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Osteitis pubis in elite athletes:Diagnostic and therapeutic approach

World Journal of Orthopedics 2015年第9期6卷 672-679页

作者： antonios g angoules Department of Medical Laboratories Technological Educational Institute of Athens

Osteitis pubis(OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient. Radiologic examinations such as plain radiographs, magnetic resonance imaging and 3 phase bone isotope scanning may be helpful to differentiate from other clinical entities with similar clinical presentation. Most cases respond well to conservative treatment which includes several physical modalities and especially a progressive rehabilitation programmed individualized to each one of patients diagnosed with OP. Local injection therapies have been also been proposed as a non-operative therapeutic option for the efficient management of these patients. In refractory cases, surgical therapeutic strategies are warranted. These include several open or minimally invasive surgical interventions such as arthroscopic or open symphysis curettage, wedge or total resection of pubic sympysis, polypropylene mesh placement and pubic fusion. In this review a critical analysis of OP in elite athletes is performed with special focus on current concepts of diagnosis and management of this source of athletic groin pain.

关键词： Osteitis pubis groin pain Sports overuse injuries Conservative management Surgery

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Synthesis of evidence for the treatment of intersection syndrome

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World Journal of Orthopedics 2017年第8期8卷 619-623页

作者： Konstantine Balakatounis antonios g angoules Nikolaos A angoules Kalomoira Panagiotopoulou Neurology Institute of Athens Department of Medical Laboratories Technological Educational Institute of Athens School of Physiotherapy AMC Metro--politan College School of Medicine University of Ioannina

Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis. Clinical examination provides with the necessary information for diagnosis, still magnetic resonance imaging scans and ultrasonography may assist in diagnosis. Treatment consists mainly of rest, use of a thumb spica splint, analgetic and oral nonsteroidal anti-inflammatory drugs and after 2-3 wk progressive stretching and muscle strengthening. Should symptoms persist beyond this time, corticosteroid injections adjacent to the site of injury may be useful. In refractory cases, surgical intervention is warranted.

关键词： Intersection syndrome Overuse injury Wrist pain Differential diagnosis Treatment

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Update on diagnosis and management of cuboid fractures

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World Journal of Orthopedics 2019年第2期10卷 71-80页

作者： antonios g angoules Nikolaos A angoules Michalis georgoudis Stylianos Kapetanakis Orthopaedic Department Athens Medical Center School of Physiotherapy AMC Metropolitan College Spine Department and Deformities Interbalkan European Medical Center

Cuboid fractures due to the particular bone anatomy and its protected location in the midfoot are rare, and they are usually associated with complex injuries of the foot. Clinical examination to diagnose these fractures should be detailed and the differential diagnosis, especially in the case of vague symptoms, should include the exclusion of all lateral foot pain causes. Conventional radiographs do not always reveal occult fractures, which can be under diagnosed especially in children. In this case, further investigation including magnetic resonance imaging or scintigraphy may be required. The treatment of these injuries depends on the particular fracture characteristics. Non-displaced isolated fractures of the cuboid bone can be effectively treated conservatively by immobilization and by avoiding weight bearing on the injured leg. In the case of shortening of the lateral column> 3 mm or articular displacement > 1 mm, surgical management of the fracture is mandatory in order to avoid negative biomechanical and functional consequences for the foot and adverse effects such as arthritis and stiffness as well as painful gait. In this review, an update on diagnosis and management of cuboid fractures is presented.

关键词： Cuboid Fracture Diagnosis Treatment Surgery

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Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid

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World Journal of Orthopedics 2017年第12期8卷 874-880页

作者： Stylianos Kapetanakis grigorios gkasdaris antonios g angoules Panagiotis givissis Spine Department and Deformities Interbalkan European Medical Center Department of Medical Laboratories Technological Educational Institute of Athens First Orthopaedic Department of "Aristotle University of Thessaloniki" "Papanikolaou" Hospital

Transforaminal Percutaneous Endoscopic Discectomy(TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed.

关键词： Transforaminal Percutaneous Endoscopic Discectomy Transforaminal Endoscopic Spine System Lumbar disk herniation Pitfalls Spine surgery

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