Foot & ankle international
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Clinical Trial
Centrocentral anastomosis with autologous nerve graft treatment of foot and ankle neuromas.
Painful neuromatas in the foot and around the ankle can be difficult to treat. Five patients of clinically and histologically proven neuromas underwent centrocentral union with autologous transplantation. Three patients had previous toe amputations involving multiple operations. ⋯ All patients but one showed definitive subjective and objective improvement after centrocentral union with the interposed autologous nerve graft. The patient with "recurrent" Morton's neuroma had the least improvement. This technique can be recommended as an alternative for the prevention of painful stump neuromata.
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The purpose of this study was to evaluate the results of a single injection of corticosteroids in patients with painful heel syndrome. Twenty-seven heels in 24 patients were injected with a combination of 1 ml of lidocaine and 1 ml of betamethasone (6 mg). ⋯ The amount of pain relief that they obtained, the length of time this lasted, and the amount of heel pain present at the final follow-up were recorded. Based on the results of our study, we believe that a steroid injection is a reasonable adjunct in the treatment of painful heel syndrome, but that it is unlikely to provide permanent pain relief.
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An acquired flatfoot deformity with significant laxity at the transverse tarsal joint was created experimentally and the amount of correction that was obtained with selective hindfoot fusions was measured radiographically. Results showed that the talonavicular, double (talonavicular and calcaneocuboid), and triple arthrodeses were able to fully correct the deformity, including correction of hindfoot valgus with just a talonavicular fusion. ⋯ This study provides experimental evidence that although the triple joints are interconnected, they differ with respect to their ability to malalignment. We conclude that talonavicular or double arthrodesis will correct deformity in a flatfoot with considerable laxity through the transverse tarsal joint, but that a subtalar fusion will not provide consistent correction.
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Review Case Reports
Arthroscopic removal of an osteoid osteoma of the talus: a case report.
This article describes a patient with a 10-year history of persistent ankle pain. Differential diagnosis included osteoid osteoma and anterior ankle impingement. ⋯ The use of a motorized instrument for excision did not preclude pathologic evaluation of the specimen. Therefore, in an accessible location on the talar neck, arthroscopic excision of an osteoid osteoma can be performed.