The popularity of skiing and snowboarding has increased tremendously over the past few decades. Whereas skiing has been an established winter sport for some time, snowboarding was created only in the 1960s. The great surge in popularity of snowboarding was sparked by its inclusion in the 1998 Winter Olympics. With increased participation in these winter activities has come a tremendous rise in ...

Since the onset of combat activity in Iraq and Afghanistan, there have been over 1100 major limb amputations among United States service members. With a sustained military presence in the Middle East, continued severe lower extremity trauma is inevitable. For this reason, combat surgeons must understand the various amputation levels as well as the anatomic and technical details that enable an o...

Evidence-Based Answer Complete decongestive physiotherapy (i.e., a noninvasive protocol consisting of skin care, lymph drainage massage, exercises, and compression bandaging1) effectively improves edema, rates of infection, and quality of life in patients with lower-extremity lymphedema. (Strength of Recommendation [SOR]: B, based on prospective cohort studies.) Microsurgery may be effective fo...

Haemophilus influenzae is a rare cause of necrotizing fasciitis with only a few previously reported cases. We describe the case of a 44-year-old man who had necrotizing fasciitis of the right lower extremity develop after intramuscular injections of paracetamol on his right buttock. The causative organism isolated was Haemophilus influenzae serotype b. This unusual infection was treated with re...

Combat-related musculoskeletal injuries occur commonly during military conflicts, as in Iraq and Afghanistan, and are caused by high-energy blasts. Ligamentous knee injuries resulting from these blasts are often associated with lower extremity fractures or traumatic, transtibial amputations. Ligamentous knee injuries in amputees are often difficult to diagnose for a variety of reasons, includin...

Obesity and osteoarthritis are complex diseases to which multiple interacting factors contribute. The moderate association between obesity and knee joint osteoarthritis reflects the amplification by obesity of role of joint loading in the development and progression of osteoarthritis. However, joint loading is insufficient to explain the disparities between the incidence of knee OA in obese peo...

INTRODUCTION Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral pro...

Diagnostic ultrasound techniques used in the evaluation of the musculoskeletal system are rapidly evolving. Conventional B-mode and Doppler ultrasound imaging methods are workhorses in the diagnosis and treatment decision making for traumatic and pathologic conditions of joints, tendons, muscles, ligaments, and peripheral nerves. Recently developed sonoelastography techniques enable the qualita...

statistically and found to be of little value in reliably determining the presence or absence of DVT. The differential diagnosis for leg pain and swelling includes lymphedema, chronic venous insufficiency, infection (cellulitis), aneurysm, pseudoaneurysm, Baker cyst, and other musculoskeletal causes. Diagnosis of DVT depends on the clinician’s pretest probability assessment and a combination of...

Eight to 12 million people in United States have PAD (Allison et al. 2007). Only ~10% of patients with PAD have classic intermittent claudication (IC), ~50% have atypical leg symptoms and ~40% are asymptomatic (Hiatt 2001). Its prevalence significantly increases with age; 12 – 20% of those above the age of 65 years suffer from PAD (Ostchega al. 2007). The prevalence of PAD is similar in men and...