leishmaniasis Symptoms, Treatment and Types Leishmaniasis is similar to malaria in that disease organisms are protozoa transmitted to humans by an insect bite, but the insect in this case is the sandfly. There are several form that leishmaniasis can take. The kind considered most lethal, with a mortality rate of up to 95 percent of untreated adults, is known as kala-azar, a term derived from the Hindi language meaning “black disease.” Kala-azar also is known as black fever, dumdum fever, and visceral leishmaniasis. It occurs from China through Russia and India to North Africa, the Mediterranean countries of Europe, and in parts of Central and South America. Kala-azar has appeared in United-States in cases contracted overseas.
Coronary Artery Disease Treatment Guidelines It can be difficult to determine whether chest pain is caused by angina. Whenever a person develops symptoms that could be angina, a complete medical evaluation is needed to determine whether coronary artery disease is present and, if so, how severe it is (see also chapter 7). The individual's medical history and descriptions of the pain, actions that cause the pain, and actions that make it better may raise a doctor's suspicion of coronary artery disease, but these factors are not sufficient for actual diagnosis. Likewise, physical examination and blood tests may show that the patient is at risk, but cannot actually diagnose the condition.
An electrocardiogram may or may not show changes of cardiac ischemia. An exercise electrocardiogram, a ''stress test'' done while a person is performing a specific amount of exercise, is more likely to demonstrate whether coronary disease is present. A particular change in the electrocardiogram during exercise can demonstrate that coronary artery disease is present. Even an exercise electrocardiogram is not 100 percent reliable in diagnosing coronary artery disease.
Listeria symptoms during pregnancy Are you looking for listeria symptoms during pregnancy? Listeria infection is a food-borne illness that can be very serious for pregnant women and people with impaired immune systems. Listeria infection is most commonly contracted by eating improperly processed deli meats and unpasteurized milk products.
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Symptoms Ovarian Cancer Are you looking for article about symptoms ovarian cancer? Here is good stuff about ovarian cancer symptoms.
The 5-year survival rate for ovarian cancer by stage is not significantly different from the 5-year survival rate for other gynecologic cancers; however, there is a significant difference in stages, with ovarian cancer usually having spread into the abdomen in about two thirds of patients at the time of diagnosis. It is clear from these data that the single most important factor in the large number of deaths from ovarian cancer is the failure to diagnosis the disease at an early stage. The reasons for this failure correspond to the growth and spread patterns of the disease. Because the ovary floats freely in the pelvic cavity, a tumor can grow for some time without producing symptoms associated with involvement of, or pressure on, other organs.
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Types of Blood Cancer Symptoms and Treatments Overview of Blood Cancer
The major forms of blood cancer are lymphoma, leukemia and multiple myeloma. These cancers are formed either in the bone marrow or the lymphatic tissues of the body. They affect the way your body makes blood and provides immunity from other diseases.
Bunion surgery recovery and photos Are you looking for Bunion surgery recovery and photos? Bunion surgery generally involves an incision in the top or side of the big toe joint and the removal or realignment of soft tissue and bone. This is done to relieve pain and restore normal alignment to the joint. If the joint is severely deformed, it may be stabilized with tiny wires, stitches, screws, or plates. There are no guarantees that a bunion surgery will fully relieve your pain.