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Sesamoidectomy for the treatment of chronic neuropathic ulcerations.

Neuropathic ulcerations in diabetic patients are frequent causes of hospitalizations and morbidity. The plantar aspect of the first metatarsophalangeal joint is a common location for these ulcerations, because of the significant weightbearing forces generated through this joint and the presence of sensory and motor neuropathy. The authors describe 24 cases in which excision of the tibial sesamoid, fibular sesamoid, or both, was performed to resolve these lesions.

Adult↗

The effect of hallux abducto valgus surgery on the sesamoid apparatus position.

A new parameter, the tibial sesamoid-second metatarsal distance, was established to determine whether the sesamoids move in relation to the foot in hallux abducto valgus surgery. The reliability of the tibial sesamoid-second metatarsal distance was assessed and shown to be excellent. Seventy-five feet underwent surgical correction of hallux abducto valgus. Four radiographic parameters--the intermetatarsal angle, the hallux abductus angle, the tibial sesamoid position, and the tibial sesamoid-second metatarsal distance--were measured before and after surgery. The hallux abductus angle, intermetatarsal angle, and tibial sesamoid position were all significantly reduced following surgery. The tibial sesamoid-second metatarsal distance was not affected by hallux abducto valgus correction. Thus the correction in sesamoid position gained with hallux abducto valgus correction is a direct result of lateral translocation of the metatarsal head, with no contribution from change in position of the sesamoid apparatus relative to the foot.

Adolescent↗

Isolated gouty tophus of a tibial sesamoid of the foot.

A case of tophaceous gout involving a foot sesamoid is described in a middle-aged man with a history of chronic gout. Microscopic findings consisting of tophaceous foci located beneath an intact hyaline articulating surface are correlated with associated radiographs.

Arthritis, Gouty↗

Congenital absence of the tibial sesamoid.

Congenital absence of the tibial sesamoid of the hallux is an infrequent occurrence. The authors present a case of congenital absence of the tibial sesamoid and a review of the literature regarding the clinical significance of this anomaly.

Female↗

[No corpora sesamoidea laryngis in man and animal].

The fact that the Corpora sesamoidea have never been precisely defined has led to a series of small cartilaginous bodies in the larynx being thus designated, for want of a better solution. Since the corpora sesamoidea have been identified as capsular bodies, however, originating in or in connection with a synovial capsule, there remained only one laryngeal cartilage which appeared to fulfill all the criteria of sesamoid cartilage, namely the papilionaceous cartilage found in all alar species from Monotremata to Carnivora, and which comparative anatomists term proarytaenoid cartilage. If Goeppert's findings are regarded as having an additional functional significance, then it is clear that this cartilage too, like cartilagines interarytaenoidea, postarytaenoidea (dorsoarytaenoidea in the dog?) pararytaenoidea, cunciformis, corniculata, intercorniculata and triticea, is a connecting cartilage.

Animals↗

Charcot arthropathy of the first metatarsophalangeal joint.

The authors present an unusual case study of a Charcot joint of the first metatarsophalangeal articulation as well as a successful tibial sesamoidectomy for an associated chronic ulceration. Serial radiographs document the destructive disease process. The authors also address the etiologies of peripheral neuropathy, diagnostic tests to differentiate between Charcot joint and osteomyelitis, and both conservative and surgical management of Charcot joints.

Aged↗