1/8. 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 = 1keywords = physical (Clic here for more details about this article) |
2/8. Pseudodiastrophic dysplasia: a distinct newborn skeletal dysplasia.Pseudodiastrophic dysplasia is a distinct disorder that differs from diastrophic dysplasia on the basis of clinical, radiographic, and chondro-osseous histopathologic findings. In addition to the rhizomelic shortening of the limbs and severe clubfoot deformity, which suggest the diagnosis of diastrophic dysplasia, distinguishing features are elbow and proximal interphalangeal joint dislocations, platyspondyly, and scoliosis, which are observed in infancy. This disorder has been reported previously in three infants, all of whom died in the first year of life. Two of these were sisters, suggesting autosomal recessive inheritance. We report four new patients with this distinct skeletal dysplasia, including two children now older than 4 years of age. In both of these patients neonatal contractures have improved with physical therapy and scoliosis has progressed significantly.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/8. vincristine neurotoxicity with residual equinocavus deformity in children with acute leukemia.vincristine has been demonstrated to be a neurotoxic agent with distal axonal degeneration progressing proximally. Five children with acute lymphoblastic leukemia developed bilateral peroneal nerve palsies with equinocavus deformities. Three developed fixed contractures requiring surgical correction. One patient was braced prior to development of fixed deformity and the other had physical therapy preventing fixed deformities and did not require surgery. All of the children obtained complete return of peroneal nerve function. Proper bracing and/or physical therapy at the time of diagnosis of neurologic deficit will prevent fixed contractures and the necessity for surgery.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
4/8. Use of an in-shoe pressure measurement system in the management of patients with neuropathic ulcers or metatarsalgia.Many injuries to the foot appear to be caused by repeated, excessive plantar pressures. In-shoe pressure systems are capable of measuring pressures at the interface between the shoe or orthotic and the plantar foot during a given functional activity. The purpose of this article is to describe the use of an in-shoe pressure system as a tool to aid physical therapists in the management of patients with foot problems as a result of excessive plantar pressures. Case histories are provided that describe the application of an in-shoe pressure device in the management of one patient with a neuropathic ulcer and one patient with metatarsalgia. A discussion of the primary clinical and equipment considerations of using this type of device is included.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/8. A 37-year-old man with left foot pain. Symptomatic accessory navicular synchondrosis.The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. The initial history, physical findings, and roentgenographic examinations are found on this page. The clinical and roentgenographic diagnoses are presented on the following pages.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/8. Postsurgical hindfoot deformity of a patient with rheumatoid arthritis treated with custom-made foot orthoses and shoe modifications.This case report describes the treatment of a 73-year-old woman with long-standing, severe rheumatoid arthritis, using custom-made foot orthoses and shoe modifications. The patient was referred for physical therapy 4 weeks after triple arthrodesis of her right foot. Her primary complaint was periodic unsteadiness during gait, which necessitated the use of a cane at all times. Other problems included a lower-extremity length discrepancy and right foot pain. Physical therapy included fabrication of bilateral semirigid foot orthoses, shoe modifications, gait training, and instruction in strengthening exercises. After treatment, the patient reported feeling steady during walking without a cane, and she was able to resume community activities without right foot pain. Computerized movement analysis of gait revealed that the use of orthoses and modified footwear reduced weight bearing and movement-pattern abnormalities, as compared with barefoot walking. The findings in this case show that physical therapy including foot orthoses, shoe modifications, gait training, and strengthening exercises can be instrumental in the postsurgical rehabilitation of a patient with severe rheumatoid arthritis.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
7/8. guillain-barre syndrome. review and presentation of a case with pedal manifestations.Guillan-Barre syndrome is an acute, symmetrical polyneuropathy with distinctive features. The early clinical course involves painful paresthesia that is usually followed by proximal motor weakness. Albuminocytologic dissociation in the cerebrospinal fluid is considered diagnostically important. Therapy ranges from supportive measures including physical therapy to surgical intervention for residual deformities. A case with pedal manifestations is presented.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/8. 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.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |