The Chopart Variant Dislocation: Plantar Dislocation of the Cuboid and Navicular.
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ABSTRACT:
SUBMITTER: Honeycutt MW
PROVIDER: S-EPMC8696829 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Cuboid-navicular synchondrosis is a rare pathology that has historically been treated with open surgery. Open surgery poses complications and precludes satisfactory visibility during the operative treatment of these lesions. Arthroscopic portals typically limit the risk of complications and provide better visibility in small joints. We describe here an original technique of arthroscopic resection followed by cuboid-navicular arthrodesis.
| S-EPMC9244640 | biostudies-literature
Project description:Isolated cuboid dislocations are rare injuries Jacobson (1990). It is clinically significant and important in surgical education, as it is an injury and a source of lateral foot pain that can be misdiagnosed at the time of initial presentation and may be difficult to identify clinically or with imaging Drummond and Hastings (1969).We present a case report in a 33year old rugby player, who was injured during a match after a tackle. The patient had ongoing concerns that he was not recovering following initial discharge, as he was unable to weight bear since his initial presentation to the Emergency Department (E.D.), and he had ongoing lateral foot pain.Important clinical findings include lateral foot pain, a palpable gap at the cuboid level and difficulty weight-bearing. Closed reduction is usually difficult as it can be blocked mechanically by the extensor digitorum brevis muscle or peroneus longus tendon Dobbs et al. (1969). Initial X-Rays may be inconclusive with this presentation. CT scanning is indicated if suspicion for pathology is high. Open reduction and internal fixation with Kirschner wires are usually necessary for isolated cuboid dislocations.Our take home message from this case report is that cuboid dislocations are rare injuries and are important to be aware of in reviewing X-rays in the E.D. Particularly in patients with inversion and plantar flexion type injuries to their foot and ankle joint, with an inability to weight bear and lateral midfoot pain following their injury.
| S-EPMC5544476 | biostudies-other
Project description:Talonavicular dislocation is a rare injury. Isolated medial or lateral talonavicular dislocations without disruption of subtalar joint are known as medial or lateral swivel dislocations respectively, both being extremely rare. We describe a rare case of neglected medial swivel dislocation with concomitant calcaneus, cuboid and 5th metatarsal fracture, which was managed with open reduction and fixation of talonavicular joint with k-wires and an external distractor. At 1 year follow up the patient was mobilizing full weight bearing without any pain or deformity, the radiographs showing well located talonavicular joint and healed calcaneus, cuboid and 5th metatarsal fractures. This is the first reported case of medial swivel talonavicular dislocation with associated calcaneum, cuboid and 5th metatarsal fracture to the best of our knowledge. This case report highlights the importance of maintaining high level of suspicion for diagnosing midfoot injuries in a polytraumatized patient as well as need of accurate and timely reduction of dislocation for good functional outcome.Level of clinical evidenceLevel 4.
| S-EPMC7920153 | biostudies-literature
Project description:The accessory navicular bone is one of the most common accessory ossicles of the foot. Fewer than 1% of accessory navicular bones are symptomatic, and most of these are type II accessory navicular bones. A separation of the synchondrosis is considered one of the main causes of pain. After an injury to the synchondrosis has resulted in a chondro-osseous disruption, the combined forces of tension and shear from the posterior tibial tendon and the foot aggravate the injury and prevent it from healing. Fusion of the synchondrosis is a logical surgical treatment option if the pain is recalcitrant to conservative measures. The purpose of this technical note is to report an endoscopic approach to achieve fusion. It has the advantages of better cosmesis, less scar pain, less risk of nonunion, and potential to examine the tibialis posterior tendon and the talonavicular joint.
| S-EPMC5263116 | biostudies-literature
Project description:BackgroundIrreducible fracture-dislocations of the ankle are rare orthopedic emergencies that should not be missed. The Bosworth fracture-dislocation is a rare fracture where an incarcerated fibula fragment remains locked behind the posterior lateral tubercle of the tibia. We present a case describing a variation of a Bosworth injury, with a dislocation of an intact distal fibula with an associated medial malleolus fracture.MethodsOur patient is a 55-year old male who presented to the emergency department with a left ankle injury after being involved in a road traffic accident. Radiographs show a posterior dislocation of an intact distal fibula associated with a fracture of the medial malleolus and disruption of the ankle mortise.ResultsAn attempt to reduce the dislocation at the emergency department under sedation was unsuccessful. The patient was subsequently taken to the operating theatre for manipulation and reduction and application of an external fixator. Definitive fixation was performed successfully a week later.ConclusionA high index of suspicion is critical for diagnosing a Bosworth fracture-dislocation, as this diagnosis is commonly missed. Early diagnosis and proper surgical anatomic reduction are important to prevent chronic ankle instability and evolution towards ankle arthritis.Level of evidenceLevel IV, case study.
| S-EPMC8696902 | biostudies-literature
Project description:BackgroundLateral column lengthening (LCL) for flexible flatfoot is an effective surgery with powerful correction of deformity because it tightens only the lateral third of the long plantar ligament (LPL). However, LCL has been associated with joint damage at the osteotomy site and loss of foot flexibility owing to joint fixation. We focused on the cuboid and investigate a novel anatomical LCL osteotomy site that effectively tightens the LPL without damaging any joints.MethodsWe studied 24 feet of 12 cadavers (mean age, 80.8 years). The lengths of the LPL and short plantar ligament, locations of the attachments, and shape and location of the cuneocuboid joint on the medial side of the cuboid were studied. ImageJ software was used to measure the osteotomy angle.ResultsThe lateral cuboid attachment of the LPL on average was located 4.6 mm from the calcaneocuboid joint, and the cuneocuboid joint on average was located 6.7 mm from the cuboid-metatarsal joint on the medial surface of the cuboid. The direct line connecting the anterior cuneocuboid joint and the oblique crest of the cuboid on average was at a 10.3-degree inclination posterior to the cuboid-metatarsal joint.ConclusionA straight line must be selected between a point 4 mm from the calcaneocuboid joint laterally and 6 mm from the cuboid-metatarsal joint medially at a 10-degree posterior tilt to the cuboid-metatarsal joint to perform a cuboid osteotomy LCL without damaging the articular surface.Clinical relevanceWe investigated a potential novel cuboid osteotomy method for LCL.
| S-EPMC8702912 | biostudies-literature
Project description:Less than a handful of cuboid and squared cells have been described in nature, which makes them a rarity. Here, we show how Candidatus Thiosymbion cuboideus, a cube-like gammaproteobacterium, reproduces on the surface of marine free-living nematodes. Immunostaining of symbiont cells with an anti-fimbriae antibody revealed that they are host-polarized, as these appendages exclusively localized at the host-proximal (animal-attached) pole. Moreover, by applying a fluorescently labeled metabolic probe to track new cell wall insertion in vivo, we observed that the host-attached pole started septation before the distal one. Similarly, Ca. T. cuboideus cells immunostained with an anti-FtsZ antibody revealed a proximal-to-distal localization pattern of this tubulin homolog. Although FtsZ has been shown to arrange into squares in synthetically remodeled cuboid cells, here we show that FtsZ may also mediate the division of naturally occurring ones. This implies that, even in natural settings, membrane roundness is not required for FtsZ function.
| S-EPMC8760462 | biostudies-literature
Project description:Compressive beamforming is a powerful approach for the direction-of-arrival (DOA) estimation and strength quantification of acoustic sources. The conventional grid-based discrete compressive beamformer suffers from the basis mismatch conundrum. Its result degrades under the situation that sources fall off the grid. The existing continuous compressive beamformer with linear or planar microphone arrays can circumvent the conundrum, but work well only for sources in a local region. Here we develop a panoramic continuous compressive beamformer with cuboid microphone arrays based on an atomic norm minimization (ANM) and a matrix pencil and paring method. To solve the positive semidefinite programming equivalent to the ANM efficiently, we formulate a solving algorithm based on the alternating direction method of multipliers. We also present an iterative reweighted ANM to enhance sparsity and resolution. The beamformer is capable of estimating the DOAs and quantifying the strengths of acoustic sources panoramically and accurately, whether a standard uniform or a sparse cuboid microphone array is utilized.
| S-EPMC6700166 | biostudies-literature
Project description:ObjectivesTo examine associations between plantar calcaneal spurs, plantar fascia thickening and plantar heel pain (PHP), and to determine whether tenderness on palpation of the heel differentiates between these presentations.MethodsAdults aged ⩾50 years registered with four general practices were mailed a Health Survey. Responders reporting foot pain within the last 12 months underwent a detailed clinical assessment. PHP in the past month was documented using a foot manikin. Plantar calcaneal spurs were identified from weight-bearing lateral radiographs and plantar fascia thickening (defined as >4 mm) from ultrasound. Tenderness on palpation of the plantar fascia insertion was documented. Associations between these factors and PHP were explored using generalized estimating equations.ResultsClinical and radiographic data were available from 530 participants (296 women, mean [s.d.] age 64.9 [8.4] years), 117 (22.1%) of whom reported PHP. Plantar calcaneal spurs and plantar fascia thickening were identified in 281 (26.5%) and 501 (47.3%) feet, respectively, but frequently coexisted (n = 217, 20.4%). Isolated plantar calcaneal spurs were rare (n = 64, 6.0%). Participants with PHP were more likely to have a combination of these features compared with those without PHP (odds ratio 2.16, 95% CI 1.24, 3.77, P = 0.007). Tenderness on palpation of the heel was not associated with plantar calcaneal spurs or plantar fascia thickening, either in isolation or in combination, in those with PHP.ConclusionPlantar calcaneal spurs and plantar fascial thickening are associated with PHP, but frequently coexist. Tenderness on palpation of the heel does not appear to differentiate between clinical presentations of PHP.
| S-EPMC6519610 | biostudies-literature
Project description:Accessory navicular bone is a common accessory ossicle of the foot and is present in 10% to 14% of normal feet. Less than 1% of the accessory navicular bones are symptomatic. Degenerative or traumatic disruption of the accessory navicular synchondrosis is one of the main causes of symptomatic accessory navicular. The disrupted synchondrosis may or may not be associated with diastasis of the synchondrosis. Fusion of the synchondrosis is indicated if the pain fails to respond to conservative measures. The purpose of this Technical Note is to describe a minimally invasive approach for fusion of the synchondrosis that has no diastasis.
| S-EPMC5442306 | biostudies-literature