The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Review Case Reports
Preemptive analgesia in elective surgery in patients with complex regional pain syndrome: a case report.
Complex regional pain syndrome (CRPS) can be a complication of injury or surgery or have an obscure etiology. Special precautions are indicated (i.e., preemptive analgesia) when surgery is required with a patient who has been diagnosed with CRPS. The complex case of a 44-year-old female diagnosed with reflex sympathetic dystrophy (RSD) is discussed, including current treatment options. A brief review of the literature as well as the features of complex regional pain syndrome (CRPS I/RSD and CRPS II/causalgia) are presented.
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Review Case Reports
Lateral subtalar dislocation: review of the literature and case presentation.
Lateral subtalar joint dislocations are rare injuries which are usually the result of a violent eversional force, driving the talar head medially and displacing the rest of the foot laterally. Associated fractures and obstruction to closed reduction are more common with lateral than medial dislocations. Avascular necrosis of the talus and navicular as well as subtalar instability may result from these injuries. ⋯ A short period of immobilization limits loss of subtalar range of motion. Open reduction may be required, particularly with entrapment of the posterior tibial tendon or obstructing fracture fragments. A case of lateral subtalar joint dislocation is presented.
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A brief review of the literature concerning the wound healing process is presented. A synopsis of the physical and physiologic factors that can affect the rate of this process is provided. ⋯ The authors define the contact layers as the layer that comes into intimate contact with the wound surface and has the greatest influence on healing. A description of some of the common products used as the contact layer is presented.
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Reflex sympathetic dystrophy is a complex progressive and potentially devastating condition generally affecting the extremities. Because clinical presentation is variable, diagnosis can be difficult. ⋯ Sympathetically maintained pain is also recognized as a separate component to this group of conditions. The authors present this new taxonomy and present cases of each condition.
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Review Case Reports
Talar fracture/dislocation in the adolescent patient.
The authors report an 18-year-old patient who sustained a two-part injury involving his right ankle. The result of this traumatic episode was a fracture/dislocation of the talus. An interesting aspect of this injury is that the body of the talus dislocated laterally, distal to the fibular malleolus. ⋯ The patient was followed for 9 months, during which time a series of radiographs was taken. Nine months postoperatively, Hawkins sign was negative indicative of avascular necrosis. In review of the literature, no fractures with lateral dislocations of this nature were found.