Support of the talus: a biomechanical investigation.
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Biomedical subjects
Publications and source records attributed to H D Schoenhaus.
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An orthotic device, which prevents hyperpronation of a human foot, has an offset, deep heel seat to cup the calcaneus. It maintains the calcaneus in approximately 5 degrees of varus with high medial and lateral flanges, which prevents lateral transverse drift of the first and fifth metatarsals.
Apophysitis of the fifth metatarsal base, or Iselin's disease, is an overuse osteochondrosis seen in growing children. Although amenable to treatment, it is a self-limiting disorder, disappearing spontaneously with completion of growth.
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In a study of 50 children, the Dynamic Stabilizing Innersole System (DSIS) was found to decrease the mean resting calcaneal stance position (RCSP) by an average of 6 degrees. A comparison between the neutral calcaneal stance position and the RCSP with the DSIS showed no statistically significant difference between the means for the right or left foot, indicating that the DSIS is capable of returning severe flat foot deformities to their neutral calcaneal stance position. The RCSP with and without the DSIS differed significantly, indicating that the DSIS provides a considerable and statistically significant amount of correction in the RCSP in our study population. Furthermore, the results of linear regression showed that the DSIS appears to be sensitive to the severity of the deformity, preventing overcorrection of less severe flatfoot deformities and providing a long awaited alternative to traditional pediatric corrective flatfoot devices.
The authors present two case studies of giant cell tumor of tendon sheath. This uncommon lesion of the lower extremity is presented in these two cases in correlation with clinical, radiographic, and intraoperative findings. After the pathologic diagnosis was made, the patient in the first case decided not to have the tumor resected. This patient's postoperative course continues uneventfully without expansion of the tumor. In the second case, a local recurrence was noted 13 months after en bloc resection. A review of the literature shows that treatment modalities for such lesions range from marginal excision to radiation therapy. The authors wish to emphasize the high risk of local recurrence of these tumors. Early marginal resection is the treatment of choice.
The authors explain the sequential development of a bunion beginning with hallux abducto valgus, then hypertrophy of the dorsomedial tubercle, followed by proximal articular set angle adaptation. This manuscript emphasizes the importance of transverse plane motion and the pull of the tibial sesamoid metatarsal ligament, and adductor hallucis tendon in the formation of a bunion.