[Transplantation of the metatarsophalangeal joint into the hand].
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A case of calcinosis localisata in the foot is presented along with a history, physical examination, ex-rays, laboratory studies, and operative report. There is a discussion of soft tissue calcification, including a concentration on types seen in the foot. In addition, a differential diagnosis is thoroughly described and treatments are discussed.
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Total hip replacements have been recorded in the Norwegian Arthroplasty Register since 1987, and recording of the other joint arthroplasties was started in January 1994. After 12 months 1,589 primary arthroplasties had been registered; these referred to 962 knees, 11 ankles, 76 toes, 113 shoulders, 69 elbows, 12 wrists, 335 fingers and 11 carpometacarpal 1 joints. Median age of the patients was 70 years. 80% were women. Rheumatoid arthritis was the predominant reason for joint replacement, except in the case of the knees where the dominant cause was osteoarthrosis (71%) and of shoulders, 28% of which were replaced because of fractures. Cement was used in 83% of the primary arthroplasties in knee, ankle, shoulder, and elbow joints. 74% of the cement types used contained antibiotics. 9% were uncemented and 8% hybrids. 97% were given systemic antibiotic prophylaxis, most commonly first generation cephalosporins. 114 reoperations were reported. The reason was aseptic loosening in 56%, and infection in 15%. The cooperation with Norwegian orthopaedic surgeons is good. The Register thus provides a reliable picture of implants of Norway, and a good basis for future follow-up studies.
Metatarsophalangeal joint injuries of the great toe (turf-toe) are receiving increasing attention in the literature because of the prevalence of synthetic surfaces and lighter, more flexible shoes. Eighty active professional football players were evaluated. The mechanism of injury was hyperextension in 85% of the players. Eighty-three percent reported their initial injury on artificial turf (P less than 0.05). Other factors significantly related to the incidence of turf-toe included player age (P less than 0.01), number of years in professional football (P less than 0.01), and range of ankle dorsiflexion (P less than 0.05). Turf-toe injury resulted in significantly decreased range of motion of the first metatarsophalangeal joint (P less than 0.01).
Plantar capsule-ligament sprain of the great toe metatarsophalangeal joint, herein referred to as "turf-toe," is discussed with emphasis on two apparantly predisposing factors, playing surface hardness and shoe stiffness. Surface hardness studies have previously been performed by the authors on natural grass and AstroTurf. A study of football shoe flexibility is presented and the results correlated with the occurrence of turftoe. We have not encountered this entity in players wearing relatively stiff conventional seven posted football shoes or the more flexible soccer style shoe on natural grass fields. We have found it to be a not uncommon injury among players wearning the soccer style shoe on AstroTurf.
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We report the results of the treatment of 23 patients with macrodactyly. Eighteen had a two-stage bulk-reducing (defatting) procedure; phalangectomy was used to shorten the digits. At a mean follow-up of nine years (2 to 12), two patients had been lost to follow-up, and three await a second-stage procedure. Good cosmetic correction was achieved in 12 patients, with satisfactory results in seven; two patients had poor results and required amputation.
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We present three cases of finger distal interphalangeal joint reconstruction in children using a new donor site, the middle phalanx of the fifth toe, transferred as a non-vascularized graft. The patients were followed a minimum of 36 months with serial radiographs, magnetic resonance imaging and photographs. Alignment was improved and persisting growth was demonstrated in all cases. Postoperative magnetic resonance imaging of the grafted phalanx and control toe showed comparable signals. The absence of a proximal epiphysis of these toe phalanges may have an important role in their survival after free transplantation, and may promote continued growth.
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In a pilot study of grown-up rabbits perichondrium from the ear was grafted to the joint surface of cavitas glenoidalis from which the normal articular cartilage had been resected. in all cases regeneration of new cartilage occurred. Five clinical cases of arthritis are reported in which, following removal of the degenerated cartilage and grafting of rib perichondrium, articular cartilage regeneration took place