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Vivek S Chawathe, Anil K Gaur, Badrinath D Athani, Shefali Gupta
A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of 'proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia' was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case...
October 25, 2016: Journal of Pediatric Orthopedics. Part B
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Manuel Villanueva, Álvaro Iborra, Guillermo Rodríguez, Pablo Sanz-Ruiz
BACKGROUND: Isolated gastrocnemius contracture is thought to lead to numerous conditions. Although many techniques have been described for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques require epidural anesthesia, lower limb ischemia, and stitches and may lead to damage of the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure...
October 3, 2016: BMC Musculoskeletal Disorders
H Sankaranarayan, Anupam Gupta, Meeka Khanna, Arun B Taly, K Thennarasu
OBJECTIVE: To study role of ankle foot orthosis (AFO) in improving locomotion and functional recovery after stroke. SETTING: Neurological Rehabilitation Department of a university research tertiary hospital. PATIENTS AND METHODS: AFO and activity based rehabilitation. MAIN OUTCOME MEASURES: Distance (meters) covered during the 6-minute walk test (6MWT) and speed (meter/second) during the 10-meter walk test. Functional abilities assessed using Functional Independence Measure (FIM(®))...
October 2016: Journal of Neurosciences in Rural Practice
Silvia Viviana Soriano, María Florencia Debiaggi, Nora Beatriz Pierangeli, Luis Alfredo Pianciola, Héctor Fabián Jesús Bergagna, Lorena Evelina Lazzarini, Melina Leonor Mazzeo, Juan Angel Basualdo
Echinococcus granulosus sensu lato (E. granulosus sl) must be considered as a species complex, comprising Echinococcus granulosus sensu stricto (E. granulosus ss, genotypes G1-G3), Echinococcus equinus (G4), Echinococcus ortleppi (G5) and Echinococcus canadensis (G6-G10) although the species status of E. canadensis is still controversial. These genotypes closely match the intermediate hosts associated strains described in earlier times among which E. canadensis G6 corresponds to the camel strain. As there are no studies concerning the development of adult stages of the G6 genotype from non-camel origin, the aims of the present study were: to characterize for the first time the development of E...
September 15, 2016: Veterinary Parasitology
Marion Prigent, Sylvain Brochard, Mathias Thepaut, Christian Lefèvre, Dominique Le Nen, Thierry Cornic, Marie-Thérèse Cariou, Catherine Le Rouzic, Phlippe Le Moine, Christelle Pons, Laetitia Houx
OBJECTIVE: Traumatic lower limb amputation is rare in pediatric population, and surgeons always try limb salvage. But rarely, later amputation occurred when the traumatic limb is painful. It is a difficult and irreversible decision needed a multidisciplinary approach. We report how we managed a programmed trans-tibial amputation on 13-years-old boy, 20 months after a foot trauma. OBSERVATIONS: Our patient is an adolescent victim of a left foot crash. The first checkup showed a degloving injury, dislocation of the interphalangeal joints and of all toes...
September 2016: Annals of Physical and Rehabilitation Medicine
Yu-Bin Liu, Shu-Yun Jiang, Li Zhao, Yan Yu, Xu-Chen Tao, Da-Hang Zhao
Background. This study was designed to evaluate the function of the foot undergoing the procedure of percutaneous Achilles tenotomy (PAT) in case of clubfoot management in terms of gait analysis. Methods. Nineteen patients with unilateral clubfeet were retrospectively reviewed from our database from July 2012 to June 2016. The result in all the cases was rated as excellent according to the scale of International Clubfoot Study Group (ICSG). The affected sides were taken as Group CF and the contralateral sides as Group CL...
2016: BioMed Research International
Nigar Dursun, Tugba Gokbel, Melike Akarsu, Erbil Dursun
OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio...
September 14, 2016: American Journal of Physical Medicine & Rehabilitation
Gloria Tapias, Mar García-Romero, Carlos Crespo, Maribel Cuesta, Carles Forné, Samuel Ignacio Pascual-Pascual
OBJECTIVE: Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy. METHOD: A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital...
September 2016: Farmacia Hospitalaria
S T J Tsang, D McMorran, L Robinson, J Herman, J E Robb, M S Gaston
The aim of this study was to evaluate the outcome of combined tibialis anterior tendon shortening (TATS) and calf muscle-tendon lengthening (CMTL) in spastic equinus. Prospectively collected data was analysed in 26 patients with hemiplegic (n=13) and diplegic (n=13) cerebral palsy (CP) (GMFCS level I or II, 14 males, 12 females, age range 10-35 years; mean 16.8 years). All patients had pre-operative 3D gait analysis and a further analysis at a mean of 17.1 months (±5.6months) after surgery. None was lost to follow-up...
August 17, 2016: Gait & Posture
Fang Pu, Weiyan Ren, Xiaoya Fan, Wei Chen, Shuyu Li, Deyu Li, Yu Wang, Yubo Fan
PURPOSE: The aim of this study was to determine whether and how real-time feedback of dynamic foot pressure index (DFPI) could be used to correct toe-walking gait in spastic diplegic children with dynamic equinus. METHODS: Thirteen spastic diplegic children with dynamic equinus were asked to wear a monitoring device to record their ambulation during daily gait, conventional training gait, and feedback training gait. Parameters based on their DFPI and stride duration were compared among the three test conditions...
August 24, 2016: Disability and Rehabilitation
Evgenia Manousaki, Tomasz Czuba, Gunnar Hägglund, Louise Mattsson, Hanneke Andriesse
Relapse after successful initial correction of idiopathic clubfoot with the Ponseti method is often related to poor compliance with the foot abduction orthosis (FAO). The aim of this study was to evaluate treatment with custom-made dynamic orthoses. Twenty children with idiopathic clubfoot (30feet) who had been treated with dynamic orthoses after the correction phase according to the Ponseti casting technique were evaluated. Relapse rates during orthotic treatment were registered. A Vicon gait analysis system was used to measure gait parameters at the age of seven years...
August 7, 2016: Gait & Posture
Stefan Schmid, Jacqueline Romkes, William R Taylor, Silvio Lorenzetti, Reinald Brunner
BACKGROUND AND PURPOSE: Foot equinus and leg length discrepancy (LLD) are common problems in hemiplegic cerebral palsy (hCP), both causing secondary deviations of pelvic motion during gait. It can therefore be assumed that the spinal deviations observed in hCP patients are secondary as a compensation for the position of the pelvis arising from the disturbed leg function. This study investigated the effects of correcting lower extremity function by orthotics on spinal gait kinematics in hCP patients...
September 2016: Gait & Posture
Tetiana A Kuzmina, Igor Dzeverin, Vitaliy A Kharchenko
An extensive analysis of the relationships between strongylid egg shedding in domestic horses and the strongylid community structure in regard to the age of the horses, their breeds and different strategies of horse management, particularly with anthelmintic treatment programs was performed. Domestic horses (n=197) of different ages (5 months to 22 years) and of various breeds from 15 farms with different types of deworming programs were included in this study. Strongylids (totally, 82,767 specimens) were collected in vivo after deworming of the horses with the macrocyclic lactone anthelmintic ("Univerm", 0...
August 30, 2016: Veterinary Parasitology
Devrim Özer, Avni İlhan Bayhan, Abdi Keskin, Seçkin Sarı, Mehmet Akif Kaygusuz
OBJECTIVES: The aim of this study was to evaluate the short-term clinical and radiological results of tibiotalocalcaneal arthrodesis (TTCA) with proximal humeral locking plate. MATERIAL AND METHODS: Eight patients (7 female, 1 male; average age 53 years (range: 24-67)) who underwent TTCA with proximal humeral locking plate between 2009 and 2011, were retrospectively evaluated with AOFAS hindfoot scale and Maryland foot score system. The mean follow up was 32.6 months (range: 23-54)...
August 2016: Acta Orthopaedica et Traumatologica Turcica
James Amis
We are currently in the process of discovering that many, if not the majority, of the non-traumatic acquired adult foot and ankle problems are caused by a singular etiology: non-neuromuscular equinus or the isolated gastrocnemius contracture. There is no question that this biomechanical association exists and in time much more will be uncovered. There are three basic questions that must be answered: why would our calves tighten as we normally age, how does a tight calf, or equinus, actually cause problems remotely in the foot and ankle, and how do the forces produced by equinus cause so many seemingly unrelated pathologies in the foot and ankle? The purpose of this paper is to address the second question: how does a tight calf mechanically cause problems remotely in the foot and ankle? There has been little evidence in the literature addressing the biomechanical mechanisms by which equinus creates damaging forces upon the foot and ankle, and as a result, a precise, convincing mechanism is still lacking...
2016: Frontiers in Surgery
Emilie R C Williamson, Constantine A Demetracopoulos, Scott J Ellis
Few reports in the literature have described the conversion of a surgically fused ankle to a total ankle replacement. The takedown of an autofusion and conversion to a prosthesis has not been described. We report the case of a patient with severe rheumatoid arthritis with an ankle autofusion fixed in equinus and severe talonavicular arthritis that was converted to ankle replacement using the Salto XT revision system. We describe the reasons why the decision was made to perform total ankle arthroplasty while concomitantly fusing the talonavicular joint, and discuss the rationale of the various surgical treatment options considered...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
K Heck, A Heck, R Placzek
OBJECTIVE: Pain-free, plantigrade, functional foot through gentle manipulation without extended surgery and with decreased probability of relapse. INDICATIONS: Idiopathic clubfoot; neurogenic and secondary clubfeet. CONTRAINDICATIONS: None. SURGICAL TECHNIQUE: Simultaneous correction of all components of the clubfoot. Mainly conservative, with serial casts. Slight supination to address the cavus and increasing abduction to align the midfoot bones while putting counter-pressure on the head of the talus...
August 3, 2016: Operative Orthopädie und Traumatologie
Zhiqun Zhang, Zhuqing Kong, Miao Zhu, Wenxiang Lu, Lei Ni, Yunfei Bai, Yue Lou
The aim of this study was to characterize a previously uncharacterized genetic disorder associated with equinus deformity in a large Chinese family at the genetic level. Blood samples were obtained and whole genome sequencing was performed. Differential gene variants were identified and potential impacts on protein structure were predicted. Based on the control sample, several diseases associated variants were identified and selected for further validation. One of the potential variants identified was a ANXA3 gene [chr4, c...
October 2016: Molecular Biology Reports
Susan A Rethlefsen, Gideon Blumstein, Robert M Kay, Frederick Dorey, Tishya A L Wren
AIM: To examine the impact of age, surgery, and Gross Motor Function Classification System (GMFCS) level on the prevalence of gait problems in children with cerebral palsy (CP). METHOD: Gait analysis records were retrospectively reviewed for ambulatory patients with CP. Gait abnormalities were identified using physical exam and kinematic data. Relationships among age, sex, previous surgery, GMFCS level, and prevalence of gait abnormalities associated with crouch and out-toeing, and equinus and in-toeing were assessed using univariable and multivariable logistic regression...
July 15, 2016: Developmental Medicine and Child Neurology
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