Foot & ankle
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The tibiofibular clear space, a commonly used parameter in assessing the reduction of the syndesmosis in the management of ankle injuries, its anatomic boundaries, and resultant diagnostic ramifications were evaluated. This interval is seen to reflect the posterior aspect of the distal tibiofibular relationship and to vary not only with direct lateral displacement of the distal fibula but also potentially with rotational abnormalities of the fibula.
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There is currently no objective reliable diagnostic test for plantar fasciitis inasmuch as diagnosis cannot be made on the basis of finding a heel spur on radiography (x-ray). In this single-blind observational study, ultrasonography was used to measure plantar fascia thickness in subjects with clinically suspected plantar fasciitis and in control subjects. It was concluded that the population mean plantar fascia thickness is greater for people with plantar fasciitis than for people without heel pain (P < .0005) and that the difference is clinically significant. The ultrasonic appearance of the plantar fascia in plantar fasciitis indicated inflammatory changes.
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We reviewed the case summaries of eight patients who developed concurrent compartment syndromes of the foot and leg after trauma. Patients with multiple fractures of the lower extremities, particularly the tibia, femur, and foot, may develop this disorder. The obvious causes of the concurrent syndromes, concurrent fractures and generalized limb ischemia, were seen only in two patients. ⋯ Delayed fasciotomy resulted in muscle necrosis and/or tibial nerve dysfunction. Suspected cases should have the diagnosis established by catheterization of the involved compartments. Prompt fasciotomies of the foot and leg should be performed if the pressures are significantly elevated.
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Shoes have been implicated as being responsible for the majority of foot deformities and problems that physicians encounter in women. A total of 356 women were studied in this investigation to evaluate trends in women's shoe wear and their effect on the development of foot deformities and pain. ⋯ Few women had their feet measured in over 5 years. The women without foot pain or deformities also wore shoes that were smaller than their feet but to a lesser degree.
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Traumatic subluxation/dislocation of the peroneal tendons has been reported following a variety of sports-related activities. The peroneal musculature contracts reflexively during the injury and overcomes the restraining soft tissue. The tendons can then dislocate anteriorly from behind the distal fibula. ⋯ The chronic, painful lesion should be treated operatively. A tremendous number of surgical procedures have been described for the treatment of chronic tendon dislocations. Choice of a surgical procedure depends upon the anatomy of the peroneal groove and the retinaculum, and the nature of the damage to the area.