ABSTRACT
BACKGROUND: Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. METHODS: We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft. The demographics of included patients and their clinical features were evaluated. Surgical outcomes and complications were analyzed. RESULTS: Among 118 patients with 194 webs (155 feet), 111 patients showed nonsyndromic cases and 7 patients showed syndromic cases. In 80 unilateral cases (72.1%), the second web was the most frequently involved (37.5%), followed by the fourth (30%), the first (15%), the third (15%), the first and second in combination (1.3%), and the second and third in combination (1.3%). Among 31 bilateral cases, 2 cases were asymmetric. Among the remaining 29 symmetric bilateral cases, the second web was the most frequently involved (45.2%), followed by the first (22.6%), and the fourth (6.5%). No specific postoperative complications were observed, except in the case of 1 patient (0.51%) who required a secondary operation to correct web creep. CONCLUSIONS: This retrospective clinical study of 118 patients with both unilateral and bilateral foot syndactyly revealed that the second web was the most frequently involved. In addition, complete division and tension-free wound closure with a full-thickness skin graft of sufficient size showed good postoperative results.
Subject(s)
Humans , Clinical Study , Demography , Asia, Eastern , Foot Deformities, Congenital , Foot , Postoperative Complications , Retrospective Studies , Skin , Syndactyly , Transplants , Wounds and InjuriesABSTRACT
A Split-hand/foot Malformation, muitas vezes aceita como sinônimo de ectrodactilia, é uma malformação com diferentes padrões de hereditariedade que pode se apresentar isoladamente ou como parte de síndromes de maior expressão clínica. Discutimos as peculiaridades do seu diagnóstico e das manifestações associadas ao quadro. Descrevemos o caso esporádico de um paciente com ectrodactilia que desenvolveu uma Síndrome Mielodisplásica associada a manifestações reumatológicas e a Trombose Venosa Profunda. Consideramos o paciente como portador da forma isolada da Split-hand/foot Malformation e as suas outras manifestações como consequências atípicas da Síndrome Mielodisplásica.
The Split-hand/foot Malformation often accepted as a synonym for ectrodactyly is a malformation with different patterns of heredity that can present it individually or as part of syndromes with most clinical significance. We discussed the peculiarities of their diagnosis and clinical manifestations associated with the condition presented. We describe a sporadic case of a patient with ectrodactyly who developed a myelodysplastic syndrome associated with rheumatic manifestations and Deep VeinThrombosis. We considered the patient as suffering from an isolated form of Split-hand/foot Malformation and its other manifestations as atypical consequences of myelodysplastic syndrome.
Subject(s)
Humans , Male , Middle Aged , Musculoskeletal Abnormalities/genetics , Foot Deformities, Congenital , Hand Deformities, Congenital , Myelodysplastic Syndromes/diagnosis , Venous ThrombosisABSTRACT
Fundamento: el metatarso varo es una enfermedad frecuente en las deformidades del pie del neonato. Objetivo: valorar el nuevo enfoque terapéutico en el metatarso varo congénito y residual de pie varo equino en un estudio de cinco años. Metodología: se realizó un estudio descriptivo longitudinal en 81 niños con el diagnóstico de metatarso varo, los que fueron atendidos en el servicio de Ortopedia y Traumatología del Hospital Pediátrico Universitario Eduardo Agramonte Piña, en el período comprendido desde enero del 2002 hasta diciembre del 2007. A partir de la consulta directa con 30 expertos, los resultados se procesaron estadísticamente con la prueba de Alpha de Cronbach . Resultados: predominaron el metatarso varo congénito, los pies bilaterales, la edad de cinco a nueve años. El resultado final fue exitoso en todos de los pacientes al corregir el parámetro clínico estático y en la mayoría el dinámico. Conclusiones: el nuevo enfoque terapéutico une los criterios clínicos y radiológicos para un mejor diagnóstico del metatarso varo. La técnica es efectiva y sencilla al ser menos invasiva sobre partes blandas, al realizarse en un tiempo quirúrgico breve las complicaciones son mínimas y se usa menos material gastable lo cual produce beneficios económico al país. Los resultados obtenidos son conclusivos debido a que la serie es adecuada y el seguimiento realizado fue a largo plazo.
Background : the metatarsus varus is a frequent illness in the deformities of the foot of the neonate. Objective : to value the new therapeutic approach in the congenital metatarsus varus and residual varus equine foot in a five-year study . Methodology : a descriptive longitudinal study in 81 children with the metatarsus varus diagnosis was carried out, these children were cared in the Orthopedics and Traumatologic service of the Pediatric University Hospital "Eduardo Agramonte Piña", from January, 2002 to December, 2007. Starting from the direct consultation with 30 experts, the results were processed statistically with the test of Alpha of Cronbach. Results: the congenital metatarsus varus, bilateral feet and the age five to nine years prevailed. The final result was good in all of the patients when correcting the clinical static parameter and in most them the dynamic one. Conclusions : the new therapeutic approach unites the clinical and radiological criteria for a better diagnosis of the metatarsus varus. The technique is effective and simple as it is less invasive on soft parts, complications are minimal as it is carried out in a brief surgical time and less expendable material is used for which it brings about economic benefits to the country. The obtained results are conclusive because the series is suitable and the performed follow up was long term.
Subject(s)
Humans , Metatarsus Varus/diagnosis , Metatarsus Varus/congenitalABSTRACT
Os autores apresentam caso de paciente do sexo feminino de nove anos de idade que apresentava dores no pé direito associadas à prática de atividades físicas. Após o diagnóstico de coalizão tarsal cuboide-navicular foi tratada cirurgicamente através de ressecção desta, com resolução dos sintomas. Realizam revisão da literatura e discutem a importância da adequada avaliação clínica e imagenológica dos casos das dores no pé nas crianças e adolescentes.
The authors present a case of a 9-year-old female patient who presents with complaints of pain in her right foot associated with physical activities. After the diagnosis of an osseous cuboid navicular coalition she was treated surgically with resection of the coalition, with symptoms resolved. The literature is reviewed and the importance of adequate physical examination and image exams to investigate foot pain in children and teenagers is discussed.
Subject(s)
Humans , Female , Child , Foot Deformities, Congenital/surgery , Tarsal Bones/surgery , Subtalar JointABSTRACT
El metatarso varo es una patología frecuente en la consulta de Ortopedia Infantil. Objetivo: valorar la técnica de Ghali modificada en el tratamiento quirúrgico de metatarso varo. Método: se realizó un estudio transversal y descriptivo en sesenta y dos niños con el diagnóstico de metatarso varo atendidos por el servicio de Ortopedia y Traumatología del Hospital Pediátrico Universitario Eduardo Agramonte Piña, en el período comprendido entre agosto de 2004 hasta agosto de 2007. Resultados: los pies bilaterales predominaron con cincuenta y cinco para un 96,5%, en la edad ocupó el primer lugar de cinco a nueve años con treinta y cuatro para un 59,6%. El resultado final fue satisfactorio, el 100% de los pacientes resolvió el parámetro clínico estático y el dinámico el 94,7%. Conclusiones: la técnica fue eficaz, económica y sencilla.
The metatarsus varus is a frequent pathology in the infantile orthopedics consultation. Objective: to value the modified Ghali technique in the surgical treatment of metatarsus varus. Method: a cross-sectional and descriptive study was conducted in sixty-two children with diagnosis of metatarsus varus attended in the service of Orthopedics and Traumatology of the Pediatric University Hospital "Eduardo Agramonte Piña", from august 2004 to august 2007. Results: in the age occupied the first place from five to nine years with thirty-four for 59,6%, the final result was satisfactory, the 100% of patients solved the static clinical parameter and the dynamic one with a 94,7%. Conclusions: it was an effective, economic and simple technique.
Subject(s)
Humans , Child , Foot Deformities, Congenital , Orthopedic ProceduresABSTRACT
@# Objective To explore the possible correlations under the interaction of multi-genes action at different stages and analyze the primary histophotomacrographic changes of hind buds tissue in congenital clubfoot and the pathodynamic developmental procedure.MethodsSeventy-seven female Wistar rats were administered with retinoic acid on the 10th day after pregnancy. And the hindlimb, buds and spinal cord were detected through transmission electron microscopic and molecular biological experiments.ResultsThere was clubfoot-like deformity in 61.8% of the experimental animals. Persistence of the embryonic position of the talus and tibia in fetuses was observed. Poor overlapping between talus and calcaneus was seen. Cell apoptosis at the anterior corner of spinal cord and hind buds were seen.ConclusionCongenital clubfoot deformities appear at early stage and exaggerate along with developmental procedure.
ABSTRACT
Objective To investigate the surgical treatment of congenital vertical talus (CVT). Methods Ten feet in six patients (4 girls and 2 boys) with CVT were reviewed. Four of the feet were associated with neuromuscular disorders(Ⅱ), five with malformation syndromes. one foot was idiopathic. The age at surgery ranged from 13 to 39 months with an average of 16.5 months. All were operated with a single-stage soft tissue procedures by using double of posterior and dorsal incisions. Elongation of tendo Achillis and capsulotomy of the ankle and subtalar joints were performed through a straight posterior incision. The dorsal approach was made over the anterior inferior ankle crease from the tip of fibula to talonavicular joint laterally. The extensor digitorum longus and peroneal tendons were lengthened, whereas the peroneus tertius was always tenotomized. The calcaneocuboid capsule, subtalar capsule, and talonavicular capsule also were released. The tibilis anterior tendon was placed through a drill hole in the neck of the talus. One K-wire was passed through the navicular and then retrograde across the talonavicular joint to maintain the reduced position. The other K-wire drove from the heel pad across the subtalar joint. A cast was applied with the ankle in slight plantarflexion for 3 months. Then special shoe was applied for 12 months. Results Six cases (10 feet) were available for follow-up from 6 to 33 months (mean, 23.1 months). The postoperative clinical outcome was evaluated by using a version of Adalaar score. All patients got good cosmetic appearance of the feet and the medial longitudinal arch of feet, had no prominent talar head, and had no the ankle and subtalar motion loss. The presence of mild hindfoot valgus on weight-bearing was noted in only two feet. Seven of ten feet were wearing special shoes. Radiographically, two parameters-talar and calcaneal axis-first metatarsal base angles (TAMBA and CAMBA) were measured from the lateral view of the feet. Preoperative and final follow-up radiographs were obtained. None had avascular necrosis of the talus. TAMBA changed from 66?(range, 50?-98?) to 1.6?(range, -11?-16?), CAMBA changed from 26.1?(range, 14?-60?) to -5.45?(range, -13?-3?). Conclusion Operative reduction has been advocated as the only effective treatment for CVT. It is the best choice to use a single-stage soft tissue surgery for infants with CVT. It is concluded that the results of this procedure are satisfactory.