RESUMEN
We conducted a randomised controlled trial to determine whether active intense pulsed light (IPL) is an effective treatment for patients with chronic mid-body Achilles tendinopathy. A total of 47 patients were randomly assigned to three weekly therapeutic or placebo IPL treatments. The primary outcome measure was the Victorian Institute of Sport Assessment - Achilles (VISA-A) score. Secondary outcomes were a visual analogue scale for pain (VAS) and the Lower Extremity Functional Scale (LEFS). Outcomes were recorded at baseline, six weeks and 12 weeks following treatment. Ultrasound assessment of the thickness of the tendon and neovascularisation were also recorded before and after treatment. There was no significant difference between the groups for any of the outcome scores or ultrasound measurements by 12 weeks, showing no measurable benefit from treatment with IPL in patients with Achilles tendinopathy.
Asunto(s)
Tendón Calcáneo , Tratamiento de Luz Pulsada Intensa , Tendinopatía/terapia , Adulto , Anciano , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In a series of 126 consecutive pilon fractures, we have described anatomically explicable fragments. Fracture lines describing these fragments have revealed ten types of pilon fracture which belong to two families, sagittal and coronal. The type of fracture is dictated by the energy of injury, the direction of the force of injury and the age of the patient.
Asunto(s)
Fracturas de la Tibia/patología , Adulto , Anciano , Femenino , Peroné/diagnóstico por imagen , Peroné/lesiones , Peroné/patología , Curación de Fractura/fisiología , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/patología , Fracturas Abiertas/diagnóstico por imagen , Fracturas Abiertas/patología , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Tibia/diagnóstico por imagen , Tibia/patología , Fracturas de la Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodosRESUMEN
Lower limb traction is applied with counter traction in the groin. The resultant tissue pressures can be high and may result in skin necrosis or nerve palsies. Volunteers were positioned on a fracture table and traction applied to the left leg. Perineal contact pressures were measured using pressure transducers connected to a laptop computer. Pressure readings and pain scores were recorded with different types of padding, whilst the leg was repositioned. Maximal pressures exceeded the 70 mmHg limit known to cause tissue damage. Larger (10 cm) padding devices significantly reduced the pressures. When employing the perineal traction post, care should be taken to pad this carefully to avoid the sequelae of high tissue pressure.