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The management of stasis ulcers of the leg where the tendo calcaneus is exposed.

Chronic leg ulcers may expose and destroy the tendo calcaneus, unless it can be covered soon. Current methods of management do not present a ready method. It is suggested that local muscle transpostion, with skin grafting over the muscle, is an effective form of treatment. An illustrative case is reported, and our clinical experience is presented.

Aged↗

Transposition of the tendo calcaneus for post-traumatic bone defects of the tibia.

Certain post-traumatic defects of the lower extremity present difficult problems in therapy and current methods of management do not offer satisfactory solutions. One such defect is an ulcerative lesion of the lower limb eroding the tibia and forming a chronic, rigid-walled cavity. We describe an operation in which the bone cavity is filled by viable tissue which acts as a bed for a skin graft. In chronic stasis ulcers it has been established that the tendo calcaneus will accept a skin graft, provided the paratenon is left undisturbred.

Achilles Tendon↗

[Combined treatment of crural shortening and calcaneus-malleolar conflict using the Ilizarov distractor].

The complex mode of treatment for crural shortening and calcaneus-malleolar conflict with Ilizarov distractor in 3 children is presented. The management resulted in fast ossification of the distal tibial epiphysis, adequate position of displaced lateral malleolus and correction of the tarsal varus as well as angular deformity of the tibia. The importance of timing for this kind of treatment is emphasized by the author.

Adolescent↗

[Fractures of the foot (excluding the talus and calcaneus)].

The submitted retrospective investigation analyzes a group of 108 casualties with injuries of the skeleton of the foot who were hospitalized in the years 1985-90. Excluded was the group of patients with fractures of the talus and calcaneus because they consider problems of these fractures specific. The structure of the group is influenced by the specialty of the authors' workplace--i.e. treatment of multiple injuries. The characteristic of the group, the mechanism of the injury, data concerning time, a summary of the diagnoses, primary treatment and complications are summarized in tables. Twenty-eight of the patients were checked after a time interval of 24-89 months (mean 51.5 months) following injury. X-ray revealed in all cases consolidation of the fracture, however, frequently in a dislocated position. The basis for evaluation was therefore the clinical examination: in 20 patients the finding was evaluated as normal (physiological); permanent sequelae recorded in eight patients are listed. Subjective evaluation was in most instances more favourable than the objective finding, in particular in patients with multiple injuries. The authors recommend to pay appropriate attention even to so-called "minor" injuries which must be also properly treated at the right time.

Adolescent↗