The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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The classic Maisonneuve fracture is localized to the proximal portion of the fibula, in association with disruption of the ankle that involves tibiofibular diastasis. This report, however, describes a case involving a Maisonneuve fracture in the presence of intact deltoid and tibiofibular syndesmotic ligaments. When this injury is suspected, further diagnostic imaging and intraoperative assessment may be useful, and operative repair does not require the use of trans-syndesmotic fixation. ⋯ 4.
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Early mobilization exercises are advocated following Achilles tendon (AT) repair, but forces on the repair during passive range of motion are unknown. The extent to which these forces change with flexion of the knee is also not known. Estimated AT forces were measured using 3 models: cadaveric, uninjured subjects, and in both legs of subjects 6 weeks following unilateral AT repair. ⋯ Normal AT showed a marked reduction in estimated AT force with knee flexion which was not present in repaired AT. This could be because of elongation of the repair, causing more slack in the tendon that would need to be taken up before force transmission occurs. ACFAS Level of Clinical Evidence: 4.
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Case Reports
Dorsal dislocation of the intermediate cuneiform with fracture of the Lisfranc joint: a case report.
Tarsal cuneiform dislocation in association with Lisfranc fracture-dislocation is a rare pedal injury. In this report, we describe the case of a patient who sustained a dorsal dislocation of the intermediate cuneiform in association with tarsometatarsal fracture-dislocation following traumatic axial loading and torsion of his foot. A satisfactory outcome was achieved by treating the injury by means of closed reduction and percutaneous Kirschner wire fixation. ACFAS Level of Clinical Evidence: 4.
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We present a report of myiasis, which is the infestation of the body by the larva of flies. In this particular case the patient traveled to Belize and was infested in her foot and leg by Dermatobia hominis or the human botfly. Treatment was initiated once she returned to the United States. ⋯ This is a rare larval infestation in humans, but is frequently seen in domestic and livestock animals in Central and South America. With increased international travel, the foot and ankle surgeon should be aware of this parasitic infection in recent travelers to Central and South American countries. ACFAS Level of Clinical Evidence: 4.
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Osteochondritis dissecans can affect any joint, although the ankle is the third most common location after the knee and elbow. When the ankle is involved, the lesion usually affects the talar dome. The authors report a case of osteochondritis of the subtalar joint affecting the talus in a 14-year-old girl without any history of trauma. ⋯ The conservative treatment failed to relieve her symptoms, and she underwent subtalar arthroscopy followed by surgical excision, curettage, and drilling through a mini-arthrotomy. Postoperatively, the patient was managed with protected weight bearing and physiotherapy. A year after surgery, she had returned to her routine activities, including sports, with no further complaints related to the affected foot.