evaluation-patients-posture-gait-profile-after-lumbar-fusion-surgery

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion ...

University Hospital Tuebingen

Symptomatic lesser toe deformities should be corrected if conservative therapy is exhausted or no longer seems appropriate. Prevention of recurrence starts with the correct indication for the appropriate surgical procedure. The occasional difficult question of the cause of the deformity is crucial in this context. A correct surgical technique and appropriate after-care reduces the risk of recurrence. Due to tensed bony and soft-tissue conditions, revision surgery of the forefoot is challenging. If a revision becomes necessary, the cause of recurrence must be re-examined. This paper explains the appropriate indications and surgical techniques for correction of lesser toe deformities. Subsequently, specific postoperative complications and their management are discussed in detail.

[Recurrent hammer and clawed toes after surgical correction].

Gout is an inflammatory-rheumatic disease characterized by an elevated serum urate concentration and recurrent flares, including painful, hot, red, and swollen joints and surrounding tissue. Untreated gout often develops into a chronic disease with tophi and destruction of joint surfaces. Giant tophi are often resistant to medication and change in diet.This article presents a case of a 44-year-old man with giant gouty tophi at his hand and wrist. The last acute gout flare in his left wrist was approximately 3 years prior. For 2 years he had refused adequate nutrition, such as a low-purine diet, and had refused to take any preventive medication. Blood urate level was elevated to 8.7 mg/dL (normal range, 3.4-7.0 mg/dL). In time, the tophi led to a massive limitation of motion and use of especially the left wrist and thumb. Under the condition that the patient changed his diet and took the medication for his underlying disease, we surgically removed the almost skin-perforating tophi. Surgical debulking significantly improved joint function and cosmetic appearance.The best treatment for gouty tophi is prevention by ensuring adequate nutrition, treating the underlying causes, and taking effective medication. In the case of massive limitation of joint motion, skin breakdown with risk of infection, and compression of neurovascular structures, surgical debulking of the tophi should be considered.

Giant gouty tophi of the hand and wrist.

Bone sialoprotein (BSP) regulates bone metabolism by directly influencing the activity of osteoblasts and osteoclasts. A significant correlation between the tissue expression of BSP in tumors and the occurrence of bone metastases was found in different cancers. Aim of this study was to identify the BSP expression in renal cell carcinomas (RCC) according to their stage of metastatic disease. Tissue samples of patients with RCC who underwent partial resection or nephrectomy were separated into three groups, each with 10 patients showing either no metastases (group I), only soft tissue metastases (group II) or bone metastases (group III) at date of surgery. Immunohistochemical analysis of BSP expression in tumor tissue and corresponding renal parenchyma was performed and evaluated with an established semiquantitative scoring system. BSP expression was detected both in tumor tissue and renal parenchyma. Concerning the expression in malignant tissue, no significant difference could be found between the three groups whereas the corresponding renal parenchyma showed a staining score of 164, 198 and 224 for group I, II and III (P = 0.07). RCC staged T3 showed only a little higher BSP expression than those staged T1/2 (P < 0.21), while the corresponding parenchyma of T3 tumors showed significantly higher expressions (P = 0.02). This pilot study revealed a correlation between expression of BSP and tumor staging and type of metastases, especially for osseous metastases in RCC. Alternation of BSP expression could be detected particularly in renal parenchyma and linked to the type of metastases.

Article	Year
[Recurrent hammer and clawed toes after surgical correction]. Der Orthopade\| PubMed ID: 21472421	2011
Giant gouty tophi of the hand and wrist. Orthopedics\| PubMed ID: 22049969	2011
Alteration of bone sialoprotein expression in osseous metastasized renal cell carcinomas and the tumor surrounding tissue. Clinical & experimental metastasis\| PubMed ID: 22130963	2012

Falk Mittag

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