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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.