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1.
Article | IMSEAR | ID: sea-219971

ABSTRACT

Background: The scapulothorasic joint plays an important role in overall shoulder function by providing a stable base for glenohumeral rotation. Snapping scapula syndrome, a likely under diagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is difficult to understand, sometimes mimic with shoulder pain. Dysfunctioning of any of muscles, ligament, bursa may cause abnormal scapular motion and predispose to scapulothoracic joint disorders. Accurate recognition of the syndrome may lead to prompt and long-term relief of symptoms by conservative or noninvesiveintervension treatment.Results:The causes of scapulothoracic bursitis and crepitus include direct or indirect trauma, overuse syndromes, glenohumeral joint dysfunction, boney abnormalities, muscle microtrauma or atrophy or fibrosis, and idiopathic causes. Scapulothoracic bursitis and crepitus remain primarily clinical diagnoses. However, imaging studies or local injections may also be helpful. The initial treatment of scapulothoracic bursitis and scapulothoracic crepitus should be conservative. Intevension procedure is best for treating modalitis for scapulothoracic dysfunction, most reports have demonstrated well to excellent outcomes in a significantly high percentage of patients.Conclusions:Clearly, the best initial approach to these conditions is a conservative treatment like nonsteroidal antiinflammatory drugs plan that combines scapular strengthening, postural reeducation, and core strength endurance. If an appropriate trial of nonoperative management proves unsuccessful, local non invesiveintervension can produce good results.

2.
Malaysian Orthopaedic Journal ; : 155-158, 2022.
Article in English | WPRIM | ID: wpr-962294

ABSTRACT

@#The coexistence of ulnar nerve subluxation and snapping medial head triceps is an uncommon occurrence. There have been few studies and case reports since it was first described in 1970. In this article, we present a case in which the condition occurred after a push-up. We analysed the pathoanatomy of the condition, and reviewed the literature regarding potential causes, typical presentations of the coexistence of both ulnar nerve subluxation and medial snapping triceps and describe our surgical technique in treatment. Elbow pain is very often under evaluated as many physicians may not be aware that elbow pain could be attributed to the coexistence of both ulnar nerve subluxation and medial snapping triceps. A thorough evaluation with physical examination and imaging are recommended. Early surgery with an appropriate rehabilitation programme may hasten recovery and return to sports in patients who continue to remain symptomatic following a trial of conservative therapy.

3.
Rev. Méd. Clín. Condes ; 32(3): 277-285, mayo-jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1518449

ABSTRACT

En adolescentes que consultan por dolor de cadera o pelvis, es crucial una adecuada historia clínica para orientarnos sobre la etiología del dolor y comprender los mecanismos que lo generan. Es importante conocer y realizar un exhaustivo examen físico, con especial énfasis en la cadera, incluyendo pruebas específicas para diferentes patologías, además de comprender las indicaciones de los diferentes estudios de imágenes, para así lograr un correcto diagnóstico.Entre las causas más frecuentes de coxalgia en adolescentes debemos considerar la epifisiolisis, el pinzamiento femoroacetabular con o sin roturas del labrum, las lesiones avulsivas de la pelvis, la coxa saltans, entre otras. Aunque son poco frecuentes, patologías sistémicas como reumatológicas y oncológicas también deben ser descartadas en adolescentes. Un diagnóstico de certeza nos permitirá realizar una adecuada estrategia de tratamiento, a fin de lograr una rehabilitación precoz y evitar futuras complicaciones.


In adolescents presenting with hip or pelvis pain, an adequate medical history is crucial to guide the etiology and understand the mechanisms that generate it. It is important to know and carry out an exhaustive physical examination, with special attention to the hip, including specific tests for different pathologies, in addition to understand the indications of the different imaging studies, in order to achieve a correct diagnosis. Among the most frequent causes of hip pain in adolescents, we must rule out slipped capital femoral epiphysis, femoroacetabular impingement with or without labral tears, avulsion lesions of the pelvis, snapping hip, among others. Although rare, systemic pathologies such as rheumatologic and oncologic diseases must also be ruled out in adolescents. An accurate diagnosis will allow us to carry out an adequate treatment strategy, in order to achieve early rehabilitation and avoid future complications.


Subject(s)
Humans , Adolescent , Pain/etiology , Epiphyses, Slipped/diagnosis , Femoracetabular Impingement/diagnosis , Hip Joint , Pelvic Pain/etiology , Epiphyses, Slipped/therapy , Femoracetabular Impingement/therapy , Groin
4.
Med. leg. Costa Rica ; 36(2): 95-100, sep.-dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1040449

ABSTRACT

Resumen La luxación del vientre medial del tríceps braquial es una rara condición que ocurre sobre el epicóndilo medial durante la flexión activa de este sobre el codo y a menudo está asociada a inestabilidad del nervio cubital, ocasionando síntomas de compresión de este.


Abstract The dislocation of the medial belly of the triceps is a rare occurrence that occurs on the medial epicondyle during active flexion of this over the elbow and is often associated with an instability of the ulnar nerve, causing symptoms of compression of this nerve.


Subject(s)
Humans , Ulnar Nerve , Joint Dislocations , Elbow , Elbow Joint
5.
Article in English | LILACS-Express | LILACS | ID: biblio-1055696

ABSTRACT

ABSTRACT Introduction: External snapping hip syndrome is characterized by a painful sensation accompanied by an audible snapping noise in the hip when moving. Even though orthopedists are widely aware of this condition, imaging findings still need to be recognized by all radiologists in order to provide more information that allows for the best multidisciplinary treatment. Z-plasty of the iliotibial band is the most used treatment with the best results. Case presentation: Female patient with bilateral external hip snapping syndrome on the right side, who was treated initially in a conservative manner without adequate response; hence, she required surgical management with arthroscopy. All treatment options used for this patient were not successful, and symptoms recurred. Discussion: The diagnosis of snapping hip syndrome is mainly clinical. However, the contribution of diagnostic imaging is important to characterize the structures involved in this nosological process, in order to develop the therapeutic planning and do the follow-up. Conclusion: Knowledge on ultrasound and magnetic resonance findings related to this pathology allows radiologists to identify this syndrome and contribute to a timely treatment.


RESUMEN Introducción. El síndrome de cadera en resorte externa es una entidad en la cual hay una sensación de dolor acompañada de un sonido palpable durante el movimiento de la cadera. Esta es una condición ampliamente conocida por los ortopedistas, pero aún es necesario que los hallazgos imagenológicos sean reconocidos por todos los radiólogos con el fin de brindar mayor información que permita un adecuado manejo multidisciplinario. La Z-plastia de la banda iliotibial es la técnica de tratamiento más reconocida y con mejores resultados. Presentación del caso. Paciente femenino con síndrome de cadera en resorte externo bilateral sintomático en el lado derecho, quien fue manejada de forma conservadora sin adecuada respuesta y requirió manejo quirúrgico por vía artroscópica. Las técnicas utilizadas en la paciente no fueron exitosas y se presentó recurrencia de los síntomas. Discusión. El diagnóstico del síndrome de cadera en resorte es principalmente clínico. Sin embargo, el aporte de las imágenes diagnósticas es importante para caracterizar las estructuras involucradas en este proceso nosológico, para realizar el planeamiento terapéutico y para hacer el seguimiento. Conclusión. Conocer los hallazgos imagenológicos en ultrasonido y resonancia magnética del síndrome en cadera en resorte externa permite a los radiólogos identificarlo y hacer aportes al manejo de esta patología en forma oportuna.

6.
Rev. chil. ortop. traumatol ; 60(3): 91-96, dic. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1146627

ABSTRACT

El Síndrome de Menisco Hipermóvil, caracterizado por bloqueos mecánicos dolorosos de la rodilla, tiene un sustento anatómico basado en los fascículos poplíteo meniscales anteroinferior y posterosuperior, responsables de la estabilidad primaria de la esquina posterolateral meniscal. Con un cuadro clínico característico, usualmente con Resonancia Magnética sin hallazgos sugerentes de patología, la artroscopía juega un rol esencial en casos de alta sospecha, comprobando el diagnóstico al presentar hipermobilidad del cuerno posterior del menisco lateral. MÉTODO: Se presentan 9 casos resueltos, con hiperlaxitud posterolateral meniscal, y presentación clínica caracterizada por bloqueo articular de rodilla sin causa aparente. En todos los casos se realizó reparación de los fascículos poplíteo meniscales con suturas meniscales, con resolución completa de la sintomatología y sin complicaciones post quirúrgicas. CONCLUSIÓN: El manejo del cuadro de menisco hipermóvil está basado por la sospecha clínica y el descarte de otras patologías como causa subyacente de la sintomatología. El manejo quirúrgico con suturas meniscales ha demostrado restaurar la biomecánica normal del compartimento posterolateral de la rodilla, logrando la resolución completa de los síntomas. NIVEL DE EVIDENCIA: IV.


Hypermobile Meniscus Syndrome, characterized by painful mechanical blockages of the knee, has an anatomical support based on the anteroinferior and posterosuperior poplíteomeniscal fascicles, responsible for the primary stability of the posterolateral meniscal corner. With a characteristic clinical presentation, usually with Magnetic Resonance without suggestive findings of pathology, arthroscopy plays an essential role in cases of high suspicion, checking the diagnosis by presenting hypermobility of the posterior horn of the lateral meniscus. METHOD: We present 9 resolved cases, with posterolateral meniscal hypermobility, and clinical presentation characterized by knee articular block without apparent cause. In all cases, poplíteomeniscal fascicles were repaired with meniscal sutures, with complete resolution of the symptoms and without post-surgical complications. CONCLUSION: The management of the hypermobile meniscus syndrome is based on clinical suspicion and the discarding of other pathologies as the underlying cause of the symptomatology. Surgical management with meniscal sutures has been shown to restore the normal biomechanics of the posterolateral compartment of the knee, achieving complete resolution of symptoms. LEVEL OF EVIDENCE: Case series IV.


Subject(s)
Humans , Male , Female , Adolescent , Menisci, Tibial/surgery , Menisci, Tibial/pathology , Joint Instability/surgery , Joint Instability/diagnosis , Arthroscopy , Sutures , Magnetic Resonance Imaging , Knee Joint/surgery , Knee Joint/pathology
7.
The Journal of Korean Knee Society ; : 147-150, 2019.
Article in English | WPRIM | ID: wpr-759364

ABSTRACT

A female patient who underwent total knee arthroplasty presented with a snapping sensation over the left knee at 10 years postoperatively. Initially, the bony mass was visible on the medial femoral condyle radiographically at 5 years postoperatively. The mass had enlarged over time and her symptoms were progressive. The mass was excised at postoperative 18 years and confirmed as an osteochondroma histopathologically. The patient’s symptoms have been completely resolved for 3-year follow-up after excision. LEVEL OF EVIDENCE: V


Subject(s)
Female , Humans , Arthroplasty , Arthroplasty, Replacement, Knee , Follow-Up Studies , Knee , Osteochondroma , Sensation
8.
China Journal of Orthopaedics and Traumatology ; (12): 484-487, 2018.
Article in Chinese | WPRIM | ID: wpr-689960

ABSTRACT

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

9.
The Journal of the Korean Orthopaedic Association ; : 364-368, 2018.
Article in Korean | WPRIM | ID: wpr-716511

ABSTRACT

This paper reports a case of a 21-year-old male patient who complained of intermittent pain and snapping at 110° of flexion in his left elbow joint. Magnetic resonance imaging revealed a band-like low signal intensity in front of the radiohumeral joint. An ultrasound was conducted to check its association with the symptoms. Observations of a high echo escaping from the radiohumeral joint at the point when snapping occurred indicated noted that the hypertrophic plica was a cause of the snapping. The hypertrophic plica removed arthroscopically, and the results were good for up to 6 months after surgery. If snapping is observed in the elbow joint, it will be necessary to consider the symptoms from the hypertrophic plica, although rare, and ultrasound might be an effective tool for a differential diagnosis.


Subject(s)
Humans , Male , Young Adult , Diagnosis , Diagnosis, Differential , Elbow Joint , Elbow , Joints , Magnetic Resonance Imaging , Ultrasonography , United Nations
10.
The Journal of Korean Knee Society ; : 144-149, 2017.
Article in English | WPRIM | ID: wpr-759263

ABSTRACT

Snapping biceps femoris tendon is an uncommon problem that can be caused by various anatomical aberrations around the knee joint. There are several case reports in the literature describing some of these anatomical variations and their treatment. We present a case of unilateral snapping biceps femoris tendon due to a previously unreported anatomical variation, our technique for successful surgical treatment, and a review of the literature.


Subject(s)
Humans , Male , Knee Joint , Knee , Tendons
11.
Hip & Pelvis ; : 187-193, 2017.
Article in English | WPRIM | ID: wpr-140095

ABSTRACT

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.


Subject(s)
Humans , Male , Follow-Up Studies , Hip , Methods , Sensation , Visual Analog Scale
12.
Hip & Pelvis ; : 187-193, 2017.
Article in English | WPRIM | ID: wpr-140094

ABSTRACT

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.


Subject(s)
Humans , Male , Follow-Up Studies , Hip , Methods , Sensation , Visual Analog Scale
13.
The Journal of Korean Knee Society ; : 172-175, 2016.
Article in English | WPRIM | ID: wpr-759211

ABSTRACT

Snapping pes syndrome is defined as a snapping sensation in the medial knee caused by pes anserinus and rarely occurs. Snapping pes syndrome after unicompartmental knee arthroplasty (UKA) has not been reported yet. We experienced two cases with this syndrome after UKA. Conservative treatment was effective in one case, while surgical excision of the gracilis tendon was necessary to relieve painful snapping in the other case. The main cause of the first case might be posteromedial overhang of the tibial tray that reached up to 5 mm. The probable cause of the second case was posteromedial overhang of the mobile bearing.


Subject(s)
Arthroplasty , Arthroplasty, Replacement, Knee , Knee , Sensation , Tendons
14.
Clinics in Orthopedic Surgery ; : 158-163, 2015.
Article in English | WPRIM | ID: wpr-69226

ABSTRACT

BACKGROUND: Arthroscopic iliopsoas tendon release was introduced in 2000. The purpose of this study was to evaluate clinical outcomes of arthroscopic iliopsoas tendon release for painful internal snapping hip with concomitant hip pathologies. METHODS: Between January 2009 and December 2011, we performed arthroscopic iliopsoas tendon release and related surgeries in 25 patients (20 men and 5 women; mean age, 32 years; range, 17 to 53 years) with combined intraarticular hip pathologies. The patients were followed for a minimum of 2 years postoperatively. Clinical and radiological evaluations were performed. RESULTS: Snapping sounds had disappeared by the 2-year follow-up in 24 of the 25 patients. All patients who had presented with loss of flexion strength postoperatively showed recovery at postoperative week 6 to 10. Harris hip score improved from 65 points (range, 46 to 86 points) preoperatively to 84 points (range, 67 to 98 points) postoperatively (p < 0.001). Seven hips (28%) had an excellent score, 15 hips (60%) a good score, 2 hips (8%) a fair score, and one hip (4%) a poor score (p < 0.001). The Tonnis grade of osteoarthritis did not change in any of the patients at the last follow-up. CONCLUSIONS: Patients with painful internal snapping hip have combined hip pathologies. Therefore, the surgeon should keep in mind that painful internal snapping hips are frequently combined with concomitant intraarticular pathologies.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Arthroscopy , Hip Joint , Joint Diseases/surgery , Retrospective Studies , Tenotomy/methods
15.
The Journal of the Korean Bone and Joint Tumor Society ; : 27-31, 2014.
Article in English | WPRIM | ID: wpr-23595

ABSTRACT

Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the 6th rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.


Subject(s)
Femur , Humerus , Osteochondroma , Ribs , Shoulder , Tibia
16.
Hip & Pelvis ; : 173-177, 2014.
Article in English | WPRIM | ID: wpr-108144

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the clinical outcome of arthroscopic treatment for recalcitrant external snapping hip. MATERIALS AND METHODS: Between September 2011 and June 2013, we evaluated 7 patients (10 cases) with snapping hip who were refractory to conservative treatments for at least 3 months. Two patients (4 cases) were impossible to adduct both knees in 90degreesof hip flexion. Surgery was done in lateral decubitus position, under spinal anesthesia. We made 2 arthroscopic portals to operate the patients, and used cross-cutting with flap resection technique to treat the lesion. We performed additional gluteal sling release in those 2 patients (4 cases) with adduction difficulty. Average follow-up length was 19 months (range, 12-33 months). Clinical improvement was evaluated with visual analog scale (VAS), modified Harris hip score (mHHS), and also investigated for presence of limping or other complications as well. RESULTS: The VAS decreased from 6.8 (range, 6-9) preoperatively to 0.2 (range, 0-2) postoperatively, and the mHHS improved from 68.2 to 94.8 after surgery. None of the patients complained of post-operative wound problem or surgical complications. CONCLUSION: The clinical outcome of arthroscopic treatment for recalcitrant external snapping hip was encouraging and all patients were also satisfied with the cosmetic results.


Subject(s)
Humans , Anesthesia, Spinal , Arthroscopy , Follow-Up Studies , Hip , Knee , Visual Analog Scale , Wounds and Injuries
17.
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine ; : 263-272, 2013.
Article in Japanese | WPRIM | ID: wpr-689142

ABSTRACT

Objective: Snapping finger is the result of gliding disorder of the superficial and deep digital flexor tendon and the flexor pollicis longus muscle tendon at the synovial and ligamentous tendon sheath (A1 pulley). In this study, acupuncture was performed at the A1 pulley of the affected finger to determine its effect on pain during snapping and the degree of the snapping phenomenon. Methods: Acupuncture was performed on 19 fingers of 15 patients. No control group of untreated patients was included in the study, and the same acupuncture treatment was used for all of the patients. The acupuncture needles were inserted in the radial and ulnar sides of the flexor tendon (left inserted for 10 min) at the A1 pulley of the affected finger. Treatment was performed a maximum of 5 times (once every 5 to 7 days). Before and after each treatment, the pain during snapping and the degree of the snapping phenomenon were evaluated using a visual analogue scale (VAS) ranging from 0 mm (no symptoms) to 100 mm (intolerable symptoms). Symptoms before the first treatment and before the fifth treatment were compared to determine the degree of change, taking a 50% improvement as the criterion for judging whether there was an improvement or not, and the relationship between improvement or lack of improvement and the duration of the disorder was examined. Results: VAS evaluation showed a significant improvement in pain during snapping and the degree of the snapping phenomenon with scores before the first treatment and before the fifth treatment of 57.1±22.2 (mm, mean±SD)→26.0±29.8, 61.2±23.1→26.1±27.6 respectively. VAS evaluation directly after the first treatment also showed a significant improvement in pain and the degree of the snapping phenomenon with scores of 40.8±19.6 and 44.3±23.9 respectively. Furthermore, by the fifth treatment, pain and the snapping phenomenon were observed to have completely disappeared in 4 and 6 fingers respectively. In patients showing an improvement in pain and the snapping phenomenon, the duration of the disorder was significantly short. Discussion: It is unlikely that acupuncture had an influence on the degeneration and thickening of the ligament tendon sheath. Improvement in the snapping phenomenon is thought to be the result of acupuncture treatment changing regional blood flow and thereby exerting a favorable influence on inflammatory swelling. The alleviation of pain during snapping is believed to be the result of improved flexor tendon gliding as well as the involvement of acupuncture in activation of the pain inhibitory system. Since no control group of untreated patients or sham treatment group were included in the study, the possibility of a placebo effect influencing the results cannot be completely excluded. However, because a difference was observed in the efficacy of the treatment depending on the duration of the disorder, the view is that acupuncture at the impaired A1 pulley could be effective treatment for snapping finger when the main cause is inflammatory swelling of the synovial membrane of the tendon sheath and when the duration of the disorder is short.

18.
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine ; : 263-272, 2013.
Article in Japanese | WPRIM | ID: wpr-375151

ABSTRACT

<B>Objective:</B> Snapping finger is the result of gliding disorder of the superficial and deep digital flexor tendon and the flexor pollicis longus muscle tendon at the synovial and ligamentous tendon sheath (A1 pulley). In this study, acupuncture was performed at the A1 pulley of the affected finger to determine its effect on pain during snapping and the degree of the snapping phenomenon.<BR><B>Methods:</B> Acupuncture was performed on 19 fingers of 15 patients. No control group of untreated patients was included in the study, and the same acupuncture treatment was used for all of the patients. The acupuncture needles were inserted in the radial and ulnar sides of the flexor tendon (left inserted for 10 min) at the A1 pulley of the affected finger. Treatment was performed a maximum of 5 times (once every 5 to 7 days). Before and after each treatment, the pain during snapping and the degree of the snapping phenomenon were evaluated using a visual analogue scale (VAS) ranging from 0 mm (no symptoms) to 100 mm (intolerable symptoms). Symptoms before the first treatment and before the fifth treatment were compared to determine the degree of change, taking a 50% improvement as the criterion for judging whether there was an improvement or not, and the relationship between improvement or lack of improvement and the duration of the disorder was examined.<BR><B>Results:</B> VAS evaluation showed a significant improvement in pain during snapping and the degree of the snapping phenomenon with scores before the first treatment and before the fifth treatment of 57.1±22.2 (mm, mean±SD)→26.0±29.8, 61.2±23.1→26.1±27.6 respectively. VAS evaluation directly after the first treatment also showed a significant improvement in pain and the degree of the snapping phenomenon with scores of 40.8±19.6 and 44.3±23.9 respectively. Furthermore, by the fifth treatment, pain and the snapping phenomenon were observed to have completely disappeared in 4 and 6 fingers respectively. In patients showing an improvement in pain and the snapping phenomenon, the duration of the disorder was significantly short.<BR><B>Discussion: </B>It is unlikely that acupuncture had an influence on the degeneration and thickening of the ligament tendon sheath. Improvement in the snapping phenomenon is thought to be the result of acupuncture treatment changing regional blood flow and thereby exerting a favorable influence on inflammatory swelling. The alleviation of pain during snapping is believed to be the result of improved flexor tendon gliding as well as the involvement of acupuncture in activation of the pain inhibitory system. Since no control group of untreated patients or sham treatment group were included in the study, the possibility of a placebo effect influencing the results cannot be completely excluded. However, because a difference was observed in the efficacy of the treatment depending on the duration of the disorder, the view is that acupuncture at the impaired A1 pulley could be effective treatment for snapping finger when the main cause is inflammatory swelling of the synovial membrane of the tendon sheath and when the duration of the disorder is short.

19.
The Korean Journal of Sports Medicine ; : 144-147, 2012.
Article in Korean | WPRIM | ID: wpr-107655

ABSTRACT

We performed modified Z-plasty (N-plasty) in the patients with snapping hip syndrome arising from the iliotibial band whose pain and clicking sensation persisted despite conservative treatments. We analyzed clinical results to evaluate the effectiveness of this new technique. Among 51 patients (65 cases) who still felt pain and reported clicking sensation during daily life despite hospitalization for at least 2 months from January 1999 to November 2011, we evaluated a total of 32 patients (37 cases) who underwent N-plasty and followed up for more than 6 months. All patients were male whose average age was 24 years. Initial symptoms developed an average of 10 months before hospital visit. Surgery was defined success by postoperative 6 months at which time the patient could be able to carry on with daily life and to exercise without clicking sensation and pain, and defined failure when either clicking sensation or pain was present. We observed that the posterior portion of the iliotibial band was thickened by an average of 8.4 mm. Tenotomy of the iliotibial band lengthened the band by an average of 23mm and narrowed the width of the iliotibial band anterior to posterior. Success was in 33 cases (89%) after surgery. Failure was observed in 4 cases. Three were improved after resurgery and 1 was treated conservatively. We found that N-plasty performed in external type snapping hip patients was an effective method yielding a high success rate.


Subject(s)
Humans , Male , Hip , Hospitalization , Sensation , Tenotomy
20.
Radiol. bras ; 44(3): 195-197, maio-jun. 2011. ilus
Article in Portuguese | LILACS | ID: lil-593342

ABSTRACT

As causas da síndrome de ressalto no joelho relatadas com maior frequência são relacionadas a anormalidades meniscais, ao tendão do músculo bíceps femoral e aos tendões grácil e semitendíneo. Neste trabalho é descrito um caso de ressalto no canto posteromedial relacionado à junção miotendínea do músculo sartório em um paciente do sexo masculino, de 58 anos de idade, com hiperextensão do joelho.


The most frequently reported causes of snapping knee syndrome are related to abnormalities of the meniscus, biceps femoris tendon, gracilis and semitendinosus tendons. The present report describes a case of snapping in the posterior-medial corner of the knee related to the myotendinous junction of the sartorius muscle in a 58-year-old male patient with knee hyperextension.


Subject(s)
Humans , Male , Adult , Aged , Knee Joint , Knee Injuries/pathology , Knee/abnormalities , Menisci, Tibial , Ultrasonography
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