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 athleteís 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 Lisfrancís 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.
Symptoms of meningitis in adults Are you looking for symptoms of meningitis in adults?
Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.
Many of the bacteria and viruses that cause meningitis are fairly common and associated with other routine illnesses. Bacteria and viruses that infect the skin, urinary system, gastrointestinal or respiratory tract can spread by the bloodstream to the meninges through cerebrospinal fluid, the fluid that circulates in and around the spinal cord.
What is the Best Treatment for Acne Scars Acne scar treatments have had a long and complicated history. Traditionally, the most famous method for getting rid of the scars left behind by acne was a harsh process known as "dermabrasion."
Now if you've never heard of dermabrasion, let me put this into perspective for you. "Derm" comes from the Greek word "Dermis", which means skin. "Abrasion" is the process of wearing down or rubbing away by means of friction. Put the two together and what do you get? Dermabrasion.
How HIV Is Transmitted HIV typically enters one personís body when another personís 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.
Types of Food Poisoning Food poisoning occurs when you swallow food or water that has been contaminated with certain types of bacteria, parasites, viruses, or toxins.
Most cases of food poisoning are due to common bacteria such as Staphylococcus or Escherichia coli (E. coli).Here is some types of food poisoning.
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.
Psychotherapy and Psychosomatic Approach fo Allergy There is little doubt that emotional factors have a profound effect upon an allergic condition. The reverse is also true, allergic disease affect the patient emotionally. A patient who suffers with a long-standing chronic condition like asthma, or a patient whose normal life is seriously interfered with during a good portion of the year because of hay fever, is bound to become nervous and upset. These patients develop emotional disturbances which in turn contribute to or aggravate their condition.
Alcohol Treatment Medication Maintenance treatment
Twelve-step programs make
a significant contribution to recovery. Alcoholics Anonymous (AA) is the root of
Drugs for treatment of alcohol
inhibits aldehyde dehydrogenase, the enzyme that catalyzes the oxidation of
acetaldehyde to acetic acid. On ingesting alcohol, patients taking disulfiram
experience the disulfiram-ethanol reaction, an increase in the acetaldehyde
level that manifests as flushing of the skin, palpitations, decreased blood
pressure, nausea, vomiting, shortness of breath, blurred vision, and confusion.
Death has been reported. Common side effects include drowsiness, lethargy,
peripheral neuropathy, hepatotoxicity, and hypertension. The usual dose of
disulfiram is 250 to 500 mg daily.
Basic facts on fats Fat, also called lipid, is a compound made by chemically bonding fatty acids to glycerol to form glycerides. When three fatty acids are hooked to glycerol, the fat compound is a triglyceride. Almost 95% of fat stored in the body is triglyceride, with the remaining 5% consisting of other glycerides and cholesterol. Scientific literature usually refers to triglycerides when it discusses fat. The fatty acids that make up triglycerides can be saturated, monounsaturated, or polyunsaturated.
Chemically, fats are chains of carbon atoms strung together with hydrogen atoms. If it is a saturated fat, the carbon chain carries all the hydrogen atoms it can . If it is unsaturated, there is room in the carbon chain for more hydrogen. If the chain is monounsaturated, there os room for two hydrogen atoms. If it is polyunsaturated, there is room for four hydrogen atoms. If it is highly polyunsaturated, there is room for many more hydrogen atoms.
Types of Schizophrenia and Symptoms Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. The onset of symptoms typically occurs in young adulthood, with a global lifetime prevalence of about 0.3Ė0.7%. Diagnosis is based on observed behavior and the patient's reported experiences.
Scarlet fever rash picture, symptoms and treatment Scarlet fever (sometimes referred to as scarlatina) is an infectious disease characterized by fever, sore throat (pharyngitis), and a characteristic rash. Scarlet fever is caused by an infection with group A Streptococcus, the same bacteria responsible for causing "strep throat" and various other skin infections (for example, impetigo and erysipelas). Scarlet fever is predominantly a childhood disease occurring in children 2-10 years of age, though it can less commonly occur in older children and adults. The incidence and mortality rates associated with this once feared disease have significantly decreased due to the introduction and widespread use of antibiotics.
What is systolic blood pressure definition What is systolic blood pressure definition? Systolic blood pressure is the amount of pressure that blood exerts on vessels while the heart is beating. In a blood pressure reading (such as 120/80), it is the number on the top. If the top and bottom blood pressures are both too high, a person is said to have high blood pressure. If only the top number is higher than 140, the person has a condition called isolated systolic hypertension.
Neutralization Therapy Neutralization therapy is an extension of the provocation-neutralization testing procedure in which specified doses of allergen extracts are used by the patient to relieve symptoms. It is also called "symptom-relieving" therapy and "tolerance." Advocates recommend it for both treatment and prophylaxis.
Gluten intolerance symptoms in children Are you looking for gluten intolerance symptoms in children? Gluten is composed of the sticky storage proteins found in wheat. Gluten-sensitive enteropathy (GSE) can range from mild inflammation of the mucosa of the small intestine to severe coeliac disease. The term gluten-sensitive is applicable when a probable diagnosis of GSE is made based on conditions such as dermatitis herpetiformis. However, GS may be used as the diagnosis in ambiguous situations when other conditions may be possible. For example, wheat allergies to gluten can result in anaphylaxis while others may be difficult to diagnose because of some of the cryptic inflammatory properties of wheat proteins. The term 'gluten sensitivity' is typically applied when diagnostic testing is not done because of prolonged gluten-free diet and/or refusal of gluten-challenge prior to biopsy. The gluten-sensitive designation may not be appropriate in all cases, as wheat allergies are often directed toward albumins or globulins of wheat, or the person may have a sensitivity to proteins commonly found with wheat products (e.g. fungal amylase or bread-yeast mannins). Therefore diagnostic criteria are preferred. The relationship between gluten and these various sensitivities is complex. For gluten enteropathy, T-cell reactivity is almost entirely restricted to prolamin-glutelin/species within the grass tribe Triticeae, and especially α-gliadins of wheat. For a tiny minority of GSE, inflammatory responses may extend to cover oats. Gluten allergies may extend over wide taxa or may be specific to certain wheat proteins and allergies may include oats.