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Biomedical subjects

G P Jolly

Publications and source records attributed to G P Jolly.

6 recordsLinked to original sources
PubMed2000

Soft tissue considerations in partial foot amputations.

Success is possible with partial foot amputations even in the diabetic patient population. Many diabetics who in the past would have undergone a major lower extremity amputation now have successful reconstruction of their complex foot wounds. Even though this article presents the levels of amputation and methods of closure for soft tissue defects in a sequential manner, in many instances, different levels and methods are used for different aspects of the same foot defect (i.e., a TMA may require a fillet of toe, STSG, and TAL for successful closure). Familiarity with the principles advocated in this article and the importance of each member of the multispecialty team involved help to ensure that good outcomes in the immediate postoperative period and in the long-term recovery period are achieved.

Amputation, Surgical↗
PubMedDate not supplied

The accessory soleus and recurrent tarsal tunnel syndrome: case report of a new surgical approach.

The accessory soleus muscle is a rare anatomic variant, which presents as a mass in the posteromedial aspect of the ankle. This anomaly has been linked with compression neuropathy of the posterior tibial nerve. The authors present a case of tarsal tunnel syndrome in which the presence of an accessory soleus was unrecognized at the time of the original procedure, but was utilized during the revisional operation to provide safe coverage of the posterior tibial nerve.

Humans↗
PubMedDate not supplied

Entrapment neuropathy: the etiology of intractable chronic heel pain syndrome.

Chronic heel pain syndrome (CHPS) is a common clinical entity. The etiology of CHPS has never been completely defined and there are no clear treatment regimens in the literature. Most authors agree that nonoperative treatment is effective in most patients. However, in 5%-10% of patients, operative intervention is required. Outcomes for these patients have been inconsistent. A series of 51 patients with intractable CHPS who were diagnosed with an entrapment of the posterior tibial nerve and its terminal branches is presented. Descriptive statistics were obtained for the demographic data and pre and postsurgical start-up and standing pain visual analog scale (VAS) scoring. Statistical testing of the VAS mean scores was performed using a paired t-test at the 0.01 level of significance. Pre- and postsurgical start-up and pre- and postsurgical standing pain VAS means were significantly different from each other (t = 19.6, p = .001 and t = 19.4, p = .001, respectively). Based on subjective and objective criteria, 96% of the patients experienced significant improvement and 90% reported completed resolution of heel pain. The presence of tarsal tunnel syndrome in all 51 patients strongly suggests entrapment neuropathy as the etiology of intractable CHPS.

Adult↗
PubMedDate not supplied

High-energy bilateral talar neck fractures secondary to motocross injury.

The authors present a case of bilateral Hawkins type II talar neck fractures sustained during a motocross race in a 23 year old man. Due to the complexity of the injuries, open reduction with internal fixation and primary subtalar joint arthrodesis was performed bilaterally. This is one of the few cases of bilateral talar neck fractures reported in the literature in the past 15 years and one of the first utilizing open reduction and internal fixation with concomitant subtalar joint arthrodesis as a primary treatment.

Adult↗
PubMedDate not supplied

A new method of excision of painful plantar forefoot lesions using a rotation advancement flap.

A new method of excision of painful plantar lesions in the forefoot was studied in 13 feet (12 patients). Etiology of the lesions was variable, including traumatic and iatrogenic scars. Localized transfer of partially undermined tissue is used to fill a triangular defect created by excising the lesions. The flap is advanced/rotated into place, without gapping or tension. Full sensation is maintained and because of the significant vascular contribution by the proximal plantar subcutaneous plexus, there is little chance of vascular compromise. Problematic scars occurred in only three feet (two patients). Complications included inclusion cysts in two cases, one parakeratotic nodule and an incidental occurrence of verruca in one case. Follow-up average was 25 months. This procedure provides an alternative method for resolving patients' painful plantar lesions.

Adolescent↗