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At least 739 records · Page 41Linked to original sources
PubMed2006

[Free micro-vascular muscle transplantation for the treatment of late facial paralysis using extensor digitorum brevis and extensor hallucis brevis].

OBJECTIVE: To investigate the result of free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis for the treatment of late facial paralysis. METHODS: From April 2003 to April 2005, 26 cases of facial paralyses were treated by transplantation of denervated extensor digitorum brevis and extensor hallucis brevis. During operation, the ends of the tendons were fixed at ala nasi, middle point of nasal labial fold,oral commissure and chin; the muscle belly were put around the masseter nerve to correct the nasal and oral deformity, microsurgery was applied to anastomose the tarsus lateral vessels to the superficial temporalis vessels or the facial vessels. The result of the operation was evaluated by the Standard of Douglas Harrison and the Paresis Assessment scoring system of Stennert. RESULTS The static appearance was satisfactory in 26 cases after operation, the bilateral oral commissure was symmetry and the dynamic appearance was greatly improved 6 months after operation. Among the 23 cases whose disease history was above 2 years, all could smile naturally and show their teeth symmetrically except 1 case who could only move the oral commissure. Among the 3 cases whose disease history was less than 2 years, one could smile naturally and show his teeth symmetrically, one could smile but could not show his teeth symmetrically, another could move oral commissure but have no motion appearance. The result was evaluated as "+++" according to Standard of Douglas Harrison, accounting for 88% (23/26). Evaluated according to the Paresis Assessment scoring system of Stennert, the difference before operation and after operation was more than 5, accounting for 86% (22/26). CONCLUSION: The free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis can reconstruct the oral appearance for the treatment of late facial paralysis.

Adolescent↗
PubMed1990

[Quantitative analysis of cell density and pattern of chondrocytes in transitory hyaline cartilage anlagen of human tarsal bones].

Changes in the distribution patterns of chondrocytes in the embryonic transitory hyaline cartilage of the tarsus were studied using 56 sagittal section of tarsi from 28 human embryos, with a vertex-foot length from 7.0 to 44.0 cm. The os naviculare and os cuboideum were not sliced in all sections. A total of 93,931 cells were transferred via a mirror to paper, and the resulting patterns were analyzed. Determinations included the numerical surface and volume density of the chondrocytes and the cell distribution patterns using the dispersion index. In the case of the calcaneus, talus, os naviculare and os cuboideum, the number of sliced cells found over a constant area decreases at a continuous linear rate in the course of the embryonic period. In all tarsal primordia the distribution pattern developed from regular to random. Particular conditions prevail immediately below the perichondrium and near the ossification centers which can be found in the calcaneus from the 6th month onwards.

Ankle↗
PubMed1991

The effects of paralysis on skeletal development in the chick embryo. I. General effects.

In order to investigate further the effects of paralysis on skeletal development in the chick embryo, paralysis was induced at 6 days of incubation by dropping 0.2% solution of decamethonium bromide onto the chorioallantoic membrane and maintaining paralysis through to 20 days of incubation. General effects of paralysis included lower body weight, marked subcutaneous oedema, twisting of the neck to the right with marked rigidity, and protrusion of the lower beak beyond the upper. Skeletal abnormalities included cartilaginous and later bony fusion between cervical vertebrae and distortion of scapula and pubis. Long bones were normal in their general form but showed marked reductions in full length and in length of the calcified diaphysis. The patella occasionally underwent chondrification, unlike the tibial cartilage at the tarsus. Reduction in length of the bones of both jaws occurred but was substantially greater in the upper, resulting in the protrusion of the lower. Ossification times of most skeletal elements were little affected by paralysis but some centres appearing nearer the end of incubation showed slight delay in their times of appearance.

Animals↗
PubMed1991

[Surgical treatment of lid retraction in Graves' ophthalmopathy].

Surgical treatment of lid retraction in Graves' ophthalmopathy consisted of resection of Müller's muscle and myotomy of Müller's muscle combined with intraoperative guided disinsertion of the levator palpebrae superioris from the tarsus. Among 10 eyes of 9 patients treated by the authors, 9 eyes achieved good cosmetic effect and corneal exposure was prevented during a follow-up of 3-42 months.

Adult↗
PubMed1991

[Correction of complete blepharoptosis with suspension by Frontalis aponeurosis flap].

The surgical corrective result of complete blepharoptosis is often uncertain. With suspension by Frontalis aponeurosis flap under the brow, the author treated 73 cases satisfactorily, the results conforming to Fox's criteria of a normal eyelid. The incision is made in the skin and Orbicularis oculi at the double-fold of the eyelid, and a muscle flap 2 cm wide is separated from under the Orbicularis oculi at the brow in the conjunction of Orbicularis oculi and Frontalis. The flap is fixed to the tarsus, and a strip of redundant skin 2-3 mm wide excised. The incision is closed with intermittent sutures.

Adolescent↗
PubMed1990

Embedded hard contact lens: reports of a case.

Contact lens migration into the upper eye lid with resultant lid mass is a rare complication of hard contact lens wear. We present a case in which a cosmetically unacceptable upper lid mass was the chief problem. The patient had switched to soft contact lenses and tolerated them well for about 13 months. From computed tomographic scan pictures and the keratoscopic change, surgical exploration through the opening of a discharging sinus in the upper forniceal area delivered a 8 x 8 mm hard contact lens and a flux of tenacious mucoid discharge. Double eversion of the upper tarsus, which was advised by Green in 1963, was the most important technique in reaching the correct diagnosis, and it should be stressed again on examining patients with a history of displaced hard contact lens.

Adult↗
PubMed1991

The anatomy of a human foot with missing toes and reduplication of the hallux.

Detailed dissection of a malformed human foot was performed so that the skeletal and soft tissue anomalies in the foot could be compared and contrasted with those found in three previous specimens that we have dissected. The specimen described here consisted of a foot with a reduplicated hallux and two missing toes. Study of the bones revealed a wide medial metatarsal that articulated with a reduplicated hallux. There were two complete lateral toes with normal bones. Two toes and their metatarsals were missing with no remnants. The arterial pattern was similar to those seen previously by us. The dorsalis pedis artery was absent and the plantar arch was abnormal in that it did not terminate with a dorsal anastomosis. There was an extra lateral branch of the medial plantar artery. The digital arteries to the missing toes were also missing. The nerves of the foot were normal with the exception of an extra lateral branch from the medial plantar nerve. As with the arteries, the nerves to the missing toes were also missing. The muscles and tendons on the dorsal surface of the foot were all present but several of the tendons were inserted in abnormal locations in apparent response to the abnormal bone pattern. Most of the muscles and tendons of the plantar surface were present with the exception of the flexor hallucis longus and brevis muscles. Several of the remaining tendons apparently were influenced by the abnormal skeletal pattern and the missing muscles to become inserted on or near the replicated phalanges of the hallux. The anatomy of this specimen suggests that the teratogenic event occurred when specification of the limb bud mesoderm cells had progressed to the level of the distal tarsus and was located in the region that normally would have formed the metatarsals and phalanges of Toes 2 and 3. Further, we propose that the association between skeletal anomalies and arterial deficiencies has aetiological significance. We hypothesise that the abnormal arterial pattern put the limb at risk of teratogenic damage by reducing the number of collateral blood supply routes and that some event, such as extravasation of blood or embolisation, compromised the blood flow in the remaining blood vessels. These events could have resulted in both general shortening of the limb and the specific defects observed in this foot.

Arteries↗
PubMed1991

[Essential osteolysis. Study of 3 cases and a classification trial].

Disappearing bone disease is a rare syndrome, characterized by an idiopathic and spontaneous progressive resorption of bone, for which different etiologies must be considered. The classification of this disease is difficult; acro-osteolysis involves the phalanges or the carpus and tarsus. Massive osteolysis corresponds to diffuse multicentric cystic hemangiomatosis and Gorham and Stout's disease. We describe two cases of acro-osteolysis and one of Gorham and Stout's disease. The mechanism of disappearing bone disease remains unknown and no treatment has yet been found to stop its evolution.

Adult↗
PubMedDate not supplied

Vibration sense and tarsal disintegration.

The extent of loss of vibration and pressure sensations was assessed in 21 leprosy patients with disintegration of the tarsus. Feet which had and did not have tarsal disintegration both showed severe impairment of pressure sensation, but the loss of vibration sense was more severe in feet which had undergone the destructive process. It appears that loss of deep sensation is an important factor in the process of tarsal disintegration in feet which are already anaesthetic. Measurement of vibration sense using a biosthesiometer may be a valuable clinical test in the investigation and follow-up of the patient with the insensitive foot to identify those at risk of developing tarsal disintegration.

Adult↗
PubMed1990

Detection of talocalcaneal coalitions by magnification bone scintigraphy.

Fibrocartilaginous talocalcaneal coalitions are very difficult to identify on plain radiography in symptomatic children and adolescents before gross ossification occurs. Computed tomography (CT) has been successful in identifying osseous and some fibro-osseous coalitions. In this series, magnification imaging of the tarsus on bone scintigraphy in the medial-lateral projection correctly identified talocalcaneal coalitions, seven of the nine bars were fibrous or fibro-osseous. Three of the fibrous lesions were equivocal or normal on conventional radiography and CT. Physiologic accumulations of activity in the growing hind foot are also presented from a control pediatric population. Magnification scintigraphy of the hind foot is offered as an adjunct to plain radiography and CT in the diagnosis of elusive nonosseous subtalar bars.

Adolescent↗
PubMed1990

[Congenital convexity of the feet. Anatomical study and practical conclusions].

The authors have studied the pathological anatomy of two congenital pes convex, (C.P.C) coming from an 8 days boy suffering of arthrogryposis. One of the feet has been dissected by stage whilst the other one has been operated on according to a procedure of correction of the deformities. The two feet combined an irreducible dislocation of the os naviculare on the neck of the talus, a calcaneo cuboïdeum subluxation, a moderate equinus of the hind foot, an important contracture of the extensor tendons and an elongation of the structural soft tissues of the sole. The main abnormalities of the talus and of the calcaneus involved the upper direction of the anterior articular facet, in relation to the dorsal dislocation of the os naviculare and the dorsal subluxation of the cuboïdeum. The subtalaris joint was little altered. The study of dissections and the clinical reports published connected with the observations of the authors confirm the pre-eminence of the transversal dislocation of the tarsus and of its irreducibility. On the other hand the abnormalities of the subtalar joint have been, probably over estimated. The sometimes important increase of talo calcaneal angle on A.P. radiographies may be explained by the incidence itself. The verticality of the talus is not a reliable feature of C.P.C. and the deformities of the fore foot are variable (pronation, supination). This study leads to a new definition of the C.P.C.: Congenital deformity of the foot with tarsi-transversa dislocation or subluxation involving mainly the talo-navicular joint. The criterious of diagnosis are debated and a logical surgical procedure of correction is suggested.

Ankle Joint↗
PubMed1990

[The floppy eyelid syndrome].

The floppy eyelid syndrome is a disease characterized by chronic papillary conjunctivitis which practically does not respond to common local treatment. Obese men are most frequently affected. The cause is degeneration of collagenous connective tissue which causes an abnormal consistency of the tarsus, floppy eyelids, in particular the upper ones and thus during sleep eversion of the eyelids occurs with subsequent drying up and mechanical irritation of the mucosa. The complaints are most severe closely after awakening. Improvement is achieved by mechanical protection of the eyelids during sleep. Surgical treatment of the eyelids would be a permanent solution.

Adult↗
PubMed1990

The aponeurotic approach to congenital ptosis.

Using a surgical technique directed at the levator aponeurosis, we successfully corrected 228 cases of congenital ptosis. The advantages of this approach are: normal anatomic planes and structures of the eyelid are maintained; basic and reflex tear secretion, goblet cells, or meibomian glands remain undisturbed, allowing maintenance of the three-layered tear film; any aponeurotic defects may be explored and repaired relatively easily; all elevating structures are preserved (aponeurosis rather than muscular levator is removed, Mueller's muscle is left intact, Whitnall's ligament is not violated); posterior sutures, which may irritate the cornea, are avoided; no tarsus or conjunctiva are removed.

Blepharoptosis↗
PubMed1990

[Biphotonic absorptiometry of the foot: methodology and application to algodystrophy].

A simple methodology for the evaluation of the bone mineral content of the foot by biphotonic absorptiometry is described. From the study of a test population, a pathological demineralization threshold of 10%, given that the measurement is expressed in g, has been defined at the level of the forepart of the tarsus. This threshold enables the significant distinction between the test population and a population with algodystrophy. Biphotonic absorptiometry seems to provide a quantitative diagnostic argument to complement the radiographical and scintigraphical examinations.

Absorptiometry, Photon↗
PubMed1989

[Ergonomic and biomechanical study of foot stress in workers using sewing machines].

Functional and morphologic examinations of the feet of 100 sewing-machine-workers have been performed, and a comparison with a control group. The relative frequency of radiological changes was similar in both groups, most commonly on metatarso-phalangeal joints, on the tarsus and in the form of a spine of Achilles tendon. However, clinical and functional changes were significantly more often on the feet of sewing-machine-workers, which were perimalleolar oedema, metatarsalgia and hallux valgus. The changes are more often and serious parallelly to the age and duration of employment, they are more common on the forefoot, and markedly influence the working ability. Concerning the shape of foot, more changes were found on an "egyptian" than on a square foot. Summation of microtraumas and previous changes on the foot (before getting employed) contribute to the development of the found changes.

Adult↗
PubMed1989

[How the cubic measure of the jumping style of the prosimian and its proportions is determined].

How does body size determine the locomotor performance and proportions of leapers? In an analysis of the mechanics of leaping we derived two principles that explain the kinematic and morphological differences between leaping prosimian primates of different body size. 1. In small animals, the distance through which the body can be accelerated during take-off, and the time available for acceleration, are short. In small-bodied leapers we therefore find adaptations that increase the distance or length of time for propulsion and maximize speed. These are: great angular excursions at the joints of the hindlimb, long load arms of body weight and short power arms for the muscles, elongated hindlimbs with a disproportionate lengthening of the distal segments, and additional joints in the tarsus. 2. With increasing body size, the time for accelerating the body is no longer a problem. Instead, the ratio of muscle force available for acceleration to mass to be accelerated is unfavorable. Accordingly, large-bodied leapers have adaptations that allow optimal use of available muscle force. These include: acceleration in energetically profitable joint positions, avoidance of acute joint angles especially at the distal joints (where the muscles work against the highest percentage of body mass), only moderate elongation of the hindlimbs with rather short distal segments, and long lever arms of those muscles that extend the hindlimb joints. In addition, take-offs of the larger-bodied leapers are characterized by a regularly occurring arm swing movement, thus making additional use of nonhindlimb muscles for acceleration. The mass-dependent differences in forces and velocities have consequences for the energy budget. As the muscles of the small species must contract very rapidly against high loads, they consume more energy per unit of mechanical work. It is not possible to optimize speed and force in the same animal. Body size in conjunction with the laws of mechanics determines how maximum leaping potential will be realized.

Animals↗
PubMed1989

[Biomechanics of the ankle joint].

According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

Ankle Joint↗