Mitchell osteotomy for adolescent hallux valgus.

Sixty-nine Mitchell osteotomies augmented with smooth-pin fixation and a trapezoidal step-off osteotomy to maintain ray length were performed on 46 adolescent patients with a painful hallux valgus deformity. Average follow-up time was 6 years. By using radiographic, clinical, and subjective patient data, we found an overall excellent or good result in 91% of cases. Nine feet were found to be cosmetically unsatisfactory, 11 required special shoewear, 10 had mild residual pain with high heels or strenuous running, and three had pain severe enough to restrict activities. Range of motion was normal in 56 feet, slightly decreased in 11 feet, and significantly reduced in two feet. We conclude that, given a success rate of 91%, this slightly modified Mitchell osteotomy is a satisfactory procedure for adolescent hallux valgus deformity with chronic bunion discomfort.

Isolated avulsion of the popliteus tendon. A case report.

We have reported a rare case of an isolated avulsion of the popliteus tendon. In this case the avulsed tendon was associated with a large osteochondral fragment that was easily relocated and fixed anatomically. We believe that the popliteus tendon is important to the mechanics of the knee. We would recommend the treatment as presented in this case should one of these rare cases be encountered.

The evolving slope of the proximal femoral growth plate relationship to slipped capital femoral epiphysis.

We measured the physeal angle (slope) of the proximal femoral physis on the standard anteroposterior (AP) radiographs. Controls consisted of 307 hips in children aged 1-18 years. Similar measurements were made on the affected (slip) and unaffected (nonslip) sides of 107 children with manifest unilateral slipped capital femoral epiphysis. An age-related increase of 14 degrees occurs in the slope of the proximal femoral physis between ages 1 and 18 years, with maximal increase between ages 9 and 12 years. Increasing obliquity of the proximal femoral physis may be yet another factor contributing to slipped capital femoral epiphysis.

Promotion of wound collagen formation in normal and diabetic mice by quadrol.

The rate of collagen deposition in implanted polytetrafluoroethylene (PTFE) tubing in non-diabetic and streptozotocin-induced (STZ) diabetic mice was measured during 14 days post-wounding. At the time of implantation, test groups received injections of either Quadrol [N,N,N',N'-tetrakis(2-hydroxypropyl)ethylenediamine], glucan, or buffer in an area adjacent to the wound site. The accumulation of collagen in the implants of Quadrol-treated non-diabetic animals was more than 200% above control on days 8 to 11 and was 50% above control on day 14. In Quadrol-treated STZ-diabetic mice, the collagen accumulation gradually increased from 50% above control on day 8 to 200% above control on day 14. Treatment with glucan increased the collagen accumulation in normal mice 200 to 300% above control from days 8 to 11 respectively and then 30% above control on day 14. Collagen accumulation in the implants of the glucan-treated STZ-diabetic mice was similar to the control group. These results indicate that Quadrol promotes in vivo collagen synthesis and that Quadrol may be effective as a stimulator of wound healing in diabetic and non-diabetic animals.