Characteristics of normal equine tarsal synovial fluid.
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Physical, biochemical, and cytologic properties of synovial fluid from normal equine tarsal joints were investigated. Tarsal synovial fluid was pale yellow, clear, free of flocculent material, and did not clot. Volume varied in direct proportion to individual tarsal joint size. Relative viscosity was related to volume, polymerization and quantity of hyaluronic acid, and protein concentration. Mucinous precipitate quality (hyaluronic acid polymerization) was uniformly high. Results of certain analyses of serum were compared with those of tarsal synovial fluid. Tarsal synovial fluid protein concentration was low in conjunction with a high A:G ratio. Serum: synovial fluid sugar ratio was 1.24:1. Serum ALP, ACP, LDH, GOT, and GPT activity levels were higher than their corresponding levels of activity in tarsal synovial fluid. Serum ALD activity level was slightly lower than its tarsal synovial fluid counterpart. Total erythrocyte counts ranged markedly, while total leukocyte counts were uniform and low. Lymphocytes were the predominant synovial fluid cell type. (+info)
Tarsal hypermobility after ankle fusion--fact or fiction?
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Thirty-seven patients have been reviewed after arthrodesis of the ankle in order to determine the reduction of dorsiflexion and plantarflexion of the foot, the incidence of tarsal hypermobility and its relevance to the clinical results of this procedure. Radiological methods of measuring movements in the foot and tarsus are described and applied to patients who had a normal foot on the opposite side which could be used as a control. Our findings suggest that tarsal hypermobility is not as common as has hitherto been supposed and that a stiff foot with minor radiological degenerative changes in the tarsal joints is quite compatible with an excellent result. (+info)
Relapsing club feet. Late results of delayed operation.
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The operation of soft-tissue release and calcaneocuboid fusion, published by Dillwyn Evans in 1961, is described in detail and a long-term review of 118 club feet is presented. The average age of the patients at review was nearly seventeen years. All were resistant cases and in all the Dillwyn Evans "collateral operation", deliberately delayed by a policy of prolonged conservative treatment, had been the main surgical procedure. (+info)
Spontaneous dislocation in diabetic neuropathy. A report of six cases.
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The clinical details of six patients who developed spontaneous dislocations in the foot or ankle are presented. All were shown to have diabetic neuropathy. This previously unreported condition can occur with a short history of diabetes. Some cases can be managed without operation, though arthrodesis probably offers the best chance of obtaining a stable foot of satisfactory shape. (+info)
Calcaneocuboid joint and stability of the longitudinal arch of the foot at high and low gear push off.
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The calcaneocuboid joint was studied in ligamentous specimens of ten human feet, and in skeletons of two gorillas (Gorilla gorilla beringei), six chimpanzees (Pan troglodytes), three orangutans (Pongo pygmaeus) and 25 human feet. The movement of the transverse tarsal joint was further studied in a living foot on a walk-way with a glass plate inserted, and with an underlying mirror. In man the joint is shaped as an asymmetrical sector of one end of an hour-glass shaped surface of revolution with its main axis oriented longitudinally in the foot. The calcaneocuboid joint becomes close packed by a pronation of the forefoot in relation to the hind foot because of a congruency between the joint surfaces obtained in this position and because the calcaneus overhangs the cuboid dorsally and stops the movement. At low gear push off the foot is inverted and the calcaneocuboid joint loose packed. The stresses are absorbed across the fibular, postaxial border of the foot. At high high gear push off there is a functional pronation of the forefoot with a stabilization of the transverse tarsal joint and a more effective tightening of the plantar aponeurosis. The foot becomes a rigid lever for propulsion. In contrast to the human condition, the anthropoid calcaneus has an anteromedial extension associated with symmetry of the calcaneocuboid joint. The calcaneus does not overhang the cuboid and there appears to be no close packed position. Correspondingly, the anthropoid foot has a mid-tarsal break at each push off in addition to the metatarsophalangeal break. (+info)
Treatment of experimental erosive arthritis in rats by injection of the muralytic enzyme mutanolysin.
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A single intravenous injection into rats of 0.4 mg of the muralytic enzyme mutanolysin, given as long as 3 d after an arthropathic dose of peptidoglycan-polysaccharide polymers derived from group A streptococci (PG-APS), resulted in a complete resolution of acute arthritis and the prevention of chronic joint disease. When administration of mutanolysin was delayed until 14 d after the injection of PG-APS, a great reduction in the severity of chronic inflammation was still observed. Quantitation of the amount of PG-APS present in the limbs, spleen, and liver by a solid phase enzyme-linked immunoassay indicated that the tissues of mutanolysin-treated rats contained as much PG-APS as tissues of PBS-treated control rats. In addition, rats treated with mutanolysin immediately after receiving an intraperitoneal injection of PG-APS developed a transient limb edema similar to that seen in rats after the injection of PG-APS digested to a small fragment size in vitro with mutanolysin. We hypothesize that mutanolysin acts in vivo by degrading PG-APS to small fragments that persist but are no longer arthropathic. (+info)
The long-term results of conservative management of severely displaced fractures of the calcaneus.
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A subjective, objective and radiographic study of 21 patients with comminuted calcaneal fractures showing severe involvement of the subtalar joint is reported. The average follow-up was 14.6 years (range 8 to 29 years). Only patients with unilateral closed fractures and no associated injuries to either lower limb were admitted to the study. All were treated by early active mobilisation of the ankle, and the subtalar and the midtarsal joints. Seventy-six per cent of the patients achieved a good result with minor symptoms which did not interfere with their occupation or leisure requirements. Although two-thirds of the patients reached a point of maximal recovery at two to three years, 24% continued to improve for six years. None of the patients experienced any deterioration after this time. Neither the degree of clinical stiffness nor the degeneration of the subtalar joint, assessed radiographically, correlated with the severity of symptoms or functional disability. The role of the soft tissues in the aetiology of residual symptoms is discussed. (+info)
Injuries to the tarsometatarsal joint. Incidence, classification and treatment.
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Injuries to the tarsometatarsal (Lisfranc) joint are not common, and the results of treatment are often unsatisfactory. Since no individual is likely to see many such injuries, we decided to make a retrospective study of patients from five different centres. In this way 119 patients with injuries of the Lisfranc joint have been collected. This paper classifies these injuries and describes their incidence, mechanism of production, methods of treatment, results and complications. Sixty-nine of the patients attended for review: 35 of these had been treated by closed methods, 27 had had an open reduction and seven patients had had no treatment. On the basis of our study we suggest that these injuries should be classified according to the type of injury rather than the nature of the deforming force and that their treatment be based upon this classification. It seems that, whatever the severity of the initial injury, prognosis depends on accurate reduction and its maintenance. (+info)