scholarly journals Surgical Treatment of Severe Forefoot Deformity

2015 ◽  
Vol 22 (3) ◽  
pp. 84-85
Author(s):  
I. V Usol’tsev ◽  
S. N Leonova ◽  
M. A Kosareva
Keyword(s):  
Surgical Treatment ◽  
Weight Bearing ◽  
Metatarsophalangeal Joint ◽  
Pain Syndrome ◽  
Lateral Release ◽  
Treatment Results ◽  
Forefoot Deformity ◽  
Scarf Osteotomy ◽  
Akin Osteotomy ◽  
The Right

Treatment results of 61 years old patient with severe forefoot deformity - right-side transverse-longitudinal stage II platypodia: right-side II-III degree deforming arthrosis of 1st metatarsophalangeal joint, hallus valgus with subluxation, combined 1st metatarsophalangeal joint contracture, pain syndrome, are presented. Surgical treatment included operation by Schede, lateral release of 1stmetatarsophalangeal joint, SCARF osteotomy of 1st metatarsal bone, Akin osteotomy of proximal hallux phalanx and tenoplasty of dorsal hallux flexor. As a result correction of right forefoot deformity was achieved, pain syndrome was arrested and weight bearing ability of the right foot was restored.

scholarly journals Methods of Reconstructive Surgical Treatment for Patients with Defects and Pseudarthroses of Femur

2010 ◽  
Vol 17 (4) ◽  
pp. 65-70
Author(s):  
Valentina Afanas'evna Kopysova ◽  
V A Kaplun ◽  
A N Svetashov ◽  
V V Shashkov ◽  
V A Kopysova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Shape Memory ◽  
Shape Memory Effect ◽  
Memory Effect ◽  
Weight Bearing ◽  
Bone Defects ◽  
Femoral Bone ◽  
Treatment Results ◽  
Stable Osteosynthesis ◽  
Bone Fragments

Treatment results of 59 patients with femoral bone defects and diaphyseal pseudarthroses were analyzed. To substitute bone defects of more than 6 cm permeable porous endoprostheses were used. In patients with normotrophic and hypertrophic pseudarthrosis stable osteosynthesis with interfragmental compression of bone fragments by shape-memory-effect tightening bows was performed. In patients with atrophic pseudarthrosis bone plasty with autograft was applied. In all patients the weight-bearing ability of the affected limb was restored. Total restoration of function was achieved in 75.6% of patients.

Effect of Akin Osteotomy on Hallux Valgus Correction After Scarf Osteotomy With Hallux Valgus Interphalangeus

2019 ◽  
Vol 40 (10) ◽  
pp. 1182-1188 ◽  
Author(s):  
Gerhard Kaufmann ◽  
Philipp Hofer ◽  
Matthias Braito ◽  
Reto Bale ◽  
David Putzer ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Level Of Evidence ◽  
Scarf Osteotomy ◽  
Loss Of Correction ◽  
Valgus Angle ◽  
Akin Osteotomy ◽  
Group A ◽  
Joint Congruity ◽  
Initial Correction

Background: Recurrence after hallux valgus correction is a relatively frequent occurrence. Little is known about the importance of initial correction on radiologic outcome. The objective of our study was to determine postoperative radiologic parameters correlating with loss of correction after scarf osteotomy and the combined scarf/akin osteotomy, respectively. Methods: Loss of correction was evaluated based on a group of 53 feet with isolated scarf osteotomy (S group) and a group of 17 feet with combined scarf and akin osteotomy (SA group) in a retrospective analysis. The intermetatarsal angle (IMA), the hallux valgus angle (HVA), the distal metatarsal articular angle (DMAA), the proximal to distal phalangeal articular angle (PDPAA), the position of the sesamoids, and joint congruity were measured in weight-bearing radiographs preoperatively and postoperatively throughout a mean follow-up of 44.8 ± 23.6 months. Results: Loss of correction was comparable between the S and the SA group ( P > .05). In contrast, we found higher loss of HVA correction in the S subgroup with a preoperative PDPAA above 8 degrees ( P = .011), whereas loss of correction in the S subgroup below 8 degrees of PDPAA was comparable to the SA group. In the S group, loss of correction showed significant correlation with postoperative IMA ( P = .015) and PDPAA ( P = .008), whereas in the SA group a correlation could be detected for IMA only ( P = .045). Conclusion: In cases with a PDPAA above 8 degrees, we recommend a combined scarf/akin osteotomy to diminish the potential for loss of correction. Level of Evidence: Level III, therapeutic, retrospective comparative series.

Results of surgical treatment of aggressive hemangiomas of the treatmental spine by the method of punctive vertebroplasty

2021 ◽  
Vol 19 (3) ◽  
pp. 75-80
Author(s):  
Sh. Sh. SHATURSUNOV ◽  
◽  
S. A. MIRZAKHANOV ◽  
A. R. SATTAROV ◽  
A. O. KOBILOV ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Pain Syndrome ◽  
Average Score ◽  
Treatment Results ◽  
Antitumor Effects ◽  
X Ray ◽  
Mri Studies ◽  
Invasive Method

The purpose — to analyze the results of surgical treatment of patients with hemangiomas of the thoracolumbar spine by puncture vertebroplasty. Material and methods. Clinical data and results of surgical treatment of 124 patients operated on in 2014-2020 were analyzed. Preoperative examinations included clinical studies, WAS, Oswestry, X-ray, MSCT, and MRI. MSCT and MRI studies were carried out for diagnosis and to study the treatment results. Single hemangiomas were present in 63 (50,8%) patients, 44 (35,4%) patients had hemangiomas at two or more levels. In 17 (13,7%) patients, hemangiomas were present in both the thoracic and lumbar regions. Results. In 87,8% of cases, MSCT studies in the postoperative period showed filling the hemangioma cavity by more than 80%. Control MRI studies 6 months and a year after surgery in none of the cases revealed a continued growth of hemangioma. Pain syndrome according to WAS before surgery averaged 46/56 points, after 12 months — 15/20 points. According to the Oswestry questionnaire, the average score reduced from 32 to 6 points after 6 months. Conclusion. Puncture vertebroplasty with bone cement is an effective, safe and minimally invasive method for treating hemangiomas of the thoracolumbar spine. The main goals of vertebroplasty are to restore the supporting ability of the affected vertebra, achieve analgesic and antitumor effects.

scholarly journals Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

2004 ◽  
Vol 8 (2) ◽  
pp. 38
Author(s):  
S.H. Botha
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Weight Bearing ◽  
Pain Syndrome ◽  
Blood Pool ◽  
Magnetic Resonance Images ◽  
Stress Fractures ◽  
X Rays ◽  
The Right ◽  
A Minor

Complex regional pain syndrome (CPRS), type 1 is a pain disorder that develops unpredictably and can follow a minor injury. A 12-year-old boy presented with severe pain in the feet and could not walk or stand weight bearing. Normal X-rays showed osteopenic changes and radiolucent lines, which appeared to be stress fractures. Three-phase bone scintigraphy showed no uptake in the left lower leg on the blood pool phase or on the immediate or delayed images. This indicated typical CPRS type 1 in children. The uptake in the right foot was increased and the stress fracture and other illness could not be differentiated. Computed tomography was done to exclude stress fractures. Only osteopenic changes in both calcaneus bones were found and there was no evidence of cortical stress fractures. Magnetic resonance images revealed oedema in the calcaneus and talus bones of both feet. The patient received epidural narcotic infusion with sympathetic blockage for 1 week combined with extensive physiotherapy. The blood pool phase of the bone scan became normal within 2 weeks, and increased uptake in both feet was noticed. The patient was followed up with MRI every 3 months and the bone marrow oedema disappeared after 6 months.

Development and Reliability of a Measurement Device for Flexion Force of the First Metatarsophalangeal Joint

2003 ◽  
Vol 19 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Jaap Swanenburg ◽  
Karel H. Stappaerts ◽  
Bart Tirez ◽  
Daniel Uebelhart ◽  
Geert Aufdemkampe
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Metatarsophalangeal Joint ◽  
Measurement Device ◽  
Good Reliability ◽  
First Metatarsophalangeal Joint ◽  
Healthy Female ◽  
The Right ◽  
Leg Dominance ◽  
Flexion Force

The purpose of this study was to present a method for repeated measurement of flexion force of the hallux in the metatarsophalangeal joint. The reliability of this measurement device was also examined. This device is suitable for situations where weight-bearing is contraindicated or when it is not possible for patients to bear load on their toes, such as hallux valgus patients. Since most such patients are female, the participants in this study were 24 healthy female volunteers. Age, weight, height, and leg dominance were determined for each. Muscle strength was measured using a device with a built-in MicroFET dynamometer. The result for the left hallux was ICC(3,1).89 (95% CI .77–.95). The result for the right hallux was ICC(3,1).94 (95% CI .87–.97). In the Bland and Altman plots, the reliability again appeared to be sufficient. The Pearson product-moment correlations gave poor results for the association between body weight, height, age, and mean force of the four trails. The test results indicate good reliability of the measurement device as used in this study. The advantage of this testing device is that it makes it easier to standardize measurements as opposed to the MicroFET used as a hand-held dynamometer. Also, patients can be tested in a nonload situation, which makes it possible to test hallux valgus at any time, and therefore it is possible to monitor variations in progression (or regression).

scholarly journals COMPLETE THORACIC ESOPHAGUS OBLITERATION: CLINICAL CASE REPORT

2021 ◽  
Vol 74 (1) ◽  
pp. 155-160
Author(s):  
Serhii O. Savvi ◽  
Alla Yu. Korolevska ◽  
Serhii Yu. Bityak ◽  
Yevhen A. Novikov
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Esophageal Stricture ◽  
Clinical Case ◽  
Middle Colic Artery ◽  
Thoracic Esophagus ◽  
Colic Artery ◽  
Treatment Results ◽  
Food Passage ◽  
The Right

Using the example of a clinical case, to present the management features of a patient with complete esophageal obliteration as a chemical burn result, the surgical intervention features in case of a non-standard situation during the operation, and the treatment results analyze. It was described a clinical case of 41-year-old patient with thoracic esophagus obliteration due to extended post-burn cicatricial esophageal stricture, dysphagia of IV degree in very severe general condition. Stamm-Senn-Kader’s gastrostomy was performed as a first step of surgical treatment. Angiography and embolization of the right colic artery and it’s branches was performed in 8 months while preserving the middle colic artery. In 20 days the cologastroanastomosis and feeding colostomy on the right chest wall were performed. In 10 days after the colostomy was disattached from the chest wall, the end-to-side esophagocoloanastomosis was performed intrapleurally. In one month after the third surgery and restoration of the food passage by the natural way, closure of the contact gastrostomy was performed. During the observation over the patient (8 years) the postoperative complications were not observed. The patient survived. The proposed staged surgical treatment tactics of patients with complete esophageal obliteration due to post-burn esophageal stricture, dysphagia of IV degree presents effective treatment results and a significant improvement in the patient’s life quality.

scholarly journals Hip Fractures: Relevant Anatomy, Classification, and Biomechanics of Fracture and Fixation

2019 ◽  
Vol 10 ◽  
pp. 215145931985913 ◽  
Author(s):  
Young Lu ◽  
Harmeeth S. Uppal
Keyword(s):  
Surgical Treatment ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Cost Effective ◽  
Clinical Results ◽  
Fracture Pattern ◽  
Helical Blade ◽  
The Right

Introduction: Hip fractures represent an important health-care dilemma, costing the US$ billions annually. Hip fractures can diminish quality of life and significantly increase morbidity and mortality if not properly treated. Recent research has brought forth new information regarding treatment as well as information on emerging complications seen within the fixation constructs themselves. Significance: Understanding the pathoanatomy of hip fractures and the biomechanics of surgical fixation constructs is critical for successful treatment. In this article, we review the relevant anatomy and classification of femoral neck and intertrochanteric fractures. Furthermore, the biomechanics of hip fracture fixation strategies as well as implant-related complications are addressed. Results: Even though laboratory testing demonstrated that intramedullary nails have greater biomechanical stability, the clinical results between fixation constructs have been similar when the chosen implant (ie, sliding hip screw vs cephalomedullary nail) has been correctly applied to the specific fracture pattern. Recently, data have shown that when using cephalomedullary nails, there is potential for increased failure with cutout when using the helical blade versus the lag screw, with majority being the atypical “medial cutout.” Conclusion: The goal of surgical treatment of hip fractures is surgical treatment that allows for early mobilization and weight bearing. A full understanding of the anatomy and fracture characteristics will allow the surgeon to correctly apply the right implant to allow for uneventful healing. Surgeons need to be aware, however, of complications that can arise when using specific implants. Further research is ongoing to further determine the treatments that will allow optimal cost-effective care for the geriatric patient with hip fracture.

scholarly journals Treatment of an Intractable Forefoot Ulcer Using Realignment Osteotomy in a Patient with Rheumatoid Arthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Makoto Imai ◽  
Naoki Kondo ◽  
Rei Kumazaki ◽  
Naoto Endo
Keyword(s):  
Rheumatoid Arthritis ◽  
Antibiotic Treatment ◽  
Weight Bearing ◽  
Foot Pain ◽  
Forefoot Deformity ◽  
Postoperative Course ◽  
Abnormal Pressure ◽  
Feasible Option ◽  
History Of ◽  
The Right

Forefoot deformities are common among patients with rheumatoid arthritis (RA). Herein, we describe a case of intractable ulceration on the dorsomedial aspect of the right 5th digit, secondary to forefoot deformity, in a 76-year-old woman with a 35-year history of RA. The ulcer was due to a persistent subcutaneous infection. Although the infection was controllable with antibiotics, there was concern of relapse because of the abnormal pressure on the skin due to an overlap of the 4th and 5th digits. We proceeded with surgical correction of the forefoot alignment, including shortening oblique osteotomy of metatarsals 2 through 5, rather than amputation of the 5th digit. Following surgery, targeted antibiotic treatment was provided. The postoperative course was unremarkable, and the patient recovered weight-bearing function without recurrence of pain or ulceration. Forefoot realignment is a feasible option that should be considered for treating intractable foot pain and ulceration secondary to long-lasting RA.

scholarly journals Combination of Modified Scarf Osteotomy and Metatarsal Shortening Offset Osteotomy for Rheumatoid Forefoot Deformity

2021 ◽  
Vol 18 (19) ◽  
pp. 10473
Author(s):  
Yuki Etani ◽  
Makoto Hirao ◽  
Kosuke Ebina ◽  
Takaaki Noguchi ◽  
Gensuke Okamura ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Surgical Procedures ◽  
Weight Bearing ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Great Toe ◽  
Forefoot Deformity ◽  
Scarf Osteotomy ◽  
Hallux Valgus Deformity

With the progress of medical treatment for rheumatoid arthritis (RA), several joint-preserving forefoot surgical procedures have been established and performed. In this situation, we have been choosing the combined surgery: modified scarf osteotomy for the great toe and metatarsal shortening offset osteotomy for the lesser toes in RA cases. A retrospective observational study of 53 RA patients (mean follow-up period: 4.6 years) who underwent the surgery was completed. RA foot ankle scores were assessed, using the Japanese Society for Surgery of the Foot (JSSF) standard rating system, and a self-administered foot evaluation questionnaire (SAFE-Q) was also checked to evaluate clinical outcomes. For radiological evaluations, deformity parameters were measured using radiographs of the feet with weight-bearing. JSSF hallux and lesser toes scores and the SAFE-Q score showed significant improvement in all indices. HVA, M1-M2A, M1-M5A, M2-M5A, and sesamoid position were significantly improved after surgery. At the final follow-up, the hallux valgus deformity had recurred in 4 feet (7.5%), and hallux varus deformity had developed in 8 feet (15.1%). No case of recurrent hallux valgus deformity required revision surgery. Recurrence of dorsal dislocation/subluxation of the lesser toe MTP joint was seen in 6 feet (11.3%) after surgery. A combination of modified scarf osteotomy for the great toe and modified metatarsal shortening offset osteotomy for the lesser toes is one of the novel surgical procedures for rheumatoid forefoot deformity. Preoperative disease activity of RA negatively affected the clinical score of the hallux. The spread of M2-M5A was a risk factor for resubluxation of the lesser toe MTP joint.

scholarly journals Staged surgical treatment of brachioplexopathy in an adolescent with Klippel-Feil syndrome: a rare clinical case and literature review

2021 ◽  
Vol 18 (1) ◽  
pp. 6-13
Author(s):  
E. V. Petrova ◽  
O. E. Agranovich ◽  
M. V. Savina ◽  
E. L. Gabbasova ◽  
V. P. Snishchuk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Brachial Plexus ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Neurogenic Pain ◽  
Neurophysiological Studies ◽  
Vertebral Bodies ◽  
The Right ◽  
Rapid Relief ◽  
Cervical Ribs

Klippel-Feil syndrome is a congenital malformation, the leading component of which is a violation of segmentation of the cervical vertebral bodies. The syndrome can be combined with other skeletal anomalies: skull asymmetry, scoliosis, high shoulder blades, and cervical ribs. Treatment of the syndrome is usually symptomatic; indications for surgical treatment are progressive neurological disorders and persistent pain syndrome, which usually develop due to instability of unblocked segments, or neurogenic pain. A clinical case of treatment of a 17-year-old patient with Klippel-Feil syndrome who developed a picture of severe upper limb monoparesis during three years due to compression of the brachial plexus associated with cervical ribs is presented. Decompression of the brachial plexus was performed, which led to rapid relief of pain syndrome and gradual partial regression of motor disorders. Due to incomplete restoration of the gripping function, tendon-muscle plasty of the right hand was performed, which significantly improved the possibility of self-care. The results of radiation and staged neurophysiological studies are described, as well as a review of the literature on the Klippel-Feil syndrome.

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