Lateral Border Of Foot Research Articles

Temporal Variation of Scores Along the Course of the Ponseti Treatment in Older Children: A Ready Guide to Progress of Treatment.

We aimed to graphically study the correction trend along the course of Ponseti treatment in older children with idiopathic clubfeet. The temporal variation of total Pirani and Dimeglio scores and their individual components at each casting session was represented graphically. Tenotomy correction was accounted for separately. We classified 0 to 4 as early, 4 to 8 as midlevel, and beyond 8 as late casts to describe the sequence of treatment. A total of 27 patients (39 feet; bilateral in 12) were studied. The average patient age was 4.78±2.36 years. Rigid equinus was the more severe pretreatment deformity in Pirani system and also the most difficult to treat component. Posterior crease and medial crease were least severe and were treated in early casts. Reducibility of lateral head of talus, curved lateral border of foot, and empty heel were moderately severe and showed a gradual improvement pattern over subsequent casting sessions. For Dimeglio components, equinus was the most resistant deformity, and it persisted until late casts. Adduction, rotation, and varus were moderately severe, and they followed a gradual improvement slope. Several components/scores did not turn 0 after correction for older clubfoot children. The treatment graphs for older clubfoot children adequately illustrated the initial severity, number of Ponseti casts used, correction of total scores and their individual components over sequential casting sessions, tenotomy influence, and the residual deformities.

Management of Soft Tissue Complications Associated with Leg Bone Injuries by Local Muscle Pedicle Flap

Background : Subcutaneous nature of tibia and poor blood supply to leg bone area causes increased complications and poor wound healing which can be managed by applying principles of plastic surgery Aims & objectives: To evaluate the use of gastrocnemius, soleus and sural flap by orthoapedic surgeon in management of complications of open leg bone fractures i.e. exposed implants, soft tissue defects. Material & methods: We prospectively studied 20patients with soft tissue complications in patients having both bone leg fracture. Out of which12 patients were managed by gastrocnemius flap,5 patients by soleus flap & 3 patients were treated by sural flap according to the location of the wound. Patients with age between 18-60 years with no or minimal infection, size of wound <50cm 2 for middle leg and <9×12cm for lower leg were included in study. The mean follow up was of 6 months. Results: Only two sural flap and one soleus flap had marginal necrosis. Hypoaesthesia over lateral border of foot was noted in two patients of sural flap which was not troublesome. Not any patient had developed significant functional loss. All flaps resulted in a good wound coverage with early healing. Conclusions: Local muscle flap is efficient and easy method of treating wound defects over leg and allows an orthopaedician to manage the compound fractures comprehensively.

Variations in the insertion of peroneus longus muscle

IntroductionPeroneus longus (PL) in man assumes special significance as it helps in maintaining the foot in plantigrade position and simultaneously maintains the arched character of foot. During evolution, insertion of PL has migrated from the lateral border of foot to reach its medial border, through the deep part of sole, getting purchase on the contiguous parts of lateral surface of the medial cuneiform and base of 1st metatarsal in its lower part. Hence, it was expected that some interesting variations in the insertion of PL may be found. MethodsThirty-eight (38) feet from 19 adult embalmed cadavers, without any deformity of foot, were utilized for this study. Soles were dissected to expose the distal part of tendon of PL from the lateral margin of foot up to its insertion. ResultsPL tendon at its insertion showed interesting variations in about 61% cases. In 23% feet, the tendon flared out into a triangular expansion, and in half of them, it received a slip from the tendon of tibialis posterior (TP) along its proximal border. The main tendon of TP was superior to the triangular expansion. In 8% specimens, a tendinous slip from the tendon of PL, near its insertion, continued with first dorsal interosseous muscle. DiscussionVariations of PL muscle are more common than they are supposed. Findings of this work will be of interest to the morphologist and of great help to the orthopedicians in correcting the foot deformities.