RESUMO
The original version of this article unfortunately contained an error. Tables and Supplementary are incorrectly processed during production. Given in this article are the correct tables.
RESUMO
PURPOSE: Elbow flexion is a key indicator of functional recovery in obstetric brachial plexus palsy (OBPP). However, lack of flexion could be a result of an entrapped musculocutaneous nerve during the healing period. The purpose of this study was to investigate the possible compression of the musculocutaneous nerve and outcomes of decompression. METHODS: The study included 11 children aged with a mean age of 10.9 ± 2.7 months (range, 8-16 months) with Narakas 2 involvement OBPP, who had insufficient elbow flexion but had satisfactory shoulder abduction. Prior to surgery, magnetic resonance imaging (MRI) was performed to identify the entrapment. The children were evaluated pre-operatively and at 3 and 12 months postoperatively using the Active Movement Scale and Faradic Excitability Test. The musculocutaneous nerve was explored and decompressed in all the children. Regular physiotherapy and a home exercise programme were prescribed after surgery. RESULTS: The MRI findings were consistent with the surgical exploration in all the infants. Statistical analyses showed that decompression of the musculoskeletal nerve improved active movement scale scores on elbow flexion and faradic excitability test values of biceps brachii within 3 months after surgery. CONCLUSION: Children with delayed elbow flexion and satisfactory shoulder abduction may have an entrapped musculocutaneous nerve in the proximal arm and decompression of the nerve improves elbow function.
Assuntos
Neuropatias do Plexo Braquial , Plexo Braquial , Transferência de Nervo , Neuropatias do Plexo Braquial/cirurgia , Criança , Descompressão , Feminino , Humanos , Lactente , Nervo Musculocutâneo/cirurgia , Paralisia , Gravidez , Amplitude de Movimento Articular , Resultado do TratamentoRESUMO
BACKGROUND: Snapping scapula syndrome, also known as scapulothoracic crepitus or bursitis, is a manifestation of a mechanical abnormality of the scapulothoracic joint. In addition to characteristic findings on physical examination, magnetic resonance imaging (MRI) exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis. CASE REPORT: We present a case of a 10-year-old boy who had snapping scapula syndrome of the right scapula that was associated with edema of the serratus anterior muscle at the scapulothoracic interface and with scapulothoracic, specifically supraserratus, bursitis on MRI. CONCLUSIONS: MRI in snapping scapula syndrome, which is a clinical diagnosis, exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis. Such soft tissue findings of snapping scapula syndrome need to be kept in mind while evaluating routine shoulder and/or scapular region MRI, especially in the absence of relevant clinical information at the time of the imaging study.
RESUMO
PURPOSE: Arthroscopic approaches have been less preferred than open techniques for treating suprascapular nerve entrapment, possibly because current arthroscopic portals are based on distances to reference points, resulting in discrepancies from differing shoulder sizes. This study reports a portal placement based on proportions rather than absolute length. METHODS: Open dissection (12 left shoulders) and arthroscopy (12 contralateral shoulders) of the suprascapular notch were performed. In left shoulders, the posterolateral prominence of the acromion, the T1 spinous process, and the suprascapular notch were marked (K-wires). Distances from the posterolateral prominence of the acromion to the suprascapular notch and to the T1 spinous process were measured, and the proportion of those distances (distance to the suprascapular notch/distance to the T1 spinous process) was calculated to indicate the portal's location. In right shoulders, arthroscopy anatomically assessed that proportion's reliability. RESULTS: Median distances from the posterolateral prominence of the acromion to the T1 spinous process and to the suprascapular notch were 175.7 mm (average 180.4, SD 11.8 mm) and 72.3 mm (average 73.9, SD 4.9), respectively. The medians of the proportions of the defined distances were 40.9 % (range 40-42 %) and 41 % (range 39.3-42.1 %), respectively. CONCLUSION: Locating the portal at the lateral, 41 % of the distance between the posterolateral prominence of the acromion and the T1 spinous process was accurate and reproducible for suprascapular notch visualization. Clinically, this portal seems to eliminate perioperative morbidity by reducing excessive soft-tissue dissection with a shorter arthroscopic route and avoiding the ligamentous damage.
Assuntos
Artroscopia/métodos , Síndromes de Compressão Nervosa/prevenção & controle , Nervos Periféricos/cirurgia , Articulação do Ombro/cirurgia , Idoso , Cadáver , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
PURPOSE: The aim of the study is to investigate the correlation between arthroscopic findings and joint space width on the standing knee radiographs at various flexion degrees in the young- and middle-aged patients with complaints of knee pain. METHODS: Middle-aged patients with complaint of knee pain ongoing more than 6 months and failure in conservative treatment methods were included. Weight-bearing full extension, 30 and 45° of flexion radiographs were obtained. Joint space width was calculated on radiograms. Arthroscopy was performed to evaluate the chondral pathologies. Correlation analysis was performed. RESULTS: Fourty-three patients (18 female, 25 male) with a mean age of 44.6 (20-63) were included. Mean joint space width was 4.87 mm ± 1.45 (2-10) mm in medial and 5.43 mm ± 1.47 (1-9) in lateral on standing extension radiographs. In 30° flexion radiographs, mean joint space width was 4.33 mm ± 1.25 (1.5-7.5) in medial and 5.36 mm ± 1.69 (1-9) in lateral. In 45° flexion radiographs, medial joint space was 4.28 mm ± 1.59 (2-9) in medial and 5.15 mm ± 1.59 (1.5-9) in lateral. In arthroscopic evaluation, one knee had grade 1 (2.3%), three knees had grade 2 (7%), nine knees had grade 3 (20.9%), and twelve knees had grade 4 (27.9%) lesions in the medial compartment. In the lateral compartment, two knees had grade 3 (4.7%) and one knee had grade 4 lesion (2.3%). Radiological data did not correlate with the arthroscopic findings. CONCLUSION: Standing knee radiographs do not correlate with the arthroscopic findings in the middle-aged population with chondral lesions in knee joint. LEVEL OF EVIDENCE: Case series with no comparison group, Level IV.
Assuntos
Artralgia/diagnóstico por imagem , Doenças das Cartilagens/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Adulto , Artralgia/cirurgia , Artroscopia , Doenças das Cartilagens/cirurgia , Feminino , Humanos , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Postura , Valor Preditivo dos Testes , Prognóstico , Radiografia , Amplitude de Movimento Articular , Suporte de Carga , Adulto JovemRESUMO
BACKGROUND: Traffic accidents are ranked first as the cause of personal injury throughout the world. The high number of traffic accidents yielding injuries and fatalities makes them of great importance to Emergency Departments. MATERIAL AND METHODS: Patients admitted to Hacettepe University Faculty of Medicine Adult Emergency Department due to traffic accidents were investigated epidemiologically. Differences between groups were evaluated by Kruskall-Wallis, Mann-Whitney, and Wilcoxon tests. A value of p<0.05 was accepted as statistically significant. RESULTS: We included 2003 patients over 16 years of age. The mean age was 39.6 ± 16.1 and 55% were males. Admissions by ambulance and due to motor vehicle accidents were the most common. In 2004 the rate of traffic accidents (15.3%) was higher than the other years, the most common month was May (10.8%), and the most common time period was 6 pm to 12 am (midnight). About half of the patients (51.5%) were admitted in the first 30 minutes. Life-threatening condition was present in 9.6% of the patients. Head trauma was the most common type of trauma, with the rate of 18.3%. Mortality rate was 81.8%. The average length of hospital stay was 403 minutes (6.7 hours) and the average cost per patient was 983 ± 4364 TL. CONCLUSIONS: Further studies are needed to compare the cost found in this study with the mean cost for Turkey. However, the most important step to reduce the direct and indirect costs due to traffic accidents is the prevention of these accidents.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Turquia/epidemiologiaRESUMO
PURPOSE: The pediatric upper extremity motor activity log-revised (PMAL-R) is a structured interview that measures use of the affected arm in daily life in children with unilateral pathologies like hemiparetic cerebral palsy (CP) or birth brachial plexus injury (BBPI). This study investigated validity and test-retest reliability of the PMAL-R in children with BBPI. MATERIALS AND METHODS: The PMAL-R was administered to parents of 132 children with BBPI between 5 and 9 years for validity, also 98 parents were re-interviewed after 3 weeks to establish test-retest reliability. Its concurrent validity was examined by correlating scores on the PMAL-R How Well (HW) and How Often (HO) scales with Brachial Plexus Outcome Measure (BPOM) and Pediatric Outcomes Data Collection Instrument (PODCI) scores. RESULTS: PMAL-R scores were strongly correlated with BPOM scores (HW, r = 0.943, p < 0.001; HO, r = 0.897, p < 0.001), also strongly correlated with PODCI (HW, r = 0.799, p < 0.001; HO, r = 0.797, p < 0.001). PMAL-R test-retest reliability (intraclass correlation; HO = 0.997, HW = 0.998) and internal consistency (Cronbach's a; HO = 0.99, HW = 0.99) were high. CONCLUSIONS: The PMAL-R has good reliability and validity for measuring everyday use of the affected arm with "how often" and "how well" questions in children with BBPI. Implications for rehabilitationThe pediatric upper extremity motor activity log-revised (PMAL-R) is the first tool to assess both "how often" and "how well" the affected arm is used in unimanual activities in children with BBPI.PMAL-R is a real-world measure providing valuable information about "how often" and "how well" the affected arm is used to guide treatment.PMAL-R is valid in both concurrent and discriminative validity in children with BBPI.PMAL-R is reliable in children with BBPI.
Assuntos
Plexo Braquial , Paralisia Cerebral , Criança , Humanos , Reprodutibilidade dos Testes , Avaliação da Deficiência , Extremidade Superior , Atividade MotoraRESUMO
Since the natural course of obstetric brachial plexus palsy is variable, several problems are encountered. One important question, in considering patients with OBPP under observation in outpatient clinical settings, is whether children will have length discrepancies in their arms. The aim of this study was to determine differences in the length of the affected extremity, in comparison to the opposite upper extremity. As such, 45 patients, aged 6 months to 18 years, with unilateral brachial plexus palsy developed due to obstetric reasons, were included in the study. Affected and healthy side humerus, ulna, radius, 2nd metacarpal and 5th metacarpal lengths were evaluated according to gender, age, side, Narakas classification, primary and secondary surgery. Statistically significant differences were found in the change rates of affected/healthy humerus, radius, 2nd metacarpal and 5th metacarpal lengths according to age (93%, 95%, 92%, 90% and 90%, respectively). Affected/healthy change rates of ulna, radius, 2nd metacarpal and 5th metacarpal lengths were found to differ statistically (p < 0.05) according to the Narakas classification variable (94%, 92%, 95%, 94% and 94%, respectively). There were no statistically significant differences in the ratios of affected/healthy change in the lengths of the humerus, ulna, radius and 5th metacarpal compared to the primary surgery (p > 0.05). The ratios of affected/healthy change in ulna, radius and 5th metacarpal lengths were found to differ statistically (p < 0.05) according to secondary surgeries (93%, 91%, 91% and 92%, respectively). Joint and bone deformities and bone shortening were observed after changes that occurred in the postnatal and growing periods due to obstetric brachial plexus palsy. Every increase in function to be gained in the upper extremity musculature was also potentially able to reduce problems, such as shortness.
RESUMO
The aim of this study was to determine the cut-off values of the range of internal rotation motion in the isolated glenohumeral joint that is required for functional tasks in children with an upper root injury of the brachial plexus. Internal rotation motion was measured using a universal goniometer in 97 participants. The Mallet Hand to Spine and Mallet Hand to Belly tasks were assessed as functional tasks that require internal rotation of the shoulder. For the Hand to Spine task, 41° passive and 30° active internal rotation were necessary to reach the S1 level. For the Hand to Belly task, 42° passive and 29° active internal rotation were required to place the palm on the belly without wrist flexion. Of our participants, 97% could touch the belly with or without wrist flexion, but 28% could not reach S1 in the Hand to Spine task. The results of this study show the necessary amount of internal rotation of the shoulder that should be considered in treatment strategies.Level of evidence: III.
Assuntos
Traumatismos do Nascimento , Neuropatias do Plexo Braquial , Plexo Braquial , Articulação do Ombro , Humanos , Criança , Ombro , Amplitude de Movimento Articular , Resultado do TratamentoRESUMO
The modified Mallet classification is widely used to measure motor function in brachial plexus birth injuries. The aim of the study was to investigate agreement and reliability of this classification under three different evaluation conditions: face-to-face; live tele-assessment; and delayed video-based assessment. A total of 100 children aged 4-15 years were included. Children were assessed by two raters except for live tele-assessment, which was performed by four raters. Agreement between the three different assessment conditions for the same rater were between strong and excellent for both raters 1 and 2. The interrater reliability for raters 1 and 2 under different assessment conditions was strong to excellent. Interrater reliability among the four raters was moderate to strong in tele-assessment. The modified Mallet classification may have appropriate reliability to be used in remote medical follow-up.Level of evidence: III.
RESUMO
PURPOSE: The objective of this study was to evaluate the effects of synovium on the proliferation of the cartilage tissue and chondrocytes using a rabbit knee model as an in vivo synovial culture medium. METHODS: Twelve New Zealand rabbits were used as the animal model in this investigation. Standard size chondral and osteochondral cartilage grafts were taken from, respectively, the left and right knees of all the animals. Two groups of 6 animals were formed: in Group I (synovium group), grafts were placed into the synovial tissue and in group II (patellar tendon group) behind the patellar tendon of the corresponding knees. After 4 months, samples were collected and evaluated macroscopically by measuring their dimensions (vertical = D1, horizontal = D2, and depth = D3) and volumes, and histologically by counting the chondrocyte number using camera lucida method. RESULTS: Macroscopically, the increase in average D1, D2, and D3 measurements and volume in the osteochondral specimens were significantly higher compared to the chondral specimens in both groups (P < 0.05). However, no significant difference was observed between the two groups in terms of macroscopic values. Histologically, the mean chondrocyte counts in osteochondral and chondral specimens for Group I (synovium) were 20.2 and 18.1, and for Group II (patellar tendon) were 18.7 and 15.6, respectively. The mean number of chondrocytes was found to be significantly higher in osteochondral specimens than that of chondral specimens in either group (P < 0.05). Overall average chondrocyte count was significantly higher for Group I compared to Group II (P < 0.05). CONCLUSION: Transplantation of the cartilage grafts into the synovial tissue in rabbit knees significantly enhanced the chondrocyte production compared with the group where the grafts were transplanted into intra-articular patellar tendon. The results of this study indicate that native synovial tissue may have the potential to be used as an in vivo culture medium for osteochondral tissue growth.
Assuntos
Cartilagem/crescimento & desenvolvimento , Condrócitos/fisiologia , Articulação do Joelho/cirurgia , Ligamento Patelar , Membrana Sinovial/fisiologia , Animais , Transplante Ósseo/métodos , Cartilagem/citologia , Cartilagem/transplante , Cartilagem Articular , Meios de Cultura , Modelos Animais , Coelhos , Distribuição Aleatória , Procedimentos de Cirurgia Plástica/métodosRESUMO
PURPOSE: Children with brachial plexus birth injury (BPBI) may eventually develop glenohumeral instability due to development of unbalanced muscular strength. Our major goal in this study is to compare the accuracy of physical examination and ultrasonography (US) in determination of glenohumeral instability in infants with BPBI compared with magnetic resonance imaging (MRI) as a gold standard, and to investigate the role and value of US as a screening modality for assessing glenohumeral instability. METHODS: Forty-two consecutive patients (mean age, 2.3±0.8 months) with BPBI were enrolled into this prospective study. Patients were followed up with physical examination and US with dynamic evaluation in 4-6 weeks intervals. Patients who developed glenohumeral instability based on physical examination and/or US (n=21) underwent MRI. Glenohumeral instability was defined as alpha angle >30° and percentage of posterior humeral head displacement >50%. Diagnostic accuracy of physical examination and US was calculated and quantitative parameters were compared with Wilcoxon test. RESULTS: Glenohumeral instability was confirmed with MRI in 15 of 21 patients. Accuracy and sensitivity of physical examination and US were 47%, 66% and 100%, 100%, respectively in determination of glenohumeral instability. No significant difference was found for the alpha angle (p = 0.173) but the percentage of posterior humeral head displacement was statistically significant between US and MRI (p = 0.028). CONCLUSION: Our results indicate that US with dynamic evaluation is a good alternative for MRI in assessment of glenohumeral instability in infants with BPBI, since it is highly accurate and specific, and quantitative measurements used for glenohumeral instability were comparable to MRI. US can be used as a screening method to assess glenohumeral instability in infants with BPBI.
Assuntos
Plexo Braquial , Articulação do Ombro , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Paralisia , Gravidez , Estudos Prospectivos , Ombro , Articulação do Ombro/diagnóstico por imagem , UltrassonografiaRESUMO
The aim of the study was to determine the differences in upper limb function and activity/participation levels between preschool children with Narakas Groups 2a and 2b obstetric brachial plexus injury; and to determine the significance level of the factors affecting upper limb functions in these patients. Sixty-seven children, aged 3 to 7, who had not had surgical intervention, were evaluated in terms of joint movements, modified Mallet classification, Raimondi hand classification, brachial plexus outcome measure, paediatric outcome data collection instrument and stereognosis. There were significant functional differences between the groups, in favour of Group 2a. The movements affecting total function of the upper limb were: hand to spine (p < 0.001), global abduction (p < 0.001) and hand to mouth (p < 0.001), in descending order of significance. Passive internal rotation was the most important passive joint movement affecting shoulder function (p < 0.001). The results of this study suggest that more emphasis should be placed on the shoulder internal rotation in treatment strategies.Level of evidence: III.
Assuntos
Traumatismos do Nascimento , Neuropatias do Plexo Braquial , Plexo Braquial , Articulação do Ombro , Plexo Braquial/lesões , Criança , Pré-Escolar , Humanos , Paralisia , Amplitude de Movimento Articular , Resultado do Tratamento , Extremidade SuperiorRESUMO
INTRODUCTION: A prospective study of modified percutaneous Achilles tendon repair performed between 1999 and 2005 under local infiltration anesthesia is presented; the study evaluated the results of percutaneous repair technique by visualization of the synovia under endoscopic control, followed by early functional postoperative treatment for surgical intervention of acute Achilles tendon ruptures. PATIENTS: Sixty-two patients (58 males, 4 females, mean age 32) were treated by percutaneous suturing with modified Bunnel technique under endoscopic control within 10 days after acute total rupture. Physiotherapy was initiated immediately after the operation and patients were encouraged to weight-bearing ambulation with a walking brace-moon boot as tolerated. Full weight-bearing was allowed minimum after 3 weeks postoperatively without brace. RESULTS: The procedure was tolerated in all patients. There were no significant ROM limitation was observed. Two patients experienced transient hypoesthesia in the region of sural nerve that spontaneously resolved in 6 months. Fifty-nine patients (95%) including professional athletes returned to their previous sportive activities, while 18 of them (29%) had some minor complaints. The interval from injury to return to regular work and rehabilitation training was 11.7 weeks (10-13 weeks). At the latest follow-up (mean: 46 months; range: 12-78 months), all the patients had satisfactory results with a mean American Orthopedic Foot and Ankle Society's ankle-hindfoot score of 94.6. No re-ruptures, deep venous thrombosis or wound problems occurred. CONCLUSION: The proposed method offers a reasonable treatment option for acute total Achilles tendon rupture with a low number of complications. The rerupture rate and return to preinjury activities are comparable to open and percutaneous without endoscopic control procedures.
Assuntos
Tendão do Calcâneo/lesões , Tendão do Calcâneo/cirurgia , Endoscopia , Técnicas de Sutura , Traumatismos dos Tendões/cirurgia , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Ruptura , Traumatismos dos Tendões/reabilitaçãoRESUMO
Osteoid osteoma is an osteoblastic benign lesion of the bone. The pathognomonic symptom is significant pain, which responds well to nonsteroidal antiinflammatory drugs. When typical clinical and radiological features are present, the diagnosis is not difficult. However, if the lesion is in an area not clearly seen on plain radiographs, or clinical features are atypical, then diagnosis becomes difficult. We present a case of osteoid osteoma with delayed diagnosis that presented itself with neurological signs. Prominent features present in the patient included pain that responded well to medication and muscle atrophy, which led to a wider differential diagnosis. Diagnosis was made approximately two years after the onset of his initial symptoms, after having been investigated and treated both in our own hospital and elsewhere. This case illustrates clinical and radiological diagnostic problems of osteoid osteoma, demonstrating that it can present itself with neurological signs. Correct diagnosis then requires detailed history and clinical awareness.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Fêmur/patologia , Osteoma Osteoide/diagnóstico , Dor/tratamento farmacológico , Dor/etiologia , Adolescente , Atrofia , Humanos , Masculino , Osteoma Osteoide/fisiopatologiaRESUMO
OBJECTIVES: The purpose of this study was to evaluate the effect of intra-articular hyaluronic acid (HA) injections after arthroscopic debridement on pain and functional parameters in patients with mild-to-moderate knee osteoarthritis. METHODS: Sixty-seven patients (21 men, 46 women; mean age 56 years; range 40 to 65 years) who underwent standard arthroscopic debridement for primary knee osteoarthritis of Kellgren-Lawrence grade II-III were randomly assigned to HA injections (n=33) or to only follow-up as controls (n=34). Intra-articular sodium hyaluronate injections (Orthovisc) were started three weeks after arthroscopic debridement, totaling three injections interspersed with a week. The two groups were evaluated with the pain and physical function subscales of the WOMAC osteoarthritis index before and after 6, 12, and 24 weeks of arthroscopic debridement. RESULTS: Improvement in pain scores at 6 weeks did not differ between the two groups (HA 21%, control 16%; p=0.478), whereas improvement in function scores was significantly higher in the HA group (23% vs 9.2%; p=0.018). The rates of improvement in pain and function scores increased in subsequent evaluations, but these did not differ significantly between the two groups. The percentages of patients who exhibited at least 30% and 40% improvement from baseline function scores were significantly greater in the HA group only at six weeks (p=0.025 and p=0.038, respectively). CONCLUSION: Intra-articular HA injections after arthroscopic debridement provide additional short-term benefits, but this combination therapy should be justified by further controlled studies with longer follow-up and larger patient groups.
Assuntos
Ácido Hialurônico/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Dor/epidemiologia , Viscossuplementos/uso terapêutico , Adulto , Artroscopia/métodos , Desbridamento , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/cirurgia , Medição da Dor , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Viscossuplementos/administração & dosagemRESUMO
We report monozygotic twins with longitudinal radial hypoplasia and low (L5) spina bifida occulta, but with differing severity. There is only one previous report of similar twins. We report these identical twins with the expression of longitudinal radial hypoplasia with mirror image pattern on contralateral sides, and the association of low spina bifida occulta.
Assuntos
Rádio (Anatomia)/anormalidades , Disrafismo Espinal/genética , Gêmeos Monozigóticos/genética , Humanos , Lactente , MasculinoRESUMO
Young children and adolescents are becoming increasingly involved in recreational and professional sports. This inevitably leads to an increase in the number of sports-related injuries involving the hand and the wrist. Hence, physicians should have a good insight into macro- and microtraumas affecting the hand and the wrist. Prevention of injuries, correction of muscle-tendon imbalances, and maintenance of strength and flexibility are important issues for the prevention of disabilities in this age group.
Assuntos
Traumatismos em Atletas/prevenção & controle , Transtornos Traumáticos Cumulativos/prevenção & controle , Traumatismos do Punho/prevenção & controle , Adolescente , Serviços de Saúde do Adolescente , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/patologia , Criança , Serviços de Saúde da Criança , Transtornos Traumáticos Cumulativos/diagnóstico por imagem , Transtornos Traumáticos Cumulativos/patologia , Humanos , Radiografia , Turquia , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/patologiaRESUMO
Isolated rupture of the vastus medialis muscle is rare, and surgical repair is recommended. The results of rehabilitation programme after the percutaneous intramuscular splintage of a nearly total vastus medialis muscle tear in a 52-year professional-master degree weight-lifter is presented in this report.