11/83. Correction of complex foot deformities using the Ilizarov external fixator.There are many drawbacks to using conventional approaches to the treatment of complex foot deformities, like the increased risk of neurovascular injury, soft-tissue injury, and the shortening of the foot. An alternative approach that can eliminate these problems is the Ilizarov method. In the current study, a total of 23 deformed feet in 22 patients were treated using the Ilizarov method. The etiologic factors were burn contracture, poliomyelitis, neglected and relapsed clubfoot, trauma, gun shot injury, meningitis, and leg-length discrepancy (LLD). The average age of the patients was 18.2 (5-50) years. The mean duration of fixator application was 5.1 (2-14) months. We performed corrections without an osteotomy in nine feet and with an osteotomy in 14 feet. Additional bony corrective procedures included three tibial and one femoral osteotomies for lengthening and deformity correction, and one tibiotalar arthrodesis in five separate extremities. At the time of fixator removal, a plantigrade foot was achieved in 21 of the 23 feet by pressure mat analysis. Compared to preoperative status, gait was subjectively improved in all patients. Follow-up time from surgery averaged 25 months (13-38). Pin-tract problems were observed in all cases. Other complications were toe contractures in two feet, metatarsophalangeal subluxation from flexor tendon contractures in one foot, incomplete osteotomy in one foot, residual deformity in two feet, and recurrence of deformity in one foot. Our results indicate that the Ilizarov method is an effective alternative means of correcting complex foot deformities, especially in feet that previously have undergone surgery.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
12/83. Cavus deformity of the foot after fracture of the tibial shaft.Twenty-three cases of claw foot with limited talocrural and subtalar mobility were the result of muscle contracture of the leg after tibial-shaft fracture. A roentgenographic study including arteriography was performed. It was concluded that the typical short cavus foot is due to fibrous contracture of the muscles in the deep posterior compartment caused by vascular damage, swelling in the deep posterior compartment, or severe muscle laceration. On physical examination the distance between the lateral malleolus and the achilles tendon was shortened in comparison with the sound side in all cases. This was found to be caused by dorsiflexion in the talocrural joint coincident with adduction in the mid-tarsal joint. The angulation of the foot forced the patients to rotate the leg outward in order to get the feet in parallel position for walking. This deformity could be misinterpreted as an inward malrotation of the tibial fracture. In severe cases a derotating three-dimensional wedge osteotomy of the distal part of the tibia was performed with promising results.- - - - - - - - - - ranking = 1.6666666666667keywords = deformity (Clic here for more details about this article) |
13/83. Checkrein deformity--flexor hallucis tethering: two case reports.The authors present two cases of checkrein deformity, a tethering of the flexor hallucis longus (FHL) tendon, following ankle surgery. The first case was treated by tenolysis and tendon lengthening posterior to the ankle. The second case was treated by lengthening of the FHL at the midfoot, a more simple procedure which produced a better outcome and faster recovery. The authors recommend this latter treatment should be considered to treat this problem.- - - - - - - - - - ranking = 1.6666666666667keywords = deformity (Clic here for more details about this article) |
14/83. The effect of ankle equinus upon the diabetic foot.The association between ankle equinus and common foot pathologies such as Achilles tendinitis, metatarsalgia, Morton's neuroma, hallux abductovalgus, and plantar fasciitis has been described. However, the association between ankle equinus and diabetic foot pathology has only been recognized recently. Over half of the non-traumatic amputations occurring in the united states are related to complications of diabetes. It is imperative that risk factors for lower extremity ulceration and amputation are identified and addressed. This article reviews the effect of ankle equinus deformity on the diabetic foot and the available treatment options. New data on the prevalence of equinus in a population of patients with diabetes are also presented.- - - - - - - - - - ranking = 0.33333333333333keywords = deformity (Clic here for more details about this article) |
15/83. Dislocation of the talonavicular joint: case report.Dislocation of the talonavicular joint is rare, caused by severe abduction or adduction of the forefoot. Proper reduction is necessary to avoid equinovarus deformity, ankylosis, or degenerative arthritis. A case of talonavicular dislocation with fracture of the head of the talus in a 52-year old woman is reported, with delayed treatment by open reduction using Kirschner wires and casting for 7 weeks. This patient is successfully employed as a waitress 2 years postinjury.- - - - - - - - - - ranking = 0.33333333333333keywords = deformity (Clic here for more details about this article) |
16/83. Tibialis spastic varus foot caused by osteoid osteoma of the calcaneus.Tibialis spastic varus foot is an extremely rare condition. A 30-year-old man had tibialis spastic varus foot caused by juxtaarticular osteoid osteoma of the calcaneus. The correct diagnosis was delayed because the symptoms were similar to arthritis and the nidus was difficult to detect on plain radiographs. curettage of the tumor was done, and the osseous defect was filled with interporous hydroxyapatite. The pain was relieved immediately after surgery. The varus deformity of the foot and spasm of the tibialis anterior muscle gradually improved. Three years 10 months after surgery, the patient was pain-free and the spasm of the tibialis anterior muscle had disappeared. The varus deformity and motion of the foot improved, but a restricted range of motion remained. To the authors' knowledge, there have been no published descriptions of tibialis spastic varus foot caused by juxtaarticular osteoid osteoma of the calcaneus.- - - - - - - - - - ranking = 0.66666666666667keywords = deformity (Clic here for more details about this article) |
17/83. Enlargement of the entire posterior aspect of the calcaneus: treatment with the Keck and Kelly calcaneal osteotomy.Painful enlargement of the entire posterior aspect of the calcaneus can be difficult to effectively treat and must be differentiated from a classical Haglund's deformity. Clinical, radiographic, and surgical treatments of this deformity will be discussed. An illustrative case presentation is also included.- - - - - - - - - - ranking = 0.66666666666667keywords = deformity (Clic here for more details about this article) |
18/83. adult-onset idiopathic progressive acro-osteolysis with proximal symphalangism.We experienced a 57-year-old female with adult-onset non-congenital idiopathic acro-osteolysis combined with proximal symphalangism. At the age of 36, she developed severe pain and swelling of the toe base of both feet and underwent Clayton surgery. However, the size of her toes diminished progressively over the 5-year period after surgery. At the age of 41, she suffered pain and swelling of the proximal interphalangeal (PIP) joints of fingers of both hands. These PIP joints became rigid and inflexible. Subsequently, she noticed shortening of the little finger of both hands, followed later by shortening of the index, middle, and ring fingers. At the age of 57, the thumbs began to shorten. Laboratory and endocrinological examinations were not abnormal. Finally, we diagnosed her with acro-osteolysis combined with proximal symphalangism by radiological examination. In this case, previously unreported mutations of the Noggin gene were identified. This is the first case report of adult-onset, non-congenital idiopathic acro-osteolysis combined with proximal symphalangism.- - - - - - - - - - ranking = 9.2578093628477E-5keywords = hand (Clic here for more details about this article) |
19/83. Chronic mucocutaneous candidiasis: a case report.Chronic mucocutaneous candidiasis is a immuno deficiency disorder primarily due to T cell dysfunction characterized by persistent candidal infection of mucous membrane, skin, scalp and nails. Chronic mucous membrane candidiasis has an onset in infancy or childhood; the primary affected site is the oral cavity; however, lesions may occur on trunk, hands, feet and scalp. This paper describes a 12-year-old girl with candidial infection of the oral mucosa and extra oral involvement of fingers, nails, toes and intertragus area.- - - - - - - - - - ranking = 4.6289046814238E-5keywords = hand (Clic here for more details about this article) |
20/83. proteus syndrome.proteus syndrome is a rare congenital disorder that is characterized by a wide variety of deformities including macrodactyly. skin and soft tissue lesions are common; they may increase in size as the child develops and may assume tremendous proportions. The syndrome is often mistaken for other more commonly recognized conditions such as neurofibromatosis. Unlike neurofibromatosis, the soft tissue masses in proteus syndrome are not nerve tumors but, rather, are hamartomas composed primarily of lipomatous tissue. The hand surgeon should be aware of this condition when evaluating a child with macrodactyly.- - - - - - - - - - ranking = 4.6289046814238E-5keywords = hand (Clic here for more details about this article) |
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