Biomedical subjects
Publications and source records attributed to G T Kuwada.
The author presents a classification system for complete tendo Achillis rupture. The system is based upon experience following 28 repairs and 102 lengthenings and gastrocnemius recessions. Specific surgical procedures based on this system are reviewed.
The authors describe use of a Silastic plug to limit subtalar joint motion in symptomatic pediatric flatfeet. Three patients sustained postoperative injury resulting in pedal complications. Successful resolution of these cases is discussed.
A 5-year review regarding the autogenous tendon graft procedure using the peroneal tendons to repair acute ruptures of the anterior talofibular and calcaneofibular ligaments, and to correct chronic, unstable ankles is presented. The autogenous tendon graft has been used to limit excessive subtalar inversion in feet with mild-to-moderate calcaneal varus causing an unstable foot and ankle. This is achieved by placing the tendon graft perpendicular or distal to the vertical axis of the lateral malleolus at the calcaneofibular ligament site.
A modified flexor tendon transfer for flexible and semiflexible toes has been described in this retrospective analysis. The study revealed three laterally deviated and one slightly dorsiflexed digit postoperatively. However, there were no recurrences of lesions or digital contractures. Varying degrees of joint stiffness was prevalent in each of the patients. The procedure was initially developed for contracted toes associated with pronated and rectus foot types. The author has found the procedure effective in cavus foot structures when other procedures failed to reduce the hammer toe deformities. The patient population studied found this procedure to be very gratifying.
Nineteen of the author's 20 patients recovered fully from a ruptured anterior talofibular ligament when it was repaired or replaced by a tendon graft from one-half of the peroneus brevis tendon. The patients wore a below-the-knee weight-bearing cast for 3 to 4 weeks after the surgery and none of the patients had residual instability.
The authors found that after either surgical or conservative treatment ankle dorsiflexion played a significant role in patients with reruptures and also in those who did not rerupture. They believe that patients who are either casted or treated by surgical repair with their foot in equinus may have a greater chance of rerupture.
The author presents a long-term follow-up on Achilles tendon rupture and repair. The study includes comparison of Achilles tendon rupture and repair performed by the author and other surgeons. There was an alarmingly high incidence of complications with the Achilles repair and partial ruptures not reported in the literature. Discussion regarding ways to reduce complications using the author's classification system, and repair, was effective based on this study.
The author presents a 15-year follow-up on conservative and surgical treatment of chronic sinus tarsi syndrome. Most of the patients eventually required surgical intervention after conservative treatment failed to alleviate their symptoms. Surgical correction proved to be effective in relieving sinus tarsi pain long-term.