Disease aggravation following surgery in a rare patient suspected to Fibrodysplasia (Myositis) ossificans progressiva: a case report.

BACKGROUND: Fibrodysplasia ossificans progressiva (FOP) as a rare and heritable disorder with the infrequent genetic transmission of the condition is a catastrophic disorder of heterotopic ossification (HO) and a cause of extraskeletal bone formation in humans. Given the lack of effective treatment for this disease, the important point is to avoid aggravating factors such as bone biopsy, surgery, and intramuscular injection. CASE PRESENTATION: In this report, we present a 52-year-old female patient, Kurdish ethnic, suspected to FOP who had a surgical intervention on the second toe of the right foot, which subsequently, it caused further deterioration of the disease in the person including necrosis and amputation of the distal phalanx of the second toe. CONCLUSIONS: Although, based on our investigation and the available scientific evidence, surgery may a cause for faster progression and worsening of the FOP disorder, but its proof requires further studies.

Comparative study of the outcome of McKay surgery with and without pin in clubfoot patients.

BACKGROUND: Clubfoot is one of the most common foot deformities in children. Surgical treatment is the only choice for patients who have failed conservative treatment. To the best of our knowledge, no studies have been done to compare the McKay surgery with a pin versus without a pin. Our study aimed to compare the outcomes of McKay surgery with and without pins in clubfoot patients. METHOD: This study is an analytical study. The sample size included patients referred to Imam Reza Hospital from 2016 to 2018. Children who did not respond to plaster therapy were under McKay surgery. In this study, patients were divided into two groups of 50 patients. In the first group, after ligament release and tendon extension, a pin was used to maintain the direction of the talonavicular joint. In the second group, no pin was used. Every six months, radiographs were taken of the patients to monitor their progress. After collecting the study data, they were entered into SPSS software (version 25, IBM Corporation, Armonk, NY) and analyzed. RESULT: The mean age of patients was 5.36±2.07 months. Of these, 79 were boys and 21 girls, most of the subjects were aged 4-6 months, and 24% had unilateral one-way clubs. The severity of the disease was 7 feet in grade 2 (moderate) and 93 feet in grade 3 (severe). There was a significant relationship between age, outcome and type of complications with surgical type. CONCLUSION: Finally, it can be concluded that McKay surgery (both with and without a pin) is exceptionally effective at treating clubfoot.