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Dermatologic Manifestations of the Lower Extremity: Nail Surgery.

Nail surgery is a fundamental component of podiatric surgery. Nail disorders are common and may cause significant morbidity and occasionally mortality. Diagnosis of inflammatory and infectious conditions, and of benign or malignant tumors, often requires a biopsy of the nail unit. Excisional surgery may also be curative for certain tumors. This article reviews key elements of nail anatomy, surgical preparation, local anesthesia, and methods to achieve and maintain a bloodless field. A familiarity with these concepts should allow clinicians to develop a surgical plan and approach when patients

Nail changes in patients with inflammatory bowel diseases.

BACKGROUND/AIM: Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. To our knowledge, no studies to date pertain to the profile of nail changes in IBD, except for onychomycosis. We aimed to study the frequency and pattern of nail changes among patients with IBD and evaluate their potential relationships with several parameters in IBD. MATERIALS AND METHODS: The study included 73 patients with IBD and 51 healthy control subjects. Nails of both groups were examined for changes with regard to color, striations, texture, curvature of nail plate…

Nail disorders: Kids are not just little people.

Nail disorders comprise an important subset of dermatologic conditions and often pose both diagnostic and therapeutic challenges to the clinician. Presentation and management can differ in adults and children. Proper understanding of these differences is important in delivering optimal patient care. This contribution discusses three common nail disorders in adults and children, onychomycosis, melanonychia striata, and trachyonychia, highlighting distinct features in the adult and pediatric populations.

HUMERAL NAIL: COMPARISON OF THE ANTEGRADE AND RETROGRADE APPLICATION.

Application of humeral nail in the treatment of humeral shaft fractures is a relatively novel method of fracture fixation. Its application at Clinical Department of Traumatology, Sestre milosrdnice University Hospital Center began in 2001. The operative procedure should be performed using a minimally invasive technique without fracture opening in order to maintain optimal conditions for fracture healing including hematoma management. However, in everyday practice it is often impossible to obtain satisfactory fracture reduction using the closed procedure, so open reduction and additional fixati

Intramedullary Nailing for Pathological Fractures of the Proximal Humerus.

BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. RESU

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… Then, an IM nail (Polarus; Acumed, Beaverton, OR, USA) was inserted antegrade in an unreamed fashion in order to avoid IM or systemic spreading of cancer. The nail was inserted carefully with special attention to avoid the proximal end of the nail impinging the rotator cuff tendons or the acromion. … IM nailing for the proximal humerus has been considered inappropriate due to the thin cortex and bony defect after curettage. 7) A number of recent clinical series on IM nailing using specially designed nails have reported high union rates and satisfactory functional outcomes of treatment of proximal …

[Retrograde intramedullary nail fixation for Charcot neuroarthropathy].

UNLABELLED: Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when

Is It Appropriate to Treat Sarcoma Metastases With Intramedullary Nailing?

BACKGROUND: Patients with primary bone and soft tissue sarcoma are at risk for skeletal metastases. Although uncommon, these metastases can … iotherapy alone or resection and an endoprosthesis, our findings suggest that use of intramedullary nails is helpful for providing fixation that in most instances lasts for the lifetime of patients with multifocal bone metastases from sarcomas. LEVEL OF EVIDENCE: Level IV, therapeutic study.

Clinical and Educational Gaps in Diagnosis of Nail Disorders.

Dermatologists care for skin, hair, and nails, yet many dermatologists find nail disorders challenging. Practice gaps in knowledge, skill, and attitude in clinical practice and resident education are sometimes impediments to timely medical and surgical diagnosis of nail disorders. Limited resident exposure to diagnosis and management of complicated nail disorders and lack of experience performing diagnostic and surgical procedures impairs progress toward surmounting these gaps.

Laser and light therapies for the treatment of nail psoriasis.

Psoriatic involvement of the nail is notoriously refractory to conventional therapy. Nail psoriasis has a high incidence amongst patients with psoriasis. It remains a significant cosmetic problem and thus, has a significant impact on quality of life. More recently, light and laser therapies have emerged as modalities for treatment of nail psoriasis. In this study, the efficacies of light and laser therapies are systematically reviewed. Light therapies involve ultraviolet light (with or without photosensitizers) or intense pulsed light. Alternatively, laser therapy in nail psoriasis is primaril

Relapse of Yellow Nail Syndrome with Pulmonary Lymphedema.

Yellow nail syndrome (YNS) is a rare disorder characterized by the triad of yellow, thickened nails, lymphedema, and respiratory manifestations such as pleural effusions, bronchiectasis, and recurrent lower respiratory tract infections. We report a case of YNS showing pulmonary interlobular septal thickening on thoracic computed tomography, implying the presence of lymphatic edema. The patient showed both the remission and relapse of yellow nail with different lung treatments over a long clinical course.

Onychoheterotopia Due to a Traumatically Transplanted Nail in a Child.

Onychoheterotopia is a rare condition characterized by ectopic nail tissue growth. It is a digital mass that is commonly misdiagnosed. We describe a 6-year-old girl who presented with onychoheterotopia after trauma to the digit. Her onychoheterotopia was incorrectly diagnosed as a common wart. It is important to include onychoheterotopia in the differential diagnosis of digital masses, especially in the setting of previous traumatic injury.

[Antegrade femoral intramedullary nailing in a lateral position].

BACKGROUND: Intramedullary nailing is the gold standard for the treatment of femoral shaft fractures; however, rotational malalignment remai … ed leg. Using the C-arm, reduction can be performed with this technique with precise placing of the nails and torsion can be exactly adjusted and controlled with the aid of the femoral neck axis, the distal locking holes and both parallel femoral condyles. RESULTS: The described technique represents an effective method for the intraoperative control of …

Surgical treatment of nail bed subungual exostosis.

INTRODUCTION: A subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe. METHODS: A total of 17 patients (12 female, five male) were included i

Tibiotalocalcaneal arthrodesis using a straight intramedullary nail.

BACKGROUND: Tibiotalocalcaneal (TTC) arthrodesis is a proven solution for severe hindfoot arthropathy that reestablishes stability for plant … chieve tibiotalocalcaneal arthrodesis. The complication concerns typically associated with straight nails were not found. We recommend using a retrograde intramedullary nail for the fixation of TTC arthrodesis and adding an allograft in cases of significant bone loss. LEVEL OF EVIDENCE: Level IV, consecutive case series.

Nail psoriasis as a predictor of the development of psoriatic arthritis.

Psoriatic arthritis is a psoriasis-related spondyloarthropathy that occurs in 20-30% of patients with psoriasis. Various imaging studies have demonstrated that there is a considerable proportion of undiagnosed psoriatic arthritis among patients with psoriasis. Since early detection and treatment of psoriatic arthritis could, ultimately, allow the prevention of clinical and radiologic progression of the disease, there is the need to establish clinical indicators to detect this risk. Nail psoriasis has been proposed as a predictor for the development of psoriatic arthritis. The inflammation invo