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Although osteochondral lesions are well-described in previous literature, lesions located at the proximal phalangeal base of the hallux are extremely rare. Here, the authors report the case of a 21-year-old male who presented with chronic right great toe pain, which was eventually diagnosed as an osteochondral lesion at the proximal phalangeal base of the hallux. The diagnosis presented herein should be kept in mind and included in the differential diagnosis when patients complain of chronic pain in the great toe.
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Ankle joint is a stable mortise structure, therefore pure ankle dislocation without ankle fracture is rare. Several adjacent anatomical structures have been reported as a cause of irreducible ankle dislocation. Author report a case of successful treatment of irreducible anterior subluxation of the ankle joint due to os trigonum and transverse ligament by closed reduction under anesthesia, and a review of the literature as well.
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Ankle joint is a stable mortise structure, therefore pure ankle dislocation without ankle fracture is rare. Several adjacent anatomical structures have been reported as a cause of irreducible ankle dislocation. Author report a case of successful treatment of irreducible anterior subluxation of the ankle joint due to os trigonum and transverse ligament by closed reduction under anesthesia, and a review of the literature as well.
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Many articles on operative treatment strategies for osteochondral lesions of the talus (OLT) have been published. On the other hand, there are only a few reports on the conservative treatment of OLT. Understanding the natural history of OLT is essential to establishing the correct treatment. Conservative treatment might lead to comparable clinical outcomes compared to the current options of the operative treatment in isolated OLT lesions. OLT lesions can be divided into two (or possibly three) types. Hence, the prognosis and outcome of certain operative treatments should be evaluated further. The prognosis of OLT combined with instability or malalignment appears poorer than that of isolated OLT lesions. Therefore, concomitant pathologies should be evaluated together when treating patients with OLT.
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Background@#Accessory bones and tarsal coalitions are the most common developmental variations of the foot and ankle. However, their clinical implications are not well understood because there is no established prevalence data in the normal population and the reported prevalence varies widely. Therefore, we aimed to investigate the incidence of accessory ossicles and tarsal coalitions in a healthy, asymptomatic Korean population. @*Methods@#A total of 448 healthy, asymptomatic participants (224 men and 224 women; 896 feet) were enrolled and stratified by age and sex. To investigate the presence of accessory bones and tarsal coalitions in the foot and ankle, we obtained the weight-bearing standing radiographs (anteroposterior and lateral views) from each participant. @*Results@#Accessory ossicles were found in 49.2% of the healthy, asymptomatic Korean adults. The prevalence of accessory bones in adults was the highest with 34% for the accessory navicular, 5.8% for the os trigonum, 3.9% for the os peroneum, and 1.7% for the os subfibulare. The prevalence of tarsal coalitions in adults was 0.4% and that of symphalangism was 16% for the fourth toe and 80.6% for the fifth toe. The frequency of the accessory navicular and fifth toe symphalangism was significantly higher in women. Most of the accessory navicular and fourth and fifth toe symphalangism were bilateral, whereas the os subfibulare was mostly unilateral. @*Conclusions@#The prevalence of accessory bones and tarsal coalitions in the healthy, asymptomatic Korean population showed some variation according to age and sex.
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BACKGROUND: The use of three-dimensional multi-segment foot models (3D MFMs) is increasing since they have superior ability to illustrate the effect of foot and ankle pathologies on intersegmental motion of the foot compared to single-segment foot model gait analysis. However, validation of the repeatability of the 3D MFMs is important for their clinical use. Although many MFMs have been validated in normal adults, research on MFM repeatability in children is lacking. The purpose of this study is to validate the intrasession, intersession, and interrater repeatability of an MFM with a 15-marker set (DuPont foot model) in healthy children. METHODS: The study included 20 feet of 20 healthy children (10 boys and 10 girls). We divided the participants into two groups of 10 each. One group was tested by the same operator in each test (intersession analysis), while the other group was tested by a different operator in each test (interrater analysis). The multiple correlation coefficient (CMC) and intraclass correlation coefficient (ICC) were calculated to assess repeatability. The difference between the two sessions of each group was assessed at each time point of gait cycle. RESULTS: The intrasession CMC and ICC values of all parameters showed excellent or very good repeatability. The intersession CMC of many parameters showed good or better repeatability. Interrater CMC and ICC values were generally lower for all parameters than intrasession and intersession. The mean gaps of all parameters were generally similar to those of the previous study. CONCLUSIONS: We demonstrated that 3D MFM using a 15-marker set had high intrasession, intersession, and interrater repeatability in the assessment of foot motion in healthy children but recommend some caution in interpreting the hindfoot parameters.
Assuntos
Adulto , Criança , Humanos , Tornozelo , Pé , Marcha , PatologiaRESUMO
PURPOSE: The purpose of this study was to determine the relationship between dorsal metaphyseal comminution and the radiographic and functional outcomes of patients with distal radius fractures treated by closed reduction and cast immobilization. METHODS: Twenty-six patients with acute distal radius fractures were retrospectively reviewed. The mean age of this patient group was 62.8 years (range, 45-87 years). Eighteeen cases were AO type-A3 and 8 were AO type-A2. Radiographic and functional parameters were analyzed and compared between the patients who presented with or without dorsal metaphyseal comminution on their initial radiographs in order to assess the clinical outcomes. The radiographic parameters included radial inclination, radial length, volar/dorsal tilt, and ulnar variance. In order to measure the functional outcomes, each patient's range of motion, grip strength, Quick disabilities of the arm, shoulder, and hand (DSAH), visual analog scale (VAS), and Mayo score were determined. RESULTS: Seventeen patients (65%) presented with dorsal metaphyseal comminution on the initial radiographs. Radial inclination, radial length, and volar/dorsal tilt were decreased and ulnar variance was increased on the final radiographs in comparison with the postreduction. However, there were no statistically significant differences between the two groups that presented with or without dorsal metaphyseal comminution (p>0.05). None of the functional parameters (i.e., range of motion, grip strength, DASH, Mayo, and VAS score) were significantly different between the two groups (p>0.05). CONCLUSION: Dorsal metaphyseal comminution seems to have no significant impact on radiographic and functional outcomes when closed reduction and cast immobilization was planned for the treatment of distal radius fracture.