The Journal of foot surgery
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The authors present a descriptive report on medial column instability with Lisfranc's fracture dislocation injuries. Subtleties of recognizing and diagnosing this injury are emphasized within a literature review. Eleven cases of tarsometatarsal injuries were reviewed over an 18-month period. ⋯ Due to the instability of the medial column, failure in reduction methods for this injury consistently occurred. With proper sequential placement of Kirschner wires, reduction failure is minimized. A fixation method for medial column Lisfranc's injuries with Kirschner wire placement is described.
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Identification and management of the acutely fractured ankle is discussed by the authors. The Lauge Hansen classification system, and in particular, supination-external rotation injuries, is evaluated. Intraoperative technique, perioperative considerations, and generalized management of these pathologic conditions are reviewed, according to the authors' experiences.
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Review Case Reports
Malignant schwannoma of the medial plantar branch of the posterior tibial nerve.
Malignant schwannoma in the foot is extremely rare. The authors present a case involving the medial plantar branch of the posterior tibial nerve in a patient with neurofibromatosis, without previous history of malignant degeneration. Following full excisional biopsy, the diagnosis was made using immunohistochemical studies and electron microscopy. A review of the literature also is presented.
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The authors present a review of bone healing. A literary search on the subject reveals a variety of experiments performed on healing bone using different techniques. ⋯ It also relates that bone healing without any fixation is not desired. Therefore, the goal of this paper is to enlighten the surgeon that controlled, semirigid, semicompressed fixation with active range of motion is the ideal criteria for bone healing, and decreases the chance of cast disease.
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Review
Vasoconstrictive agents commonly used in combination with local anesthetics: a literature review.
A review of the current medical literature concerning the use of various vasoconstrictive agents with local anesthetics is presented. These agents are employed in podiatry primarily for the purpose of prolonging the duration of anesthesia and surgical hemostasis. Epinephrine, phenylephrine, levonordefrin, felypressin, and norepinephrine have all been utilized in conjunction with the local anesthetics by the various medical professions. Although controversy surrounds the use of these agents, this article should assist the podiatric physician in making an informed decision.