Asian Journal of Orthopaedic Research

Hallux Valgus in Adolescents: A Retrospective and Descriptive Study

Karima Atarraf — 2022-12-30

Hallux valgus is the deviation of the first metatarsal in varus and the big toe in valgus.

Through a retrospective study we analyzed 10 feet managed fr hallux valgus between January 2014 and March 2020. The average age was 14 years with female predominance. Patients reported pain and the deformation. Idiopathic origin was the most frequent. The average of M1P1 angle was 44.08°, the M1M2 angle was 14. 05°.The mean DMAA value was 18.8°, and the mean M1M5 angle was 32.4°.

Sesamoid class 1 was found in six feet (60%), four others had sesamoid class 2 (40%). Seven feet had dislocated or subluxated non-congruent metatarsophalangeal joints with a percentage of 70%. The average medial arch measurement was 110°, the average angle of attack of M1 was 20.87°.

All patients underwent uneventful surgery. McBride surgery was performed on two feet. A stabilized re-axation osteotomy with K-wires associated with a release of the abductor hallux was performed in six feet out of the other eight. In these eight, 40% had a chevron osteotomy, 30% had a Mitchell Osteotomy and 10% had a modified Scarf Osteotomy.

They resumed walking on the heel immediately with a 6weeks boot cast.

The mean value of the M1P1 angle decreased from 44.08° pre-operatively to 15.46° post-operatively with a reduction rate of 64.92%.

Given the immaturity of the child's skeleton, the surgical treatment of hallux valgus must be as innocuous as possible.

Proximal Femoral Derotational Osteotomy in a 14-Year-old Patient with Cerebral Palsy: Osteosynthesis Material Failure Three Weeks Postoperative

Nader Fadi — 2022-12-30

Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture. Excessive femoral internal rotation is one of the gait problems encountered and can be corrected by femoral derotation osteotomy.

We present here the case of 14 years old boy, known to have cerebral palsy, with increased femoral anteversion treated with proximal subtrochanteric femoral de-rotation osteotomy fixed with plate and screws.

He experienced a catastrophic failure of the plate. First time revision was done with a dynamic hip screw sliding plate, second time revision was done for pseudarthrosis and consisted of adding a dynamic compression plate (DCP) on the anterior cortex to increase the fixation stability.

As a conclusion, a robust system should be utilized when trying to osteosynthesis fractures near spastic muscles, and tenotomy should be added whenever needed without hesitation.

My Hand, My Survival: Rehabilitating the Hand for Optimal Function

Abiola Olayinka Fafolahan — 2022-12-30

Background: Compartment syndrome is a medical emergency that needs to be treated right away with surgery to stop further complications.

Case Presentation: A 54-year-old man presented with acute compartment syndrome of the right upper limb. He underwent fasciotomy, and physiotherapy management started immediately after the surgery. The treatment plan aimed to address pain, preserve muscle function, prevent complications post-fasciotomy, preserve range of motion, strengthen affected muscles, and restore function. The treatment involved a combination of therapeutic interventions and treatment plans and was carried out over a period of 3.5 months. The treatment approach involved passive movements, free active exercises, isometric contraction, assisted active exercises, massage therapy, cryotherapy, electrical muscle stimulation, and scar massage. Throughout the treatment period, the patient's progress was closely monitored, and adjustments were made to the treatment plan as needed. By the end of 12th week, there had been a noticeable improvement in the affected upper limb's UEFI-15 score and gross muscle power.

Conclusions: Pain management, muscle function preservation, and limb function restoration were all achieved successfully with physiotherapy management. The successful outcomes seen in this case study highlight the benefit of early diagnosis and prompt intervention of compartment syndrome, as well as a team-based, all-inclusive approach to care that includes physiotherapists, medical experts, and other members of the healthcare team.