Axis Scientific 9-Part Foot with Muscles, Ligaments, Nerves & Arteries A-105857
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Tibialis Posterior Tendon Transfer Corrects the Foot Drop Component
456 COPYRIGHT Ó 2014 BY THE JOURNAL OF BONE AND JOINT SURGERY,INCORPORATED Tibialis Posterior Tendon Transfer Corrects the Foot DropComponentofCavovarusFootDeformity in Charcot-Marie-Tooth Disease T. Dreher, MD, S.I. Wolf, PhD, D. Heitzmann, MSc, C. Fremd, M.C. Klotz, MD, and W. Wenz, MD Investigation performed at the Division for Paediatric Orthopaedics and Foot Surgery, Department for Orthopaedic and Trauma Surgery, Heidelberg University Clinics, Heidelberg, Germany Background: The foot drop component of cavovarus foot deformity in patients with Charcot-Marie-Tooth disease is commonly treated by tendon transfer to provide substitute foot dorsiflexion or by tenodesis to prevent the foot from dropping. Our goals were to use three-dimensional foot analysis to evaluate the outcome of tibialis posterior tendon transfer to the dorsum of the foot and to investigate whether the transfer works as an active substitution or as a tenodesis. Methods: We prospectively studied fourteen patients with Charcot-Marie-Tooth disease and cavovarus foot deformity in whom twenty-three feet were treated with tibialis posterior tendon transfer to correct the foot drop component as part of a foot deformity correction procedure. Five patients underwent unilateral treatment and nine underwent bilateral treatment; only one foot was analyzed in each of the latter patients. Standardized clinical examinations and three-dimensional gait analysis with a special foot model (Heidelberg Foot Measurement Method) were performed before and at a mean of 28.8 months after surgery. Results: The three-dimensional gait analysis revealed significant increases in tibiotalar and foot-tibia dorsiflexion during the swing phase after surgery. These increases were accompanied by a significant reduction in maximum plantar flexion at the stance-swing transition but without a reduction in active range of motion. -
Chronic Tibialis Anterior Tendon Tear Treated with an Achilles Tendon Allograft Technique
n tips & techniques Section Editor: Steven F. Harwin, MD Chronic Tibialis Anterior Tendon Tear Treated With an Achilles Tendon Allograft Technique Ezequiel Palmanovich, MD; Yaron S. Brin, MD; Lior Laver, MD; Dror Ben David, MD; Sabri Massrawe, MD; Meir Nyska, MD; Iftach Hetsroni, MD tus,16,17 rheumatoid arthritis,17 erative tibialis anterior tendon Abstract: Tibialis anterior tendon tear is an uncommon in- psoriasis,18 and deposition of was diagnosed clinically and jury. Nontraumatic or degenerative tears are usually seen gout tophi19,20 also have been confirmed by ultrasound. in the avascular zone of the tendon. Treatment can be con- reported to be associated with After 3 months of phys- servative or surgical. Conservative treatment is adequate tendon ruptures. In older pa- iotherapy treatment without for low-demand older patients. For active patients, surgical tients and in partial tears, non- improvement, surgical treat- treatment can be challenging for the surgeon because after operative treatment has been ment was recommended. The debridement of degenerative tissue, a gap may be formed described.8,21 patient’s American Orthopae- that can make side-to-side suture impossible. The authors Surgical techniques de- dic Foot and Ankle Society present allograft Achilles tendon insertion for reconstruc- scribed in the literature in- (AOFAS)22 score was 23 and tion of chronic degenerative tears. Using Achilles tendon al- clude direct side-to-side his Foot and Ankle Disabil- lograft has the advantage of bone-to-bone fixation, allowing repair and interposition of ity Index (FADI)23 score was rapid incorporation and earlier full weight bearing. autogenous tendon graft for 34.6 preoperatively. -
Treatment of Spastic Foot Deformities
TREATMENT OF SPASTIC FOOT DEFORMITIES penn neuro-orthopaedics service Table of Contents OVERVIEW Severe loss of movement is often the result of neurological disorders, Overview .............................................................. 1 such as stroke or brain injury. As a result, ordinary daily activities Treatment ............................................................. 2 such as walking, eating and dressing can be difficult and sometimes impossible to accomplish. Procedures ........................................................... 4 The Penn Neuro-Orthopaedics Service assists patients with Achilles Tendon Lengthening .........................................4 orthopaedic problems caused by certain neurologic disorders. Our Toe Flexor Releases .....................................................5 team successfully treats a wide range of problems affecting the limbs including foot deformities and walking problems due to abnormal Toe Flexor Transfer .......................................................6 postures of the foot. Split Anterior Tibialis Tendon Transfer (SPLATT) ...............7 This booklet focuses on the treatment of spastic foot deformities The Extensor Tendon of the Big Toe (EHL) .......................8 under the supervision of Keith Baldwin, MD, MSPT, MPH. Lengthening the Tibialis Posterior Tendon .......................9 Care After Surgery .................................................10 Notes ..................................................................12 Pre-operative right foot. Post-operative -
Lower Extremity Focal Neuropathies
LOWER EXTREMITY FOCAL NEUROPATHIES Lower Extremity Focal Neuropathies Arturo A. Leis, MD S.H. Subramony, MD Vettaikorumakankav Vedanarayanan, MD, MBBS Mark A. Ross, MD AANEM 59th Annual Meeting Orlando, Florida Copyright © September 2012 American Association of Neuromuscular & Electrodiagnostic Medicine 2621 Superior Drive NW Rochester, MN 55901 Printed by Johnson Printing Company, Inc. 1 Please be aware that some of the medical devices or pharmaceuticals discussed in this handout may not be cleared by the FDA or cleared by the FDA for the specific use described by the authors and are “off-label” (i.e., a use not described on the product’s label). “Off-label” devices or pharmaceuticals may be used if, in the judgment of the treating physician, such use is medically indicated to treat a patient’s condition. Information regarding the FDA clearance status of a particular device or pharmaceutical may be obtained by reading the product’s package labeling, by contacting a sales representative or legal counsel of the manufacturer of the device or pharmaceutical, or by contacting the FDA at 1-800-638-2041. 2 LOWER EXTREMITY FOCAL NEUROPATHIES Lower Extremity Focal Neuropathies Table of Contents Course Committees & Course Objectives 4 Faculty 5 Basic and Special Nerve Conduction Studies of the Lower Limbs 7 Arturo A. Leis, MD Common Peroneal Neuropathy and Foot Drop 19 S.H. Subramony, MD Mononeuropathies Affecting Tibial Nerve and its Branches 23 Vettaikorumakankav Vedanarayanan, MD, MBBS Femoral, Obturator, and Lateral Femoral Cutaneous Neuropathies 27 Mark A. Ross, MD CME Questions 33 No one involved in the planning of this CME activity had any relevant financial relationships to disclose. -
Traumatic Tear of Tibialis Anterior During a Gaelic Football Game: a Case Report M Constantinou, a Wilson
1of3 Br J Sports Med: first published as 10.1136/bjsm.2003.007625 on 23 November 2004. Downloaded from CASE REPORT Traumatic tear of tibialis anterior during a Gaelic football game: a case report M Constantinou, A Wilson ............................................................................................................................... Br J Sports Med 2004;38:e30 (http://www.bjsportmed.com/cgi/content/full/38/6/e30) were considered irrefutable evidence of a rupture, so Reports of traumatic injury to the anterior lower leg muscles operative management was undertaken one week after the are scarce, with only a handful of reports of traumatic injury injury. to the tibialis anterior. A database search of Medline, Cinhal, Surgery revealed a complete traumatic tear of tibialis and Sports Discus only revealed three such cases, and they anterior at the musculotendinous junction. The tendon had did not result from a direct sporting injury. This report ruptured directly from the muscle belly, which had also documents the case of a traumatic rupture of tibialis anterior sustained some muscle fibre damage (fig 1). The tendon was muscle in a young female Gaelic football player. It details the subsequently sutured back to the muscle belly using surgical repair and management of tibialis anterior muscle absorbable interrupted sutures. and the physiotherapy rehabilitation to full function. Post-surgical management consisted of an initial period of six weeks non-weight bearing and immobilisation in a short leg fibreglass cast, followed by four weeks in an ankle-foot orthosis with partial weight bearing. Active physiotherapy raumatic injuries to the lower limb are often associated rehabilitation was begun 10 weeks after surgery. The with contact team sports. -
Contents VII
Contents VII Contents Preface .............................. V 3.2 Supply of the Connective Tissue ....... 28 List of Abbreviations ................... VI Diffusion ......................... 28 Picture Credits ........................ VI Osmosis .......................... 29 3.3 The “Creep” Phenomenon ............ 29 3.4 The Muscle ....................... 29 Part A Muscle Chains 3.5 The Fasciae ....................... 30 Philipp Richter Functions of the Fasciae .............. 30 Manifestations of Fascial Disorders ...... 30 Evaluation of Fascial Tensions .......... 31 1 Introduction ..................... 2 Causes of Musculoskeletal Dysfunctions .. 31 1.1 The Significance of Muscle Chains Genesis of Myofascial Disorders ........ 31 in the Organism ................... 2 Patterns of Pain .................... 32 1.2 The Osteopathy of Dr. Still ........... 2 3.6 Vegetative Innervation of the Organs ... 34 1.3 Scientific Evidence ................. 4 3.7 Irvin M. Korr ...................... 34 1.4 Mobility and Stability ............... 5 Significance of a Somatic Dysfunction in the Spinal Column for the Entire Organism ... 34 1.5 The Organism as a Unit .............. 6 Significance of the Spinal Cord ......... 35 1.6 Interrelation of Structure and Function .. 7 Significance of the Autonomous Nervous 1.7 Biomechanics of the Spinal Column and System .......................... 35 the Locomotor System .............. 7 Significance of the Nerves for Trophism .. 35 .............. 1.8 The Significance of Homeostasis ....... 8 3.8 Sir Charles Sherrington 36 Inhibition of the Antagonist or Reciprocal 1.9 The Nervous System as Control Center .. 8 Innervation (or Inhibition) ............ 36 1.10 Different Models of Muscle Chains ..... 8 Post-isometric Relaxation ............. 36 1.11 In This Book ...................... 9 Temporary Summation and Local, Spatial Summation .................. 36 Successive Induction ................ 36 ......... 2ModelsofMyofascialChains 10 3.9 Harrison H. Fryette ................. 37 2.1 Herman Kabat 1950: Lovett’s Laws ..................... -
Pathogenesis, Diagnosis, and Treatment of the Tarsal-Tunnel Syndrome
CLEVELAND CLINIC QUARTERLY Volume 37, January 1970 Copyright © 1970 by The Cleveland Clinic Foundation Printed in U.S.A. Pathogenesis, diagnosis, and treatment of the tarsal-tunnel syndrome THOMAS E. GRETTER, M.D. Department o£ Neurology ALAN H. WILDE, M.D. Department of Orthopaedic Surgery N recent years many peripheral nerve compression syndromes have been I recognized. The carpal-tunnel syndrome, or compression of the median nerve at the wrist beneath the transverse carpal ligament, is the com- monest nerve entrapment syndrome. Less familiar but no less important is the tarsal-tunnel syndrome. Since the first case reports of the tarsal-tunnel syndrome by Keck1 and by Lam,2 in 1962, this syndrome is being diag- nosed with increasing frequency. Within the last two years 17 patients with the tarsal-tunnel syndrome have been treated at the Cleveland Clinic. Our report presents a review of the pathogenesis, diagnosis, and treatment of the tarsal-tunnel syndrome. Anatomy The tarsal tunnel is a canal formed on the medial side of the foot and ankle by the medial malleolus of the tibia and the flexor retinaculum. The flexor retinaculum spans the medial malleolus of the tibia and the medial tubercle of the os calcis (Fig. 1). The space beneath the ligament is divided by septae into four compartments. Each compartment contains one of the four structures of the tarsal tunnel. These structures are the pos- terior tibial tendon, flexor digitorum longus tendon, posterior tibial nerve, artery and veins, and the flexor hallucis longus tendon. Each tendon is invested with a separate synovial sheath. -
Hallux Varus As Complication of Foot Compartment Syndrome
The Journal of Foot & Ankle Surgery 50 (2011) 504–506 Contents lists available at ScienceDirect The Journal of Foot & Ankle Surgery journal homepage: www.jfas.org Tips, Quips, and Pearls “Tips, Quips, and Pearls” is a special section in The Journal of Foot & Ankle Surgery which is devoted to the sharing of ideas to make the practice of foot and ankle surgery easier. We invite our readers to share ideas with us in the form of special tips regarding diagnostic or surgical procedures, new devices or modifications of devices for making a surgical procedure a little bit easier, or virtually any other “pearl” that the reader believes will assist the foot and ankle surgeon in providing better care. Please address your tips to: D. Scot Malay, DPM, MSCE, FACFAS, Editor, The Journal of Foot & Ankle Surgery, PO Box 590595, San Francisco, CA 94159-0595; E-mail: [email protected] Hallux Varus as Complication of Foot Compartment Syndrome Paul Dayton, DPM, MS, FACFAS 1, Jean Paul Haulard, DPM, MS 2 1 Director, Podiatric Surgical Residency, Trinity Regional Medical Center, Fort Dodge, IA 2 Resident, Trinity Regional Medical Center, Fort Dodge, IA article info abstract Keywords: Hallux varus can present as a congenital deformity or it can be acquired secondary to trauma, surgery, or deformity neuromuscular disease. In the present report, we describe the presence of hallux varus as a sequela of great toe calcaneal fracture with entrapment of the medial plantar nerve in the calcaneal tunnel and recommend that metatarsophalangeal joint clinicians be wary of this when they clinically, and radiographically, evaluate patients after calcaneal fracture. -
Tibialis Posterior Muscle Pain Effects on Hip, Knee and Ankle Gait
Human Movement Science 66 (2019) 98–108 Contents lists available at ScienceDirect Human Movement Science journal homepage: www.elsevier.com/locate/humov Tibialis posterior muscle pain effects on hip, knee and ankle gait mechanics T Morten Bilde Simonsena,b, Aysun Yurtseverb,c, Ketill Næsborg-Andersenb, Peter Derek Christian Leutscherb,d, Kim Hørslev-Petersene, ⁎ Michael Skipper Andersenf, Rogerio Pessoto Hirataa, a Center for Sensory-Motoric Interaction (SMI®), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7, DK-9220 Aalborg East, Denmark b Centre for Clinical Research, North Denmark Regional Hospital, Bispensgade 37, DK-9800 Hjoerring, Denmark c Department of Rheumatology, Hjørring Hospital, Bispensgade 37, DK-9800 Hjørrring, Denmark d Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, DK-9000, Denmark e King Christian 10th Hospital for Rheumatic Diseases, University of Southern Denmark, Toldbodgade 3, DK-6300 Gråsten, Denmark f Department of Materials and Production, Aalborg University, Fibigerstraede 16, DK-9220 Aalborg East, Denmark ARTICLE INFO ABSTRACT Keywords: Background: Tibialis posterior (TP) dysfunction is a common painful complication in patients Tibialis posterior with rheumatoid arthritis (RA), which can lead to the collapse of the medial longitudinal arch. Dysfunction Different theories have been developed to explain the causality of tibialis posterior dysfunction. Gait In all these theories, pain is a central factor, and yet, it is uncertain to what extent pain causes the Experimental pain observed biomechanical alterations in the patients. The aim of this study was to investigate the Rheumatoid arthritis effect of experimental tibialis posterior muscle pain on gait mechanics in healthy subjects. Methods: Twelve healthy subjects were recruited for this randomized crossover study. -
The Postural and Biomechanical Effects of High Heel Shoes: a Literature Review
1 The Postural and Biomechanical Effects of High Heel Shoes: A Literature Review By Shavonda L. Pannell Faculty Advisor: Dana L. Underkofler-Mercer, B.S., M.S., D.C. April 10, 2012 A Senior Research Project Submitted in Partial Requirement for the Degree of Doctor of Chiropractic 2 ABSTRACT Objective: The purpose of this literature is to provide an overview of literature concerning the postural and biomechanical effects that high heel shoes have on the musculoskeletal system. The implications of postural imbalances, the roles that muscles play in the maintenance of both ideal and imbalanced human posture and certain gait distortions that may occur. Prevention and treatment options are also discussed. Data Collection: The resources utilized included indexed/referenced journal articles, text and reference books. Pubmed, Chiroweb, Chiroaccess and Mantis were databases used to find journal articles and publications related to the effects of posture on the musculoskeletal system and or the effects of high heel shoes on posture and musculoskeletal biomechanics. Results: The keywords high heel shoes, high heeled posture, gait, posture, postural balance, lower crossed syndrome and spinal instability turned up various articles. The most relevant articles were chosen and included in this compilation. Conclusion: An extensive body of literature supports a conclusion that faulty posture due to the wearing of high heels can have detrimental effects on the musculoskeletal system and its biomechanics. The means to evaluate and address faulty posture is crucial in the evaluation and treatment of the biomechanical stresses placed on the musculoskeletal system. Most women who wear high heels have at some point experienced the conditions associated with the faulty body biomechanics. -
Clinical Anatomy of the Lower Extremity
Государственное бюджетное образовательное учреждение высшего профессионального образования «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации Department of Operative Surgery and Topographic Anatomy Clinical anatomy of the lower extremity Teaching aid Иркутск ИГМУ 2016 УДК [617.58 + 611.728](075.8) ББК 54.578.4я73. К 49 Recommended by faculty methodological council of medical department of SBEI HE ISMU The Ministry of Health of The Russian Federation as a training manual for independent work of foreign students from medical faculty, faculty of pediatrics, faculty of dentistry, protocol № 01.02.2016. Authors: G.I. Songolov - associate professor, Head of Department of Operative Surgery and Topographic Anatomy, PhD, MD SBEI HE ISMU The Ministry of Health of The Russian Federation. O. P.Galeeva - associate professor of Department of Operative Surgery and Topographic Anatomy, MD, PhD SBEI HE ISMU The Ministry of Health of The Russian Federation. A.A. Yudin - assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU The Ministry of Health of The Russian Federation. S. N. Redkov – assistant of department of Operative Surgery and Topographic Anatomy SBEI HE ISMU THE Ministry of Health of The Russian Federation. Reviewers: E.V. Gvildis - head of department of foreign languages with the course of the Latin and Russian as foreign languages of SBEI HE ISMU The Ministry of Health of The Russian Federation, PhD, L.V. Sorokina - associate Professor of Department of Anesthesiology and Reanimation at ISMU, PhD, MD Songolov G.I K49 Clinical anatomy of lower extremity: teaching aid / Songolov G.I, Galeeva O.P, Redkov S.N, Yudin, A.A.; State budget educational institution of higher education of the Ministry of Health and Social Development of the Russian Federation; "Irkutsk State Medical University" of the Ministry of Health and Social Development of the Russian Federation Irkutsk ISMU, 2016, 45 p. -
Tibialis Anterior Tendon Rupture: a Case Report
CHAPTER 32 Tibialis Anterior Tendon Rupture: A Case Report James Uh, DPM Cameron Barr, MD INTRODUCTION weave technique. This patient had a predisposing factor that may have contributed to her rupture, which was the use of Closed rupture of the tibialis anterior tendon is a rare injury. local corticosteroids. However, she had no history of acute Bruning fi rst described it in 1905 and there have been fewer trauma to the area of her tibialis anterior tendon or any than 120 cases reported in literature since (1). The rupture other systemic factors that could have been attributed to can be a result of a direct, closed trauma without ankle her tibialis anterior tendon rupture. motion. However, it is more commonly associated with forced ankle plantarfl exion against resistance (1). It has also been CASE REPORT established that a normal tendon rarely ruptures. Conditions that increase the likelihood of rupture are systemic lupus A 70-year-old female presented to our clinic with complaint erythematosus, hyperparathyroidism, and psoriasis (2). Other of vague pain and weakness of 1 month duration that was factors may contribute to tibialis anterior tendon ruptures localized to the anterior aspect of her right ankle. She denied including metabolic disorders such as diabetes mellitus, gout, any history of trauma to the area. However, she did recall rheumatoid arthritis, or after local injections or chronic use that while walking normally that she felt a discomfort that of corticosteroids (1). The typical patient is a male older than was present to the anterior aspect of her ankle that presented the age of 45 years with a complaint of slapping of the foot as a popping type of sensation.