Clinics in podiatric medicine and surgery
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Clin Podiatr Med Surg · Apr 1989
ReviewNail changes associated with systemic disease and vascular insufficiency.
In some cases, nail changes may not only be the presenting sign of systemic disease, but a sensitive indicator of treatment efficacy as well. Awareness of nail dystrophies and their association with underlying pathology can aid the practitioner in the diagnosis and management of the podiatric patient.
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Two principal classifications of ankle fractures are reviewed. Anatomic and roentgenographic criteria used for the assessment of reduction in ankle fractures are highlighted in this review of ankle trauma.
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Clin Podiatr Med Surg · Oct 1988
ReviewArthrography, tenography, and bursography of the ankle and foot.
A brief description of normal anatomy and common arthrographic, tenographic, and bursographic procedures is presented. The described procedures are important diagnostic tools and do not carry major risk. Therefore, these procedures can be performed on an outpatient basis.
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A thorough knowledge of functional growth plate anatomy and physiology is essential to proper management of epiphyseal foot and ankle injuries. The ability to classify foot and ankle fractures according to the Salter-Harris anatomic and radiographic classification provides useful prognostic information that may affect treatment. The Dias-Tachdjian mechanistic classification system for pediatric ankle fractures provides useful information about the extent of osseous and soft tissue injury and the best method of closed reduction and correlates well with the Lauge-Hansen system, which is widely used for adult ankle fractures. ⋯ Finally, younger children (under age 10 years) have a better prognosis for spontaneous correction of nongrowth arrest-induced deformities but a much poorer prognosis with growth arrest injuries than do older children, in whom growth arrest does not usually cause a significant problem. All children with growth plate injuries should be followed at regular intervals for at least 2 years or to skeletal maturity in the case of physeal disturbance. Treatment of epiphyseal fractures of the foot and ankle must be individualized but should always be based upon a thorough knowledge of anatomy, bone growth physiology, classification, potential pitfalls, and prognosis.