Comparative Effect of Static Stretching and Mulligan Stretching on Hip Adductor Flexibility in Footballers - A Two Group Trial

Groin pain due to adductor strain is commonly seen in footballers. Many methods of stretching a muscle likeballistic stretching, static stretching etc are used to increase flexibility of hip adductors and prevent groinstrain. Static hip adductor stretching till now is more favored technique whereas mulligan adductor stretchingis very new and popular method of increasing muscle flexibility. The present study was undertaken to comparethe effectiveness of 2 stretching programs i.e. Mulligan adductor stretching and static stretching on tight hipadductor. In this trial, 42 athletes who fulfilled the selection criteria were selected and then divided into twogroups based on block randomization. Group-1 received Mulligan’s adductor stretching while Group-2 receivedstatic stretching of hip adductors for 3 alternative days. Hip abduction range of motion (Abd-ROM) wasmeasured on baseline, after first day treatment and finally after third day treatment by a universal goniometer.Mean difference of Abd-ROM within groups on baseline, 1st day after treatment and 3rd day after treatmentwere -8.07, -12.76, -4.69 which shows highly significant difference (p = 0.00) between 3 sessions. MeanAbd-ROM between two groups has not shown significant different (F = 2.99, p > 0.05). It is concluded thatMulligan’s adductor stretching and static stretching both are equally effective in increasing Abd-ROM

Differences in Scapular Movement and Muscle Activity of the Periscapular Muscle According to the Belt-tying Movement Method / The Japanese Journal of Rehabilitation Medicine

Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.

Differences in Scapular Movement and Muscle Activity of the Periscapular Muscle According to the Belt-tying Movement Method / The Japanese Journal of Rehabilitation Medicine

Objective：The belt-tying movement is of two types. One uses an abduction method in which the scapular on the same side as the upper limb to be moved is touched. The other type uses an adduction method in which the scapular on the opposite side is touched. The purpose of this study was to determine the scapular movement and muscle activity of the periscapular muscle in each method.Methods：Ten healthy men performed abduction and adduction belt-tying movements. The scapular upward rotation, anterior tilt, and internal rotation angles were measured using a three-dimensional operation analysis device. The joint angles were compared between the abduction and adduction methods by using a multiple comparison procedure. In addition, the muscle activities of the trapezius upper, middle, lower, and serratus anterior muscles were measured and analyzed using surface electromyography.Results：The abduction method involved an anterior tilt and upward rotation of the scapular muscle. By contrast, the adduction method involved an upper limb descent at the L5/T12 level, a scapular anterior tilt and upward rotation, and a scapular downward rotation at a level higher than L5/T12. The muscle activity of the upper trapezius muscle fiber was always increased between the ptosis and T7 by the abduction method but was attenuated at a higher level than T12 by the abduction method.Conclusion：Rehabilitation therapy that focuses on scapular anterior tilt and downward rotation, and the muscle activity of the upper trapezius muscle fiber is important for acquiring the belt-tying movement ability using the adduction method.

Eficacia del tratamiento quirúrgico mediante neurotización radial en pacientes con lesión traumática aislada de nervio axilar / Efficacy of surgical treatment by radial nerve transfer in patients with traumatic isolated axillary nerve injury

Resumen: Objetivo: Determinar la eficacia del tratamiento quirúrgico mediante neurotización radial en pacientes con diagnóstico de lesión traumática aislada de nervio axilar. Material y métodos: Se presenta una serie de siete casos, seis hombres y una mujer, con promedio de edad de 51.6 años, con diagnóstico de lesión traumática aislada de nervio axilar tratados quirúrgicamente entre Enero 2013 y Diciembre 2016. Todos los pacientes fueron tratados mediante transferencia nerviosa de rama motora radial de la cabeza medial del tríceps, entre el sexto y decimoséptimo mes después del traumatismo, con un seguimiento mínimo de 12 meses. Se evaluó la eficacia del tratamiento mediante la Medical Research Council (MRC) y el cuestionario DASH. Resultados: En el análisis bivariado encontramos diferencias estadísticamente significativas con respecto al grado de mejoría de fuerza de rotación externa y de abducción medido por MRC preoperatoria y postoperatoria (p < 0.05). Los resultados también demostraron una significancia estadística en el rango de movimiento de abducción postoperatorio de hombro (p = 0.01). El cuestionario DASH demostró un porcentaje promedio de discapacidad de 20.29% después de 12 meses de seguimiento. Conclusión: La neurotización radial en pacientes con diagnóstico de lesión traumática aislada de nervio axilar proporciona un excelente grado de mejoría de fuerza de rotación externa y abducción, además de mejorar significativamente el rango de abducción del hombro; también se demostró, mediante cuestionario DASH, que el porcentaje de discapacidad es bajo.

Abstract: Purpose: To determine the efficacy of surgical treatment by radial nerve transfer in patients with a diagnosis of isolated axillary nerve traumatic injury. Material and methods: We present a series of seven cases, six men and one woman, with a mean age of 51.6 years, with a diagnosis of isolated traumatic axillary nerve injury between January 2013 and December 2016. All patients were treated by radial motor branch nerve transfer of the medial triceps head between the sixth and seventeenth months after trauma, with a minimum follow-up of 12 months. The efficacy of the treatment was evaluated by the Medical Research Council (MRC) and the DASH questionnaire. Results: In the bivariate analysis we found statistically significant differences regarding the degree of external rotation and abduction strength measured by preoperative and postoperative MRC (p < 0.05). The results also demonstrated a statistical significance in the range of postoperative shoulder abduction movement (p = 0.01). The DASH questionnaire showed an average percentage of disability of 20.29% after 12 months of follow-up. Conclusion: Radial nerve transfer in patients diagnosed with axillary nerve traumatic injury provides an excellent degree of improvement in external rotation and abduction strength, in addition to significantly improving the shoulder abduction range, it was also demonstrated by DASH questionnaire that the percentage disability is low.

Overcoming obstacles to creativity in science / Superando obstáculos à criatividade na ciência

Creativity is a crucial issue in science. Scientific research should not be restricted to the logical development and application of known ideas, but should promote new ideas to expand knowledge beyond the existing frontiers. Stimulating scientific creativity means not only giving a boost to creative thinking, but also taking into account the factors that put a brake on creativity. This article is devoted to factors that keep scientific creativity in check and how we could address them. We analyze several obstacles lying inside and outside the researcher's mind. The most important obstacles inside the researcher's mind are epistemological obstacles and cognitive bias (confirmation bias). While the most important obstacle outside are the social norms, i.e. the pressure for the scientific community and, sometimes, the whole society, to conform to the dominant scientific model. We conclude with some proposals to overcome these obstacles.

A criatividade é uma questão crucial na ciência. Sua pesquisa científica não deve se restringir ao desenvolvimento e aplicação lógica de ideias já conhecidas, mas deve promover novas ideias para expandir o conhecimento além das fronteiras existentes. Estimular a criatividade científica significa não apenas estimular o pensamento criativo, mas também levar em conta os fatores que dificultam a criatividade. Este artigo é dedicado aos fatores que mantêm a criatividade científica sob controle e como podemos resolvê-los. Analisamos diversos obstáculos dentro e fora da mente do pesquisador. Os obstáculos mais importantes dentro da mente do pesquisador são os obstáculos epistemológicos e o viés cognitivo (viés de confirmação). Enquanto o obstáculo externo mais importante é composto pelas normas sociais, ou seja, a pressão por parte da comunidade científica e, por vezes, por parte de toda a sociedade, para se adequar ao modelo científico dominante. Concluímos com algumas propostas sobre como superar esses obstáculos.

Survival analysis of hip resurfacing arthroplasty / 医学研究生学报

Objective At present, there is little report of clinical results of metal-on-metal HRA in China.This study was aimed at retrospectively analyzing the factors of survival rate of HRA in China. Methods A retrospective study was conducted in 113 patients who accepted HRA in our hospital from September 2005 to May 2010.All patients were followed up by telephone or outpatient visit,and the average follow-up time was 10.2 years.The clinical function was evaluated by Harris score,and the prosthesis was evalu-ated by pelvic film.Inductively coupled plasma mass spectrometry(ICP-MS)was used to detect the concentration of blood metal ions, ultrasound and MRI were used to screen and diagnose inflammatory pseudotumor.Cox proportional hazards models were used to analyze the factors affecting the survival rate of the prosthesis. Results A total of 91 patients(120 hips)were followed up while 22 patients (26 hips)were lost,the follow-up rate was 80.5%.17 patients underwent revision surgeries,including 8 cases of femoral neck fracture and 8 cases of aseptic loosening,the other one was infection.Revision in 13 cases was within 3 years, the proportion was as high as 76.5%.The 10-year survival rate of prosthesis was 87.1%,the abduction angle of acetabular prosthesis is the only risk factor affecting the survival. Conclusion Postoperative survival rate of HRA is relatively high, and the survival rate of prosthesis is relevant to socket position.We should notice that the risk increased when the acetabular abduction angle of the prosthesis was over 55 degree.O-verall,HRA is still a successful surgical method.

Changes in lateral ocular movement after two muscle exotropia surgery / 中华实验眼科杂志

Objective This study was to identify the surgical procedures associated with changes of lateral eye movement to help inform surgical planning for patients with concomitant exotropia.Methods The medical records of 87 concomitant exotropia surgical procedures that were performed at Henan Eye Hospital from June 2014 to August 2015 were retrospectively reviewed.The deviation angle was measured by prism and alternate cover test.Photographs and arc campimeter was used to obtain changes of abduction and lateral monocular fixation field respectively.Data were compared preoperatively and postoperatively among five groups based on the surgical procedures.The surgical procedures were 0 mm for control group (61 eyes),8 mm unilateral rectus recession for lateral rectus recession (LR) group (27 eyes),5-6 mm recession/4-5 mm resection for small amount recess-resect (R-R) group (24 eyes),7-8 mm recession/5-6 mm resection for medium amount R-R group (29 eyes) and 8-10 mm recession/7-8 mm resection for large amount R-R group (33 eyes).The minimum follow-up period was 6 months.Informed consent was signed from each patient or the guardian.Results The success,overcorrection and undercorrection rate was 81.61％,5.56％ and 12.64％,respectively.Mean preoperative abduction of each group was (11.86± 1.11)mm in the control group,(12.04±0.68)mm in the LR group,(11.58 ± 1.06)mm in the small amount R-R group,(11.86±0.93)mm in the medium amount R-R group and (12.22±0.60)mm in the large amount R-R group.The postoperative mean abduction of each group was (11.81±1.03),(11.81 ±0.70),(10.78±1.05),(10.54±1.07) and (9.90±0.82)mm,respectively.Mean abduction among the five groups was not significantly different preoperatively (F =1.85,P =0.12),while it was significantly different postoperatively (F =28.04,P =0.00).The abduction between control group and small amount R-R group was not significantly different postoperatively (P =0.99),but the abduction of control group was significantly greater than that of all the R-R groups (all at P=0.00).Mean lateral monocular fixation field of each group preoperatively was (50.82 ± 3.30) ° in control group,(51.48 ±2.39)° in LR group,(50.13±3.51)° in small amount R-R group,(51.06±2.90)° in medium amount R-R group and (52.09±2.61)° in large amount R-R group.The postoperative mean lateral monocular fixation field of each group was (50.52 ± 3.51)°,(50.11 ± 2.36)°,(46.38 ± 3.67)°,(44.00 ± 3.00)°,(41.84 ±2.46)°,respectively.Preoperative lateral monocular fixation field among the five groups was not significantly different (F =1.75,P =0.14),while postoperative difference was significant (F =55.75,P =0.00).Lateral monocular fixation field between control group and LR group was not significantly different postoperatively (P=0.57),but the mean lateral monocular fixation field of control group was significantly greater than that of all the R-R groups (all at P =0.00).Conclusions The successful alignment rate of unilateral recess/resect procedure is satisfying,but it can also create abduction deficit especially in large surgical amounts eye.Patients with binocular vision will be sensitive to diplopia in side gaze;in such cases,the consequences of recess/resect procedure should be considered particularly to avoid decrease of the binocular single vision field.

The Effect of Plank Exercises with Hip Abduction Using Sling on Trunk Muscle Activation in Healthy Adults

PURPOSE: The purpose of this study is to investigate the effects of healthy persons performing a plank exercise with hip abduction and use of sling on trunk muscle activity. METHODS: Twenty-three subjects participated in this study. Muscle activities of the multifidus, rectus abdominis, external oblique and internal oblique were assessed with electromyography (EMG) while the subjects performed 6 various types of plank exercises in random order. RESULTS: There was a significant difference in multifidus and internal oblique on the supported side and the multifidus, external oblique, and internal oblique on the elevated side (p<0.05), and differences in plank methods were significantly higher in the multifidus, rectus abdominis, external oblique, internal oblique of the supported side and the rectus abdominis, external oblique and internal oblique on the elevated side (p<0.05). In addition, post-hoc analysis of the various plank methods showed that muscle activity was significantly higher during the general plank exercise compared with the knee-supported-in-sling plank exercises (p<0.05), and was significantly higher with the ankle-supported-in-sling plank exercises compared with the general plank exercise. CONCLUSION: There was greater trunk muscle activity with plank exercises performed with the ankle-supported-in-sling and hip abduction plank exercises compared with the general or knee-supported-in-sling plank exercises. Through this study, various plank exercises have been discovered that can be selected at different intensities for core muscle training purposes based on trunk muscle strength.

Condiciones del cautiverio y significados construidos del secuestro extorsivo económico, desde la narrativa de los sobrevivientes / Captivity conditions and constructed meanings of economic kidnapping based on survivors' narrative accounts / Condições do cativeiro e dos significados construídos do sequestro por resgate econômico, da narrativa dos sobreviventes

Los objetivos de este estudio fueron: 1. Analizar, desde las narrativas de las víctimas, las condiciones del cautiverio y el trato que recibieron de sus captores, y 2. Identificar, desde el construccionismo social, los significados que las víctimas construyeron del secuestro. Se empleó como método el estudio de casos y el análisis de narrativas. La muestra estuvo conformada por ocho personas sobrevivientes de secuestro extorsivo económico, de las cuales dos fueron mujeres y seis hombres; siete mayores de edad y uno menor, secuestrados en promedio entre tres y cinco días. Algunas víctimas se mantuvieron en cautiverio en lugares poco salubres, y otras en sitios acondicionados con servicios básicos. Los secuestradores presentaron violencia instrumental, y también violencia sin otro fin más que humillar a su víctima. El secuestro se calificó como: acto terrible, que no se le desea a nadie; consecuencia del pecado; prueba de fortaleza puesta por Dios; acto denigrante e inhumano; acto para conseguir dinero, entre otros.

The following were the objectives pursued in this study: 1. Analyzing from the victims' narrations their captivity conditions and the treatment received from their captors, and 2. Identifying, from the social constructionism point of view, the meaning of abductions as built by the own kidnapped themselves. Case study and the analysis of narrative reports was the method used in this survey. The sample was integrated by eight victims (two women and six men, seven adults and one minor) having survived economic abductions, after being kept for three to five days on average. Some victims remained captive in unhealthy places and others at locations adapted with basic services. The violence exhibited by the kidnappers was both instrumental and senseless, with no other purpose than inflicting humiliation on their captives. The kidnapping was variedly and distinctly described as "a terrible deed you would never wish anyone to experience; a consequence of sin; a strength test imposed by God; a degrading and inhuman act; an awful action aimed at obtaining money", among other definitions

Os objetivos deste estudo foram: 1. Analisar, das narrativas das vítimas, as condições do cativeiro e do tratamento que receberam dos seus capturadores, e 2. Identificar, do construcionismo social, os significados que as vítimas construíram do seqüestro. O estudo dos casos e a análise das narrativas foi usado como o método. A amostra foi conformada por oito pessoas sobreviventes de seqüestro por resgate econômico, das quais duas foram mulheres e seis homens; sete maior de idade e um menor, sequestrados entre três e cinco dias, média. Algumas vítimas permaneceram no cativeiro em locais pouco salubres, e outras em locais equipados com os serviços básicos. Os sequestradores apresentaram violência instrumentais, e também violência sem um outro alvo mais do que para humilhar a sua vítima. O sequestro foi descrito como: ato terrível, aquele que não é desejado para ninguém; consequência do pecado; o teste da fortaleza por Deus; ato degradante e desumano; ato para obter dinheiro, entre outros.

El sentimiento inconsciente de culpa freudiano: clínica diferencial y suposición de sujeto. Una aproximación metodológica / The freudian unconscious feeling of guilt: differential clinic and supposition of subject. A methodological approximation

En este artículo presentamos dos aspectos del estado de avance de nuestra investigación sobre el sentimiento inconsciente de culpa y su relación con el deseo. En primer lugar, y en relación con nuestro primer objetivo específico, damos cuenta aquí de la revisión bibliográfica sobre el contexto de surgimiento y el camino de construcción de la noción mencionada. Luego, en un segundo movimiento, realizamos un análisis de la metodología aplicada por Freud en su investigación, para establecer y explicitar, por comparación, nuestra propia metodología. Respecto de la primera parte del trabajo, hemos hallado que Freud parte, a modo de regla general, de la postulación de la represión del complejo de Edipo y la formación del Superyó como instancia subrogante de la autoridad paterna; luego formula la hipótesis de sentimiento inconsciente de culpa para aquellos casos en que detecta diversos fenómenos clínicos, como la reacción terapéutica negativa, por ejemplo. A continuación, prosigue su conceptualización hacia la necesidad de auto-castigo, y de allí, al masoquismo generalizado de las neurosis. En lo que respecta a la segunda parte del trabajo, encontramos que la metodología freudiana responde al razonamiento abductivo. Por comparación con dicha metodología, caracterizamos y explicitamos la nuestra, que también responde a la abducción.

In this article we are going to introduce two aspects about our state of progress regarding our first investigation about the unconscious feeling of guilt and its relation with desire. Firstly, and in relation to our first purpose, we notice here the literature review about the context of emergence and the way of the construction of the mentioned notion. Then, in a second movement, we analyze the methodology applied by Freud in his investigation, to state and explain, by comparison, our own methodology. In regards with the first part of the work, we have found that Freud begins, as a general rule, with the postulation related to the repression of the Oedipus complex and the formation of the superego as a surrogate instance of paternal authority; then he formulates the hypothesis of unconscious feeling of guilt for those cases in which he detects various clinical phenomena, like negative therapeutic reaction, for instance. After that, he continues his conceptualization to the need of self-punishment, and from there, to the widespread masochism of neuroses. In the second part of the article, we find that the freudian methodology goes along with the abductive reasoning. By comparing these methodologies, we describe and explain ours, which also responds to abduction.

USE OF SMARTPHONE IN ACETABULAR COMPONENT ANGLE MEASUREMENT DURING TOTAL HIP ARTHROPLASTY / 中国修复重建外科杂志

OBJECTIVE: To evaluate the accuracy of using smartphone to measure the angle of acetabular component in total hip arthroplasty (THA). METHODS: Between June 2012 and September 2015, the acetabular abduction and anteversion angles were measured in 50 patients undergoing THA. There were 24 males and 26 females, aged 37 to 83 years (mean, 71 years). The left hip was involved in 22 cases and the right hip in 28 cases. Of 50 patients, 34 suffered from fracture of the femoral neck, and 16 suffered from avascular necrosis of the femoral head. Acetabular dysplasia was excluded in all cases. A smartphone was used to measure the acetabular abduction and anteversion angles during operation; standard Picture Archiving and Communication Systems (PACS) was used to measured the acetabular abduction and anteversion angles on the X-ray film at 1 week after operation. It was defined as positive that the component angle values by PACS measurement were greater than those by the smartphone measurement, whereas as negative. The two measurement methods were compared, and intra-observer variability was assessed by analyzing the intraclass correlation coefficient (ICC), the Mann-Whitney U-test was used to analyze difference. RESULTS: The ICC was 0.84 in the acetabular component angles by smartphone and PACS measurement methods. The acetabular component abduction angle was (44.02±1.33)° and the anteversion angle was (17.62±2.20)° by smartphone measurement. The acetabular component abduction angle was (44.74±4.05)° and the anteversion angle was (17.22±5.57)° by PACS measurement. There was no significant difference between two measurement methods (Z=-1.977, P=0.482; Z=-0.368, P=0.713). The acetabular component angle was in the safe zone in 44 cases; and the acetabular component anteversion angle was beyond safe range of 1 to 5°, and the abduction angle was beyond safe range of 1 to 3° in 6 cases. Intra-measurement variability was -21 to +10° for the anteversion angle and -10 to + 9° for the abduction angle, indicating that the acetabular component anteversion angle by smartphone measurement was greater than that by the PACS measurement, and the abduction angle was less than that by PACS measurement. CONCLUSIONS: Smartphone is a convenient tool to measure the acetabular component angle in THA.

SCREENING THE NEWBORN FOR DYSPLASIA OF THE HIP / Шинэ санаа Шинэ нээлт

Developmental Dysplasia of the Hip (DDH) is a major health problem which can lead to lifelong handicapped condition of individuals if early diagnosis is missed. Cost for treatment, surgery and rehabilitation of these cases is much higher than that for prevention. According to Graf, hip ultrasound screening method is simple, reproducible, innocuous and can be performed by well- trained neonatologists. The purpose of this study is to determine prevalence and types of hip dysplasia by Graf standard screening method. A prospective study was carried out. Hip ultrasound screening using Graf method was performed by neonatologists at the Amgalan of maternity of the Capital city from January 2013 to March 2015.Totally 6154 neonates were eligible for the study and 50.9% of them were male, 93.27% term and 6.72% preterm, in 8.53% of babies, type IIa (physiological retardation of ossification)was found. Dysplasia or dislocation of hips (type III and IV) was found in 5 (0.08%) neonates. Babies diagnosed with type I on both hips were discharged. Type IIa cases were stopped being swaddled and reassessed after 4 weeks. Cases with type III and IV cases were all treated with abduction treatment or Tubinger. This study is an ongoing project. The implementation of the hip ultrasound screening according to Graf is feasible and can be performed by well-trained neonalogists in Amgalan of maternity of the Capital city.

A Case of Sphenoidal Sinus Carcinoma Associated with Partial Oculomotor and Abducens Nerve Palsy

PURPOSE: To report a rare case of a patient with diplopia due to a mass in the sphenoidal sinus, histologically diagnosed as carcinoma. CASE SUMMARY: A 57-year-old male visited our clinic complaining of diplopia and ptosis for 10 days. He had esotropia 45 prism diopters in the primary position, markedly limited abduction, and a 4 mm dilated pupil in the right eye compared with a 2 mm pupil in the left eye. Enhanced magnetic resonance imaging revealed a sphenoidal sinus mass extended into the pituitary gland and sella turcica with homogeneous intense enhancement. Metastatic workups, including CT of the head, neck, chest, and abdomen were unremarkable. He underwent a transsphenoidal approach mass debulking surgery followed by radiotherapy for 6 weeks. Histological findings were compatible with carcinoma. Six weeks after radiotherapy he had esotropia of 20 prism diopters in the primary position. Abduction limitation was partially recovered postoperatively. CONCLUSIONS: Diplopia may develop as a result of multiple cranial nerve palsy due to carcinoma in the sphenoidal sinus and may be improved by debulking surgery and radiation treatment.

Relapse of Clubfoot after Treatment with the Ponseti Method and the Function of the Foot Abduction Orthosis

Ponseti clubfoot treatment has become more popular during the last decade because of its high initial correction rate. But the most common problem affecting the long-term successful outcome is relapse of the deformity. Non-compliance with Ponseti brace protocol is a major problem associated with relapse. Although more comfortable braces have been reported to improve the compliance, they all have the same design and no significant changes have been made to the protocols. After refinement in the Ponseti method and emphasizing the importance of brace to parents, the relapse rate has been markedly decreased. Nevertheless, there are patients who do not have any recurrence although they are not completely compliant with the brace treatment, whereas other patients have a recurrence even though they are strictly compliant with the brace treatment. The aim of this article is to review the relapse of clubfoot and the function of the brace and to develop an individualized brace protocol for each patient by analyzing the mechanism of the brace and the biomechanical properties of muscles, tendons, and ligaments.

Influence from acetabular component orientation on stress distributions of periacetabulum / 医用生物力学

Abstract： Objective To study the influence from different placement angles of acetabular component on inner and outer stress distributions of periacetabulum in acetabular reconstruction of total hip arthroplasty (THA), so as to explore proper orientation for improving stability of acetabular component after THA. Methods Based on model with inhomogeneous material property assignment, nine THA models with acetabular component at different anteversion angles(15°, 20°, 25°) and abduction angles(40°, 45°, 50°) as well as one normal hip model were constructed. The maximal hip contact force in phase of single leg stance during normal gait cycle was chosen as the loading condition. In addition, according to the qualitative and quantitative principle, inner and outer stress distributions on 9 THA models were analyzed and compared with the normal hip model as control. Results When abduction angle of acetabular component was the nearest to anatomic angle (19° anteversion, 46° abduction) of acetabulum, the phenomenon of stress shielding on periacetabulum was the most obvious. When abduction angle of acetabular component was placed at 45° and anteversion angle changed from 15° to 25°, no significant influence was exerted on the whole stress distributions of THA models. Meanwhile, when anteversion angle of acetabular component was 15°, the THA model had good stability in stress distributions, and the phenomenon of stress shielding on cortical and cancellous bone was obviously improved. Conclusions For patients who have normal anatomic acetabulum and need to be treated with THA, the abduction angle of acetabular component should be placed at 45°, as that of normal acetabulum; the anteversion angle should be 5° smaller than that of normal acetabulum and between 15° and 20°.

Quantitative Evaluation of Median Nerve Motor Function in Carpal Tunnel Syndrome Using Load Cell : Correlation with Clinical, Electrodiagnostic, and Ultrasonographic Findings

OBJECTIVE: Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. METHODS: Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. RESULTS: The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). CONCLUSION: Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

Soft-tissue Releases to Treat Spastic Hip Subluxation in Children with Cerebral Palsy: Effect of Age at the Time of Surgery / The Japanese Journal of Rehabilitation Medicine

Objectives : Muscle imbalance poses a problem for adequate motor function in patients with cerebral palsy. The adductor and flexor muscles around the hip become dominant, leading to a high risk of hip dislocation. When left untreated, flexion and adduction contracture progresses, leading to various impairments ; hence, it is important to undertake preventive measures at an early stage. Selective muscle release is one form of surgical treatment that has been proven effective, but there is no consensus on the timing of the surgery. Here, we investigated the difference in outcome after muscle release surgery with respect to age. Subjects and methods : The subjects were 26 patients (52 hips) from our medical center who underwent muscle release (partial modification of Matsuo's method) around the hip and were followed up for at least 6 months. Abduction was retained postoperatively by using a cast or prosthetic device. Migration percentage (MP) was measured by simple hip radiography image, and the rates of improvement (preoperative MP . final MP during observation/preoperative MP ×100%) were compared. Results : Higher rates of improvement were observed among patients aged 5 years or less at the time of surgery than those among patients aged 6 years or more. Conclusion : We consider that surgery performed at the age of 5 years or less could lead to favorable results.

CT measurement of acetabulum geometric parameter / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.013

Abduction of Children by Their Parents: A Psychopathological Approach to the Problem in Mixed-Ethnicity Marriages.

Aim: Child abduction by one parent and their transport to a foreign country is increasing worldwide but has not received adequate scientific interest. When inter-marital relationships reach the point of break-up and divorce, one of the parents abducts his/her child/children. Method: Records of forty seven (47) cases of inter family abduction that took place in 2007 in Greece were obtained. The majority of cases concerned relocation of children in a foreign country. A special inventory was developed for data collection. This consisted of three distinctive parts, for the father, the mother, or the abducted child. Results: Results showed that a typical abductive mother is of non Greek nationality, more likely of having psychiatric symptoms, without indication of substance abuse and no signs of violent behavior. Abductive fathers are of Greek nationality, less likely of having psychiatric symptoms, no substance abuse, and tend to exhibit violent behavior. Legal resolution of these cases and repatriation takes very long adding to the child and family’s distress. Conclusions: Child abduction is associated with cases of dissolved marriages. Domestic violence is frequent. Child abduction cases takes on average 3.5 years to be resolved, a phenomenon that has obvious implications on the mental health of the children and the parents involved.

The effects of hip abduction with external rotation and reverse Trendelenburg position on the size of the femoral vein; ultrasonographic investigation / 대한마취과학회지

BACKGROUND: Femoral vein (FV) catheterization is required for critically ill patients, patients with difficult peripheral intravenous access, and patients undergoing major surgery. The purpose of this study was to evaluate the effects of hip abduction with external rotation (frog-leg position), and the frog-leg position during the reverse Trendelenburg position on diameter, cross-sectional area (CSA), exposed width and ratio of the FV using ultrasound investigation. METHODS: Ultrasonographic FV images of 50 adult subjects were obtained: 1) in the neutral position (N position); 2) in the frog-leg position (F position); 3) in the F position during the reverse Trendelenburg position (FRT position). Diameter, CSA, and exposed width of the FV were measured. Exposed ratio of the FV was calculated. RESULTS: The F and FRT positions increased diameter, CSA and exposed width of the FV significantly compared with the N position. However, the F and FRT positions had no significant effect on exposed ratio of the FV compared with the N position. The FRT position was more effective than the F position in increasing FV size. CONCLUSIONS: The F and FRT positions can be used to increase FV size during catheterization. These positions may increase success rate and reduce complication rate and, therefore, can be useful for patients with difficult central venous access or at high-risk of catheter-related complication.