RESUMO
The surgical correction of hallux limitus can be most rewarding for both patient and surgeon when marked degenerative changes exist in older individuals. Many foot and ankle surgeons would perform an implant arthroplasty in a patient over 60 years of age with hallux limitus or rigidus. In a patient without gross first metatarsophalangeal joint arthrosis, but with limitation in range of motion, the literature is replete with biomechanically sound surgical options. However, surgical repair of the moderate-to-severe arthritic first metatarsophalangeal joint in younger individuals remains quite a challenge. The authors present the use of a sagittal plane "Z" osteotomy of the proximal phalanx along with cheilectomy and chondroplasty for the treatment of hallux limitus and rigidus in the young, active patient.
Assuntos
Cartilagem Articular/cirurgia , Hallux Valgus/cirurgia , Articulação Metatarsofalângica/cirurgia , Osteoartrite/cirurgia , Osteotomia/métodos , Amplitude de Movimento Articular/fisiologia , Adolescente , Adulto , Idoso , Parafusos Ósseos , Fios Ortopédicos , Humanos , Pessoa de Meia-Idade , Terapia Passiva Contínua de Movimento , Osteotomia/instrumentação , Complicações Pós-Operatórias , Instrumentos CirúrgicosRESUMO
There is a high incidence of radiation toxicity associated with Kaposi's sarcoma. The authors review acute radiodermatitis and present a case where it occurred in the foot following radiotherapy for classic Kaposi's sarcoma.
Assuntos
Dermatoses do Pé/etiologia , Doenças do Pé/radioterapia , Radiodermite/etiologia , Radioterapia/efeitos adversos , Sarcoma de Kaposi/radioterapia , Doença Aguda , Idoso , Humanos , MasculinoRESUMO
A composite retrospective radiographic analysis of 71 patients who had undergone the Keller arthroplasty and 76 who had undergone the Keller with hemi-implant was performed. The combined mean preoperative intermetatarsal angle was 11.4 degrees, the mean postoperative intermetatarsal angle was 9.4 degrees, and the mean change in intermetatarsal angle was 2.0 degrees. Although the reduction of the metatarsus primus adductus deformity obtained was less than previous studies, the amount of correction was directly proportional to the magnitude of deformity. The authors conclude that through reverse buckling at the first metatarsophalangeal joint, adequate reduction in the positional component of metatarsus primus adductus can be obtained with the Keller arthroplasty alone or with a hemi-implant. These procedures are preferred over metatarsal osteotomies in the physiologically older patient, especially when a severe metatarsus primus adductus deformity exists.
