Reports of isolated avulsion fracture at the planter lateral base of the first metatarsal without injury of the tarsometatarsal joint are very rare. A 24 year old man sustained an avulsion fracture at the plantar lateral base of the first metatarsal. Normal alignment of metatarsal bones and tarsometatarsal joint was maintained. In this paper, we describe internal fixation of the displaced fragment usingxray and minimally invasive surgery with good results.
Globular filamentous bodies are one of the well-known inclusion bodies in hepatocellular carcinoma. The article describes a 56-year-old man with an occult hepatocellular carcinoma in whom the first histologic diagnosis was made from a biopsy from bone. Ultrastructural examination showed many globular filamentous bodies similar to Mallory bodies. The ultrastructural findings and the diagnostic value of these filamentous bodies are discussed.
BackgroundThe 11 and The 11+ are accepted effective injury-prevention training programs for junior football players. However, their impact on physical fitness is unclear.ObjectiveTo elucidate the effectiveness of The 11 and The 11+A in injury prevention and physical fitness improvement.DesignA prospective and pre-post intervention study.SettingThe first division of a Japanese collegiate football league.ParticipantsThis study included 182 collegiate male football players, who were divided into three groups: The 11 (n=62), The 11+A (n=60) and Control (n=59). 77 players were evaluated for physical fitness.InterventionsThe 11 program, originally developed by FIFA, and The 11+A, by one of the authors, were conducted once or twice a week for 6 months. The 11+A focuses on plyometric training and differs slightly from The 11+.Main outcome measuresInjury incidence rates during football (game and training), game and training were reported as the number of injuries per 1000 player-hours (PH). Using several field tests (sprint, pro-agility, bounding and balance), each subject's physical fitness level was evaluated prior to and 6 months after training.ResultsThe incidence rates during football, game and training were 3.62, 19.18 and 2.58 injuries/PH in the Control group, 2.27, 11.92 and 1.53 injuries/PH in The 11 group and 2.24, 10.75 and 1.75 injuries/PH in The 11+A group, respectively. The injury incidence rate during football was significantly lower in both the training groups than in the Control group (p<0.05). Pro-agility time was significantly decreased in both training groups than in the Control groups (p<0.05). Balance ability improved significantly only in the 11 group (p<0.05).ConclusionThe 11 and The 11+A were effective in injury prevention and physical fitness improvement.
The llizarov external fixator with a hinge is useful for treatment of joint contractures and correction of deformities. We use it in the treatment of two cases of fractures around the knee for the purpose of enabling ROM exercise using CPM. Excellent results were obtained in terms of ROM. The construction of the llizarov external fixator with a hinge is complicated and time consuming, so the frame must be preconstructed and disinfected before the operation. During the operation, the hinges should be placed at the estimated center of motion of the knee joint, about 2cm from the articular edge, at the posterior third of the femoral condyle. The actual procedures used in positioning the hinge are demonstrated in detail in this article. We hope for further development and refinement of the hinged distraction llizarov external fixator for application to other joints, specifically the elbow, wrist and ankle.
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