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1.
Rev. bras. ortop ; 57(5): 891-895, Sept.-Oct. 2022. graf
Article in English | LILACS | ID: biblio-1407710

ABSTRACT

Abstract Freiberg disease is a rare condition whose diagnosis requires a high clinical suspicion. Avascular necrosis of the metatarsal head progresses with articular collapse, leading to forefoot pain and limitation of the daily activities. Several surgical techniques have been described to address the disease, and since it is usually diagnosed in later-stages, most of them include joint-destructive procedures. The use of arthroscopy on the small joint of the foot has arisen in the last few years, but its application in Freiberg disease is still scant. Joint-preserving procedures have been advocated for cases of early-stage disease, aiming to relieve symptoms while preventing the progression of the disease. In the present report, we describe a successful treatment of a 12-year-old patient with early-stage Freiberg disease using core decompression and bone marrow graft through a minimally-invasive approach assisted by arthroscopy.


Resumo A doença de Freiberg é rara, e seu diagnóstico requer alto grau de suspeita clínica. A necrose avascular da cabeça do metatarso progride com colapso articular, e causa dor no antepé e limitação da atividade. Há diversas técnicas cirúrgicas para o tratamento da doença; como o diagnóstico geralmente é feito em estágios posteriores, a maioria dessas técnicas inclui procedimentos de destruição articular. A artroscopia tem sido utilizada nas pequenas articulações do pé nos últimos anos, mas sua aplicação na doença de Freiberg ainda é escassa. Procedimentos de preservação articular têm sido preconizados na doença em estágio inicial, com o objetivo de aliviar os sintomas e impedir a progressão. Neste relato, descrevemos o tratamento bem-sucedido de uma paciente de 12 anos de idade com doença de Freiberg em estágio inicial por meio de descompressão central e enxerto de medula óssea, por meio de abordagem minimamente invasiva assistida por artroscopia.


Subject(s)
Humans , Female , Child , Arthroscopy , Metatarsal Bones , Bone Marrow Transplantation , Foot
2.
Medisan ; 26(2)abr. 2022. ilus
Article in Spanish | LILACS-Express | LILACS, CUMED | ID: biblio-1405793

ABSTRACT

Se describe el caso clínico de un paciente de 34 años de edad, con antecedente de salud, atendido en la consulta intermunicipal de II Frente, provincia de Santiago de Cuba, por presentar, desde hacía 8 meses, una lesión en el nervio peroneo común, en la cara lateral del tercio superior de la pierna derecha, a causa de una mordida de cerdo, la cual no fue diagnosticada inicialmente, sino que se trató como una herida sin lesión neurológica. Se realizó proceder quirúrgico, consistente en una transposición tendinosa del músculo tibial posterior. Se inmovilizó el pie con una férula de yeso por 15 días, se le retiró la sutura a las 6 semanas y se indicó rehabilitación. A las 12 semanas comenzó a caminar sin dificultad y logró reincorporarse a sus actividades cotidianas.


The case report of a 34 years patient with health history is described. He was assisted in the intermunicipal visit of II Frente, province of Santiago de Cuba, due to a lesion in the common peroneal nerve during 8 months, in the lateral face of the superior third of the right leg, because of a pig bite, which was not diagnosed initially, but instead it was treated as a wound without neurological lesion. A surgical procedure was carried out, with a tendon transposition of the posterior tibial muscle. The foot was immobilized with a plaster splint for 15 days, the suture was removed 6 weeks later and rehabilitation was indicated. Twelve weeks later he began to walk without difficulty and he was able to return to his daily activities.


Subject(s)
Surgical Procedures, Operative , Tendon Transfer , Foot
3.
Rev. bras. ciênc. mov ; 29(2): [1-16], mar. 2022. tab
Article in Portuguese | LILACS | ID: biblio-1363866

ABSTRACT

O objetivo do estudo foi verificar a influência do estímulo visual e posicionamento dos membros superiores no controle postural ortostático e avaliar o efeito do sexo e idade nas respostas posturais de crianças e adolescentes. Estudo transversal, com amostra de 84 participantes com idade entre 11 e 14 anos, ambos os sexos (55 meninas), de escola pública de Goiânia (GO). Além do exame físico, o controle postural foi avaliado na posição ortostática pela baropodometria computadorizada em três condições: olhos abertos, olhos fechados e olhos abertos com ombros a 90° de abdução. A ausência do estímulo visual gerou maior instabilidade postural em comparação à condição de olhos abertos. Em relação as diferenças existentes entre os sexos, foi observado que as meninas tiveram menores valores de deslocamento anteroposterior e área da elipse que os meninos. Comparando-se os olhos abertos e fechados, as meninas apresentaram maiores valores na área da elipse e os meninos nos deslocamentos anteroposterior e látero-lateral. Ao analisar o efeito da idade foi observado que o grupo com 13 e 14 anos apresentou maiores valores em todas as variáveis analisadas. A ausência do estímulo visual aumentou os valores da área da elipse no grupo com 11 e 12 e dos deslocamentos no grupo com 13 e 14 anos. Não foi verificado efeito interativo entre sexo e idade. Na condição de abdução dos membros superiores não houve diferença no controle postural. Conclui-se que a ausência do estímulo visual foi mais impactante na manutenção do controle postural ortostático em crianças e adolescentes em relação as outras condições avaliadas, existindo diferença entre os sexos e a idade, em que os meninos e o grupo com 13 e 14 anos realizaram mais ajustes para manter o controle postural. (AU)


The aim of this study was to verify the influence of visual stimulus and positioning of the upper limbs in the orthostatic postural control, and to assess the effects of gender and age in the postural responses of children and adolescents. This was a transversal study involving 84 participants (of which 55 were girls) from public schools in Goiania (GO - Brazil) with age between 11 and 14 years. Besides physical examination, the participants' postural control was assessed in the orthostatic position by computerized baropodometry in three different conditions: eyes-open, eyes-closed, and eyes-open with shoulders at 90º abduction. The absence of visual stimulus generated more postural instability in relation to the eyes-open condition. Regarding gender differences, the girls had lower anteroposterior and ellipse area displacement than boys. Comparing the eyes-open and eyes-closed conditions, the girls presented higher values in the ellipse area and the boys presented higher values in the anteroposterior and laterolateral displacements. Analyzing the effect of age, the participants between 13 and 14 years old presented higher values in all variables. The absence of visual stimulus increased the values of the ellipse area in the participants between 11 and 12 years of age and the values of displacements in the participants between 13 and 14 years of age. Interactive effect between genders and age has not been verified. There were no postural control differences in the upper limbs abduction condition. Conclusion: The absence of visual stimulus was more impacting in the support of orthostatic postural control in children and adolescents than the other conditions assessed; the boys and the participants between 13 and 14 years of age made more adjustments in order to maintain postural control. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Child Development , Upper Extremity , Postural Balance , Standing Position , Photic Stimulation , Physical Education and Training , Posture , Sense Organs , Shoulder , Eye , Foot , Core Stability , Locomotion , Motor Skills
4.
Rev. bras. ciênc. mov ; 29(2)mar. 2022. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1363980

ABSTRACT

O objetivo deste estudo foi comparar e correlacionar o tempo de experiência e as habilidades técnicas em crianças praticantes de futsal da categoria sub-11. 22 crianças praticantes de futsal (21 do sexo masculino e uma do sexo feminino), com idade entre nove e onze anos, participantes de uma escolinha de futsal foram divididas em dois grupos de praticantes: com menor tempo de experiência (G1); e, com maior tempo de experiência (G2), todos em fase de aprendizagem e de treinamento do futsal. Ambos grupos foram avaliados pelo teste Skills, adaptado ao futsal. Foram obtidas, comparadas e correlacionadas a idade, massa corporal, estatura, condução de bola, domínio de bola, precisão do chute e precisão de passe com o pé direito e esquerdo. A avaliação ocorreu individualmente com um período de adaptação da criança as tarefas do teste e teve duração aproximada de três minutos para cada criança. Dois avaliadores com experiência na modalidade participaram da realização do teste. Comparações das variáveis entre os grupos foram realizadas e correlações entre o tempo de experiência e as habilidades técnicas foram testadas com α de 5%. Os achados deste estudo indicam que todas as habilidades técnicas apresentaram valores similares (p > 0,05). Assim, na categoria sub-11, o tempo de experiência não foi um fator determinante no nível de aprendizado das habilidades técnicas e nas características antropométricas das crianças. Ainda, foram identificadas correlação entre o tempo de experiência com as variáveis da idade, domínio1,95m, domínio3,05m, passe com o pé esquerdo e condução de bola. Portanto, independente do tempo de experiência em jogadores da categoria sub-11, os mesmos podem apresentar desempenho similar nas habilidades técnicas do futsal....(AU)


The objective of this study was to compare and correlate the time of experience and technical skills in children practicing futsal in the sub-11 category. 22 children playing futsal (21 male and one female), aged between nine and eleven years old, participating in a futsal school were divided into two groups of practitioners: with less experience (G1); and, with a longer experience (G2), all of them in the futsal learning and training phase. Both groups were evaluated by the Skills test, adapted to futsal. Age, body mass, height, ball handling, ball control, kick accuracy and passing accuracy with the right and left foot were obtained, compared and correlated. The evaluation took place individually with a period of adaptation of the child to the test tasks and lasted approximately three minutes for each child. Two evaluators with experience in the modality participated in the test. Comparisons of variables between groups were made and correlations between time of experience and technical skills were tested with α of 5%. The findings of this study indicate that all technical skills showed similar values (p>0.05). Thus, in the sub-11 category, the length of experience was not a determining factor in the level of learning of technical skills and anthropometric characteristics of children. In addition, a correlation was identified between the time of experience with the variables of age, domain1.95m, domain3.05m, pass with the left foot and ball handling. Therefore, regardless of the time of experience in players of the sub-11 category, they can present similar performance in the technical skills of futsal. (AU)


Subject(s)
Humans , Male , Female , Child , Sports , Child , Learning , Soccer , Child Development , Physical Fitness , Athletic Performance , Test Taking Skills , Youth Sports , Foot , Motor Skills
5.
Rev. bras. ortop ; 57(1): 167-174, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365740

ABSTRACT

Abstract Objective To evaluate the biomechanical behavior of the medial longitudinal arch (MLA) of the foot and the kinematic parameters of the lower limbs with biomimetic footwear (BF) and non-biomimetic (NB1, NB2, NB3 and NB4) footwear in children at the beginning of the gait acquisition phase. Methods Four toddlers were evaluated at the beginning of the gait acquisition phase under the following conditions: walking barefoot, ambulation with BF and NB1, NB2, NB3 and NB4 footwear in hard floor. BF is described as biomimetic because of its property of emulating natural and irregular floors through a dynamic internal insole. The MLA and kinematics of the hip, knee, and ankle during gait were evaluated by three-dimensional motion analysis system. The similarity between the kinematic curves of barefoot and footwear conditions was analyzed by root mean square error (RMSE). Results The use of BF presented the highest magnitude of MLA and the greatest difference in relation to barefoot condition (higher RMSE). The BF showed less difference in the kinematics of the knee and ankle joints during gait when compared to barefoot condition (lower RMSE). NB2 footwear presented hip kinematics more similar to barefoot condition (lower RMSE). Conclusion Biomimetics footwear and NB2 shoes (both with wider forefoot region) generated smaller differences in lower limbs compared to barefoot. In addition, the MLA was higher in the BF, probably because different design from other shoes.


Resumo Objetivo Avaliar o comportamento do arco longitudinal medial do pé (ALM) e os parâmetros cinemáticos dos membros inferiores durante a deambulação com calçados biomiméticos (CBs) e não biomiméticos (NB1, NB2, NB3 e NB4) em crianças no início da fase de aquisição da marcha. Métodos Foram avaliadas quatro crianças no início da fase de aquisição da marcha nas seguintes condições: andar descalço, andar com CBs e calçados NB1, NB2, NB3 e NB4 em solo plano. O calçado biomimético é descrito como biomimético por emular pisos naturais e irregulares por meio de uma palmilha interna dinâmica. O ALM e a cinemática do quadril, joelho e tornozelo durante a marcha foram avaliados por meio de sistema de análise do movimento tridimensional. A similaridade entre as curvas cinemáticas das condições descalça e com calçado foi analisada por meio do cálculo de root mean square error (RMSE). Resultados O CB foi o que apresentou maior magnitude do ALM e maior diferença do ALM em relação à condição descalça (maior RMSE). O CB apresentou ainda menor diferença na cinemática das articulações do joelho e tornozelo durante a marcha quando comparado à condição descalça (menor RMSE). O calçado NB2 apresentou a cinemática do quadril mais semelhante à condição descalça (menor RMSE). Conclusão Os calçados CB e NB2 que apresentam a região do antepé mais larga geraram menores diferenças na cinemática dos membros inferiores. Além disso, o ALM foi maior no CB provavelmente devido a seu design ser diferente daquele dos demais calçados.


Subject(s)
Humans , Infant , Shoes , Walking , Biomimetics , Foot , Gait
6.
Article in Spanish | LILACS, BINACIS | ID: biblio-1411617

ABSTRACT

Introducción: Los estudios dinámicos de la función del pie habitualmente se realizan en laboratorios de marcha de gran complejidad. El objetivo de este estudio fue analizar parámetros funcionales utilizando una plataforma de fuerza en una serie de pacientes asintomáticos evaluados en consultorios externos. materiales y métodos: Estudio de corte transversal que incluyó una serie consecutiva de pacientes asintomáticos voluntarios a quienes se les realizó una medición con una plataforma de fuerza (TekScan MatScan®, Boston, MA, EE.UU.) entre 2014 y 2020, en la Ciudad Autónoma de Buenos Aires, Argentina. Resultados: Se incluyeron 316 registros de 158 pacientes con mediciones bilaterales. La mayoría eran mujeres (66,5%) y el promedio de la edad era de 47 años (DE 16.1). Se evaluaron 14 variables, correspondientes a parámetros de fuerza, trayectoria y tiempo de contacto de la fuerza. El tiempo de contacto total fue de 0,79 segundos (DE 0,09), el CoF time según la región del pie fue del 20% en el talón, 26% en el mediopié y 46% en el antepié. El CPEI (center of pressure excursion index) fue del 16,55% (DE 7,14). Conclusiones: Se comunican los parámetros funcionales del pie en pacientes asintomáticos. Se midieron el tiempo de contacto del pie en el suelo, la fuerza (en talón, mediopié y antepié) y la trayectoria de la fuerza con una platafor-ma de fuerza. No se utilizaron radiaciones ionizantes. Estos hallazgos podrían ser utilizados como valores de referencia para detectar marchas patológicas. Nivel de Evidencia: II


Introduction: Dynamic studies of foot function are usually carried out in highly complex gait analysis laboratories. The objective of this study was to analyze functional parameters using a force platform in a series of asymptomatic patients evaluated in an outpatient clinic. materials and methods: Cross-sectional study, which included a consecutive series of volunteer asymptomatic patients who underwent a force platform measurement (TekScanMatScan®, Boston, MA, USA) between 2014 and 2020, in the City of Buenos Aires, Argentina. Results: 316 records were included, corresponding to 158 individuals with bilateral measurements. Most were women (66.5%), with a mean age of 47 years (SD 16.1). Fourteen variables were evaluated, corresponding to parameters of force, trajectory, and contact time. The total contact time was 0.79 seconds (SD 0.09), and the COF time according to the region of the foot was 20% in the heel, 26% in the midfoot, and 46% in the forefoot. The CPEI (Center of Pressure Excursion Index) value was 16.55% (SD 7.14). Conclusion:Foot functional parameters in asymptomatic patients are presented. The contact time of the foot on the ground, the force in the heel, midfoot, and forefoot, and the force trajectory were measured. No ionizing radiation was used. These findings could be used as reference values to detect pathological gaits. Level of Evidence: II


Subject(s)
Biomechanical Phenomena , Foot , Gait Analysis
7.
Article in Spanish | LILACS, BINACIS | ID: biblio-1411625

ABSTRACT

Introducción: Los hemangiomas son neoplasias benignas que se originan de células endoteliales; rara vez resultan malignos. El síntoma más común es el dolor, porque el hemangioma comprime un tronco nervioso cercano o un nervio directamente. Presentamos un caso de hemangioma en una región muy poco frecuente. Se trata de una mujer de 35 años que presentaba una tumoración friable, de coloración marrón, dolorosa, en la región distal del hallux, con aumento de tamaño en los últimos meses. Se realizó la exéresis completa de la tumoración. El diagnóstico anatomopatológico fue hemangioma capilar. No se observó recidiva luego de 36 meses de seguimiento. Conclusión: Frente a estas neoplasias, se recomienda la exéresis de la pieza y su posterior estudio. Nivel de Evidencia: IV


Introduction: Hemangiomas are benign neoplasms originating from endothelial cells and may rarely be malignant. The most common symptom is pain, due to the compression of a nerve or nerve trunk by the hemangioma. We present the case of a patient with this type of tumor in an infrequent location. The patient was a 35-year-old female with a painful, brown-colored and friable tumor in the distal region of the hallux which had increased in size in the last months before treatment. Complete surgical resection of the tumor was performed, with a histopathological diagnosis of capillary hemangioma. No recurrence was observed during the 36-month follow-up. Conclusion: We recommend a complete resection of these neoplasms and their posterior histopathology analysis. Level of Evidence: IV


Subject(s)
Adult , Hallux , Hemangioma, Capillary , Foot
8.
Arq. Asma, Alerg. Imunol ; 5(4): 437-441, out.dez.2021. ilus
Article in English | LILACS | ID: biblio-1399813

ABSTRACT

Atopic Dermatitis, also called atopic eczema, is a complex systemic inflammatory disease with heterogeneous clinical morphologies. Common features are eczematous lesions, intense pruritus and chronic or relapsing disease course. Eczematous lesions typically show an age-related distribution. However, this disease can present different phenotypes, like follicular/papular dermatitis and prurigo nodularis. We reported a male, 22 years old, phototype IV, African descent, with personal and familial history of atopy. He reported pruritus, xerosis and lesions on skin since he was 2 years-old, with relapsing and chronic course. Clinical examination showed disseminated perifollicular accentuation and rough follicular papules. Extensor surfaces of the legs showed excoriated papules and nodules, beside generalized post-inflammatory hypopigmentation. He had lichenified plaques on the back, neck, hands and foot. Skin biopsy showed spongiosis, parakeratosis and irregular acanthosis at the epidermis. The diagnosis was late and occurred only in adulthood. Due to the extensive and relapsing presentation, he received Cyclosporin 3 mg/Kg/day, associated to steroids and emollients, with improvement of pruritus, xerosis and lechinification. But he maintained perifollicular accentuation. The patient presented common features of Atopic Dermatitis, like chronic and relapsing lesions, history of atopic, dry skin, pruritus, and early disease onset. However, atypical morphologies were presented, exemplified by prurigo nodularis and follicular/papular dermatitis. Other relevant finding it was the fact that the lesions occurred outside the classic areas, with prevalence on extensor surfaces and trunk. These atypical morphologies and unusual location of lesions are prevalent on adults with high phototypes, as seen in this case. It is essential to identify these challenging phenotypes, because the diagnosis of Atopic Dermatitis is clinical. Given the diversity of clinical presentation and difficult to recognize some cases, this article will contribute to demonstrate atypical manifestations and common features in non-white patients, facilitating correct diagnosis and early treatment.


A dermatite atópica, também chamada de eczema atópico, é uma doença inflamatória sistêmica complexa, com morfologias clínicas heterogêneas. As características comuns são lesões eczematosas, prurido intenso e curso crônico ou recidivante. Lesões eczematosas geralmente mostram uma distribuição relacionada à idade. No entanto, essa doença pode apresentar diferentes fenótipos, como dermatite folicular/papular e prurigo nodular. Relatamos um homem, 22 anos, fototipo IV, afrodescendente, com história pessoal e familiar de atopia. Referia prurido, xerose e lesões na pele desde os 2 anos, com recidiva e curso crônico. O exame clínico mostrou acentuação perifolicular disseminada e pápulas foliculares ásperas. As superfícies extensoras das pernas apresentavam pápulas e nódulos escoriados, além de hipopigmentação pós-inflamatória generalizada. Notaram-se placas liquenificadas no dorso, pescoço, mãos e pés. A biópsia de pele demonstrou espongiose, paraqueratose e acantose irregular na epiderme. O diagnóstico foi tardio e ocorreu apenas na idade adulta. Devido ao quadro clínico extenso e recidivante, recebeu Ciclosporina 3 mg/Kg/dia, associada a esteroides e emolientes, com melhora de prurido, xerose e liquenificação, mas manteve a acentuação perifolicular. O paciente apresentava características comuns de dermatite atópica, como lesões crônicas e recidivantes, história de atopia, pele seca, prurido e início precoce da doença, no entanto, foram apresentadas morfologias atípicas, exemplificadas por prurigo nodular e dermatite folicular/papular. Outro achado relevante foi o fato das lesões localizarem-se em áreas não clássicas da doença, com predomínio nas superfícies extensoras e tronco. Essas morfologias atípicas e localizações incomuns são prevalentes em adultos com fototipos elevados, como visto neste caso. É essencial identificar esses fenótipos desafiadores, porque o diagnóstico de dermatite atópica é clínico. Devido à diversidade de apresentações clínicas e dificuldade de reconhecimento de alguns casos, este artigo contribuirá para demonstrar manifestações atípicas e características comuns em pacientes não brancos.


Subject(s)
Humans , Male , Young Adult , Phenotype , Hypopigmentation , Blacks , Dermatitis, Atopic , Pruritus , Skin , Therapeutics , Back , Cyclosporine , Diagnosis , Torso , Foot , Hand , Neck
9.
Rev. bras. ortop ; 56(6): 697-704, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357135

ABSTRACT

Abstract Venous thromboembolism (VTE) is among the most feared complications by orthopedists both for due to its potentially lethal outcome and the uncertainties related to its prevention. Despite the vast literature on VTE prevention in major orthopedic surgeries, little is known about it in ankle and foot procedures. In orthopedics, adequate thromboprophylaxis requires a careful assessment of the thrombotic and hemorrhagic risks based on the procedure to be performed, as well as and knowledge on anticoagulant agents. The presentis review has the goal of assessing the risk of developingdiscusses VTE risk assessment, the modalities of thromboprophylaxis modalities, and the drugs used, with an emphasis on foot and ankle surgeries.


Resumo O tromboembolismo venoso (TEV) é uma das complicações mais temidas pelos ortopedistas, tanto pelo seu desfecho potencialmente letal quanto pelas incertezas relacionadas à sua prevenção. Apesar da vasta literatura existente sobre a prevenção de TEV nas grandes cirurgias ortopédicas, pouco se sabe sobre sua prevenção nas cirurgias do tornozelo e do pé. Uma adequada prescrição da tromboprofilaxia em ortopedia exige criteriosa avaliação dos riscos trombóticos e hemorrágicos com base no tipo de cirurgia a ser realizada, além do conhecimento sobre os anticoagulantes. Esta revisão tem como objetivos abordar a avaliação do risco de desenvolver TEV, as modalidades de tromboprofilaxia, e os fármacos utilizados, tendo como ênfase as cirurgias do pé e do tornozelo.


Subject(s)
Risk Assessment , Orthopedic Procedures , Disease Prevention , Venous Thromboembolism , Pre-Exposure Prophylaxis , Foot , Orthopedic Surgeons , Anticoagulants
10.
San Salvador; MINSAL; nov, 05, 2021. 53 p. ilus.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1352951

ABSTRACT

Se puede prevenir y/o reducir el riesgo de complicaciones por la mala circulación en los pies (ulceraciones e infecciones) con una adecuada estrategia que comprenda el tamizaje, la clasificación del riesgo y medidas efectivas de prevención y tratamiento. En vista de estos riesgos, es importante que las personas con diabetes reciban una atención integral que incluya la evaluación regular de los pies y un manejo de las complicaciones por un equipo multidisciplinario, de forma oportuna y eficaz, con el fin de reducir la morbilidad relacionada con las infecciones, larga estancia hospitalaria y las amputaciones, para esto es necesario contar con los lineamientos para establecer las directrices del abordaje integral, multidisciplinario e interinstitucional en lo referente a la prevención, control, diagnóstico, tratamiento y rehabilitación del pie diabético, de la población que requiera de estos servicios de salud


It can prevent and / or reduce the risk of complications from poor circulation in the feet (ulcerations and infections) with an adequate strategy that includes screening, classification of the risk and effective prevention and treatment measures. In view of these risks, it is important that people with diabetes receive comprehensive care that include regular foot evaluation and team management of complications multidisciplinary, in a timely and effective manner, in order to reduce morbidity related to infections, long hospital stay and amputations, for this it is necessary to have the guidelines to establish the guidelines of the comprehensive, multidisciplinary and inter-institutional approach with regard to the prevention, control, diagnosis, treatment and rehabilitation of diabetic foot, of the population requiring these health services


Subject(s)
Attention , Diabetic Foot , Diagnosis , Foot , Mass Screening , Risk , Morbidity , Infections
11.
Fisioter. Bras ; 22(3): 306-317, Jul 15, 2021.
Article in Portuguese | LILACS | ID: biblio-1284264

ABSTRACT

Introdução: As características morfológicas do pé sugerem desalinhamento dos membros inferiores, tornando praticantes de corrida mais susceptíveis a dor e lesões. Objetivo: Analisar a prevalência de dor e comparar as características morfológicas dos pés e alinhamento do retropé entre corredoras com sintomas no joelho e assintomáticas. Métodos: Estudo caso-controle, exploratório com abordagem quantitativa, com 31 mulheres corredoras. A presença de dor e lesões foi avaliada por meio de um questionário padronizado. A morfologia dos pés foi realizada através da inspeção, com registros fotográficos no plano posterior e o arco longitudinal do pé foi analisado através de podometria de pressão. Os dados foram analisados pelo SPSS versão 18.0. Na comparação das médias das variáveis dos ângulos de retropé foi utilizado o teste t Student para amostras independentes, considerando o p < 0,05. Resultados: Observouse que 86% das mulheres relataram sintoma predominante no joelho (64,51%). Na análise das características morfológicas dos pés, encontrou-se predomínio do tipo rebaixado e assimetria dos retropés no grupo sintomático. Conclusão: Apenas a assimetria entre os membros e as caraterísticas morfológicas do pé apresentam associação com a presença de dor no joelho. (AU)


Introduction: The morphological characteristics of foot suggests lower limbs misalignment, making street runners more susceptible to pain. Objective: To compare the morphological characteristics of the foot and rearfoot alignment between runners with or without knee symptoms, as well as to analyze the prevalence of pain. Methods: Case-control, exploratory and quantitative approach study, with 30 female runners. The presence of pain and lesions was evaluated by a standardized questionnaire. Foot morphology was analyzed through inspection, with photographic records in the posterior plane, and the longitudinal arch of the foot was measured by pressure podometry. The data were analyzed by SPSS 18.0. In the comparison of the means of the variables of the hindfoot angles, the Student t test was used for independent samples, considering p < 0.05. Results: We observed that 86% of the women reported a symptom, predominant in the knee (64.51%). In the analysis of the foot morphological characteristics, we found a predominance of the recessed type and asymmetry of the symptomatic group backs. Conclusion: Asymmetry between the limbs and morphological features of the foot are associated with knee pain. (AU)


Subject(s)
Humans , Female , Pain , Running , Foot , Knee , Ankle
12.
Pensar mov ; 19(1)jun. 2021.
Article in Spanish | LILACS-Express | LILACS, SaludCR | ID: biblio-1386751

ABSTRACT

Resumen Costa Loures, P L., Pereira Santos, F., Monteiro, L G., Duarte Rocha da Silva, C C y Fernandes da Silva, S. (2020). Actividad electromiografíca de los músculos del cuádriceps asociada a las diferentes posiciones del pie: un estudio piloto. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-15. El fortalecimiento de los músculos del cuádriceps femoral (CF) es importante debido a su función en el movimiento. La posición de la articulación puede generar cambios en el reclutamiento muscular. De esa forma el presente estudio tiene como objetivo verificar si variaciones en las posiciones del pie durante la extensión de las rodillas son eficaces para la selección específica de los músculos recto femoral, vasto lateral y vasto medial, que componen el CF. Once mujeres universitarias (edad 22.36 ± 3.56 años) participaron del estudio. Fue evaluada la activación de los músculos a través de la electromiografía de superficie, con una configuración bipolar, en 3 series de 10 repeticiones máximas (RM) de extensión bilateral de rodilla, en tres posiciones de los pies: neutra, rotación interna y rotación externa. Los resultados no presentaron diferencias significativas entre los músculos del CF en todas las posiciones del pie. En conclusión, los resultados del presente estudio sugieren que las variaciones en los grados de rotación de los pies durante la extensión de las rodillas no son eficaces para la selección específica de los músculos que componen el CF.


Resumo Costa Loures, P L., Pereira Santos, F., Monteiro, L G., Duarte Rocha da Silva, C C e Fernandes da Silva, S. (2020). Atividade eletromiográfica da musculatura do quadríceps associado às diferentes posições do pé: um estudo piloto. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-15. O fortalecimento do grupo muscular quadríceps femoral (QF) é muito importante devido sua função para o movimento. Mudanças na posição do pé, podem gerar alterações no recrutamento muscular, desta forma o presente estudo objetivou verificar se as variações nas posições dos pés, durante a extensão de joelhos, são eficazes para a seleção específica dos músculos reto femoral, vasto lateral e vasto medial, que compõem o QF. Onze mulheres universitárias (idade 22.36 ± 3.56 anos) participaram do estudo. Foi avaliada a ativação dos músculos através da eletromiografia de superfície, com configuração bipolar, em 3 séries de 10 repetições máximas (RM) de extensão de joelhos bilateral, em três posições dos pés: posição neutra, rotação interna e rotação externa. Os resultados não apontam diferenças significativas entre os músculos do QF superficial em todas as posições dos pés. Em conclusão, os resultados do presente estudo sugerem que as variações nos graus de rotação dos pés durante a extensão de joelhos, não são eficazes para a seleção específica dos músculos que compõem o QF.


Abstract Costa Loures, P L., Pereira Santos, F., Monteiro, L G., Duarte Rocha da Silva, C C & Fernandes da Silva, S. (2020). Electromyographic activity of the quadriceps musculature associated with the different functions of the foot: a pilot study. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-15. Strengthening the femoral quadriceps (FQ) muscular group is very important due to its function in moving. The joint position may generate modifications in muscle recruitment. Consequently, the objective of this study was to verify if foot position variations during knee extension are efficient in the specific selection of the rectus femoris, vastus lateralis, and vastus medialis muscles comprising the FQ. Eleven female college students (ages 22.36 ± 3.56 years old) participated in the study. Muscle activation was evaluated through surface electromyography, with bipolar configuration, in 3 series of 10 maximum repetition (MR) of bilateral knee extension, in three foot positions: neutral position, internal rotation, and external rotation. Results do not indicate significant differences among the superficial FQ muscles in all foot positions. In conclusion, results suggest that variations in foot rotation degrees during knee extension are not efficient for the specific selection of the muscles comprising FQ.


Subject(s)
Humans , Electromyography , Quadriceps Muscle , Foot , Knee
13.
Säo Paulo med. j ; 139(5): 424-434, May 2021. tab, graf
Article in English | LILACS | ID: biblio-1290254

ABSTRACT

ABSTRACT BACKGROUND: Leg length discrepancy (LLD) may play a key role in exercise biomechanics. Although the Podoprint platform has been used in dynamic pressure studies, there are no data regarding the reliability and repeatability of dynamic measurements under simulated LLD conditions. OBJECTIVES: To determine the intra and intersession repeatability and reliability of dynamic parameters of the Podoprint pressure platform under simulated LLD conditions. DESIGN AND SETTING: Observational cross-sectional study at a public university. METHODS: Thirty-seven healthy volunteers participated in this study. LLD was simulated using ethyl vinyl acetate plantar lifts with heights of 5 mm, 10 mm, 15 mm and 20 mm located under the right shoe of each volunteer. The procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Stance time, mean pressure and peak pressure measurements were registered in three trials for each foot and each LLD level. Data were collected during two separate testing sessions, in order to establish intrasession and intersession reliability. RESULTS: The intraclass correlation coefficients (ICCs) for intrasession reliability ranged from 0.775 to 0.983 in the first session and from 0.860 to 0.985 in the second session. The ICCs for intersession reliability ranged from 0.909 to 0.990. Bland-Altman plots showed absence of systematic measurement errors. CONCLUSIONS: The results from this study indicate that the Podoprint platform is a reliable system for assessing dynamic parameters under simulated LLD conditions. Future studies should evaluate plantar pressures under LLD conditions, in association with exercise, biomechanics and musculoskeletal disorders.


Subject(s)
Humans , Foot , Leg , Exercise , Cross-Sectional Studies , Reproducibility of Results
14.
Rev. bras. ortop ; 56(2): 235-243, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1251356

ABSTRACT

Abstract Objective The present study aims to evaluate the prevalence of foot and ankle pain complaints, radiographic parameters, and functional performance in subjects with severe obesity (body mass index [BMI] > 40) who are candidates to bariatric surgery. Methods Forty severely obese patients were evaluated at a bariatric surgery outpatient facility. These severely obese subjects (BMI > 40) were divided into two subgroups: those with BMI < 50 (n = 24) and BMI > 50 (n = 16). These patients were compared with a control group of 42 volunteers with a mean BMI value of 24. The following parameters were assessed: foot pain (according to the visual analog scale [VAS]), functional performance (according to the American Orthopeadic Foot and Ankle Society [AOFAS] scale, including forefoot, midfoot and hindfoot domains), age, gender, hallux metatarsal-phalangeal angle, hallux intermetatarsal angle, talocalcaneal angle, calcanean pitch angle and Meary angle. Results Incidence of foot pain was higher in the severely obese group compared with the control group (p < 0.0001; odds ratio [OR]: 4.2). Functional performance according to the AOFAS scale was lower in obese subjects compared with the control group (p < 0.0001; OR for hindfoot, 4.81; OR for midfoot, 3.33). Conclusion The incidence of foot pain was higher in the group of severely obese patients compared with the control group. According to the AOFAS scale, functional forefoot, midfoot and hindfoot performance was worse in severely obese individuals.


Resumo Objetivo Avaliar a prevalência de queixas álgicas no pé e tornozelo, parâmetros radiográficos e o desempenho funcional de indivíduos com obesidade grave, Índice de Massa Corpórea (IMC) com valor > 40 e indicação de cirurgia bariátrica. Métodos Foram avaliados 40 pacientes com obesidade grave acompanhados em ambulatório de cirurgia bariátrica. Este grupo de obesos graves (IMC > 40) foi subdividido em dois subgrupos: obesos com IMC < 50 (n = 24); e outro de obesos com IMC > 50 (n = 16). Foi realizada comparação com grupo controle de 42 indivíduo voluntários com IMC médio de 24. Foram avaliados a presença de dor no pé pela escala visual (EVA), o desempenho funcional pela escala da Associação Americana de Cirurgia do Pé e Tornozelo (AOFAS, na sigla em inglês) (domínios antepé, mediopé e retropé), idade, gênero, ângulo (âng) metatarso-falangeano do hálux, âng intermetatarsal do hálux , âng talocalcaneano, "pitch" calcaneano e âng de Meary. Resultados Foi observada maior incidência de dor no pé no grupo de obesos graves em relação ao controle (p < 0,0001, razão de chances [odds ratio, OR]: 4,2). O desempenho funcional pela escala AOFAS foi inferior no grupo de obesos em relação ao controle (p < 0,0001, retropé com OR = 4,81; mediopé com OR = 3,33). Conclusão Houve maior incidência de dor no pé no grupo de obesos graves em relação ao controle. Houve pior desempenho funcional pela escala AOFAS nas regiões do antepé, mediopé e retropé no grupo de obesos graves.


Subject(s)
Pain , Foot , Ankle , Obesity
18.
Rev. colomb. ortop. traumatol ; 35(3): 261-267, 2021. ilus.
Article in Spanish | LILACS, COLNAL | ID: biblio-1378707

ABSTRACT

Introducción la técnica de masquelet se utiliza en el tratamiento de los defectos óseos de los huesos largos con éxito. En el pie se ha descrito para el tratamiento de perdidas oseas en el 1er metatarsiano y medio pie. El objetivo del reporte de caso es describir la experiencia con la técnica en paciente con defecto óseo del cuarto y quinto metatarsianos asociado a defecto cutáneo transfixiante Reporte de caso En un paciente de 42 años que presentó herida por proyectil de arma de fuego sobre columna lateral de pie derecho con posterior defecto de cobertura transfixiante y defecto óseo por fractura conminuta de cuarto y quinto metatarsianos. Se realizó tratamiento quirúrgico en 3 tiempos, el primero estabilización y lavado quirúrgico, 2do tiempo Cobertura con colgajo sural de flujo reverso, fijación con placa y espaciador de cemento. Para un tercer tiempo se realiza retiro de cemento y colocación de injerto óseo cortico esponjoso autólogo. Se realiza seguimiento clínico y radiológico a 18 meses. Resultados el paciente no presentó complicaciones, presenta área de anestesia en territorio del sural, viabilidad completa del colgajo, no presentó infecciones. Se evidencia marcha normal sin metatarsalgia, en la evaluación radiológica presenta integración del injerto en el 90%, adecuado espacio sobre la artroplastia de interposición cuboideo metatarsiana, con un EVA de 1/10 y una AOFAS midfoot score de 85. Discusión Existen 7 reportes en la literatura acerca de la técnica de masquelet en el pie, con resultados favorables en su mayoría con restitución funcional en casos complejos y ningún reporte sobre la columna lateral. En nuestro caso la técnica demuestra ser una alternativa viable lográndose la restitución funcional y estructural del pie.


Background The Masquelet technique is used in the treatment of bone defects in long bones with high success rete reports. It has been described for the treatment of bone loss in the 1st metatarsal and midfoot. The aim of the report is to describe the experience with the technique in a patient with a bone defect of the fourth and fifth metatarsals associated with a transfixing skin defect. Case report In a 42-year-old patient who presented a gunshot wound to the lateral column of the right foot with subsequent transfixing coverage defect and bone defect due to comminuted fracture of the fourth and fifth metatarsals. Surgical treatment was performed in 3 stages, the first stabilization and surgical lavage, 2nd stage coverage with a reverse flow sural flap, fixation with a plate and a cement spacer. For a third stage, the bone cement was removed and an autologous cortico-cancellous bone graft was placed. Clinical and radiological follow-up was carried out for 18 months. Results The patient did not present complications including infection, presented anesthesia area in the sural nerve territory, complete viability of the flaps. Normal gait without metatarsalgia was evidenced and in the radiological evaluation it presents graft integration of 90% at described follow up term. Adequate space over the metatarsal cuboid interposition arthroplasty was observed, with a VAS of 1/10 and an AOFAS mid foot score OF 85. Discussion There are 7 reports in the literature about the Masquelet technique in the foot, with favorable results, mostly with functional restoration in complex cases in the medial column and no reports on the lateral column. In our case, the technique proves to be a viable alternative, achieving functional and structural restitution of the foot.


Subject(s)
Humans , Metatarsal Bones , Foot
19.
Actual. osteol ; 17(2): 78-91, 2021. graf, ilus
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1370190

ABSTRACT

La concepción original del mecanostato como un regulador de la rigidez estructural ósea orientado a mantener un determinado 'factor de seguridad' en todos los esqueletos parece no corresponder por igual a cualquier hueso y para cualquier tipo de estímulo. Hemos descubierto que la estructura cortical diafisaria del peroné humano manifiesta un comportamiento ambiguo del sistema, referido al uso del pie. La diáfisis peronea, además de ser insensible al desuso, se rigidiza, como sería de esperar, por entrenamientos en disciplinas deportivas que rotan o revierten el pie (hockey, fútbol, rugby); pero, llamativamente, se flexibiliza en su mitad proximal por entrenamiento en carrera larga, que optimiza el rendimiento del salto que acompaña a cada paso. La referida rigidización robustecería la región peronea de inserción de los músculos que rotan o revierten el pie, favoreciendo la locomoción sobre terrenos irregulares o 'gambeteando', propia de especies predadoras como los leopardos. La 'inesperada' flexibilización proximal, pese a reducir la resistencia a la fractura por flexión lateral (poco frecuente en el hombre), favorecería la absorción elástica de la energía contráctil de la musculatura inserta, optimizando el rendimiento del salto al correr, condición vital para especies presas como las gacelas. La falta de analogía de estas respuestas de la estructura peronea a distintos entrenamientos, incompatible con el mantenimiento de un factor de seguridad, sugiere su vinculación preferencial con la optimización de aptitudes esqueléticas con valor selectivo. Esto ampliaría el espectro regulatorio del mecanostato a propiedades esqueléticas 'vitales', más allá del control de la integridad ósea. Su manifestación en el hombre, ajena a connotaciones selectivas (quizá resultante del mantenimiento de genes ancestrales), permitiría proponer la indicación de ejercicios orientados en direcciones preferenciales a este respecto, especialmente cuando estas coincidieran con las de las fuerzas que podrían fracturar al hueso. (AU)


The original notion of the mechanostat as a regulator of bone structural rigidity oriented to maintain a certain 'safety factor' in all skeletons does not seem to correspond equally to every bone and for any type of stimulus. We have discovered that the diaphyseal cortical structure of the human fibula shows an ambiguous behavior of the system, with reference to the use of the foot. The peroneal shaft, in addition to being insensitive to disuse, becomes stiffened, as might be expected, by training in sport disciplines that involve rotating or reversing the foot (hockey, soccer, rugby); but, remarkably, it becomes more flexible in its proximal half by long-distance running training, which optimizes the performance of the jump that accompanies each step. The stiffening would strengthen the peroneal region of insertion of the muscles that rotate or reverse the foot, favoring locomotion on uneven terrain or 'dribbling', typical of predatory species such as leopards. The 'unexpected' proximal flexibilization, despite reducing the resistance to lateral flexion fracture (rare in human), would favor the elastic absorption of contractile energy from the inserted muscles, optimizing jumping performance when running, a vital condition for prey species such as gazelles. The lack of analogy of these responses of the peroneal structure to different training, incompatible with the maintenance of a safety factor, suggests its preferential link with the optimization of skeletal aptitudes with selective value. This would expand the regulatory spectrum of the mechanostat to 'vital' skeletal properties, beyond the control of bone integrity. Its manifestation in humans, oblivious to selective connotations (perhaps resulting from the maintenance of ancestral genes), would make it possible to propose the indication of exercises oriented in preferential directions, especially when they coincide with the direction of the forces that could fracture the bone. (AU)


Subject(s)
Humans , Animals , Sports/physiology , Bone and Bones/physiology , Exercise/physiology , Fibula/physiology , Foot/physiology , Soccer/physiology , Track and Field/physiology , Biomechanical Phenomena , Fractures, Bone/prevention & control , Fibula/anatomy & histology , Football/physiology , Hockey/physiology
20.
Article in Chinese | WPRIM | ID: wpr-942273

ABSTRACT

OBJECTIVE@#To analyze the effects of visual restoration after cataract surgery on plantar pressure and biomechanics of foot in elder individuals.@*METHODS@#Thirty-two patients [male/female 5/27, (70.1±5.2) years old] with age-related cataract were recruited between October 2016 and December 2019. The footscan system was employed to record the data of plantar pressure during level walking before and 1-month after the cataract surgery. Parameters of peak pressure (PP), impulse (I), pressure-time integral (PTI) and time to peak pressure (TPP) from the regions of the 1st toe (T1), 2nd to 5th toes (T2-5), 1st to 5th metatarsal heads (M1-M5), midfoot (MF), medial hindfoot (HM) and lateral hindfoot (HL) were analyzed respectively.@*RESULTS@#Post-operatively, the visual function was effectively reconstructed with improved visual acuity in both eyes (Z=-4.878, -4.801; P < 0.001). The PP (t=2.266, P=0.031) and I (t=2.152, P=0.039) values in M2 region on the dominant side (right foot) increased statistically at post-operative phase, while the changes of pressure and temporal para-meters in other regions remained stable. There was laterality in plantar pressure at pre-operative phase, manifested as greater PP values in M1, M2, MF, and HM regions on the dominant sides (t=-2.414, -2.478, -2.144, -5.269; P < 0.05), greater PP values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.830, 3.155, 2.686, 3.683; P < 0.05), greater I values in M1, MF, and HM regions on the dominant sides (t=-2.380, -2.185, -5.320; P < 0.05) and greater I values in T1, M3, M5 and HL regions on the non-dominant sides (t=4.489, 2.247, 2.838, 3.992; P < 0.05). post-operatively, the pressure tended to be compatible between the two sides in regions of M3 and MF, while the magnitude of laterality in regions of M1 (ZPP△= -2.721, P=0.007; ZI△=-2.581, P=0.010), M2 (ZPP△=-2.674, P=0.007; ZI△=-2.375, P=0.018) and M5 (ZPP△=1.991, P=0.046; ZI△=2.150, P=0.032) was further increased.@*CONCLUSION@#Changes in plantar pressure after cataract surgery were characterized as increased pressure in the 2nd metatarsal head area on the dominant side. Visual restoration might intensify the laterality in the medial of forefoot on the dominant side and the lateral of forefoot on the non-dominant side.


Subject(s)
Aged , Biomechanical Phenomena , Female , Foot , Humans , Male , Middle Aged , Pressure
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