Osgood Schlatter syndrome runs a self-limiting course, and usually complete recovery is expected with closure of the tibial growth plate. Overall prognosis for Osgood Schlatter syndrome is good, except for some discomfort in kneeling and activity restriction in a few cases.

One hundred and thirty-seven idiopathic clubfeet were treated by the Ponseti technique and followed for at least 2 years. Nine feet (7%) were not corrected with initial casting and required early surgery. Recurrence after correction was related to compliance with bracing. At latest follow-up, two-thirds of those noncompliant with brace had recurrences with one-third of these recurrences requiring more extensive surgery than Achilles tenotomy and anterior tibial tendon transfer while only 14% of those compliant with brace had recurrences with none requiring more than Achilles tenotomy and anterior tibial tendon transfer. Early failures and recurrences constituted about 20% of our 137 feet by 2 years of follow-up. When the Ponseti method was fully followed, including initial casting, compliance with brace and treatment of recurrences by recasting, Achilles tenotomy and/or anterior tibial tendon transfer, our success rate was 93%.

Introduction High mortality in the 2001 US and recent European anthrax outbreaks suggests that better understanding of the effects of this bacteria’s toxins is needed to improve treatment. Methods and results Here, 24h edema (ETx) and lethal (LeTx) toxin infusions were investigated for 96h in sedated and mechanically ventilated canines. Initial study compared similarly lethal doses of ETx (n=8) or LeTx (n=15) alone. ETx was 24 times less lethal than LeTx, while median time to death in non-survivors (n=6 and 9 respectively) was shorter with ETx (42 vs. 67h, p=0.04). Compared to controls (n=9), both toxins decreased arterial and central venous pressures (CVP) and systemic vascular resistance (SVRI) and increased heart rate (HR), cardiac index, blood urea nitrogen (BUN), creatinine (Cr), BUN:Cr ratio, and hepatic transaminases (p≤0.05, toxin effect or time interaction). However, ETx stimulated early diuresis, reduced serum sodium and had more pronounced vasodilatory effects than LeTx as reflected by greater or earlier CVP, SVRI, and BUN:Cr changes (p≤0.01). LeTx progressively decreased left ventricular ejection fraction (p≤0.002). In subsequent study, lethal dose LeTx with an equimolar nonlethal ETx dose (n=8) increased mortality versus LeTx alone (n=8) (p=0.05). Conclusion Shock with ETx or LeTx may require differing supportive therapies while toxin antagonists should likely target both toxins.

The purpose of this study was to evaluate the need for the use of a foot abduction orthosis (FAO) in the treatment of idiopathic clubfeet using the Ponseti technique. Forty-four idiopathic clubfeet were treated with casting using the Ponseti method followed by FAO application. Compliance was defined as full-time FAO use for 3 months and part-time use subsequently. Noncompliance was failure to fulfill the criteria during the first 9 months after casting. Feet were rated according to the Dimeglio and Pirani scoring systems at initial presentation, at the time of FAO application, and at 6 to 9 months of follow-up. At the time of application, no significant differences in scores were found between the groups. At follow-up, the compliant group's scores were significantly (P < 0.01) better than those of the noncompliant group. From the time of application to follow-up, for the compliant group, the Dimeglio scores improved significantly (P = 0.005). For the noncompliant group, the Dimeglio scores deteriorated significantly (P = 0.001). The feet of patients compliant with FAO use remained better corrected than the feet of those patients who were not compliant. Proper use of FAO is essential for successful application of the Ponseti technique.