RESUMO
Numerous surgical procedures have been proposed for reconstructing and correcting adult flatfoot deformity. Most procedures include lengthening of the tight Achilles tendon and transferring the FDL tendon to substitute for a dysfunctional PTT. These procedures commonly are combined with a bone procedure to stabilize the correction and correct the pathologic anatomy. All of these procedures have the potential for a range of complications, many of them serious. In general, the clinician should perform the least invasive procedure that decreases pain and improves function. The effects of each procedure and the associated morbidity and complications must be considered.
Assuntos
Artrodese/efeitos adversos , Pé Chato/cirurgia , Ossos do Pé/cirurgia , Deformidades Adquiridas do Pé/cirurgia , Complicações Pós-Operatórias , Articulações Tarsianas/cirurgia , Adulto , Artrodese/métodos , Terapia Combinada , Humanos , Transferência Tendinosa , Tendões/cirurgiaRESUMO
Total ankle replacement was developed in the 1970s after the success of total hip and knee arthroplasty. The goal of total ankle arthroplasty is to decrease pain and improve function in the lower limb. Ideally, to be superior to an arthrodesis, the ankle replacement should provide the patient with good patterns of joint motion and the ability to walk and run and should have low complication rates. Unfortunately, total ankle arthroplasty has not been as successful as replacement of other joints. Published studies of early series with greater follow-up show that ankle arthroplasties did not provide lasting pain relief or improve function, and most ultimately failed. During the 1980s, many authors concluded that a total ankle arthroplasty was not warranted because of the generally poor long-term results and the high rate of complications. However, newer second-generation design techniques, innovative operative procedures, and dissatisfaction with the results of ankle arthrodesis have renewed interest in total ankle arthroplasties. This review describes the numerous types of ankle joint replacements, critically reviews the results, and reports on newer prostheses that incorporate more anatomic designs.
Assuntos
Articulação do Tornozelo/cirurgia , Artrite/cirurgia , Artroplastia de Substituição , Articulação do Tornozelo/anatomia & histologia , Artrodese/efeitos adversos , Fenômenos Biomecânicos , Humanos , Desenho de Prótese , Resultado do TratamentoRESUMO
Longitudinal deficiencies of the ulna are very rare deformities. Despite the cosmetic appearance, patients usually have very functional extremities. The limb function has been adversely related to ipsilateral hand deformities and radiohumeral synostosis. Surgical treatment should be aimed at correcting such deformities. It is prudent to wait and observe patients before definitive wrist or forearm treatment is recommended.
