Clinical Results of Simultaneous Adjacent Interdigital Neurectomy in the Foot

1996 ◽  
Vol 17 (5) ◽  
pp. 264-268 ◽  
Author(s):  
Roy S. Benedetti ◽  
Donald E. Baxter ◽  
Pamela F. Davis
Keyword(s):  
Surgical Excision ◽  
Metatarsal Head ◽  
Clinical Results ◽  
Sensory Loss ◽  
Residual Symptoms ◽  
The Third ◽  
Significant Pain ◽  
Plantar Aspect ◽  
Web Space

Fifteen patients (19 feet) who underwent simultaneous surgical excision of two primary interdigital neuromas in adjacent web spaces of the foot were studied retrospectively. There were 11 female patients (73%). The average age of the patients was 54.4 years. Other causes of multiple web space tenderness were excluded prior to surgical resection of both neuromas. At an average follow-up of 68.6 months (range, 32–113 months), 10 feet (53%) had complete resolution of symptoms and six feet (31%) had minimal residual symptoms. Three feet in two patients (16%) continued to have significant pain after surgery. One sequela of the procedure was dense sensory loss of the plantar aspect of the third metatarsal head to the tip of the third toe. There was also proximal dorsal sensory loss to the second, third, and fourth toes which was a function of the type of incision used. The sensory loss did not cause disability in the patients, but did cause some awkwardness with nail care. Resection of adjacent interdigital neuromas, although rarely indicated, can be expected to provide significant pain relief in 84% of patients, which is similar to results reported for resection of a single neuroma.

Plantar Dislocation of the Metatarsophalangeal Joint: Case Report

1994 ◽  
Vol 15 (8) ◽  
pp. 446-449 ◽  
Author(s):  
Kenneth A. Stephenson ◽  
Timothy L. Beck ◽  
E. Greer Richardson
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Kirschner Wire ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
The Third ◽  
Vehicle Accident ◽  
Plantar Aspect ◽  
Patient Reported ◽  
Metatarsophalangeal Joints

Dislocations of lesser metatarsophalangeal joints are rare and are almost always dorsal hyperextension injuries. The patient reported sustained plantar dislocations of the second and third metatarsophalangeal joints in a motor vehicle accident; the mechanism of injury was hyperflexion. Closed reduction was not possible, and at the time of open reduction, the extensor digitorum longus and brevis tendons to the third toe were trapped beneath the plantar aspect of the third metatarsal head. Once the tendons were retracted dorsomedially, the joint was easily reduced. Fixation with a Kirschner wire was necessary because of joint instability.

scholarly journals Distal Linear Metatarsal Osteotomy Combined with Akin Osteotomy for Hallux Valgus with Hallux Valgus Interphalangeus

2019 ◽  
Vol 13 (1) ◽  
pp. 34-41
Author(s):  
Kazuki Kanazawa ◽  
Ichiro Yoshimura ◽  
Tomonobu Hagio ◽  
Takuaki Yamamoto
Keyword(s):  
Hallux Valgus ◽  
Metatarsal Head ◽  
Clinical Results ◽  
Osteotomy Site ◽  
Metatarsal Osteotomy ◽  
Intermetatarsal Angle ◽  
Hallux Valgus Interphalangeus ◽  
Valgus Angle ◽  
Akin Osteotomy

Background: Minimally invasive distal linear metatarsal osteotomy is commonly performed to correct mild-to-moderate hallux valgus. The technique is easy to perform, fast, and has a low complication rate with satisfactory clinical results. However, it has so far not been applied to hallux valgus with concomitant hallux valgus interphalangeus deformity. Objective: We aimed to investigate the short-term clinical results of distal linear metatarsal osteotomy combined with Akin osteotomy in hallux valgus with concomitant hallux valgus interphalangeus deformity. Methods: We retrospectively reviewed 10 patients (10 feet) who underwent surgery for hallux valgus with hallux valgus interphalangeus between 2012 and 2016. Akin osteotomy was performed and fixated with a screw/K-wire, followed by distal linear metatarsal osteotomy and K-wire fixation. Clinical evaluations pre- and postoperatively used the Japan Society for Surgery of the Foot (JSSF) scale and the Visual Analog Scale (VAS). Radiography pre-and postoperatively assessed the hallux valgus, hallux valgus interphalangeus, and the intermetatarsal angle. Results: The mean follow-up period was 20.2 months. Both the JSSF and VAS score improved significantly, from 64.5 to 90.0 and from 5.5 to 1.1, respectively. In all patients, bone healing was complete within four months with no osteonecrosis of the metatarsal head or malunion at the osteotomy site. The hallux valgus angle improved from 31.5° to 7.7°, the hallux valgus interphalangeus angle from 17.2° to 5.8°, and the intermetatarsal angle from 11.7° to 5.5°. Conclusion: Distal linear metatarsal osteotomy combined with Akin osteotomy safely and effectively corrects mild-to-moderate hallux valgus with hallux valgus interphalangeus deformity.

scholarly journals A Recurrence of a Giant Odontogenic Keratocyst: Radiographic Follow-Up

2018 ◽  
Vol 1 (1) ◽  
pp. 42-46
Author(s):  
Luis Alberto Mendez ◽  
Ricardo Martinez ◽  
David Josue Echavarria ◽  
Raul Antonio Gonzalez
Keyword(s):  
Periodontal Disease ◽  
Clinical Evaluation ◽  
Surgical Excision ◽  
The Body ◽  
Dental School ◽  
Odontogenic Keratocyst ◽  
Imaging Studies ◽  
Central Lesion ◽  
The Third

Odontogenic keratocyst could be a very aggressive lesion which may be imperceptible for the patient, not giving any type of symptomatology. This is usually discovered as a finding during a clinical evaluation of the maxillofacial area. The diagnosis of this lesion is merely histological, although it has some radiographic features that presumptively indicate the diagnosis. During a dental school brigade a patient came referring dental mobility, periodontal disease was absent and oral examination revealed a large swelling identified in the body of the mandible. Imaging studies revealed a large central lesion diagnosed as OKC when biopsy was performed. After enucleation and curettage of the lesion radiographic follow-up was conducted every six months, at the third six month period recurrence of the lesion was present and surgical excision was performed with the recommendation of and strict radiographic follow-up in quarterly periods.

scholarly journals Primary ovarian carcinoid tumor: a report of 4 cases

2017 ◽  
Vol 4 (8) ◽  
pp. 2826 ◽  
Author(s):  
H. Salhi ◽  
B. Laamouri ◽  
N. Boujelbène ◽  
J. B. Hassouna ◽  
T. Dhiab ◽  
...  
Keyword(s):  
Carcinoid Tumor ◽  
Radical Surgery ◽  
Cystic Teratoma ◽  
Surgical Excision ◽  
Clinical Results ◽  
Disease Recurrence ◽  
Carcinoid Tumors ◽  
Stage Iii ◽  
Pathological Findings

Ovarian carcinoid tumor is a rare neoplasm that account for 0.3% of all ovarian tumors. It is commonly seen in perimenopausal and postmenopausal women. The aim of this study is to investigate the clinical features and to evaluate the treatment of this rare tumor. The study reviewed retrospectively the clinical and pathological findings of 4 cases of primary OCT treated in Salah Azaiez Institute between 1994 and 2012. The median age was 50 years (ranging from 28 to 75 years). All the patients underwent radical surgery. Two patients had carcinoid tumors occurring in mature cystic teratoma. Three patients had stage I diseases, and one patient had stage III disease, this patient had adjuvant chemotherapy. The follow up median was 23 months. There was one case of bone and lung metastasis diagnosed in the patient who had stage III disease, fourteen months after the surgery but the patient died of her disease four month later. The other patients were alive without evidence of disease recurrence. Primary Ovarian carcinoid tumors are most of the time associated with good clinical results. Surgical excision of the tumor is usually sufficient treatment for most of the patients

Cavernous Malformations in and Around the Third Ventricle: Indications, Approaches, and Outcomes

2019 ◽  
Vol 18 (6) ◽  
pp. 736-746
Author(s):  
M Neil Woodall ◽  
Joshua S Catapano ◽  
Michael T Lawton ◽  
Robert F Spetzler
Keyword(s):  
Third Ventricle ◽  
Lateral Wall ◽  
Clinical Results ◽  
Extent Of Resection ◽  
Subtotal Resection ◽  
Total Resection ◽  
Cavernous Malformations ◽  
Presenting Symptoms ◽  
The Third

Abstract BACKGROUND Cavernous malformations in structures in and around the third ventricle are a challenging conceptual and surgical problem. No consensus exists on the ideal approach to such lesions. OBJECTIVE To perform a retrospective review of our institutional database to identify and evaluate approaches used to treat cavernous malformations located in and around the third ventricle. METHODS Information was extracted regarding lesion size and location, extent of resection, time to last follow-up, surgical approach, presenting symptoms, preoperative and postoperative neurological status, and specific approach-related morbidity. RESULTS All 39 neurosurgical operations (in 36 patients) were either an anterior interhemispheric (AIH) (44%, 17/39) or a supracerebellar infratentorial (SCIT) (56%, 22/39) approach. Gross-total resection was achieved in 23 of 39 procedures (59%), a near-total resection in 1 (3%), and subtotal resection in 15 (38%). For the 31 patients with at least 3 mo of follow-up, the mean modified Rankin Scale (mRS) score was 1.5. Of the 31 patients, 25 (81%) had an mRS score of 0 to 2, 4 had a mRS score of 3 (13%), and 1 each had a mRS score of 4 (3%) or 5 (3%). CONCLUSION Most approaches to cavernous malformations in and around the third ventricle treated at our institution have been either an AIH or a SCIT approach. The AIH approach was used for lesions involving the lateral wall of the third ventricle or the midline third ventricular floor, whereas the SCIT approach was used for lesions extending from the third ventricle into the dorsolateral midbrain, with acceptable clinical results.

Pediatric Subtalar Joint Synovial Chondromatosis

2015 ◽  
Vol 105 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Balaji Saibaba ◽  
Pebam Sudesh ◽  
Gokul Govindan ◽  
Mahesh Prakash
Keyword(s):  
Lower Limb ◽  
Subtalar Joint ◽  
Clinical Presentation ◽  
Surgical Excision ◽  
Synovial Chondromatosis ◽  
Age Group ◽  
The Third ◽  
Synovial Osteochondromatosis ◽  
Pediatric Age Group

Synovial chondromatosis is a rare, usually benign disorder affecting the population predominantly in the third and fourth decades of life and mainly involving the large weightbearing joints of the lower limb—the knees and the hip. In this report, we highlight an unusual pediatric clinical presentation of synovial osteochondromatosis involving the subtalar joint and discuss its surgical management; we also provide a comprehensive up-to-date literature review of the disorder. This patient was successfully treated with en masse surgical excision. He has been doing well, with complete pain relief and improved range of motion at 1-year follow-up. An exceptional involvement of the subtalar joint and an unusual presentation in the pediatric age group makes this case unique.

The Weil Osteotomy of the Lesser Metatarsals: a Clinical and Pedobarographic Follow-up Study

2000 ◽  
Vol 21 (5) ◽  
pp. 370-374 ◽  
Author(s):  
Geoffroy Vandeputte ◽  
Greta Dereymaeker ◽  
Annie Steenwerckx ◽  
Louis Peeraer
Keyword(s):  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Clinical Results ◽  
Complete Disappearance ◽  
Joint Range Of Motion ◽  
Shortening Osteotomy ◽  
Joint Range ◽  
Metatarsophalangeal Joints ◽  
Mtp Joints

The clinical results with pedobarographic analysis were assessed in 32 patients (59 metatarsals) who underwent a distal metatarsal shortening (Weil) osteotomy for either intractable plantar keratoses or chronically dislocated lesser metatarsal phalangeal joints. All patients had increased pressure under the involved metatarsal heads. Thirty three of the 59 metatarsophalangeal (MTP) joints were chronically dislocated. At an average follow-up of 30 months, patients rated the result as excellent or good for 32 of the 37 feet (86%). The mean preoperative AOFAS score was 59 (maximum 100), which improved to 81 postoperatively. This difference is significant : p= 0,00001 (with t-test). Comparison of the pre and post-operative pedobarographic measurements showed a significant decreased load under the affected metatarsal heads (p = 0.05). A complete disappearance of the callus was noted under 44 operated metatarsals (75%) and partial disappearance under 12 metatarsals (20%). Two symptomatic transfer lesions occurred under an adjacent metatarsal head. Recurrent dislocations occurred in 5 joints (15%). While metatarsophalangeal joint range of motion was significantly diminished, toe strength was maintained. Average metatarsal shortening was 5.9 mm with no nonunions, delayed unions, or malunions. The Weil shortening osteotomy is a simple and reliable procedure which can effectively reduce the load under the lesser metatarsophalangeal joints and is helpful for the reduction of dorsally dislocated MTP joints.

scholarly journals Hemangioblastoma in the Lung: Metastatic or Primary Lesions?

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Li Lu ◽  
Peter A. Drew ◽  
Anthony T. Yachnis
Keyword(s):  
Case Report ◽  
Posterior Fossa ◽  
Surgical Excision ◽  
Metastatic Tumor ◽  
Lung Nodules ◽  
Pathological Study ◽  
The Third ◽  
History Of ◽  
Multiple Lung Nodules

Hemangioblastoma primarily occurs in the CNS, most commonly in the posterior fossa. Extracranial locations are less common, and metastatic tumor involving the lung is exceedingly rare with only three cases previously reported. Two were autopsy studies in patients who died of complications of the CNS hemangioblastomas in 1943 and 1981, and the third was mentioned in a case report addendum providing follow-up information on hepatic hemangioblastoma in 1991. We report a case of a 48-year-old man who presented with multiple lung nodules treated by surgical excision. Pathological study revealed features classic for hemangioblastoma. The patient had a remote history of hemangioblastomas having been excised from the posterior fossa 7 and 20 years previously. This report details a fourth case of metastatic pulmonary hemangioblastoma. It is the first report on surgically resected hemangioblastomas from the lung of a living patient with histological and immunohistochemical characterization.

scholarly journals Endoscopic carpal tunnel release using the modified Chow's extrabursal dual portal technique: Clinical results of 640 patients

2007 ◽  
Vol 60 (1-2) ◽  
pp. 54-60 ◽  
Author(s):  
Poong-Taek Kim ◽  
Ivan Micic ◽  
Il-Hyng Park ◽  
In-Ho Jeon
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical Results ◽  
The Third ◽  
Endoscopic Carpal Tunnel Release ◽  
Nocturnal Pain ◽  
Tunnel Syndrome ◽  
Web Space ◽  
Open Carpal Tunnel Release ◽  
Portal Technique

During a 4-year period, a total of 784 wrists of 640 patients were treated using a modified Chow's extrabursal dual portal endoscopic technique. All surgeries were performed under local anesthesia. A 1-cm incision was marked 1 - 2 cm proximal to the distal wrist crease, in the midline, ulnar to the palmaris longus. A distal portal was established along a line bisecting an angle created by the intersection of the ulnar border of the abducted thumb and the third web space. An obturator and cannula assembly were inserted under the portal, and three blades were used to cut under endoscopic vision. Subjective results showed that 706 hands (90%) had a reduction in the severity of pain after carpal tunnel release, 706 hands (90%) had a reduction in the severity of paresthesia and 729 hands (93%) had a reduction in the severity of numbness. Nocturnal pain and paresthesia were relieved in 745 cases (95%). Compared with the conventional open carpal tunnel release, less postoperative pain and faster recovery have been reported following endoscopic carpal tunnel release. This study suggests that extrabursal dual portal technique is a safe and reliable treatment option for carpal tunnel syndrome with a high success rate.

Surgical embolization of cerebral arteriovenous malformations through internal carotid and vertebral arteries

1975 ◽  
Vol 42 (4) ◽  
pp. 443-451 ◽  
Author(s):  
Alfred J. Luessenhop ◽  
John H. Presper
Keyword(s):  
Arteriovenous Malformations ◽  
Previous History ◽  
Surgical Excision ◽  
Clinical Results ◽  
Prior History ◽  
Cerebral Arteriovenous Malformations ◽  
Content Type ◽  
Progressive Neurological Deficit ◽  
History Of

✓ The authors describe the clinical results of surgical embolization in 55 patients with large cerebral arteriovenous malformations. Follow-up intervals ranged from 2 months to 14 years, averaging 4½ years. The authors believe the procedure is safe in properly selected patients and is useful as a preliminary to direct surgical excision. It relieves associated headaches, and usually reverses or stabilizes a progressive neurological deficit. The potential for seizures probably is not altered. The incidence of hemorrhage following embolization is low for patients with no previous history of hemorrhage; however, the procedure does not reduce the likelihood of recurrence in patients with a prior history of hemorrhage.

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