1/6. Secondary reconstruction of a giant congenital lentiginous dermal nevus with serial, large-volume tissue expansion.Giant congenital pigmented nevi pose a substantial reconstructive challenge for the treating physician. Due to the increased risk of malignant transformation in such lesions, complete excision with tissue expansion or skin grafting is the generally accepted treatment. These modalities can, however, leave the patient with secondary deformities that also require complex reconstructive procedures. The following case details a patient requiring secondary reconstruction with large-volume tissue expansion 12 years after excision of a giant nevus, and split-thickness skin grafting. This patient illustrates a severe secondary deformity and the usefulness of large-volume serial expansion in such patients.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Disuse contractures in a patient with tinea manuum and irritant contact dermatitis.Disuse contractures are reported in a patient with tinea manuum and irritant contact dermatitis. The case is presented to alert the physician to the potential for this problem in any patient with a chronic fissured dermatosis of the hands.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Steroid treatment of the painful pacemaker pocket.chronic pain about a pacemaker secondary to sterile fibrotic contracture of the capsule is an uncommon but frustrating complication for both the physician and the patient. Three cases of this complication controlled by the late injection of triamcinolone are reported.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. rehabilitation after upper extremity burns.The rehabilitation of the patient with an upper extremity burn begins with the study and understanding of the magnitude of burn problems. The initial care as well as reconstruction of selected chronic deformities is presented to help the physician to develop an approach to some of the more common burn injuries.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/6. Periarticular fractures after manipulation for knee contractures in children.We report two cases, each of which sustained two separate periarticular fractures from overzealous manipulation for knee contracture. The four fractures reported in this study involve one normal child sustaining asynchronous ipsilateral distal femoral and proximal tibial fractures and a child with the diagnosis of amyoplasia sustaining bilateral proximal tibial fractures. The child with knee contracture must be treated carefully and not exposed to overzealous physiotherapy or manipulation. The child who has developed a joint contracture secondary to lengthy immobilization may be at increased risk for periarticular fracture secondary to disuse osteopenia. The knee joint is at particular risk because of the long lever arm of the leg. These concerns should be conveyed to anyone involved in the patient's care, including the parents, therapists, nurses, and physicians. Passive range of motion in the child should never be painful. Normal children often can obtain maximal range of motion if left alone and not restricted.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. Residual calcaneovalgus deformity: review of the literature and case study.The treatment of pediatric deformities is relatively common in the typical foot and ankle practice. Talipes calcaneovalgus deformity represents one of the more prevalent deformities. This postural deformity, which is present at birth, is characterized by marked dorsiflexion and valgus position of the foot in relation to the leg. It is essential that an accurate diagnosis is established early and conservative treatment instituted. In most cases, the deformity is highly responsive to conservative therapy consisting of manipulation and casting. Deformity not identified at birth or soon thereafter, or residual deformity treated later in life, presents a greater challenge to the physician. This paper is intended to provide an overview of the deformity of calcaneovalgus including a discussion of etiology, incidence, clinical and radiographic manifestations, differential diagnosis, and recommended treatment. The authors present an unusual case of residual talipes calcaneovalgus left untreated since birth and the approach to management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |