Variation ranges were large for almost all anatomic parameters of the FT. Six cadavers (14.63%) in our study fulfilled one of the anatomic diagnostic criteria for tethered cord syndrome. Neurosurgeons must remember the normal variations in the anatomic features of this region when establishing the diagnosis of tethered cord syndrome or performing surgical procedures involving the caudal part of the dural sac.

Variation ranges were large for almost all anatomic parameters of the FT. Six cadavers (14.63%) in our study fulfilled one of the anatomic diagnostic criteria for tethered cord syndrome. Neurosurgeons must remember the normal variations in the anatomic features of this region when establishing the diagnosis of tethered cord syndrome or performing surgical procedures involving the caudal part of the dural sac.

The authors present the case of a nine-year-old female patient who presented with pain in her right foot associated with physical activities. After this case was diagnosed as cuboid-navicular tarsal coalition, the patient was treated surgically with resection of the coalition, thereby resolving the symptoms. The literature was reviewed and the importance of adequate physical examination and imaging assessment for investigating foot pain in children and adolescents was discussed.

No abstract

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Objective This trial has the objective to investigate the incidence of mechanical ankle instability after the conservative treatment of first episode, severe ankle ligamentar lesions. This common lesion affects young, professional and physical active patients, causing important personal and economic consequences. There are difficulties related to adequate diagnosis and treatment for these lesions. Method 186 patients with severe ankle ligament lesions were included in this trial. They were randomized in two treatment options. In group A patients were treated using ankle long orthoosis, weight bearing allowed as confortable, pain care, ice, elevation with restricted joint mobilization for three weeks. After that they were maintained in short, functional orthosis (air cast), starting the reabilitation program. In group B patients were immobilized using a functional orthosis (air cast), following the same other sequences that patients in group A. Results We did not find significant differences in relation to the residual mechanical ankle instability between both groups. We did not find differences in the intensity of pain, but the functional evaluation using AOFAS score system showed better results in the functional treatment group. Conclusion The functional treatment (Group B) had better AOFAS score and few days off their professional activities, comparing with patients treated with rigid orthosis (Group A), without increased chance in developing ankle mechanical instability.

The aim of this case report was to describe a successful diabetic limb salvage procedure in the treatment of an infected diabetic foot ulcer through a multidisciplinary team approach and complex surgical reconstruction involving a femoral head bone allograft and musculocutaneous latissimus dorsi free flap. The decision to proceed with aggressive staged efforts at diabetic limb salvage should be made only after careful consultation with the patient, his or her family, and the rest of the multidisciplinary healthcare team.

Declaramos inexistência de conflito de interesses neste artigo RESUMOOs autores apresentam caso de paciente do sexo feminino de nove anos de idade que apresentava dores no pé direito associadas à prática de atividades físicas. Após o diagnóstico de coalizão tarsal cuboide-navicular foi tratada cirurgicamente através de ressecção desta, com resolução dos sintomas. Realizam revisão da literatura e discutem a importância da adequada avaliação clínica e imagenológica dos casos das dores no pé nas crianças e adolescentes. INTRODUçãOA coalizão tarsal é uma anormalidade congênita em que ocorrem graus variáveis de fusão entre dois ou mais ossos do tarso. Acomete aproximadamente 2% da população e muitas vezes é assintomática (1) . A importância clínica desta patologia foi proposta por Holl, em 1880, que descreveu a relação entre as barras intertarsais e o pé plano rígido e doloroso (2) . Pode, eventualmente, apresentar-se como pé cavo varo rígido por espasmo do músculo tibial anterior (3) . As coalizões podem ser ósse-as, cartilaginosas ou fibrosas. Os locais mais comuns das pontes ósseas são entre o tálus e o calcâneo (talocalcaneana medial) e entre o navicular e o calcâneo, correspondendo a 90% destas, respectivamente com 48% e 44% dos casos de coalizão tarsal. As barras entre o tálus e o navicular e entre o calcâneo e o cuboide correspondem a adicionais 1% cada. Johnson et al (4) relatam caso de barra cubonavicular tratada cirurgicamente através de ressecção. A barra entre o cuboide e o navicular é rara, com poucos casos descritos na literatura (5)(6)(7)(8)(9)(10) . RELATO DE CASOCriança de nove anos, sexo feminino, com queixa de desconforto no pé direito relacionado à prática de exercícios físicos há um ano, já havia sido tratada como tendinite e entorse do tornozelo, sem melhora do quadro. O tratamento incluiu restrição da atividade habitual, períodos de imobilização, fisioterapia, uso de palmilhas e medicamentos anti-inflamatórios não hormonais.Clinicamente, apresentava-se com marcha normal, pé plantígrado, com diminuição da varização ativa do retropé quando ficava na ponta dos pés. Havia limitação da mobilidade da mediotársica, com mobilidade do tornozelo e da articulação subtalar preservadas.A paciente foi encaminhada para tomografia computadorizada que evidenciou a presença de barra óssea entre o cuboide e o navicular (Figuras 1, 2, 3 e 4).Rev Bras Ortop. 2010;45(5):497-9