A method to study ligament-length patterns in situ with roentgenstereophotogrammetry, using strings of glued tantalum markers, was developed. The method was tested against a bone-to-bone marking method in five carpal ligaments in three specimens, whereby the hand was moved through dorsopalmar flexion and radioulnar deviation. The "glued-string" marking method was found to be superior to the bone-to-bone marking method. The length patterns obtained were found to be reproducible in the specimens and different from earlier expectations presented in the literature. The radiocapitate ligament seems to limit the displacements of the capitate in both radial and ulnar deviation, and dorsal flexion. The radiolunate ligament has the same effect for the lunate. Both the dorsal radiotriquetrum and the palmar triquetrocapitate ligaments seem to play a stabilizing role in the neutral position of the hand, whereas the radiotriquetrum ligament also has a function in palmar flexion and the triquetrocapitate ligament functions in dorsal flexion, ultimately resisting these excursions. These findings require confirmation in more extensive experiments, whereby the relationship between ligament length patterns and carpal motion axes is investigated.
DOCUMENT
Background Altered muscle-tendon properties in clubfoot patients could play a role in the occurrence of a relapse and negatively affect physical functioning. However, there is a lack of literature about muscle-tendon properties of clubfoot relapse patients. Research question The aim of this study was to determine whether the muscle architecture of the medial gastrocnemius and the morphology of the Achilles tendon differ between typically developing children (TDC) and clubfoot patients with and without a relapse clubfoot and to determine the relationships between morphological and functional gait outcomes. Methods A cross-sectional study was carried out in clubfoot patients treated according to the Ponseti method and TDC aged 4–8 years. A division between clubfoot patients with and without a relapse was made. Fifteen clubfoot patients, 10 clubfoot relapse patients and 19 TDC were included in the study. Morphologic properties of the medial head of the Gastrocnemius muscle and Achilles tendon were assessed by ultrasonography. Functional gait outcomes were assessed using three-dimensional gait analysis. Mean group differences were analysed with ANOVA and non-parametric alternatives. Relationships between functional and morphologic parameters were determined for all clubfoot patients together and for TDC with Spearman’s rank correlation. Results Morphological and functional gait parameters did not differ between clubfoot patients with and without a relapse, with exception of lower maximal dorsiflexor moment in clubfoot relapse patients. Compared to TDC, clubfoot and relapse patients did show lower functional gait outcomes, as well as shorter and more pennate muscles with a longer Achilles tendon. In all clubfoot patients, this longer relative tendon was related to higher ankle power and plantarflexor moment. Significance In clubfoot and relapse patients, abnormalities in morphology did not always relate to worse functional gait outcomes. Understanding these relationships in all clubfoot patients may improve the knowledge about clubfoot and aid future treatment planning.
MULTIFILE
Talloze studies tonen aan dat een fysiek actieve leefstijl bloeddruk, cholesterol en gewicht verlaagt, botten en spieren versterkt en het risico van hart- en vaatziekten, darmkanker en diabetes type II vermindert. Bewegen kan dus worden gezien als een medicijn wat voor iedereen toegankelijk is.
DOCUMENT
