Concomitant Talocalcaneal Coalition as a Risk Factor for Early Relapse Following Ponseti Treatment of Idiopathic Clubfoot

Concomitant talocalcaneal coalition (TCC) in idiopathic clubfeet is not well documented in the literature. The purpose of this study was to describe our experience with very early relapsing idiopathic clubfeet associated with TCC. Although cases have been successfully treated with the Ponseti casting method, all recurred within 2 months of removing the final cast. A single-centre cohort of twelve feet in eight patients treated by a single surgeon between 2006 and 2020 was investigated retrospectively. Recurred cavus with variable degrees of equinus was the earliest findings noted. TCC was incidentally detected during the open reduction of the earliest three feet in our series. Afterwards, ultrasonography was advised as a screening tool for detecting an associated anomaly; however, only the use of magnetic resonance imaging (MRI) was 100% accurate in diagnosing concurrent TCC. All coalitions were cartilaginous and the posterior facet was most commonly involved facet. The average age was 18 months for the coalition resection and open reduction of a dislocated talonavicular joint, and the average duration of follow-up was 52 months. None of the patients showed clinical signs of relapse at the latest follow-up. We recommend that an associated TCC should be considered in very early relapsing idiopathic clubfoot cases.

Download Full-text

DISI DEFORMITY AND POST-OPERATIVE SYMPTOMS OF SCAPHOID NON-UNION

Hand Surgery ◽

10.1142/s0218810499000393 ◽

1999 ◽

Vol 04 (02) ◽

pp. 117-124 ◽

Cited By ~ 3

Author(s):

T. Wada ◽

M. Aoki ◽

M. Usui ◽

S. Ishii

Keyword(s):

Internal Fixation ◽

Grip Strength ◽

Bone Grafting ◽

Open Reduction ◽

Average Duration ◽

Bone Screw ◽

Non Union ◽

Significant Difference ◽

Corticocancellous Bone Grafting

The correlation between the residual dorsal intercalated segmental instability (DISI) deformity and symptoms of the wrist was investigated in 20 patients with healed scaphoid non-union who had open reduction and bone grafting. In seven patients, inlay corticocancellous bone grafting (modified Russe procedure) was performed. In four of the seven patients, an additional Herbert bone screw was used for internal fixation. The remaining 13 patients were treated with open reduction, anterior bone grafting, and internal fixation with Herbert bone screw. Average duration of follow-up period after operation was 20 months (range, 6 to 57 months). The average extension-flexion arc of the injured wrists was 129°, which was 31° less than that of the uninjured wrists. The average grip strength of the injured wrists was 89% of that of the uninjured wrist. Before the operation, all 20 patients were symptomatic and complained of wrist pains. Post-operatively, three patients experienced mild pains and only one complained of moderate wrist pains. Post-operative radiolunate angle ranged from 0° to 34° (average 10°). DISI deformity remained uncorrected in eight patients. Post-operative symptoms were compared amongst the eight patients who had DISI deformity and 12 patients who had no deformity. There was no significant difference in range of motion, grip strength, and incidence of pain between these two groups of patients. The presence of DISI deformity after bone grafting for a symptomatic scaphoid non-union was not predictive of post-operative symptoms of the wrist.

Download Full-text

Gamma Knife for Cerebral Arteriovenous Malformations at a Single Centre

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100012427 ◽

2011 ◽

Vol 38 (6) ◽

pp. 851-857 ◽

Cited By ~ 6

Author(s):

F. A. Zeiler ◽

P. J. McDonald ◽

A. Kaufmann ◽

D. Fewer ◽

J. Butler ◽

...

Keyword(s):

Gamma Knife ◽

Arteriovenous Malformations ◽

Consecutive Series ◽

Average Dose ◽

Cerebral Arteriovenous Malformations ◽

Single Centre ◽

Magnetic Resonance Imaging Mri ◽

Persistent Headache ◽

Lost To Follow Up

Background:We report the results of a consecutive series of patients treated with Gamma Knife (GK) Surgery for cerebral arteriovenous malformations (AVMs).Methods:We retrospectively reviewed 69 patients treated with GK for cerebral AVMs between November 2003 and April 2009, recording clinical data, treatment parameters, and AVM obliteration rates in order to assess our effectiveness with GK in treating these lesions.Results:Ten patients were lost to follow-up. Presentations included: seizure (24), hemorrhage (18), persistent headache (12), progressing neurological signs (10), and incidental (9). In 24 patients (34.8%) treatment planning consisted of digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and computed tomogram (CT) angiography (CTA). Currently we rely predominantly on CTA and/or MRI scanning only. Fourty-one patients have been followed for a minimum of 3 years; average age 40.9yr., 58.5% males. Average dose at the 50% isodose line was 20.3 Gy (range 16 to 26.4 Gy). Obliteration was observed in 87.8% by MRI, CT, or DSA. Not all obliteration was confirmed by DSA. Complications occurred in 12 of 59 (20.3%) patients, and in 11 of 41 (26.8%) with 3 year follow-up. Major (temporary) complications for the 59 included symptomatic cerebral edema (7), seizure (2), and hemorrhage (1). Major permanent complications occurred in one patient suffering a cranial nerve V deafferentation, and in two patients suffering a hemorrhage.Conclusion:GKS for cerebral AVM's offers an effective and safe method of treatment, with low permanent complication rate.

Download Full-text

Carpal tunnel syndrome and finger deformities in children with mucopolysaccharidoses and mucolipidoses: a retrospective review of 52 patients

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211061980 ◽

2021 ◽

pp. 175319342110619

Author(s):

Clément Thirache ◽

Mathilde Gaume ◽

Cyril Gitiaux ◽

Arielle Salon ◽

Caroline Dana ◽

...

Keyword(s):

Retrospective Study ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Signs ◽

Single Centre ◽

Level Of Evidence ◽

Age At Surgery ◽

Tunnel Syndrome ◽

The Mean

This single-centre retrospective study reports our management of carpal tunnel syndrome in 52 children (103 hands) with mucopolysaccharidoses and mucolipidoses. All except one were bilateral. The median age at surgery was 4 years (range 1.5 to 12). The diagnosis of carpal tunnel syndrome was confirmed by an electromyogram (EMG) in all patients; 38% of these presented without any clinical signs. Surgical neurolysis was performed in all hands, combined with epineurotomy in 52 hands (50%) and flexor tenosynovectomy in 75 hands (73%). Surgery was bilateral in 98% of children (102 hands). The mean follow-up was 12 years (range 1 to 19) and the EMG was normalized in 78% of hands. Ten patients suffered recurrence, eight of whom required further surgery. Screening for carpal tunnel syndrome is essential for the management of children mucopolysaccharidoses and mucolipidoses. Surgical treatment should be carried out early with follow-up by EMG to detect recurrence. Level of evidence: IV

Download Full-text

Progressive Myelopathy Due to a Spontaneous Intramedullary Hematoma in a Dog: Pre- and Postoperative Clinical and Magnetic Resonance Imaging Follow-up

Journal of the American Animal Hospital Association ◽

10.5326/0440266 ◽

2008 ◽

Vol 44 (5) ◽

pp. 266-275 ◽

Cited By ~ 4

Author(s):

Jean-Laurent Thibaud ◽

Antoine Hidalgo ◽

Ghita Benchekroun ◽

Laurent Fanchon ◽

Francois Crespeau ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Neurological Examination ◽

Clinical Signs ◽

Resonance Imaging ◽

Surgical Scar ◽

Progressive Myelopathy ◽

History Of ◽

Magnetic Resonance Imaging Mri

A 4-year-old, male Jack Russell terrier was presented for a 6-month history of progressive right hemiparesis with episodic cervical hyperesthesia. The neurological examination showed a right-sided, upper motoneuron syndrome and partial Horner’s syndrome. Two magnetic resonance imaging (MRI) examinations were performed 3 months apart and revealed a persistent cervical intramedullary hematoma. A dorsal myelotomy was performed. A subacute hematoma was confirmed histologically without underlying lesions. Eighteen months later, the dog’s clinical signs were minimal. Two MRI examinations were performed 2 weeks and 5 months after surgery and revealed regressing signal abnormalities at the surgical site, consistent with a surgical scar.

Download Full-text

Two different indications of ventriculoperitoneal and cystoperitoneal shunting in six dogs

Acta Veterinaria Hungarica ◽

10.1556/004.2020.00010 ◽

2020 ◽

Vol 68 (1) ◽

pp. 95-104 ◽

Cited By ~ 2

Author(s):

László Lehner ◽

Kálmán Czeibert ◽

Gábor Nagy

Keyword(s):

Clinical Signs ◽

Unknown Origin ◽

Chronic Subdural Haematoma ◽

Congenital Hydrocephalus ◽

Subdural Hygroma ◽

Intracranial Pressure Elevation ◽

Mri Scans ◽

Magnetic Resonance Imaging Mri ◽

Cystoperitoneal Shunting

AbstractIn this study we described two different indications of ventriculo- and cystoperitoneal shunting (VPS, CPS) procedures in six dogs, including their clinical data and magnetic resonance imaging (MRI) examinations. One dog had moderate and two dogs had severe congenital hydrocephalus, one was presented with intracranial pressure elevation due to meningoencephalitis of unknown origin (MUO) associated with congenital hydrocephalus, and two with quadrigeminal cysts (QC). VPS procedures were done in four and CPS in two dogs, using low-pressure valve systems. The follow-up period ranged from 1 to 6 months and control MRI scans were also made. Significant improvement was detected in five cases during the short-term follow-up period (1 month) and in four cases in the medium-term follow-up (2–6 months). Major complications were found in two cases: one dog with acute-hypertensive hydrocephalus died one week after surgery, and in another case development of a chronic subdural haematoma and hygroma caused death 3 months after the surgery. Minor complications (e.g. subdural hygroma) were found in two cases. In cases of severe hydrocephalus or intracranial cysts, higher-pressure valve systems are recommended in order to prevent subdural hygroma. Transient postoperative clinical signs usually resolve within one week after the surgery.

Download Full-text

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽

10.1024/0301-1526/a000287 ◽

2013 ◽

Vol 42 (4) ◽

pp. 264-274

Author(s):

Dagmar Krajíčková ◽

Antonín Krajina ◽

Miroslav Lojík ◽

Martina Mulačová ◽

Martin Vališ

Keyword(s):

Death Rate ◽

Long Term Outcomes ◽

Single Centre ◽

Intracranial Atherosclerotic Stenosis ◽

Atherosclerotic Stenosis ◽

Angioplasty And Stenting ◽

Aggressive Medical Management ◽

Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

Download Full-text