RESUMO
The authors present two case studies of giant cell tumor of tendon sheath. This uncommon lesion of the lower extremity is presented in these two cases in correlation with clinical, radiographic, and intraoperative findings. After the pathologic diagnosis was made, the patient in the first case decided not to have the tumor resected. This patient's postoperative course continues uneventfully without expansion of the tumor. In the second case, a local recurrence was noted 13 months after en bloc resection. A review of the literature shows that treatment modalities for such lesions range from marginal excision to radiation therapy. The authors wish to emphasize the high risk of local recurrence of these tumors. Early marginal resection is the treatment of choice.
Assuntos
Tumores de Células Gigantes/cirurgia , Neoplasias Musculares/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Tendões , Adolescente , Tornozelo , Feminino , Pé , Tumores de Células Gigantes/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Neoplasias Musculares/diagnóstico , Recidiva Local de Neoplasia , Neoplasias de Tecidos Moles/diagnósticoRESUMO
In a study of 50 children, the Dynamic Stabilizing Innersole System (DSIS) was found to decrease the mean resting calcaneal stance position (RCSP) by an average of 6 degrees. A comparison between the neutral calcaneal stance position and the RCSP with the DSIS showed no statistically significant difference between the means for the right or left foot, indicating that the DSIS is capable of returning severe flat foot deformities to their neutral calcaneal stance position. The RCSP with and without the DSIS differed significantly, indicating that the DSIS provides a considerable and statistically significant amount of correction in the RCSP in our study population. Furthermore, the results of linear regression showed that the DSIS appears to be sensitive to the severity of the deformity, preventing overcorrection of less severe flatfoot deformities and providing a long awaited alternative to traditional pediatric corrective flatfoot devices.
Assuntos
Pé Chato/reabilitação , Aparelhos Ortopédicos , Adolescente , Fenômenos Biomecânicos , Calcâneo/fisiopatologia , Criança , Pré-Escolar , Desenho de Equipamento , Pé Chato/fisiopatologia , Humanos , Lactente , Postura , Pronação , Análise de RegressãoRESUMO
Magnetic resonance (MR) arthrography is a useful technique in evaluating the articular structures of the ankle. With intra-articular administration of gadolinium-DTPA (Gd-DTPA), visualization and delineation of anatomic structures, that would not be depicted by other traditional imaging techniques, are achieved. It is a technique that proves to be advantageous as it does not require the use of ionizing radiation, nor iodinated contrast material as other conventional diagnostic modalities. MR arthrography also allows multiplanar imaging and provides excellent resolution.
Assuntos
Traumatismos do Tornozelo/diagnóstico , Articulação do Tornozelo/patologia , Imageamento por Ressonância Magnética , Idoso , Humanos , Ligamentos Articulares/lesões , Ligamentos Articulares/patologia , MasculinoRESUMO
An orthotic device, which prevents hyperpronation of a human foot, has an offset, deep heel seat to cup the calcaneus. It maintains the calcaneus in approximately 5 degrees of varus with high medial and lateral flanges, which prevents lateral transverse drift of the first and fifth metatarsals.
Assuntos
Pé Chato/reabilitação , Aparelhos Ortopédicos , Calcâneo , Desenho de Equipamento , Pé Chato/fisiopatologia , Humanos , PronaçãoRESUMO
The authors explain the sequential development of a bunion beginning with hallux abducto valgus, then hypertrophy of the dorsomedial tubercle, followed by proximal articular set angle adaptation. This manuscript emphasizes the importance of transverse plane motion and the pull of the tibial sesamoid metatarsal ligament, and adductor hallucis tendon in the formation of a bunion.
Assuntos
Hallux Valgus/etiologia , Hallux Valgus/patologia , Humanos , Tendões/fisiopatologiaRESUMO
Apophysitis of the fifth metatarsal base, or Iselin's disease, is an overuse osteochondrosis seen in growing children. Although amenable to treatment, it is a self-limiting disorder, disappearing spontaneously with completion of growth.
Assuntos
Metatarso , Osteocondrite/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Osteocondrite/diagnósticoRESUMO
A crescentic osteotomy of the first metatarsal is unstable during the preliminary healing stage. The authors present a modification in the direction of the cut of the osteotomy. This alteration increases stability at the first metatarsal base.
Assuntos
Deformidades do Pé/cirurgia , Ossos do Metatarso/cirurgia , Osteotomia/métodos , Fios Ortopédicos , Criança , Estudos de Avaliação como Assunto , HumanosRESUMO
The juvenile fracture of Tillaux is a Salter-Harris type III fracture of the distal tibial epiphysis. The mechanism of injury is an external rotational force of the foot. The fracture fragment is avulsed from the anterolateral aspect of the distal tibial epiphysis by the anteroinferior tibiofibular ligament. Treatment is based on the amount of displacement after closed reduction techniques are attempted. If complete anatomical reduction cannot be obtained, the authors recommend open reduction with internal fixation. The method of internal fixation should be based on the skeletal maturity of the distal tibial epiphysis. The prognosis usually is good if anatomical reduction is performed. The most serious complication reported is pain and stiffness secondary to articular incongruity following inadequate closed reduction techniques. The case of a 14-year-old girl with a juvenile Tillaux fracture treated by open reduction with excellent functional results at 11 months follow-up was presented.
