sulaiman a. almousa pgy3. Calcaneal fractures occur on the calcaneus or heel bone, a large bone that forms the foundation of the rear part of the foot. Stress fractures are common Orthopaedic Trauma Association. RADIOGRAPHIC ANATOMY Gissanes angle: Formed by a line that runs along the lateral border of the posterior facet, and a line extending along the beak of the calcaneus. In Disorders of the Foot and Ankle, edited by M. H. Jahss. JBJS. Show: Recommended. M ller et al Benign bone lesion Malignant bone lesion Infection Metabolic bone disease Categorize/Make Diagnosis Skeletal dysplasia Neuropathic Osteopenia-disuse Overuse * Just like a SAD ankle fracture potentially has medial gutter comminution, a PAB ankle fracture potentially has lateral gutter comminution tibia, fibula. Navicular most common of tarsal bones - Non operative treatment. Boston Med. Reduces the fracture, Also associated with drugs, alcohol and psychiatric disease Clay-shoveler fracture. christina copple, dvm radiology resident monday september 21, 2009 accession #s 120984, FRACTURES - . Treatment. Hindfoot. type causes investigation symptoms, Fractures - . Approximately 10% of injuries are bilateral . "The mechanism, reduction technique, and results in fractures of the os calcis.". fractures. Approximately 10% of patients will have a spine fracture as well due to the axial load. Nonunion A, Cancellous screw (6.4 mm) for posterior lip ankle fracture. I don't have enough time write it by myself. Calcaneus Fractures - Trauma - Orthobullets orthoBULLETS MBBULLETSStep 1For 1st and 2nd Year Med Students MBBULLETSStep 2 & 3For 3rd and 4th Year Med Students ORTHOBULLETSOrthopaedic Surgeons & Providers JOIN NOWLOGIN Home Topics Techniques Cards QBank Evidence Cases Videos Podcasts Groups Products Trauma Spine Shoulder & Elbow Knee & Sports introduction. In isolated cases, there may be a relatively simple . Calcaneus Fracture PowerPoint PPT Presentations. Diagnosis is suspected based on symptoms and confirmed by X-rays or CT scanning. Free access to premium services like Tuneln, Mubi and more. 13. However, operative treatment was rarely done due, Sound understanding of internal fixation was, Throughout the 1940s and 1950s treatment varied, In the 1960s and 1970s, as the result of an, In the last 30 years, better anesthesia, Abx, the, Even with improvement, the treatment still, Bohlers Angle- Formed by line from highest point, Gissanes angle Formed by a line that runs along, http//radiographics.rsna.org/content/25/5/1215.lo, After coronal CT, Sanders typically used to, A Non-displaced fracture, regardless of the, Force through subtalar joint driving talus, The axe of the lateral process of talus is, The force extends posteriomedially into the ST, This produces a fracture that runs superior, The lateral process of the talus is impacted at, Residual force is then dissipated medially into, If the momentum stops here then part or all of, A secondary fracture line is then resulted from, The front end of the tongue is driven down, but, Parmar et al, in a 1993 study of 56 patients who, NO DIFFERENCE between the groups at one year of, In another 1993 study by OFarell et al, twelve, In a meta-analysis published in 2000, Randle et, 218 with 262 fractures treated nonoperatively, Certain subgroups showed better results treated, Patients not involved in workers comp claims, Patients with a higher initial Bohlers angle, Those with an anatomic reduction on post-op CT, Buckley et al study showed that overall, there, However, patients undergoing nonoperative, Operative treatment is generally indicated for. - Osteochondral injuries Lateral process fracture Anterior calcaneus fracture Base of 5th MT fracture AP Lateral Mortise Ankle Fractures Classification Weber - Foot and Ankle Fractures Foot and Ankle Fractures Anatomy Three groups of stabilizing ligaments: 1)Lateral -anterior talofibular ligament (ATFL) -calcaneofibular - . For the combined group, an increase of Preop lateral demonstrating joint depression type of fracture. Parmar HV, Triffitt PD, Gregg PJ. Calcaneal fractures are relatively uncommon, comprising 1 to 2 percent of all fractures, but important because they can lead to long-term disability. The metatarsals. Draw line bisecting leg from start of Achilles tendon to distal end of calcaneus Leg length discrepancy, excessive pronation, inflexible longitudinal arch, tight 43 (5%) of those women have been previously assessed by DEXA scan Physiotherapy. this happens when a, Fractures - . The uncontrolled results of the univariate proportional hazard model for all three fracture groupings are provided in Table 2. Symptoms may include pain, bruising, trouble walking, and deformity of the heel. Trauma. brevis tendon to pull away the base of the 5th metatarsal (Ballerina fracture) - Allied Health I Ms. Campanicki Ankle (Tarsus) Consists of 7 tarsal bones Talus Calcaneus (heel bone) Cuboid bone Navicular bone Medial cuneiform Intermediate - LOWER EXTREMITY Foot Ankle Knee Hip FOOT ANATOMY BONES TARSALS Calcaneus Talus Cuniforms (3) Cuboid Navicular METATARSALS #1-5 PHALANGES #1-5 ARCHES - APPENDICULAR SKELETON BONES TO KNOW 2 REVIEW a scaphoid b lunate c triquetral d pisiform a hamate b capitate c trapezium d trapezoid a calcaneus b - (Scoliosis) Vertebral compression fracture Etiology of back pain MALIGNANCY Spinal cord tumors (lipoma, teratoma) Bone tumors Osteoid osteoma Ewing s - Foot and Ankle Fractures,Sprains, and Soft Tissue Disorders tenderness over talonavicular joint anterior to the medial malleolus, Metastatic Bone Disease and Multiple Myeloma. Now customize the name of a clipboard to store your clips. Title: Cuboid Fractures Author: Philip Parr Last modified by: Paul Created Date: 1/21/2013 6:53:47 PM Document presentation format: On-screen Show (4:3). Tarsal tunnel. The three bones of the ankle include: The tibia, or shinbone The fibula, the smaller bone in the lower leg 14 LOWER EXTREMITY Francis Neuffer, MD USC SOM Gross Anatomy / Radiology * Here the CT scan is used as a surgical planning tool to better appreciate fracture position In Forefoot. A Non-displaced fracture, regardless of the amount of fracture lines is a Sanders Type I, MECHANISM OF INJURY OF CALCANEAL FRACTURES, MECHANISM OF INJURY OF CALCANEAL FRACTURES High-energy Force through subtalar joint driving talus lateral process into everted calcaneus to create fracture patterns described by Essex-Lopresti.5, MECHANISM OF INJURY OF CALCANEAL FRACTURES The axe of the lateral process of talus is driven into lateral wall of calcaneus. free download common fractures powerpoint presentation. We've updated our privacy policy. Br J Surg 1952;39:395-419. Historical Treatment of Calcaneal Fractures Bohler in 1931 recommended operative treatment. Major fractures of the calcaneus can result in displacement of the superficial flexor tendon or can involve the sustentaculum tali. KyphX IBT Inflation. Surgery should be within 3 weeks. OPERATIVE TREATMENT SUMMARY Immediately elevate in the ED with Jones Compression and splint. Vol. Cotton, F. J., and Wilson, L. T.: Fractures of the os calcis. HISTORICAL TREATMENT OF CALCANEAL FRACTURES Throughout the 1940s and 1950s treatment varied between ORIF attempts and subtalar joint arthrodesis. symptoms and signs. : 0043 664 5778077 [email protected] Back to content . Calcaneal Fractures Lover's Fracture General Considerations Calcaneous is the most commonly fractured tarsal bone A so-called "lover's Fracture" is an intra-articular fracture produced by an axial loading force typically produced by a leap from a height with person landing on heels (also called a "Don Juan" fracture) Blog Archive 2014 (51) June (30) May (21) . 7 5 12 8 The heel bone Tibia Calcaneus Phalange humerus The combining form for stiff - Asian women have a lower risk of fracture than Caucasian women. Well convert it to an HTML5 slideshow that includes all the media types youve already added: audio, video, music, pictures, animations and transition effects. Get powerful tools for managing your contents. Reduce the risk of further fractures. - Indore Arthroscopy Center is one of the best ortho clinics in Indore for Rotator cuff orthopedic surgery, Frozen shoulder surgery, PCL knee surgery, ACL reconstruction surgery, Arthroscopic knee surgery and and Shoulder rotator cuff surgery. HISTORICAL TREATMENT OF CALCANEAL FRACTURES In the last 30 years, better anesthesia, Abx, the AO principles, CT, and fluoroscopy, have allowed surgeons to obtain good outcomes with operative intervention in most fractures3. If you are searching for Best orthopedic surgeon in Indore for Frozen shoulder surgery in Indore, visit Indore Arthroscopy Center. Stress Fractures. In addition, this approach permits indirect reduction of the medial wall and the sustentaculum. This treatment was abandoned in the 1920s. I like this service www.HelpWriting.net from Academic Writers. - The uncontrolled results of the univariate proportional hazard model for all three fracture groupings are provided in Table 2. Treatment of a calcaneal fracture depends upon the location and severity of the fracture. Residual force is then dissipated medially into the sustentaculum tali which may be sheared off. Bohler in 1931 recommended operative treatment. Collimation side to side: to include soft tissue around calcaneus Prevention and Treatment of Osteoporosis Jane A. Cauley, DrPH University of Pittsburgh Osteoporotic Bone Loss A skeletal disorder characterized by compromised bone | PowerPoint PPT presentation | free to view, The anatomy of fractures of the calcaneus. Hock Fracture in a 2 Month Old Heifer. Stress Fractures. Depressed lat fragment is visulaized, The exposed corner of the calcaneal tuberosity is then predrilled and a short Schantz pin is screwed into place. outline. Advances in cross-sectional imaging, particularly in computed tomography (CT), have given this modality an important role in identifying and characterizing calcaneal fractures. McReynolds, I. S.: Trauma to the os calcis and heel cord. 10, INTRODUCTION Calcaneal fractures were first described by Malgaigne in 1843, but were not consistently diagnosed until the development of plain radiography in the late 1890s.10 The industrial revolution led to the development of taller buildings, and the automobile, so that falls from heights and MVAs became increasingly more common, and remain the most common cause of calcaneal fractures.10. Looks like youve clipped this slide to already. Calcaneal fractures dr.pradeep pathak 3.7k views 58 slides Calcaneum fractures Siddharth Gupta 212 views 71 slides Talus anatomy, blood supply & fractures Hiren Divecha 19.7k views 21 slides calcaneal fractures by dr.waleed maher ali - minia university 2011 Waleed Ali 5.1k views 99 slides FRACTURES of CALCANEUS AND TALUS Ajit Rampure 2A).Findings in cases of calcaneal fracture include calcaneal shortening, varus tuberosity deformity, or a decreased Bhler's angle*.. The calcaneal fractures seen in the emergency department or referred to orthopaedic surgeons at each centre during the recruitment period were identified prospectively. [1] Clinically Relevant Anatomy Newer Post Older Post Home. Sulaiman A. Almousa PGY3. 1497-1538. Investigations. 8. 7. fifth metatarsal fractures. complete break between bones. As the largest tarsal bone and the most inferior bone in the body, the calcaneus is responsible for supporting the axial load from the weight of the body. ICE neuroma. Injuries were the Achilles tendon pulls off a piece of bone (avulsion fracture) can lead to soft tissue injury and are an orthopaedic emergency as skin death (necrosis) can occur rapidly. 1.fractures has no obvious displacement Operative treatment. Because of this calcaneal fractures tend to come with other problems that vary with the extent of the injury. Historical Treatment of Calcaneal Fractures As early as 1908, Cotton and Wilson suggested that ORIF of a calcaneal fracture was contraindicated.1 McLaughlin likened attempts of operative fixation as nailing custard pie to a wall.2 Cotton and Wilson recommended closed treatment with use of a medially placed sandbag, a laterally placed felt pad, and a hammer to reduce the lateral wall and reimpact the fracture. It has millions of presentations already uploaded and available with 1,000s more being uploaded by its users every day. J. Orthop. Calcaneal Fracture - See: - Calcaneal Frx in Children - Fatigue Fractures of the Calcaneus - Fractures of the Anterior Process - Sub-Talar Joint - Sustentaculuum Tali Fractures - Discussion: - typically results from fall from height (see mechanism) - 2 types of frx may occur: extra-articular and intra-articular: - intra-articular fracture: Fracture Patterns Extraarticular 2533% of calcaneus fractures Twisting injury or direct impact (not compressive) Involve anterior process, sustentaculum, body, or posterior tuberosity Intraarticular(75%) Involve Posterior Facet EssexLopresti Classification Sanders Classification The PowerPoint PPT presentation: "Calcaneal Fractures" is the property of its rightful owner. By accepting, you agree to the updated privacy policy. [ 1] It is the most inferior bone in the body that constantly supports the axial load from the weight of the body. It appears that you have an ad-blocker running. There are many types of calcaneal fractures that are described by several calcaneal fracture classifications schemes. LOWER EXTREMITY. It is part of the hindfoot and sits directly below the three bones that make up the ankle joint. - a bony structural defect at a tendinous or aponeurotic insertion resulting from excess stress 11 year old fell from tree Salter-Harris Fracture Salter-Harris - Draw line bisecting leg from start of Achilles tendon to distal end of calcaneus Leg length discrepancy, excessive pronation, inflexible longitudinal arch, tight - 43 (5%) of those women have been previously assessed by DEXA scan Physiotherapy. - 1 Harrington, K. (1986). Chronic. This treatment was abandoned in the 1920s. - Orthopaedic Trauma Association. You may see blisters form. If so, just upload it to PowerShow.com. - An intra-articular fracture disrupts the relationship of the Articular branches to hip, motor to biceps, semitendinosus, semimembranosus and adductor magnus - Axial loading injury with compression force to C1. You can read the details below. LOWER EXTREMITY. This region is comprised of. Consistently allows reduction of the calcaneal body and restoration of calc height, length, and width, regardless of the extent of comminution, as well as reduction of the intra-articular surface when possible. Buckley RE, Tough S, McCormack R, et al: Operative compared to nonoperative treatment of displaced intraarticular calcaneal fractures: A prospective, randomized, controlled multicenter trial. Calcaneus fractures usually hurt and get very swollen right after the injury. This region includes. For the combined group, an increase of the foot from a plantar-fixed position and looking for normal skin with the sole of the foot and then curving slightly up anteriorly at its distal extent. Fractures - . It also allows for complete reduction from the tuberosity to the anterior process and the calcaneocuboid joint. Acute. View calcaneal-fractures.pptx from HHS MISC at St. John's University. 7. Activate your 30 day free trialto unlock unlimited reading. Calcaneal Tuber Fracture The Achilles tendon attaches to the back portion of the calcaneus. This joint is important for normal foot function. Calcaneus fractures are rare in children. KyphX IBT Inflation. Treatment. wrinkle test is done by bringing the foot from the plantarflexed position (A) into dorsiflexion and observing the wrinkles (B) that form on the lateral side of the ankle and foot. PLANTAR FASCIITIS. Though, bone mineral density is lower in Asian women - ? introduction. Displaced intraarticular fractures represent 60-75% of all calcaneal fractures. The management continue to be topics for debate. A broken heel bone is called a calcaneal fracture. . tibial fractures. statistics, FRACTURES - . Unilateral or bilateral fractures of anterior and posterior arches of C1. It can happen from a fall, directly impacting the heel or twisting the ankle. The extensile lateral approach should include a full-thickness skin flap. The calcaneus connects with the talus and cuboid bones. the injury. The gap thus formed is filled by the proliferation of bone resulting in formation of a bony spur to secure the detached attachment. - NO DIFFERENCE between the groups at one year of follow-up. Dr. Christian Rodemund Alpenblickstrasse 38. J Bone Joint Surg Br. classification of fractures. 3. fracture, Fractures - . 18% Metatarsals - 2nd and 3rd metatarsals. This region is comprised of. 4 Fractures of . Anesthesia not always effective Radiology not well-developed Abx did not exist Sound understanding of internal fixation was lacking. 2015. that ORIF of a calcaneal fracture was contraindicated.1 McLaughlin likened attempts of operative fixation as nailing custard pie to a wall.2 Cotton and Wilson recommended closed treatment with use of a medially placed sandbag, a laterally placed felt pad, and a hammer to reduce the lateral wall and reimpact the fracture. Essex Lopresti P. The mechanism, reduction technique, and results in fractures of the os calcis. A calcaneal fracture is a break of the calcaneus (heel bone). Advisors: Dr. Hayley Lang. The metatarsals. OVERVIEW OF CALCANEAL FRACTURES The calcaneus is the largest tarsal bone and most commonly injured tarsal bones that account for 2% of all fractures. 1993;24:263-5. Graft jacket for coverage? http://radiographics.rsna.org/content/25/5/1215.long Radiographic Anatomy Compression Trabeculae - THICKENED THALAMIC PORTION - COMPRESSION TRABECULAE- TRACTION TRABECULAE Traction Trabeculae, ANATOMY Neurovascular Bundle Sustentaculum Tali Medial Talocalcaneal Ligament, QUICK CLASSIFICATION REFRESHER: Rowe 1a: Plantar Tuberosity Rowe 1c: ant process Rowe IIIa Rowe IIIb Rowe Va Rowe 1b: ST secondary to inversion Rowe IIa: Beak fx Rowe IIb: Avulsion fx Rowe IVa&b Rowe Vb, SANDERS CLASSIFICATION Based on Posterior Facet After coronal CT, Sanders typically used to classify. Sanders, R: Intra-articular fractures of the calcaneus:present state of the art. PLANTAR FASCIITIS. Dr. Chirag Patel, orthopedic surgeon in Mumbai explain here about calcaneal fracture. The calcaneus, known as the heel bone, is the largest of the tarsal bones and articulates with the cuboid bone anteriorly and the talus bone superiorly. Then you can share it with your target audience as well as PowerShow.coms millions of monthly visitors. Pediatric Falls from Height. PowerShow.com is brought to you byCrystalGraphics, the award-winning developer and market-leading publisher of rich-media enhancement products for presentations. objectives. OPERATIVE VS NON-OPERATIVE CARE In another 1993 study by O Farell et al, - Cuboid Fractures By: Philip Parr Ligaments attaching to the Cuboid Superior: The calcaneocuboid band of the bifurcate ligament dorsal calcaneocuboid ligament Inferior - Participants will increase their comfort in diagnosing stress fractures Usually in distal third of fibula. Philadelphia, W. B. Saunders, 1982. 2/19/2014. What Is a Calcaneal Fracture? - PowerPoint PPT presentation Number of Views:800 Avg rating:3.0/5.0 Slides: 27 Provided by: William783 Category: Tags:calcaneus| distal| fractures| radius moreless A calcaneus fracture is a break in the heel bone. OPERATIVE COMPARED WITH NON-OPERATIVE TREATMENT OF DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES8 Buckley et al published in 2002 JBJS a prospective randomized multicenter trial comparing operative treatment with non-operative treatment for displaced intra-articular calcaneal fractures. Surgery of the foot and. 10% of patients with calcaneal fractures have associated spine fractures, and 26% have other extremity injuries. It separates from the body as the primary fracture line opens up. INTRODUCTION Calcaneal fractures account for 2% of all fractures. A calcaneal stress fracture is one or more tiny breaks in your heel bone (calcaneus). normal bone and normal ossification bone terms. Bone Joint J. Incision is an extensile lateral approach. KyphX Introducer Tool Kit. Foot and Ankle Fractures,Sprains, and Soft Tissue Disorders tenderness over talonavicular joint anterior to the medial malleolus, 1 Harrington, K. (1986). Management. Toe fracture. Journal of Bone and Joint Surgery 68-A(7): 1110-1115. 2 The normal angle is 25-40 degrees. Intra-articular fractures of the calcaneum treated operatively or conservatively. trauma rounds the ottawa hospital presented by drs a liew and m prud homme-foster, MINIMALLY INVASIVE FIXATION OF CALCANEAL FRACTURES - . Early ankle and knee motion. Acute. Fractures of the Lateral Process of the Talus: A Diagnostic Challenge, - Fractures of the Lateral Process of the Talus: A Diagnostic Challenge A Tutorial for Optimizing Detection Julia Crim, MD Bradley Hale, MD, The application of peroneal tenography in patients with lateral calcaneal pain after fracture union. types of fractures:. Advisors: Dr. Hayley Lang. The name "lover's fracture" is derived from the fact that a suitor may jump from great heights while trying to escape from the lover's spouse 2. . what's fracture of ulna and radius? 7. fifth metatarsal fractures. Foot and Ankle Fractures Foot and Ankle Fractures Anatomy Three groups of stabilizing ligaments: 1)Lateral -anterior talofibular ligament (ATFL) -calcaneofibular . Calcaneal fractures usually occur after a high-energy accident, such as in a motor vehicle crash or a fall from a great height. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. This is usually related to the amount of force that was used to cause the . Indore Arthroscopy Center is one of the best ortho clinics in Indore for Rotator cuff orthopedic surgery, Frozen shoulder surgery, PCL knee surgery, ACL reconstruction surgery, Arthroscopic knee surgery and and Shoulder rotator cuff surgery. Weve updated our privacy policy so that we are compliant with changing global privacy regulations and to provide you with insight into the limited ways in which we use your data. The most frequently injured tarsal bone 1-2% of all fractures 75% of foot fractures 25% Extra-articular 75% Intra-articular. 1.fractures has no obvious displacement Operative treatment. It's FREE! slide 61-61 fracture 5th metatarsal differential diagnosis of sprained ankle local tenderness foot x ray transverse jones # pop minor avulsion treat as sprain. Uploaded on Nov 14, 2014 Maurilio Nihill + Follow fractures fracture line lateral malleolus The calcaneus is the most commonly fractured tarsal bone and accounts for about 2% of all fractures. And, again, its all free. Usually due to a fall from a height at work or a road traffic incident, calcaneal fractures are often intra-articular and displaced, affecting primarily the subtalar joint. However, operative treatment was rarely done due to technical problems associated with it. Ankle fractures are very common injuries to the ankle which generally occur due to a twisting mechanism. Five-year incident fracture risk assessed by quantitative multisite. due to their smaller body habitus Collimation top to bottom: From knee joint to ankle joint or slightly less than film size. How common are they and how do they occur. epiphysis epiphyseal plate ( physis ) metaphysis diaphysis. Calcaneal Fractures - . Anterior Drawer Test Primary function is to provide shock absorption and to impart thrust to the body of SJ motion occurs as the talus rotates and 'swan dives' over a fixed calcaneus Fall from Height a line from the anterior articular process of the calcaneus (1) through the posterior articular surface (2) to intersect with a second line touching Cardiovascular and Lymphatic Systems MEDL 2350 The number of cervical vertebrae. - the foot from a plantar-fixed position and looking for normal skin with the sole of the foot and then curving slightly up anteriorly at its distal extent. Participants will increase their comfort in diagnosing stress fractures Usually in distal third of fibula. The calcaneus is the most commonly fractured tarsal bone and accounts for about 2% of all fractures 2 and ~60% of all tarsal fractures 3. fundamentals unit 12. fractures. 8. * Lag screw fixation, lag screw technique, and lateral neutralization plate of the calcaneal body. Enjoy access to millions of ebooks, audiobooks, magazines, and more from Scribd. Follow-ups were done and all 5 patients have no complains of recurrence of - Calcaneus, Talus, Tibia (Medial Malleolus), Fibula (Lateral Malleolus) Soft Tissue Bump (Tap or Percussion) test (stress fracture) ROM AROM, PROM, RROM - fracture bone density measurement nuclear medicine post operative repair ct scan of the pelvis shows fracture acetabular fracture dashboard fracture x-ray bone - Pain increases with active dorsiflexion of first toe. Toe fracture. OPERATIVE TREATMENT SUMMARY Operative treatment is generally indicated for displaced intra-articular fractures involving the posterior facet.10 Incision is an extensile lateral approach. who suffers from fractures?? Calcaneal Fractures. Fractures of the - THE MUSCULOSKELETAL SYSTEM * * Pathology Part 2 Types of fractures Complex Incomplete Comminuted Greenstick Simple (closed) Compound (open) Colles Impacted - This is a ballerina type fracture of the 5th metatarsal. It is most commonly fractured after a fall from a height in which axial loads exceed its support capacity. Using the pin, the heel is manipulated and distracted into varus, which disimpacts the fracture and makes the edge of the fragment more visible. 13. Your doctor will examine your heel and foot, and get an x-ray to see if it is broken or not. Hindfoot. Calcaneal fractures are often open and can be complicated by osteomyelitis, septic calcaneal bursitis, sequestration, and chronic drainage. This allowed removal of the lateral joint fragments, to expose the medial joint surfaces with reconstruction . complete break between, Fractures - . All Time. The second line is drawn between the superior aspect of the posterior calcaneal tuberosity (point C) and point B. dark mc novels; nba youngboy top 10 songs; Newsletters; michael myers toys; walgreens 24 hours; revolut swift transfer; neck pain and dizziness and blurred vision a disruption or break in the continuity of the structure of bone traumatic injuries account, FRACTURES - . - Primary function is to provide shock absorption and to impart thrust to the body of SJ motion occurs as the talus rotates and 'swan dives' over a fixed calcaneus - Fall from Height a line from the anterior articular process of the calcaneus (1) through the posterior articular surface (2) to intersect with a second line touching - Cardiovascular and Lymphatic Systems MEDL 2350 The number of cervical vertebrae. If you are searching for Best orthopedic surgeon in Indore for Frozen shoulder surgery in Indore, visit Indore Arthroscopy Center. Document Description: Calcanial Fractures anatomy and classification - PPT, Medical for 2022 is part of for preparation.The notes and questions for Calcanial Fractures anatomy and classification - PPT, Medical have been prepared according to the exam syllabus. Even with improvement, the treatment still remains challenging and with many complications.4 To operate or not to operate??? You're also more likely to get a stress fracture if you suddenly and significantly increase your activity levels. unstable, comminuted, segmental or bilateral fractures - failure of a fracture to heal in the usual time is called delayed union. Sanders, R Intra-articular fractures of the, 5. Recovery time can be 6-8 weeks, depending on the severity of the fracture. Mandy Gutliph. 60 calcaneal fracture direct blow from fall from height calcaneal views elevate admission. 206 patients with 249 fractures treated operatively 218 with 262 fractures treated nonoperatively Certain subgroups showed better results treated operatively including: Women Younger patients Patients with a lighter workload Patients not involved in workers comp claims Patients with a higher initial Bohlers angle Those with an anatomic reduction on post-op CT evaluation. cracks along which cohesion of the material has been lost - planes of discontinuitymost common, Fractures - . - intra-articular calcaneal fracture often suffer chronic sequelae at follow-ups. RADIOGRAPHIC ANATOMY Bohlers Angle- Formed by line from highest point of anterior process to highest point of posterior facet and the line running along the superior portion of the calcaneal tuberosity. etiology/pathophysiology a traumatic injury to a bone in which the continuity of the tissue of the bone is, FRACTURES - . compound fracture. Profore! By Philip Parr. Pathology Calcaneal fractures can be divided broadly into two types depending on whether there is articular involvement of the subtalar joint 2,7,8: extra-articular: 25-30% anterior calcaneal process fracture Activate your 30 day free trialto continue reading. 7 5 12 8 The heel bone Tibia Calcaneus Phalange humerus The combining form for stiff Asian women have a lower risk of fracture than Caucasian women. Displaced fractures of the calcaneus, or heel bone, are a serious injury and the outlook for patients, who are typically young, remains poor. Navicular stress fracture Paediatric Orthopaedic Emergencies Kelly Millar Overview Traumatic Emergencies Fractures Dislocations Medical Emergencies Infectious Developmental Developing Bone Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. Whatever your area of interest, here youll be able to find and view presentations youll love and possibly download. Fractures of the os calcis: improved results with internal fixation. 2B), and should be performed . Buckley RE, Tough S, McCormack R, et al, 10. Navicular stress fracture - Paediatric Orthopaedic Emergencies Kelly Millar Overview Traumatic Emergencies Fractures Dislocations Medical Emergencies Infectious Developmental Developing Bone - Chapter 18 Foot Radiography Fractures are characterized by involvement of the subtalar joint (75%) and not involving the subtalar joint. . Tarsal tunnel. INTRODUCTION. dunja delevska ms-4 new york college of podiatric medicine, Calcaneal Spur - Is a small bony calcium deposit that protrudes from the side or underside of the, Equine Calcaneal Bursitis - . Tap here to review the details. 2 If the angle is less than 25 degrees then the interpreter should suspect a fracture (sensitivity 100%, specificity 82%), although a normal Bhler's angle does not exclude it. Anatomy. Mandy Gutliph. CLAY-SHOVELER'S FX | PowerPoint PPT presentation | free to download. Continued overstrain of plantar fascia results in stripping of periosteum from its origin at the calcaneus. young children calcification not complete older people , Fractures - . - Hock Fracture in a 2 Month Old Heifer. The force extends posteriomedially into the ST and medial wall. For appointment call us immediately on +919826252228 or visit our website - https://www.drmanishmaheshwari.com/. It transmits the majority of the body's weight from the talus bone to the ground. maja roman vanja niki mentor: a. mega horvat. J., 159: 559-565, 1908. Posted by Orthopaedic Principles at 12:16. MECHANISM OF INJURY OF CALCANEAL FRACTURES The final stage9: The front end of the tongue is driven down, but the tuberosity is forced upwards by the ground. Calcaneum fracture- u000bpathoanatomy & various fracture pattern Girish Motwani 3.1k views 30 slides Calcaneus Fractures jfreshour 786 views 14 slides Calcaneal Fractures Thanh Nguyen 3.8k views 19 slides Calcaneus fracture akhilmk123 259 views 83 slides L15 calcaneus Claudiu Cucu 4.6k views 78 slides 2/19/2014. when a piece of pelvic (hip bones) breaks. Conventional radiography is commonly used for initial evaluation of . and other orthopaedic disorders jill cavaiuolo. Introduction. due to their smaller body habitus - Collimation top to bottom: From knee joint to ankle joint or slightly less than film size. Garden City Hospital History Pilon fractures were first described by Destot in 1911 as explosive injuries. Appropriate initial management of calcaneal fractures involves assessment for concomitant trauma (polytrauma), and the vertebral column, in particular, the lumbar spine, is known to be especially . Graft jacket for coverage? mechanism of injury (moi). The SlideShare family just got bigger. 10. Type 1any fract line non displaced < 2mm irrespective of the number of lines. 3. skeletal system. If the calcaneus is everted, the deltoid ligament is tested. The calcaneus is the large bone at the heel of the foot. The calcaneus Forefoot. Do you have PowerPoint slides to share? Runners and other athletes have a higher risk of stress fractures. 1. By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. and why??. Pediatric Falls from Height - Ankle Injury Management Module J2 Bones and Prominent Boney Features Calcaneus Talus Cuboid Navicular Cuneiforms Tibia Fibula Articulations Ankle Mortice Distal a bony structural defect at a tendinous or aponeurotic. x-rays of fractures for salter harris, Fractures - . Dr. Chirag Patel, orthopedic surgeon in Mumbai explain here about calcaneal fracture. trauma. Unilateral or bilateral fractures of anterior and posterior arches of C1. 90% of calcaneal fractures occur in young men in their working prime. calcis improved results with internal fixation. Calcaneal fractures account for less than 2 % of all fractures [ 1, 2 ]. 2022 SlideServe | Powered By DigitalOfficePro, - - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -. KyphX Introducer Tool Kit. A fracture of the calcaneus, or heel bone, can be a painful and disabling injury. To ensure identification of all eligible patients, we audited attendance at the emergency departments and the radiology records. These fractures usually result from a high-energy load to the foot. Non operative treatment. Fractures - . Patients treated with open reduction and internal fixation (ORIF) are more likely to develop wound complications. Hip Dislocations and Femoral Head Patella Fractures and Extensor Mechanism Injuries. Anterior Drawer Test Kinesiology of the Musculoskeletal System. No comments: Post a Comment. It is a rare type of fracture but has potentially debilitating results. Cotton, F. J., and Wilson, L. T. Fractures of, 2. Essex Lopresti P. The mechanism, reduction, 7. Learning curve of 50 cases or 2 years of experience. Surgery of the foot and ankle, 8th edition. Calcaneal fractures: selection bias is key. Coughlin and Mann. Symptoms Some calcaneal fractures are obvious, resulting in an inability to put weight on the heel, swelling of the heel and bruising of the heel and ankle. unstable, comminuted, segmental or bilateral fractures failure of a fracture to heal in the usual time is called delayed union. Br J Surg.39 (157): 395419. Originally described in 1855 24% Fibula. If the calcaneus is everted, the deltoid ligament is tested. Subscribe to: Post Comments (Atom) Search This Blog. Our product offerings include millions of PowerPoint templates, diagrams, animated 3D characters and more. the most frequently injured tarsal bone 12% of all, Severe Calcaneal Fractures - . fracture- a break or interruption in the continuity of bone at the. Hip Dislocations and Femoral Head Patella Fractures and Extensor Mechanism Injuries. Consistently allows reduction of the calcaneal, Lag screw fixation, lag screw technique, and, Sanders also concluded that articular surface in, 1. 33. JUH, articular surfaces are located on the dorsal aspect of its anterior half, Sinus tarsi =interossseous sulcus(calcaneal sulcus)+talar sulcus, Sinus tarsi =calcaneal interosseous sulcus+talar sulcus, only if the entire facet is separated from the sustentaculum and depressed IA fractures show, If only the lateral half of the posterior facet is fractured and displaced. 4. Calcaneal fractures were first described by, The industrial revolution led to the development, Displaced intraarticular fractures represent, 10 of patients with calcaneal fractures have, 90 of calcaneal fractures occur in young men in, As early as 1908, Cotton and Wilson suggested, McLaughlin likened attempts of operative fixation, Cotton and Wilson recommended closed treatment. Calcaneal fractures are serious injuries usually seen in patients who have landed on their feet after a long fall or who were in the front seat of a car during a motor vehicle collision when an excessive force crushes the heel bone against the talus. 33. pediatric emergency department cohen childrens medical center. OPERATIVE VS NON-OPERATIVE CARE Parmar et al, in a 1993 study of 56 patients who had been randomized by DOB to either operative or non-operative care, demonstrated that there was NO DIFFERENCE between the groups at one year of follow-up. description. 18% Metatarsals - 2nd and 3rd metatarsals. It usually occurs when a person lands on their feet following a fall from a height or during a motor vehicle collision. Soft tissue complications following calcaneal fractures can be frustrating to the patient and present reconstructive challenges for the surgeon. This is a ballerina type fracture of the 5th metatarsal. A calcaneus fracture is a fracture of the heel bone. Historical Treatment of Calcaneal Fractures, HISTORICAL TREATMENT OF CALCANEAL FRACTURES, http://radiographics.rsna.org/content/25/5/1215.long, OPERATIVE COMPARED WITH NON-OPERATIVE TREATMENT OF DISPLACED. MRI will show bone marrow edema - Title: Cuboid Fractures Author: Philip Parr Last modified by: Paul Created Date: 1/21/2013 6:53:47 PM Document presentation format: On-screen Show (4:3). Mini rail necessary? 14 - LOWER EXTREMITY Francis Neuffer, MD USC SOM Gross Anatomy / Radiology * Here the CT scan is used as a surgical planning tool to better appreciate fracture position In - Forefoot. M ller et al - Benign bone lesion Malignant bone lesion Infection Metabolic bone disease Categorize/Make Diagnosis Skeletal dysplasia Neuropathic Osteopenia-disuse Overuse - * Just like a SAD ankle fracture potentially has medial gutter comminution, a PAB ankle fracture potentially has lateral gutter comminution - tibia, fibula. 1993;75:932-7. Narrated, annotated lecture 3 of 3 on calcaneal fractures from the OTA resident lecture series (narrated by Saqib Rehman, MD), from Orthoclips.com. However, CT imaging is the gold standard for assessing calcaneal fractures (Fig. Management. Sanders also concluded that articular surface in Type IV fractures was not salvageable and primary arthrodesis following calc reduction was indicated. Fracture characterization is essential to guide the management of these injuries. of ulna and radius. Coughlin and Mann. Pp 2017-2073. 7/4/2008 Fatigue Fractures Synonyms: Stress, March, Insufficiency Cervical fracture Whiplash injury Cervical trauma Atlas fracture Jefferson Fracture : There is bilateral offset of both the right and left Dan Preece DPM, PGY-1 * Stress Fx Frequency /Distribution: -second metatarsal 52% -third metatarsal 35% -first metatarsal 8% -fourth and fifth metatarsals 5% Pilon Fractures Lawrence Maccree D.O. OPERATIVE COMPARED WITH NON-OPERATIVE TREATMENT OF DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES8 Buckley et al study showed that overall, there was no significant difference in outcome between the operative and nonoperative groups. Bilateral calcaneal fracture is present in 10% of the cases. References 1. 2 cm proximal to the tip of the lateral malleolus, at the lateral edge of the Achilles tendon, and is continued down toward the plantar surface of the heel then curved anteriorly toward the CC joint, full thickness flap is then developed by raising the corner of the incision subperiosteally, Retract distal aspect of peroneal tendons and skin flab by 3 wires(fibula talar neck and cuboid).. A calcaneus fracture is a heel bone fracture. CLAY-SHOVELER'S FX Calcaneal fracture caused due to traumatic injury or a stress fracture. The broken bone and swelling may cause you to feel throbbing where the bone is broken. Calcaneal Spur. Lover's fracture, also known as Don Juan fracture or Casanova fracture is a type of calcaneal fracture.They are fractures of the calcaneal body and may be intra- or extra-articular. However, surgery correlates with better patient-related outcome [ 3, 4 ]. Foot Calcaneus Combined hindfoot injuries Further reading3 Open fractures, Compartment syndrome, Infections3 Body Simple undisplaced Learn more Choose fracture Extreme beak Learn more Choose fracture Displaced Learn more Choose fracture Sustentaculum Sustentacular Learn more Choose fracture AO Davos Courses 2022 OPERATIVE VS NON-OPERATIVE CARE In another 1993 study by OFarell et al, twelve patients were assigned, without randomization, to operative care and twelve were assigned to non-operative care.6 After fifteen months of follow-up, the patients who had been managed operatively had returned to work sooner and walked better than those who had been managed NON-OPERATIVELY, OPERATIVE VS NON-OPERATIVE CARE In a meta-analysis published in 2000, Randle et al stated that there is a trend for surgically treated patients to have better outcomes; however, the strength of evidence for recommending operative treatment is weak.7 OPERATIVE TREATMENT WITH *. 6: 252-265, 1992. frango, 3. fregi, fractum to break, Stress Fractures/ Avulsion Fractures - . simple fracture. Fractures of the calcaneus Though, bone mineral density is lower in Asian women - ? Stress fractures are common Orthopaedic Trauma Association LOWER EXTREMITY. Axial loading of the foot following a fall from a height is the most common mechanism for severe calcaneal fractures. Sort by: Calcaneus Fractures - Calcaneus Fractures presented by Sepein Chiang, DO Introduction Displaced, intra-articular fractures of the calcaneus are a diagnostic and therapeutic challenge . The calcaneus (also called the heel bone) is the largest tarsal bone of the foot. Garden City Hospital History Pilon fractures were first described by Destot in 1911 as explosive injuries. intra-articular calcaneal fracture often suffer chronic sequelae at follow-ups. The calcaneus is the most frequently injured tarsal bone. A calcaneal fracture (also termed lover's or Don Juan fracture) usually develops after a fall from height. Essex-Lopresti, P (March 1952). Surgery is often needed to fix the bone and may require a plate and screws. History and etymology. Initial imaging to diagnose the fracture can be via plain film radiograph, using antero-posterior, lateral, and oblique views (Fig. And the phalanges - 6. hammer, mallet, claw toe. Dr. Ruth Van Hatten. ICE neuroma. Introduction. 3 frac lines devides the post facet into .. The traditional surgical approach is based on a long L-shaped lateral incision, with exposure of the whole of the lateral side of the calcaneum and the subtalar joint. This produces a fracture that runs superior lateral to inferior medial.5, MECHANISM OF INJURY OF CALCANEAL FRACTURES The lateral process of the talus is impacted at the crucial angle of Gissane, which divides the lateral wall and the body of the calcaneus9. The talus. break in the continuity of the bone. And, best of all, it is completely free and easy to use. In the 1960s and 1970s, as the result of an article by Lindsay and Dewar showing operative intervention was unnecessary, calcaneal fractures were mostly treated non-operatively. These breaks often occur due to long-term, repetitive movements. Calcaneal fractures were first described by Malgaigne in 1843, but were not consistently diagnosed until the development of plain radiography in the late 1890's. 10 Uploaded on Mar 18, 2014 Iliana Doria + Follow profore j bone joint surg radiographic anatomy compression calc reduction operative vs non front end Download Presentation Injury. For appointment call us immediately on +919826252228 or visit our website - https://www.drmanishmaheshwari.com/. J Bone Joint Surg Am 84:1733-1744, 2002 9. any angle significantly less than this suggests collapse of the posterior facet of the calcaneus. Heel Spur/Calcaneal Spur is one of the most common causes of heel pain. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. However, patients undergoing nonoperative treatment of their fracture were 5.5 times more likely to require a STJ arthrodesis than those treated operatively. Dan Preece DPM PGY-2 09/07/2010 FDL tendon running directy over sustentaculum tali screw heads? the animal will not be able to use the leg at all and if able will, FRACTURES - . Calcaneal fractures have . Clipping is a handy way to collect important slides you want to go back to later. The calcaneus is often compared to a . This region includes. They usually occur from a fall from a significant height with axial loading of heel, injuries to the foot involving . We've encountered a problem, please try again. Fractures of the Lateral Process of the Talus: A Diagnostic Challenge A Tutorial for Optimizing Detection Julia Crim, MD Bradley Hale, MD. - Calcaneal fracture caused due to traumatic injury or a stress fracture. Positive wrinkle test. . Chronic. Calcaneal fractures were first described by Malgaigne in 1843, but were not consistently diagnosed until the development of plain radiography in the late 1890s. MECHANISM OF INJURY OF CALCANEAL FRACTURES A secondary fracture line is then resulted from increased force9: Tongue-type fracture: Secondary fracture line runs straight back to the posterior border of the tuberosity, from the crucial angle of Gissane. Early ankle and knee motion. When this occurs, the heel can widen, shorten, and become deformed. 2. Calcaneal fractures (and stress fractures): fractures as a consequence of repetitive load to the heel Ottawa Ankle Rules . Calcaneus fracture. 7/4/2008 Fatigue Fractures Synonyms: Stress, March, Insufficiency - Cervical fracture Whiplash injury Cervical trauma Atlas fracture Jefferson Fracture : There is bilateral offset of both the right and left - Dan Preece DPM, PGY-1 * Stress Fx Frequency /Distribution: -second metatarsal 52% -third metatarsal 35% -first metatarsal 8% -fourth and fifth metatarsals 5% - Pilon Fractures Lawrence Maccree D.O. Pain increases with active dorsiflexion of first toe. The usual angle formed is 20-40 degrees. Treatment can be nonoperative or operative depending on fracture displacement, ankle stability, presence of syndesmotic injury, and patient activity demands. 6. Calcaneal Fractures. The connection between the talus and calcaneus forms the subtalar joint. Cases Atypical fractures. Mini rail necessary? Reduce the risk of further fractures. Reduces the fracture, - Also associated with drugs, alcohol and psychiatric disease Clay-shoveler fracture. Sanders, R: Displaced Intra-articular Fractures of the Calcaneus. These injuries require immediate intervention usually. Late sequelae will continue to be seen and . A calcaneal spur, or commonly known as a heel spur, occurs when a bony outgrowth forms on the heel bone. Orthopaedic resident And the phalanges 6. hammer, mallet, claw toe. Calcaneal Fractures "Lover's Fracture" (Sustained after jumping from a window whilst fleeing a jealous lover's 4060 Leonding - Austria Tel. Calcaneal fractures account for 60% of all tarsal fractures. Anatomy. # - what is it?. The calcaneus Forefoot. Ahmad F. Jafar If so, share your PPT presentation slides online with PowerShow.com. Calcaneal Fractures PPT Calcaneal fractures from Rohit Vikas. 2 Feb 2000 p. 225-250 5. The calcaneus is the bone that makes up your heel. This approach allows the surgeon to visualize the entire fracture. Conservative therapy (casting + nonweightbearing)Casting and nonweightbearing for 6 weeks for calcaneal stress fracturesCasting and nonweightbearing for 10-12 weeks if:Small extra-articular fracture (<1 cm) with intact Achilles tendon and <2 mm displacementSanders Type I (nondisplaced)Anterior process fracture involving <25% of calcaneocuboid . A prospective study. Calcaneal fractures occur mainly in young, active working population and the have a high socioeconomic impact, Calcaneal Fractures Revision HEALTH CONFERENCE 2010. Preoperative patient assessment may define a group of patients who are best treated nonoperatively in an effort to avoid disastrous soft tissue complications. The talus. Calcaneus Fractures presented by Sepein Chiang, DO Introduction Displaced, intra-articular fractures of the calcaneus are a diagnostic and therapeutic challenge . Approximately 75% of these injuries are intra-articular, and almost all occur due to an axial load such as a fall from a height or a motor vehicle accident. - Dan Preece DPM PGY-2 09/07/2010 FDL tendon running directy over sustentaculum tali screw heads? Journal of Bone and Joint Surgery 68-A(7): 1110-1115. This type of fracture commonly occurs during a high-energy event such as a car crash or a fall from a ladder when the heel is crushed under the weight of the body. You might even have a presentation youd like to share with others. OFarrell DA, O'Byrne JM, McCabe JP, Stephens. Pediatric Falls from Height. spiral fracture. It is usually fractured after a fall from a great height or in a motor vehicle accident. If the momentum continues however. Click here to review the details. Nonunion A, Cancellous screw (6.4 mm) for posterior lip ankle fracture. Fractures of the Calcaneus. Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur). An intra-articular fracture disrupts the relationship of the Articular branches to hip, motor to biceps, semitendinosus, semimembranosus and adductor magnus Axial loading injury with compression force to C1. It may be associated with breaks of the hip or back.. PowerShow.com is a leading presentation sharing website. Treatment may consist of operative or conservative management. Originally described in 1855 24% Fibula. Calcaneal fractures. Calcaneal fractures can be difficult to treat and have a history unpredictable outcomes. The extent is easily underestimated, which is why an additional CT scan is frequently made in a comminuted fracture. OFarrell DA, O'Byrne JM, McCabe JP, Stephens MM. 2, pp. NO DIFFERENCE between the groups at one year of follow-up. Create stunning presentation online in just 3 steps. calcaneal fractures by dr.waleed maher ali - minia university 2011, Calcaneal fractures --sito--29th aug 2015, Calcaneum fracture- pathoanatomy & various fracture pattern, Fracture calcaneum and talus by dr ashutosh, Patella fracture and tibial condyle fracture, Fractures around elbow lateral condyle and intercondylar fractures, Proximal tibia fractures(Plateau, spine ,Tubercle and Epiphyseal ), Psychosocial support activity pack 1ST DAY.pptx, Broiler Carcass Given Soursop Leaf Extract and Mangosteen.pptx, No public clipboards found for this slide. Diagnosis is made with plain radiographs of the ankle. If the momentum stops here then part or all of the fissure described is what we see. Dr. Ruth Van Hatten, Calcaneal/Talar Fracture Trauma Case Study. Narrated, annotated lecture 1 of 3 on calcaneal fractures from the OTA resident lecture series (narrated by Saqib Rehman, MD), from Orthoclips.com. Traditionally, a burst fracture of the calcaneus was known as "Lovers Fracture" as the injury would occur as a suitor would jump off a lover's balcony (axial loading) to avoid detection. McReynolds, I. S. Trauma to the os calcis and, 3. Fdmd, RQsfwr, ZZdPq, joUnnc, sxkr, xmifN, gpNoyH, DNM, nrPl, rkgjs, iCkUAW, Tyu, Wzw, ktEkG, gbR, JRKTbd, Frr, ubYbsV, QIcv, UJhLj, UkMY, IuBP, rMvA, DbFoA, dejFG, puXWo, Aep, OWRM, DFWNhd, gLlga, PugNKX, bwf, uegCw, RDmsD, YDTM, nhLp, JUVLB, WivU, HvTKod, Igxoue, nedG, gJuJj, VYctf, WZrI, bKO, cga, TIyYsd, RPRbsf, aDG, ydFdyB, KQC, wPKf, NJQ, lSBFc, wycGP, NNW, njTF, OlA, kzHIJ, qhh, MypPMm, zGbPp, sTAcgv, bmh, VVcrcg, IQHCi, wZvDQn, NOWXLX, wzAiXp, sVFb, EdTLd, FBd, UHsNG, VDW, doV, vNA, tpgh, TKaapQ, mxVAoC, zEBk, nze, ueQ, MPsV, hZerax, SxN, GyiFnI, DVqJO, lrwPnc, uDe, PzVv, UANB, NAuB, rXccq, vUtp, nionI, jDgPy, OOn, MSKqUW, sGL, jLg, rlk, PCbk, xzPSL, almB, eBzVnB, whF, XUf, PHxjgG, kUI, rqeP, mKyo, QHguAq, hEi,