Descriptive Posters - Yellow
Adhesive Capsulitis Secondary to an Anterior Shoulder Dislocation in a 17-year-old Football Player: A Case Study
Subject: Research Poster (Athletic Training)
Presenter: Ashley Consolini
Faculty Sponsor: Sue Guyer
"An Acute Fracture Blister without the presence of a fracture in a forty-three-year-old female recreational softball player: A Case Study
Cintron, M. & Rudolph, L.: Springfield College Athletic Training Program, Springfield, Massachusetts
Subject: Research Poster (Athletic Training)
Presenters: Lauren Rudolph, Miranda Cintron
Faculty Sponsor: Sue Guyer
Background: A fracture blister is defined as a tense vesicle or bullae which forms on edematous skin directly over a fracture (Tolpinrud, Rebolledo, Lorich, & Grossman, 2015). Fracture blisters develop when an injury to the dermal-epidermal junction occurs from a high shear in the skin during the mechanism of injury (Strauss, Petrucelli, Bong, Koval, & Egol, 2006). Any anatomical area where superficial bony prominences and minimal soft tissue is covering the bone is a common site for fracture blisters (Tolpinrud et al., 2015). Two types of fracture blisters are clear-fluid filled and hemorrhagic blisters (Uebbing, Walsh, Miller, Abraham, & Arnold, 2011). Clear-fluid filled fracture blisters occur when minimal injury to the dermis and some epidermal cells are still attached. Hemorrhagic blisters appear when the dermis is completely separated from epidermal cells (Uebbing et al., 2011).
Case Presentation: The patient is a forty-three year old recreational softball player who was hit by a line drive on the medial aspect of her lower right leg. Swelling and discoloration were present immediately. Two small blisters were noticed by the patient over the area where the softball made impact. The blisters contained clear fluid. The patient was able to walk but reported some pain and continued to play the next softball game. The patient reported being able to continue playing with pain. In the next twenty-four hours, the patient noticed the blisters became larger and eventually merged into one. Within the initial twenty-four hours post injury, the patient went in a hot tub. After returning home, the patient visited a doctor to undergo an X-ray approximately seventy-two hours post injury. The X-Ray was negative for fracture, but the blister which formed had all the same characteristics of a fracture blister. Treatment consisted of heat approximately seventy-two hours post injury. The athletic trainer attempted to immobilize the extremity to provide pain free walking; however, due to concern of the blister popping the patient was not immobilized. A week after the injury the patient reported hitting her leg against the stairs causing the blister to open. No infection or complications were reported after the blister was ruptured.
Conclusions: The forty-three year old female recreational softball player sustained a blunt force to the right tibia from the line drive during the softball game. Although the patient was diagnosed with a fracture blister, no research was found to support a fracture blister would occur without the presence of a fracture. The blunt force caused a gap in the dermal-epidermal junction over the site of the injury (Uebbing et al., 2011). When the patient entered the hot tub, the heat increased the amount of blood flow and swelling to the area (Malagna, Yan & Stark, 2015). The increased serous fluid to the area caused the fluid to seep through into the gap in the dermal-epidermal junction and caused the fluid-filled fracture blister on the leg of the patient. Clinical Bottom Line: Fracture blisters can occur without the presence of a fracture. The blister is formed due to the increased interstitial pressure of the edema from the traumatic stress (Uebbing et al. 2011).
References
Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine, 127(1), 1-9.
Strauss, E. J., Petrucelli, G., Bong, M., Koval, K. J., & Egol, K. A., (2006). Blisters associated with lower-extremity fracture: Results of a prospective Treatment protocol. Journal of Orthopedic Journal, 20(9), 618-622
Tolpinrud, W. L., Rebolledo, B. J., Lorich, D. G., & Grossman, M.
E. (2015). A case of extensive fracture bullae: A multidisciplinary approach for acute management. JAAP Case Reports, 1(3), 132-135.
Uebbing, C. M., Walsh, M., Miller, J. B., Abraham, M., & Arnold,
C. (2011). Fracture blisters. Western Journal of Emergency Medicine, 12(1), 131-133."
Anterior Acetabular Labral Tear Secondary to Femoral Acetabular Impingement in a 21yro Male Soccer Athlete: A Case Study - Springfield, Massachusetts
Subject: Research Poster (Athletic Training)
Presenters: Erik King
Faculty Sponsor: Sue Guyer
Background: Anterior acetabular labral tears are characterized by acute or chronic pain, catching and clicking within the acetabulofemoral (FA) joint and commonly coexist with femoral-acetabular impingement (FAI) (Anderson, Strickland, & Warren, 2001; Yuan, Sierra, & Trousdale, 2008). FAI is a condition in which the space between the acetabulum and femoral head is reduced (Macfarlane, R., & Haddad, F. 2010) FAI and associated labral tears are common in young, college aged athletes (Macfarlane & Haddad, 2010). Both conditions are common in men’s soccer and ice hockey athletes (Kerbel, Smith, Prodromo, Nzeogu, & Mulcahey, 2018; Macfarlane, & Haddad, 2010).
Typically, a non-operative approach for treating the condition is implemented. Partial weight bearing for roughly four weeks and modification of activity is suggested. (Anderson et al., 2008; Macfarlane & Haddad, 2010). If the non-operative approach is ineffective, arthroscopic surgery to repair the labrum and to readjust the FA joint space is recommended (Anderson et al., 2008; Kerbel et al., 2018; Macfarlane & Haddad, 2010). An arthroscopic iliopsoas tendon release is recommended (Fabricant et al., 2015).
Presentation: A 21-year-old male soccer player complained of left hip pain, clicking and catching. Following MRI, the patient was diagnosed with a left acetabular labral tear, along with FAI. MRI is reliable in diagnosing labral tears of the hip and FAI (Beaulé, O’Neil, and Rakhra, 2009; Macfarlane & Haddad, 2010). The patient received daily treatment, focusing on increasing range of motion and decreasing pain. The therapeutic interventions were deemed ineffective as the patient was not improving. The patient opted for FAI surgery including an iliopsoas tendon release to repair the labral pathology. Following post-operative rehabilitation, the patient continued to have mild pain but participated in a full season of soccer without limitation.
Avulsion Fracture at the Anterior Superior Iliac Spine of the Sartorius in a High School Track Athlete: A Case Study
Subject: Research Poster (Athletic Training)
Presenters: Gabrianna Matthews, Bridget Walsh
Faculty Sponsor: Sue Guyer
Background: An avulsion fracture of the anterior superior iliac spine (ASIS) is a rare injury, but most commonly seen within the athletic adolescent population (Kautzner, Trc, & Havlas, 2014). The injury occurs as a result of the sudden contraction of the sartorius during an explosive movement causing the sartorius to forcefully remove part of its proximal attachment, the ASIS (Dhinsa, Jalgaonkar, Mann, Butt, & Pollock, 2011). The injury is most common in track athletes, especially during the beginning of running or jumping phase. Treatments for an avulsion fracture of the ASIS depend on the severity of the displacement of the fracture (Dhinsa et al., 2011). Conservative treatment is ideal, involving the combination of rest, analgesics, anti-inflammatories, and rehabilitation (Dhinsa et al., 2011). Surgical intervention could be recommended based on the displacement of the fracture and the rehabilitation needs of the patient (Kautzner, Trc, & Havlas, 2014). The surgical treatment of open-reduction with internal fixation has been shown to produce a faster recovery time when compared to conservative treatment (Kautzner, Trc, & Havlas, 2014).
Case Presentation: A 15-year old male track athlete complained of hip pain after competing in a meet over the weekend. The patient stated the injury occurred to his lead leg while hurdling. The patient was referred to an orthopedic specialist for further evaluation and received diagnostic imaging. The patient was given crutches to assist with ambulation. The x-ray confirmed an avulsion fracture of the ASIS at the sartorius attachment site. A computed tomography (CT) scan was taken to measure the length of retraction of the avulsion fracture. Imaging is used to diagnose an injury as well as assist in determining a treatment plan. The treatment of an avulsion fracture is determined to be surgical or non-surgical by the length of detachment or the presence of a secondary injury (Kautzner, Trc, & Havlas, 2014). An avulsion greater than three centimeters should be considered for a surgical intervention (Kautzner, Trc, & Havlas, 2014). Surgery was not necessary for the mentioned athlete. The conservative method of treatment consists of 10 to 12 weeks of healing time with a physical therapy program for strengthening. The patient is to be reevaluated by the doctor before returning to play at the end of rehabilitation.
Conclusions: The challenge of the injury is the two different treatments with the purpose of proper healing. Clinically, an avulsion fracture at the ASIS can be properly identified with a CT scan. The use of imaging will provide the patient with more information to determine an appropriate treatment plan for effective recovery. The conservative based treatment allows the patient to focus on restoring range of motion and reestablishing muscular strength before returning to play. Clinical Bottom Line: Avulsion fractures of the ASIS are rare but are most commonly seen in track athletes. The use of diagnostic imaging determines the treatment plan, whether the athlete undergoes surgery or conservative treatment. Getting the correct and accurate imaging is essential in the diagnosis and treatment of an avulsion fracture of the ASIS.
Bilateral Chronic Exertional Compartment Syndrome of All Four Compartments of the Lower Leg Treated with Simultaneous Bilateral Fasciotomy in an 19 year old Female Lacrosse Patient: A Case Study
Subject: Research Poster (Athletic Training)
Presenters: Matt Johnson, Luke Edmondson
Faculty Sponsor: Sue Guyer
Background: Chronic exertional compartment syndrome (CECS) is an increase in intra-compartmental pressure within fascial space resulting in lower leg pain (Tucker, 2010). Increased pressure within the muscle compartments causes compression of nerves and arteries within the given compartment. CECS typically occurs in young adults who participate in endurance activities (Tucker, 2010). Tucker (2010) found no differences in incidence rates between men and women. Treatment for CECS begins with a conservative approach involving a reduction in volume of training.
Conservative treatment often leads to short-term reduction of symptoms, ultimately failing to resolve the pathology (Meehan & O’Brien, 2018). Failure of conservative treatment can indicate the need for a surgical procedure to reduce intra-compartmental pressure. Fasciotomies yield the best outcomes for an athletic population (Meehan & O’Brien, 2018).
Case Presentations: A-19-year old female lacrosse patient presented with a bilateral shooting pain and numbness in the lower leg which worsened after participation. Symptoms began in senior year of high school and persisted throughout the first year of college. The patient was referred to an orthopedic specialist who recommended conservative treatment involving stretching and strengthening activities.
Conservative treatment failed and the orthopedic specialist recommended intra-compartmental pressure measurements of both legs. Intra-compartmental pressure testing is the gold standard for diagnosing CECS (Hislop & Batt, 2011). Testing involves reproducing symptoms through physical exertion, then inserting a pressure manometer into each compartment to record the pressure (Hislop & Batt, 2011). Tucker (2010) reports pressures of ≥15 mmHg at rest and pressures of ≥20 mmHg post exercise as diagnostic indicators of CECS. All lower leg compartments were significantly high before exercise and worsened for post exercise measures. The results were positive for bilateral CECS in all four compartments of the lower leg. The patient was referred for a bilateral double incision fasciotomy. A bilateral double incision fasciotomy involves making medial and lateral incisions on the lower leg, allowing all four compartments to be accessed and decompressed (Fry, Wade, Smith, & Asensio-Gonzales, 2013). The patient underwent surgery without complication on 6/7/18. The patient began rehabilitation therapy four months post-operation. While the plan of care reduced the majority of symptoms, the patient continues to experience some unresolved symptoms in the left leg. Additional surgery is being considered. Patient is currently practicing in sport to tolerance.
Conclusions: Early diagnosis and treatment of CECS is crucial to improve patient outcomes. Garner, Taylor, Gausden, & Lyden (2014) report delayed diagnosis may increase risk of failed treatment, result in poor outcomes, and result in additional surgery. A fasciotomy has been identified to be the only successful form of treatment for CECS (Tucker, 2010). A proposed alternative to surgical intervention has been a reduction in participation and arch support orthotics. However, literature does not support conservative methods (Tucker, 2010). After surgical intervention, rehabilitation was delayed until the fall. Due to the delay in treatment only partial resolution of the pathology occurred.
Clinical Bottom Line: Early diagnosis and treatment of CECS leads to increased rate of recovery, improved patient outcomes, and an increase in functional ability.
Bilateral Ulnar Impaction Syndrome Treated with Ulnar Shortening Surgery in an 18-year-old Male Gymnast: A Case Study
Subject: Research Poster (Athletic Training)
Presenter: Erin Rosier
Faculty Sponsor: Sue Guyer
Background: Ulnar variance is a condition where the ulna is longer or shorter in length than the radius. When the ulna is longer than the radius ulnar impaction syndrome (UIS) may be indicated (Rajgopal, Roth, King, Faber, & Grewal, 2015). UIS is a condition in which the ulna comes in contact with the TFCC and adjacent carpal bones causing damage to the structures (Rajopal et al., 2015). UIS is common in the non-athletic population but usually is not problematic (DiFiori, Caine, & Malina, 2006). In sports such as gymnastics, the amount of axial load put on the wrist as well as repetitive wrist movements can cause pain and UIS is more likely to be detected and treated (DiFiori et al., 2006). Axial load can increase ulnar variance by up to 1mm with 18.1 kilogram force causing more pain in an athlete with preexisting ulnar variance (Ozer, Zhu, Siljander, Lawton, & Waljee, 2018).
Case Presentations: An 18-year-old male gymnast presented with bilateral wrist pain described pain as aching and burning. The patient reported 7/10 on the pain scale when performing handstands or weight bearing exercises. ROM of wirst extension and ulnar deviation was reduced. The patient received a cortisone injection which did not relieve symptoms. The patient also completed four months of physical therapy with no improvement. In 2015, the patient went to a wrist and elbow specialist and was diagnosed with ulnar variance bilaterally utilizing radiographs. The patient opted for ulnar shortening osteotomy surgery to correct the variance on the left ulna and the right ulna, the surgeries included removing a piece of the bone and placing a plate and six screws into each ulna to assist in healing and bone strength (Nagy, Jungwirth-Weinberger, Campbell, & Pino, 2014). The patient had a significant decrease in wrist pain and was able to continue participating in gymnastics competitively at the college level post-surgery. Currently the patient complains of muscle tightness in the forearms and is treated with a combination of instrument assisted soft tissue massage (IASTM), dynamic cupping therapy, and massage in order to eliminate adhesions while still being able to compete.
Conclusions: UIS can be classified by the amount of variance when the ulna is compared to the radius. When the positive variance is 2mm the load on the ulnocarpal joint increased by 40% (Woitzik, DeGraauw, & Easter, 2014). Patients with increased discrepancy, UIS non-surgical interventions are not as effective as osteotomy in decreasing long term pain (Tatebe, Nishizuka, Hirata, & Nakamura, 2014). Due to the nature of the pathology, osteotomy is the most accepted treatment (Nagy et al., 2014). Many different techniques for osteotomy have been developed and are being evaluated for patient outcomes. The main issues with osteotomy include the risk of non-union and irritation of the surrounding soft tissue (Nagy et al., 2014).
Clinical Bottom Line: Patients complaining of wrist pain participating in activity with increased axial load and repetitive wrist movements should be evaluated for ulnar variance. Ulnar shortening osteotomy surgery is an effective treatment of UIS caused by positive ulnar variance. Patient outcomes of ulnar shortening osteotomy surgery are positive. However, other problems such as muscle tightness due to metal fixations can cause some pain after surgery. Muscular tightness caused from shortening surgery can be treated with manual techniques such as massage, IASTM, and myofascial decompression. Osteotomy is a good treatment option for young active individuals with UIS participating in activity which involves wrist flexion with axial load.
Effects of Femur Misalignment in a 20 year old Distance Runner and Equestrian Rider: A Case Study Bramhall, M & Menze, R.: Springfield College Athletic Training Program, Springfield, Massachusetts
Subject: Research Poster (Athletic Training)
Presenters: Margaret Bramhall, Rachel Menze
Faculty Sponsor: Sue Guyer
Background: According to Lill, Attal, Rudisch, Wick, Blauth & Lutz (2016), midshaft femoral fractures may be fixed using minimally invasive plate osteosynthesis (MIPO) or open reduction internal fixation (ORIF). Higher rates of malalignment such as length and rotation discrepancies have been reported after MIPO. Malrotation is defined femoral rotation greater than 10°. If more than 15° of rotation are present, clinically relevant problems with activities such as sports, running, and climbing stairs become more prevalent. In all cases, patients with external rotation had a greater femoral rotation than patients with internal rotation (Lill et al., 2016). Lower extremity malalignment may affect the load distribution on the joints, mechanical efficiency of the muscles, and proprioceptive orientation and feedback from the hip and knee, which can alter neuromuscular function and control of the lower extremities (Choi & Kang, 2015). According to Lill et al. (2016) long term complications of rotational malalignment include degenerative arthritis of the knee and hip. Radiographs, magnetic resonance imaging (MRI), and ultrasounds are methods used to detect rotational malalignment. The gold standard is computed tomography (CT). (Lill et al., 2016) Intramedullary nailing is the standard method of fixation of femoral shaft fractures (Said, Said, & El-Sharkawi, 2011).
Case Presentation: A 20-year-old female competitive equestrian rider and long-distance runner suffers from consistent right hip pain and right sacroiliac joint discomfort. At age 16, the patient was in an equestrian riding accident. The horse fell on top of the patient fracturing the right femur and pelvis, dislocating the hip, and grade III tear of the quadriceps muscles. The patient received surgery in which the femur was set with a rod and screws, and the hip was relocated. When the patient began physical therapy, the right foot of the patient was externally rotated 90°. A second surgery was performed six months after the initial injury to take out the placed hardware. During surgery, the surgeon found 25° of external rotation of the femur with a leg length discrepancy of a half of inch, which is still present to date. In physical therapy the patient initially worked on neuromuscular control and strength of internal rotators. After returning to play the patient now works on balance. The patient also suffers from discomfort in the right hip and sacroiliac joint and has trouble finding comfortable running shoes. The patient receives chiropractic adjustments to correct sacroiliac joint dysfunction due to repetitive stress on the hip.
Conclusions: The patient presented with 25° of external rotation while the normative value is less than 10°. The patient experienced sacroiliac dysfunction on the same side as the injury. Treatment for the patient consisted of chiropractic adjustment of the sacroiliac joint and physical therapy for the quadriceps, hamstrings, and other relevant musculature. A common presentation not experienced by the patient is pain at the knee joint, especially while walking up stairs (Karman, Ayhan, Kesmezacar, Saker, Unlu & Aydingo, 2014).
Clinical Bottom Line: Karaman et al. (2014) study found 41.7% of people who received intramedullary nailing as in intervention resulted in >10° of rotation after surgery. Due to the malalignment the patients have to deal with long term consequences such as back, hip, knee pain. Clinicians should be able to identify structural abnormalities in patients and be able to administer corrective exercises to prevent further injury. Further research should be done to improve the results of intramedullary nailing so the percentage of femoral rotation after surgery is decreased.
References:
Choi, B. R., & Kang, S. Y. (2015). Intra- and inter-examiner reliability of goniometer and inclinometer use in Craig's test. Journal of physical therapy science, 27(4), 1141-1144.
Karaman, O., Ayhan, E., Kesmezacar, H., Seker, A., Unlu, M., & Aydingoz, O. (2014). Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life. European Journal of Orthopaedic Surgery & Traumatology, 24(7), 1243-1247.
Lill, M., Attal, R., Rudisch, A., Wick, M., Blauth, M., & Lutz, M. (2016). Does MIPO of fractures of the distal femur result in more rotational malalignment than orif? a retrospective study. European Journal of Trauma and Emergency Surgery: Official Publication of the European Society for Trauma and Emergency Surgery,42(6), 733-740.
Said, G., Said, H., & El-Sharkawi, M. (2011). Failed intramedullary nailing of femur: Open reduction and plate augmentation with the nail in situ. International Orthopaedics, 35(7), 1089-1092.
Exploration of Aquatic Species in La Selva, Costa Rica
Subject: Research Poster (Biology)
Presenters: Gina Santapaola, Diara Vicedomini
Faculty Sponsor: Melinda Fowler & Justin Compton
Abstract: La Selva Research Base is located at the convergence of the Puerto Viejo and Sarapiquí Rivers in Costa Rica, which meet at the station’s northern border. The preserve is surrounded on three sides by the natural barriers created by these rivers and their tributaries. The Peje River is located to the west, and the Sábalo-Esquina creeks to the east. The research performed was designed to examine characteristics of the aquatic environment that varied between two major aspects: succession types (old growth, selectively forested, agricultural land) and rate of water flow (fast, medium, slow). The correlation between presence of vertebrates and invertebrate species abundance.
Additionally, the variation in organism diversity was investigated between succession types and water flow characteristics. Collection methods consisted of sampling by hand, holding containers downstream after disturbing the rocky sediment to dislodge invertebrates. Invertebrates traveled into the container and samples were held and further examined under a dissecting microscope in the laboratory. In order to gather vertebrates, a weighted seine was dragged across the river collecting fish below the surface.
Further analysis will help to conclude whether there is a correlation between abundance of vertebrate species and presence and diversity of invertebrates. These findings will assist in identifying a possible link in predator-prey relationship of these cohabitating species. Factors such as competition and predation may drive species interactions and understanding how species interact along environmental gradients is an important part of understanding ecosystem dynamics.
Local Blood Flow Restriction Therapy with Moderate Training 8 weeks Following ACL Reconstruction Surgery: A Case Study
Subject: Research Poster (Athletic Training)
Presenters: Johjan Mussa, Jessica Lane
Faculty Sponsor: Sue Guyer
Background: The anterior cruciate ligament (ACL) is a key stabilizer and the most frequently injured ligament of the knee (Guenoun et al., 2017). When torn, ACL reconstruction is common to return patients to an active lifestyle (Wright et al., 2008). A new approach to post-surgical rehabilitation is local blood flow restriction (BFR) therapy (Wright et al., 2008). BFR therapy uses periods of venous blood flow restriction during the performance of moderate exercise, typically at 20% to 30% of a single maximum repetition (1RM)(Tennent et al., 2017). Recent literature supported local BFR therapy as an advantageous way to recruit fast-twitch glycolytic (type II) muscle fibers (Fujita et al., 2007). The lack of oxygen allows for an increase of protein synthesis and subsequent muscle hypertrophy (Fujita et al., 2007).
Case Presentation: A former college track athlete, 25 years of age, pivoted and twisted while playing pickup football. The patient immediately returned to play despite pain in the right knee. He attempted to cut a second time, but was too unstable to complete the movement. An MRI was taken, revealing a grade three ACL rupture. The patient had reconstructive surgery using a semitendinosus graft. The patient began rehabilitation two weeks later primarily focusing on decreasing swelling, regaining mobility, and decreasing pain. During the early postoperative period, it is common to have significantly reduced muscular strength and muscle atrophy, specifically in the quadricep muscle group (Ohta et al., 2003).
However, Ohta et al. (2003) suggested moderate exercise accompanied with proximal BFR to the lower extremity with an air tourniquet can increase muscle strength and size as much as high-load muscular training performed six months postoperative. The duration typically runs ten to twelve minutes during the early stages of rehabilitation. The patient began a four-week long BFR therapy progression; an air tourniquet was applied to the right leg of the patient as he performed cardiovascular training. Training began conservatively; the patient would speed walk for 8-10 minutes depending on his pain tolerance. By week two of BFR training, he advanced to a 10-12 minute duration with less pain. By week three, the treadmill was incorporated; the setting was set to 3.5 MPH with no incline. The patient continued to respond well to treatment despite discomfort. During week four, the patient trained at 3.5 MPH with incline to 3.0%. Weekly circumferential measurements were recorded 3 inches above/below the joint to assess progression. There was an increase in muscle mass noted weekly and the patient reported feeling significantly stronger and faster.
Conclusions: The patient began BFR with circumference measurements of 13.5 and 15.5 inches; however, upon completion of BFR, measurements were 15.5 and 18.5 inches, indicating a significant increase in muscle mass of 2 and 3 inches respectively. The patient progressed into the next stage of ACL rehabilitation running protocol successfully. Clinical Bottom Line: Local BFR therapy showed promise to increase muscle girth and strength when compared to ACL rehabilitation without BFR. BFR therapy does not alter the duration of ACL rehabilitation protocol; however, the patient increased muscle tone and reported feeling significantly stronger following treatment.
References
Tennent, D. J., Hylden, C. M., Johnson, A. E., Burns, T. C., Wilken, J. M., & Owens, J. G. (2017). Blood flow restriction training after knee arthroscopy: A randomized controlled pilot study. Clinical Journal of Sport Medicine, 27(3), 245-252.
Duthon, V. B., Barea, C., Abrassart, S., Fasel, J. H., Fritschy, D., &
Menetrey, J. (2006). Anatomy of the anterior cruciate ligament. Knee Surgery, Sports Traumatology, Arthroscopy, 14(3), 204-213.
Fujita, S., Abe, T., Drummond, M. J., Cadenas, J. G., Dreyer, H. C.,
Sato, Y., Volpi, E., Rasmussen, B. B. (2007). Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. Journal of Applied Physiology, 103(3), 903-910.
Ohta, H., Kurosawa, H., Ikeda, H., Iwase, Y., Satou, N., & Nakamura, S. (2003). Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction. Acta Orthopaedica Scandinavica, 74(1), 62-68.
Wright, R. W., Preston, E., Fleming, B. C., Amendola, A., Andrish, J.
T., Bergfeld, J. A., et al… Williams, G. N. (2008). Acl reconstruction rehabilitation: A systematic review part II.Journal of Knee Surgery, 21(3), 225-234.
Lincoln Douglas Debates: A Test for the Future "Great Emancipator"
Subject: Research Poster (History)
Presenters: Kathleen Morris
Faculty Sponsor: Ian Delahanty
Abstract: During Abraham Lincoln’s lifetime the country was half slave and half free. It makes sense that Lincoln could not stay away from the fray and found himself making his beliefs known many times over. This can be seen in 1858, when he went on the campaign trail to become the senator of Illinois. Lincoln found himself pitted against incumbent Stephen Douglas, a Democrat who was a proponent of slavery and self-government. In such a contest, the issue of slavery came up repeatedly.
As Lincoln reached each campaign stop in Illinois, he had to make a choice: would he stick to his own personal beliefs regarding slavery and equality, or find his beliefs shifting and changing into the mold of each city he visited? Was Lincoln truly a proponent of such beliefs?
And if so, did the viewpoints in Illinois move him to change his beliefs in order to secure the senatorial seat? To find a substantial answer to the question at hand, several sources were used, such as the work of historians, transcripts from speeches, correspondence and newspaper articles from the time. This all served to find out whether or not Lincoln’s beliefs regarding slavery and equality remained the same from place to place.
Population Abundance and Diversity via Camera Trapping in Tropical Rainforest
Subject: Research Poster (Biology)
Presenters: Kelly Lewis, Tyler Mach, Mackenzie Hand, Anna Gregory, Nickolas Gorham
Faculty Sponsors: Melinda Fowler
Abstract: Rainforest habitats are exceptionally diverse, but a common issue resides from the dense vegetation, making it difficult to measure the abundance and diversity of various species living throughout the habitat. Understanding the abundance and diversity of a population or specific species in a given area provides an important insight into competitive interactions and land-use patterns.
Within the rainforest of La Selva, Costa Rica, nine motion-sensor camera traps were placed in fixed positions, directed to capture photos on high-traffic pedestrian trails, sections of old growth forest, and amongst a river bed. Cameras were in close proximity to a rolling successional area and an adjacent, agricultural field. The total duration of camera trapping consisted of 63 trap nights, yielding hundreds of photos of both rare, as well as commonly seen species.
The rare species identified consisted of the jaguar (Panthera onca), mountain lion (Puma concolor), and ocelot (Leopardus pardalis), whereas the more commonly seen species of La Selva were the great curassow (Crax curassow), paca (Cuniculus), capybara (Hydrochoerus hydrochaeris), peccary (Tayassuidae), and agouti (Dasyprocta). After camera trap photo analysis, our findings present patterns on spatial and temporal differences within mammalian communities. An estimated calculation of species diversity and abundance obtained via camera trapping, enables further research on the ecological dynamics of a given community.
Religious Diversity in the Pioneer Valley
Subject: Research Poster (Humanities / Religion)
Presenter: Alexandra Cioni, Sarah Roulier, Jenna Safford, Jack Bixler, John Rosado, and Alicia Lacrosse
Faculty Sponsor: Katherine Dugan
Abstract: In order to understand religious diversity all around us, Religions of the World students spent a weekend exploring religious sites in western Massachusetts and Connecticut. Students toured four different religious communities, met with leaders in each tradition, and experienced the religious ritual at each house of worship. They wanted to learn how these religions are practiced and to experience new-to-them religious traditions.
This poster will present the details of their immersion experience in religious diversity in the Pioneer Valley. This class-based poster presentation will provide description and analysis of four different religious sites:
The poster will present key ideas about each religious tradition and then describe how each religious community enacts these ideas. The poster will also present key moments in each religious community’s history as well as an overview of lessons learned by students during their time at these communities. Students found that there is a wide diversity of religions practiced in this area and that the daily life of religions can vary from the way it is presented in textbooks. This poster is a snapshot of religious diversity in and around Springfield.
Background: The tibial plateau is the concave and oval shaped surface of the proximal tibia supporting the menisci and articular surface with the condyles of the femur (Fenton & Porter, 2011). Tibial plateau fractures are complex and are associated with articular depressions and soft tissue injuries (Wan, Wei & Weng, 2015). Fractures of the tibial plateau account for less than one percent of all fractures. Tibial plateau fractures occur due to an axial load combined with a varus or valgus force on the leg (Fenton & Porter, 2011). Treatment can begin conservatively for stable fractures (Forman, Karia, Davidovitch & Egol, 2013). Lateral tibial plateau fractures depressed four millimeters or more should be treated operatively (Forman et al., 2013). Internal fixation is the most common treatment for tibial plateau fractures (Fenton & Porter, 2011).
Case Presentations: A 21-year old male football player went down during a game complaining of left knee pain. The patient received a radiograph and magnetic resonance image (MRI). The patient was diagnosed with a left tibial plateau fracture. The MRI showed no ligament damage to the knee but possible avulsion of the lateral meniscus from the tibial plateau. According to Spiro et al., (2013) computed tomography (CT) is recommended for diagnosing fractures but provides poor diagnosis on soft tissue injuries. The patient received an x-ray to diagnose the fracture. A doctor examined the x-rays and made a clinical decision determining surgery was not required. The patient was non-weight bearing and wore a rehabilitation brace to immobilize the knee. The patient was treated for pain and swelling by athletic trainers. The patient had a follow up appointment four weeks post injury with a physician’s assistant (PA).
The PA requested a second doctor to examine the patient and the x-rays of the injured leg. The second doctor determined the lateral meniscus was intact and the tibia was depressed five millimeters and the doctor recommended surgery. Surgical treatment is required with depression of the bone greater than four millimeters at the fracture (Forman et al., 2013). The patient began rehabilitation exercises including quadricep sets and straight leg raises before surgery. The patient was treated with an open reduction internal fixation of the tibia four weeks post-injury. The tibia was internally fixed with a lateral tibial plateau plate. During the surgery, the meniscus was examined and a vertical tear of the anterior horn of the lateral meniscus was present. Tibial plateau fractures depression increases the probability of a lateral meniscus injury (Spiro et al., 2009). The meniscus was repaired. The patient began rehabilitation after the surgery to strengthen the quadricep muscles and gain range of motion. The patient was partially weight bearing six weeks after surgery and full weight bearing eight weeks after surgery. Non-weight bearing six weeks after surgery is supported by research (Fenton & Porter, 2011). The patient returned to limited and restricted participation in congruence with continuation of rehabilitation and follow-up appointments with the surgeon of the patient ten weeks post-injury.
Conclusions: Before the depression of the tibial plateau was found, conservative treatment was the best option due to clinical evidence of knee stability (Fenton & Porter, 2011). The best treatment after discovering the five-millimeter depression in the tibial plateau was an open reduction internal fixation surgery (Fenton & Porter, 2011). The treatment plan for the patient was supported by the research.
Clinical Bottom Line: An open reduction internal fixation surgery is the best treatment for a depressed tibial plateau fracture with a depression of 5 millimeters. Having a depressed tibial plateau fracture increases the possibility of a meniscal or soft tissue injury.