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1/5. 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.
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2/5. Functional hallux rigidus in the rheumatoid foot.

    hallux rigidus results from arthritic involvement of the first metatarsophalangeal joint. The authors have observed loss of motion at this joint in patients with rheumatoid arthritis in the absence of hallux valgus or joint destruction. A hyperextension deformity of the interphalangeal joint has also been observed, with a painful callus beneath it. The first metatarsophalangeal joint appears normal on roentgenograms, and passive motion of the joint is normal when it is examined clinically. The loss of first metatarsophalangeal motion is functional, and stems from muscle spasm of the great toe intrinsic muscles in an effort to relieve pressure on the lesser metatarsal heads. The interphalangeal hyperextension may develop secondary to "functional hallux rigidus."
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3/5. Talipes equinocavovarus deformities corrected with the aid of a hinged-distraction apparatus.

    In 56 patients (70 feet) with talipes equinocavovarus, various components of deformity were surgically corrected in multiple stages with the aid of a hinged-distraction apparatus and concurrent training and rehabilitation of motion in the ankle joint. Good results were obtained in 53 feet, satisfactory results in 13 feet, and unsatisfactory results in four feet. The complications brought on by apparatus-assisted therapy of talipes equinocavovarus deformities require additional treatment but do not depreciate the method.
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4/5. stroke and its manifestations in the foot. A case report.

    CVA is a very common problem that can lead to lower extremity complications. Impairment in gait pattern occurs often due to spasticity and less frequently due to prolonged flaccidity. This problem is manifested by equinus, varus, equinovarus, and toe flexion deformities. Therefore, prevention or elimination of spasticity must be achieved. Various modalities have been used, both conservative and surgical. Nonsurgical interventions include range of motion and strengthening exercises, pharmacologic agents, local anesthetic and phenol motor point blocks, and the use of orthoses. Surgical intervention should be considered after conservative treatment has failed. The goal of treatment is to reduce the deforming force as a result of spasticity and to allow for almost normal function to be achieved. This includes tendon transfers, tendon lengthenings, tenotomies, and arthrodeses of small toe joints. Preoperatively, the extent and progression of spasticity must be determined because this may affect the rate of recurrence of the deformity following surgical correction. The combination of arthrodeses of the interphalangeal joints and flexor tendon release is the best option in the presence of a spastic deformity. arthrodesis provides for stability at the joint, whereas a flexor release eliminates the deforming force. Failure to address the plantar-flexor force of the long flexors can lead to instability at the fusion site. This may in turn lead to nonunion and recurrence of flexion contracture as shown in the case report in this article.
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5/5. Examination and management of a patient with tarsal coalition.

    The purpose of this case report is to illustrate how the literature can be used to guide clinical decisions related to a relatively uncommon pathological condition of the foot. This case report describes the approach used to examine and treat a 14-year-old boy referred by a physician for physical therapy with a diagnosis of peroneal spastic flatfoot (PSFF). Peroneal spastic flatfoot is a syndrome typically characterized by limited tarsal joint motion, a clonus response of the evertors, and a pes planus deformity. The patient reported having a limp for several years, but he said he was pain-free until he had an inversion injury of his foot. Because the physical therapists had not seen a patient with a diagnosis of PSFF, they reviewed the literature related to PSFF. They describe how their review enhanced their understanding of PSFF and how PSFF is related to the diagnosis of tarsal coalition, a pathological condition eventually identified in this child. Following 5 unsuccessful physical therapy sessions, they referred the patient to another physician who diagnosed a talocalcaneal coalition, a type of tarsal coalition.
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