Data Trace Editor – Discussion: – in the normal foot, metatarsal heads bear one half of a person’s body wt, when the foot is plantigrade; – the first metatarsal normally bears half the wt of the forefoot; – long 2nd metatarsal can contribute to pressure under metatarsal head; – limitation of dorsiflexion (from heel cord contracture or ankle … Read more
– See: Forefoot and Midfoot Stress Frx – Discussion: – march frx usually occurs in shaft of second or less often in the third metatarsal; – stress frx of 5th metatarsal represents a distinct fracture; – in runners stress frxs occur most often in metatarsal neck, … Read more
– See: – Claw Toes – Hammer Toes – Hallux Valgus: – Turf Toe – Windlass Mechanism – MP joint is stabilized by plantar plate, & when it is disrupted, subluxation or frank dislocation of the joint can occur
– Discussion: – metastatic breast disease survival averages 34 months; – avg life expectancy w/ metastatic disease to bone is > 18 months; – Radiographs: – permeative destructive lesions of bone; – permeative destruction of the proximal femur is the most common type of destruction leading to … Read more
– See Metastatic Carcinoma: – Discussion: – will destroy the cortex and will have a soft tissue component; – diagnosis is confirmed either w/ a bone scan which shows a renal mass (inaddition to the metastatic bone lesions) or an abdominal CT scan; – note that this type of carcinoma can often be succesfully treated … Read more
– Discussion: – pathologic fractures thru lesions w/ increased density is indicated only if the pain persists after completion of the irradiation and no other cause is found; – labs: – acid phosphatase – PSA Prostate cancer and bone metastases: medical … Read more
Discussion: – pathologic fractures through lesions w/ increased density is rare; – lesion should be irradiated if the patient has pain, & internal fixation is indicated only if the pain persists after completion of the irradiation and no other cause is found; – PSA: … Read more
– Discussion: – bone scans tend to be hot (unlike multiple myeloma); – bone lesion may be less likely to cause pathologic fractures than other metatsatic lesions; – if bone lesions are asymptomatic, consider non operative treatment; – associated features include lymphadenopathy or splenomegaly; – evaluate cervical, … Read more
– Discussion: – see metastatic carcinoma; – will also produce increased bone density – 30% of lung mets will show increased bone density on radiographs; – avgerage life expectancy w/ metastatic lung Ca + pending pathologic frx is 3 months (vs. 18 months in breast ca); – … Read more
– Operative Considerations (see IM nailing and Synthes IM Nail); – should be considered when x-rays show more than 50% loss of the shaft diameter on any view; – risk of pathologic frx is low for lesions involving 50% of the shaft diameter (assuming that patient is touch down weight bearing), but rises dramatically after the … Read more