Electrocution injuries. A case report

A case study of a high-voltage injury was presented. The short period that the patient was in contact with the electrical source prevented further systemic injury and may have saved her life. The patient's present neuritis is indicative of long-term sequelae of electrocution injury, in which ischemic necrosis of the surrounding nerves can occur near or at the site of the exit wound.</jats:p

The minimally invasive osteotomy &quot;S.E.R.I.&quot; (simple, effective, rapid, inexpensive) for correction of bunionette deformity.

A bunionette is a deformity of the fifth metatarsal bone with a varus deviation of the toe which can require surgical correction. Although numerous bony or soft tissue surgical procedures have been described, the ideal treatment has not yet been identified. The aim of this study was to retrospectively evaluate the results of a series of 50 consecutive feet affected by symptomatic bunionette deformity treated by S.E.R.I. (simple, effective, rapid, inexpensive) osteotomy. MATERIALS AND METHODS: Between February 1998 and March 2004, 50 feet with symptomatic type II-III bunionette deformity in 32 patients (18 bilateral) underwent S.E.R.I osteotomy. The average age of the patients at the time of operation was 33 +/- 13 years. The average followup was 4.8 (range, 2 to 8) years. RESULTS: The average modified lesser toe AOFAS score increased from 62.8 +/- 15.2 points preoperatively to 94 +/- 6.8 points at last followup (p &lt; 0.0005). The average fifth metatarsophalangeal (MTP) angle decreased from 16.8 +/- 5.1 degrees preoperatively to 7.9 +/- 3.1 degrees at final followup (p &lt; 0.0005). The 4-5 intermetatarsal angle (I.M.A) averaged 12 +/- 1.7 degrees preoperatively, while postoperatively was 6.7 +/- 1.7 degrees (p &lt; 0.0005). Complications included a skin inflammatory reaction around the Kirschner wire and 2 symptomatic plantar callosities under the fourth metatarsal heads. CONCLUSIONS: The minimally invasive osteotomy is an effective and reliable technique for the treatment of painful bunionette, and it achieved more than 90% excellent and good results with reduced surgical time and complications

Subtalar Joint Arthroereisis in the Management of Pediatric Flexible Flatfoot: A Critical Review of the Literature

Background: Pediatric flexible flatfoot is a common deformity for which a small, but significant number undergo corrective surgery. Arthroereisis is a technique for treating flexible flat-foot by means of inserting a prosthesis into the sinus tarsi. The procedure divides opinion in respect of both its effectiveness and safety. Methods: A database search up until 2010 was used to find articles regarding arthroereisis in pediatric patients. We summarized the findings of this study. Results: Seventy-six studies were identified. Eight of the nine radiographic parameters reported show significant improvement following arthroereisis reflecting both increased static arch height and joint congruency. Calcaneal inclination angle demonstrated the least change with only small increases following arthroereisis. Arthroereisis remains associated with a number of complications including sinus tarsi pain, device extrusion, and under-correction. Complication rates range between 4.8% and 18.6% with unplanned removal rates between 7.1% and 19.3% across all device types. Conclusion: Current evidence is limited to consecutive case series or ad hoc case reports. Limited evidence exists to suggest that devices may have a more complex mode of action than simple motion blocking or axis altering effects. The interplay between osseous alignment and dynamic stability within the foot may contribute to the effectiveness of this procedure. Although literature suggests patient satisfaction rates of between 79% to 100%, qualitative outcome data based on disease specific, validated outcome tools may improve current evidence and permit comparison of future study data.</p