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Management of the flexible flat foot in the child: a focus on the use of osteotomies for correction.

Pes planus, commonly referred as flat foot, is a combination of foot and ankle deformities. When faced with this deformity in children, the treating surgeon should use a systematic method for evaluation to distinguish normal variation from true pathology, as well as conditions that have a benign natural history versus those that may lead to significant disability if left untreated. Certain deformities will inevitably worsen and therefore require surgery. Common sense clearly supports the indication for a simple procedure, such as an arthroereisis or an osteotomy, performed in the young child a…

Deformity or dysfunction? Osteopathic manipulation of the idiopathic cavus foot: A clinical suggestion.

Observed gait abnormalities are often related to a variety of foot deformities such as the cavus foot, also known as pes cavus, cavovarus, uncompensated varus, and the high arched foot. When gait abnormalities related to cavus foot deformities produce symptoms or contribute to dysfunctional movement of the lower extremity, foot orthotics are commonly used to accommodate the deformity and optimize the function of the lower extremity. In more severe cases, surgical intervention is common. Hypomobility of the many joints of the foot and ankle may be mistaken as an idiopathic cavus foot deformity.…

The impact of hallux valgus on foot kinematics: a cross-sectional, comparative study.

BACKGROUND: Hallux valgus is a very common foot deformity in modern societies. The impact of this condition on foot function has been described qualitatively and quantitatively. Published patho-mechanical models are mainly underpinned by findings originating from plantar pressure measurements. However, the kinematical patterns of the many foot segments during gait have not been quantified. This study aims to evaluate the kinematics of the various foot segments in the presence of this deformity. METHODS: Using the Oxford Foot Model and a 12-camera Motion Analysis System, gait analysis was cond…

Quantitative ultrasound of lower leg and foot muscles: feasibility and reference values.

BACKGROUND: Ultrasound is a non-invasive method to quantitatively measure various muscle parameters. Purpose of this study was to assess the feasibility of ultrasound of lower leg and foot muscles and to obtain reference values for muscle thickness (MT) and echo intensity (EI). METHODS: Ultrasound measurements of leg and foot muscles were performed in 60 healthy adults. MT and EI were quantitatively determined for the abductor hallucis (AH), extensor digitorum brevis (EDB), extensor hallucis longus (EHL) and peroneus longus (PER) muscles. Influence of age, height, weight and sex was determine…

Tendon disorders of the foot and ankle, part 1: peroneal tendon disorders.

Pathologic abnormality of the peroneal tendons is an uncommon but underappreciated source of lateral hindfoot pain and dysfunction that can be difficult to distinguish from lateral ankle ligament injuries. When left untreated, peroneal tendon disorders can lead to persistent lateral ankle pain and substantial functional problems. Unfortunately, the treatment recommendations for these disorders are primarily based on case series and expert opinion. The goals of this review are to develop a current understanding of the anatomy and diagnostic evaluation of the peroneal tendons, and to present cur…

Pitfalls in diagnosis and problems in extraction of retained wooden foreign bodies in the foot.

The detection and removal of a radiolucent foreign body in soft tissues is a problem. It is further complicated when it is not radio-opaque and embedded in the deep layers of the foot. Despite advances in imaging techniques, the detection of retained wooden foreign bodies remains a difficult and challenging task. Although radiographs have been proven to be ineffective, it is often the first method used. Wood often splinters, causing incomplete removal and persistent symptoms. In such cases complete surgical extraction cannot be guaranteed in spite of our best efforts. Therefore, a post-procedu…

[Functional stability of the vertical posture in children depending on foot arch condition].

Functional stability of the vertical posture was evaluated in 112 children aged 7-10 years with normal or flattened arch of foot and platypodia. The following parameters were measured in each child during 20 s by a Stabilan 01 computerized stabilograph: stabilogram, average frequency of centre of pressure changes, mean dispersion (R), oscillation period, and ellipse area (S). Children with flattened foot arch had lower vertical posture stability (estimated from amplitude characteristics of changes of the foot pressure centre, R and S) than those with normal foot arch or platypodia. Children of…

Can patterns of segmental injuries of the foot and ankle predict amputation and disability?

The purpose of the study was to determine the risk of digital or distal segmental amputation and permanent unemployment in patients with these injury patterns. A retrospective chart review of 23 patients with multiple, ipsilateral injuries of the foot and ankle was performed. Amputations occurred in five patients (21.7%) and were most common in those with three-level injuries. Odds ratios showed that patients with an amputation were 9.75 times more likely to have a three-level injury than a two-level injury. At a mean follow-up of 12.9 months, 12 patients had not returned to work (60%), seven …

Случай Варичеллы в сочетании с болезнью ручных ступней в здоровом ребенке.

Мы сообщаем здесь о 11-летнем ребенке с извержением пастуловицы на ее теле, включая ее ладони, подошвы и пероральную слизь, и это сопровождалось лихорадкой. Серологический тест был положительным для антител IgM varicella зостера и коксакивируса A16. Гистопатологический анализ с пальмы выявил внутрипайдермальные пуштулы, которые не показали ни интеграционного тела, ни многонуклеарных гигантских клеток. Мы сделали окончательный диагноз, согласно серологическим тестам и гистопатологическим заключениям, как варицелла в сочетании с болезнью ручной ступни, вызванной коксакивирусом А16 у ранее здоров

Совпадение в аннотации оригинала
We report here on an 11-year-old child with a pustulovesicular eruption on her whole body, including her palms, soles and oral mucosa, and t … sis, according to the serologic tests and histopathologic findings, as varicella combined with hand-foot-mouth disease caused by coxsackievirus A16 in a previously healthy child.

Epidemiology and control of hand, foot and mouth disease in Singapore, 2001-2007.

INTRODUCTION: We reviewed the epidemiology of hand, foot and mouth disease (HFMD) in Singapore after the 2000 epidemic caused by Enterovirus 71 (EV71), with particular reference to the cyclical pattern, predominant circulating enteroviruses and impact of prevention and control measures in preschool centres. MATERIALS AND METHODS: We analysed the epidemiological data from all clinical cases and deaths of HFMD diagnosed by medical practitioners and notified to the Ministry of Health, as well as laboratory data on enteroviruses detected among HFMD patients maintained by the Department of Patholo…

[Association between hand-foot-and-mouth disease in Xi'an and enterovirus 71].

OBJECTIVE: To isolate the prevalent strain of enterovirus 71 (EV71) in Xi'an area in 2008, and compare the concordance of viral isolation, reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescent technique in detecting EV71, find the fast and effective method for detection, and analyze the differences between the EV71 strains isolated from Xi'an and Fuyang, Anhui. METHOD: Virus isolation and RT-PCR were carried out on vesicle fluid and throat swab specimens that were collected from the patients with hand-foot-and-mouth disease, RD and HEp-2 cell lines were used for viral…

[Study on the etiology of hand-foot-mouth disease outbreaks in Beijing in 2007].

OBJECTIVE: To identify the etiology of 8 human hand-foot-mouth disease (HFMD) outbreaks in Beijing, during May to July 2007. METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) method was used to directly type the specimens including fluid from the herpes and throat swabs from the HFMD patients. Using RD cell lines, the collected stool specimens were cultured followed by typing. Partial VP1 region of selected EV positive specimens and cultures were sequenced and both nucleic acid sequence and predicted amino acid sequence were analyzed. RESULTS: The two HFMD outbreaks in Daxing…

Acral lentiginous melanoma of the foot and ankle: A case series and review of the literature.

BACKGROUND: Acral lentiginous melanoma (ALM) is an uncommon, cutaneous malignant tumour which may arise on the foot. Its relative rarity, atypical appearance and late presentation frequently serve as poor prognostic indicators. METHODS: At a tertiary skin tumour centre, a retrospective review was undertaken of all patients diagnosed with the tumour at the level of ankle or below. RESULTS: Over a six year period, 27 cases (20 female, 7 male) were identified with positive histology confirming the disease. The age ranged from 35-96 years of age (mean 62.7 years). The majority of the cohort were…

Hearing impairment in congenital diaphragmatic hernia: the inaudible and noiseless foot of time.

AIM OF THE STUDY: Infants with congenital diaphragmatic hernia (CDH) are at high risk of sensorineural hearing loss (SNHL). Extracorporeal membrane oxygenation is known to increase this risk, but little is known about other potential causes. We evaluated the impact of several risk factors on SNHL development in CDH survivors not treated with extracorporeal membrane oxygenation. METHODS: All high-risk CDH survivors consecutively treated between 1999 and 2005 were included. SNHL was diagnosed based on formal assessment with standard audiologic tests. Patients with and without SNHL were compared

[Extramembranous transfer of the tibialis posterior tendon for the correction of drop foot deformity].

OBJECTIVES: We evaluated the effectiveness of extramembranous transfer of the tibialis posterior (TP) tendon for the treatment of drop foot deformity. METHODS: The study included 13 patients (6 females, 7 males; mean age 30 years; range 10 to 46 years) who underwent 15 tendon transfers for drop foot deformity. Ten patients (76.9%) had deformity due to unrepairable nerve injuries, which were associated with surgical procedures in six patients and trauma in the remaining four. In four feet (26.7%), the TP tendon was turned from the intero-anterior aspect of the tibia and fixed by tenodesis to t…

Surgery can reduce the nonoperative care associated with an equinovarus foot deformity.

UNLABELLED: Equinovarus is the most common lower extremity deformity seen after a stroke. Despite its frequency, there are no specific guidelines in determining when surgery should be considered and for which patients it is appropriate. We evaluated the charges of nonsurgical and surgical treatments for equinovarus foot in 29 consecutive patients who underwent surgery for a unilateral equinovarus deformity after stroke. Twenty-six patients (seven males, 19 females) were available for followup. Mean patient age at the time of stroke was 48.2 years (range, 3-66 years). The average age at surgery…

Intramedullary screw fixation for balancing of the dysvascular foot following transmetatarsal amputation.

Transmetatarsal amputation is a viable alternative to more proximal pedal amputations or leaving a deformed partial forefoot amputation. Balancing the transmetatarsal amputation in order to correct soft-tissue deformities is an accepted approach and consists of various tendon transfers, However, in the recently re-vascularized limb or in those patients who can not undergo re-vascularization, additional incisions to balance the transmetatarsal amputation are not performed. The authors present a simple and effective technique utilizing a large diameter, cannulated screw extending from the residu…