Common Stress Fractures BRENT W
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Skeletal Foot Structure
Foot Skeletal Structure The disarticulated bones of the left foot, from above (The talus and calcaneus remain articulated) 1 Calcaneus 2 Talus 3 Navicular 4 Medial cuneiform 5 Intermediate cuneiform 6 Lateral cuneiform 7 Cuboid 8 First metatarsal 9 Second metatarsal 10 Third metatarsal 11 Fourth metatarsal 12 Fifth metatarsal 13 Proximal phalanx of great toe 14 Distal phalanx of great toe 15 Proximal phalanx of second toe 16 Middle phalanx of second toe 17 Distal phalanx of second toe Bones of the tarsus, the back part of the foot Talus Calcaneus Navicular bone Cuboid bone Medial, intermediate and lateral cuneiform bones Bones of the metatarsus, the forepart of the foot First to fifth metatarsal bones (numbered from the medial side) Bones of the toes or digits Phalanges -- a proximal and a distal phalanx for the great toe; proximal, middle and distal phalanges for the second to fifth toes Sesamoid bones Two always present in the tendons of flexor hallucis brevis Origin and meaning of some terms associated with the foot Tibia: Latin for a flute or pipe; the shin bone has a fanciful resemblance to this wind instrument. Fibula: Latin for a pin or skewer; the long thin bone of the leg. Adjective fibular or peroneal, which is from the Greek for pin. Tarsus: Greek for a wicker frame; the basic framework for the back of the foot. Metatarsus: Greek for beyond the tarsus; the forepart of the foot. Talus (astragalus): Latin (Greek) for one of a set of dice; viewed from above the main part of the talus has a rather square appearance. -
Medial Lateral Malleolus
Acutrak 2® Headless Compression Screw System 4.7 mm and 5.5 mm Screws Supplemental Use Guide—Medial & Lateral Malleolus Acumed® is a global leader of innovative orthopaedic and medical solutions. We are dedicated to developing products, service methods, and approaches that improve patient care. Acumed® Acutrak 2® Headless Compression Screw System—4.7 mm and 5.5 mm This guide is intended for supplemental use only and is not intended to be used as a stand-alone surgical technique. Reference the Acumed Acutrak 2 Headless Compression Screw System Surgical Technique (SPF00-02) for more information. Definition Indicates critical information about a potential serious outcome to the Warning patient or the user. Indicates instructions that must be followed in order to ensure the proper Caution use of the device. Note Indicates information requiring special attention. Acumed® Acutrak 2® Headless Compression System—Supplemental Use Guide—Medial & Lateral Malleolus Table of Contents System Features ...........................................2 Surgical Techniques ........................................ 4 Fibula Fracture (Weber A and B Fractures) Surgical Technique: Acutrak 2®—5.5 .......................4 Medial Malleolus Surgical Technique: Acutrak 2®—4.7 ......................10 Ordering Information ......................................16 Acumed® Acutrak 2® Headless Compression System—Supplemental Use Guide—Medial & Lateral Malleolus System Features Headless screw design is intended to minimize soft tissue irritation D Acutrak 2 Screws Diameter -
Assessment, Management and Decision Making in the Treatment Of
Pediatric Ankle Fractures Anthony I. Riccio, MD Texas Scottish Rite Hospital for Children Update 07/2016 Pediatric Ankle Fractures The Ankle is the 2nd most Common Site of Physeal Injury in Children 10-25% of all Physeal Injuries Occur About the Ankle Pediatric Ankle Fractures Primary Concerns Are: • Anatomic Restoration of Articular Surface • Restoration of Symmetric Ankle Mortise • Preservation of Physeal Growth • Minimize Iatrogenic Physeal Injury • Avoid Fixation Across Physis in Younger Children Salter Harris Classification Prognosis and Treatment of Pediatric Ankle Fractures is Often Dictated by the Salter Harris Classification of Physeal Fractures Type I and II Fractures: Often Amenable to Closed Tx / Lower Risk of Physeal Arrest Type III and IV: More Likely to Require Operative Tx / Higher Risk of Physeal Arrest Herring JA, ed. Tachdjian’s Pediatric Orthopaedics, 5th Ed. 2014. Elsevier. Philadelphia, PA. ISOLATED DISTAL FIBULA FRACTURES Distal Fibula Fractures • The Physis is Weaker than the Lateral Ankle Ligaments – Children Often Fracture the Distal Fibula but…. – …ligamentous Injuries are Not Uncommon • Mechanism of Injury = Inversion of a Supinated Foot • SH I and II Fractures are Most Common – SH I Fractures: Average Age = 10 Years – SH II Fractures: Average Age = 12 Years Distal Fibula Fractures Lateral Ankle Tenderness SH I Distal Fibula Fracture vs. Lateral Ligamentous Injury (Sprain) Distal Fibula Fractures • Sankar et al (JPO 2008) – 37 Children – All with Open Physes, Lateral Ankle Tenderness + Normal Films – 18%: Periosteal -
Multiplanar CT Analysis of Fifth Metatarsal Morphology
FAIXXX10.1177/1071100715623041Foot & Ankle InternationalDeSandis et al 623041research-article2015 Article Foot & Ankle International® 2016, Vol. 37(5) 528 –536 Multiplanar CT Analysis of Fifth Metatarsal © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav Morphology: Implications for Operative DOI: 10.1177/1071100715623041 Management of Zone II Fractures fai.sagepub.com Bridget DeSandis, BA1, Conor Murphy, MD2, Andrew Rosenbaum, MD1, Matthew Levitsky, BA1, Quinn O’Malley1, Gabrielle Konin, MD1, and Mark Drakos, MD1 Abstract Background: Percutaneous internal fixation is currently the method of choice treating proximal zone II fifth metatarsal fractures. Complications have been reported due to poor screw placement and inadequate screw sizing. The purpose of this study was to define the morphology of the fifth metatarsal to help guide surgeons in selecting the appropriate screw size preoperatively. Methods: Multiplanar analysis of fifth metatarsal morphology was completed using computed tomographic (CT) scans from 241 patients. Specific parameters were analyzed and defined in anteroposterior (AP), lateral, and oblique views including metatarsal length, distance from the base to apex of curvature, apex medullary canal width, apex height, and fifth metatarsal angle. Results: The average metatarsal length in the AP view was 71.4 ± 6.1 mm and in the lateral view 70.4 ± 6.0 mm, with 95% of patients having lengths between 59.3 and 83.5 mm and 58.4 and 82.4 mm, respectively. The average canal width at the apex of curvature was 4.1 ± 0.9 mm in the AP view and 5.3 ± 1.1 mm in the lateral view, with 95% of patients having widths between 2.2 and 5.9 mm and 3.2 and 7.5 mm, respectively. -
Rethinking the Evolution of the Human Foot: Insights from Experimental Research Nicholas B
© 2018. Published by The Company of Biologists Ltd | Journal of Experimental Biology (2018) 221, jeb174425. doi:10.1242/jeb.174425 REVIEW Rethinking the evolution of the human foot: insights from experimental research Nicholas B. Holowka* and Daniel E. Lieberman* ABSTRACT presumably owing to their lack of arches and mobile midfoot joints Adaptive explanations for modern human foot anatomy have long for enhanced prehensility in arboreal locomotion (see Glossary; fascinated evolutionary biologists because of the dramatic differences Fig. 1B) (DeSilva, 2010; Elftman and Manter, 1935a). Other studies between our feet and those of our closest living relatives, the great have documented how great apes use their long toes, opposable apes. Morphological features, including hallucal opposability, toe halluces and mobile ankles for grasping arboreal supports (DeSilva, length and the longitudinal arch, have traditionally been used to 2009; Holowka et al., 2017a; Morton, 1924). These observations dichotomize human and great ape feet as being adapted for bipedal underlie what has become a consensus model of human foot walking and arboreal locomotion, respectively. However, recent evolution: that selection for bipedal walking came at the expense of biomechanical models of human foot function and experimental arboreal locomotor capabilities, resulting in a dichotomy between investigations of great ape locomotion have undermined this simple human and great ape foot anatomy and function. According to this dichotomy. Here, we review this research, focusing on the way of thinking, anatomical features of the foot characteristic of biomechanics of foot strike, push-off and elastic energy storage in great apes are assumed to represent adaptations for arboreal the foot, and show that humans and great apes share some behavior, and those unique to humans are assumed to be related underappreciated, surprising similarities in foot function, such as to bipedal walking. -
Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors Acasereport
1 COPYRIGHT Ó 2020 BY THE JOURNAL OF BONE AND JOINT SURGERY,INCORPORATED Free Vascularized Fibula Graft with Femoral Allograft Sleeve for Lumbar Spine Defects After Spondylectomy of Malignant Tumors ACaseReport Michiel E.R. Bongers, MD, John H. Shin, MD, Sunita D. Srivastava, MD, Christopher R. Morse, MD, Sang-Gil Lee, MD, and Joseph H. Schwab, MD, MS Investigation performed at Massachusetts General Hospital, Boston, Massachusetts Abstract Case: We present a 65-year-old man with an L4 conventional chordoma. Total en bloc spondylectomy (TES) of the involved vertebral bodies and surrounding soft tissues with reconstruction of the spine using a free vascularized fibula autograft (FVFG) is a proven technique, limiting complications and recurrence. However, graft fracture has occurred only in the lumbar spine in our institutional cases. We used a technique in our patient to ensure extra stability and support, with the addition of a femoral allograft sleeve encasing the FVFG. Conclusions: Our technique for the reconstruction of the lumbar spine after TES of primary malignant spinal disease using a femoral allograft sleeve encasing the FVFG is viable to consider. he treatment of primary malignant neoplasms of the spine mended a magnetic resonance imaging (MRI), but the request currently mainly relies on surgery, often in conjunction with was denied by the insurance company, and the patient T 1-3 radiotherapy .Totalen bloc spondylectomy (TES) is a widely underwent a course of physical therapy with no benefitand accepted surgical technique and has lower reported recurrence rates progression of back pain and radiculopathy. Four months compared with patients who undergo intralesional surgery3,4. -
Foot and Ankle Systems Coding Reference Guide
Foot and Ankle Systems Coding Reference Guide Physician CPT® Code Description Arthrodesis 27870 Arthrodesis, ankle, open 27871 Arthrodesis, tibiofibular joint, proximal or distal 28705 Arthrodesis; pantalar 28715 Arthrodesis; triple 28725 Arthrodesis; subtalar 28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse 28735 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction) 28737 Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure) 28740 Arthrodesis, midtarsal or tarsometatarsal, single joint 28750 Arthrodesis, great toe; metatarsophalangeal joint 28755 Arthrodesis, great toe; interphalangeal joint 28760 Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure) Bunionectomy 28292 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with resection of proximal phalanx base, when performed, any method 28295 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method 28296 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy, any method 28297 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method 28298 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with -
Metric and Non Metric Characteristics of Human Forefoot: a Radiological Study in Egyptian Population
Australian Journal of Basic and Applied Sciences 2019 February; 13(2): pages 46-54 DOI: 10.22587/ajbas.2019.13.2.6 Original paper AENSI Publications Journal home page: www.ajbasweb.com Metric and Non metric characteristics of human forefoot: A radiological study in Egyptian population Samah Mohammed, Mahmoud Abozaid and Fatma Elzahraa, Fouad Abd Elbaky Department of Anatomy, Faculty of medicine, Minia University, Minia, Egypt. Correspondence Author: Samah Mohammed, Department of Anatomy, Faculty of medicine, Minia University, Minia, Egypt. Received date: 1 January 2019, Accepted date: 15 January 2018, Online date: 28 February 2019 Copyright: © 2019 Samah Mohammed et al, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Human forefoot is composed of metatarsal bones and phalanges. Their morphology and dimensions are important for proper bipedal locomotor function. Structural defects affecting forefoot bones result in foot dysfunction. The aim of the present study is to describe the morphology of the bones of forefoot and to measure their lengths and widths. A digital radiographic study was conducted on right and left feet of 100 healthy individuals (50 males and 50 females) above 21 years old. Inspection of the forefoot bones using radiographs was done to describe general shapes of bones. The lengths and widths of metatarsal bone and phalanges were measured using Digital Imaging and Communications in Medicine (DICOM) format. Mean and standard deviations were obtained for all measurements of each side of both sexes. -
A Morphometric and Morphological Study on Dry Adult Cuboid Bones
Review Article Clinician’s corner Images in Medicine Experimental Research Case Report Miscellaneous Letter to Editor DOI: 10.7860/JCDR/2021/47259.14447 Original Article Postgraduate Education A Morphometric and Morphological Case Series Study on Dry Adult Cuboid Bones Research Protocol Anatomy Section Short Communication SREYA MOITRA ABSTRACT software, version 19. Students t-test was applied to find the Introduction: Precise biometric data of cuboid and difference between the mean values of the parameters. calcaneocuboid joint are not discussed very distinctly in the text Results: Mean medial length of cuboid was 33.41 mm, lateral books of Anatomy. A better knowledge of the joint surfaces of length was 19.73 mm, height was 26.17 mm, length index cuboid and biometric data would generate a three dimensional was 169.33, vertical and transverse diameters of calcaneal modeling of the calcaneocuboid joint and would help in the articular facet were 24.24 mm and 16.45 mm respectively, vertical and transverse diameters of metatarsal articular facet management of Cuboid Syndrome. were 21.32 mm and 13.85 mm respectively, depth of peroneal Aim: To study about morphological and morphometric analysis groove was 0.63mm. Concavo-convex facet with posteromedial in adult dry cuboid bone. projection and oval or reniform in shape (Type 1A) was the most Materials and Methods: This study was conducted in the common calcaneal articular facet and convex pattern was the Department of Anatomy of a Medical College using 60 dry most common metatarsal articular facet of cuboid. cuboid bones from museum. Each bone was observed for its Conclusion: Morphological characterisation of articular facet morphometric analysis as well as its pattern of calcaneal and of cuboid and its morphometric analysis help to understand the metatarsal articular facets. -
Bones of the Upper and Lower Limb Musculoskeletal Block - Lecture 1
Bones of the Upper and Lower limb Musculoskeletal Block - Lecture 1 Objective: Classify the bones of the three regions of the lower limb (Thigh, leg and foot). Memorize the main features of the – Bones of the thigh (femur & patella) – Bones of the leg (tibia & Fibula) – Bones of the foot (tarsals, metatarsals and phalanges) Recognize the side of the bone. Color index: Important In male’s slides only In female’s slides only Extra information, explanation Editing file Click here for Contact us: useful videos [email protected] Please make sure that you’re familiar with these terms Terms Meaning Example Ridge The long and narrow upper edge, angle, or crest of something The supracondylar ridges (in the distal part of the humerus) Notch An indentation, (incision) on an edge or surface The trochlear notch (in the proximal part of the ulna) Tubercles A nodule or a small rounded projection on the bone (Dorsal tubercle in the distal part of the radius) Fossa A hollow place (The Notch is not complete but the fossa is Subscapular fossa (in the concave part of complete and both of them act as the lock of the joint the scapula) Tuberosity A large prominence on a bone usually serving for Deltoid tuberosity (in the humorous) and it the attachment of muscles or ligaments ( is a bigger projection connects the deltoid muscle than the Tubercle ) Processes A V-shaped indentation (act as the key of the joint) Coracoid process ( in the scapula ) Groove A channel, a long narrow depression sure Spiral (Radial) groove (in the posterior aspect of (the humerus -
Broken Foot (Fractured Metatarsal)
www.healthinfo.org.nz Broken foot (fractured metatarsal) Your metatarsal bones are the long, straight bones in the middle of your foot. If your metatarsals are fractured, it means they are broken. Metatarsal bones often break when a heavy object falls on to your foot. The outside bone can also break because of a twisting injury at the ankle or by kicking a heavy object. Runners can develop stress fractures in these bones, caused by repeated force on their feet. Treating broken metatarsals A broken metatarsal can be treated in different ways. If your bone is broken in a good position but is stable, you may be put into a plaster of Paris cast to support your foot and stop the broken bone from moving while it heals. You will learn how to use crutches or a frame to get around. Your doctor or nurse will also tell you how much weight you can put through your injured foot. You will have a follow-up appointment at the Orthopaedics Outpatient Clinic one to two weeks after your injury to check how well you are healing. This will include an X-ray. If the metatarsal on the outside of your foot has a small break (called an avulsion fracture), it may be treated with a Tubigrip bandage and crutches to help you walk. You might need an operation to move the bones in to the right position and fix them in place. This will happen if the broken bones are not in a good position or are unstable, or if you have also dislocated the joint of your bone. -
Stress Fractures in the Foot and Ankle of Athletes Fratura Por Estresse No Pé E Tornozelo De Atletas Authors: Asano LYJ, Duarte Jr
GUIDELINES IN FOCUS ASANO LYJ ET al. Stress fractures in the foot and ankle of athletes FRATURA POR ESTRESSE NO PÉ E TORNOZELO DE ATLETAS Authors: Asano LYJ, Duarte Jr. A, Silva APS http://dx.doi.org/10.1590/1806-9282.60.06.006 The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standar- dize procedures to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, de- pending on the conditions and the clinical status of each patient. DESCRIPTION OF THE EVIDENCE COLLECTION INTRODUCTION METHOD Stress fractures were described for the first time in 1855 To develop this guideline, the Medline electronic databa- by Breihaupt among soldiers reporting plantar pain and se (1966 to 2012) was consulted via PubMed, as a primary edema following long marches.1 For athletes, the first cli- base. The search for evidence came from actual clinical nical description was given by Devas in 1958, based so- scenarios and used keywords (MeSH terms) grouped in lely on the results of simple X-rays.2 Stress injuries are the following syntax: “Stress fractures”, “Foot”, “Ankle”, common among athletes and military recruits, accoun- “Athletes”, “Professional”, “Military recruit”, “Immobili- ting for approximately 10% of all orthopedic injuries.3 zation”, “Physiotherapy”, “Rest”, “Rehabilitation”, “Con- It is defined as a solution for partial or complete con- ventional treatment”, “Surgery treatment”. The articles tinuity of a bone as a result of excessive or repeated loads, were selected by orthopedic specialists after critical eva- at submaximal intensity, resulting in greater reabsorp- luation of the strength of scientific evidence, and publi- tion faced with an insufficient formation of bone tissue.1 cations of greatest strength were used for recommenda- Although stress fractures may affect all types of bone tion.