Syndesmosis Injuries of the Ankle: an Update

Dr. Jorge de las Heras Romero Recognized expert in the area of Orthopaedics and Trauma Surgery, Chief of reconstructive knee, foot and ankle unit at University Reina Sofia Hospital, La Vega and Virgen de la Caridad private Hospitals in Murcia, Spain. He received his PhD at University of Murcia where he is currently a lecturer. He has authored numerous articles and book chapters in his field and is the Director of Foot and Ankle Surgery Update Conference held annually in Murcia. Also, Editor of Orthopaedics, Traumatology and Sports Medicine International Journal (OTSMIJ), MOJ Orthopaedics and Rheumatology and EC Orthopaedics Journal. Being an invited keynote speaker at World Congresson Rheumatology & Orthopedics Conference held by Scientific Federation. Dr. Jorge de las Heras Romero is going to talk on “Syndesmosis Injuries of the Ankle: an Update.” A brief summary is presented here.

The term syndesmotic injury is used to describe a lesion of the ligaments that connect the distal fibula and the tibial notch surrounded on both sides by the anterior and posterior tibial tubercles, with or without an associated injury of the deltoid ligament. It includes four major ligaments: the anterior inferior tibiofibular ligament (AITFL), which limits the fibular external rotation; the interosseous ligament (IOL), which limits the lateral translation of the fibula; the posterior inferior tibiofibular ligament (PITFL), which prevents the posterior fibular translation; and the inferior transverse ligament, which limits posterior talar displacement. Injuries to the tibioperoneal syndesmosis are more frequent than previously thought and their treatment is essential for the stability of the ankle mortise. Recognition of these lesions is essential to avoid long-term morbidity. Diagnosis often requires complete history, physical examination, weight-bearing radiographs and MRI. Treatment-oriented classification is mandatory. It is recommended that acute stable injuries are treated conservatively and unstable injuries surgically by syndesmotic screw fixation, suture-button dynamic fixation or direct repair of the anterior inferior tibiofibular ligament. Subacute injuries may require ligamentoplasty and chronic lesions are best treated by syndesmotic fusion. However, knowledge about syndesmotic injuries is still limited as recommendations for surgical treatment are only based on level IV and V evidence.

For More information: http://scientificfederation.com/rheumatology-orthopedics-2018/

Skeletal Adaptation: Exercise, Diet, and Osteoarthritis

We are extremely delighted to announce our plenary speakers for the World Congress on Rheumatology &Orthopedics will be:

Ronald Zernicke, PhD, DSc, is a Professor of Orthopaedic Surgery, Kinesiology, and Biomedical Engineering, and a Fellow of the International, Canadian, and American Societies of Biomechanics, American College of Sports Medicine, and National Academy of Kinesiology. He has published more than 600 research papers and abstracts and 2 books. Ronald Zernicke, PhD, DSc, will be giving plenary talk on Skeletal Adaptation: Exercise, Diet, and Osteoarthritis A brief summary is given below:

Throughout the life span, significant skeletal adaptations occur during maturation to maturity, within the mature state, and during senescence with males and females different in this regard. The associated microstructural and mechanical changes can be influenced by intrinsic and extrinsic factors, such as exercise, diet, and joint injury. Although exercise can positively benefit bone, skeletal muscle, and joint health, chronic exposure to an obesity-inducing diet and its inflammatory sequelae can result in loss of functional integrity with dysregulated tissue repair and risk for musculoskeletal tissue damage. Systemic inflammation from diet-induced obesity and metabolic syndrome can adversely affect bone density and subchondral trabecular bone mechanics and structure, which can negatively impact articular cartilage. Joint injuries (e.g., loss of the anterior cruciate ligament—ACL of the knee) can have rapid and detrimental effects on the structure and mechanical integrity of periarticular bone, joint cartilage, and other joint tissues, and thus, a joint should be considered a multicomponent organ system. After an ACL injury, finite element analyses have revealed specific changes in periarticular bone modulus, 3D trabecular connectivity, and microarchitecture, as well as loss of quadriceps muscle complex integrity. With development of early post-traumatic osteoarthritis, architectural adaptations predominate over bone tissue modulus changes. Altered muscle-tendon-bone cross-talk can also be produced from dysfunctional mechanical and biological stimuli resulting from compromised muscle integrity and contribute to bone loss. The potent interconnectivities among musculoskeletal tissues underscore the importance of implementing a complex systems approach to detailed understanding of mechanisms of skeletal adaptation in health and disease.

You can visit the conference webpage: http://scientificfederation.com/rheumatology-orthopedics-2018/

Carpal Tunnel Syndrome (CTS) Symptoms

Scientific Federation invites all the participants from all over the world to attend WorldCongress on Rheumatology & Orthopedics which will be held on September 24-25, 2018 in Madrid, Spain which includes Keynote presentations, Oral talks, Poster presentations and Exhibitions

Carpal tunnel syndrome happens once the median nerve that runs from the forearm into the palm of the hand becomes ironed or squeezed at the articulatio radiocarpea. Pressure on the nerve can be caused by an injury or sustained use for common activities like typing, chopping, hammering, or writing. Then result may be pain, or weakness, in the hand and wrist, diffuse up the arm. Evaluation of patients presenting with carpal tunnel syndrome (CTS) symptoms has long relied on their clinical assessment as well as nerve conduction studies. However, whilst standard symptoms and positive provocative testing may enable identifying some of the cases, the subjectivity and sensitivity of these measures results in very poor reliability and diagnostic accuracy. Similarly, though studies revealed sensitivity and specificity data in favour of electro diagnostic testing for the CTS diagnosis, abnormal nerve conduction testing results do not surely equate to the correct diagnosis. Nerve conduction studies can be normal in early cases. Also, nerve studies were reported as not sensitive to change or management, hence, a poor predictor of treatment outcomes. Inspite of some limitations, ultrasonography was found to be a good tool not only for the CTS diagnosis, but also for identifying the median affection severity. The search for markers identifying key targets for the assessment of major outcomes in musculoskeletal diseases has become one of the hot issues in rheumatology. Possible markers should be objectively measured, indicatory of normal biology as well as the pathologic process, indicator of response to therapy and prognosis. It should also be a good indicator of modification of the pathological process and help to identify (in early cases) the patients who are going to respond quickly to therapy with the vision to tailor management to the patient status. This presentation will discuss the outcomes of a recent study investigating the feasibility of initial CTS assessment parameters for setting up a treatment plan tailored to the patient’s needs and its ability to predict treatment outcomes. In most cases, a Chiropractic adjustment to the affected area is an extremely effective solution. In some cases, a Chiropractic manipulation of the neck or spine can also conduct as an effective treatment possibility. Chiropractic treatments, along with kinesitherapy, stretching, and strengthening exercises, can in most cases effectively reduce and eventually eliminate the indication associated with CTS.

 For More Information: http://scientificfederation.com/rheumatology-orthopedics-2018/

Rodding in patients with Osteogenesis

Dr Fizza Hassan is a Final Year Student at Karachi Medical and Dental College, affiliated with Karachi University. She has been a keen researcher since High School and took part in many scientific projects at city level. She has attended several national and international seminars and conferences. She has taken part in many researches successfully published in international journals and many are ongoing. She is looking forward to a bright future in medical career. Being an speaker at World Congress on Rheumatology & Orthopedics Conference held by Scientific Federation. Dr. Fizza Hassan is going to talk on “Prognosis of Functional Capability after Telescopic Femoral Intramedullary Rodding in patients with Osteogenesis Imperfecta type IV.” A brief summary is presented here.

Osteogenesis imperfecta is a group of genetic bone disorder of significant clinical variability secondary to mutations in the genes that code for type I pro-collagen. Major clinical characteristics of OI are bone fragility, osteopenia, variable degrees of short stature, and progressive skeletal deformities.The severity of the disease influences the ability to walk. Therefore it is important for physicians, patients, and the patients’ parents to gain insight into the severity and classification of the disease and the influence of disease-related characteristics on the prognosis for walking. Intramedullary strengthening of the fragile bones of Osteogenesis imperfecta by rodding results in great benefit on the affected individual. Rodding is an sign of disease severity. In general, intramedullary rodding in the lower extremities is primarily indicated in the most severe types to stabilize bone and to correct deformities. Early closed rodding has improved the early management of the disease without causing and ill effects. Because no randomized clinical trials have been performed for ethical reasons, the improvement of possibilities for ambulation after intramedullary rodding of the lower extremities remain questionable. Several authors state that intramedullary rodding of the legs improved the possibility for ambulation and expanding intramedullary rods reduce incidence of deformity, fractures, and increase walking capability, whereas others found no differences in patients who did and did not receive intramedullary rodding in the age of first achieving motor milestones and the ability for walking in later life. After intramedullary rodding of the legs was performed, functional ability, especially in the preexisting milestones, improved in patients with type III and IV, whereas in patients with type I, walking ability improved.

It has been reported that in type IV, even when ambulation is achieved, walking is frequently lost in the second decade of life because of progressive spinal deformity, decreased motivation in physical therapy and the increasing use of a wheelchair

For More Information: http://scientificfederation.com/rheumatology-orthopedics-2018/