Salvage arthrodesis for fracture-dislocation of the cuneonavicular and calcaneocuboid joints: a case report. (33/85)

We present a 22-year-old man with dislocation of both the calcaneocuboid and cuneonavicular joints and fractures of the calcaneum and navicular of the right foot. The joints were reduced with percutaneous Kirschner wires, but the disrupted dorsal cuneonavicular ligaments were left unrepaired. Reduction was suboptimal and the joints were subluxed resulting in disabling arthralgia. Six months later, he underwent salvage arthrodesis of the subluxed calcaneocuboid and cuneonavicular joints. At 24-month follow-up, the patient had returned to work and remained pain-free when walking, with good fusion of both joints. Early anatomic reduction, stable fixation, and ligament reconstruction are essential for a good outcome. Arthrodesis is indicated when subluxation and posttraumatic arthritis are present. Primary arthrodesis is a viable option for severe midfoot fracture-dislocations, because it facilitates rehabilitation and functional recovery, and obviates the need for a secondary arthrodesis should arthritis arise.  (+info)

CT study on the effect of different treatment protocols for clubfoot pathology. (34/85)

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Sonographic evaluation of Lisfranc ligament injuries. (35/85)

OBJECTIVE: This study characterized the sonographic appearances of Lisfranc injuries. METHODS: Sonography reports (2000-2007) were searched for "Lisfranc," resulting in 10 patients. Sonographic images of affected and asymptomatic contralateral feet were reviewed, recording the thickness of the dorsal ligament between the first (medial) cuneiform (C1) and second metatarsal (M2) ligaments, distance between C1 and M2, and change in this distance with weight bearing, hyperemia, and fractures. Correlations were made to clinical, surgical, and other imaging findings. RESULTS: In 5 asymptomatic feet, the dorsal C1-M2 ligament was 0.9 to 1.2 mm thick, and the C1-M2 distance was 0.5 to 1 mm. Of the symptomatic feet, 1 group (n=3) had normal sonographic findings (thickness, 0.9-1.1 mm; distance, 0.6-0.7 mm; all had normal radiographic findings and follow-up, and 1 had normal magnetic resonance imaging [MRI] findings). Another group (n=3) had abnormal hypoechogenicity and thickening of the dorsal C1-M2 ligament (1.4-2.3 mm), a normal C1-M2 distance (0.6-0.7 mm), and no widening with weight bearing (1 of 1), consistent with a ligament sprain (1 had normal computed tomographic [CT] findings, and all had uneventful follow-up). The third group (n=4) had nonvisualization of the dorsal C1-M2 ligament, an increased C1-M2 distance of 2.5 to 3.1 mm, and further widening with weight bearing (3 of 4) from Lisfranc ligament disruption (shown at surgery in 2, MRI in 1, and CT in 1). CONCLUSIONS: Nonvisualization of the dorsal C1-M2 ligament and a C1-M2 distance of 2.5 mm or greater were indirect signs of a Lisfranc ligament tear. Dynamic evaluation with weight bearing showed widening of the space between C1 and M2.  (+info)

A 3-portal approach for arthroscopic subtalar arthrodesis. (36/85)

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Stress fractures of the base of the metatarsal bones in young trainee ballet dancers. (37/85)

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The intertarsal joint of the ostrich (Struthio camelus): Anatomical examination and function of passive structures in locomotion. (38/85)

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TAK1 mediates BMP signaling in cartilage. (39/85)

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Development of the tarsometatarsal skeleton by the lateral fusion of three cylindrical periosteal bones in the chick embryo (Gallus gallus). (40/85)

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