Osteochondritides of the Foot - Lucy Dennell 4/3/2002
Sever's disease
Only 3 papers in Embase since 1988 and 8 in Medline since 1966, searching under" Sever's"
See attatched printout of two abstracts. The majority of the papers were overviews of the subject like the first paper.
The remaining papers were miscellaneous “ such as relationship to TaeKwon Do and to equinus deformity.
Kohler's disease “
described by Kohler 1908
Aetiology- described by Waugh
(JBJS 1958;40-B:765-777)“ noted to occur more commonly in late ossifying naviculars ? due to normal pressure on an unprotected ossifying nucleus
Only place for surgical treatment when presenting late - arthrodesis
Author
Gary A Williams + Henry Cowell
Title
Kohler's disease of the tarsal navicular
Reference
CORR (158):53-8,1981 Jul-Aug
Summary
23 pts w radiographic changes in the navicular, 20 true Kohlers; 16 M‚:4 F, 3 asymptomatic.
Onset 2-9 years ; 6 y 2months M : 4 y 6months F. Fifty percent had prior foot problems; toeing in or CCV.
Follow up average 91/2 years(2m-25 y). Findings; all asymptomatic w normal radiographic appearance of the navicular (8 minor faceting, no arthritis).
Acute management 11pts short leg cast/9 pts shoe correction, rest or NWB w crutches.
Cast group had 3.2 m of symptoms, non had 15.2 m of symptoms.Also found that cast for less than 8/52 prolonged symptoms by six weeks.
Critique
Case series, retrospective. Made the point that Kohler's is primarily a clinical diagnosis. A description of the natural history of Kohler's.
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