Heel pad thickness and athletic activity in healthy young adults: a sonographic study.

PURPOSE: The aim of this study was to investigate the sonographic changes of heel fat pad thickness and compressibility index in healthy young adults in relation to level of athletic activity. MATERIALS AND METHODS: One hundred ten young adults (55 women and 55 men) with a body mass index between 18.5 and 24.9 were divided into 3 groups according to their athletic activity level: group 1, sedentary (n = 50); group 2, athletic activity <7 hours/week (n = 30); and group 3, athletic activity >or=7 hours/week (n = 30). The loaded heel pad thickness (LHPT) and unloaded heel pad thickness (ULHPT) were measured via sonography, and the heel pad compressibility index (HPCI) was calculated. RESULTS: The mean values of ULHPT, LHPT, and HPCI in group 1 were similar to those of group 2 (p > 0.05) and group 3 (p > 0.05). The mean values of ULHPT, LHPT, and HPCI were similar in the left and right feet in the 3 groups (p > 0.05). There was no correlation between level of athletic activity and ULHPT, LHPT, or HPCI. CONCLUSIONS: The heel pad thickness and HPCI of individuals engaging in athletic activity up to an average of 11 hours/week were similar to those of sedentary individuals.

Pyogenic granuloma on the hand subsequent to friction blister in a hand surgeon.

A case of pyogenic granuloma in a 62-year-old hand surgeon secondary to friction blister is reported. He developed a fast growing, hypertrophic inflammatory papule consisting of exceptionally richly vascularized granular tissue. This dusky red lesion was located on the thenar part of the hand. We find no prior report of PG attributed to friction blister.

Comparison of ultrasonography and radiography in assessment of the heel pad compressibility index of patients with plantar heel pain syndrome. Measurement of the fat pad in plantar heel pain syndrome.

AIMS: The shock absorption of the heel fat pad is assessed by heel-pad compressibility index measuring the thickness of the heel pad on the lateral radiographs unloaded and loaded by body-weight. Ultrasonography is an easily applicable method without radiation and magnification inherent in radiographs. There are no reports comparing these measurements by diagnostic ultrasonography and direct radiography in healthy individuals and in different clinical entities. The efficacy of ultrasonography in assessment of heel-pad compressibility index in patients with plantar heel pain syndrome was investigated comparing it with direct radiography. METHODS: The loaded and unloaded heel-pad thicknesses by ultrasonography and direct radiography were measured in 69 feet of 42 patients with plantar heel pain syndrome and their results were compared. RESULTS: In direct radiographs, the mean unloaded heel-pad thickness was 20+/-2 mm and ranged from 14 to 26 mm. Heel-pad compressibility index was 0.62+/-0.09. There was a strong positive correlation between the measurements of the unloaded thickness (r=0.84, P<0.001) and also between the measurements of the loaded thickness (r=0.88, P<0.001) done using ultrasonography and direct radiography. The difference between the results of measurements in two modalities did not exceed +/-1 mm in 50% and +/-2 mm in 81% in unloaded position and +/-1 mm in 62% and +/-2 mm in 82% in loaded position. CONCLUSION: Measuring unloaded and loaded heel pad thickness by ultrasonography is reliable in the adult feet with heel pain. The preference of ultrasonography is reasonable in the studies involving the heel fat pad.

Finger-level avulsion-type injuries.

Fifty-nine avulsed fingers were managed between May 1986-December 2004. Of 59 cases, 39 (66%) were treated with microsurgical techniques, and the remaining 20 cases (34%) were treated in the conventional manner. Follow-up time varied between 9-18 years. All cases were classified according to the Kay-Wolff classification. Replantation was done in 26 fingers, and revascularization in 13 fingers. The survival rate was 100% in the revascularization cases, and 80.7% in the replantation cases. The total active range of motion was more than 90 degrees in the interphalangeal joints in 48% of cases, and sensory recovery was good in 38% of cases (between 4-10 mm, static two-point discrimination test). Although the data show that avulsion injuries can be treated successfully by microsurgical techniques, functional results are not as successful. However, the decision for surgery at times is determined by nonmedical factors such as the patient's age, occupation, economic situation, and level of motivation.

The influence of athletic activity on the plantar fascia in healthy young adults.

PURPOSE: Complaints deriving from the plantar fascia are relatively common in athletes. This study aimed to investigate the changes of thickness of plantar fascia via sonography in healthy young adults with different levels of activity. PATIENTS AND METHODS: One hundred ten adults with normal body mass index were separated into three groups according to activity level: sedentary (group 1, n = 50), athletic activity less than 7 hours per week (group 2, n = 30), and athletic activity 7 or more hours per week (group 3, n = 30). The thicknesses of the plantar fascia at origin and at a point 5 mm distal to origin were measured via sonography. RESULTS: The mean values of the thickness of the proximal plantar fascia (PFp) and the distal plantar fascia (PFd) in group 1 were similar to those of groups 2 and 3 (p > 0.05). The mean values of PFp and PFd were significantly higher in men than in women (p < 0.05). The mean values of PFp and PFd were similar in left and right feet (p > 0.05). There were moderate positive correlations between PFp and weight, height, and body mass index but no correlation between PFp and amount of athletic activity. CONCLUSIONS: The thickness of the plantar fascia at origin did not change with athletic activity at the amateur level.

[Knowledge and attitude of nursing and midwifery college students on developmental dysplasia of the hip]. / Hemsirelik ve ebelik bölümü ögrencilerinde gelisimsel kalça displazisi konusundaki bilgi ve tutumun degerlendirilmesi.

OBJECTIVES: It is of special importance to educate families and health care providers, in particular midwives and nurses who are in close and frequent contact with families, for the prevention and early diagnosis of developmental dysplasia of the hip (DDH). A knowledge and attitude study was conducted concerning DDH among students of Nursing and Midwifery College of Kahramanmaras Sütçü Imam University. METHODS: A structured form was prepared consisting of 28 statements about medical and practical knowledge and traditional attitudes with regard to DDH and was administered to 232 voluntary students before and after an educational session of 60 minutes by a specialist in orthopedics. Prior to the study, the students of grade I and II had not received any theoretical or practical lectures about DDH, which were included in the curriculum of grades III and IV. RESULTS: The knowledge of the students about risk factors and prevention strategies for DDH was of a moderate level. They were not sufficiently furnished with information about traditional attitudes and applications that predispose infants to DDH. The mean test scores before and after training were 51.52+/-13.90 and 87.86+/-5.90, respectively (p=0.000). Compared to grade III and IV students, grade I students performed significantly less in the former test (p=0.00); however, the scores of the latter test did not differ significantly between the grades (p>0.05). CONCLUSION: The curriculum during the license education of midwives and nurses should include essential information on traditional attitudes. With sufficient knowledge and application skills, midwives and nurses may play an important role in the primary and secondary prevention of DDH in our country.

Hand grip strength in patients with type 2 diabetes mellitus.

AIM: The aim of the present study was to compare hand grip strength and pinch power, which are important parameters of hand function, in 76 patients with type 2 diabetes mellitus (T2DM) (mean age: 50.11+/-7.6) with 47 non-diabetic control subjects (mean age: 46.93+/-10.2). METHODS: Grip strength was assessed with a Jamar dynamometer and pinch power was measured with a pinch gauge. Body composition was measured using a Tanita body composition analyzer. Mann-Whitney test, chi-square test, Fisher's exact test, T-test, Kruskal-Wallis variance analysis, Wilcoxon's signed rank test and Pearson's correlation coefficients were used to determine the differences and relations between groups. A p-value <0.05 was taken as statistically significant. RESULTS: Hand grip strength test values were significantly lower in the diabetic group compared with the control group. Key pinch power value for the right hand was significantly lower in the diabetic group than in the control group whereas the left hand value was similar. CONCLUSION: Hand grip strength and key pinch power values were found to be lower in patients with T2DM than in age-matched control subjects. Hands, as well as feet, are also affected by diabetes and physicians should be aware of this.

Does long-term ischemia affect the oxidant status during fracture healing?

INTRODUCTION: The influence of transient circulatory arrest on oxidant status during the healing of a tibial fracture was investigated in rats by the use of a hindlimb tourniquet technique. MATERIALS AND METHODS: One of the most reliable indicators for cytological damage is lipid peroxidation, which can be demonstrated by malondialdehyde (MDA) levels. Fifty-eight Wistar rats were used in this study. To determine the basal MDA levels of bone, 10 rats not exposed to ischemia were killed by an overdose of ether. The remaining 48 rats were randomly divided into two groups (control and ischemia). The control and ischemia groups were then randomly divided into 4 groups of 6 rats each. In 48 rats, the left tibia was fractured and fixed intramedullarly. In the ischemic group, complete acute transient ischemia for 4.5 h was imposed after the fracture. In the control group, no other intervention except the fracture was done. Rats from the control and ischemic groups were killed on days 3, 7, 14, and 28, and MDA levels were determined in tibial bone and callus tissue. The MDA levels of the control and ischemic groups were compared with basal MDA levels in the bone of 10 rats. RESULTS: There was an apparent difference between the basal and control group MDA levels on days 3 and 7 (p < 0.01), between the basal and ischemic group MDA levels on days 3, 7, and 14 (p < 0.01). In addition, the ischemic group showed a statistically significant increase in MDA levels on days 3, 7 and 14 compared with the control group (p < 0.01). CONCLUSION: We conclude that complete acute transient ischemia affects the oxidant status during fracture healing. This effect especially occurs during the ischemic period, inflammation, and callus formation of fracture healing.

Tuberculosis of the knee in a child.

The diagnosis for skeletal tuberculosis is often overlooked. We report a 9-year-old patient with a history of 2 years of swollen joint, with a diagnosis of tuberculosis of the knee with involvement of the proximal tibial epiphysis, and treated surgically and with anti-tuberculosis drug therapy.

Swan-neck deformity and paresthesia following giant orf.

Orf is a zoonotic infection caused by a parapoxvirus that primarily infects sheep and goats. Human orf infection can take place when abraded skin comes into contact with infected animals. It occurs most commonly on the index finger. The characteristic lesion resembles a tumor and resolves spontaneously, usually without any complications. However, rare complications such as lymphangitis, adenitis, erythema multiforme, erysipelas, papulovesicular eruption, Pseudomonas aeruginosa infection, and bullous pemphigoid have been reported. Herein, we report a case of giant orf causing swan-neck deformity and paresthesia. These complications have not been previously reported in the literature.

[A case of ball-and-socket deformity of the ankle joint]. / Ayak bileginin ball-and-socket deformitesi: Olgu sunumu.

Ball-and-socket deformity of the ankle joint is a rare entity that is usually associated with inequality of leg length, fibular hypoplasia, coalition of the tarsal bones, and ray deficiency. This deformity was encountered in a nine-year-old girl with a short right limb, cavovarus foot, partial fusion of the 4th and 5th metatarsals, and talocalcaneonavicular coalition. No surgical intervention was necessary; the patient was recommended to wear a high-heeled shoe of 2.5 cm thickness to compensate for the difference in the leg length.