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Matthias Feuerecker - One of the best experts on this subject based on the ideXlab platform.
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pregabalin as adjunct in a multimodal pain therapy after traumatic Foot amputation a case report of a 4 year old girl
Scandinavian Journal of Pain, 2017Co-Authors: Stephanie Wossner, Kirsten Weber, Anna C Steinbeck, Markus Oberhauser, Matthias FeuereckerAbstract:Abstract Background and purpose The purpose of this case report is to describe a multimodal pain therapeutic concept including the adjunct use of pregabalin in a 4.5 year-old child after foreFoot amputation. Phantom limb pain and sensation is a complex pain syndrome that is difficult to treat and prevent. 70–75% of all children develop such a pain syndrome after amputation. We describe here a paediatric patient who underwent foreFoot amputation following traumatic Foot Injury and received multimodal pain therapy including pregabalin. Methods A 4.5 year-old otherwise healthy girl suffered severe injuries of the right Foot and lower leg during a motor vehicle accident. Due to development of severe necrosis, foreFoot amputation had to be performed during the hospital stay. Results Initial pain therapy included paracetamol, ibuprofen, metamizol, morphine and fentanyl. With mounting pain and anxiety, regional anaesthesia of the distal sciatic nerve was administered in combination with a ketamine and morphine patient controlled analgesia pump (PCA). The peripheral blockade of the distal sciatic nerve was placed with the guidance of ultrasound and nerve stimulator. The PCA concept included a continuous basal rate combined with a bolus function. Although the regional anaesthesia was well positioned and functioning, there was inadequate pain control. The pain was described by the patient as short, highly intense and sharp sensations with intensity on the visual analogue scale (VAS) of 10 (out of 10). Furthermore, she suffered from anxiety episodes and sleep disturbance. The medical team decided to treat with pregabalin to resolve these issues while awaiting amputation (Lisfranc line). She received psychological counselling as adjunct treatment. This multimodal concept enabled an early and efficient pain reduction pre- and post-amputation and allowed for the possibility of a hospital discharge without any opioid pain medication. Conclusion The multimodal pain therapy including pregabalin was well tolerated, safe and highly effective in this case of traumatic limb Injury and subsequent amputation. The use of pregabalin allowed significant pain and anxiety reduction for the patient. Implications Pregabalin is frequently used in adult patients for severe complex pain syndromes. There are only few reports of such adjunct medication (pregabalin) in paediatric pain syndromes. These reports focus mainly on the paediatric oncologic population. The case reported here encourages physicians to consider adjunct medications when treating complex pain, which are well established in the adult population. The benefits of such therapy in complex pain and anxiety can be extended to the paediatric population in select cases. Of course, one must always take into account that many routine medications used in children are well established but are off-label use. The authors are well aware of this problem and have conducted a critical literature review prior to pregabalin administration, including the search for randomized trials examining safety and tolerability. The parents or legal guardians of a minor must be thoroughly informed and consent to such a constellation of medical treatment.
Felipe P Carpes - One of the best experts on this subject based on the ideXlab platform.
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plantar loading in the youth soccer player during common soccer movements and risk for Foot Injury
Injury-international Journal of The Care of The Injured, 2020Co-Authors: Renato Ribeiro Azevedo, Suellen Belmonte Nery, Darren J Stefanyshyn, Felipe P CarpesAbstract:Abstract Introduction Soccer players are at high risk of stress injuries in the Foot. While most research addresses this issue in professional athletes, there is little information concerning young athletes. As soccer is practiced around the world since early infancy, we set out to determine whether young soccer athletes are susceptible to increased Foot loading that increase risk factors for Foot injuries in a similar manner as reported by the literature to the adult athlete. Methods twenty-six male adolescents (mean age 16 years old) were organized into two groups: soccer players (n = 13) and controls (n = 13). Groups were compared regarding Foot sensitivity, ankle range of motion, Q-angle, and plantar pressure determined during running and cutting movements performed at maximal speed and using different shoes. Results Foot sensitivity, ankle range of motion and Q-angle did not differ between the groups. During performance of soccer actions, young players showed higher peak pressure in the lateral region of the Foot including the fifth metatarsal region. These higher peaks were minimized by manipulation of the Footwear. Conclusion In summary, young soccer athletes show dynamic plantar pressure patterns that are related to Foot Injury in the adult athlete, and this condition can be minimized by the manipulation of the Footwear. Additional attention should be paid to the young athlete in soccer aiming to minimize long-term risk for stress injuries in the Foot.
Yuddhasert Sirirungruangsarn - One of the best experts on this subject based on the ideXlab platform.
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chronic irreducible dislocation of the proximal interphalangeal joint of the fifth toe a case report
BMC Research Notes, 2014Co-Authors: Tanawat Vaseenon, Chaiyarit Cheewawattanachai, Yuddhasert SirirungruangsarnAbstract:Background Traumatic dislocation of the interphalangeal of the fifth toe is an unusual Foot Injury.
Hak Jun Kim - One of the best experts on this subject based on the ideXlab platform.
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predictors of compartment syndrome of the Foot after fracture of the calcaneus
Journal of Bone and Joint Surgery-british Volume, 2018Co-Authors: Young Hwan Park, Jae Won Lee, Jaeyoung Hong, G W Choi, Hak Jun KimAbstract:Aims Identifying predictors of compartment syndrome in the Foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors. Patients and Methods We retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant Foot Injury, mechanism of Injury, fracture classification, time from Injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation. Associations with predictors were analyzed using logistic regression analysis. Results Of the 313 fractures of the calcaneus, 12 (3.8%) developed a compartment syndrome. A Sanders type IV fracture was the only strongly associated factor (odds ratio 21.67, p = 0.007). Other variables did not rea...
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Predictors of compartment syndrome of the Foot after fracture of the calcaneus
SAGE Publishing, 2018Co-Authors: Hak Jun KimAbstract:Category: Trauma Introduction/Purpose: Identifying predictors of compartment syndrome in the Foot after a fracture of the calcaneus may lead to earlier diagnosis and treatment. The aim of our study was to identify any such predictors. Methods: We retrospectively reviewed 303 patients (313 fractures) with a fracture of the calcaneus who presented to us between October 2008 and September 2016. The presence of compartment syndrome and potential predictors were identified by reviewing their medical records. Potential predictors included age, gender, concomitant Foot Injury, mechanism of Injury, fracture classification, time from Injury to admission, underlying illness, use of anticoagulant/antiplatelet agents, smoking status and occupation. Associations with predictors were analyzed using logistic regression analysis Results: Of the 313 fractures of the calcaneus, 12 (3.8%) developed a compartment syndrome. A Sanders type IV fracture was the only strongly associated factor (odds ratio 21.67, p = 0.007). Other variables did not reach statistical significance. Conclusion: A Sanders type IV fracture is the best predictor of compartment syndrome after a fracture of the calcaneus
Renato Ribeiro Azevedo - One of the best experts on this subject based on the ideXlab platform.
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plantar loading in the youth soccer player during common soccer movements and risk for Foot Injury
Injury-international Journal of The Care of The Injured, 2020Co-Authors: Renato Ribeiro Azevedo, Suellen Belmonte Nery, Darren J Stefanyshyn, Felipe P CarpesAbstract:Abstract Introduction Soccer players are at high risk of stress injuries in the Foot. While most research addresses this issue in professional athletes, there is little information concerning young athletes. As soccer is practiced around the world since early infancy, we set out to determine whether young soccer athletes are susceptible to increased Foot loading that increase risk factors for Foot injuries in a similar manner as reported by the literature to the adult athlete. Methods twenty-six male adolescents (mean age 16 years old) were organized into two groups: soccer players (n = 13) and controls (n = 13). Groups were compared regarding Foot sensitivity, ankle range of motion, Q-angle, and plantar pressure determined during running and cutting movements performed at maximal speed and using different shoes. Results Foot sensitivity, ankle range of motion and Q-angle did not differ between the groups. During performance of soccer actions, young players showed higher peak pressure in the lateral region of the Foot including the fifth metatarsal region. These higher peaks were minimized by manipulation of the Footwear. Conclusion In summary, young soccer athletes show dynamic plantar pressure patterns that are related to Foot Injury in the adult athlete, and this condition can be minimized by the manipulation of the Footwear. Additional attention should be paid to the young athlete in soccer aiming to minimize long-term risk for stress injuries in the Foot.