Patient Characteristics and Treatment of Hallux Polydactyly Associated with Varus Deformity

Purpose To evaluate patient characteristics such as deformity type, associated disease, and family history, and results of treatment of pre-axial polydactyly with hallux varus deformity. Materials and Methods We carried out a retrospective study of 5 patients who presented with preaxial polydactyly with hallux varus deformity, and were treated between 2003 and 2010 at the authors' hospital. Surgeries including extra digit excision, local flap, osteotomy, and interphalangeal joint fusion were performed taking into consideration the deformity types and patient's age. Family history, associated disease, and types of duplication were assessed, and the outcomes of surgery were evaluated with radiographs and appearances of foot. The mean follow-up period was 34 months. Results All 5 patients had one or more associated anomalies such as congenital anterolateral tibial bowing and polydactyly in three, translocation of chromosome 2 : 13 associated with cryptorchidism in one, pes planovalgus in one, residual poliomyelitis in one, syndactyly of the foot in two, and leg length discrepancy in one patient. There was no family history of hallux polydactyly in any of the cases. All five patients had duplication of the distal phalanx and one of them had a blocked proximal phalanx. The extra digit was completely removed and the varus deformity was corrected in all cases. Conclusion There was a high incidence of associated diseases in patients with hallux polydactyly and varus deformity. Deformity correction could be obtained by surgeries chosen according to the individual deformity type and patient age

Estimation of Ascitic Fluid Volumes in Patients with Liver Cirrhosis

This study usinig the indirect dilution method employing bromsulfalein was undertaken to measure ascitic fluid volumes of patients who had the classical manifestations of portal cirrhosis with ascites. In addition, the investigation was designed to compare the results of the indirect method with that of the direct method of paracentesis. The bromsulfalein dilution method described by Baker, et aI. , was followed: A sample of ascitic fluid approximately equal to the volume of bromsulfalein to be injected, was withdrawn through a 20-gauge needle. Five millimeters of 5 % B.S,P, solution was injected through the same needle. After injection, the needle was withdrawn, the abdomen was ballotted, and the pati~nts position shifted frequently during a 15 minute period. A 20-gauge needle was then inserted intraperitonealy at a site 15 to 20em. away from the site of the previous injection. and ascitic fluid samples were periodically withdrawn. Following the indirect measurement of ascitic fluid volume in 7 patients, paracentesis were performed to obtain a direct measurement of the ascitc fluid volumes. The results are summarized as follows. 1) No toxic or side reactions were noted after intraperitoneal injection of B.S.P. solut'on. 2) The mean value of ascitic fluid volumes by indirect measurement in the 12 cases is 8, 533 millilters, and in 7 of these patients, the mean volume by direct measurement is 7,990 milliliters. It can be seen that the two volumes compare favorablo with a mean difference of 420 milliliters. 2) FOr routine clinical purposes, B.S.P. may be used to estimate ascitic fluid volumes of liver cirrhosis by the indirect dilutbn method