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.
Meningitis and Sepsis in Children
Sepsis in the newborn. By and large the most common organism is group B strep and most of the disease reflects maternal colonization with group B Streptococci. The risk of a child having sepsis in the newborn period increases with reports of a number of other factors, including maternal fever, prolonged rupture of membranes, premature rupture of membranes, being a low birth weight infant where they may not have received antibody from the mother which would be protective against these encapsulated bacteria. Epidemiological data continue to link lower socioeconomic status with a higher risk of sepsis, and a point not to forget; when you see one pair of twins who is septic, the other should be promptly evaluated because there tends to be a high concordance rate of group B strep disease among twins. The other point, early onset disease. Sepsis appearing in the first week of life tends to be sepsis or pneumonia. >From seven days of age to 28 days of age sepsis is more frequently associated with bacterial meningitis.
New Treatments for Arrhythmias in Children This is a general outline of the approach to arrhythmias. The first thing you are going to do is; what is the heart rate? Fast, slow? Is it regular, irregular? The next thing you will notice is; is it wide or narrow QRS, because obviously you will be worried about how dangerous this might be. And then you will probably start to look a little more closely and see if you see P waves. And the P waves are what’s going to really give you a diagnosis. They can be absent, they can be normal, they might be retrograde or they might be intermittent or multiple. Whenever possible, it’s very helpful to obtain 12-lead EKGs to diagnose a rhythm disorder. Obviously if the patient is unstable it’s not worth it, in a pulseless patient. But if a patient is stable talking to you, it’s very helpful to figure out what this was and how to treat it long-term, if you have 12-lead EKGs. It’s also very helpful to run rhythm strips, preferably rhythm strips out of an EKG machine that will give you three leads rather than something off of a defibrillator or monitor during interventions when you give adenosine, even vagal maneuvers.
Herpes Symptoms in Men Herpes simplex virus (HSV) affects more than one-third of the world's population. HSV exists as types 1 and 2, which have affinities for different body sites. Ninety percent of infections caused by HSV-2 are genital, and 90 percent of those caused by HSV-1 are oral.
Downs syndrome Symptoms and Prevention Down’s syndrome is a congenital (present at birth) disorder characterized by varying degrees of mental retardation and a variety of physical abnormalities.
Down’s syndrome Causes
Normally, each cell in the human body has 46 chromosomes; the cells in someone with Down’s syndrome, however, have 47. In ways that are as yet unknown, the presence of the extra chromosome causes all of the unusual characteristics of Down’s syndrome. In 95 percent of cases, the condition is called trisomy 21 (because the extra chromosomes is attached to the twenty-first pair of chromosomes), and the mistake in genetic coding is one that apparently could happen to anyone. In five percent of cases, the syndrome is caused by a defect that is believed to run in families.
Mesenteric Ischemia Mesenteric ischemia is classified as acute mesenteric ischemia (AMI) chronic mesenteric ischemia (CMI). AMI is subdivided into occlusive and nonocclusive mesenteric ischemia. Occlusive mesenteric ischemia results from either thrombotic or embolic arterial or venous occlusion. Approximately 80% of cases of AMI are occlusive in etiology, with arterial emboli or thromboses in 65% of cases and venous thrombosis in 15%. Arterial occlusions result from emboli in 75% of patients and in situ thrombosis cause the remaining 25%. NOMI is caused by low perfusion states and is responsible for 20% of AMI.
Hiatus Hernia Treatment The term hiatus hernia describes diaphragmatic hernia or weakness in the diaphragm, the horizontal muscular wall separating the organs of the chest from the organs of the abdomen. A hernia is an abnormal protrusion of an organ or tissue through an opening. A hiatus, or opening, permits the esophagus to carry food from the mouth to the stomach. Blood vessels and nerves also pass through the diaphragm. The diaphragm is an important group of muscles for contracting and expanding the lungs, forcing air in and out of the lung tissues.
Natural Head Lice Treatment Are you looking for natural head lice treatment? here is some good stuff about natural head lice treatment. Head lice are tiny wingless insects that are grey-brown in colour. They are the size of a pinhead when they hatch and 3mm long (the size of a sesame seed) when fully grown. Head lice cannot fly, jump or swim. They are spread by head-to-head contact and climb from the hair of an infected person to the hair of someone else.
Diverticulitis Diet Foods to Avoid A low residue diet is one that consists of a daily intake of no more than 10 grams of fiber. While on this diet for an extended period of time it is recommended that a multi-vitamin or mineral supplement be taken daily. This ensures that minerals and vitamins lost while on the low residue diet are made by taking supplements.
Until recently, many doctors suggested avoiding foods with small seeds because it was believed that particles could lodge in the diverticula and cause inflammation. However, this is now a controversial point and no evidence supports this recommendation. So the seeds in tomatoes, zucchini, cucumbers, strawberries and raspberries, as well as poppy seeds, which are part of your diverticulitis diet, are generally considered harmless.
Naegleria fowleri life cycle Are you looking for naegleria fowleri life cycle? Naegleria fowleri is a free-living ameboflagellate that can cause primary amebic meningoencephalitis in humans (PAM). Of the 30+ species of Naegleria that have been isolated, only N. fowleri has been demonstrated to be pathogenic in humans. Another species, N. australeinsis, has been proven to be pathogenic in mice and is useful in laboratory study of Naegleria pathogenesis (De Jonchheere, 2004). While the number of reported cases of N. fowleri infection is small, because of the fatality of PAM (98% death rate), the amoeba and resulting meningoencephalitis are a public health interest.
How HIV Is Transmitted HIV typically enters one person’s body when another person’s infected body fluids (semen, vaginal secretions, blood, etc.) gain entry through a breach in body defenses. Mucous membranes of the genital organs and the anus provide the easiest route of entry. If there is a break in mucous membranes (as can occur during sexual intercourse, particularly anal intercourse), the virus enters and begins to multiply.
Heterochromia Iridium Causes In anatomy, heterochromia refers to a difference in coloration, usually of the iris but also of hair or skin. Heterochromia is a result of the relative excess or lack of melanin (a pigment). It may be inherited, or caused by genetic mosaicism, disease, or injury.
Heterochromia of the eye (heterochromia iridis or heterochromia iridum; the common wrong form "heterochromia iridium" is not correct Latin) is of two kinds. In complete heterochromia, one iris is a different color from the other. In partial heterochromia or sectoral heterochromia, part of one iris is a different color from its remainder.
Schistosomiasis Symptoms and Treatment A worm of a different sort—the trematode, a flatworm of the class Trematoda, which includes the flukes—is responsible for schistosomiasis. This disease occurs in various forms if Africa, Asia, South America, and the Caribbean, including Puerto Rico. About 200 million people infected with schistosomiasis, also called bilharziasis.
Life Cycle of the Fluke Parasite
The process of infection by one kind of fluke involves free swimming larvae that penetrate the skin of a human who has entered waters containing the organism. The larvae follow the human bloodstream to the liver, where they develop into adult worms. The adult worms then move into the intestine or urinary bladder and are excreted with the urine or feces of the host. If they find their way to fresh water, the eggs hatch and the released organisms find their way to the body of a snail. Inside the snail they multiply into thousands of new larvae over a period of one or two months, after which they return to the water and invade the skin of another human. In this manner the fluke worm continues its life cycle, infecting more humans who venture into the contaminated waters.
Genetics of Behavior Behavior Genetics is a “science that combines aspects of psychology, psychiatry, physiology and genetics,” the goal of which “is to clarify the role that genetic factors play in the determination of behavior.” The term genotype refers to the total set of genes present in an individual at the time of conception and coded in the DNA. The physical manifestations of a particular genotype ate designated by characteristics that specify a specific Phenotype. Examples of phenotypes include eye color, height, blood type, language and hair type. As evident by the examples presented, phenotypes are not only genetic but may also be acquired (i.e. influenced by the environment) or a combination of both. It is likely that most psychiatric disorders are the result of a combination of genetics and environment influences)
Investigators who study the etiological implications for psychiatric illness may explore several risk factors. Studies to determine if an illness is Familial compare the percentages of family members with the illness to those in the general population of in a control group of unrelated individuals. These studies estimate the prevalence of psychopathology among relatives and make predictions about the predisposition to an illness based on familial risk factors. Schizophrenia, bipolar disorder, major depression anorexia nervosa, panic disorder and alcoholism are examples of psychiatric illness in which familial tendencies have been indicated.