- Anterior Tarsal Tunnel Syndrome With Thrombosed Dorsalis Pedis Artery: A Case Report. [Journal Article]
- ATArch Trauma Res 2015; 4(1):e21738
- CONCLUSIONS: The anterior tarsal tunnel syndrome is a known disease. A high index of clinical suspicion is required while dealing with the chronic cases. A detailed history to rule out any traumatic event is necessary too. Timely investigations and surgical release give dramatic relief.
- Temporary Internal Fixation for Ligamentous and Osseous Lisfranc Injuries: Outcome and Technical Tip. [Journal Article]
- FAFoot Ankle Int 2015; 36(8):976-83
- CONCLUSIONS: With longer and conservative postoperative management, open reduction and temporary internal fixation in ligamentous and osseous Lisfranc injuries led to equal medium-term outcome. Inferior outcome in ligamentous injuries was not found.
- Talar positional fault in persons with chronic ankle instability. [Journal Article]
- APArch Phys Med Rehabil 2010; 91(8):1267-71
- CONCLUSIONS: An anterior talar positional fault is present in the involved limb of individuals with CAI relative to their uninvolved limb and compared with the matched limb of a control group. The talar position measurement technique has excellent intratester and intertester reliability.
- [Transnasal canthopexy]. [Journal Article]
- RSRev Stomatol Chir Maxillofac 2010; 111(1):36-42
- Medial canthopexy is a permanent and stable fixation of the internal canthus and its elements in an anatomical position. Transnasal canthopexy is difficult to perform. The specific material includes ...
Medial canthopexy is a permanent and stable fixation of the internal canthus and its elements in an anatomical position. Transnasal canthopexy is difficult to perform. The specific material includes two square pins, a large and a small one, plus material to explore the lachrymal duct. After infiltration with adrenalin xylocaine at 1 %, the Tessier's orbitonasal incision follows a bayonet route along the medial canthus and then a sub-tarsal route. A succession of broken lines allows increasing the maxillary upward branch and a larger sub-periosteal dissection. The medial canthal tendon (MCT) is exposed. After intubating the inferior lachrymal duct and pushing the lachrymal sac downwards, any resistance to medial traction is freed with a raspatory. The contralateral approach is arch formed, in front of the MCT, 10mm away from the medial eyelid commissure. The frontal apophysis of the maxillary bone is exposed. The bone is perforated with a square pin while protecting the lachrymal sac and the ocular globe. The MCT is pulled by twisted metallic wire, which is anchored on a wedge. Closing the wound is performed in two layers. A large dressing is applied for 48hours. In case of medial bone defect, parietal bone graft is used to stabilize canthopexy. There are few complications and esthetic and functional results are favorable and long lasting.
- The lateral tarsal strip mini-tarsorrhaphy procedure. [Journal Article]
- AFArch Facial Plast Surg 2009 Mar-Apr; 11(2):136-9
- The lateral canthus normally sits 1 to 2 mm higher than the medial canthus. With time, aging and gravity produce inferior displacement of the canthus. Numerous eyelid disorders can also result in low...
The lateral canthus normally sits 1 to 2 mm higher than the medial canthus. With time, aging and gravity produce inferior displacement of the canthus. Numerous eyelid disorders can also result in lower eyelid or lateral canthal tendon laxity or malposition, requiring horizontal eyelid tightening or canthal repositioning. The lateral tarsal strip procedure has proven to be a useful technique in addressing these problems. Care must be taken when suspending the tarsal strip to the lateral orbital rim to preserve the almond shape of the lateral canthal angle. If mild to moderate upper eyelid laxity is present, suspension of the strip can result in upper eyelid overhang with lower eyelid and eyelash imbrication. We describe the lateral tarsal strip mini-tarsorrhaphy procedure that overcomes this problem. The technique provides excellent functional and aesthetic results and adds to the versatility of a time-tested procedure.
- [Sinus tarsi syndrome: what hurts?]. [Journal Article]
- UUnfallchirurg 2008; 111(2):132-6
- Sinus tarsi syndrome, described by O'Connor in 1958 and Brown in 1960, is a clinical finding often seen after an accident, consisting of a painful reaction to pressure on the sinus tarsi. This syndro...
Sinus tarsi syndrome, described by O'Connor in 1958 and Brown in 1960, is a clinical finding often seen after an accident, consisting of a painful reaction to pressure on the sinus tarsi. This syndrome has also been described in dancers, volleyball and basketball players, overweight individuals, and patients with foot deformities (flatfoot). We looked for mechanical and functional macroscopic structures in the canalis and sinus tarsi that can be associated with sinus tarsi syndrome in order to deduce therapeutic consequences. We found a complex fibrous layer in the sinus and canalis tarsi that forms slips around the synovial sheats of the extensor tendons under the inferior extensor retinaculum. Both limbs run deep to the base of the sinus and canalis tarsi. The lateral band inserts into the sinus tarsi at the calcaneus, while the medial band inserts at the canalis tarsi at the talus and calcaneus. Instead of the term "interosseous ligaments," we recommend referring to the "fundiform ligament" with one lateral and one medial band. Regarding function, one can assume that the medial band of these fundiform ligaments controls the talus at eversion and inversion together with the well-vasculated and well-innervated interarticular fat pads in the sinus and canalis tarsi. While contracting the long extensor muscles of the toes, the ligament forms a control mechanism for the longitudinal arch of the foot in the moving phase.A question is how variations in vascularization or disorders in innervation will alter the turgor of the pads of fat tissue. That is, such alterations would influence the distribution of synovia in the neighboring joints as well as the tension of the involved ligaments.
- [The role of plantar calcaneonavicular ligament complex in the development of the adult flat foot--anatomical study]. [Journal Article]
- CNChir Narzadow Ruchu Ortop Pol 2007 Jul-Aug; 72(4):265-8
- Acquired adult flat foot, despite numerous research projects, is a controversial clinical entity. Recently the role of plantar calcaneonavicular ligament complex (spring ligament) in stabilization of...
Acquired adult flat foot, despite numerous research projects, is a controversial clinical entity. Recently the role of plantar calcaneonavicular ligament complex (spring ligament) in stabilization of the longitudinal arch of the foot has drawn an attention. Since there are differences in anatomical description of his complex in the literature, the main aim of our study was to anatomically evaluate this complex. Ten cadaver feet were examined. In four cases spring ligament complex comprised two components: superomedial calcaneonavicular ligament and inferior calcaneonavicular ligament. In six cases complex was composed of three ligaments and we were able to identify structure of the third ligament. In this subgroup in two cases the spring ligament had its own fibrocartilage surface connected by tiny fibrous band with fibrocartilage articular surface. In summary, the spring ligament complex comprises superomedial calcaneonavicular ligament and inferior calcaneonavicular ligament. In majority of cases one can distinguish structure of the third ligament.
- [Idiopathic loss of lateral tarsal suspension]. [Case Reports]
- ASArch Soc Esp Oftalmol 2007; 82(6):369-71
- CONCLUSIONS: Disinsertion of the union of the inferior tarsus with the lateral canthus, of unknown cause, is a very uncommon finding that has almost never been reported in the world literature. There are two cases described of eyelid elastolysis with loss of lateral tarsal suspension, as in our case, but both showed eyelid skin atrophy and had histopathologic confirmation. Our case did not have skin atrophy.
- Variations in the origin of the medial and inferior calcaneal nerves. [Journal Article]
- AOArch Orthop Trauma Surg 2006; 126(1):6-14
- CONCLUSIONS: Knowledge of fine anatomy of the calcaneal nerves is necessary to ensure safe surgical intervention in the medial heel region.
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- Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. [Journal Article]
- JFJ Foot Ankle Surg 2003 Nov-Dec; 42(6):327-33
- Much of the work describing support of the medial longitudinal arch has focused on the plantar fascia and the extrinsic muscles. There is little research concerning the function of intrinsic muscles ...
Much of the work describing support of the medial longitudinal arch has focused on the plantar fascia and the extrinsic muscles. There is little research concerning the function of intrinsic muscles in the maintenance of the medial longitudinal arch. Ten healthy volunteer adults served as subjects for this study, which was approved by the University Investigational Review Board. The height of the navicular tubercle above the floor was measured in both feet while subjects were seated with the foot in a subtalar neutral position and then when standing in a relaxed calcaneal stance. Subtalar neutral was found by palpating for talar congruency. Recordings of muscle activity from the abductor hallucis muscle were performed while the subjects maintained a maximal voluntary contraction in a supine position by plantarflexing their great toes. An injection of lidocaine (1% with epinephrine) was then administered by a Board-certified orthopedic surgeon in the region of the tibial nerve, posterior and inferior to the medial malleolus. Measurements were repeated and compared by using a paired t test. After the nerve block, the muscle activity was 26.8% of the control condition (P =.011). This corresponded with an increase in navicular drop of 3.8 mm. (P =.022). The observation that navicular drop increased when the activity of the intrinsic muscles decreased indicates that the intrinsic pedal muscles play an important role in support of the medial longitudinal arch.