Distribution of plantar pressure during jogging barefoot or in minimalistic shoes in people who used to run in cushioned shoes.

BACKGROUND: In recent years, an increasing number of runners prefer jogging barefoot or in minimalistic shoes. The aim of this study was to compare the distribution of plantar pressure during jogging barefoot, in minimalistic shoes, or in shoes with cushioned soles, as these forces modulate the risk of injury. METHODS: The study included nine men aged between 24 and 25 years, who engaged in long-distance running. The plantar pressure of three foot zones (forefoot, midfoot, and hindfoot) was examined with WIN-POD electronic podometer during running barefoot, in minimalistic shoes, or in shoes with cushioned soles. RESULTS: Individuals who ran barefoot showed the greatest forefoot pressure, followed by those running in minimalistic shoes and cushioned shoes. In contrast, the heel pressure in individuals running in cushioned shoes was significantly greater than in those using minimalistic shoes or running barefoot. CONCLUSIONS: Switching from running in cushioned shoes to jogging barefoot is associated with the accumulation of greatest pressure in the forefoot and midfoot. The accumulation of the greatest pressure at the insertion of plantar aponeurosis can lead to the injuries of musculoskeletal system, in particular plantar aponeurositis. Even distribution of pressure among various parts of the foot in persons running in minimalistic shoes is associated with lower risk of injury than in the case of running barefoot.

Pigmented villonodular synovitis: extrasynovial recurrence.

A 32-year-old female athlete underwent arthroscopy for a second recurrence of pigmented villonodular synovitis (PVNS), which was extrasynovial, seen on magnetic resonance imaging. It was noted on arthroscopy that (1) the nodules moved medially with joint insufflation, (2) the nodules were less prominent than on magnetic resonance imaging, and (3) more than 95% of the recurrent tumor was hidden by neosynovium. We believe that the extrasynovial location is because of the more rapid proliferation of the neosynovium relative to the growth of the remaining tumor cells after the previous resection. In resecting pigmented villonodular synovitis with a high risk of recurrence, a layer of periarticular fat should be removed and the surgeon should be wary of change in position with insufflation.

Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007.

Running for exercise is a popular way to motivate children to be physically active. Running-related injuries are well studied in adults but little information exists for children and adolescents. Through use of the National Electronic Injury Surveillance System database, cases of running-related injuries were selected by using activity codes for exercise (which included running and jogging). Sample weights were used to calculate national estimates. An estimated 225 344 children and adolescents 6 to 18 years old were treated in US emergency departments for running-related injuries. The annual number of cases increased by 34.0% over the study period. One third of the injuries involved a running-related fall and more than one half of the injuries occurred at school. The majority of injuries occurred to the lower extremities and resulted in a sprain or strain. These findings emphasize the need for scientific evidence-based guidelines for pediatric running. The high proportion of running-related falls warrants further research.

Isolated congenital absence of posterior cruciate ligament? A case report.

A rare case of a 28-year-old Asiatic male with the isolated absence of a posterior cruciate ligament is reported. Clinical features, diagnostic steps, therapeutic strategies and follow-up are described. A review of the literature is also presented.

Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy.

We present 2 cases of severe, rapidly progressive chondral disease in the lateral compartment within 12 months after meniscectomy. In both cases, the lateral compartment was salvaged with simultaneously performed cartilage repair techniques and meniscal transplantation. The first case is of a 16-year-old boy who suffered a complex irreparable posterior horn lateral meniscus tear that was treated with an aggressive partial meniscectomy, and developed a rapid onset of severe lateral compartment symptoms associated with a focal grade IV chondral defect of the lateral femoral condyle within 10 months of his index meniscectomy. The second case is that of an athletic 43-year-old orthopaedic surgeon who suffered a complex lateral meniscus tear that required a near total lateral meniscectomy. Within 5 months of the lateral meniscectomy, he developed severe lateral symptoms with a focal grade IV chondral defect of the lateral femoral condyle. In both cases, the articular cartilage defects were treated with osteochondral grafting at the time of lateral meniscus transplantation with excellent results at 2-year follow-up. These cases highlight the significant need for a heightened the awareness of the relatively increased risk of rapid lateral compartment degeneration following lateral meniscectomy. This, in combination with the appropriate use of cartilage restoration techniques, provides the potential to salvage or prevent rapid onset, unicompartmental degenerative disease, and the ability to reduce symptoms and improve function in these challenging patients.

[Complete rupture of the proximal semimembranosus tendon. Minimally invasive surgical repair by use of a suture anchor in a rare but often underestimated injury]. / Komplette Ruptur der proximalen Semimembranosussehne. Minimal-invasive Refixation mittels Nahtanker bei einer seltenen und in ihrer Schwere häufig unterschätzten Verletzung.

Complete rupture of the proximal semimembranosus tendon is a rare injury associated with significant functional loss. Conservative treatment has proven inadequate in returning patients to their previous activity level. However, diagnosis is often delayed because of underestimation of the severity of this injury. Satisfactory results can be achieved with both early and late surgical tendon repair in the majority of cases. However, repair delayed by more than 4 weeks post trauma usually requires extended mobilisation of the injured muscle and neurolysis of the sciatic nerve. Therefore, we recommend surgical repair as early as possible. We report on the successful minimally invasive surgical repair of a complete rupture of the proximal semimembranosus tendon by use of a suture anchor 18 days after injury.

[Reconstruction of a real car-pedestrian-accident. Part I: Generating an individual digital topographic image of the victim]. / Rekonstruktion eines realen PKW-Fussgänger-Unfalls. Teil I: Erstellung der individuellen digitalen Oberfläche eines Unfallopfers.

The aim of forensic biomechanics is the reconstruction of traumatic events based on the pathological findings in the victim's morphology, the accident traces and the car damages. The use of forensic documentation tools (e.g. Streifenlichttopometrie) enables 3-dimensional and proportional accurate documentation of the victim's body, of its injuries and of the car damages with submillimeter precision. The generated topographic image serves as input for a multi-body system model of the victim. It allows further to determine exactly the contact points between car and victim for a computer simulated dynamical reconstruction of the impact situation. In the case of an accident involving a car and a pedestrian the generation and application of computer aided 3-dimensional reconstruction models are shown.

[Reconstruction of a real car-pedestrian-accident. Part 2: Modelling and simulation]. / Rekonstruktion eines realen PKW-Fussgänger-Unfalls. Teil II: Modellbildung und Simulation.

A real pedestrian-car-crash was reconstructed by use of a multi-body simulation. The main aspect was the use of an individual body surface for the human body model and the car. The simulation allowed a plausible reconstruction of the accident. A good correlation of the contact-pairs in the model and the real forensic data was achieved by variation of the hypothetical szenario.

Repetition of an unusual stress fracture in an anorexic man: a case report.

Stress fractures of the fibula commonly occur distally in runners, whereas stress fractures of the proximal fibula are uncommon and typically occur in jumpers. Furthermore, it is rare for a stress fracture to be repeated in the same bone. We report a case of a repeated stress fracture of the proximal fibula in a male runner with abnormal gait that primarily involved excessive pronation. Unusual risk factors in this case were anorexia nervosa and use of an inhaled corticosteroid. The patient was treated conservatively, and healing of the fracture was completed at 12 weeks.