Purpose: To evaluate 2 surgical prosedures in treatment of congenital clubfeet in children younger than 24 months. Materials and methods: Data were analyzed on 319 patients (448 feet) from July 1990 to December 2005. ...Purpose: To evaluate 2 surgical prosedures in treatment of congenital clubfeet in children younger than 24 months. Materials and methods: Data were analyzed on 319 patients (448 feet) from July 1990 to December 2005. Clinical and classification for all patients according to Diméglio. Operated patients were devided into two group: Group1, selective soft tissue release;and Group 2, selective soft tissue release combined with cuboid decancelation. Surgical result were classified according to McKay’s system. Results: There were 103 females (32.3%) and 216 males (67.7%) in this study. There were 192 patients (268 feet) in group 1, 127 patients (180 feet) in group 2. Bilateral involvement was found in 129 patients (40.4%), only the left foot affected in 65 patients (20.4%), and only the right in 125 patients (39.2%). According to the classification of Diméglio Grade II was seen in 32.4%, Grade III in 53,1%, and Grade IV in 14.5%. Postoperatively, in group 1, we got excellent result in 29.1%, good result in 49.2%, fair result in 18.3%, and poor result in 3.4%. In group 2, we attained excellent result in 50.6%, good result in 42.2%, fair result in 6.1% and poor result in 1.1%. The good to excellent result in group 2 was significantly higher in group 1 with p = 0.000042. There was no failure in both groups. Residual adduction of forefoot in frontal plane was seen in 78.0% of group 1, and 10.6% of group 2, which was also statistically significant with p ~ 0. Conclusion: Generally speaking, the procedure of selective soft tissue releases combined with cuboid decancelation showed an outstanding result with good to excellent result of 92.8%. Surgical procedure is simple, safe, and applicable for all patients with clubfeet’s deformyties.展开更多
Fracture dislocation of the navicular bone~ fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and c...Fracture dislocation of the navicular bone~ fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and can be caused by forcible plantar flexion and inversion of the foot at the time of impact onto the ground. Here we reported such a case in a 35-year-old male patient who was treated by open reduction and fixation with a partially threaded screw and two K-wires for the navicular bone,and two interfragmentary screws with a one third tubular plate for the lateral malleolus. K-wires were removed 6 weeks after surgery followed by partial weight bearing. After 6 months, the patient can walk normally with minimal pain and swelling of the foot.展开更多
Accessory navicular(AN)is a developmental variation of the secondary ossification center of the navicular tuberosity.Ten percent of patients with AN will have pain symptoms that affect walking and life.As the AN chang...Accessory navicular(AN)is a developmental variation of the secondary ossification center of the navicular tuberosity.Ten percent of patients with AN will have pain symptoms that affect walking and life.As the AN changes the position of the posterior tibial tendon insertion,children with AN often have posterior tibial tendon function insufficiency and flexible flat foot.Surgical treatment is often required after failure of conservative treatment.This article reviewed the etiology,clinical manifestations,complications,and treatment methods of AN.展开更多
A 33 years old female patient presented with posttraumatic pain in the right ibot tor which radiographs of the right foot was advised. No fracture was detected on radiographs and patient was managed conservatively on ...A 33 years old female patient presented with posttraumatic pain in the right ibot tor which radiographs of the right foot was advised. No fracture was detected on radiographs and patient was managed conservatively on medications and posterior splint immobilization. We found coincidentally a short fourth metatarsal and an accessory navicular bone in the right foot radiographs. After 3 weeks of immobilization, she underwent mobilization of the right foot, weight bearing and intensive physio- therapy for 6 weeks. After two months of injury she was still complaining of pain on the plantar aspect of right foot which was diagnosed as metatarsalgia and operated on by excision of the neuroma present in the 3rd web space of the right foot. After surgery she was completely relieved of pain and could do activities well related to the right foot.展开更多
BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypi...BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypical locations are presented,and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored.Additionally,different causes of stress fractures,as well as various modalities of treatment,are highlighted.Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY Six cases of stress fractures in the calcaneus,intermediate cuneiform bone,sacrum,tibia(bilateral),navicular bone and femoral neck are presented,with different types of diagnostic imaging and treatments.All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION The type of therapeutic procedure selected should depend on the specific clinical case,i.e.,the patient’s condition and level of physical activity.展开更多
文摘Purpose: To evaluate 2 surgical prosedures in treatment of congenital clubfeet in children younger than 24 months. Materials and methods: Data were analyzed on 319 patients (448 feet) from July 1990 to December 2005. Clinical and classification for all patients according to Diméglio. Operated patients were devided into two group: Group1, selective soft tissue release;and Group 2, selective soft tissue release combined with cuboid decancelation. Surgical result were classified according to McKay’s system. Results: There were 103 females (32.3%) and 216 males (67.7%) in this study. There were 192 patients (268 feet) in group 1, 127 patients (180 feet) in group 2. Bilateral involvement was found in 129 patients (40.4%), only the left foot affected in 65 patients (20.4%), and only the right in 125 patients (39.2%). According to the classification of Diméglio Grade II was seen in 32.4%, Grade III in 53,1%, and Grade IV in 14.5%. Postoperatively, in group 1, we got excellent result in 29.1%, good result in 49.2%, fair result in 18.3%, and poor result in 3.4%. In group 2, we attained excellent result in 50.6%, good result in 42.2%, fair result in 6.1% and poor result in 1.1%. The good to excellent result in group 2 was significantly higher in group 1 with p = 0.000042. There was no failure in both groups. Residual adduction of forefoot in frontal plane was seen in 78.0% of group 1, and 10.6% of group 2, which was also statistically significant with p ~ 0. Conclusion: Generally speaking, the procedure of selective soft tissue releases combined with cuboid decancelation showed an outstanding result with good to excellent result of 92.8%. Surgical procedure is simple, safe, and applicable for all patients with clubfeet’s deformyties.
文摘Fracture dislocation of the navicular bone~ fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and can be caused by forcible plantar flexion and inversion of the foot at the time of impact onto the ground. Here we reported such a case in a 35-year-old male patient who was treated by open reduction and fixation with a partially threaded screw and two K-wires for the navicular bone,and two interfragmentary screws with a one third tubular plate for the lateral malleolus. K-wires were removed 6 weeks after surgery followed by partial weight bearing. After 6 months, the patient can walk normally with minimal pain and swelling of the foot.
文摘Accessory navicular(AN)is a developmental variation of the secondary ossification center of the navicular tuberosity.Ten percent of patients with AN will have pain symptoms that affect walking and life.As the AN changes the position of the posterior tibial tendon insertion,children with AN often have posterior tibial tendon function insufficiency and flexible flat foot.Surgical treatment is often required after failure of conservative treatment.This article reviewed the etiology,clinical manifestations,complications,and treatment methods of AN.
文摘A 33 years old female patient presented with posttraumatic pain in the right ibot tor which radiographs of the right foot was advised. No fracture was detected on radiographs and patient was managed conservatively on medications and posterior splint immobilization. We found coincidentally a short fourth metatarsal and an accessory navicular bone in the right foot radiographs. After 3 weeks of immobilization, she underwent mobilization of the right foot, weight bearing and intensive physio- therapy for 6 weeks. After two months of injury she was still complaining of pain on the plantar aspect of right foot which was diagnosed as metatarsalgia and operated on by excision of the neuroma present in the 3rd web space of the right foot. After surgery she was completely relieved of pain and could do activities well related to the right foot.
文摘BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypical locations are presented,and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored.Additionally,different causes of stress fractures,as well as various modalities of treatment,are highlighted.Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY Six cases of stress fractures in the calcaneus,intermediate cuneiform bone,sacrum,tibia(bilateral),navicular bone and femoral neck are presented,with different types of diagnostic imaging and treatments.All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION The type of therapeutic procedure selected should depend on the specific clinical case,i.e.,the patient’s condition and level of physical activity.
