Indication for Achilles Tenotomy in Congenital Clubfoot: Effectiveness of Using the Tibio-Plantar Fascia Angle as a Radiographic Parameter.

Congenital clubfoot is one of the most common deformities in children, and currently, the Ponseti method is used worldwide because of its favorable short-term results. With the Ponseti method, the indication for Achilles tenotomy is traditionally based on only physical examination findings; however, some surgeons have also utilized plain radiographs. Because using physical examinations to determine the degree of hindfoot dorsiflexion for the indication of tenotomy can lead to underestimation. We developed and utilized the effectiveness of the tibio-plantar fascia angle (Ti-P angle) in the lateral maximum dorsiflexion view in determining the need for Achilles tenotomy. A retrospective analysis of consecutive 26 patients with congenital idiopathic clubfeet (37 feet) was performed. Whether Achilles tenotomy was indicated was determined based on physical examination for a former period (Group P). For the latter period, whether tenotomy was indicated was determined by referencing radiographs (Group X). No significant differences were found in any of the background factors or severity between Group P and Group X. Cases with larger tibiocalcaneal and Ti-P angles were more likely to require Achilles tenotomy or additional soft tissue release. An angle of more than 72° of the Ti-P angle demonstrated adequate specificity for the indication of Achilles tenotomy. The radiographic lateral tibio-plantar fascia angle is useful for deciding whether a tenotomy needs to be performed.

Anisotropic Crystal Growth of Layered Nickel Hydroxide along the Stacking Direction Using Amine Ligands.

Edge surfaces of two-dimensional crystals play crucial roles in their properties, such as intercalation behavior and catalytic activities; however, reports on the preparation of crystals with a high aspect ratio of thickness to lateral size, typically a prism-like crystal morphology composed of stacked layers, are scarce. We report the anisotropic crystal growth of ß-Ni(OH)2 along the stacking direction using bidentate amine ligands, which act as both the base and the reservoir of Ni2+ through the formation of Ni-diamine complexes. Various characterization results of the crystal structure, composition, and crystal orientation indicate the formation of hexagonal prisms of ß-Ni(OH)2 with an unusually high aspect ratio of the thickness to the lateral size higher than 1. A systematic investigation focusing on the molar ratio of amine ligands to Ni2+, the concentration of Ni-diamine complexes, and stability constants of the complexes revealed that anisotropic growth was promoted when the supersaturation was relatively high and was maintained constant for a long time. We clarified the role of amine ligands in controlling supersaturation through the controlled release of metal ions from stable complexes. ß-Co(OH)2 with a hexagonal prism shape was prepared using this protocol. This study provides valuable indications for developing synthetic chemistry for various layered compounds to achieve a controlled aspect ratio.

Hydrolysis of Methoxylated Nickel Hydroxide Leading to Single-Layer Ni(OH)2 Nanosheets.

Various methods for the preparation of inorganic nanosheets have been established and they have contributed to the substantial development of the research on diverse two-dimensional materials. Covalent surface modification of layered metal hydroxides with alkoxy groups is known to effectively weaken the interactions between layers, although the modified ligands are irreversibly immobilized. This study proposes the use of methanol as a removable surface modifier forming monodentate alkoxy bonds to prepare nickel hydroxide nanosheets through hydrolysis. Methoxylated layered nickel hydroxide, consisting of randomly stacked nano-sized nickel hydroxide sheets (10-20 nm in size) having Ni-OCH3 groups on its surface, was synthesized in a powder form through the precipitation reaction of a nickel salt in methanol at room temperature. After dispersing the aggregated methoxylated nickel hydroxide in water, single-layer nickel hydroxide nanosheets with a thickness of 1.2 nm and a lateral size of 460 nm at maximum, which is larger than the size of original methoxylated nickel hydroxide were found in the suspension. The time-course experiments during hydrolysis suggested that two-dimensional crystal growth of exfoliated nickel hydroxide sheets proceeded, resulting in the formation of the nanosheets. Moreover, single-layer and nano-sized cobalt hydroxide was prepared through a similar manner. This work demonstrates that two-dimensional alkoxides consisting of polymeric M-O-M bonds are useful precursors for the design of metal-hydroxide-based nanomaterials.

Modyfied wedge osteotomy for osteoarthritis of elbow secondary to osteochondritis dissecans in adolecent with multiple epiphyseal dysplasia. A case report.

Multiple epiphyseal dysplasia (MED) may be complicated by osteochondritis dissecans (OCD), most commonly reported in the knee, but involvement of the elbow is very rare. Optimal treatment for MED-associated elbow OCD and treatment outcome have not been established. This report describes the case of an adolescent male patient with elbow OCD treated by arthroscopic drilling at a previous clinic. Progression of osteoarthritis and radial head subluxation were observed. Resection of the osteophytes and modified wedge osteotomy of the lateral condyle were then performed, and a favorable result was obtained by decompression and sufficient congruency of the radiohumeral joint.