RESUMO
A unique case of combined anterolateral, anterior, and anteromedial ankle impingement in an adolescent soccer player is presented in this article. To the best of our knowledge, this is the only report of circumferential, massive, anterior ankle impingement in children described in the literature. The importance of proper diagnosis and treatment of such a lesion is illustrated in this case report. We also emphasize that clinical examination combined with 3D computed tomography scan reconstruction is an excellent and cost-effective imaging modality that can help with the diagnosis of anterior ankle impingement. Finally, open surgical treatment showed excellent results in an elite athlete.
Assuntos
Traumatismos do Tornozelo/diagnóstico por imagem , Osteófito/diagnóstico por imagem , Futebol/lesões , Atividades Cotidianas , Adolescente , Traumatismos do Tornozelo/cirurgia , Artralgia/etiologia , Desbridamento , Edema/etiologia , Humanos , Imageamento Tridimensional , Masculino , Osteófito/cirurgia , Radiografia , Tomografia Computadorizada por Raios X/métodosRESUMO
Manipulation and casting according to the Ponseti method are the 'gold standard' for clubfoot treatment, and this method is endorsed by the American Association of Orthopaedic Surgeons. We conducted a retrospective study from January 2004 to December 2012 in our institution. All patients with idiopathic clubfoot were included, and a very strict analysis of the treatment outcomes, relapses and their treatment was carried out. A total of 382 children were included and followed up for a mean period of 6 years. The initial correction rate was 100%. At latest follow-up, the relapse rate was 19.03%, the initial correction being recovered by recasting, second or third percutaneous Achilles tenotomy or anterior tibial tendon lateral transfer. The Ponseti method is safe, efficient in the conservative treatment of clubfoot and decreases the number of surgical interventions, and the very good results are maintained through a 9 years follow-up period.
