RESUMEN
Posterior tibial tendon dysfunction (PTTD) is a complex multifaceted condition that can affect the lower extremity. Rarely mentioned 20 years ago, today it is the subject of numerous articles, books, and is a topic at most scientific seminars relating to the foot and ankle. It is a muscle imbalance initiated by a rupture, avulsion, or chronic inflammation of the tibialis posterior tendon. With time, it progresses from a flexible to rigid flatfoot deformity. Left untreated, peritalar dislocation and degenerative joint disease may develop. This article discusses the diagnosis, evaluation, and treatment of PTTD.
Asunto(s)
Pie/cirugía , Traumatismos de los Tendones , Traumatismos de los Tendones/cirugía , Pie Plano/etiología , Pie Plano/cirugía , Humanos , Podiatría , Traumatismos de los Tendones/complicaciones , Traumatismos de los Tendones/diagnósticoRESUMEN
The authors present two unusual cases of isolated medial cuneiform fracture. Both fractures were difficult to see on plain films and therefore diagnosed with ancillary tests (computed tomography and magnetic resonance imaging). Treatment was nonweightbearing cast immobilization, in which both patients healed within twelve weeks of treatment without complication and returned to full work related activities.
Asunto(s)
Fracturas Óseas/diagnóstico , Huesos Tarsianos/lesiones , Adulto , Errores Diagnósticos , Fracturas Óseas/terapia , Humanos , Inmovilización , Imagen por Resonancia Magnética , Masculino , Huesos Tarsianos/diagnóstico por imagen , Huesos Tarsianos/patología , Tomografía Computarizada por Rayos XRESUMEN
Eighteen randomly selected pieces of nonleaded glass from a collection of 30 pieces from broken bottles of four known color types found on the streets of Houston were sorted into four sets with one control. The purpose of this study was to determine if regular glass is visible on plain radiographs and whether color, location, or volume of these fragments had any effect on the detection of nonleaded glass. These sets were then placed into a fresh-frozen cadaver foot and ankle with a history of insulin-dependent diabetes and peripheral vascular disease. This foot was radiographed utilizing four standard foot projections. Five examiners read these five sets of radiographs twice and recorded the number seen. Overall sensitivity for all of the examiners was 90% with an overall false-positive rate of 10%. Intraobserver and interobserver Pearson's correlation coefficients showed that there was reliability between the first and second readings and between observers. The authors concluded that regular nonleaded glass is radiographically visible and that factors such as color and location of the glass have no effect on its detection, while a volume of less than 15 mm3 may have an effect on the detection of glass.
Asunto(s)
Pie Diabético/diagnóstico por imagen , Pie/diagnóstico por imagen , Cuerpos Extraños/diagnóstico por imagen , Vidrio , Cadáver , Reacciones Falso Positivas , Humanos , Modelos Biológicos , Radiografía , Distribución AleatoriaRESUMEN
Intraosseous cystic formation in the talus is a complication of subtalar joint arthroereisis which has not been previously reported. The authors present a case whereby STA-peg implants were utilized to correct a bilateral flatfoot deformity in an adolescent girl. The surgical procedure was successful in treating the structural deformity of the foot; however, the formation of talar cysts occurred. A review of the literature and the treatment of this previously undescribed complication is presented.
Asunto(s)
Quistes Óseos/etiología , Complicaciones Posoperatorias , Articulación Talocalcánea/cirugía , Astrágalo , Adolescente , Niño , Femenino , Humanos , Masculino , Articulación Talocalcánea/fisiopatologíaRESUMEN
The diagnosis of Morton's neuroma is usually made from evaluation of a patient's subjective complaints, clinical findings, and exclusion of other differential diagnoses. Occasionally, when other neurological conditions exist or when the clinical findings are atypical, various imaging techniques may be helpful in the diagnosis of interdigital neuromas. This article will discuss these techniques and briefly review this common lower extremity disorder.
Asunto(s)
Enfermedades del Pie/diagnóstico , Neuroma/diagnóstico , Enfermedades del Pie/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Neuroma/diagnóstico por imagen , Radiografía , UltrasonografíaRESUMEN
Nonunions can be frustrating complication for the lower extremity surgeon. The cessation of bone healing requires an understanding of its etiology before it may be treated appropriately. This article will review nonunions and, in the context of this special issue, discuss the role of bone grafts in their treatment.
Asunto(s)
Trasplante Óseo , Traumatismos de los Pies/cirugía , Fracturas no Consolidadas/cirugía , Trasplante Óseo/métodos , HumanosRESUMEN
Neglected Achilles tendon ruptures, although rare, can be a surgical challenge for the lower extremity specialist. These injuries often present with large defects which require special reconstructive techniques and principles. This paper presents an overview of this problem, various treatment strategies, and two case reports utilizing a triceps surae muscle tendon flap advancement.
Asunto(s)
Tendón Calcáneo/lesiones , Traumatismos de los Tendones/cirugía , Transferencia Tendinosa/métodos , Tendón Calcáneo/patología , Tendón Calcáneo/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Rotura , Traumatismos de los Tendones/diagnóstico , Resultado del TratamientoRESUMEN
Compartment syndromes of the lower extremity can cause significant mobidity when appropriate treatment is not rendered. Paramount to the management of a compartment syndrome is a timely diagnosis. The physician must be intimately familiar with the anatomy as well as the signs and symptoms that a compartment syndrome presents. This familiarity can provide the opportunity for early diagnosis and treatment to prevent debilitating sequalae.
Asunto(s)
Síndromes Compartimentales/complicaciones , Enfermedades del Pie , Enfermedades del Sistema Nervioso Periférico/etiología , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/patología , Síndromes Compartimentales/cirugía , Diagnóstico Diferencial , Pie/patología , Enfermedades del Pie/patología , Humanos , Pierna/patología , Neuroma/etiología , Neuroma/patología , Enfermedades del Sistema Nervioso Periférico/patologíaRESUMEN
Giant cell tumors of bone are tumors of somewhat obscure origin. Clinically, they often do not present until late in their development. Radiographically, they can appear quite aggressive. However, most are intermediate-type lesions. Curettage has shown a tendency toward recurrence with en bloc resection becoming more popular when located in a long bone. The following is a brief review and a case report of an aggressive giant cell tumor of the first metatarsal. An en bloc resection of the proximal two-thirds of the metatarsal with an autogenous middle fibular strut graft is presented.
Asunto(s)
Neoplasias Óseas/cirugía , Trasplante Óseo/métodos , Tumor Óseo de Células Gigantes/cirugía , Huesos Metatarsianos/cirugía , Adulto , Peroné/trasplante , Humanos , Masculino , Trasplante AutólogoRESUMEN
This article addressed the tarsal tunnel syndrome. Its etiology, symptomatology, diagnosis, treatment, and surgical decompression were discussed.
Asunto(s)
Síndrome del Túnel Tarsiano/cirugía , Tobillo/anatomía & histología , Diagnóstico Diferencial , Electrodiagnóstico , Humanos , Procedimientos Quirúrgicos Operativos/métodos , Síndrome del Túnel Tarsiano/diagnóstico , Síndrome del Túnel Tarsiano/etiología , Síndrome del Túnel Tarsiano/terapiaRESUMEN
Ruptures and dysfunctions of the tibialis posterior tendon are often overlooked or misdiagnosed and can cause considerable loss of function to the patient. This article reviews the etiology, clinical as well as radiologic diagnosis, classification, and alternative surgical approaches. Case reports and photography of magnetic resonance imaging examples are included as well as a description of flexor digitorum longus tendon transfer in the treatment of this disorder.
Asunto(s)
Transferencia Tendinosa/métodos , Tendones/fisiopatología , Tibia , Adulto , Anciano , Femenino , Pie Plano/etiología , Humanos , Masculino , Persona de Mediana Edad , Tendones/cirugíaRESUMEN
Tibialis posterior dysfunction, a syndrome that leads to a progressive, unilateral, acquired flat foot, can be missed easily by the podiatric specialist. This paper discusses various etiologies, its clinical presentation, and varying treatment regimes. A case report using the flexor digitorum longus tendon transfer for its repair is presented.