The Journal of foot surgery
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By way of literature review, clarifications are made in the terminology employed in discussing the atypical post-traumatic pain syndromes, particularly reflex sympathetic dystrophy (RSD). Causalgia is a form of RSD and is the focus of a case report presented from the files at St. Anne's Hospital-West, Northlake, Illinois.
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Pneumatic ankle tourniquets are currently used in podiatry for maintaining hemostasis during foot surgery. The literature is limited concerning the safest pressure to use with this device. This study was undertaken to develop a simple and reliable method of deriving a proper pressure setting that would be safe and efficacious. ⋯ The lower pressures used were felt to be safer and better tolerated by the patients. The authors concluded that the minimum effective pressure should be determined for each patient preoperatively and the routine use of a maximum safe pressure of 250 mm. Hg should be discouraged.
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The authors report on the results of eight calcaneal fractures treated conservatively with the Robert-Jones compression dressing technique. They believe that conservative treatment of fractures of the calcaneous, the most frequently fractured tarsal bone, is successful and nonunions are rare. Also, the risk of complications is lessened and the results are uniformly satisfactory.
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Two local anesthetics, Duranest 1% (etidocaine HCl) and Sensorcaine 0.5% (bupivacaine HCl), were tested against each other in dose-related blocks of the fifth ray. This study was conducted under double-blind cross-over conditions using 24 healthy volunteers. It was found that 4 ml. of either agent was sufficient to anesthetize the fifth ray area in all but 4.2% of the injections and 8 ml. of etidocaine always accomplished complete fifth ray anesthesia. ⋯ Residual pain was noted in some of the subjects given etidocaine after complete resolution of sensory anesthesia. Residual pain was not noted in any of the subjects given bupivacaine. Etidocaine was found to have a more rapid onset and a longer duration than bupivacaine or a lidocaine-bupivacaine mixture, and was thus found to be a superior agent in the subjects tested.
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The goal of reduction in displaced ankle fractures is the restoration of normal function in the involved extremity. This can be accomplished only by restoring the normal anatomy of the involved joints. ⋯ Open reduction with internal fixation allows for direct visualization of the involved parts and an accurate and rigid form of fixation. A case report of a displaced ankle fracture treated with open reduction and internal A-O fixation is presented.