RESUMO
Pes cavus is a complicated, multiplanar deformity that requires a thorough understanding in order to provide the appropriate level of care. The foot and ankle surgeon should perform a comprehensive examination, including a neurologic evaluation, in the workup of this patient population. Understanding the cause of the patient's deformity is a critical step in predicting the disease course as well as the most acceptable form of treatment. The surgical correlation with the patient's pathologic anatomy requires an in-depth clinical evaluation, in addition to the radiographic findings, as the radiographic findings do not necessarily correlate with the patient's discomfort.
Assuntos
Pé Cavo/fisiopatologia , Pé Cavo/cirurgia , Articulação do Tornozelo/fisiopatologia , Contratura/fisiopatologia , Fáscia/fisiopatologia , Fasciíte Plantar/fisiopatologia , Ossos do Pé/fisiopatologia , Marcha/fisiologia , Humanos , Músculo Esquelético/fisiopatologia , Procedimentos Ortopédicos , Pé Cavo/etiologia , Dedos do Pé/fisiopatologiaRESUMO
Familiarity with the systemic manifestations of rheumatoid arthritis as well as familiarity with drug therapy used for the management of rheumatoid arthritis may be helpful in the avoidance of some postoperative complications. Drug effects on soft tissues and bone may complicate reduction, stabilization, and fixation of deformities. Evaluation of the patient with rheumatoid arthritis for extraarticular disease may also explain symptomatology, and reduce the incidence of complications by unrecognized contributions of soft tissue pathology of osseous and articular disorders.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/fisiopatologia , Assistência Perioperatória , Complicações Pós-Operatórias/prevenção & controle , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Antirreumáticos/administração & dosagem , Antirreumáticos/efeitos adversos , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/fisiopatologia , Técnicas de Laboratório Clínico , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Humanos , Imobilização/efeitos adversos , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Penicilamina/administração & dosagem , Penicilamina/efeitos adversos , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/efeitos adversos , Complicações Pós-Operatórias/etiologia , Radiografia , Doenças da Coluna Vertebral/fisiopatologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controleRESUMO
Soft tissue procedures for the stabilization of symptomatic, advanced hyperpronation deformity are performed most frequently in conjunction with osteotomy, arthrodesis, or arthroereisis of the subtalar joint. A variety of such procedures are available for the selective reinforcement or repair of the posterior tibial tendon, spring ligament, deltoid ligament, or medial intertarsal joint capsules. Recently, the focus has been on the direct repair or reinforcement of the posterior tibial tendon using the long flexor tendons. This article reviews additional procedures that have been of value in the management of posterior tibial tendon dysfunction and the procedures now most commonly employed.
