A case of isolated dorsal midtarsal (Chopart) dislocation resulting from blunt trauma is reported. The mechanism of injury, management, and longterm outcome are discussed. A 45-year-old inebriated man fell from a 4-m height and landed on his feet. He had immediate bilateral foot and back pain. Radiographs showed a burst fracture of the second lumbar vertebra, a left Pott's fracture, and an isolated dorsal dislocation of the right midtarsal (Chopart) joint. No neurovascular deficits or signs of compartment syndrome were noted. The image intensifier showed the unstable midtarsal joint with dorsal translation of the navicular and cuboid from the talus and calcaneum, respectively. Closed reduction of the midtarsal joint was performed with 2 transfixing 3.5-mm AO cortical screws. The right foot was immobilised in a short leg cast for 6 weeks; screws were removed 14 weeks later. At 76-month follow-up, the patient had returned to work as a construction worker, but still had right midfoot pain on prolonged walking or standing, because of persistent plantar opening up and dorsal ossification of the midtarsal joints and degenerative change at the talonavicular
Background: The commonly encountered unstable geriatric trochanteric hip fractures are frequently managed with a proximal femoral nail and spiral blade. Although well recognized risks and complications including cut-out/backing-out of the blade have been reported; current literature has put less emphasis into describing the intra-operative problems.
Introduction Low-intensity pulsed ultrasound (L-IPUS) has been reported, by various authors, to promote bone healing. The aim of our review was to review the available literature and evaluate the effectiveness of LIPUS in the treatment of various types of complicated fracture union. Materials and methods Different search engines including MEDLINE, EMBASE and the Cochrane Library were used, and the trials adopting LIPUS in the treatment of fractures were included. Data concerning functional outcomes, time to union, delayed or nonunion and adverse effects were extracted. Few complications were reported. Results The results of many trials were probly biased as the data collection was not complete. The study method and materials recruited varied between studies. Conclusion Based on the literature, the available evidence did not support LIPUS as a mean to speed up bone healing.
Each issue, we ask different practitioners how they treat a certain condition. This month's topic is minimal incision surgery. In this edition of "Roundtable Discussion," Foot and Ankle Specialist has assembled 6 foot and ankle surgeons from around the globe with tremendous experience in minimally invasive techniques. We have surgeons from Hong Kong, Great Britain, France, and the United States who have contributed to this lively exchange about the increasingly important topic of minimally invasive surgery.
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