Cases reported "Equinus Deformity"

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1/6. Fibular nonunion and equinovarus deformity secondary to posterior tibial tendon incarceration in the syndesmosis: a case report after a bimalleolar fracture-dislocation.

    A 39-year-old woman sustained a grade II open bimalleolar fracture-dislocation of the left ankle. Six months after an ORIF of these fractures was performed, she presented with a nonunion of the distal fibula fracture and with a fixed hindfoot equinovarus and forefoot adduction deformity. At surgery for repair of the fibular nonunion, the posterior tibial tendon (PTT) was found to be entrapped in the posterior tibiotalar joint, with a portion of the tendon interposed between the tibia and the fibula in the area of the posterior syndesmosis. After extrication of the PTT, the hindfoot varus and forefoot adduction deformity were corrected. To our knowledge, this is the first case report in the English literature of a missed PTT syndesmotic entrapment that resulted in a fibular nonunion and in a fixed foot deformity after an open bimalleolar ankle fracture dislocation.
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keywords = equinovarus
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2/6. Congenital diastasis of the inferior tibiofibular joint: report of three additional cases treated by the Ilizarov method and literature review.

    Congenital diastasis of the inferior tibiofibular joint presents clinical problems of talipes equinovarus, ankle diastasis, and leg-length inequality. In the past, foot disarticulation and prosthetic fitting has often been chosen as a solution because of the difficulty involved in functional reconstruction. The authors report three additional cases of congenital diastasis of the inferior tibiofibular joint that were satisfactorily treated by lengthening of the tibia and fibula and foot repositioning by the ilizarov technique. After treatment, all patients had a plantigrade, functional foot with normal sensation at skeletal maturity and were satisfied with the cosmetic and functional outcomes. The ilizarov technique is effective in accomplishing the goals of leg-length equalization and foot repositioning.
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ranking = 0.32319074394615
keywords = equinovarus, talipes equinovarus, talipes
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3/6. Tonic dystonia: an uncommon complication of reflex sympathetic dystrophy syndrome. A review of five cases.

    Tonic dystonia is an underrecognized complication of reflex sympathetic dystrophy syndrome (RSDS) characterized by an increase in muscle tone at the site of injury. Case-reports.- We describe five cases of tonic dystonia complicating RSDS of the lower extremity. There were four women and one man, with a mean age of 52 years. In addition to the typical features of RSDS, the patients had fixed equinovarus of the foot with hyperextension or hyperflexion of the great toe. In two patients, examination after spinal anesthesia showed that the deformity was reducible. Spontaneous resolution of the dystonia occurred in one patient. Another patient failed to experience meaningful improvement after a motor block followed by botulinic toxin injections. In two patients, the same treatment was followed by a slight improvement. Treatment options are still being evaluated in the last patient. Discussion.- Tonic dystonia is an underrecognized complication of RSDS that often develops after a minor injury yet causes prolonged pain and disability. Spread of the dystonia to other sites is not infrequent. The underlying mechanisms remain unclear but may involve dysfunction of the central or peripheral nervous system or psychogenic factors. Suggested treatments include motor block, intrathecal baclofen, sympathetic block, and sympathectomy. However, none of these treatments has been proved effective. Conclusion.- The five cases described here provide useful information on RSDS-associated tonic dystonia, a condition that runs a protracted course and remains difficult to manage.
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ranking = 0.2
keywords = equinovarus
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4/6. Transient talipes equinus deformity of bilateral lower limbs following malignant hyperthermia: a case report and review of literature.

    malignant hyperthermia (MH) is a potentially fatal disease triggered by general anaesthesia. Four cases of compartment syndrome complicating MH have been reported. We report here a case of transient talipes equinus deformity of bilateral lower limbs, a condition similar to compartment syndrome, following MH in a previously healthy pediatric patient. MRI revealed high intensity in the bilateral soleus muscles but not in the gastrocnemius muscles. We discuss the possible mechanisms of the deformity of the lower limbs after the MH crisis.
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ranking = 0.081884034947866
keywords = talipes
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5/6. Does fascicular neurotomy have long-lasting effects?

    OBJECTIVE: To determine whether fascicular neurotomy has long-lasting effects on spasticity. DESIGN: We present 4 clinical cases and a critical analysis of the literature. patients: This is a retrospective study on 4 patients referred to our department for spastic equinovarus foot deformity. For all 4, neurotomy was successful not long after surgery, but spasticity reappeared after a few months. methods: We compared our results with those in the pubmed database. RESULTS: Most publications acknowledge the immediate effectiveness of this surgery, but do not study the long-term effects of neurotomy. No publication proved long-lasting effects of neurotomy for spastic equinovarus foot deformity. The only long-term follow-up with a sufficient population is the one of Berard et al. who reported 61% recurrence. CONCLUSION: There is no study showing that tibial nerve neurotomy has long-lasting effects. The 4 cases reported are an illustration that recurrence of spasticity may occur after neurotomy. These findings have to be taken into account for treatment decision-making and for provision of information to patients.
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ranking = 0.4
keywords = equinovarus
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6/6. A new method for treating postburn talipes equinovarus.

    Postburn talipes equinovarus has long been a challenging problem for plastic surgeons, who usually replace the overlying scar in multistaged flap or tube transfer operations before lengthening the shortened achilles tendon. This always requires long hospitalization and causes much discomfort for the patient because of postural immobilization. In 1975, I designed a new and simple procedure by Z-lengthening the scar tissue and the achilles tendon as a whole in one stage. To date, the operative result in 10 cases has been excellent, without failure or recurrence.
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ranking = 1.6159537197308
keywords = equinovarus, talipes equinovarus, talipes
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