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Clinical and dynamic range-of-motion techniques in subjects with and without diabetes mellitus.

Thirty subjects with type 1 diabetes, 30 subjects with type 2 diabetes, and 30 age- and sex-matched controls were evaluated through clinical goniometry and two-dimensional motion analysis systems to determine the dynamic and static range of motion of the knee, ankle, and hallux joints. The purpose of this study was to determine if the knee and ankle joints of patients with diabetes mellitus are affected by limited joint mobility syndrome. The study results support previous medical literature showing significant reduction of range of motion of the hallux in subjects with type 1 diabetes. Significant differences were found between the range of motion of male and female subjects in all lower-limb joints for both subject groups with diabetes compared to the control group, and male subjects in all groups recorded less range of motion than female subjects.

Adult↗

Magnetic resonance imaging of the foot and ankle.

Beginning with its early success in the hip and knee, magnetic resonance has been universally acknowledged as a major advance in musculoskeletal imaging. Subsequent technical improvements encouraged its rapid adaptation for delineating wrist and shoulder joint pathology. In part because of the small, complex curvilinear structures involved, however, the required technology as well as the potential advantages of magnetic resonance imaging in the ankle and foot were realized only recently. This article illustrates some of the clinical applications of magnetic resonance imaging in foot and ankle pathology.

Ankle↗

Subtalar arthroereisis. Valente procedure.

The Valente procedure is a technically improved version of the original subtalar arthroereisis idea of LeLevre. It involves the control of pronation in a selective type of flatfoot deformity in which the predominant pathology is seen within the subtalar joint. Careful workup is necessary to prevent performing this procedure in flatfeet when other procedures, such as arthrodesis or calcaneal osteotomy, would produce better results. In choosing the proper implant, it is important to allow some pronation of the joint (usually 3 to 4 degrees). Failure to do so can result in complications, such as sinus tarsitis, adductovarus deformity, or dislodging of the implant. The procedure is effective in the treatment of painful flatfoot deformity if the guidelines for patient selection, operative technique, and postoperative care, as presented here, are followed.

Child↗

Radiographic evaluation of inflammatory arthritis of the foot.

This article provides a brief overview of the radiographic appearance of the more commonly encountered arthridities in the foot. Also reviewed is a stepwise approach to interpreting radiographs in a patient suspected of having a synovial-based disease.

Ankle Joint↗

Flat foot. II.

Explore the source record for details and available documents.

Achilles Tendon↗

Transient regional osteoporosis of the ankle and foot. A report of four cases and review of the literature.

Transient regional osteoporosis of the ankle and foot is an uncommon clinical entity characterized by local tenderness over the involved area. Plain radiographs demonstrate osteopenia of the involved bone and technetium diphosphonate bone imaging shows increased tracer uptake at the same location. This disorder is benign and self-limiting, and treatment is conservative.

Ankle Joint↗

Long-term retrospective analysis of the treatment of sinus tarsi syndrome.

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.

Adult↗

[Stabilization of the hindfoot by talonavicular arthrodesis. Results apropos of 50 cases].

UNLABELLED: Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis as well as a triple arthrodesis. MATERIAL: There were 27 cases of unstable neurological foot, 13 cases of Rhumatoid foot, 7 cases of flat feet and 3 cases of post-trauma arthritis of the talonavicular joint. The procedure was, in all cases, a talonavicular arthrodesis, associated in some cases to a lengthening of the Achilles tendon, tendon transfer and forefoot correction. METHOD: 50 cases were reviewed with a mean follow-up of 40 months. RESULTS: There were 18 per cent cases of non-union. This could be explained by 2 technical errors: bad cartilagenous resection of the surfaces and unstable bone fixation. No subtalar mobility was noted in all cases. Only one case had a midtarsal mobility associated to a non-union. 39 feet had a normal heel axation. In most cases functional improvement was significant with a painless gait. DISCUSSION: Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis. Non-union could be avoided by a better surgical technique and a cast immobilization of 2 and a half months. The pre-operative deformities should be reduced manually, because isolated fixed valgus and varus can not be corrected by an isolated talonavicular arthrodesis. In conclusion, the indications are: An early valgus deformity of the hindfoot in rhumatoid arthritis. The aim is to avoid a fixed valgus deformity. Neurological induced equino varus deformities specially after stroke and other reducible neurological deformities. Flat foot due to posterior tibialis insufficiency. Isolated arthritis of the talonavicular joint.

Adult↗