Tender Spot Injection Therapy for Ankle and Foot Pain

1997 ◽  
Vol 15 (1) ◽  
pp. 19-22 ◽  
Author(s):  
I H J Bourne
Keyword(s):  
Soft Tissue ◽  
Achilles Tendon ◽  
Tissue Damage ◽  
Foot Pain ◽  
Case Histories ◽  
Normal Length ◽  
Relieve Pain ◽  
Long Acting ◽  
Tender Spot ◽  
Ankle And Foot

Pain of the ankle and foot following injury or surgery indicates soft tissue damage to muscle, tendons, periosteum or ligaments. Injection of a long acting corticosteroid such as triamcinolone with lignocaine to tender spots will relieve pain. Softened collagen at the site of injection will stretch, and heal to normal length and strength. However, care must be taken not to inject close to tendon, since softening may induce rupture. There is particular danger of this in the Achilles tendon. Case histories are given showing the tender spot injection sites used, and composite diagrams of all 69 tender spots found in a series of 28 patients with ankle or foot pain are illustrated.

Tissue Damage Caused by the Intramuscular Injection of Long-Acting Penicillin

PEDIATRICS ◽  
1985 ◽  
Vol 75 (4) ◽  
pp. 741-744
Author(s):  
Harry Schanzer ◽  
Julius H. Jacobson
Keyword(s):  
New Zealand ◽  
Femoral Artery ◽  
Normal Saline ◽  
Tissue Damage ◽  
Intramuscular Injection ◽  
Penicillin G ◽  
Left Femoral Artery ◽  
New Zealand White Rabbits ◽  
Long Acting ◽  
The Right

In order to elucidate whether tissue damage produced on occasion by intramuscular injection of longacting penicillin is due to accidental intra-arterial injection or vasospasm, two types of experiments were carried out in rabbits. In the first set of experiments, six New Zealand White rabbits were given intra-arterial injections of 0.4 mL of a mixture containing 300,000 U of penicillin G benzathine and 300,000 units of penicillin procaine per milliliter (Bicillin C-R) into the left femoral artery and 0.4 mL of normal saline into the right femoral artery as autocontrol. In a second set of experiments, 0.4 mL of the same penicillin preparation was injected in the space surrounding the left femoral artery in five New Zealand rabbits, and 0.4 mL of normal saline was injected in a similar fashion around the right femotal artery as control. The legs of the rabbits that received the intra-arterial injection of penicillin invariably developed ischemic manifestations. None of the legs of rabbits given intra-arterial injections of normal saline had pathologic manifestations. None of the rabbits that received the periarterial penicillin preparation or normal saline developed abnormalities. These results strongly suggest that the tissue damage produced by penicillin is secondary to the intra-arterial administration of the drug.

Ankle and Foot Pain in a 39-Year-Old Man

1996 ◽  
Vol 328 ◽  
pp. 304-307,310-311
Author(s):  
S. C. Wilson ◽  
J. H. Healey ◽  
A. G. Huvos ◽  
D. M. Panicek
Keyword(s):  
Foot Pain ◽  
Ankle And Foot

scholarly journals Percutaneous Repair Method and Achilles Tendon Rupture Rehabilitation

2020 ◽  
Author(s):  
Krzysztof Ficek ◽  
Paweł Gwiazdoń ◽  
Jolanta Rajca ◽  
Grzegorz Hajduk
Keyword(s):  
Side Effects ◽  
Soft Tissue ◽  
Minimally Invasive ◽  
Achilles Tendon ◽  
Range Of Motion ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Well Being ◽  
Professional Activity ◽  
Rehabilitation Protocol

Abstract Background: Subcutaneous, spontaneous, complete ruptures of the Achilles tendon are usually caused indirectly by trauma associated with rapid movement. When minimally invasive Achilles tendon repair is performed, an active rehabilitation protocol can be implemented that allows for fast, measurable progress, reduced tissue atrophy, and an improved range of motion, thereby reducing pain and increasing patients’ overall physical well-being. However, overestimating the effectiveness of rehabilitative interventions can lead to arbitrary advancements in rehabilitation that significantly exceed the permitted levels of daily or professional activity. This issue can lead to various side effects and slow rehabilitation. The aim of the study was to evaluate the influence of adverse effects on objective outcomes after minimally invasive Achilles tendon repair.Methods: The study included 36 individuals with complete Achilles tendon rupture who underwent the percutaneous Ma-Griffith technique. The same rehabilitation protocol was used.Results: Five side effects were identified during rehabilitation: deformation of the repair construct (DRC), irritation of the sural nerve (SNI), morning ankle stiffness (MAS), edema of the soft tissue around the tendon (OST) and suture knots. DRC and MAS were associated with a longer time being required to achieve full ankle range of motion. SNI and OST were associated with a longer time being required to meet the criteria for dynamic training. None of the side effects were related to the isokinetic strength of the ankle plantar and dorsiflexors.Conclusions: The incidence of the assessed side effects in the postoperative period is not related to the type of activity, whether it is professional or amateur. Among the identified side effects, deformation of the regenerated shape of the heel tendon and MAS cause a delay in the recovery of full ankle range of motion. Calf nerve irritation and soft tissue swelling increase the time it takes to meet the criteria for starting dynamic training.Trial registration:The study was approved by the ethics committee of the Academy of Physical Education in Katowice (no. 13/2007)

scholarly journals Extended reverse sural artery pedicle flap: a versatile and reproducible option for coverage of ankle and foot defects

2019 ◽  
Vol 7 (3) ◽  
pp. 866
Author(s):  
Bhushan R. Patil ◽  
Chandrashekhar Wahegaonkar ◽  
Nikhil Agarkhedkar ◽  
Bharat Bhushan Dogra
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Free Tissue Transfer ◽  
Soft Tissue Defects ◽  
Pedicle Flap ◽  
Tissue Transfer ◽  
Major Vessel ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Background: Coverage of soft tissue defects around distal third of the leg, particularly ankle and foot is a common situation faced by a plastic and reconstructive surgeon. Options available for such defects are limited due to scarcity of additional soft tissue that can be used without exposing tendons or bone. Associated conditions such as major vascular compromise, comorbidities and lack of facilities or expertise make free tissue transfer less preferred. Distally based sural artery flap has been a frequently used flap in such conditions, easy to perform and has reproducible results. We extended the reach of the flap and reproduced the results.Methods: We performed extended reverse sural artery pedicled flaps in 19 patients who presented to us between 2015 to 2017 with soft tissue defects around ankle and foot. Patients included 15 post RTA, 2 diabetic foot, 1 post resection defect and 1 post burn contracture release defect. Size of the defect ranged between 8x6cm to 14x10cm. Average follow up period was ranging from 8 months to 2.5 years.Results: All the flaps healed well without any obvious complications except one patient in whom marginal necrosis (2 cm margin of distal most flap) was observed and was secondarily treated with skin grafting.Conclusions: We observed that extended reverse sural pedicle flap is a rapid, reliable option for coverage of soft tissue defects around ankle and heel, sparing major vessel compromise and lengthy surgical procedure during free tissue transfer. This flap should be the first option for the patients with trauma and defects over weight bearing foot in whom peroneal axis vessels are preserved.

Enhancement of Thrombolysis In Vivo Without Skin and Soft Tissue Damage by Transcutaneous Ultrasound

1998 ◽  
Vol 89 (4) ◽  
pp. 171-177 ◽  
Author(s):  
Huai Luo ◽  
Yochai Birnbaum ◽  
Michael C. Fishbein ◽  
Thomas M. Peterson ◽  
Tomoo Nagai ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Soft Tissue Damage

The perils of dressings: a cautionary tale of ischaemia

2021 ◽  
Vol 30 (5) ◽  
pp. 420-422
Author(s):  
Alexandra Khoury ◽  
Kirsten Taylor ◽  
Tania Cubison
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Skin Grafting ◽  
Soft Tissue Damage ◽  
Cautionary Tale ◽  
Cause Analysis ◽  
Root Cause ◽  
Queen Victoria ◽  
Post Procedure ◽  
Learning Skill

A cohort of patients presented to Queen Victoria Hospital, UK, with iatrogenic toe ischaemia following application of a different, newly available post-procedure dressing with different properties to those usually used. This resulted in ischaemia with extensive skin and soft tissue damage, requiring debridement surgery and, in some cases, skin grafting. We aim to highlight the risk of morbidity from dressing application to the digits. This is a key learning skill for anyone who may either perform dressings or evaluate dressings on digits in the community and across multiple specialties in hospital. This article follows a thorough root cause analysis and addresses other possible causes of an acutely painful erythematous toe post-Zadek's procedure.

200 A Scoring System for Equine Dental Health

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 107-107
Author(s):  
Jesse Fenton ◽  
Mary Beth Gordon ◽  
Erin B Perry ◽  
Zach Dombek ◽  
Micheal Jerina ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Damage ◽  
Scoring System ◽  
Dental Health ◽  
Soft Tissue Damage ◽  
Kappa Statistics ◽  
Joint Movement ◽  
Dental Abnormalities ◽  
Nutrition Research ◽  
Chewing Ability

Abstract Scoring systems have been implemented in veterinary practice to indicate the severity of pathologies, such as lameness and gastric ulceration. The need for a scoring system of equine dentition in relation to digestive health has been identified. A scoring system would allow veterinarians, owners, and researchers to more accurately assess dental health and the resulting impact it may have on chewing ability. A proposed system, the Equine Dental Scoring System (EDSS), was developed via collaboration of a team of veterinarians and equine nutritionists familiar with equine dental abnormalities. The EDSS was designed to assign higher scores corresponding to increasing severity of dental abnormalities that would impede proper chewing. The proposed scoring system ranges from 0 to 5 as follows: 0) no sharp enamel points, soft tissue damage, or malocclusion, (1) sharp enamel points, but no soft tissue damage or malocclusion, (2) sharp enamel points and soft tissue damage, but no malocclusion, (3) mild malocclusion with all aligned teeth meeting level (ex. ramps, hooks), (4) moderate malocclusion with all teeth meeting but not level (ex. wave, smile, diagonal, frown), (5) major malocclusion with one or more teeth not meeting or inhibited temporomandibular joint movement (ex. step, shear, retained cap), and/or infection, and/or pain while chewing. The EDSS was validated by assessing agreement via the Cohen’s kappa statistic between four trained professionals scoring ten images of horse dentition. Both the weighted (к = 0.62) and unweighted (к = 0.73) kappa statistics indicated substantial agreement between scorers, signifying reliable repeatability of the EDSS. Presenting dental health in the form of a score would indicate severity of dental pathologies and allow for quantitative and statistical evaluation of dental health in nutrition research and veterinary medicine.

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