1/14. Congenital dislocation of the patella. Part II: orthopaedic management.Five patients (eight knees) with diagnosed congenital dislocation of the patella and well-documented charts were reviewed. Age at diagnosis ranged from 4 days to 6 years. A flexion contracture of the knee and femorotibial rotatory dislocation of varying degrees were present in all the cases. The quadriceps was active in all the cases, producing knee flexion in four cases. Foot deformity was associated in all the cases (clubfoot, calcaneovalgus, or congenital vertical talus). Gradual correction of knee flexion contracture with serial casting was attempted in five cases leading to an almost complete extension in two cases. Treatment of patellar dislocation was surgical in all the cases, consisting in extensive quadriceps release (seven knees) or V-Y lengthening (one knee), division of lateral soft tissues, and reefing of the medial retinaculum and capsule. Intraoperative anomalies were recorded. At an average follow-up of 6.9 years, all the patients are able to walk on their operated limb, and the patella is centered in the trochlea in all the cases. knee mobility, rotatory dislocation, and daily function were improved in seven cases.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
2/14. fibroma of a tendon-sheath presenting as toe deformity.We describe a rare manifestation fibroma in a tendon-sheath in an 83-year-old man. The patient complained initially of a slowly progressive spreading, apart of the right second and third toes. A mass was found in the plantar aspect of the foot. It was completely excised at surgery. Histological examination revealed sparse spindle or stellate cells with slit-like vessels in the dense collagenous matrix. There had been no recurrence at follow-up 17 months after surgery.- - - - - - - - - - ranking = 4keywords = deformity (Clic here for more details about this article) |
3/14. Lethal hydrops fetalis due to congenital dyserythropoietic anemia in a newborn: association of a new skeletal abnormality.Congenital dyserythropoietic anemias (CDAs) are a group of hereditary refractory anemias characterized by ineffective erythropoiesis, typical morphological abnormalities of erythroblasts, a low or no reticulocyte response, hyperbilirubinemia, and splenomegaly. A massive hydropic newborn born with a very severe anemia (Hb 4.8 g/dL), diffuse edema, hepatosplenomegaly, ascites, pulmonary edema and respiratory distress, and shortness and hallux varus deformity of the great toe of the right foot was diagnosed to have congenital dyserythropoietic anemia on the basis of the hematological (macrocytosis, anisopoikilocytosis, fragmented red cells and erythroblastosis in the peripheral blood, and erythroid hyperplasia with erythroblastosis and erythroblasts with double nuclei and thin chromatin bridges connecting these nuclei in the bone marrow) and serological (negative acidified serum lysis test and no agglutination with anti-i antibodies) findings. In this article the seventh case of neonatal congenital dyserythropoietic anemia presenting with a very severe (lethal) form of hydrops fetalis and a new (hallux varus) deformity of the great toe of the right foot is presented. Congenital dyserythropoietic anemia should be considered in the differential diagnosis of hydrops fetalis presenting with a very severe anemia and a skeletal abnormality of the great toe.- - - - - - - - - - ranking = 2keywords = deformity (Clic here for more details about this article) |
4/14. Split cord malformation in two sisters.Split cord malformations (SCMs) are uncommon congenital spinal anomalies and are seen mostly in females. SCMs in siblings are extremely rare. We report two sisters with SCM. These 10- and 8-year-old girls were the first and second children, respectively, of nonconsanguineous parents. Both sisters had a hypertrichosis and pes cavus deformity. The first child had a type I SCM and the second a type II SCM. They had additional spinal lesions, with tethering of the spinal cord. They were operated on and showed an uneventful postoperative course. All reported siblings with SCM have been female. The present data are not sufficient to account for the sex predilection. Therefore, further data and knowledge are needed.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
5/14. Peripheral neuropathy: the importance of history and examination for correct diagnosis.A 48-year-old woman presented to the emergency department with hematemesis and a 6-month history of unsteady gait and falls due to tripping. Because of a history of alcohol abuse, the initial diagnosis was upper gastrointestinal bleeding secondary to alcoholic gastritis or gastric ulcer, with the neuropathy likely due to alcoholism or chronic inflammatory demyelinating polyneuropathy. After further neurological examination and careful review of nerve conduction studies, however, an inherited neuropathy was suspected. Despite denial by the patient and her daughter of a family history of neuropathy, both had a pes cavus deformity with muscle atrophy and partial foot drop gait. Subsequent testing of the daughter revealed the same nerve conduction findings as the patient's. genetic testing showed that both women had the myelin PMP22 repeat defect characteristic of charcot-marie-tooth disease. endoscopy revealed that the patient had Osler-Weber-Rendu disease, which accounted for the hematemesis.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
6/14. Minimal incision tenotomy for hallux interphalangeal joint extensus.The spoon-toe hallux deformity causing symptomatic hallux pathology can be corrected through a minimal incision stab tenotomy of the extensor hallucis longus tendon that is usually performed at the level of the interphalangeal joint. This procedure is recommended rather than a traditional tenoplasty because it creates very little disability, successfully reduces the deformity, has low incidence of complications, and produces lasting results in maintaining the correction. The procedure can be used as both a solo procedure or in conjunction with other procedures on the hallux.- - - - - - - - - - ranking = 2keywords = deformity (Clic here for more details about this article) |
7/14. Metatarsal osteotomy for the cavus foot.Thirty-nine patients with pes cavus-type deformities were treated with osteotomy of the proximal metatarsals for the cavus component of the deformity. Fifty operations were followed for an average of 15 years, many for up to 26 years. Of the 39 patients, 11 had bilateral involvement. Each patient was clinically evaluated for postoperative mobility and categorized according to the massachusetts General Hospital rating scale. Excellent or good results were obtained in 84% of the proximal metatarsal osteotomies.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
8/14. Surgical correction of brachymetatarsia.Brachymetatarsia describes the condition of an abnormally short metatarsal. Although the condition has been recorded since antiquity, surgical options to correct the deformity have been available for only two decades. Most published procedures involve metaphyseal lengthening with autogenous grafts from different donor sites. The author discusses one such surgical technique. In addition, the author proposes specific criteria for the objective diagnosis of brachymetatarsia.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
9/14. Crossover second toe deformity: etiology and treatment.The pathogenesis, etiology, diagnostic features, and treatment of the crossover second toe deformity are discussed in this manuscript. The crossover second toe deformity is an undescribed entity in podiatric literature. Two cases are presented by the authors to illustrate the deformity and surgical correction.- - - - - - - - - - ranking = 7keywords = deformity (Clic here for more details about this article) |
10/14. Post-traumatic partial closure of the distal tibial growth plate, treated by the Langenskiold procedure.A young child was treated for an epiphysio-metaphyseal bone bridge at the level of the medial malleolus by desepiphysiodesis as described by Langenskiold. The varus deformity of the ankle was not corrected by an osteotomy, but a progressive correction did take place, and after two-and-a-half years, the position of the foot and the ankle was completely normal.- - - - - - - - - - ranking = 1keywords = deformity (Clic here for more details about this article) |
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