Surgical correction of relapsed club foot

Thirty eight relapsed club feet in 28 children previously treated by soft tissue release were corrected by further surgical procedures. Nineteen feet with relapse of all the three elements of the deformity, treated by extensive posteromedial release with limited plantar release and correction of the talonavicular subluxation or dislocation. Eight feet with relapse of the forefoot adduction were treated by medial release and limited plantar release with correction of talonavicular subluxation. Six feet with recurrent cavovarus deformity were treated by radical medial and radical plantar release with reduction of talonavicular subluxation. The reduction of talonavicular dislocation or subluxation was maintained by thin K-wire. Five feet had relapse of varus heel were treated by open or closed calcaneal wedge osteotomy. The average age of the patients at the final surgical treatment was 2 years and 4 months. The average follow up was 5 years and 8 months. Assessment was made up on strict clinical criteria and the functional results were 76% satisfactory [7 feet were excellent and 22 feet were good], 24% were poor [9 feet]. The satisfactory results decrease with the increasing age at which the final operation was done. The best result obtained in children who underwent final correction when they were two years old or younger. Talonavicular subluxation or dislocation was present in every case. In the majority of patients, feet and ankle motion was limited but relatively free of pain and able to fit into normal shoes

Surgical management of neglected club feet between two and twelve years of age

The result of surgical treatment for neglected cases of congenital talipes equino varus deformity in 76 children [114 feet] who were followed for two to ten years were evaluated. They were divided into three groups according to their age and the type of treatment used. Group I consisted of thirty six children [48 feet], their age ranged between two to five years and were treated by extensive postero medial soft tissue release with fixation of the talo navicular joint by Kirschner wire in some cases. Group II consisted of 22 children [34 feet], their age ranged between five to ten years and were treated by combined extensive postero medial soft tissue release with excision of lateral segment of bone including the calcaneo cuboid joint. Group III consisted of 18 children [32 feet], their age ranged between ten and twelve years and were treated by triple arthrodesis. Group I had 84%, group II had 76% and group III had 72% excellent or good long term result. In group I and II 90% of the patients or their parents were satisfied with both the appearance and function of club foot

Recurrent anterior shoulder dislocation result of putti platt operation

A review of twenty three cases of the Putti Platt procedure for recurrent anterior shoulder dislocation is presented. Their age ranged from 16 to 44 years averaged 19 years. A follow up of 3 to 10 years, averaged 5.5 years, revealed only two recurrences, one of them for only one time and no serious complications. The clinical results were excellent in 18 cases [78.2 percent], satisfactory in 4 cases [17.4 percent] and bad in one case [4.4 percent]. The restriction of outward rotation of less than 10 degrees could be observed in eighteen cases and of 10°-20° in five cases. Only three cases had pain. Putti Platt repair permitted good function without significant disability in most case

Assessment of the surgical treatment of the lumbar intervertebral disc

One hundred and sixty two patients with sciatic pain who had primary excision of a lumbar disc by interlaminar approach over a period of nine years [1987-1995] were studied. Of these, one hundred and forty eight patients were available for comprehensive review. The duration of follow-up ranged from two years to eight years. Patients in the age group 30-49 years were most prone to develop sciatica. At operation L5-S1 level was involved in 51% of cases. There were five negative explorations and six patients needed re-exploration. The functional outcome was good in 85% of the patients, fair in 9% of the patients and poor in 6% of the patients according to Stauffer and Coventry Criteria. Critical analysis of these results were comparable to other reviews where wide laminectomy approach was used