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P T Fortin

Publications and source records attributed to P T Fortin.

8 recordsLinked to original sources
PubMed2001

Posterior tibial tendon insufficiency. Isolated fusion of the talonavicular joint.

In selected patients, fusion of the talonavicular joint can be an effective treatment of adult flatfoot deformity. Restriction of motion and altered hindfoot mechanics, however, are a consequence of talonavicular fusion and can lead to accelerated arthrosis of adjacent joints. In patients with severe long-standing deformity, medial displacement calcaneal osteotomy may be a necessary adjunct to talonavicular fusion for adequate correction of heel valgus.

Adult↗
PubMed1999

Triple arthrodesis.

Twenty-five adult patients with 32 fused hind-feet were evaluated at an average of 4.3 years after triple arthrodesis. All patients had Stage 3 or 4 deformity secondary to adult acquired flatfoot. All operations were performed using a standardized technique using rigid internal fixation. Postoperative American Orthopaedic Foot and Ankle Society hindfoot scores improved an average of 36 points. There was one nonunion and two residual varus malunions in patients who underwent additional procedures to obtain satisfactory position and fusion. All but one patient were satisfied with the result of their procedures and would have surgery again. With careful attention given to positioning, a triple arthrodesis is an acceptable treatment for late stage deformities in patients with adult acquired flatfoot.

Achilles Tendon↗
PubMed1995

Malignant melanoma of the foot and ankle.

The records of sixty patients who had a malignant melanoma of the foot or ankle were reviewed retrospectively to determine the clinical features, prognostic factors, and distinguishing characteristics. Fifty-seven patients were white and three were black. There were forty-two women and eighteen men (a female-to-male ratio of 2.3 to 1). The mean age at the time of presentation was fifty-seven years (range, twenty-two to eighty-three years). The most common site of involvement was the plantar aspect of the foot. The mean duration of follow-up was forty-five months (range, three to 144 months). Kaplan-Meier life-table analysis revealed an over-all five-year survival rate of 63 per cent and an over-all ten-year survival rate of 51 per cent. The mean duration of survival for the patients who had a plantar or subungual lesion was significantly shorter than that for the patients who had a lesion at another site on the dorsal aspect of the foot or on the ankle (forty-seven compared with seventy-two months) (p = 0.02). The mean depth of the lesion, according to the criteria of Breslow, was 3.03 millimeters, and the mean level, according to the classification of Clark et al., was IV. According to the classification of the American Joint Commission on Cancer, forty-three patients had stage-I or II (local) disease, thirteen had stage-III disease (nodal or in-transit disease, defined as cutaneous or subcutaneous metastases more than two centimeters from the primary tumor but not beyond the regional lymph nodes), and four had stage-IV disease (distant visceral metastases) at the time of presentation. Lesions at plantar and subungual sites were also associated with a higher prevalence of clinical misdiagnosis compared with lesions on the dorsal aspect of the foot or on the ankle (p = 0.02). The misdiagnoses included a benign nevus (one patient), a paronychia (one patient), a pyogenic granuloma (two patients), a plantar wart (three patients), a ganglion cyst (one patient), a blister (two patients), and a traumatic lesion (five patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Long-term follow-up of scaphoid-trapezium-trapezoid arthrodesis.

A series of 19 consecutive patients who underwent scaphoid-trapezium-trapezoid arthrodesis for chronic scapholunate instability or isolated arthrosis was reviewed. The average follow-up of 14 patients was 62 months. Eight of these 14 patients had significant residual symptoms and/or functional limitations at follow-up, and 11 had complications, including radiocarpal arthrosis (six patients), trapeziometacarpal arthrosis (four patients), and nonunion (three patients). Fusion without reduction of the scaphoid to a normal orientation was predictive of a poor result, but normal scaphoid positioning did not preclude development of arthrosis. Development of a painful degenerative thumb carpal-metacarpal joint may occur as an isolated phenomenon after scaphoid-trapezium-trapezoid arthrodesis.

Adult↗
PubMed1992

Perineural hemangiomas of the upper extremity: report of four cases.

Perineural hemangiomas in the upper extremity have been the subject of few reports. We found only eight such cases reported in the literature. We report four additional cases in which there were neurologic symptoms. The specific diagnosis of cavernous hemangioma was not made preoperatively in any of the patients. The greater the extent of intrafascicular involvement, the more difficult is total eradication of the hemangioma.

Adolescent↗
PubMedDate not supplied

Talus fractures: evaluation and treatment.

Fractures of the talus are uncommon. The relative infrequency of these injuries in part accounts for the lack of useful and objective data to guide treatment. The integrity of the talus is critical to normal function of the ankle, subtalar, and transverse tarsal joints. Injuries to the head, neck, or body of the talus can interfere with normal coupled motion of these joints and result in permanent pain, loss of motion, and deformity. Outcomes vary widely and are related to the degree of initial fracture displacement. Nondisplaced fractures have a favorable outcome in most cases. Failure to recognize fracture displacement (even when minimal) can lead to undertreatment and poor outcomes. The accuracy of closed reduction of displaced talar neck fractures can be very difficult to assess. Operative treatment should, therefore, be considered for all displaced fractures. Osteonecrosis and malunion are common complications, and prompt and accurate reduction minimizes their incidence and severity. The use of titanium screws for fixation permits magnetic resonance imaging, which may allow earlier assessment of osteonecrosis; however, further investigation is necessary to determine the clinical utility of this information. Unrecognized medial talar neck comminution can lead to varus malunion and a supination deformity with decreased range of motion of the subtalar joint. Combined anteromedial and anterolateral exposure of talar neck fractures can help ensure anatomic reduction. Posttraumatic hindfoot arthrosis has been reported to occur in more than 90% of patients with displaced talus fractures. Salvage can be difficult and often necessitates extended arthrodesis procedures.

Ankle Injuries↗