The Journal of foot surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative analgesic effects of dexamethasone sodium phosphate in bunion surgery.
A double-blind study was performed to evaluate the postoperative analgesic effects of dexamethasone sodium phosphate. This steroid or normal saline was randomly injected immediately after surgery into both feet of 51 patients who had identical procedures performed on each foot for the correction of bunion deformities. ⋯ No complications were attributed to the steroid treatment. This study supports the use of dexamethasone sodium phosphate for postoperative analgesia.
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The authors have evaluated the long-term results of the Keller/Mayo bunionectomy with replacement of the first metatarsophalangeal joint with a Silastic double-stemmed implant (Swanson design). Examination of 50 preoperative and postoperative radiographs revealed a decrease in the hallux abductus angle of 21.46 +/- 2.66 degrees, and the intermetatarsal angle of 6.40 +/- 0.67 degrees; both of these figures have a statistically significant probability value of 0.05 attached. The mean patient age at time of surgery was 61.31 years; the mean follow-up time was 5.01 months. A literature review of implant arthroplasty for correction of hallux abducto valgus deformity is also presented.
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A disabling peripheral myeloneuropathy developed in a health professional with a history of chronic exposure and abuse of nitrous oxide. The distinctive clinical symptoms were radicular sensory loss rather than purely distal, and a "reverse" Lhermitte's sign in the absence of signs of specific spinal cord involvement. The entity of nitrous oxide-induced myeloneuropathy is discussed with a review of the literature, as well as present information regarding the etiology, pathophysiology, symptoms, and treatment. In addition, a case report of nitrous oxide-induced myeloneuropathy is presented.
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In this paper, the authors discuss postoperative fever--the patterns, pathophysiology, thermoregulation, intraoperative and postoperative changes, and etiology of postoperative fevers. They stress the need for a thorough history and physical examination and the importance of determining the cause.