RESUMO
Hallux varus deformity most commonly occurs as a complication of bunion surgery. Surgical option depends on the underlying cause, flexibility of the deformity, and presence of osteoarthritis of the first metatarsophalangeal joint. Joint-preserving surgery including medial soft tissue release, metatarsal osteotomy, and tendon transfer can be considered in flexible deformity without degeneration of the first metatarsophalangeal joint. First metatarsophalangeal arthrodesis is indicated in cases of inflammatory arthritis, avascular necrosis, osteoarthritis, neuromuscular disorder, or failed previous hallux varus corrective surgery. The purpose of this technical note is to describe the technique of arthroscopic arthrodesis of the first metatarsophalangeal joint to correct hallux varus deformity. It has the potential advantages of less surgical trauma, preservation of blood supply, less postoperative pain, and better cosmetic results.
RESUMO
Fracture of the posteromedial talar process (Cedell fracture) is a rare injury and is usually associated with other injuries such as medial subtalar dislocation. Diagnosis of the fracture necessitates a heightened clinical suspicion, and computed tomography should be performed in any suspicious cases. Timely treatment is important for restoration of proper anatomy and function of the subtalar joint. Significant morbidity is associated with an undiagnosed or nonoperatively treated fracture of the posteromedial talar process, especially in a larger fracture that is intra-articular at both the ankle and subtalar joints. In this Technical Note, the technical details of endoscopically assisted reduction and screw fixation of acute posteromedial talar fracture is described. This can allow fracture reduction and fracture fixation under endoscopic visualization.
RESUMO
Schwannomas are the most common peripheral nerve tumors; they can present as painful masses or paresthesia. The aim of surgical treatment of a symptomatic schwannoma is total to gross total excision of the tumor along with preservation of the affected nerve and its function, particularly in patients with conserved functionality of a major nerve trunk. This Technical Note describes the technical details of nerve-preserving endoscopically assisted resection of a schwannoma of the radial nerve. This is an intracapsular resection of the tumor, and the risk of nerve injury is minimized.
RESUMO
A 7-year-old girl presented with a 2-day history of acute neck pain without any preceding injury. The pain was around the left posterior paraspinal muscle and was aggravated by neck movement. There was no neurological abnormality; white cell count and inflammatory markers were slightly elevated. Radiology of the cervical spine showed calcification of C3/4 and C4/5 discs as well as the posterior longitudinal ligament over C3/4. She was treated conservatively with a neck collar and Panadol syrup. No non-steroidal anti-inflammatory drug was prescribed. Two months later, calcification of the posterior longitudinal ligament had resolved and calcification at C3/4 and C4/5 discs and the C4 lower endplate had decreased. After one year, she was painfree with no tenderness over her neck and had full range of neck motion and complete resolution of the calcification.