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Biomedical subjects

A Steenwerckx

Publications and source records attributed to A Steenwerckx.

12 recordsLinked to original sources
PubMed2000

The Weil osteotomy of the lesser metatarsals: a clinical and pedobarographic follow-up study.

The clinical results with pedobarographic analysis were assessed in 32 patients (59 metatarsals) who underwent a distal metatarsal shortening (Weil) osteotomy for either intractable plantar keratoses or chronically dislocated lesser metatarsal phalangeal joints. All patients had increased pressure under the involved metatarsal heads. Thirty three of the 59 metatarsophalangeal (MTP) joints were chronically dislocated. At an average follow-up of 30 months, patients rated the result as excellent or good for 32 of the 37 feet (86%). The mean preoperative AOFAS score was 59 (maximum 100), which improved to 81 post-operatively. This difference is significant: p = 0.00001 (with t-test). Comparison of the pre and post-operative pedobarographic measurements showed a significant decreased load under the affected metatarsal heads (p = 0.05). A complete disappearance of the callus was noted under 44 operated metatarsals (75%) and partial disappearance under 12 metatarsals (20%). Two symptomatic transfer lesions occurred under an adjacent metatarsal head. Recurrent dislocations occurred in 5 joints (15%). While metatarsophalangeal joint range of motion was significantly diminished, toe strength was maintained. Average metatarsal shortening was 5.9 mm with no nonunions, delayed unions, or malunions. The Weil shortening osteotomy is a simple and reliable procedure which can effectively reduce the load under the lesser metatarsophalangeal joints and is helpful for the reduction of dorsally dislocated MTP joints.

Adult↗
PubMed1999

Results after cheilectomy in athletes with hallux rigidus.

From 1987 to 1993, 20 athletes (22 feet) underwent cheilectomy for Regnauld grade I, grade II hallux rigidus. Average age was 31 years (10 men and 12 women); mean follow-up was at 5.1 years. All patients performed high-level sports (judo, track & field, soccer, and skating). Indications for surgery included failure of nonsurgical treatment with persistent pain during sports activities, shoefitting problems, and recurrent bursitis. The aim of our study was to evaluate the results clinically, radiographically, and objectively, using dynamic and static pedodynographic measurements. After a mean follow-up of 5 years, cheilectomy was demonstrated to be a reliable treatment method in athletes with Regnauld grades 1 and 2 hallux rigidus. Functionally, 14 excellent, seven good, and one fair result were noted. Radiological progression was noted in 7 of 13 patients, with a follow-up of >4 years. Postoperative dynamic pedodynographic findings demonstrated moderate but significant changes in peak pressures under the first metatarsal head, the hallux, and in the center of pressure distribution under the forefoot.

Adult↗
PubMed1999

Forefoot reconstruction in rheumatoid arthritis patients: Keller-Lelièvre-Hoffmann versus arthrodesis MTP1-Hoffmann.

The aim of this study was to compare the subjective, clinical and pedodynographic results of two large groups of patients operated on in our department. From January 1987 to December 1992, 38 rheumatoid patients (59 feet) underwent a Keller-Lelièvre arthroplasty of the first metatarsophalangeal (MTP1) joint and a Hoffmann resection of the lesser metatarsal heads. The mean follow-up was 35 months. From June 1992 to August 1997 48 patients (62 feet) with rheumatoid arthritis underwent an arthrodesis of the MTP1 joint and Hoffmann resection of the lesser metatarsal heads. The mean follow-up was 25 months. In 10 feet the arthrodesis was performed as a revision procedure of a failed Keller-Lelièvre arthroplasty. The patients of both series were assessed in the same way: personal interview, clinical examination, radiographs, bilateral footprints, and pedodynographic measurements. Static and dynamic pedodynographic measurements were taken with a 64-sensor matrix insole in a standard shoe. Six of our patients had an arthrodesis-Hoffmann procedure performed on one foot and a Keller-Lelièvre-Hoffmann procedure on the contralateral side. Although there is better loadbearing of the first ray with relative unloading of the central metatarsal heads in the arthrodesis MTP1-Hoffmann group, subjective evaluation of the procedure was slightly better in the Keller-Lelièvre-Hoffmann group. Ninety-three percent of the patients in the Keller group were satisfied or satisfied with minor reservations versus 87 percent in the arthrodesis group. This difference is not statistically significant. Recurrent deformity was not more prominent in the Keller-Lelièvre-Hoffmann group; however, it may be that with a longer follow-up, the feet in the arthrodesis-Hoffmann group hold up better over time. The arthrodesis MTP1-Hoffmann procedure can be used as a revision procedure for a failed Keller- Hoffmann operation, although these procedures were more difficult and needed a longer recovery time than the primary MTP1 arthrodesis.

Arthritis, Rheumatoid↗
PubMed1998

The so-called congenital trigger digit: further experience.

The authors reviewed 53 patients with 70 congenital trigger digits. Three of these were seen at an early age. Most "congenital" trigger digits present later than the neonatal period. A clear difference exists between trigger thumbs and trigger fingers. In our series, thumbs were more frequently affected, 30% were bilateral and none resolved spontaneously. The long fingers were less frequently affected, and two of them (28%) recovered without operation. All other children had an operative release of the A1 pulley of the flexor tendon sheath, with excellent results.

Child, Preschool↗
PubMed1997

Proximal row carpectomy: an alternative to wrist fusion?

Problems with implant failure and silicone synovitis and a high complication rate in wrist arthrodesis have recently increased the interest in solutions that use residual biological articular surfaces. These include limited intercarpal fusions and proximal row carpectomy (PRC). PRC is a relatively easy procedure with few complications. We reviewed 27 personal cases. According to this study PRC offers a painless range of motion, with an average of 68 degrees flexion/extension range and an average grip strength of 60% of the contralateral side. The failure rate is 18.5%. However, failures can be successfully converted into wrist arthrodesis. Our follow-up period ranges from 6 to 36 months. Late deterioration has not been reported in the literature. On the contrary, improvement of mobility and grip strength several months after operation have been observed. We still favor PRC as a salvage procedure in order to offer the patient some motion, provided that there is no osteoarthritis over the capitate and the lunate facet preoperatively.

Adult↗
PubMed1996

Congenital trigger digit.

For this study, cases involving 41 patients with 57 congenital trigger digit were reviewed. Two of these digits were seen when the patient was very young. However, most "congenital" trigger digits present sometime after the neonatal period. A clear difference exists between trigger thumbs and trigger fingers. In this series, thumbs were more frequently affected; 10 were bilateral, and none resolved spontaneously. Fingers were less frequently affected, and two of them recovered without operation. All 39 children had an operative release of the A1 pulley of the flexor tendon sheath, with excellent results.

Female↗
PubMed1996

Results of excision of the interdigital nerve in the treatment of Morton's metatarsalgia.

Thirty-one patients (thirty-two feet) had excision of the interdigital nerve as treatment of their Morton's metatarsalgia. A longitudinal dorsal incision was used in all cases. Twenty-five out of 32 cases had a macroscopically visible neuroma, and only two had no evidence of a neuroma on histological examination. All thirty-two patients were available for follow-up at an average of 44.7 months (range 14 to 71 months) postoperatively. Eighty-one per cent of the patients had a good or excellent result, 12.5% had a fair result, with residual pain and some restriction of activities, and 6.5% had no improvement after their operation. It is noteworthy that 19 patients (60%) benefitted from wearing adapted shoes or inner soles for a considerable time after the operation. Even at final follow-up, only 10 patients (30%) had no restrictions in the choice of their shoes.

Female↗
PubMed1996

Is there a correlation between mobility of the thumb and mechanical hand function?

Is there a correlation between thumb mobility and mechanical hand function? The metacarpophalangeal mobility, the web, grip force and dexterity were measured on volunteers. Statistical analysis showed a good correlation between the dominant and nondominant hand. Thumb mobility shows no correlation with grip force and dexterity while the width of the webspace has a clear influence on them. We could not find a compensatory mechanism between thumb mobility and the first web.

Adolescent↗
PubMed1996

The Judet quadricepsplasty: a retrospective analysis of 16 cases.

Sixteen quadricepsplasties performed for severe extension contractures of the knee were reviewed. Preoperatively all cases showed a severe extension contracture with an average of 23 degrees flexion. Only two patients had more than 30 degrees flexion preoperatively. The average improvement in knee flexion at follow-up was 69 degrees with 11 (68.7%) patients achieving a final flexion of 90 degrees or more. In four cases there was a 15 degrees loss of terminal active extension. In one case a rapid recurrence of the contracture was seen during the initial postoperative weeks. One patient developed a deep infection, and another an acute compartment syndrome.

Adolescent↗
PubMed1995

Radial osteotomy and Sauvé-Kapandji procedure for deformities of the distal radius.

We treated 12 patients with a posttraumatic or congenital deformity of the distal radius. A radial osteotomy and a Sauvé-Kapandji procedure were carried out. In 9 patients the deformity was caused by a malunited fracture; the other 3 patients were referred to us with a Madelung deformity. We performed 6 open wedge osteotomies and 6 closing wedge osteotomies. All but one patient rated the result of the operation as good or excellent. The reason for the only failure could be carpal instability.

Adolescent↗
PubMed1995

Value of clinical provocative tests in carpal tunnel syndrome.

The value of five provocative tests for the diagnosis of carpal tunnel syndrome (CTS) was assessed in four groups: 54 hands with confirmed CTS, 12 with typical symptoms but normal electrophysiological studies, 16 hands in persons with diabetes and 81 hands in normal controls. Compared to normal controls the Tinel sign and the closed first test are highly specific; Durkan's compression test is not useful to discriminate between symptomatic patients with and without EMG disturbances. The closed fist test is specific in these situations.

Adult↗