Foot & ankle international
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Randomized Controlled Trial Clinical Trial
Local anesthesia for postoperative pain relief after foot surgery: a prospective clinical trial.
A prospective, randomized, controlled clinical trial was set up to test whether the addition of ankle block to general anesthesia was useful in providing postoperative pain relief following forefoot surgery. Forty feet (20 treatment, 20 control) were entered into the trial and all underwent bony operations on the first ray. ⋯ A significant difference was found between the pain scores in the two groups at the 6-hr stage, but there was no difference in any of the other assessments. It is concluded that ankle block is a useful addition to general anesthesia for this type of surgery.
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We report the occurrence of a bipartition and occult growth plate fracture in the medial cuneiform of a 5-year, 11-month-old traumatic amputee. Initial radiographs of the foot taken in an oblique projection revealed what appeared to be an osseous fracture of the medial cuneiform. Histologic examination of the pathologic specimen showed that the radiolucent cleft separating the two foci of ossification was actually a hyaline synchondrosis (growth plate) functioning in the normal endochondral transformation of the bone. ⋯ Yet, as with all growth plates of the chondro-osseous skeleton, occult injury to the growth mechanism should be suspected in instances of obvious trauma. Discriminating between normal development of the skeleton and skeletal pathology can be a challenge to the treating physician. Therefore, an awareness of possible anatomic variations will enhance diagnostic evaluations.