Midfoot Charcot arthropathy is a progressive deforming condition characterized by recurrent ulceration leading to high morbidity and amputation with lack of timely intervention. Nonoperative treatment is largely reserved for acute phase disease. Recent trend in management is early surgical interventions which could alter deforming forces and prevent deformity progression, as well as surgeries which provide osseously stable plantigrade foot. However, there are no clear-cut evidencebased guidelines regarding timing of interventions and method of techniques in surgical stabilization. This study discusses about surgical technique in the management of midfoot Charcot.
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Silvampatti S, Nagaraja HS, Rajasekaran S. Midfoot Charcot Arthropathy: Overview and Surgical Management. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):97-106.
Irreducible dislocation of interphalangeal joint is a rare condition with only a few case reports in literature. Here, we report a case with irreducible dislocation of interphalangeal joint due to sesamoid bone interposition, which required open reduction. A 45-year-old male had a fall from height with irreducible dislocation of interphalangeal joint of great toe. Intraoperatively, the interposition of sesamoid bone over the dorsal aspect of proximal phalanx was identified. Displaced volar plate with sesamoid bone was reduced into the position, and the joint was stabilized with k wire. On follow-up, we observed that the patient had no discomfort or pain for 6 months. The displacement of sesamoid bone with volar plate and intact collateral ligaments locks the joint in extension and obstructs the reduction of interphalangeal joint dislocation. One should have the suspicion of possibility of open reduction after observing the interposition of sesamoid bone over the dorsal aspect of the proximal phalanx. Dorsal approach is usually advocated; medial approach can be used if there is wound over the plantar aspect.
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Silvampatti S, Rajasekaran S. Irreducible Dislocation of Great Toe Interphalangeal Joint by an Accessory Sesamoid Bone: A Case Report and Review of Literature. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):56-58.
Navicular fractures are the most common stress fractures of tarsal bones, with calcaneum fractures accounting for almost all of the remainder. Diagnosis is commonly delayed and these fractures carry on with a risk of displacement and nonunion, thus affecting the outcome.
A 17-year-old university level female athlete presented with pain along the anteromedial aspect of her foot suffering since one- and half-year without a history of specific trauma. On evaluation, she was found to have stress fracture of navicular bone which was neglected and has gone for nonunion.
Satisfactory outcome was achieved by open reduction and internal fixation with cancellous screw and iliac crest strut grafting followed by appropriate rehabilitation.
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Silvampatti S, Pradeep AR, Rajasekaran S. Neglected Stress Fracture of Navicular Bone: A Case Report and Literature Review. J Foot Ankle Surg (Asia-Pacific) 2015;2(1): 38-40.
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