[Abnormally wide palpebral fissure due to hypoplasia (aplasia?) of the tarsus].
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The authors have studied 32 tarsal coalitions in 20 children. Twenty two were between the talus and the calcaneum, 4 were medial and 6 were rare varieties. The diagnosis is often missed because 40 p. 100 of the children with tarsal coalition had no complaints. The indirect radiological signs have been analysed and precise techniques described for detecting the coalition. Only 11 feet were operated on. On 4 occasions the coalition was simply resected. This always gave a good functional result and good mobility was obtained in the subtaloid joint in 2 cases. The other cases were treated by triple arthrodesis. The authors consider that an earlier diagnosis would lead to better prevention of secondary deformities. The best indication for simple resection is in coalition between the calcaneum and the navicular.
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The author describes a case of ball and socket ankle joint in a man aged 30 years. The deformity was associated with a congenital synostosis between the talus and calcaneus, absence of the fifth toe and 2 centimetres of shortening of the limb. The literature is reviewed.
An isolated dorsomedial dislocation of the medial cuneiform and first ray at the medial cuneonavicular joint in a 37-year-old woman was reduced easily under general anesthesia. The reduction was stable. Early diagnosis, including comparative roentgenographic views and expeditious treatment are essential for recovery of normal function.
Within 4 years (September 1977 to September 1981) 169 closed fractures of the feet were seen at our paediatric-surgical outpatient dept. Special therapeutic problems arose only in fractures of the talus and the calcaneus, although necrosis of the talus were rare. Concerning treatment a plaster cast, sufficient relief and early arch-support are essential. Fractures of the other tarsal bones were mostly without problems, a conservative treatment was used for these cases.
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