1/8. The musculoskeletal manifestations of Werner's syndrome.Werner's syndrome is a rare condition usually presenting as premature ageing in adults. Over a period of 30 years we have followed two siblings with extensive musculoskeletal manifestations including a soft-tissue tumour, insufficiency fractures, nonunion and tendonitis, with associated problems of management. The literature is reviewed.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
2/8. adult hallux valgus with metatarsus adductus: a case report.It is difficult to surgically treat a hallux valgus deformity with significant metatarsus adductus, because the space between the first and second metatarsals is too narrow to correct the metatarsus primus varus with a first metatarsal osteotomy. A 55-year-old woman had severe hallux valgus with significant adduction of the second and third metatarsals. A distal soft tissue procedure and a proximal crescent-shaped osteotomy of the first metatarsal combined with corrective osteotomies of the second and third metatarsals were done. The patient's symptoms disappeared, and hallux valgus and adduction of the second and third metatarsals were corrected. To the authors' knowledge, there is no previous description of surgical treatment including correction of metatarsus adductus and hallux valgus for adult hallux valgus with metatarsus adductus.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
3/8. Pseudoaneurysm after modified Lapidus arthrodesis: a case report.Pseudoaneurysms are a pulsatile swelling secondary to an arterial-wall defect. blood flows through the defect but is contained within the surrounding soft tissue. This article describes a rare form of an iatrogenic pseudoaneurysm of the perforating deep plantar artery 1 month after a modified Lapidus arthrodesis for hallux valgus. A presumptive diagnosis of pseudoaneurysm was confirmed by Doppler ultrasonography. The patient was treated with ligation of the artery and resection of the pseudoaneurysm and remained free of symptoms 1 year postoperatively.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
4/8. Turf toe: ligamentous injury of the first metatarsophalangeal joint.Injuries to the metatarsophalangeal (MTP) joint of the great toe have increased in incidence over the past thirty years following the introduction of artificial playing surfaces and the accompanying use of lighter footwear. Although most common in American football players, similar injuries can also occur in other sporting activities including soccer and dance, or following trauma to the great toe. The mechanism of injury is typically hyperextension of the MTP joint, but injuries have also been reported secondary to valgus or varus stress, or rarely as a result of hyperflexion injury. The abnormal forces applied to the first MTP joint at the time of injury, result in varying degrees of sprain or disruption of the supporting soft tissue structures, leading to the injury commonly referred to as turf toe. The extent of soft tissue disruption is influential in treatment planning and can be used to determine the prognosis for recovery. This report will review the anatomy of the first MTP join, followed by a discussion of the mechanism of injury and the typical clinical presentation of an individual with turf toe. Finally, the role of imaging including radiography and magnetic resonance imaging, and standard treatment options for turf toe will be discussed.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
5/8. Tumoral calcinosis simulating osteomyelitis.A case of tumoral calcinosis simulating osteomyelitis and associated with bunion formation in a 20-year-old female is presented. The most striking findings in this patient were the soft tissue calcifications. There was no evidence of any of the known causes of heterotopic calcifications. This kind of simulation between tumoral calcinosis bunion formation and osteomyelitis has not been previously described.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
6/8. hallux valgus and hallux flexus associated with cerebral palsy: analysis and treatment.hallux valgus and hallux flexus associated with cerebral palsy foot deformity may be due to equinovalgus and/or metatarsus primus adductus or combinations of these. Occasionally the condition occurs in equinovarus feet. Hallux flexus or "dorsal bunion" is usually due to a weak extensor hallucis longus, overpull of the anterior tibial muscle on the first metatarsal and spasticity or contracture of the flexor hallucis longus or brevis. A weak peroneus longus muscle has not caused this deformity. The condition is usually predictable in the growing child if all factors related to gait, collagen stability and foot alignment are observed. Treatment includes soft-tissue and bone realignment. Release of the adductor hallucis, lateral collateral ligaments of the metatarsophalangeal joint, plication of the medial capsule and of the abductor hallucis and centralization of the extensor hallucis longus will realign the first ray. The flexor hallucis longus is transferred to athe extensor hallucis longus proximal to the metatarsophalangeal joint and the anterior tibial tendon is transferred to the second metatarsal. An osteotomy at the base of the first metatarsal and at the base of the proximal phalanx will realign the skeleton. Twenty-six great toes in 16 patients have been observed for two to 20 years. The correction has been maintained without arthrodesis of the metatarsophalangeal joint except where chondromalacia occurred. Once the pattern of deformity is evident, progression is unrelenting and treatment is indicated in order to prevent chondromalacia of the articular cartilage.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
7/8. Foreign body reactions to absorbable implant fixation of osteotomies.The authors present two case studies which describe a destructive, nonspecific foreign-body reaction encountered while using the Biofix absorbable rod system. At Dallas family Hospital, the Biofix system has been used in 32 first metatarsal procedures, 10 lesser metatarsal procedures, and 15 digital procedures. Twenty-seven patients are included, with two developing a reaction that required surgical drainage and debridement. The first reaction was noted to be extremely violent with destruction of bone and soft tissue. Prompt diagnosis and aggressive therapy is necessary to minimize the soft tissue and bony destruction that may occur. Surgical drainage and debridement are often necessary to control the reaction.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
8/8. The traumatic bunion.In seven cases of Lisfranc joint injury after trauma, bunion deformity developed. This "traumatic bunion" occurs over a prolonged period of time after injury. A high index of suspicion is needed to identify the deformity as being traumatic in origin. Injury about the first metatarsophalangeal joint complex may also contribute to this deformity. When recognized, it may need to be treated with a first metatarsal-cuneiform fusion and distal soft tissue realignment.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |