| Ischemic necrosis following clubfoot surgery: the purple hallux sign. | |
| | |
MedLine Citation:
|
PMID: 15552558 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Ischemic necrosis, which develops rarely after clubfoot surgery, may have a vascular etiology, since many idiopathic and neurogenic clubfeet have congenital deficiency of the anterior tibial and dorsalis pedis arteries. Dorsalis pedis deficiency is demonstrated more frequently in those clubfeet showing greater deformity. Substantial hypoplasia of the profunda femoris and posterior and anterior tibial arteries was evident in the affected limb of a patient in this series who underwent postoperative arteriography. Herein, we report massive necrosis in seven limbs of six patients after clubfoot surgery and have combined this series with seven previously published cases. Additional cases support our hypothesis that arterial deficiencies put some postoperative clubfeet at risk of perioperative ischemic necrosis. Necrosis occurs in those regions supplied by the congenitally diminished anterior tibial and dorsalis pedis arteries. Knowing that children with congenital vascular deficiency are at risk for ischemic necrosis, surgeons should be alert to the subtle, early signs of ischemia and be prepared to prevent or ameliorate the consequences of this condition. Since hypoperfusion in these postoperative feet is a surgical emergency, we propose clinical guidelines for treatment for this phenomenon, which we have named the purple hallux sign. |
| | |
Authors:
|
R Hootnick David; David S Packard; E Mark Levinsohn; Scott A Berkowitz; David D Aronsson; Russell J Crider |
Related Documents
:
|
19610578 - Uncorrected tetralogy of fallot with agenesis of the left pulmonary artery in a 70-year... 12975508 - Congenital pulmonary venolobar syndrome: spectrum of helical ct findings with emphasis ... 16287728 - Multidetector row computed tomography: imaging congenital coronary artery anomalies in ... 11312178 - Congenital esophageal stenosis in adults: clinical and radiographic findings in seven p... 12002238 - Occlusive scrub suits in operating theaters during cataract surgery: effect on airborne... 3415878 - Surgical creation of a double outlet right atrium for tricuspid valve stenosis after a ... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of pediatric orthopedics. Part B Volume: 13 ISSN: 1060-152X ISO Abbreviation: J Pediatr Orthop B Publication Date: 2004 Sep |
Date Detail:
|
Created Date: 2004-11-19 Completed Date: 2004-12-09 Revised Date: 2012-09-17 |
Medline Journal Info:
|
Nlm Unique ID: 9300904 Medline TA: J Pediatr Orthop B Country: United States |
Other Details:
|
Languages: eng Pagination: 315-22 Citation Subset: IM |
Affiliation:
|
Department of Orthopedic Surgery State University of New York, Upstate Medical University, Syracuse, New York 13210, USA. hoot4@twcny.rr.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abnormalities, Multiple
/
surgery Angiography Arterial Occlusive Diseases / etiology, radiography Child Child, Preschool Clubfoot / diagnosis, surgery* Female Foot / blood supply Hallux / blood supply* Humans Infant Ischemia / diagnosis, etiology* Male Necrosis Orthopedic Procedures / adverse effects*, methods Postoperative Complications / diagnosis Prognosis Risk Assessment Sampling Studies Severity of Illness Index Tibial Arteries |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Influence of speed variation and age on the asymmetry of ground reaction forces and stride parameter...
Next Document: Dysplasia epiphysealis hemimelica of the hand: two cases at the proximal interphalangeal joint.