Foot & ankle specialist
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Foot & ankle specialist · Oct 2012
Case ReportsIrreducible dislocation of all the lesser metatarsophalangeal joints of the foot: a case report.
We report a case of irreducible dorsal dislocation of all the lesser metatarsophalangeal joints of the foot following injury at sport. Plantar plate prevented reduction at all the joints, which necessitated an open reduction and stabilization with K-wire. This report highlights the necessity of prompt open reduction and reviews the mechanism of injury and complex anatomy at metatarsophalangeal joint.
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Foot & ankle specialist · Apr 2012
Lengthening z-osteotomy of the fibula to correct persistent talar shift following open reduction internal fixation of ankle fractures.
In cases where ankle fracture union has been compromised by persistent syndesmotic diastasis following open reduction internal fixation, both external rotation and shortening of the fibula have been identified as prominent features. ⋯ Therapeutic Level V.
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Foot & ankle specialist · Apr 2012
Case ReportsPeriosteal osteosarcoma of the calcaneum: a case report.
A 30-year-old woman presented with a 6-month history of pain and swelling over the sole of her right foot. Plain radiograph showed a calcified mass in the heel pad, which appeared to be arising from the spur on inferior aspect of calcaneum. ⋯ Open biopsy of the mass was indicative of periosteal osteosarcoma, the variety that has never been reported in calcaneum. Below-knee amputation was done with no recurrence or distance metastasis seen at 24 months of follow up.
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Foot & ankle specialist · Dec 2011
Efficacy of intravenous tissue plasminogen activator in frostbite patients and presentation of a treatment protocol for frostbite patients.
Frostbite can be a devastating and even debilitating injury. Early identification and proper treatment of frostbite is critical in saving digits and limbs. Tissue plasminogen activator (tPA) has been shown to be effective in reducing the number of digits amputated after severe frostbite injury. Nothing has been presented in the podiatric literature regarding the use of tPA in treating frostbite patients for preserving toes and feet. Intravenous tPA and IV heparin were used to treat severe frostbite injuries that did not show improvement after rapid rewarming, had absent Doppler pulses in the distal limb or digits, showed limited or no perfusion by Tc-99 3-phase bone scan, and had no contraindications to use of tPA. All 11 patients included in this study were treated at Hennepin County Medical Center between 2008 and 2010. A total of 73 digits (upper and lower extremity) were considered at risk for amputation after evaluation with Tc-99 bone scan. Of those digits that were affected, 43 were amputated. Intravenous tPA is a safe and effective treatment to reduce the number of digital amputations after severe frostbite injury. The authors' protocol for treating severe frostbite includes the use of tPA. ⋯ Therapeutic, Level IV.
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Foot & ankle specialist · Dec 2011
Long-term results of neurectomy in the treatment of Morton's neuroma: more than 10 years' follow-up.
The objective of this retrospective study was to evaluate the long-term follow-up results of neurectomy clinical outcomes and complications in the treatment of Morton's neuroma. ⋯ Therapeutic, Level IV, Retrospective case series.