Assessment of hindfoot deformity by three-dimensional MRI in infant club foot.
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In 12 infants aged under 16 months with unilateral club foot we used MRI in association with multiplanar reconstruction to calculate the volume and principal axes of inertia of the bone and cartilaginous structures of the hindfoot. The volume of these structures in the club foot is about 20% smaller than that in the normal foot. The reduction in volume of the ossification centre of the talus (40%) is greater than that of the calcaneus (20%). The long axes of both the ossification centre and the cartilaginous anlage of the calcaneus are identical in normal and club feet. The long axis of the osseous nucleus of the talus of normal and club feet is medially rotated relative to the cartilaginous anlage, but the angle is greater in club feet (10 degrees v 14 degrees). The cartilaginous structure of the calcaneus is significantly medially rotated in club feet (15 degrees) relative to the bimalleolar axis. The cartilaginous anlage of the talus is medially rotated in both normal and club feet, but with a smaller angle for club feet (28 degrees v 38 degrees). This objective technique of measurement of the deformity may be of value preoperatively. (+info)
Fractures of the posteromedial process of the talus. A report of two cases.
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The authors present two cases of fractures of posteromedial process of talus. One was treated conservatively and the other by excision. The appearances of the CT scans, the therapeutic options and the mechanisms of injury are discussed. (+info)
Congenital convex pes valgus.
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Congenital convex pes valgus (congenital vertical talus) is a rare condition. We reviewed ten feet in seven patients who had had surgical correction. All had been operated on by the senior author (JF) and the same surgical technique was used throughout, incorporating transfer of the tibialis anterior to the neck of the talus. The mean age at surgery was 31 months and the mean follow-up was nine years (6 to 14). All patients completed a questionnaire and had clinical, radiological and photographic evaluation performed by an independent examiner. None had required further surgery. All but one were satisfied with the result, and had no functional limitations. They all wore normal shoes. The mean ankle dorsiflexion was 17 degrees and plantar flexion 21 degrees. The mean arc of subtalar motion was 27 degrees. All radiological parameters measured were within the normal range, although irregularity of the talonavicular joint was common. No avascular necrosis of the body of the talus was seen. We conclude that the medium-term results of this procedure are very satisfactory. (+info)
Subtalar arthrodesis with correction of deformity after fractures of the os calcis.
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We have reviewed the long-term results of 22 patients (23 fusions) with fractures of the os calcis, who had subtalar arthrodesis with correction of the deformity between 1975 and 1991. The mean follow-up was nine years (5 to 20). All patients were evaluated according to a modified foot score. A radiological assessment was used in which linear and angular variables were measured including the fibulocalcaneal abutment, the height of the heel and fat pad, the angle of the arch and the lateral talocalcaneal and the lateral talar declination angles. The technique used restores the normal relationship between the hindfoot and midfoot and corrects the height of the heel. This leads to better biomechanical balance of the neighbouring joints and gives a favourable clinical outcome. The modified foot score showed a good or excellent result in 51% of the feet. Residual complaints were mostly due to problems with the soft tissues. Subjectively, an excellent or good score was achieved in 78% of the cases. After statistical analysis, except for the height of the heel and the degenerative changes in the calcaneocuboid joint, no significant difference was found in the measured variables between the operated and the contralateral side. (+info)
Fracture of the entire posterior process of the talus.
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A 25 year old, who had sustained a fracture of the entire posterior process of the talus, is presented. THe fracture was successfully managed conservatively. (+info)
The diagnosis of the os trigonum syndrome with a fluoroscopically controlled injection of local anesthetic.
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PURPOSE: To report the results of excision of the os trigonum using a fluoroscopically controlled injection of local anesthetic to diagnose the os trigonum syndrome. DESIGN AND PATIENTS: Os trigonum syndrome is a recognized cause of pain in the posterior aspect of the foot and ankle. The symptoms and physical findings, however, are often nonspecific and difficult to differentiate from other causes of posterior ankle pain. We report four patients with persistent posterolateral ankle pain despite prolonged nonoperative treatment. An os trigonal syndrome was diagnosed by a positive response to a fluoroscopically guided local anesthetic injection in the region of synchondrosis between the os trigonum and the posterior talus. RESULTS: All four patients underwent excision of the os trigonum with complete resolution of symptoms and return to full activity. CONCLUSIONS: Fluoroscopically controlled injection can help confirm the suspected diagnosis of an os trigonum syndrome and may have positive predictive value regarding the outcome of excisional surgery. (+info)
Differences in men's and women's mean ankle ligamentous laxity.
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The incidence of ligamentous ankle injuries is known to be one of the most common athletic injuries that exists. Recently, there has been a great deal of interest regarding the increased risk of female ligamentous injury, such as the anterior cruciate ligament, lateral ankle sprains and others. The purpose of this study is to evaluate whether or not normal lateral ankle ligamentous laxity is similar in male and female athletes. This study selects 22 male and 27 female college athletes who have had no significant ligamentous ankle injuries requiring medical treatment. They were placed on a Telos ligamentous stress device and stressed to a level of 15 daN. Radiographs were then obtained to determine talar tilt at this level of ankle stress. Results were compared between men and women showing that there was a statistically significant difference. Women had a much greater ligamentous laxity of the lateral ankle than men. (+info)
The study of morphological variation in the hominid fossil record: biology, landmarks and geometry.
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This review considers some recent advances in shape analysis based on landmark data, and focuses on the application of these methods to the study of skeletal evolution in primates. These advances have provoked some controversy. The major aims of this review are to put these debates in context and to provide an overview for the nonmathematician. The purpose of morphometric studies is considered, together with issues relating to the nature, significance and identification of landmarks before turning to a review of available technologies for the analysis of morphological variation. These are considered in terms of underlying models and assumptions in order to clarify when each is appropriate. To illustrate the application of these methods, 3 example studies are presented. The first examines differences amongst ancient and modern adult human crania using 2-dimensional data. The second illustrates the extension of these methods into 3 dimensions in a study of facial growth in monkeys. The third presents an application to the analysis of the form of the hominoid talus. The review ends with an account of available software resources for shape analysis. (+info)