Foot & ankle最新文献_第5页

Comminuted fracture of the calcaneus associated with subluxation of the talus. 跟骨粉碎性骨折伴距骨半脱位。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400702

N A Ebraheim, E R Savolaine, K Paley, W T Jackson

{"title":"Comminuted fracture of the calcaneus associated with subluxation of the talus.","authors":"N A Ebraheim, E R Savolaine, K Paley, W T Jackson","doi":"10.1177/107110079301400702","DOIUrl":"https://doi.org/10.1177/107110079301400702","url":null,"abstract":"Two cases of complex fracture dislocation of the calcaneus having an unusual pattern of injury are described. The cases exhibit the following special characteristics: (1) fracture dislocation of the calcaneus where the primary fracture line separates the calcaneus into an anteromedial fragment that maintains its normal relationship to the talus and a posterolateral fragment that is dislocated from the subtalar joint. This posterolateral fragment moves laterally and lies adjacent to the fibula; (2) a secondary fracture line separating the lateral portion of the posterior facet from the tuberosity of the calcaneus. Both fragments are dislocated from their normal anatomical position; (3) talar tilt as shown on AP view of the ankle caused by inversion of the talus due to rupture of the lateral collateral ligament. Also, the posterolateral fragments impinging on the fibula pushes the heel downward and contributes to the talar tilt; (4) involvement of the calcaneocuboid joint; (5) dislocation of the peroneal tendons. This fracture pattern is unusual and has not been described before. Recognition of this unusual injury with subsequent and proper management may prevent major disability to the patient. Conservative treatment by casting or early range of motion is contraindicated. Closed reduction should be attempted immediately, and if not successful, a lateral approach with open reduction and internal fixation is the treatment of choice for this complex injury.","PeriodicalId":77133,"journal":{"name":"Foot & ankle","volume":"14 7","pages":"380-4"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107110079301400702","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19389850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Flexor tendon transfer for metatarsophalangeal instability of the second toe. 屈肌腱转移治疗第二趾跖趾不稳。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400703

F M Thompson, J T Deland

{"title":"Flexor tendon transfer for metatarsophalangeal instability of the second toe.","authors":"F M Thompson, J T Deland","doi":"10.1177/107110079301400703","DOIUrl":"https://doi.org/10.1177/107110079301400703","url":null,"abstract":"Flexor to extensor transfer was used to treat painful second metatarsophalangeal joint instability in thirteen feet in eleven patients. All patients had their pain reproduced with vertical stress motion of 50% to 100% at the metatarsophalangeal joint. Seven feet had concomitant hallux valgus correction, two feet had no hallux valgus, and four feet underwent no correction for asymptomatic hallux valgus. Results at an average of 33.4 months followup showed that all patients had substantial pain relief, with eight patients becoming pain-free, and five patients experiencing mild pain. All but one were satisfied with their result. Stiffness appeared to be the source of the mild residual pain. All toes, including six toes with preoperative medial crossover toe deformity, were corrected into valgus alignment with adjacent toes. All toes operated on for the first time were able to touch the ground with grasp postoperatively. Flexor to extensor transfer is successful in reducing the second toe and relieving pain caused by instability of the second metatarsophalangeal joint, but may require rapid postoperative mobilization to ensure passive dorsiflexion equal to that of the adjacent toes to reduce postoperative uncomfortable stiffness.","PeriodicalId":77133,"journal":{"name":"Foot & ankle","volume":"14 7","pages":"385-8"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107110079301400703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19389852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 81

Treatment of infected pilon nonunions with small pin fixators. 小针固定器治疗感染的阴部不连。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400701

P J Stasikelis, J H Calhoun, B R Ledbetter, D M Anger, J T Mader

{"title":"Treatment of infected pilon nonunions with small pin fixators.","authors":"P J Stasikelis, J H Calhoun, B R Ledbetter, D M Anger, J T Mader","doi":"10.1177/107110079301400701","DOIUrl":"https://doi.org/10.1177/107110079301400701","url":null,"abstract":"Six consecutive patients with infected intra-articular fractures of the distal tibia were studied. They were treated with resection of all infected or necrotic bone, systemic antibiotics, and instrumentation with a small pin fixator (Ilizarov external fixator). The fixator was used to perform an ankle arthrodesis and to fill the defect created by bone resection with distraction osteogenesis. In all cases, the infections were eradicated, and a solid arthrodesis was attained. The patients required from zero to two revision procedures (average 1.3), and their time in the fixator varied from 3 to 13 months (average 8 months). All of the patients experienced at least minor complications during treatment (superficial pin tract infections). At final follow-up, no patient demonstrated shortening of more than 1.5 cm. One patient has an internal rotation deformity of 15 degrees; a second has a varus deformity of 10 degrees and occasionally uses lateral support (a cane) secondary to unsteadiness on uneven ground; and one patient uses aspirin occasionally for subtalar pain. All are pleased with their results and would undergo the same procedure again without reservation.","PeriodicalId":77133,"journal":{"name":"Foot & ankle","volume":"14 7","pages":"373-9"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107110079301400701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19391670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 36

Achilles tendon injuries: a comparison of surgical repair versus no repair in a rat model. 跟腱损伤:大鼠模型中手术修复与不修复的比较

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400706

G A Murrell, E G Lilly, A Collins, A V Seaber, R D Goldner, T M Best

{"title":"Achilles tendon injuries: a comparison of surgical repair versus no repair in a rat model.","authors":"G A Murrell, E G Lilly, A Collins, A V Seaber, R D Goldner, T M Best","doi":"10.1177/107110079301400706","DOIUrl":"https://doi.org/10.1177/107110079301400706","url":null,"abstract":"Controversy exists regarding the treatment of Achilles tendon ruptures. The aim of this study was to determine whether surgical repair of the rat Achilles tendon offered any biomechanical, functional, or morphological advantage over no repair. Thirty-two male Sprague-Dawley rats were randomly allocated into four groups: (1) sham operated (skin incision only), (2) no repair (complete division of the Achilles tendon and plantaris tendon without repair), (3) internal splint (plantaris left intact), and (4) Achilles repair (with a modified Kessler-type suture). Functional performance was determined from the measurements of hindpaw prints utilizing the Achilles Functional Index. On day 15, the animals were killed, and biochemical and histological evaluations were performed on both the injured and uninjured Achilles tendon constructs. All groups subjected to Achilles tendon division had a significant initial functional impairment that gradually improved so that by day 15 there were no functional or failure load impairments in any group. The injured tendons in all three groups subjected to Achilles tendon division had a 13-fold increase in the cross-sectional area and were less stiff and more deformable than uninjured and sham-operated tendons on day 15 (P < .001). The magnitude of the biomechanical and morphological changes at postoperative day 15 and the initial impairment and rate of functional recovery were similar for no repair, internal splint, and Achilles repair groups. In summary, this study demonstrates that surgical repair of the Achilles tendon in the rat does not offer any advantage over nonoperative management.","PeriodicalId":77133,"journal":{"name":"Foot & ankle","volume":"14 7","pages":"400-6"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107110079301400706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19391566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 42

Fatty acid composition of normal and atrophied heel fat pad. 正常与萎缩足跟脂肪垫的脂肪酸组成。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400704

W R Buschmann, L C Hudgins, F Kummer, P Desai, M H Jahss

{"title":"Fatty acid composition of normal and atrophied heel fat pad.","authors":"W R Buschmann, L C Hudgins, F Kummer, P Desai, M H Jahss","doi":"10.1177/107110079301400704","DOIUrl":"https://doi.org/10.1177/107110079301400704","url":null,"abstract":"Capillary gas-liquid chromatography was used to analyze the fatty acid composition of normal heel fat pads from subjects without systemic disease (N = 8) and atrophied heels from patients with diabetic peripheral neuropathy (N = 4), rheumatoid arthritis (N = 1), peripheral vascular disease (N = 1), and hereditary sensory neuropathy (N = 1). In the normal subjects, the fatty acid composition of subcutaneous abdominal fat was also obtained for comparison. Three saturated fatty acids (myristate, palmitate, and stearate) and four unsaturated fatty acids (palmitoleate, oleate, vaccenate, and linoleate) comprised over 90% of the total fatty acid composition. Higher percentages of unsaturated fatty acids and lower percentages of saturated fatty acids were found in the normal heel fat pads when compared to subcutaneous abdominal fat. The increase in the ratio of unsaturated fatty acids to saturated fatty acids (4.4 versus 2.5, P < .01) may decrease triglyceride viscosity and enhance the biomechanical efficiency of the heel fat pad. Though the number of patients is small, no statistically significant compositional differences were noted between the heel fat from normal subjects and from subjects with peripheral neuropathies, rheumatoid arthritis, or peripheral vascular disease. However, the heel fatty acid composition of the one subject with a hereditary sensory neuropathy was less unsaturated and more saturated than normal with a ratio of unsaturates to saturates similar to that of the abdomen (2.8).","PeriodicalId":77133,"journal":{"name":"Foot & ankle","volume":"14 7","pages":"389-94"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/107110079301400704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19389854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Spontaneous atraumatic rupture of the flexor hallucis longus tendon under the sustentaculum tali: case report, review of the literature, and treatment options. 拇长屈肌腱在他托下的自发性非外伤性断裂:病例报告、文献回顾及治疗方案。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400709

F M Thompson, S W Snow, S J Hershon

引用次数: 41

Tarsal tunnel syndrome secondary to cosmetic silicone injections. 美容硅胶注射继发的跗骨隧道综合征。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400707

C Frey, W Naritoku, R Kerr, N Halikus

引用次数: 12

Arthrodesis of the first metatarsophalangeal joint: a biomechanical study of internal fixation techniques. 第一跖趾关节融合术:内固定技术的生物力学研究。

Foot & ankle Pub Date : 1993-09-01 DOI: 10.1177/107110079301400705

M J Curtis, M Myerson, R H Jinnah, Q G Cox, I Alexander