RESUMEN
Iatrogenic hallux varus is a relatively rare complication of corrective hallux valgus surgery that has multiple pathologic facets. It requires a comprehensive assessment that focuses on joint flexibility, joint integrity, soft tissue balance, and bony deformity. A step-wise treatment approach is used to address all elements of the deformity. The literature on hallux varus treatments consists mainly of retrospective case series, with several proposed procedures addressing various degrees of deformity. Comparison of these procedures is a challenging endeavor and each case should be considered on an individual basis.
Asunto(s)
Hallux Varus/terapia , Osteotomía/efectos adversos , Algoritmos , Hallux Valgus/cirugía , Hallux Varus/diagnóstico , Hallux Varus/etiología , Hallux Varus/fisiopatología , Humanos , Enfermedad IatrogénicaRESUMEN
Though uncommon, iatrogenic hallux varus is most often the result of overresection of the medial eminence, overtranslation of an osteotomy, overrelease of the lateral soft tissues, or overtightening of the medial tissues. It is not always symptomatic, as the degree of deformity can be well tolerated. For soft-tissue reconstructions, releases have little role to play unless minor deformity is detected early on and the longevity of tendon transfer and tenodesis remains unknown. For bony reconstruction, arthrodesis is the recommended salvage technique.
Asunto(s)
Hallux Varus/cirugía , Hallux/cirugía , Artrodesis , Hallux/diagnóstico por imagen , Hallux Varus/clasificación , Hallux Varus/diagnóstico por imagen , Hallux Varus/terapia , Humanos , Enfermedad Iatrogénica , Huesos Metatarsianos/diagnóstico por imagen , Huesos Metatarsianos/cirugía , Osteotomía , Radiografía , Transferencia Tendinosa , TenodesisRESUMEN
La prevalencia de alteraciones ortopédicas es muy elevada en los niños con síndrome de Down. En ello juegan un papel importante la hipotonía muscular y la hiperlaxitud ligamentosa, lo que hace que, a lo largo de la infancia, se vayan acumulando afecciones de este tipo. Con gran frecuencia se trata de alteraciones que no ponen en juego la vida del paciente, pero que pueden ser causa de aumento de discapacidad. Destacan las alteraciones de los miembros inferiores, incluyendo pies, rodillas y caderas y las del raquis, con alta prevalencia de escoliosis y presencia ocasional de trastornos de la unión atlo-axoidea (AU)
The prevalence of orthostatic disorders is very high in children with Downs Syndrome. Muscular hypotony and ligamentous hyperlaxity play an important role in it. For this reason, conditions of this type accumulate during childhood. Very frequently, these disorders are not life-threatening for the patient but they may cause an increase in incapacity. Alterations of the lower limbs, including feet, knees and hips and the spinal cord standout, with high prevalence of scoliosis and occasional presence of disorders of the atlantoaxial junction (AU)
Asunto(s)
Humanos , Masculino , Femenino , Niño , Procedimientos Ortopédicos/métodos , Síndrome de Down/complicaciones , Hipotonía Muscular/complicaciones , Hipotonía Muscular/diagnóstico , Inestabilidad de la Articulación/complicaciones , Escoliosis/complicaciones , Escoliosis/cirugía , Escoliosis , Articulación Atlantoaxoidea/lesiones , Inestabilidad de la Articulación/diagnóstico , Lesiones de la Cadera/complicaciones , Lesiones de la Cadera/cirugía , Luxación de la Rótula/complicaciones , Luxación de la Rótula/terapia , Pie Plano/complicaciones , Genu Valgum/complicaciones , Hallux Varus/complicaciones , Hallux Varus/diagnóstico , Hallux Varus/terapia , Ortopedia/tendenciasRESUMEN
El autor efectúa un análisis sobre el antepié varo, sus causas y consecuencias biomecánicas. Presenta un caso de antepié varo en un paciente que practica atletismo. Propone un protocolo de exploración general y, en particular, un método de valoración en carga de los grados de varo de antepié. Para concluir, también explica como el mencionado sistema de medida del antepié sirve para verificar la corrección sobre el soporte plantar(AU)
The author makes an analysis on the forefoot varus his causes and biomechanical consequences. It presents a case of forefoot varus in a patient that practical athletics. It proposes a protocol of general exploration and in particular a method of valuation in load of the grades of varus of forefoot. To conclude, he also explains, as the one mentioned system of measure of the forefoot it is good to verify the correction on the support to plant(AU)
Asunto(s)
Humanos , Masculino , Adulto , Hallux Varus/terapia , Antepié Humano/anomalías , Fenómenos Biomecánicos/métodos , Procedimientos Ortopédicos/métodosRESUMEN
Appropriate treatment for hallux varus requires comprehensive radiographic and systematic clinical assessment to identify the involved factors. A classification scheme must incorporate many variables in order to determine the best approach to correcting the deformity. This article focuses on iatrogenic hallux varus following bunion surgery, but the same principles apply to other causes of acquired hallux varus.
Asunto(s)
Hallux Varus/clasificación , Hallux Varus/terapia , Hallux Varus/etiología , Humanos , Articulación Metatarsofalángica/diagnóstico por imagen , Articulación Metatarsofalángica/patología , Articulación Metatarsofalángica/fisiopatología , RadiografíaRESUMEN
During the skeletal development of the axis and foot of the child physiological specialties can occur. Those are thick fatty sole, increased valgus in the ankle joint, tibial varus as a toddler with first varus, later on valgus in the knee, increased laxity of the ligaments, increased anteversion of the femoral neck with "kneeing in" and "toeing in", and with knees first in flexion, later on hyperextension. The knowledge of those specialties is important to be able to diagnose and treat deformities of the foot during childhood. Included are club foot, flexible flatfoot, vertical talus, pes adductus, equinus, cavus foot and talipes calcaneovalgus. If treated at the right time, those disorders of the feet can resolve completely. If an operation can't be avoided, the indication has to be chosen with care.