Concurrent Interdigital Neuroma and MTP Joint Instability: Long-term Results of Treatment

2002 ◽  
Vol 23 (11) ◽  
pp. 1018-1025 ◽  
Author(s):  
Michael J. Coughlin ◽  
Robert C. Schenck ◽  
Paul J. Shurnas ◽  
David M. Bloome
Keyword(s):  
Surgical Treatment ◽  
Joint Instability ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
Radiographic Examination ◽  
Common Source ◽  
Persistent Symptoms ◽  
Second Toe

Introduction: An interdigital neuroma is a common source of forefoot pain, and while second metatarsophalangeal joint instability is a less common entity, it can be a concomitant source of pain. The purpose of this study was to evaluate the long-term clinical course and surgical outcomes of the treatment of these concomitant problems. Methods: 121 consecutive patients (131 feet and 136 neuromas) were evaluated and treated for a symptomatic interdigital neuroma from 1981 to 1997. Of these, 24 patients (20%) had a concurrent interdigital neuroma (IDN) and second metatarsophalangeal (MTP) capsular instability that underwent surgical treatment. At the final follow-up examination, 20 patients (21 feet) were evaluated by an independent orthopaedic surgeon with a standardized clinical and radiographic examination, patient self-assessment and outcome measures. Results: Overall, there were 18 females and two males (21 feet) treated with an average age of 54 years at the time of surgery that returned for examination and follow-up at an average of 80 months (48 to 108 months) following surgery. Seventeen patients (85%) rated their result as good or excellent and three as fair. Six patients had mild continued symptoms referable to the second toe and none to the neuroma. Simultaneous neuroma excision and second MTP stabilization was performed in 15 cases and in six cases a staged repair was performed. The mean visual analog pain score was 1.4 (0 = no pain, 10 = severe pain) and mean MHAQ score was 1.13 (1–1.625) with activity modification stemming from hip, back and knee complaints. Conclusion: With careful patient selection and preoperative assessment, resection of an interdigital neuroma and stabilization of second metatarsophalangeal joint instability resulted in a high percentage of successful results at greater than four years following the procedure. Objective results were comparable to previous reports on the surgical treatment of isolated interdigital neuroma and crossover second toe reconstruction. Subjective patient satisfaction was high but both subjective and objective results were lower in patients with persistent symptoms of MTP instability.

scholarly journals Treatment of Injuries of the Lumbar Spine

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Thoracolumbar Spine ◽  
Spinal Injuries ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

Gamma Knife thalamotomy for treatment of essential tremor: long-term results

2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Ronald F. Young ◽  
Francisco Li ◽  
Sandra Vermeulen ◽  
Robert Meier
Keyword(s):  
Surgical Treatment ◽  
Essential Tremor ◽  
Gamma Knife ◽  
Surgical Intervention ◽  
Long Term Results ◽  
The Mean ◽  
Lost To Follow Up ◽  
Deep Brain

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.

scholarly journals Long-term Results of Hemiarthroplasty for Osteoarthritis of the First Metatarsophalangeal Joint

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Stefan Beekhuizen ◽  
Ron Onstenk
Keyword(s):  
Patient Satisfaction ◽  
Scale Score ◽  
Operative Treatment ◽  
Primary Outcome ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Satisfaction Rates

Category: Big toe, MTP-1 joint osteoarthritis Introduction/Purpose: Osteoarthritis of the first metatarsophalangeal joint is the second most common disorder affecting the hallux. If non-operative treatment is not efficacious, operative treatment should be considered. Arthrodesis is considered standard care for grade III and IV osteoarthritis of the first metatarsophalangeal joint. If preservation of joint mobility is preferred, implant arthroplasty could be considered. Total arthroplasty is less recommendable because of high failure rates. However, recent studies showed similar short term results after arthrodesis and hemi joint replacement with greater satisfaction rates, as well as low postoperative pain, after hemiarthroplasty. In our study we mainly focussed on long-term subjective results like patient satisfaction as well as patient recommendation for the performed procedure including our primary outcome; the postoperative AOFAS HMI score. Methods: We therefore evaluated primary arthrodesis and hemiarthroplasty as treatment for arthritis of the first metatarsophalangeal joint. All 102 patients operated between January 2005 and December 2011 were asked to participate in our study, sixty-seven patients responded and were included. Forty-seven arthrodesis were performed in 40 patients using different fixation techniques and thirty-one hemiarthroplasties were performed in 27 patients using the BiopPro® First MPJ implant. Both procedures performed for stage 3 or 4 osteoarthritis and patients had been followed for at least five years, the American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scale score was measured as primary outcome. Secondary outcomes addressed satisfaction rates, recommendation of the performed procedure, number of unplanned surgical repeat procedures, return to daily activities (work as well as sports), and influence of smoking and diabetes mellitus on postoperative results. Finally, financial costs for both procedures were calculated. Results: The 47 primary arthrodeses and 31 hemiarthroplasties performed between January 2005 and December 2011 were evaluated. After a mean follow-up of 8.3 years (range 5-11.8) the mean AOFAS-HMI scale score after arthrodesis and after hemiarthroplasty were 72.8±14.5 and 89.7±6.6 respectively (p =.001). Patients were significantly more pleased after hemiarthroplasty (p<.001) and this procedure was better recommended (p<.001). The number of unplanned repeat surgical procedures did not differ between the two groups. No differences were found in postoperative work resumption, but patients returned to sports significantly sooner after hemiarthroplasty (p=.002). No association was found between smoking and the total AOFAS-HMI score. Overall costs, the sum of procedure costs as wel as additional costs, were quite similar for both procedures. Conclusion: Higher postoperative AOFAS HMI scores after a long-term follow-up (mean 8.3 years, range 5-11.8 years) were found after hemiarthroplasty compared to arthrodesis of the MTP-1 joint. Also greater patient satisfaction and better recommendation is seen after hemiarthroplasty. However return to work showed no differences, a significantly faster return to sports was seen after hemiarthoplasty. Based on these long-term results we could recommend hemiarthroplasty in future patient with osteoarthritis of the MTP-1 joint, with modest preference for the younger, more active patients.

Long-Term Results of the Surgical Treatment of Spinal Dermoid and Epidermoid Tumors.

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 860-864 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Franco M. Gagliardi ◽  
Aldo Fortuna
Keyword(s):  
Surgical Treatment ◽  
Nervous Tissue ◽  
Working Life ◽  
Clinical Findings ◽  
Long Term Results ◽  
Tumor Capsule ◽  
Follow Up Study

Abstract The clinical findings and the results of surgical treatment in 16 patients with spinal dermoid or epidermoid tumors are reported. In 9 patients the tumor capsule adhered so tightly to the nervous tissue that part of it was left in situ. In a follow-up study ranging from 5 to 30 years with a mean of 14.2 years only 1 patient had a recurrence of the tumor and 10 patients resumed a normal working life.

Evaluation of Metatarsal Head Resurfacing Hemiarthroplasty in the Surgical Treatment of Hallux Rigidus: A Retrospective Study and Mid- to Long-Term Follow-up

2017 ◽  
Vol 11 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Musa Uğur Mermerkaya ◽  
Erkan Alkan ◽  
Mehmet Ayvaz
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Treatment Method ◽  
Hallux Rigidus ◽  
Retrospective Case ◽  
First Metatarsophalangeal Joint

Background. The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final follow-up visit (P < .001). The median preoperative first MTPJ ROM was 25° (range = 15° to 40°), which had increased to 75° (range = 30° to 85°) at the final follow-up visit (P < .001). Conclusions. First MTPJ hemiarthroplasty is an effective treatment method that recovers toe function and first MTPJ ROM, and provides good mid- to long-term functional outcomes. Levels of Evidence: Level IV: Retrospective case series

The Donor Foot in Free Toe or Joint Transfers

2000 ◽  
Vol 25 (4) ◽  
pp. 382-384 ◽  
Author(s):  
X. B. YANG ◽  
Y. D. GU
Keyword(s):  
Metatarsophalangeal Joint ◽  
Foot Deformities ◽  
Case Review ◽  
Dorsal Aspect ◽  
Mild Reduction ◽  
Second Toe

Eighty-four cases of free second toe, multiple toe or second metatarsophalangeal joint transfers were studied by case review and follow-up. The function of the donor foot had recovered completely within 6 months in 89% of patients. The wounds on the donor foot healed in 2–3 weeks in 90% of patients. Slight numbness on the dorsal aspect of the donor foot, intolerance to cold, mild reduction in push-off, scar tenderness and pain or swelling occurred in only a few patients and generally were not considered of significance. Multiple toe transfers created more donor problems in terms of healing and appearance. Some foot deformities with plantar callosities were observed at long term review. However, all patients were capable of work and normal activities.

scholarly journals LAPAROSCOPIC ADRENALECTOMY IN SURGICAL TREATMENT OF ADRENANOCORTICAL CARCINOMA

2019 ◽  
Vol 21 (1) ◽  
pp. 75-78
Author(s):  
A V Krivosheev ◽  
T A Britvin ◽  
M E Beloshitsky
Keyword(s):  
Surgical Treatment ◽  
Laparoscopic Adrenalectomy ◽  
Distant Metastases ◽  
Long Term Results ◽  
R0 Resection ◽  
Morphological Examination ◽  
Number Of Patients ◽  
Immunohistochemical Studies

Relevance of research: аdrenalectomy remains the only method of potentially radical treatment of adrenocortical carcinoma (AСС), and the complete resection is considered one of the leading factors in the prognosis of disease. The question of the possibility and feasibility of using video- endoscopic technologies in the treatment of patients with ACC is still being discussed. Objective: the purpose of our study was to evaluate the effectiveness of laparoscopic adrenalectomy in the treatment of ACC patients. Material and methods: the study is based on the analysis of the results of diagnostics and surgical treatment of 12 patients who underwent laparoscopic adrenalectomy and verified ACC during histological and immunohistochemical studies. Results: stage I were verified (according to the ENSAT) in 4 cases, in 4 - II stage, and in 4 - III stage. The median of tumor size was 4.9 cm. Intraoperative and postoperative complications did not occur. In all cases, the R0-resection was confirmed by morphological examination. The median patient follow-up was 71 months (1; 141), during this period 11 patients were alive, 1 patient, who had surgery in stage III died of disease progression (distant metastases) 49 months after surgery. During the follow-up period tumor recurrence did not occur. Overall 5-year survival was 75% (95% CI; 30-95%). Conclusion: despite the small number of patients included in this study, satisfactory immediate results (absence of complications, R0-resection) and long-term results allow us to consider video- endoscopic surgery as an effective treatment for patients with ACC.

scholarly journals Surgical Treatment of Severe Idiopathic Flexible Flatfoot by Evans–Mosca Technique in Adolescent Patients: A Long-Term Follow-Up Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Vincenzo De Luna ◽  
Fernando De Maio ◽  
Alessandro Caterini ◽  
Martina Marsiolo ◽  
Lidio Petrungaro ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Adolescent Patients ◽  
The Mean

Flexible idiopathic flatfoot is very common in growing age and rarely causes pain or disability. Surgery is indicated only in severe symptomatic cases that are resistant to conservative treatment, and numerous surgical procedures have been proposed. Lateral column calcaneal lengthening as described by Evans and modified by Mosca is a widely used surgical technique for the correction of severe symptomatic flexible flatfoot. In the present study, we report the long-term clinical and radiographic results in 14 adolescent patients (mean age: 12.8 years) affected by severe symptomatic flexible flatfoot, surgically treated by Evans–Mosca procedure, for a total of 26 treated feet (12 cases bilateral and 2 unilateral). In all cases, surgery was indicated for the presence of significant symptoms resistant to nonsurgical management. Clinical evaluation was made according to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale, the Foot and Ankle Disability Index (FADI) Score, and Yoo et al.’s criteria. Radiographic evaluation was made using anteroposterior and lateral weight-bearing radiographs of the feet to evaluate Meary’s angle and Costa–Bertani’s angle and to evaluate possible osteoarthritic changes in the midtarsal joints. At follow-up (mean: 7 years and 7 months), we observed a satisfactory result in all patients. The mean average score of the AOFAS Ankle-Hindfoot Scale improved from 60.03 points to 95.26; the mean FADI score improved from 71.41 to 97.44; and according to Yoo et al.’s criteria, the average clinical outcome score was 10.96. At radiographic examination, nonunion of the calcaneal osteotomy was never observed. Meary’s angle improved from an average preoperative value of 25° to 1.38° at follow-up; Costa–Bertani’s angle improved from an average preoperative value of 154.2° to 130.9° at follow-up. In no case, significant radiographic signs of midtarsal joint arthritis were observed. According to our results, we believe that Evans–Mosca technique is a valid option of surgical treatment for severe idiopathic flexible flatfoot and allows a satisfactory correction of the deformity with a low rate of complications.

scholarly journals PRIMARY-MULTIPLE TUMORS IN PATIENTS WITH NEOPLASMS OF THYROID GLAND

2015 ◽  
Vol 174 (2) ◽  
pp. 70-76
Author(s):  
A. F. Romanchishen ◽  
K. V. Vabalaite
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Chemical Nature ◽  
Malignant Tumors ◽  
Long Term Results ◽  
Occupational Hazard ◽  
Other Neoplasms

The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.

scholarly journals LIVER HYDATIDOSIS: OPTIMIZATION OF SURGICAL TREATMENT METHODS

2018 ◽  
Vol 3 (4) ◽  
pp. 20-26
Author(s):  
S A Ivanov ◽  
M V Kenarskaya ◽  
K A Panfilov
Keyword(s):  
Data Analysis ◽  
Surgical Treatment ◽  
Postoperative Mortality ◽  
Liver Cyst ◽  
Long Term Results ◽  
Modern Approach ◽  
Liver Hydatidosis ◽  
Hepatic Echinococcosis

Objectives - optimization of hepatic echinococcosis treatment schemes based on the data analysis of the immediate and long-term results. Material and methods. The study included 373 clinical cases of patients with liver echinococcosis who received treatment in 2005-2018 in Samara Regional Clinical Hospital n. a. V.D. Seredavin. 342 patients underwent a traditional operation, the surgical puncture was performed in 31 patient. Starting from 2003 all patients received the antirelapse chemotherapy with albendazole according to the WHO's recommendations in the postoperative period. Results. The treatment tactics in patients with liver hydatidosis was defined according to the parasite's developmental stage, its localization, and the size of liver cyst. The traditional surgery was successful after one operation in more than 93% of cases, postoperative mortality was 1.46%, the number of postoperative complications - 12.5%, the number of relapses in 5 year follow-up period was 6.8%. In 31 patients we used the puncture surgery treatment of hepatic echinococcosis PAIR and PEVAC-methods. Conclusion. Modern approach to hepatic echinococcosis treatment should provide differentiated

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