[Control observation between mild moxibustion and TDP for obsolete collateral ligament injury of interphalangeal joints].

OBJECTIVE: To compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints. METHODS: Sixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups. RESULTS: The excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05). CONCLUSION: Mild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.

Treatment of a medial collateral ligament sprain using prolotherapy: a case study.

Prolotherapy is effective in treating refractory tendinopathies, but inadequate clinical evidence exists to recommend its use as a treatment for acute or chronic, medial collateral ligament (MCL) injuries. The current case study documents an illustrative case of a rugby player who had a grade 2 sprain of the MCL and shows the clinical and radiological outcomes following injections of 15% dextrose combined with 0.2% lidocaine. In his case, the prolotherapy, together with an exercise therapy, lasted 3 wk. At the end of the 3 wk, the patient was pain free, with a full range of motion (ROM), and he was able to perform all rugby-specific movements. The mean duration for recovery with conservative treatment of isolated, complete tears of the MCL is normally 4-8 wk.

Superimposed electrical stimulation improves mobility of pre-stiff thumbs after ulnar collateral ligament injury of the metacarpophalangeal joint: a randomized study.

OBJECTIVE: This study aimed at testing the ability of the superimposed electrical stimulation technique to restore the mobility of pre-stiff thumbs after operative repair for rupture of the ulnar collateral ligament. MATERIAL AND METHODS: Eight patients demonstrating a pre-stiff metacarpophalangeal joint were involved in two rehabilitation sessions of a counterbalanced design. In the voluntary contraction session, they performed 20min of repeated active flexions of the impaired metacarpophalangeal joint. In the superimposed electrical stimulation session, they performed 20min of percutaneous neuromuscular electrical stimulations which were superimposed to voluntary flexion. RESULTS: Mean active range of motion improvement from pre- to post-session was significantly greater in the superimposed electrical stimulation condition compared to the voluntary contraction condition (11±5 deg versus 3±4 deg; P<0.01). CONCLUSION: Superimposing electrical stimulation to voluntary contractions is an efficient technique to improve active range of motion of the pre-stiff metacarpophalangeal joint of the thumb.

[Effects of acupuncture-moxibustion intervention on proprioception in athletes with lateral collateral ligament injury of ankle joint].

OBJECTIVE: To compare the efficacy differences between acupuncture-moxibustion and physiotherapy interventions in improving proprioception of athletes with lateral collateral ligament injury of the ankle joint. METHODS: Thirty patients with injured lateral collateral ligament of ankle joint were randomly divided into acupuncture group (n = 15) and physiotherapy group (n = 15). Patients of the acupuncture group were treated by acupuncture and moxibustion stimulation of Qiuxu (GB40), Kunlun (BL 60), Shenmai (BL 62), Jiexi (ST 41), and Ashi-points, etc., and those of the physiotherapy group treated with TDP irradiation of the regional lateral malleolus. The treatment of the two groups was conducted once the other day, 3 times each week, continuously for 8 weeks. Before and after the treatment, the ankle-joint's active and passive repositioning error angles were measured by using a joint angle ruler. RESULTS: The average error angle values of active and passive reposition tests of the injured ankle-joint were 4.98 +/- 1.11 and 4.78 +/- 1.3 before the treatment, and 3.67 +/- 0.58 and 3.51 +/- 0.64 after the treatment, respectively in the acupuncture group, being reduced significantly after the treatment (both P < 0.01). No significant changes of the average error angle values of both active and passive reposition tests of the ankle-joint were found after the treatment in the physiotherapy group (P > 0.05). Comparison between two groups showed that the average error angle, average active and passive reposition angles of the injured ankle in the acupuncture group were evidently lower than those in the physiotherapy group (P < 0.01). CONCLUSION: Acupuncture and moxibustion can effectively improve the proprioception of the injured lateral collateral ligament of the ankle joint in athletes, which is superior to conventional physiotherapy in the therapeutic effect.

Ultrasound phonophoresis of panax notoginseng improves the strength of repairing ligament: a rat model.

This study examined the phonophoretic effect of a therapeutic ultrasound coupled with a Panax notoginseng (PN) gel and compared it with a therapeutic ultrasound alone for medial collateral ligament repair in rats. Twenty mature male Sprague-Dawley rats receiving surgical transection to the left medial collateral ligament (MCL) were divided randomly into three groups: ultrasound (US, n = 7), ultrasound with PN coupling gel (PNUS, n = 7) and control (n = 6). The treatments started on day 3 after surgery for six days per week over a two-week period. The US group received 4 min of pulsed ultrasound (1 MHz) at the intensity of 0.5W/cm(2) with a normal ultrasonic coupling gel. The PNUS group received the same ultrasound treatment, but with a coupling gel that contained PN extract. The control group received a placebo ultrasound treatment similar to the other two groups. On day 17, the ligaments were mechanically tested for load-relaxation, stiffness and ultimate tensile strength (UTS). Values of the left side were normalized against that of the right side of each animal for analysis. Results revealed significantly higher normalized stiffness (p = 0.009) and UTS (p = 0.022) in the PNUS group than the other two groups, but insignificant difference in load-relaxation among all groups. This study reveals a positive ultrasonic phonophoretic effect of Panax notoginseng extract for improving the strength of ligament repair than ultrasound therapy alone.

Isolated rupture of the lateral collateral ligament during yoga practice: a case report.

We report a case of isolated rupture of the lateral collateral ligament (LCL) of the knee while attempting to place the left foot behind the head during yoga practice. The 34-year-old man had discomfort of the lateral aspect of the knee particularly with varus strain. A magnetic resonance image revealed rupture of the LCL at the insertion onto the fibula. The patient had grade-II laxity of the LCL and was treated non-operatively. At the 12-month follow-up, grade-I laxity of the LCL remained clinically evident, but function was not impaired.

Open lateral collateral ligament injury of the interphalangeal joint of the great toe in adolescents during Taekwondo.

BACKGROUND: Sports-related open lateral collateral ligament injury of the interphalangeal joint of the great toe has not been previously described in the English literature. HYPOTHESIS: This injury can occur in adolescents while performing barefooted high-kicking or fast-running exercises involving rapid, 180 degrees turns on a dry, rough, wooden floor in a Taekwondo gymnasium. Injury occurs when the whole body turns quickly while supported only by the plantar aspect of the distal phalanx of the great toe. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The 7 study subjects consisted of 6 boys and 1 girl between 10 and 16 years old. Causes, pattern, mechanism of injury, treatment, and outcomes were investigated. RESULTS: All patients showed the same injury pattern and mechanism. They all had an open wound on the dorsolateral aspect of the interphalangeal joint. It was postulated that rapid whole body turning supported only by the distal phalanx of the great toe produces nonphysiologic varus stress at the interphalangeal joint, which results in open detachment of the lateral collateral ligament and adjoining periosteum from the proximal phalanx and interphalangeal joint subluxation. All 7 patients regained full great toe function after surgical repair. CONCLUSION: This unique sports-related open interphalangeal joint injury should be recognized. Participants, trainers, and health providers engaged in Taekwondo or similar sports should understand the pathomechanism of this injury and develop preventive measures.