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Biomedical subjects

E O Leventen

Publications and source records attributed to E O Leventen.

10 recordsLinked to original sources
PubMed1991

Sesamoid disorders and treatment. An update.

The anatomy, function, and disorders of the hallucal sesamoids show that the diagnosis and current concept of management are based on the individual patient's problems. The treatment should always be initiated in a conservative fashion, generally using a molded insole with an appropriate excavation to shift weight from a painful sesamoid. The advantages and disadvantages of sesamoidectomy are influenced by surgical technique. Care in handling the medial and lateral hallucal nerves is essential. Removal of both the medial and lateral sesamoids invariably leads to an intractable clawtoe deformity and is absolutely contraindicated.

Foot Deformities, Acquired↗
PubMed1990

Distal metatarsal osteotomy for intractable plantar keratoses.

A relatively simple distal osteotomy of the metatarsal necks is presented. Twenty-one feet were followed for an average of 31 months with a diagnosis of intractable plantar keratosis causing metatarsalgia. A treatment plan is given that indicates which metatarsals to osteotomize, depending on location of the keratosis. Results and complications are discussed.

Adult↗
PubMed1989

Medial displacement metatarsal osteotomy for treatment of painful bunionette.

A medial displacement metatarsal osteotomy was performed in 23 feet of 16 patients who had painful bunionette deformities. The mean follow-up period was 22 months. Relief of symptoms, e.g., lateral forefoot pain, plantar pain, toe deformity, functional limitation, and shoewear limitation, was achieved. Lateral forefoot tenderness also was relieved. Forefoot width and intermetatarsal four-to-five, intermetatarsal two-to-five, and metatarsophalangeal five angles were consistently decreased. Overall results based on objective and subjective criteria were good in 88%, fair in 4%, and failure in 8%. Complications were superficial wound infection in one case and possible nonunion in one case. This operation is appropriate for the painful bunionette with metatarsal splaying or outflaring with or without intractable plantar keratosis and varus toe deformity.

Adolescent↗
PubMed1988

Silicone implant arthroplasty for second metatarsophalangeal joint disorders with and without hallux valgus deformities.

Subluxation or dislocation of the second metatarsophalangeal joint (MTPJ) is usually associated with a hammertoe deformity and, frequently, with a significant hallux valgus deformity. Although the joint itself may be painful, there is also pain in the hammertoe deformity, especially when the patient is wearing closed shoes. A painful intractable plantar keratosis is usually present. We reviewed all of our patients with second MTPJ subluxation or dislocation, in whom a double-stem silicone implant had been used to relocate the joint. In 31 feet of 28 patients, 32 implants were used. All but six feet with advanced degenerative joint disease secondary to Freiberg's infraction had severe associated forefoot pathology that necessitated surgical correction. Several feet had previous bunion operations as well as operations on the second toe. In addition to the second toe, we performed hallux valgus corrections in 23 feet, seven of which were revision procedures. At an average follow-up time of 37 months, good results were seen in 20 feet (63%), good results with reservations in eight feet (25%), and failure in four feet (12%). Transfer metatarsalgia was the most frequent complication. The implants remained stable, and in only one was there a suspected fracture. More optimum results might have been achieved had there been better correction of the hallux valgus deformities, more frequent correction of the hammertoe deformity, and less resection of the second metatarsal head. These patients with pathology usually involving both the first and second MTPJ are difficult to treat, therefore. Their results are less predictable and not as favorable as those achieved for patients with isolated similar deformities.

Adult↗
PubMed1986

Charcot foot--a technique for treatment of chronic plantar ulcer by saucerization and primary closure.

A series of four cases of refractory plantar ulcer in Charcot feet was successfully treated by a wide plantar exposure, excision of the ulcer, and primary closure over suction drainage. Thorough saucerization of the underlying convexity in the tarsals is thought to be necessary to achieve healing and prevent recurrence. Surgical intervention is considered worthwhile in those cases that show a marked rocker-bottom foot deformity on lateral radiography and have a persistent ulcer after conservative treatment in a plaster cast.

Arthropathy, Neurogenic↗
PubMed1981

A new osteotomy for hallux valgus: a horizontally directed "V" displacement osteotomy of the metatarsal head for hallux valgus and primus varus.

A new operation for hallux valgus consists of a horizontally directed "V" displacement osteotomy done in the head of the first metatarsal. This procedure corrects most of the primus varus, the valgus tilt of the articular surface of the first metatarsal and, if present, the axial rotation of the great toe. The osteotomy is combined with a release and balancing of soft-tissue structures on both sides of the joint. No casting and usually no internal fixation is necessary. Ambulation is generally recommended on the third postoperative day. The operative techniques, indications for surgery, clinical material, and postoperative care are discussed. The operation, when done correctly, does not result in recurrence of the deformity. Significant complications are rare.

Biomechanical Phenomena↗
PubMedDate not supplied

Hallux valgus correction with proximal metatarsal osteotomy: two-year follow-up.

We evaluated the results of 33 feet in 23 patients who underwent a basilar crescentic osteotomy with a modified McBride procedure with a minimum 24-month follow-up. The average hallux valgus improved from 37.5 degrees to 13.8 degrees and the intermetatarsal 1-2 angle from 14.9 degrees to 4.7 degrees. The angle of declination of the first metatarsal was found to have dorsiflexed an average of 6.2 degrees. Unfortunately, osteotomies secured with staples dorsiflexed to a greater degree. Bilateral foot surgery produced results similar to those with unilateral procedures. Four of our patients developed a hallux varus (range 2-8 degrees); however, none were dissatisfied at the time of evaluation. Although this bunion procedure resulted in more prolonged swelling and pain than a distal osteotomy, it should be considered for more complex deformities to avoid the failure that a distal metatarsal osteotomy might produce given a high 1-2 intermetatarsal angle or a high hallux valgus angle.

Adult↗