Biomedical subjects
Publications and source records attributed to M M Casillas.
The authors describe a previously unreported adjunctive passive provocative maneuver that has been found to clinically reproduce the intensity of symptoms in patients diagnosed with disorders of the sesamoids. This test is useful for the initial diagnosis as well as monitoring response to treatment.
On the basis of intraoperative observations in 13 consecutive adolescents (14 hips) with slipped capital femoral epiphysis (SCFE), we found that when the anterior femoral metaphysis was level with or extended past the epiphysis, it caused labrum and cartilage damage. As a result of an impingement between the metaphysis and the superomedial acetabular rim, the labrum revealed erosions, scars or tears. Further jamming of the metaphysis into the joint damaged the adjacent acetabular cartilage, varying from a partial- to a full-thickness cartilage loss. In all patients, the femoral head cartilage was intact; no avascular necrosis was present. Our findings suggest that arthrosis in SCFE can be triggered by early mechanical damage of the acetabular cartilage.
We retrospectively reviewed the results of using a biplanar chevron osteotomy performed on patients who presented with hallux valgus deformities with an increased distal metatarsal articular angle (DMAA). The study included 17 feet (14 patients) of 12 women and 2 men. The average follow-up was 33 months. The average American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Clinical Rating Score was 91. Ten of the 14 patients (13 of 17 feet) stated that they would choose to undergo the procedure again. The hallux valgus angle was improved from an average of 22 degrees to 18 degrees, the intermetatarsal angle from 11 degrees to 9 degrees, and the DMAA from 16 degrees to 9 degrees. We have demonstrated this procedure to be useful in the treatment of symptomatic bunion deformities with an increased DMAA.