Search PubMed⌕ Search

Biomedical subjects

A Manoli

Publications and source records attributed to A Manoli.

At least 55 records · Page 3Linked to original sources
PubMed1993

The Mitchell procedure for the treatment of adolescent hallux valgus. A long-term study.

Thirty patients who had had a total of fifty-one Mitchell procedures to correct adolescent hallux valgus deformities were examined clinically and radiographically an average of seven years (range, three to seventeen years) after the operation. The average age of the patients at the time of the operation was fifteen years (range, ten to nineteen years). The result was excellent in nineteen feet, good in sixteen, fair in six, and poor in ten. The fair and poor results were associated with recurrence of the deformity, stiffness (real or perceived), and unsightly scars. The cause of the fair and poor results was inadequate correction at the time of the operation in six feet and loss of fixation in two; the loss of fixation resulted in one recurrence and one malunion. The remaining eight patients who had a fair or poor result were not totally satisfied and had reservations about more than one of three categories (relief of discomfort, appearance, or range of motion). Seventeen feet had a plantar callosity beneath the second metatarsal head, suggesting increased load-bearing by the second metatarsal. Although sixteen callosities caused no symptoms at the most recent follow-up evaluation, the long-term implications of this altered pattern of weight-bearing are unknown.

Adolescent↗
PubMed1993

Compartment syndromes of the foot after calcaneal fractures.

Approximately 10% of calcaneal fractures develop compartment syndromes of the foot, and of these, one half develop clawing of the lesser toes and other foot deformities, including stiffness and neurovascular dysfunction. Tense swelling and severe pain are the hallmarks of an impending compartment syndrome. The diagnosis is confirmed by multistick invasive catheterization, particularly of the calcaneal compartment in the hindfoot. Immediate fasciotomy is recommended to prevent the development of ischemic contracture. It is recommended that open reduction and internal fixation of a calcaneal fracture is performed on a delayed basis, after the fasciotomy wounds are closed.

Calcaneus↗
PubMed1993

Scarred muscle excision for the treatment of established ischemic contracture of the lower extremity.

Nine patients with rigid equinocavovarus contractures of the foot and ankle after ischemic episodes of the leg were treated from 1986 to 1989. The ischemic contractures occurred after tibial and fibular fractures in six cases, and after a trimalleolar ankle fracture, an electrical burn, and cardiac bypass surgery in one case each. Previous tendon and nerve releases had failed. The scarred portion of the various involved muscles of the deep posterior compartment were widely excised along with the respective tendons. A variety of additional foot procedures were generally necessary to obtain a plantigrade foot. Night splinting to maintain a plantigrade foot was prescribed for all patients.

Adolescent↗
PubMed1992

Acute foot compartment syndromes.

Twelve cases of compartment syndrome of the foot in 10 patients were retrospectively reviewed. All were high-energy injuries sustained in a fall from a height (six), crush (three), or motor vehicle accident (three). Bone injuries of the foot included five calcaneal fractures, three multiple metatarsal and/or phalangeal fractures, and two Lisfranc fracture-dislocations with multiple metatarsal neck fractures. The most consistent physical finding was tense swelling of the foot. The diagnosis was confirmed with compartmental pressure measurements in all cases. Decompressive fasciotomies were adequately performed by the medial approach of Henry or a combined approach with medial and dorsal incisions. An additional lateral incision was used in two instances.

Adult↗
PubMed1991

Traumatic boutonnière deformity as a cause of acute hammer toe: a case report.

Traumatic boutonnière deformity, well-described when occurring in the fingers, can occur in a lesser toe. The deformity mimics that of a hammer toe, but the onset is acute, and develops immediately after trauma. Open repair of the central slip rupture and recentralization of the displaced lateral bands of the extensor mechanism with temporary pinning of the toe can give an excellent result.

Acute Disease↗
PubMed1990

Fracture of the entire posterior process of the talus: a case report.

A 31-year-old man sustained a displaced fracture of the entire posterior process of the talus. Despite anatomic reduction and internal fixation, limitation of ankle and subtalar joint motion persisted at follow-up, 32 months after the injury. Great toe dorsiflexon was also limited, presumably from flexor hallucis longus tethering behind the ankle joint. The fracture healed without evidence of avascular necrosis of either the talar body or the posterior fragment.

Adult↗
PubMed1990

Fasciotomy of the foot: an anatomical study with special reference to release of the calcaneal compartment.

Three patients with calcaneal fractures developed clawing of the lesser toes as a late sequela. Believing that this complication may be the result of contractures from an occult compartment syndrome of the foot, an investigation of the anatomical compartments of the foot was performed. The various compartments of 17 unembalmed adult lower limb specimens were injected with dyed gelatin in a controlled fashion. After freezing, the feet were sectioned either transversely or sagittally. The distribution of the dyed gelatin was then studied. Nine compartments were identified. These were the (1) medial, (2) superficial, (3) lateral, (4) adductor, (5-8) four interossei, and (9) calcaneal. The contents of each compartment was then studied as was the compartment's location in the foot and its position relative to other compartments. We identified a new, separate compartment which lies deep to the superficial compartment in the hindfoot area only. This compartment contains the quadratus plantae muscle. We have named it the "calcaneal" compartment to emphasize its hindfoot location. In addition, a communication was demonstrated between the calcaneal compartment and the deep posterior compartment of the leg through the retinaculum behind the medial malleolus, following the neurovascular and tendinous structures. Claw toe deformity following calcaneus fracture appears to be due to late contracture of the quadratus plantae muscle in the calcaneal compartment. A surgical technique for release of all of the foot compartments is described.

Adult↗
PubMed1990

Compartment syndromes of the foot: current concepts.

The foot has been mentioned as a site for the development of a compartment syndrome for approximately 9 years. Despite this, very little information exists in the literature containing specifics on the nature of the disorder. Very recent work has shown that crush injuries, forefoot and midfoot fractures and dislocations, and calcaneal fractures are prone to the development of foot compartment syndromes (FCS). The classical clinical signs of pain with passive stretch of the involved muscles, and dysfunction of the nerves that pass through the involved compartments are less helpful in the diagnosis of the syndrome in the foot than elsewhere. Tense swelling of the foot may be of some help in arousing suspicion that a FCS has developed, but the diagnosis is best made by invasive catheterization of the foot compartments. Since recent work has discovered that at least nine foot compartments exist, multi-stick catheterization is recommended. Fasciotomy should be performed when the pressures are significantly elevated, to prevent the development of late contractures. A communication exists between a newly-found compartment of the foot, the calcaneal compartment, and the deep posterior compartment of the leg. A combined pattern of FCS and deep posterior compartment syndromes of the leg exists, and should be remembered by the clinician treating injuries of the foot or leg. Also, a foot injury alone may cause a deep posterior compartment syndrome in the leg. Claw-toe deformity seems to be the primary late sequela of FCS. Local procedures may be of only temporary benefit.

Compartment Syndromes↗
PubMed1988

Unusual penetrating injury of the knee joint. A case report.

Although not commonly recognized, glass may be radiopaque in soft tissue. Its density can be similar to that of bone, and it may be misinterpreted as fracture fragments. The radiodensity of glass is dependent on its varying quantities of iron, silicon, dioxide, aluminum, calcium, magnesium, and sodium salts. The awareness that the radiodensity of glass can be similar to that of human bone on roentgenogram can help the surgeon avoid the pitfall of misdiagnosis. Roentgenograms may be used to detect intraarticular glass and to assist in a localization of glass imbedded in the soft tissue.

Child↗
PubMed1988

Sternal Hodgkin's disease. Report of two cases.

Hodgkin's disease of the mediastinum presented as a sternal mass in two young adults. The original biopsy materials were incorrectly interpreted as eosinophilic granuloma of bone (histiocytosis X). A delayed diagnosis (15 months) resulted in the death of one patient, whereas the other patient, whose diagnosis was made in one week, had an excellent response to therapy.

Adolescent↗
PubMed1987

Maisonneuve fracture: case report of a missed diagnosis.

We report the case of a Maisonneuve fracture of the fibula in which the diagnosis was initially missed. The patient presented with a chief complaint of medial ankle pain. Rentograms of the ankle were unremarkable, and the proximal fibula was not examined. He returned four days later with increased pain, at which time examination revealed tenderness along the proximal fibula and medial ankle. Roentgenograms showed widening of the medial joint space of the ankle and an oblique crush of the proximal fibula. The patient underwent open reduction and internal fixation of the syndesmosis and repair of the deltoid ligament, and recovered uneventfully. Physical examination of ankle injuries should include the proximal fibula.

Adult↗
PubMed1987

Pyogenic sacroiliitis in i.v. drug abusers.

We evaluated the sensitivity of imaging studies in six IV drug abusers who had back pain from pyogenic sacroiliitis. Initial radiographs of the sacroiliac joints showed bone destruction in two. A third had slight joint narrowing and sclerosis resembling degenerative disease. Radiographs were considered normal in three. Two of the patients with initially normal radiographs subsequently showed loss of cortices on follow-up studies within 2 weeks. All of the patients had increased activity on scintigrams (five were obtained with technetium-99m methylene diphosphonate; one was with gallium). The findings suggest that scintigraphy is useful in the detection of pyogenic sacroiliitis in IV drug abusers when plain films are normal.

Adult↗
PubMed1987

The antiglide plate for distal fibular fixation. A biomechanical comparison with fixation with a lateral plate.

Posterior antiglide plates recently have been introduced as a method of fixation for the short oblique fracture (Type B, as defined by the AO Group) of the distal part of the fibula. This method has several advantages over the more commonly used lateral plate for the fixation of this type of fracture, including dissection of a smaller area and less operative time, minimum bending of the plate, and no potential for penetration of a screw into the joint. The system can also be applied without insertion of a screw into the distal fragment. This prompted us to compare the biomechanical properties of fixation with the antiglide and lateral plating systems. Short oblique fractures of the distal part of the fibula were produced mechanically in cadaveric legs by supination and external rotation of the foot. The torque that was necessary to produce the fracture in each of twenty-four fibulae was recorded. After fracture, each fibula was reduced anatomically and fixed internally with a lateral plate or antiglide plate applied posteriorly. The strength of fixation was measured by restressing the legs until failure of fixation occurred. The stiffness of the fixation system and the amount of energy required to produce failure of fixation were also calculated. The system using the lateral plate for fixation failed when the torque reached an average of 64.3 per cent of the torque that produced the fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed1987

Posteromedial dislocation of the ankle without fracture.

We report the results of treatment in eight patients who had posteromedial dislocation of the ankle without fracture. The ages of seven of the eight patients ranged from twenty-three to thirty-six years. Four patients had increased generalized ligamentous laxity. One-half of the injuries were sustained during athletic competition. The mechanism of injury appeared to be forced inversion of the foot when it was maximally plantar flexed and axially loaded. Five of the eight patients had an open injury, and four of the five patients had an associated injury to the anterolateral neurovascular structures. No patient had an injury to the distal tibiofibular ligaments or to the syndesmosis. The three patients who had a closed dislocation achieved good long-term functional and roentgenographic results after closed reduction and immobilization. The patients who had an open injury that was treated by anatomical repair of the disrupted lateral ligaments at the time of initial débridement also achieved good long-term functional and roentgenographic results. It does not appear to be necessary to repair the deltoid ligament. In one patient who had an open dislocation and in whom the lateral ligaments were not repaired, moderate instability of the ankle resulted and degenerative changes developed in the joint.

Adult↗
PubMed1986

Malassembly of the sliding screw-plate device.

Four fractures of the femur (three distal femoral and one intertrochanteric) were treated by sliding screw-plate procedures. Complications in all cases were caused by malassembly of the components. A lag screw of adequate length, proper parallel position of the components, confidence that the components are completely engaged, and, where appropriate, preliminary assembly with free, smaller lag screws, are recommended.

Aged↗
PubMed1983

Ectopic calcification as a late sequela of compartment syndrome. Report of two cases.

Ectopic calcification occurred in two patients as a late sequela of compartment syndrome. The clinical and roentgenographic appearance are sufficiently typical that the diagnosis should be made without difficulty. Leaving the wound open after incision and drainage of these lesions may lead to secondary infection. Closing the wound after decompression over suction drainage or needle decompression are treatment alternatives that may lead to more satisfactory results.

Aged↗