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Idiopathic osteonecrosis of the first metatarsal sesamoid.

Four patients with histologically confirmed osteonecrosis of the first metatarsal sesamoid are presented. No patient was an athlete, nor recalled any noticeable trauma or significant stress as having occurred to the feet. No foot deformities or joint malalignments were found. Excellent results were obtained by excision of the affected sesamoid in all patients, after follow-up periods of 1 to 12 years. Microscopic findings were compatible with those seen in idiopathic osteonecrosis of the femoral head.

Adolescent↗

Peroneal nerve palsy due to fabella.

In general, the fabella has been considered to have a minor clinical significance, and has not been recognized as one of the causes of peroneal nerve palsy. Seven cases of peroneal nerve palsy due to the fabella are reported. The typical clinical features and the importance of electrophysiological examinations in making an accurate diagnosis are described. Of the seven cases mentioned above, three cases were treated by surgery and four cases by conservative methods.

Adult↗

Arthroscopic fibular sesamoidectomy in the management of the sesamoid osteomyelitis.

This is the first report in the English literature discussing the arthroscopic approach in the management of the fibular sesamoid osteomyelitis. First metatarsophalangeal joint fibular sesamoidectomy was successfully performed using big toe arthroscopy. The morbidity of the open surgical sesamoidectomy may be minimized by the arthroscopic approach. The authors describe the surgical principles and the potential advantages of arthroscopic sesamoidectomy compared with the open approach.

Arthroscopy↗

Tooth mineralization as an indicator of the pubertal growth spurt.

The commencement of adolescent peak growth velocity in body height and facial growth is closely related in timing to certain ossification events which occur in the hand and wrist. An investigation into calcification patterns of the teeth revealed a high degree of correlation between the stage of mineralization of the lower canine and these events. The possibility of the use of this tooth as a maturational indicator of the pubertal growth spurt is discussed.

Adolescent↗

Atraumatic avascular necrosis of an index sesamoid.

Avascular necrosis of an index sesamoid is our topic. In literature we found a lot of papers published about Hallux and the thumb sesamoid. There were only few articles concerning index sesamoid pathology. But in contrast to these, there's no evidence for trauma, nor arthritis in the personal history of the case discussed. This pathology is rare. Diagnosis is difficult. Treatment by sesamoid resection was successful.

Female↗

Racquet player's pisiform.

Four patients whose sport involved wielding a racquet presented with symptoms at the base of the hypothenar eminence which were due to minor degrees of subluxation of the pisiform. In two there was in addition a chondromalacia of the articular cartilage of the joint.

Adolescent↗

Locked thumb metacarpophalangeal joint caused by sesamoid entrapment.

We report an unusual case of locked thumb in a 24-year-old man, caused by entrapment of the radial sesamoid in the metacarpophalangeal joint. Tomography clearly revealed sesamoid entrapment in the joint. Surgical exploration and cadaver dissection demonstrated that avulsion of the proximal portion of the palmar plate and some dissociation of the sesamoid from the palmar plate with intraarticular displacement were necessary for the sesamoid to be trapped in the joint.

Adult↗