Caron AZ, Drouin G, Desrosiers J, Trensz F, Grenier G. A novel hindlimb immobilization procedure for studying skeletal muscle atrophy and recovery in mouse. J Appl Physiol 106: 2049–2059, 2009. First published April 2, 2009; doi:10.1152/japplphysiol.91505.2008.—Skeletal muscle atrophy is a serious concern for patients afflicted by limb restriction due to surgery (e.g., arthrodesis), several art...

A 35 year old man presented to our emergency department after a traffic injury. Radiographic evaluation showed plantar dislocation of the second metatarsophalangeal joint and dorsal dislocation at the second tarsometatarsal joint. Under general anesthesia, closed reduction of the metatarsophalangeal joint was performed, followed by percutaneous fixation with a Kirschner-wire, and immobilization...

Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-...

Low-molecular-weight heparin (LMWH) prophylaxis significantly reduces the total incidence of deep venous thrombosis (DVT) for patients with lower-limb fractures managed with surgical fixation and cast immobilization (strength of recommendation [SOR]: A, based on multiple randomized controlled studies [RCTs]). Evidence is insufficient to show whether LMWH specifically reduces the risk of clinica...

Twenty-four children under the age of 10 years with femoral shaft fractures were treated by early immobilization of fracture and application of hip spica cast. The average hospital stay was 3.5 days. The average shortening at time of fracture union was 15 mm. The average time of follow up was 6.7 months. All fractures healed, except for one, in an acceptable position. The average shortening at ...

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury (Garrigues and Aldridge III in J Bone Joint Surg Am 89:1594-1597, 2007]. Reports of isolated DRUJ luxations, volair or dorsal, are often case reports and rarely a series of cases [Dameron Jr in Clin Orthop Relat Res 83:55-63, 1972]. We present a case of an acute traumatic dorsal DRUJ dislocation treated with cast immobil...

In four women with occult fracture-subluxation of the midtarsal joint incurred in trivial accidents, the correct diagnosis was made promptly, assisted in one case by bone scintigraphy. Treatment was conservative, consisting of cast immobilization for six to eight weeks and a weight-bearing restriction. At the minimum follow-up time of 24 months, the functional results were rated good in three p...

EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: (1) Identify preoperative factors that may contribute to a patient's ability to return to driving after orthopedic surgery. (2) Understand the role of upper-extremity immobilization and how it may impair a patient's ability to operate a motor vehicle. (3) Recognize how various forms of lower-extremity immo...

Tendons are susceptible to injury, either due to major overload or repeated sublinical injury. Individual fibres can withstand 2-5% strain before undergoing plastic deformation & permanent elongation. Tendons as a whole can withstand up to 20-50% strain, while still demonstrating a linear response and return to normal length. Under normal usage, tendons are strained only to 25-33% of maximum st...

Decision-making is a crucial aspect of emergency response during mass casualty incidents (MCIs). MCIs require rapid decisions to be taken by geographically-dispersed teams in an environment characterized by insufficient information, ineffective collaboration and inadequate resources. Despite the increasing adoption of decision support systems in healthcare, there is limited evidence of their va...