ABSTRACT
Objetivo: Relatar os resultados com médio prazo de seguimento após a implantação de Arthrosurface-HemiCap em pacientes com diagnóstico de hállux rígidus (HR). Método: Onze pacientes foram submetidos à artroplastia parcial da primeira metatarso-falangeana. Seis mulheres e cinco homens com idade média de 51,9 anos (46 a 58 anos) e média de seguimento pós-operatório de 3,73 anos (3-4 anos); foram classificados através do sistema de Kravitz e avaliados pelas escalas da american orthopaedic foot and ankle society (AOFAS) para hállux, visual analog scale (VAS) analógico funcional de dor - e pela amplitude de movimento da primeira articulação metatarsofalangeana no periodo pré-operatório, pós-operatório de seis meses e pós-operatório atual. Resultados: Os resultados revelam melhora significativa dos três parâmetros analisados no estudo, tanto para análise global como para comparações pré e pós-operatórias individuais. A análise comparativa de cada variável nos períodos pós--operatórios de seis meses e atual não mostram diferença estatística o que indica manutenção dos parâmetros durante esse intervalo. Conclusão: A hemiartroplastia da primeira metatarsofalangeana é opção reprodutível e segura para o tratamento cirúrgico do hállux rígidus II e III, com significativa melhora dos parâmetros avaliados para a população estudada. Nível de Evidência IV, Série de casos.
Objective: To report the results of medium-term follow-up after deploying arthrosurface-Hemicap in patients with diagnosis of hállux rígidus (HR). method: eleven patients underwent partial arthroplasty of the first metatarsal-phalangeal joint. six women and five men with an average age 51.9 years (46 to 58 years) and average postoperative follow-up of 3.73 years (3-4 years); were classified through the Kravitz system and evaluated by the american orthopaedic foot and ankle society (aofas) scales for hallux, visual analogical scale (vas) analog functional pain - and motion range in the first metatarsal joint in preoperative, postoperative after six months and present post-operative. Results: the results show significant improvement of the three analyzed parameters, both for overall analysis and for pre and post-operative comparisons individually. the comparative analysis of each variable in the six months and the current postoperative periods do not show statistically significant differences, indicating maintenance of parameters during this interval. conclusion: hemiarthroplasty of first metatarsophalangeal joint is a reproducible and safe option for the surgical treatment of hállux rígidus II and III, with significant improvement of the evaluated parameters for the studied population. Level of Evidence IV, Case Series.
Subject(s)
Humans , Male , Female , Middle Aged , Range of Motion, Articular/physiology , Metatarsophalangeal Joint/physiopathology , Arthroplasty, Replacement, Finger/rehabilitation , Hallux Rigidus/surgery , Osteoarthritis/surgery , Osteoarthritis/rehabilitation , Radiography , Data Interpretation, StatisticalABSTRACT
AIM: Limited joint mobility and plantar pressure in the foot has not been assessed in type 1 diabetes. The aim of this study was to investigate the joint mobility and plantar foot pressure in Asian Indian type 1 diabetic subjects and to see its association with duration of diabetes. MATERIAL AND METHODS: The joint mobility and plantar pressure were measured in 115 consecutive subjects attending the foot clinic. The study groups were: Control- non diabetic controls (n=40) (M:F 19:21) and type 1 diabetic patients (n=75) (M:F 42:33). Joint mobility was assessed using a goniometer at two sites, in the subtalar joint and in the hallux. Plantar pressure was measured using the RS-Scan platform system. Data obtained on the metatarsal heads were used for analysis. RESULTS: Patients with type 1 diabetes had significantly lesser joint mobility (p < 0.0001) and higher plantar pressure (p < 0.0001) compared with the control group. Duration of diabetes had an inverse association with joint mobility (p < 0.0001). The degree of joint mobility was more restricted in patients with longer duration of diabetes. Plantar pressure increased with increasing duration of diabetes. CONCLUSION: In conclusion, type 1 diabetic patients in India had limited joint mobility which decreased further with longer duration of diabetes and they had high plantar pressure also.
Subject(s)
Adult , Ankle Joint/physiopathology , Arthrometry, Articular , Case-Control Studies , Diabetes Mellitus, Type 1/physiopathology , Diabetic Foot/prevention & control , Disease Progression , Female , Humans , India , Male , Metatarsophalangeal Joint/physiopathology , Muscle, Skeletal/physiopathology , Pressure , Time FactorsABSTRACT
La osteocondrosis de los sesamoideos, es como todas las osteocondrosis una necrosis avascular subcondral, seguida de un proceso de reparación incompleta la mayor parte de las veces. Predispone incluso a la fractura por fatiga del sesamoideo afectado. Es debida a la hipersolicitación de los sesamoideos, frecuentemente por actividades deportivas. Nos hemos encontrado con una incidencia del 0.2 por ciento entre 5,000 deportistas asistidos en consultas cada año, sobre todo en los deportistas de salto (baloncesto y balonmano) y en los bailarines, en proporción igual en las mujeres que en los hombres. Con el tratamiento conservador basado principalmente en la descarga, se ha llegado a un buen resultado en todos nuestros casos, sin haber tenido nunca necesidad de recurrir al tratamiento quirúrgico, el cual da problemas al menos en un 50 por ciento
Subject(s)
Humans , Male , Female , Adolescent , Adult , Osteochondritis/etiology , Osteochondritis/therapy , Athletic Injuries/diagnosis , Athletic Injuries/epidemiology , Sesamoid Bones/physiopathology , Sesamoid Bones , Metatarsophalangeal Joint/physiopathologyABSTRACT
Se presentan cuatro casos de mujeres jóvenes con cuadro clínico de inflamación aguda de la primera articulación metatarsofalángica y a quienes se les demostró en los rayos X calcificaciones a ese nivel. Consideramos que se trata de los primeros cuatro casos de suedopodagra por hidroxiapatita descritos en Colombia. Se hace una descripción yel diagnóstico diferencial de esta entidad