Success of Calcaneonavicular Coalition Resection in the Adult Population

1996 ◽  
Vol 17 (9) ◽  
pp. 569-572 ◽  
Author(s):  
Bruce E. Cohen ◽  
W. Hodges Davis ◽  
Robert B. Anderson
Keyword(s):  
Conservative Treatment ◽  
Adult Population ◽  
Adult Patients ◽  
Radiographic Evidence ◽  
Degenerative Arthritis ◽  
Calcaneonavicular Coalition ◽  
Hindfoot Arthrodesis

Twelve adult patients (13 feet), average age 33 years (range, 19–48 years), with calcaneonavicular coalitions remained symptomatic after a trial of conservative treatment. Surgical resections were performed. Before surgery, there was <5° of inversion/eversion in 11 patients, radiographic evidence of degenerative arthritis in 10 feet (77%), and talar beaking in 7 feet. At an average postoperative follow-up of 36 months, subjective relief of preoperative symptoms was achieved in all but two patients. Two patients required subsequent hindfoot arthrodesis. Resection of calcaneonavicular coalition in the adult can be successful and provides an option to arthrodesis after nonoperative methods have failed.

Calcaneonavicular Coalition Resection with Extensor Digitorum Brevis Interposition in Adults

2007 ◽  
Vol 28 (8) ◽  
pp. 890-895 ◽  
Author(s):  
Aaron T. Scott ◽  
H. Robert Tuten
Keyword(s):  
Extensor Digitorum ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Radiographic Evidence ◽  
Degenerative Arthritis ◽  
Superficial Infection ◽  
Calcaneonavicular Coalition ◽  
Average Patient ◽  
American Orthopaedic ◽  
Extensor Digitorum Brevis

Background: Traditionally, pediatric patients with symptomatic calcaneonavicular coalitions have been treated with resection of the coalition and interposition of the origin of the extensor digitorum brevis muscle. Despite the success of calcaneonavicular coalition resection in children, many surgeons are reluctant to perform this procedure in adults or in patients with osseous coalitions, and joint sacrificing arthrodesis often is done instead. Methods: Seven adult patients (eight feet) had calcaneonavicular coalition resection with extensor digitorum brevis interposition. The average patient age was 41 years, and all patients displayed isolated, symptomatic calcaneonavicular coalitions without any radiographic evidence of degenerative arthritis. At followup, physical and radiographic evaluations were performed, and an American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score was recorded. Charts were reviewed for complications and patients were questioned with regards to their overall satisfaction with the surgery. Results: At a mean postoperative followup of 56.5 months, the average AOFAS score was 87. Review of most recent radiographs revealed no degenerative changes or recurrence of the coalition. All patients responded that they would have this surgery again and that they would recommend this procedure to a friend. Complications included one superficial infection and one dysesthesia involving the sural nerve. Conclusions: The results of the present study suggest that resection combined with muscular interposition can be successful in patients over the age of 18 in whom conservative management of their symptomatic coalitions has failed. This procedure offers an excellent alternative to arthrodesis and has a very low complication rate.

scholarly journals Is There an Increase in Sickle Cell Related Events Among the Adult Belgian Population?

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4923-4923
Author(s):  
Phu-Quoc Le ◽  
Beatrice Gulbis ◽  
Laurence Dedeken ◽  
Laurence Rozen ◽  
Christiane Vermylen ◽  
...  
Keyword(s):  
Viral Infections ◽  
Conflicts Of Interest ◽  
Positive Impact ◽  
Adult Population ◽  
Median Number ◽  
Adult Patients ◽  
Acute Chest Syndrome ◽  
Acute Complications ◽  
Before And After

Abstract Survival among children and adults with SCD in Belgium published in 2015 showed a low mortality rate (0.25/100 patient years (PY)) among the 469 patients included (5,110 PY) with no significantly increase above 18 years of age. Hydroxyurea (HU) had a positive impact on patients' survival rate when compared to those without disease-modifying treatments (DMT) or transplanted. This led us to compare the incidence of acute complications and hospitalizations among children and adults to see if significant change occurred. Complications before and after the age of 18 for 84 patients with severe genotype followed after 18 years of age and not transplanted for whom the data during childhood were recorded in the registry are detailed in Figure 1 and Table I. Data on the pre- and post-18 years' events for the entire severe genotype cohort are detailed in Table II and include data from the patients under 18 years and data at the pediatric age of those more than 18 years. Data was censored from the time of the transplantation. Furthermore, data from adult patients before age 18 and beyond with severe genotype treated or not with HU are given in Table III. There were 139 patients (1759 PY) more than 18 years who had at last follow up a median age of 21 years (range: 18-53 years). 42% (59/139) of the patients were treated with HU. The median number of vaso-occlusive crisis (VOC) was statistically lower during adulthood (0 vs 29.6/100 PY; p= 0.007) and the median number of acute chest syndrome (ACS) was not statistically higher in adult period compared to their follow-up during childhood. Overall, severe infections as well as hospitalizations number (19 vs 63/100 PY; p=0.0006) and days (119 vs 259/100 PY; p=0.021) are significantly higher in children. The comparison of adults under HU and without DMT showed a significant higher incidence of acute events in HU patients (Table III). This is true for follow-up in childhood and beyond the age of 18 (Table III). Patients without DMT obviously seems to have attenuated symptomatology (clinical phenotype not very severe despite their severe genotype) and were therefore not considered benefiting from DMT. In the latter, no ACS was recorded during their follow-up in adulthood (Table III). The increase in CVO and ACS incidence with age is well described in the literature but not found in our results. Higher number of hospitalizations and infections before 18 years of age are observed. This can be explained by the fact that children consult more quickly and frequently and they are more readily monitored in hospital compared to adults. They also live in community, which increases the risk of seasonal viral infections. Compared with data available in the literature, our adult patients, most of whom are treated with HU, have fewer acute complications. Nevertheless the comparison is jeopardized because of different methodological approaches. In addition, our cohort of adult patients is limited, has a relatively short follow-up and consists mainly of adults under 21 at the last follow-up. The shorter length of follow up and the underrepresentation of older adults who pay a heavier toll on SCD because of co-existence of chronic complications, may explain the reduced incidence of acute complications in our cohort. In conclusion, the incidence of events observed in our adult population is lower than that described in the literature. This difference is probably related to a larger proportion of HU patients in our cohort. But these results should be confirmed by data from a larger number of adult patients with longer prospective follow-up. Disclosures No relevant conflicts of interest to declare.

Triple Arthrodesis in Adults

Foot & Ankle ◽  
1991 ◽  
Vol 12 (3) ◽  
pp. 138-143 ◽  
Author(s):  
Gordon L. Bennett ◽  
Charles E. Graham ◽  
Donald M. Mauldin
Keyword(s):  
Patient Satisfaction ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Adult Patients ◽  
Talonavicular Joint ◽  
Triple Arthrodesis ◽  
Radiographic Evidence ◽  
Incision Technique ◽  
Arthritic Changes

Twenty-two adult patients who underwent a triple arthrodesis because of hindfoot pain and/or deformity were reviewed retrospectively with a minimum 3-year follow-up. All procedures were performed by the same surgeon using a two-incision technique and internal fixation. Objective results were good in eight (36%) patients, fair in 13 (59%), and poor in one (5%). There were two asymptomatic nonunions of the talonavicular joint, no infections, and no neuromas. Eleven patients had radiographic evidence of tibiotalar arthritis, and eleven patients had midfoot arthritic changes that had progressed after the operation. Patient satisfaction with the procedure was high, and 21 of 22 (95%) patients felt that they were improved overall and would have the surgery again if indicated. Although the procedure is technically demanding, patient satisfaction is high and complications can be kept to a minimum if proper surgical technique is utilized.

Treatment of moyamoya disease in the adult population with pial synangiosis

2014 ◽  
Vol 120 (3) ◽  
pp. 612-617 ◽  
Author(s):  
Ning Lin ◽  
Joshua P. Aronson ◽  
Sunil Manjila ◽  
Edward R. Smith ◽  
R. Michael Scott
Keyword(s):  
Moyamoya Disease ◽  
Adult Population ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Adult Patients ◽  
Cerebral Revascularization ◽  
Age At Surgery ◽  
Indirect Revascularization ◽  
Revascularization Surgery

Object Surgical treatment of moyamoya disease in the adult population commonly uses direct revascularization, the superficial temporal artery (STA) to middle cerebral artery (MCA) bypass (STA-MCA). Pial synangiosis, a method of indirect revascularization, has been used in adult patients with moyamoya when STA-MCA bypass was not technically feasible. Although the effectiveness of pial synangiosis has been well described in children, only limited reports have examined its role in adult patients with moyamoya disease. In this study the authors report on their experience with pial synangiosis revascularization for this population. Methods The authors reviewed the clinical and radiographic records of all adult patients (≥ 18 years of age) with moyamoya disease who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results From 1985 to 2010, 66 procedures (6 unilateral, 30 bilateral) were performed on 36 adult patients with moyamoya disease. The mean age at surgery was 28.3 years, and 30 patients were female. Twenty-eight patients (77.8%) presented with transient ischemic attacks (TIAs), 24 (66.7%) with stroke, and 3 (8.3%) with hemorrhage. Preoperative Suzuki stage was III or higher in 50 hemispheres (75.8%) and 3 patients had undergone prior treatments to the affected hemisphere before pial synangiosis surgery. Clinical follow-up was available for an average of 5.8 years (range 0.6–14.1 years), with 26 patients (72.2%) followed for longer than 2 years. Postoperative angiography was available for 24 patients and 46 revascularized hemispheres, and 39 (84.8%) of the 46 hemispheres demonstrated good collateral formation (Matsushima Grade A or B). Postoperative complications included 3 strokes, 5 TIAs, and 2 seizures, and there was no hemorrhage during the follow-up period. One patient required additional revascularization surgery 8 months after pial synangiosis. Conclusions Pial synangiosis is a safe and durable method of cerebral revascularization in adult patients with moyamoya and can be considered as a potential treatment option for moyamoya disease in adults.

scholarly journals Comparison of Intracranial Neuroendoscopic Procedures in Children versus Adults

2015 ◽  
Vol 42 (6) ◽  
pp. 427-435 ◽  
Author(s):  
Fady Girgis ◽  
Roberto Diaz ◽  
Walter Hader ◽  
Mark Hamilton
Keyword(s):  
Pediatric Patients ◽  
Endoscopic Third Ventriculostomy ◽  
Adult Population ◽  
Major Complication ◽  
Adult Patients ◽  
Therapeutic Modality ◽  
Third Ventriculostomy ◽  
Complication Rates ◽  
Common Procedure

AbstractBackground:The emphasis regarding intracranial neuroendoscopy has been traditionally advocated and focused on the role in pediatric patients, although a significant usage has developed in adult patients. In this study, we examine and contrast the role of predominantly intracranial neuroendoscopy in both a pediatric and adult population with a minimum postprocedure follow-up of 5 years.Methods:A retrospective review was conducted for patients in the two hospitals that manage neurosurgical care for Southern Alberta, Canada, undergoing neuroendoscopic surgery between 1994 and 2008. The pediatric group was defined as age ≤17 years and the adult group as age ≥18 years.Results:A total of 273 patients who underwent a total of 330 procedures with a mean postprocedure follow-up of 12.9 years were identified. There were 161 adult and 112 pediatric patients, and both groups underwent surgery by the same surgeons. The most common procedure was endoscopic third ventriculostomy, accounting for 55% of procedures. One postoperative death occurred in an adult patient. Endoscopic third ventriculostomy success 1-year postprocedure was 81%, with only three late-term failures. Postoperative infection was the most common serious complication (two pediatric/four adult patients). Adult and pediatric patients had similar major complication rates (4.2% vs 5.7%, p=0.547).Conclusions:Neuroendoscopy overall had a similar role in both pediatric and adult neurosurgical populations, with the most commonly associated complication being infection. Neuroendoscopy is an important therapeutic modality in the management of appropriate adult patients.

Conservative Treatment of Vestibular Schwannomas: A Follow-Up Study on Clinical Outcomes

2012 ◽  
Vol 73 (S 02) ◽  
Author(s):  
M. Sadadcharam ◽  
R. Wormald ◽  
M. Javadpour ◽  
D. Rawluk ◽  
R. McConn-Walsh
Keyword(s):  
Conservative Treatment ◽  
Clinical Outcomes ◽  
Vestibular Schwannomas ◽  
Follow Up Study

A combined lateral-crestal approach of sinus floor elevation: A report on three cases

2020 ◽  
Author(s):  
Xin Zhang ◽  
Yuting Zhang ◽  
Jian Wang ◽  
Qianbing Wan ◽  
Lei Li
Keyword(s):  
Clinical Study ◽  
Conservative Treatment ◽  
Lateral Approach ◽  
Clinical Report ◽  
Sinus Lift ◽  
Sinus Floor Elevation ◽  
Long Term Follow Up ◽  
Sinus Floor

This clinical report describes a combined lateral-crestal approach to elevate the sinus floor when placing implants on a wide maxillary posterior ridge. The buccally enlarged osteotomy broadens vision of practitioners and facilitates access of instruments in the sinus. Compared to the traditional lateral approach of sinus lift, the proposed technique may offer a more conservative treatment modality. And a clinical study with sufficient subjects and long term follow up is needed to validate the potential and limitations of the proposed technique.

scholarly journals Follow-up study of compression fractures of the thoracic and lumbar vertebral bodies by conservative treatment.

1987 ◽  
Vol 35 (4) ◽  
pp. 1430-1434
Author(s):  
Takashi Toyoumi ◽  
Sekio Tominaga ◽  
Kazutomo Date ◽  
Keiji Ohuchi ◽  
Minoru Katayama ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Compression Fractures ◽  
Follow Up Study ◽  
Vertebral Bodies

scholarly journals Appendiceal Neuroendocrine Tumours - Experience of One Service

2021 ◽  
Author(s):  
Vítor Devezas ◽  
Laura Elisabete Barbosa
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Neuroendocrine Tumours ◽  
Adult Population ◽  
Right Hemicolectomy ◽  
Good Prognosis ◽  
Alive Today

AbstractTumours of the appendix are rare and tend to be diagnosed incidentally, in cases of acute appendicitis. For some authors, appendiceal neuroendocrine tumours (ANETs) are the most frequent neoplasm of the appendix, observed in 0.3% to 0.9% of cases acute appendicitis. The present is a unicentric retrospective study conducted between January 2005 and March 2017. Out of a total of 3,007 surgeries for appendiceal pathologies performed in the adult population at the hospital where the present study was conducted, there were 70 (2.33%) malignant cases, 20 (28.6%) of which were ANETs. The patients had a median age of 44 years (range: 18 to 85 years), and were predominantly women (there were 1.9 times more women than men). In 16 cases (80%), a simple appendicectomy was performed (1 patient was submitted to a right hemicolectomy later). The cases of ANETs had a good prognosis in our series: 85% of the patients are either alive today or were alive after 5 years of follow-up. Despite the fact that ANETs are described as the most frequent tumor of the appendix, this was not confirmed in our series, in which they only represented 28.6% of the cases; adenocarcinoma was the most frequent tumor (65.7%) among our sample.

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