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Arzu Ozcan Akcal, Kerim Ünal, Tahsin Gorgulu, Mehmet Akif Akcal, Zekiye Bigat
In this report we present two cases of gunshot injury related midfoot defects, reconstructed with a chimeric partial scapula and latissimus dorsi muscle flap and short perforator-based skin flap. The first case, a 14 years old male, had 10 × 8 cm medial plantar and 6 × 4 cm dorsal foot defects and the second case, a 55 years old female, had only 8 × 6 cm dorsal foot defect. In both cases the defects were associated with fractures, one with lateral cuneiform and cuboid with 90% bone loss and the other with navicular bone, respectively...
October 13, 2016: Microsurgery
Vipul Vijay, Nishint Gupta, Raju Vaishya
Osteoarticular TB around the tarsal navicular is a chronic, uncommon condition affecting the midfoot, which causes significant morbidity to the patient. Tuberculosis around the tarsal navicular is rarely described in the literature. A series of three cases - two involving the talo-navicular joint and one involving the naviculo-cuneiform joint is described. Biopsy was used in all the cases for achieving diagnosis. All patients had good to fair outcome following medical management with anti-tubercular therapy...
September 20, 2016: Foot
Stephen J Kriger, Shontal A Behan, Parth J Bhakta, Nicholas G Bruning, Brennan A Menninger, Mark C Razzante
INTRODUCTION AND OBJECTIVES: Due to its inert character and desired biocompatibility, titanium (Ti) implants have been universally accepted as safer alternatives to the previous conventional orthopedic hardware implants. However, a recent emergence of Type IV hypersensitivity reactions to Ti have displayed symptoms that include eczema, contact dermatitis, prolonged fever, sterile osteomyelitis, and impaired fracture and wound healing. The following case presents a patient with postoperative incision dehiscence and devascularization of cortical surfaces in contact with Ti hardware after undergoing a medial displacement calcaneal osteotomy and a first metatarsal-cuneiform arthrodesis...
September 2016: Journal of the American Podiatric Medical Association
Eduardo Saldías, Assumpció Malgosa, Xavier Jordana, Albert Isidro
Sexual estimation is fundamental to reconstruct the biological profile of individuals, but postdepositional factors can alter the resistance of the bones, thereby preventing accurate diagnosis especially when the skull and the pelvis are absent. Navicular bones are usually well preserved in archeological and forensic contexts and can a good alternative to discriminate sex. On the basis of these aspects, the present investigation analyzed the sexual dimorphism in 231 pairs of navicular bones from documented contemporary collections from Spain...
October 2016: Forensic Science International
Hasan Raza Mohammad, Waqar Bhatti, Anand Pillai
Erosive bony lesions are radiographic findings where localized bone resorption and cortical line breakage occurs. One less common cause of bone erosions is arteriovenous malformations (AVMs). This should always be included in the differentials for foot pain.A 33-year-old gentleman presented with a 5-year history of chronic left foot pain. Clinical examination was unremarkable. Magnetic resonance imaging (MRI) and computerized tomography demonstrated erosive bone changes in the navicular, the intermediate and lateral cuneiforms bones and their corresponding metatarsal bases...
2016: Journal of Surgical Case Reports
Lisa M Knijnenberg, Siem A Dingemans, Maaike P Terra, Peter A A Struijs, Niels W L Schep, Tim Schepers
BACKGROUND: Injuries to the Lisfranc joint in children and adolescents are rare. The incomplete ossification of the bones of the foot makes it difficult to detect injuries.The aim of this study was to determine age-specific radiographic measurements of the Lisfranc joint to provide guidance to the radiologist, emergency physicians, and surgeons to decrease misdiagnosis of Lisfranc injuries and improve detection. METHODS: We retrospectively reviewed all foot radiographs without traumatic injury made between August 2014 and February 2015 in all patients younger than 18...
September 3, 2016: Journal of Pediatric Orthopedics
Tuğba Kuru Çolak, İlker Çolak, Eren Timurtaş, Güven Bulut, M Gülden Polat
Misalignment of the talar neck after surgical repair can redistribute the load among the posterior, middle, and anterior facets of the subtalar joints, which can change the joint biomechanics, cause arthritis, and impair function. However, we found no studies analyzing the plantar pressures after treatment of talus neck fracture. We determined the dynamic plantar pedobarographic and radiographic characteristics and ankle range of motion, function, and pain among patients after surgical repair of talar neck fractures...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Mindi Feilmeier, Paul Dayton, Merrell Kauwe, Andrea Cifaldi, Britney Roberts, Hannah Johnk, Rachel Reimer
: Intercuneiform instability has been recognized as a potential cause of hallux valgus recurrence following tarsal-metatarsal joint (TMTJ) fusion. Recommendations have been made for additional screw placement between the metatarsals and/or the cuneiforms to improve stability. The screw orientation that provides the best stability has not been documented. Twelve cadavers with the first TMTJ fixated were used for testing. Using a consistent force application of 15 pounds in both the transverse and coronal planes, we measured the change in intermetatarsal angle on radiographs...
September 5, 2016: Foot & Ankle Specialist
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
Saravanaraja Muthusamy, Sheila A Conway, J David Pitcher, H Thomas Temple
Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton...
July 19, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
S Ochman, M J Raschke, C Stukenborg-Colsman, K Daniilidis
OBJECTIVE: Debridement of infected tissue with the main aim being the re-establishment of mobilization with preservation of standing and walking ability. Prevention of secondary pressure points or amputations due to inadequate resection or deficient soft tissue cover. INDICATIONS: In the case of increasing necrosis of the big toe, surgical abrasion and/or amputation is considered unavoidable. Other indications where surgery could be considered include diabetes and its associated angiopathies together with peripheral arterial angiopathy...
October 2016: Operative Orthopädie und Traumatologie
Lewis E Zionts, Michael H Jew, Kathryn L Bauer, Edward Ebramzadeh, Sophia N Sangiorgio
BACKGROUND: The Ponseti method has become the standard of care for the treatment of idiopathic clubfoot. A commonly reported problem encountered with this technique is a relapsed deformity that is sometimes treated in patients older than 2.5 years by an anterior tibial tendon transfer (ATTT) to the third cuneiform. Presently, there is insufficient information to properly counsel families whose infants are beginning Ponseti treatment on the probability of needing later tendon transfer surgery...
July 2, 2016: Journal of Pediatric Orthopedics
Shiu-Bii Lien, Hsain-Chung Shen, Leou-Chyr Lin
Subtle injuries of the Lisfranc joint complex are uncommon and difficult to diagnose clinically and thus are easily missed even by experienced orthopedic doctors. Misdiagnosed injuries can lead to chronic disability until eventual fusion surgery. We describe 10 cases diagnosed with subtle injury of the Lisfranc joint that were treated with combined innovative portal arthroscopy and fluoroscopy-assisted reduction and percutaneous screw fixation in an interfragmentary fashion. The distance between the first and second metatarsals (the Lisfranc distance) and that between the medial cuneiform and fifth metatarsal base (foot arch height) was measured before and after surgery...
June 21, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Eva Llopis, Javier Carrascoso, Inigo Iriarte, Mariano de Prado Serrano, Luis Cerezal
The Lisfranc joint is composed of the cuneiform bones and the cuboid and metatarsal bases, united by a synovial capsule and ligamentous complex. Familiarity with the anatomy is essential for image planning and for understanding injury patterns. The more important structures are the Lisfranc ligament and the plantar ligaments that can be visualized with MR, although careful attention to technique and orientation of scan planes is required for accuracy. A combination of conventional radiographs, computed tomography, and MR allow precise diagnosis of Lisfranc fractures, fracture dislocation, and subtle Lisfranc injuries to guide clinical management and surgical planning...
April 2016: Seminars in Musculoskeletal Radiology
Alessandro Bilella, Gonzalo Alvarez-Bolado, Marco R Celio
The parvafox nucleus is an elongated structure that is lodged within the ventrolateral hypothalamus and lies along the optic tract. It comprises axially located parvalbumin (Parv)-positive neurons and a peripheral cuff of Foxb1-expressing ones. In the present study, injections of Cre-dependent adenoviral constructs were targeted to the ventrolateral hypothalamus of Foxb1/Cre mice to label specifically and map the efferent connections of the Foxb1-expressing subpopulation of neurons of the parvafox nucleus. These neurons project more widely than do the Parv-positive ones and implicate a part of the axons known to emanate from the lateral hypothalamus...
October 15, 2016: Journal of Comparative Neurology
Shaleen Vira, Richard McCormack, Gabriel Felder, Norman Otsuka
Coalitions involving three joints of the midfoot are rare. To our knowledge, this is the first report of a patient having fibrocartilaginous coalition of the calcaneonavicular joint along with partial osseous fusion of the naviculocuneiform (Chopart's joint) and medial cuneiform-first metatarsal joints. These multi-coalition pathologies are challenging to address operatively as pain can persist even after recognizing and surgically addressing each coalition in a patient.
June 2016: Bulletin of the Hospital for Joint Diseases
Laurent Goetz, Brigitte Piallat, Manik Bhattacharjee, Hervé Mathieu, Olivier David, Stéphan Chabardès
The mesencephalic reticular formation (MRF) mainly composed by the pedunculopontine and the cuneiform nuclei is involved in the control of several fundamental brain functions such as locomotion, rapid eye movement sleep and waking state. On the one hand, the role of MRF neurons in locomotion has been investigated for decades in different animal models, including in behaving nonhuman primate (NHP) using extracellular recordings. On the other hand, MRF neurons involved in the control of waking state have been consistently shown to constitute the cholinergic component of the reticular ascending system...
July 2016: Journal of Neural Transmission
Laurent Goetz, Brigitte Piallat, Manik Bhattacharjee, Hervé Mathieu, Olivier David, Stéphan Chabardès
UNLABELLED: The mesencephalic reticular formation (MRF) is formed by the pedunculopontine and cuneiform nuclei, two neuronal structures thought to be key elements in the supraspinal control of locomotion, muscle tone, waking, and REM sleep. The role of MRF has also been advocated in modulation of state of arousal leading to transition from wakefulness to sleep and it is further considered to be a main player in the pathophysiology of gait disorders seen in Parkinson's disease. However, the existence of a mesencephalic locomotor region and of an arousal center has not yet been demonstrated in primates...
May 4, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Songbo Liu, Dong Huang, Yongjun Huang, Weijie Liu, Xiaochun Liu
OBJECTIVE: To explore the feasibility of Lisfranc ligament reconstruction with autogenous tendon through biomechanical testing. METHODS: Twelve fresh-frozen cadaveric lower limbs were prepared three sequential testing conditions: intact Lisfranc ligament (intact group), disrupted Lisfranc ligament (disrupted group), and Lisfranc ligament reconstruction (reconstruction group). Under fixing on the Bose mechanical test machine, three models were given 0-600 N axial loading in the neutral position and the plantar flexion of 30 degrees according to the speed of 10 N/s, every 100 N load with a 1-minute interval...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Faith A Schick, Joseph N Daniel, Juliane S Miller
A unicameral bone cyst is a relatively uncommon, benign bone tumor found in the metaphysis of long bones, such as the humerus and the femur, in skeletally immature persons. In the foot, these benign, fluid-filled cavities are most commonly found within the os calcis. We present a case report of a 10-year-old female with a unicameral bone cyst of the medial cuneiform.
March 31, 2016: Journal of the American Podiatric Medical Association
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