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      9Scopus© Citations 7
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    Evidence-Based Treatment Algorithm for Freiberg Disease
    (2023)
    Ichiro Yoshimura
    ;
    Masato Takao
    ;
    ;
    Sjoerd Stufkens
    ;
    Jari Dahmen
    <jats:p> Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion. </jats:p>
    Scopus© Citations 9  1
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    Protocol for outpatient management in cleft lip and palate repair
    (2021)
    María Santos
    ;
    Jacqueline García
    ;
    Stephanie Graf
    ;
    Carlos Giugliano
      11Scopus© Citations 7
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    Pathological axis fracture secondary to a solitary bone plasmacytoma: Two cases and a literature review
    (2021) ;
    Alvaro Silva
    ;
    Matias Delgado
    ;
    Marilaura Nuñez
    ;
    Juan Lopez
    <jats:sec id="st1"> <jats:title>Background: </jats:title> <jats:p>Solitay bone plasmocytoma (SBP) account for just 5–10% of all plasma cell neoplasms. They are infrequent in the cervical spine, especially involving the C0–C2 segment. In this article we conducted a literature review and present the diagnosis, management and long term course of two patients with SBP of C2 causing cervical instability.</jats:p> </jats:sec> <jats:sec id="st2"> <jats:title>Methods: </jats:title> <jats:p>We assessed the clinical records of two patients with SBP in C2 and cervical instability attributed to SP-B involving C2. Both patients presented with progressive, severe cervicalgia, and the “sensation” of skull instability. Magnetic resonance imaging revealed an extensive, infiltrative lesion involving C2 vertebral body and lateral masses, consistent with a plasmacytoma.</jats:p> </jats:sec> <jats:sec id="st3"> <jats:title>Results: </jats:title> <jats:p>Both patients underwent emergency posterior surgical stabilization with craniocervical fixation; this was accompanied by a C2 transpedicular biopsy. Postoperatively, patients exhibited no focal neurological deficits and rapidly became pain free. They additional recieved 25 sessions of local conventional radiation therapy. Both patients are doing well as respective 2 and 7-year follow-up.</jats:p> </jats:sec> <jats:sec id="st4"> <jats:title>Conclusion: </jats:title> <jats:p>Although rare, unstable SBP may present atypical cervical location that readily responds to surgical descompression/fusion and radiotherapy.</jats:p> </jats:sec>
    Scopus© Citations 2  1