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.
Drug Classification Drugs are commonly classified according to the physiological effect they have. Categories include stimulants, depressants, hallucinogens, narcotics, and inhalants. Two other types are also important. First, designer drugs are manufactured to mimic the effects if drugs found in the previously mentioned categories. Designer drugs usually are not illegal because their chemical formula has been altered from the original drug. The other drug, marijuana, is difficult to classify but is usually included as a hallucinogen. Depending on the dose, marijuana can mimic a variety of substances found in other categories.
Radiation Safety Principles and Standard
The International Commission on Radiological Protection (ICRP) has
proposed that following principles should guide the use of ionizing
radiation safety standard:
No practice involving exposures to radiation should be adopted unless it
produces sufficient benefit to the exposed individuals or society to offset
the radiation detriment it causes (the justification of practice)
In relation to any particular source within a practice, the magnitude of
individuals doses, the number of people exposed, and the likelihood on
incurring exposures where these are not certain to be received should all kept
as low as reasonably achievable (ALARA), economic and social factors being
taken into account. This procedure should be constrained by restrictions of
the doses to individuals (dose constraint), so as to limit the inequity likely
to result from the inherent economic and social judgments.
The exposure of individuals resulting from the combination of all the
relevant practices should be subject to dose limits, or to some control of
risk in the case of potential exposures. These are aimed at ensuring that no
individual is exposed radiation risks that are judged to be unacceptable from
these practices in any normal circumstances. Not all sources are susceptible
of control by action at the source and it is necessary to specify the sources
to be included as relevant before selecting a dose limit.
Arteries of the Body Function and Pictures Arteries facts
Arteries are vessels that conduct blood away from the heart
Arteries transport oxygenated blood under pressure to the cells of the
body. (The pulmonary artery is an exception; it transports deoxygenated blood
to the lungs)
The arterial wall consists of three primary layers:
The innermost layer consists of simple squamous epithelium (the endothelium)
surrounded by a connective tissue basement membrane with elastic fibers.The
middle layer consists mainly of smooth muscle and is usually the thickest layer.
It not only provide support for the vessel but also changes vessel
diameter to regulate blood flow and blood pressure.The outermost layer,
which attaches the vessel to the surrounding tissue, consists of connective
tissue with varying amounts of elastic and collagen fibers.
Glucosamine Side Effects in Humans and Dosage Glucosamine (C6H13NO5) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is part of the structure of the polysaccharides chitosan and chitin, which compose the exoskeletons of crustaceans and other arthropods, cell walls in fungi and many higher organisms. Glucosamine is one of the most abundant monosaccharides. It is produced commercially by the hydrolysis of crustacean exoskeletons or, less commonly by fermentation of a grain such as corn or wheat. In the US it is one of the most common non-vitamin, non-mineral, dietary supplements used by adults.
Osteoporosis Symptoms, Treatment and Prevention Osteoporosis is a widespread condition that causes fractures. Osteoporosis is defined as a systemic disease characterized by low bone mass, microarchitectural deterioration of bone tissue with the consequent increase in bone fragility and susceptibility of fracture. Osteoporosis is a disease of thin bones that break easily. We have nice strong vertebral structures on the left and thin porous bones that snaps easy. So the role really of your situation in this disease is trying to recognize these people before there’s a fracture, when you know they’ve got thin bones, and treat them and see if you can actually prevent the fracture.
Criteria for osteoporosis is based on bone densitometry readings and a standard deviation or two below your peak bone mass would be considered osteopenia, or thin bones but not osteoporotic. A value of two standard deviations below would be osteoporosis and worthy of investigation and/or treatment. The World Health Organization took a slightly different stance and most of the bone densitometry equipment manufacturers installed this definition in their software, and that is: osteoporosis really starts at 2 ½ standard deviations, or a T-score of -2.5, and severe osteoporosis means not only do you have a low T-score but you’ve had a fragility fracture of some sort. Either a collapsed spine, a broken hip, a broken wrist with relatively mild trauma. So we have a functional definition, a quantitative definition, and I think we have a pretty good framework to work with in terms of understanding who we need to recognize and treat.
Lasik Eye Surgery Cost and Prices Are you looking how much Lasik Eye Surgery Cost?
There have always been concerns about LASIK because of its tendency to induce higher-order aberrations. The advancement of the LASIK technology has helped reduce the risk of clinically significant visual impairment after surgery. There is a correlation between pupil size and aberrations. Effectively, the larger the pupil size, the greater the risk of aberrations. This correlation is the result of the irregularity between the untouched part of the cornea and the reshaped part. Daytime post-lasik vision is optimal, since the pupil is smaller than the LASIK flap. But at night, the pupil may expand such that light passes through the edge of the LASIK flap into the pupil which gives rise to many aberrations, including the appearance of halos surrounding sources of light. There are other currently unknown factors in addition to pupil size that also may lead to higher order aberrations
Hypertension treatment food and nutrients When pressure exerted by blood on the walls of the arteries is greater than normal, blood pressure rises. Usually, blood pressure falls when at rest. It rises in response to strenuous physical activity, stress, or a perceived danger in which the sympathetic nervous system dominates, arteries constrict and more blood is sent to the brain increasing blood pressure. This heightened state of the sympathetic system does not seem to retreat in individuals with hypertension and damage to the heart, kidney, arteries, and other organs becomes inevitable.
Blood pressure is considered high at a reading of 140/90. There are no symptoms of the illness and it is recommended individuals over 40 be checked. Hypertension can be controlled by permanent diet and lifestyle changes; this includes reducing stress, maintaining proper weight (not more than 5 lb overweight), and eating foods containing compounds that reduce blood pressure such as celery, garlic, and fresh fruits and vegetables. Having a home monitor is helpful. Smoking, alcohol, refined sugar, food allergies, and high sodium foods can contribute to hypertension. Some people may need extra calcium to stabilize blood pressure. Some individuals are salt sensitive which cause a rise in their blood pressure. Daily exercises and various stress reduction techniques lower systolic and diastolic blood pressure.
Nephritis Symptoms and Treatment Nephritis is a disorder characterized by inflammation of the glomeruli of the kidneys. The glomeruli are tiny coiled blood vessels through which the liquid portion of the blood is filtered as it enters the outer structure of the kidneys. There are about one million of these tiny blood vessels in each kidney. The fluid from the blood passes from them into many little ducts called tubules. Water and various substances are secreted into and absorbed from the liquid in the tubules. The final product of this passage of filtered fluid from the glomeruli through the tubules to the uterus and then to the bladder is urine. It contains the excess fluid and waste products produced by the body during normal functioning.
Adrenal Insufficiency Causes, Symptoms and Treatment Autoimmune adrenalitis is the most common cause of primary adrenal insufficiency. Adrenalitis caused by tuberculosis was once the most common cause. Autoimmune adrenalitis is sometimes accompanied by other autoimmune endocrine deficiencies, such as thyroid disease, diabetes mellitus, pernicious anemia, hypoparathyroidism, or ovarian failure (Table 14). Recently, AIDS and antiphospholipid syndrome have been cited as additional causes.
Iatrogenic tertiary adrenal insufficiency, a common secondary cause of adrenal insufficiency, results from suppression of hypothalamic-pituitary-adrenal function secondary to glucocorticoid administration. Secondary adrenal insufficiency may also result from pituitary or hypothalamic disease, as described earlier.
Common Ankle Problems The primary care physician will often be the first to evaluate common foot and ankle problems. The patient's complaints will range from acute traumatic injuries to chronic conditions, which have progressed in severity.
The recognition of local and systemic factors that contribute to the patient's condition in conjunction with a thorough history and physical examination will direct the initial plan of management, the use of further diagnostic testing and the necessity of an Orthopaedic referral.
Echocardiographic diagnosis in carcinoid heart disease W.F. Wonnink-de Jonge, C.T.A.M. Knibbeler-van Rossum, C. van der Heul, W.H. Pasteuning 181
In this case report the typical echocardiographic features
of carcinoid heart disease are presented. Newer treatments
such as the use of a somatostatin analogue, interferon and
hepatic de-arterialisation have improved the prognosis in
patients with carcinoid syndrome. Nevertheless this syndrome
portends a poor prognosis in patients with cardiac
involvement. Cardiac lesions are mainly located in the
right side of the heart.
What is lisfranc injury and how to recovery 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.
Reproductive health care By Felicia H. Stewart, MD; Wayne C. Shields; Ann C. Hwang, MD
In the long aftermath of war, the people of both Iraq and
Afghanistan are struggling to rebuild their nations.