Congenital metatarsus varus: early diagnosis and conservative treatment in 112 patients.

PURPOSE: To describe a conservative treatment algorithm to manage Congenital Metatarsus Varus. BACKGROUNDS: Congenital Metatarsus Varus is a congenital disorder with an estimated incidence of 1/1000 newborns. Despite the deformity being mostly an aesthetic problem, residual and incorrect forms may be responsible for abnormal in-toe gait and shoe-wearing issues. No consensus has still been gathered regarding its correct treatment algorithm. METHODS: Between May 2019 and September 2020, 2156 newborn patients underwent an orthopedic examination at birth. Patients affected by Congenital Metatarsus Varus were classified according to Bleck's classification as flexible, semi-flexible or non-flexible deformity. A conservative treatment algorithm was followed, based on the application of manipulations, Bebax-type braces or plaster cast. All patient were followed until the clinical resolution of the deformity. Complications were also recorded. RESULTS: One-hundred twenty-four patients were diagnosed Congenital Metatarsus Varus, with an overall prevalence of 5/1000. One-hundred twenty-two patients presented with a flexible or semi-flexible foot deformity and were firstly treated with manipulations: 52 patients reported good results, while 70 required additional treatment with Bebax-type braces for achieving correction. Two patients presented a non-flexible deformity at birth: one required plaster cast due to a non-flexible deformity, and one patient was firstly managed with Bebax-type braces due to a severe semi-flexible deformity. Only two patients presented superficial skin ulcerations, healed within a week. Two patients were lost during the follow-up. CONCLUSION: An early diagnosis allowed by an orthopedic examination in all newborns may be a valid instrument to avoid Congenital Metatarsus Varus misdiagnosis. Early treatment with manipulation and orthosis resulted in good clinical outcome, with only few complications.

[Intestinal schwannoma: case report and literature review]. / Schwannoma intestinale: case report e revisione della letteratura.

Digestive Tract Schwannomas (DTS) are benign mesenchymal tumours, usually affecting female between 20 and 70 years old. They are most commonly found in the stomach but they can arise anywhere from the digestive tract. DTS are usually asymptomatic but can present with different symptoms. Definitive diagnosis can only be made with immunohistochemistry because endoscopy and computed tomography can't distinguish them from other non epithelial neoplasms. Surgical resection is the treatment of choice.