RESUMO
Repair of osteochondral lesions of the talus can be difficult. Smaller lesions respond well to simple arthroscopy and microfracture, whereas larger cystic lesions may require allograft talus replacement or ankle fusions. The lesions in between are more difficult to treat. Autologous chondrocyte implantation and matrix-associated autologous chondrocyte implantation have shown promising results. Future research may include new techniques, pharmacologic intervention, and cell-based therapies, and may be better served with prospective observational studies instead of costly randomized controlled studies. A representative example of arthroscopic implantation is given.
Assuntos
Traumatismos do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Doenças das Cartilagens/cirurgia , Cartilagem Articular/cirurgia , Traumatismos do Tornozelo/terapia , Artroplastia , Artroscopia , Cartilagem Articular/lesões , Previsões , Humanos , Tálus/lesões , Tálus/cirurgia , Transplante Autólogo , Transplante HomólogoRESUMO
UNLABELLED: Vitamin D is a generic name for a group of essential vitamins, or secosteroids, important in calcium homeostasis and bone metabolism. Specifically, efficacy of vitamin D with regard to bone healing is in question. A literature review was performed, finding mostly large studies involving vitamin D effects on prevention of fractures and randomized animal model studies consisting of controlled fractures with vitamin D interventions. The prevention articles generally focus on at-risk populations, including menopausal women and osteoporotic patients, and also most often include calcium in the treatment group. Few studies look at vitamin D specifically. The animal model studies often focus more on vitamin D supplementation; however the results are still largely inconclusive. While recent case reports appear promising, the ambiguity of results on the topic of fracture healing suggests a need for more, higher level research. A novel study design is proposed to help determine the efficacy on vitamin D in fracture healing. LEVELS OF EVIDENCE: Therapeutic, Level IV: Systematic Review.
Assuntos
Fraturas do Tornozelo/tratamento farmacológico , Suplementos Nutricionais , Traumatismos do Pé/tratamento farmacológico , Consolidação da Fratura/efeitos dos fármacos , Vitamina D/administração & dosagem , Idoso , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/cirurgia , Feminino , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/cirurgia , Fixação Interna de Fraturas/métodos , Consolidação da Fratura/fisiologia , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Prognóstico , Radiografia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de PesquisaRESUMO
UNLABELLED: This study was undertaken to help confirm the percentages concerning the presence or absence of the flexor digitorum brevis muscle tendon to the fifth toe. We also hope to be able to determine the presence based on gender and nationality. It is known to be absent occasionally; however, there is no definitive study dedicated to its prevalence. Using a pool of 60 cadavers, 97 total feet were included in our analysis. Of these feet, 47 (48%) lacked a flexor digitorum brevis tendon to the fifth toe at all. Furthermore, 25 (26%) had notably small tendons to the fifth toe. The final 25 (26%) had what the researchers deemed present tendons. This information could be helpful in surgical planning, including tendon transfer techniques, and biomechanical evaluations. Further research would need to be conducted as this was a cadaveric study. LEVELS OF EVIDENCE: Cadaver/anatomy research, Level V.
