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Biomedical subjects

M J Shereff

Publications and source records attributed to M J Shereff.

At least 37 records · Page 2Linked to original sources
PubMed1991

MR imaging of the lateral collateral ligament of the ankle.

The ankle is stabilized by three sets of ligaments: the medial collateral (deltoid) ligament, the syndesmotic ligamentous complex, and the lateral collateral ligament. Of these three, the lateral collateral ligament is the one most often injured in ankle sprains. Assessment of the extent of injury has classically relied on clinical evaluation; plain film radiographs (including stress views); and, in some acute situations, ankle arthrography and/or peroneal tenography. In this report we illustrate the use of MR in the evaluation of the lateral collateral ligament. The normal anatomy, pitfalls in image interpretation, and findings in cases of ligamentous injury are demonstrated.

Ankle Joint↗
PubMed1991

Electron microscopic analysis of the interdigital neuroma.

Electron microscopic evaluation was investigated in surgical specimens of interdigital neuroma. Edema of the endoneureum, fibrosis beneath the perineurium, axonal degeneration and necrosis suggest nerve damage occurs secondary to mechanical impingement in the etiology of interdigital neuroma.

Adult↗
PubMed1990

A comparison of nonweight-bearing and weight-bearing radiographs of the foot.

This study compares the standardized measurements of the foot in nonweight-bearing and weight-bearing radiographs. Both normal and hallux valgus patients were studied. The results show that some changes thought to occur with weight-bearing cannot be consistently demonstrated. Obtaining both weight-bearing and nonweight-bearing views may not be routinely indicated in all patients.

Adolescent↗
PubMed1990

MR imaging of the tarsal tunnel and related spaces: normal and abnormal findings with anatomic correlation.

The tarsal tunnel syndrome may be caused by extrinsic or intrinsic pressure on the posterior tibial nerve or its terminal branches. The specific symptoms depend on the extent of nerve involvement, and compression distal or proximal to the tarsal tunnel may result in variants of the syndrome. To define better the capability of MR imaging for evaluating this entity, we performed MR imaging on three normal subjects and correlated the images with cryomicrotome sections. Six patients with symptoms suggestive of tarsal tunnel syndrome also were studied with MR. In all normal subjects, MR images showed the flexor retinaculum and the structures passing deep to the retinaculum: the tibialis posterior tendon, flexor digitorum longus tendon, flexor hallucis longus tendon, and the posterior tibial neurovascular bundle. The medial calcaneal sensory branch(es) and the medial and lateral plantar nerves also were delineated. Mechanical causes of compression were shown in all six symptomatic patients. The pathologic entities included two neurilemomas, tenosynovitis involving all three tendons, a ganglion cyst arising from the flexor hallucis longus tendon sheath, posttraumatic fibrosis, and post-traumatic fibrosis with associated posttraumatic neuroma. The MR findings were confirmed surgically in five cases. MR imaging can accurately depict the contents of the tarsal tunnel and the courses of the terminal branches of the posterior tibial nerve. In our small series, MR imaging accurately showed the lesions responsible for tarsal tunnel syndrome.

Ankle↗
PubMed1990

Compartment syndromes of the foot.

Acute compartment syndrome of the foot is a clinical entity that can cause severe impairment and permanent residual disability. Early diagnosis and prompt intervention are necessary to achieve optimal clinical results.

Compartment Syndromes↗
PubMed1990

Fractures of the forefoot.

In conclusion, the principles of fracture management recommended for treatment of musculoskeletal injuries elsewhere should be applied to the forefoot. Anatomic reduction, adequate fixation, and meticulous soft-tissue management will provide optimum functional recovery.

Forefoot, Human↗
PubMed1989

In vitro determination of midfoot motion.

Midfoot motion was determined using an in vitro model. Ten fresh-frozen below-the-knee amputation specimens were instrumented by inserting reference pins into each of the bones of the hindfoot, midfoot and metatarsals. Dorsiflexion-planatar flexion and supination-pronation were simulated and the reference pin location in three dimensional space was determined. Comparing the location of the reference pins at each simulated position, motion was determined. Motion occurring through each articulation (dorsiflexion-plantar flexion/supination-pronation) in degrees was: talonavicular (7.0/17.7), calcaneocuboid (2.3/7.3), naviculo-medial cuneiform (5.0/7.3), naviculo-middle cuneiform (5.2/3.5), naviculo-lateral cuneiform (2.6/2.1), medial cuneiform-first metatarsal (3.5/1.5), middle cuneiform-second metatarsal (0.6/1.2), lateral cuneiform-third metatarsal (1.6/2.6), cuboid-fourth metatarsal (9.6/11.1), and cuboid-fifth metatarsal (10.2/9.0).

Foot↗
PubMed1989

Soft-tissue tumors and tumor-like lesions of the foot. An analysis of eighty-three cases.

The cases of eighty-three patients who had a soft-tissue tumor or tumor-like lesion in the foot or ankle were retrospectively analyzed to determine the relative frequency of the lesions and which factors, if any, could be used to identify them preoperatively. Seventy-two (87 per cent) of the lesions were benign, with ganglion cysts and plantar fibromatoses being the most common, and eleven (13 per cent) were malignant tumors, five (45 per cent) of which were synovial sarcomas. The age of the patient and the location of the lesion were the two most important factors that characterized the malignant tumors. For eight patients (12 per cent), radiographs were helpful in identifying the nature of the lesion. The sex of the patient, a history of trauma, the duration of the symptoms, the size of the lesion, and the presence of pain or of neurological symptoms were not useful in discriminating a benign lesion from a malignant tumor.

Adolescent↗
PubMed1989

The pathological anatomy of claw and hammer toes.

We sought to determine the optimum surgical treatment of claw and hammer toes (except for the hallux) on the basis of the specific pathological anatomy of each type of deformity. We dissected thirty-three fresh-frozen specimens that had been obtained from below-the-knee amputations. The specimens included ten normal feet, fourteen feet that had claw toes, six feet that had hammer toes, and three feet that had an uncategorized deformity. The contributions of abnormalities of the skin, tendons, joint capsule, and collateral ligaments to deformity of the metatarsophalangeal and proximal interphalangeal joints were determined by sequential sectioning of all of those soft-tissue components. Any alteration in the range of motion of the joints was recorded after each stage of the dissection. The findings of this study suggested that surgical correction of claw and hammer toes may necessitate more extensive sectioning of the soft tissues than had previously been believed.

Foot Deformities, Acquired↗
PubMed1988

Rupture of the posterior tibial tendon: CT and surgical findings.

Computed tomography (CT) was performed in 42 patients with 49 clinically suspected tears of the posterior tibial tendon. Twenty-eight of the 49 suspected tears were subsequently surgically explored and repaired. Three patterns of tendon abnormalities were recognized on CT scans: type I-intact, hypertrophied, heterogeneous tendon; type II-attenuated tendon; and type III-absence of a portion of a tendon. Types I and II correlated with partial rupture seen during surgery, and type III correlated with complete rupture of the tendon. CT findings were accurate in 96% of the patients who underwent surgery. In four cases (14%), tendon rupture was seen on CT scans, but the extent of the injury was underestimated and the rupture was misclassified. Reactive periostitis of the distal tibia was seen in 71% of diseased tendons and may represent an important factor in the diagnosis of tendon rupture.

Adult↗
PubMed1988

Tendon injuries about the ankle in athletes.

Tendinous injuries about the foot and ankle are often the result of overloading and repetitive microtrauma stemming from training errors, poor technique, and the use of inappropriate surfaces or equipment. Other factors that must be considered include anatomic malalignment and muscle imbalance. Injuries involving tendons include inflammation, subluxation, and rupture. A correct and timely diagnosis should assist athletes, trainers, coaches, and physicians in preventing and treating these disorders.

Achilles Tendon↗
PubMed1988

Common ankle disorders of the elderly: diagnosis and management.

Ankle pain can be disabling for the geriatric patient. Unlike symptoms in younger individuals, symptoms in the elderly are often insidious in onset and result from chronic disease processes. Acute injuries, when they occur, are often managed differently than in younger patients. Accurate diagnosis is essential for appropriate treatment. An anatomic approach to diagnosis is presented along with guidelines for appropriate conservative and surgical treatment.

Achilles Tendon↗
PubMed1987

Extraosseous and intraosseous arterial supply to the first metatarsal and metatarsophalangeal joint.

The extraosseus and intraosseous circulation to the first ray was evaluated by means of vascular injection techniques. The first metatarsal and metatarsophalangeal joint receive their blood supply from the first dorsal metatarsal artery, the first plantar metatarsal artery, and the superficial branch of the medial plantar artery. These three source arteries provide variable numbers of branches to the base, shaft, and head of the first metatarsal. Ramifications of branches to the head form an extensive capsular network that is more consistent and abundant on the dorsal and lateral aspects of the joint. The source of intraosseous vascularity consists of a diffuse network of fine periosteal arteries enveloping the diaphysis of the metatarsal, a single nutrient artery that perforates the first metatarsal at the lateral aspect of the shaft distally, and a system of metaphyseal and capital arteries that appear to constitute a major source of blood supply to the metatarsal head.

Arteries↗
PubMed1987

Geriatric foot disorders: how to avoid undertreating them.

Because the primary care physician often is the first health professional the elderly patient will consult about a foot problem--and because many conservative therapeutic measures are available and should be attempted before resorting to surgery--the primary care office can be an appropriate setting for foot care for the elderly. A brief review of foot anatomy is given, followed by a discussion of common disorders of the foot and conservative treatment measures.

Achilles Tendon↗
PubMed1986

Combined ankle and subtalar instability.

Ipsilateral ankle and subtalar instability has been alluded to in the orthopaedic literature. A case demonstrating this combined instability pattern is presented and a technique for documenting this disorder is described.

Adolescent↗
PubMed1986

Kinematics of the first metatarsophalangeal joint.

The kinematics of both the first metatarsophalangeal joint and the articulation of the hallux sesamoid bones with the metatarsal head were investigated with fifteen fresh-frozen below-the-knee amputation specimens using a radiographic technique. Six feet were of normal structural anatomy, six displayed hallux valgus, and three had hallux rigidus. Normal specimens demonstrated an average total range of motion in the sagittal plane of 111 degrees, with about 76 degrees of dorsiflexion and 34 degrees of plantar flexion. The abnormal specimens revealed a decreased total arc of motion, with a limitation of plantar flexion in feet with hallux valgus and a loss of dorsiflexion in feet with hallux rigidus. Motion analysis of the normal metatarsophalangeal joints demonstrated minimum scattering of instant centers of rotation. This was in contrast to the diseased articulations, which displayed markedly displaced instant centers of rotation located eccentrically about the metatarsal head. Surface motion in the normal joints was characterized as tangential sliding from maximum plantar flexion to moderate dorsiflexion, with some compression at maximum dorsiflexion. The feet with hallux valgus and the feet with hallux rigidus displayed distinctive patterns of distraction and jamming throughout specific portions of the range of motion in the sagittal plane. Motion of the metatarsophalangeal joint in the transverse plane concomitant with motion in the sagittal plane, which has been hypothesized by other investigators, was confirmed and quantified in this study. The feet with hallux rigidus displayed a reduction in this motion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗