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Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Under the Ottawa rules for x-ray of ankle injuries, an x-ray is indicated if one of the following is present: pain over the posterior edge of either lateral or medial malleolus; pain at the base of the 5th metatarsal or navicular bone, as well as the inability to weight bear immediately after injury.
Miscellaneous Topics
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Prateek Behera, Karthick Rangasamy, Nirmal Raj Gopinathan
The medial plantar nerve is marked by connecting the following points: The first point is at the midpoint between the medial malleolus and heel prominence.The second point is midway between the heel and base of the big toe over the navicular bone.
Paediatric and adolescent foot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
The senior author uses a titanium implant (80), which has a conical lateral end for seating in the sinus tarsi and has a cylinder extending into the tarsal canal. Our review (81) of the results of the first of 31 patients with painful flatfeet (56 feet) who underwent AR, with a mean follow-up of 51.3 months and age range of 9–17 years, showed that 12 had no pain with any activity, 4 had occasional pain with no restriction of any activity and 11 had pain with sports but not with other activities and 4 failed to improve. The average talar-second MT angle was 35° for those who had postoperative peroneal spasm and 26° for the remaining group, indicating that severe forefoot abduction was a contraindication. Additional procedures included excision of the accessory navicular bone in 8 patients and 1 patient each had a medial cuneiform osteotomy and a gastrocsoleus fractional lengthening. The importance of calf muscle stretching exercises on a daily basis was stressed. In spite of persistence of some limitations in function, 81% were satisfied with the procedure, due to the relative improvement.
Comparative functional anatomy using rigid multibody simulation and anatomical transfer: Homo sapiens, Pan paniscus and Papio anubis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
A. Perrier, M. Bucki, A. Supiot, N. Delcroix, F. Lamberton, F. Druelle, A. Herrel, G. Berillon
The anatomical transfer is only functional if the target model and the atlas have the same number of bones. Thus, it was necessary to remove, from the Papio anubis model, the sesamoid bones present on the metatarsophalangeal joints of the 2,3,4 and 5th rays as well as an accessory cuboid bone. For Pan paniscus, an accessory navicular bone was removed. The anatomical transfer did not allow stable resting models, instability of the metatarsophalangeal and metatarsocunean joints for Papio anubis and the metatarsophalangeal and metatarsocuboidian instability for Pan paniscus. Simulationsr performed without toes and metatarsals have good joint stability for both specimens. A set of polyarticular ligament structure, fascias and ligaments as well as very specific uniarticular ligament structures, particularly on metatarsal-phalangeal ligaments enable good mid and forefoot stability on the validated Homo sapiens model. The muscles of these species are well described in the literature, but not the joints or the union means of polyarticular cohesion such as aponeuroses. In addition, the muscles have different paths allowing the opposability of the first ray.
Focussing on the foot in psoriatic arthritis: pathology and management options
Published in Expert Review of Clinical Immunology, 2018
Aimie Patience, Philip S. Helliwell, Heidi J. Siddle
Despite the lack of research around the peripheral vascular supply of patients with PsA, it is important to assess the vascular supply to the lower limb as we know PsA is actually equivalent to RA and diabetes mellitus in terms of general cardiovascular risk [64]. Clinically this can be assessed by looking for skin color changes, presence of hair, and potential tissue breakdown/ulceration. It is important to check the vascular supply to the foot by palpating the dorsalis pedis pulse as it runs over the dorsal prominence of the navicular bone and the posterior tibial pulse as it runs behind the medial malleolus. If they are not palpable a handheld vascular Doppler should be used to locate these pulses and assess the strength of the blood flow to the peripheries.
Reliability of normalised truncated navicular height in assessment of static foot posture in children (6–12 years)
Published in European Journal of Physiotherapy, 2018
Fatma A. Hegazy, Emad A. Aboelnasr, Hoda A. El-Talawy, Faten H. Abdelazim
Furthermore, Evans et al. [31] had reported moderate intrarater reliability of navicular height with ICC of 0.69 in a sample of 10 children aged 4 years. This may be due to a small sample size of 10 subjects which could have an impact on the measurement results. In addition, the variable and formative nature of the navicular bone would seem to make it a difficult structure to be used in assessment of foot posture in 4-year-old children especially if the examiner was unfamiliar with the child’s developing foot as the navicular is the last foot bone to ossify between the ages of 2 and 5 years and navicular ossification is reported to occur later in boys than girls [32].