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1/76. dystonia: a case report and review.

    dystonia is a movement disorder characterized by increased muscular tone for which surgical treatment has met with less than ideal results. Surgical treatment in patients with dystonia is often avoided due to the relative success of medical therapy. However, if expectations stay realistic and if the patient with dystonia is continuously evaluated, appropriate surgical measures may be taken when necessary to optimize patient satisfaction. The authors present a case of successful surgical treatment in a patient with a relatively static but crippling lower extremity deformity. A review of dystonia is included with successful surgical treatment of this compound neurologic disease causing lower extremity deformity in a young female. diagnosis and treatment options including surgical planning and principles in the dystonic patient are highlighted.
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ranking = 1
keywords = deformity
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2/76. 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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ranking = 3.5
keywords = deformity
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3/76. Early onset cerebellar ataxia with retained tendon reflexes: foot deformity in a first grade family member.

    Early onset cerebellar ataxia with retained tendon reflexes (EOCA) is a clinical syndrome characterised by progressive cerebellar ataxia with an onset before the age of 25 years and a wide spectrum of associated features. It is distinguished from Friedreich's ataxia (FA) mainly by the preservation of tendon reflexes, a better prognosis, and the absence of GAA expansion in the frataxin gene. Although EOCA is thought to be a hereditary disorder with an autosomal recessive mode of inheritance, genetic heterogeneity might underlie the spectrum of clinical features. In this case report we describe a patient with EOCA accompanied by pes cavus, hammer toes and peripheral neuropathy. The patient's father did not have any ataxia, but had the same foot deformities as his daughter and a slight peripheral neuropathy. The possible relationship between these clinical features is discussed.
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ranking = 2
keywords = deformity
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4/76. Correction of scar contracture deformities of the big toe with a multiplanar distraction device.

    A multiplanar distraction device was used in a 65-year-old woman for correction of multiplanar deformities of her right big toe. These deformities were caused by long-standing scar contracture after a crushing injury to the right foot. Without the necessity of other complicated procedures, the dorsal contracture and lateral deviation were corrected from 43 deg to 0 deg and from 22 deg to 0 deg respectively 3 weeks postoperatively. Kirschner wires were inserted temporarily for prevention of recurrence after removal of the frame, and were removed 6 weeks later. In follow-up after 8 months, the position of the big toe was stable and without recurrence of contracture. Application of the multiplanar distraction device simplified the surgical procedure to achieve this correction.
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ranking = 0.14220424068005
keywords = contracture
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5/76. Correction of ankle valgus deformity secondary to multiple hereditary osteochondral exostoses with Ilizarov.

    The following case report highlights basic aspects of Multiple Hereditary Osteochondral exostoses (MHOCE) and discusses the successful treatment of an adult with ankle pain secondary to growth arrest and foreshortening of the fibula. Two salient features include the age of the patient at presentation and the success of the procedure. Symptomatic valgus deformities of the ankle secondary to MHOCE are normally corrected during adolescence, prior to physeal closure. Reducing the ankle mortise by distally displacing the fibula and correcting rotational and angular ankle deformities with Ilizarov external fixation improved this patient's ankle function and relieved his pain.
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ranking = 2
keywords = deformity
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6/76. Complex foot deformities associated with soft-tissue scarring in children.

    Two cases of deformities in scarred feet are presented. One case had an old, well healed forefoot amputation with severe equinovarus deformity, and the other had an equinus deformity following a burn injury 10 months prior. Both the cases were managed by primary release of the contracted joint capsules. The correction of the soft-tissue contractures was achieved by gradual distraction using the Ilizarov apparatus. The clinical presentation and surgical treatment of complex foot deformities, complicated by the presence of scar tissue, are presented. These cases illustrate the benefits of combining soft-tissue release with the ilizarov technique of distraction histogenesis in the treatment of complicated foot deformities associated with scarring in pediatric patients.
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ranking = 34.388967280226
keywords = equinus deformity, equinus, deformity, contracture
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7/76. An unusual exostosis presenting as a bunion deformity.

    A large exostosis was the source of a bunion deformity in a 60-year-old woman. Its unusual clinical and radiographic features were suggestive of a bizarre parosteal osteochondromatous proliferation. However, histologic features were most consistent with a benign osteocartilaginous exostosis.
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ranking = 2.5
keywords = deformity
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8/76. Surgically induced Charcot's foot.

    The neuropathic foot has the potential to develop Charcot arthropathy. This study describes multiple cases of Charcot's foot following surgery. Of all the cases described, only one patient had any preexisting Charcot deformity or acute Charcot event. The study concludes that alterations of mechanical forces in the foot play an important role in triggering an acute Charcot episode.
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ranking = 0.5
keywords = deformity
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9/76. Tibialis posterior insufficiency occurring in a patient without peronei: a mechanical etiology.

    A patient presented with a painful flatfoot deformity, which developed after the onset of a drop-foot secondary to a herniated lumbar disk. On examination, the only functioning muscles were her gastrocnemius-soleus complex and her intrinsic toe flexors. Her affected foot had taken the classic deformity seen with tibialis posterior dysfunction--a valgus heel, midfoot collapse and an abducted forefoot. Peroneus brevis was not functioning and therefore could not be implicated as part of the etiology of this patient's acquired flatfoot deformity. The mechanism in which the ground reaction force produces the foot deformity in a tibialis posterior insufficient foot will be presented.
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ranking = 2
keywords = deformity
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10/76. A giant schwannoma of cauda equina.

    A case of giant schwannoma occurring in a woman 23 years of age with deformity of the foot developing at the age of five years is reported. The gross radiological changes of increased interpedicular distance and erosion of the posterior surface of the vertebra suggested the massive size of the tumour (6'' x 21/2'' x 11/2''). Successful surgical excision of such a large size schwannoma has not been reported previously.
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ranking = 0.5
keywords = deformity
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