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[PMID]:29437059
[Au] Autor:Petrie MJ; Blakey CM; Chadwick C; Davies HG; Blundell CM; Davies MB
[Ad] Endereço:Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
[Ti] Título:A new and reliable classification system for fractures of the navicular and associated injuries to the midfoot.
[So] Source:Bone Joint J;100-B(2):176-182, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Fractures of the navicular can occur in isolation but, owing to the intimate anatomical and biomechanical relationships, are often associated with other injuries to the neighbouring bones and joints in the foot. As a result, they can lead to long-term morbidity and poor function. Our aim in this study was to identify patterns of injury in a new classification system of traumatic fractures of the navicular, with consideration being given to the commonly associated injuries to the midfoot. PATIENTS AND METHODS: We undertook a retrospective review of 285 consecutive patients presenting over an eight- year period with a fracture of the navicular. Five common patterns of injury were identified and classified according to the radiological features. Type 1 fractures are dorsal avulsion injuries related to the capsule of the talonavicular joint. Type 2 fractures are isolated avulsion injuries to the tuberosity of the navicular. Type 3 fractures are a variant of tarsometatarsal fracture/dislocations creating instability of the medial ray. Type 4 fractures involve the body of the navicular with no associated injury to the lateral column and type 5 fractures occur in conjunction with disruption of the midtarsal joint with crushing of the medial or lateral, or both, columns of the foot. RESULTS: In order to test the reliability and reproducibility of this new classification, a cohort of 30 patients with a fracture of the navicular were classified by six independent assessors at two separate times, six months apart. Interobserver reliability and intraobserver reproducibility both had substantial agreement, with kappa values of 0.80 and 0.72, respectively. CONCLUSION: We propose a logical, all-inclusive, and mutually exclusive classification system for fractures of the navicular that gives associated injuries involving the lateral column due consideration. We have shown that this system is reliable and reproducible and have described the rationale for the subsequent treatment of each type. Cite this article: 2018;100-B:176-82.
[Mh] Termos MeSH primário: Traumatismos do Pé/classificação
Fraturas Ósseas/classificação
Ossos do Tarso/lesões
[Mh] Termos MeSH secundário: Traumatismos do Pé/diagnóstico por imagem
Fraturas Ósseas/diagnóstico por imagem
Seres Humanos
Reprodutibilidade dos Testes
Estudos Retrospectivos
Ossos do Tarso/diagnóstico por imagem
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0879.R1


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[PMID]:28470459
[Au] Autor:Smolen C; Quenneville CE
[Ad] Endereço:Department of Mechanical Engineering, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L7, Canada.
[Ti] Título:A Finite Element Model of the Foot/Ankle to Evaluate Injury Risk in Various Postures.
[So] Source:Ann Biomed Eng;45(8):1993-2008, 2017 08.
[Is] ISSN:1573-9686
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The foot/ankle complex is frequently injured in many types of debilitating events, such as car crashes. Numerical models used to assess injury risk are typically minimally validated and do not account for ankle posture variations that frequently occur during these events. The purpose of this study was to evaluate a finite element model of the foot and ankle accounting for these positional changes. A model was constructed from computed tomography scans of a male cadaveric lower leg and was evaluated by comparing simulated bone positions and strain responses to experimental results at five postures in which fractures are commonly reported. The bone positions showed agreement typically within 6° or less in all anatomical directions, and strain matching was consistent with the range of errors observed in similar studies (typically within 50% of the average strains). Fracture thresholds and locations in each posture were also estimated to be similar to those reported in the literature (ranging from 6.3 kN in the neutral posture to 3.9 kN in combined eversion and external rotation). The least vulnerable posture was neutral, and all other postures had lower fracture thresholds, indicating that examination of the fracture threshold of the lower limb in the neutral posture alone may be an underestimation. This work presents an important step forward in the modeling of lower limb injury risk in altered ankle postures. Potential clinical applications of the model include the development of postural guidelines to minimize injury, as well as the evaluation of new protective systems.
[Mh] Termos MeSH primário: Fraturas do Tornozelo/fisiopatologia
Traumatismos do Pé/fisiopatologia
Modelos Biológicos
Postura
Medição de Risco/métodos
Ossos do Tarso/lesões
Ossos do Tarso/fisiopatologia
[Mh] Termos MeSH secundário: Cadáver
Força Compressiva
Simulação por Computador
Módulo de Elasticidade
Análise de Elementos Finitos
Seres Humanos
Masculino
Meia-Idade
Amplitude de Movimento Articular
Estresse Mecânico
Resistência à Tração
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s10439-017-1844-2


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[PMID]:29209416
[Au] Autor:Pritchard NS; Smoliga JM; Nguyen AD; Branscomb MC; Sinacore DR; Taylor JB; Ford KR
[Ad] Endereço:Department of Physical Therapy, High Point University, High Point, NC USA.
[Ti] Título:Reliability of analysis of the bone mineral density of the second and fifth metatarsals using dual-energy x-ray absorptiometry (DXA).
[So] Source:J Foot Ankle Res;10:52, 2017.
[Is] ISSN:1757-1146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: Metatarsal fractures, especially of the fifth metatarsal, are common injuries of the foot in a young athletic population, but the risk factors for this injury are not well understood. Dual-energy x-ray absorptiometry (DXA) provides reliable measures of regional bone mineral density to predict fracture risk in the hip and lumbar spine. Recently, sub-regional metatarsal reliability was established in fresh cadaveric specimens and associated with ultimate fracture force. The purpose of this study was to assess the reliability of DXA bone mineral density measurements of sub-regions of the second and fifth metatarsals in a young, active population. Methods: Thirty two recreationally active individuals participated in the study, and the bone density of the second (2MT) and fifth (5MT) metatarsals of each subject was measured using a Hologic QDR x-ray bone densitometer. Scans were analyzed separately by two raters, and regional bone mineral density, bone mineral content, and area measurements were calculated for the proximal, shaft, and distal regions of the bone. Intra-rater, inter-rater, and scan-rescan reliability were then determined for each region. Results: Proximal and shaft bone mineral density measurements of the second and fifth metatarsal were reliable. ICC's were variable across regions and metatarsals, with the distal region being the poorest. Conclusions: Bone mineral density measurements of the metatarsals may be a better indicator of fracture risk of the metatarsals than whole body measurements. A reliable method for measuring the regional bone mineral densities of the metatarsals was found. However, inter-rater reliability and scan-rescan reliability for the distal regions were poor. Future research should examine the relationship between DXA bone mineral density measurements and fracture risk at the metatarsals.
[Mh] Termos MeSH primário: Absorciometria de Fóton/métodos
Densidade Óssea/fisiologia
/diagnóstico por imagem
Ossos do Metatarso/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
/patologia
Traumatismos do Pé/diagnóstico por imagem
Fraturas Ósseas/diagnóstico por imagem
Fraturas de Estresse
Seres Humanos
Masculino
Ossos do Metatarso/metabolismo
Ossos do Metatarso/patologia
Reprodutibilidade dos Testes
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1186/s13047-017-0234-1


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[PMID]:28452830
[Au] Autor:Janssen L; Allard NAE; Ten Haaf DSM; van Romburgh CPP; Eijsvogels TMH; Hopman MTE
[Ti] Título:First-Aid Treatment for Friction Blisters: "Walking Into the Right Direction?"
[So] Source:Clin J Sport Med;28(1):37-42, 2018 Jan.
[Is] ISSN:1536-3724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Blisters are common foot injuries during and after prolonged walking. However, the best treatment remains unclear. The aim of the study was to compare the effect of 2 different friction blister treatment regimens, wide area fixation dressing versus adhesive tape. DESIGN: A prospective observational cohort study. SETTING: The 2015 Nijmegen Four Days Marches in the Netherlands. PARTICIPANTS: A total of 2907 participants (45 ± 16 years, 52% men) were included and received 4131 blister treatments. INTERVENTIONS: Blisters were treated with either a wide area fixation dressing or adhesive tape. MAIN OUTCOME MEASURES: Time of treatment application was our primary outcome. In addition, effectiveness and satisfaction were evaluated in a subgroup (n = 254). During a 1-month follow-up period, blister healing, infection and the need for additional medical treatment were assessed in the subgroup. RESULTS: Time of treatment application was lower (41.5 minutes; SD = 21.6 minutes) in the wide area fixation dressing group compared with the adhesive tape group (43.4 minutes; SD = 25.5 minutes; P = 0.02). Furthermore, the wide area fixation dressing group demonstrated a significantly higher drop-out rate (11.7% vs 4.0%, P = 0.048), delayed blister healing (51.9% vs 35.3%, P = 0.02), and a trend toward lower satisfaction (P = 0.054) when compared with the adhesive tape group. CONCLUSIONS: Wide area fixation dressing decreased time of treatment application by 2 minutes (4.5%) when compared with adhesive tape. However, because of lower effectiveness and a trend toward lower satisfaction, we do not recommend the use of wide area fixation dressing over adhesive tape in routine first-aid treatment for friction blisters.
[Mh] Termos MeSH primário: Fita Atlética
Bandagens
Vesícula/terapia
Traumatismos do Pé/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Primeiros Socorros
Fricção
Seres Humanos
Masculino
Meia-Idade
Países Baixos
Estudos Prospectivos
Caminhada/lesões
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/JSM.0000000000000424


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[PMID]:29280881
[Au] Autor:Colen LB
[Ad] Endereço:Norfolk, Virginia From the Division of Plastic and Reconstructive Surgery, Eastern Virginia Medical School.
[Ti] Título:Discussion: Reconstruction of the Heel, Middle Foot Sole, and Plantar Forefoot with the Medial Plantar Artery Perforator Flap: Clinical Experience with 28 Cases.
[So] Source:Plast Reconstr Surg;141(1):209-210, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Calcanhar/cirurgia
Retalho Perfurante/cirurgia
[Mh] Termos MeSH secundário: /irrigação sanguínea
Traumatismos do Pé/cirurgia
Seres Humanos
Procedimentos Cirúrgicos Reconstrutivos
Retalhos Cirúrgicos/irrigação sanguínea
Artérias da Tíbia/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003991


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[PMID]:28801039
[Au] Autor:Alhamdani M; Kelly C
[Ad] Endereço:Department of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, 506 6th Street, Brooklyn, NY 11215, United States. Electronic address: Dr.mazin_alhamdani@hotmail.com.
[Ti] Título:Kohler's disease presenting as acute foot injury.
[So] Source:Am J Emerg Med;35(11):1787.e5-1787.e6, 2017 Nov.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Kohler's disease is rare cause of foot pain and limping in the pediatric population. The exact etiology of Kohler's disease is unknown. It usually presents as sudden and unexplained foot pain and limping. We report a case of a 5-year-old male who presented to the Pediatric Emergency Department with foot pain and inability to bear weight for two days after overactivity and acute foot injury. The patient was eventually diagnosed with Kohler's disease (avascular necrosis of the navicular bone). Although Kohler's disease is not very common, it should be considered in the differential diagnosis of foot pain in the pediatric population, as it may prevent unnecessary tests and treatments.
[Mh] Termos MeSH primário: Osteocondrose/diagnóstico por imagem
Osteonecrose/diagnóstico por imagem
Ossos do Tarso/diagnóstico por imagem
[Mh] Termos MeSH secundário: Pré-Escolar
Diagnóstico Diferencial
Traumatismos do Pé/diagnóstico
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170813
[St] Status:MEDLINE


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[PMID]:28577785
[Au] Autor:Yeoh JC; Taylor BA
[Ad] Endereço:Campbell Clinic Foot & Ankle Department, 1400 South Germantown Road, Germantown, TN 38138, USA.
[Ti] Título:Osseous Healing in Foot and Ankle Surgery with Autograft, Allograft, and Other Orthobiologics.
[So] Source:Orthop Clin North Am;48(3):359-369, 2017 Jul.
[Is] ISSN:1558-1373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In the surgical treatment of foot and ankle abnormality, many problems require bone grafting for successful osseous union. Nonunion, reconstruction, and arthrodesis procedures pose specific challenges due to bony defects secondary to trauma, malunions, or previous surgery. Nonunion in foot and ankle arthrodesis is a significant risk and is well documented in recent literature. This article is a review of the recent literature regarding the use of bone graft and orthobiologics in foot and ankle surgery.
[Mh] Termos MeSH primário: Traumatismos do Tornozelo
Terapia Biológica/métodos
Transplante Ósseo/métodos
Traumatismos do Pé
[Mh] Termos MeSH secundário: Traumatismos do Tornozelo/complicações
Traumatismos do Tornozelo/fisiopatologia
Traumatismos do Tornozelo/terapia
Deformidades Adquiridas do Pé/etiologia
Deformidades Adquiridas do Pé/fisiopatologia
Deformidades Adquiridas do Pé/terapia
Traumatismos do Pé/complicações
Traumatismos do Pé/fisiopatologia
Traumatismos do Pé/terapia
Consolidação da Fratura/fisiologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE


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[PMID]:28514214
[Au] Autor:Linklater JM; Hayter CL; Vu D
[Ad] Endereço:From Castlereagh Imaging, 60 Pacific Hwy, St Leonards, Sydney, NSW, Australia 2065 (J.M.L., C.L.H.); and Department of Anatomy, School of Medical Science, University of Notre-Dame Australia, Sydney, Australia (D.V.).
[Ti] Título:Imaging of Acute Capsuloligamentous Sports Injuries in the Ankle and Foot: Sports Imaging Series.
[So] Source:Radiology;283(3):644-662, 2017 Jun.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ankle and foot are commonly injured during sporting activities. Clinical diagnosis can at times be challenging, due to the complex anatomy and multiple sites of potential injury. In the athlete, there is a reduced threshold for imaging to clarify diagnosis, guide prognosis, and treatment. Diagnostic imaging is also helpful in evaluating ongoing symptoms in the subacute or chronic setting. RSNA, 2017.
[Mh] Termos MeSH primário: Traumatismos do Tornozelo/diagnóstico por imagem
Traumatismos em Atletas/diagnóstico por imagem
Traumatismos do Pé/diagnóstico por imagem
Cápsula Articular/diagnóstico por imagem
Cápsula Articular/lesões
Ligamentos Articulares/diagnóstico por imagem
Ligamentos Articulares/lesões
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017152442


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[PMID]:28482680
[Au] Autor:Watson GI; Karnovsky SC; Konin G; Drakos MC
[Ad] Endereço:1 Vanderbilt University Medical Center, Franklin, TN, USA.
[Ti] Título:Optimal Starting Point for Fifth Metatarsal Zone II Fractures: A Cadaveric Study.
[So] Source:Foot Ankle Int;38(7):802-807, 2017 Jul.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally accepted starting point for the fifth metatarsal is "high and inside" to accommodate the fifth metatarsal's dorsal apex and medial curvature. We used a retrograde technique to identify the optimal starting position for intramedullary fixation of fifth metatarsal fractures. METHODS: Five matched cadaveric lower extremity pairs were dissected to the fifth metatarsal neck. An osteotomy was made to access the intramedullary canal. A retrograde reamer was passed to the base of the fifth metatarsal to ascertain the ideal entry point. Distances from each major structure on the lateral aspect of the foot were measured. Computed tomography scans helped assess base edge measurements. RESULTS: In 6 of 10 specimens, the retrograde reamer hit the cuboid with a cuboid invasion averaging 0.7 mm. The peroneus brevis and longus were closest to the starting position with an average distance of 5.1 mm and 5.7 mm, respectively. Distances from the entry point to the dorsal, plantar, medial, and lateral edges of the metatarsal base were 8.3 mm, 6.9 mm, 9.7 mm, and 9.7 mm, respectively. CONCLUSION: Optimal starting position was found to be essentially at the center of the base of the fifth metatarsal at the lateral margin of the cartilage. Osteoplasty of the cuboid or forefoot adduction may be required to gain access to this site. CLINICAL RELEVANCE: This study evaluated the ideal starting position for screw placement of zone II base of the fifth metatarsal fractures, which should be considered when performing internal fixation for these fractures.
[Mh] Termos MeSH primário: Traumatismos do Pé/cirurgia
Fraturas Ósseas/cirurgia
Ossos do Metatarso/cirurgia
Tíbia/fisiologia
[Mh] Termos MeSH secundário: Traumatismos do Tornozelo/complicações
Parafusos Ósseos/efeitos adversos
Fixação Interna de Fraturas/efeitos adversos
Seres Humanos
Músculo Esquelético/fisiologia
Ossos do Tarso/fisiologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717702688


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[PMID]:28358780
[Au] Autor:Sullivan E; Hudson J
[Ad] Endereço:Erin Sullivan, CPNP, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, Massachusetts General Hospital for Children, Boston. Jeremy Hudson, MSPT, Sollus Therapeutics LLC, 137 Newbury Street, Boston, MA.
[Ti] Título:The Cure That Lies Within: The Mind-Body Connection in Orthopaedics.
[So] Source:Orthop Nurs;36(2):153-158, 2017 Mar/Apr.
[Is] ISSN:1542-538X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The mind and the body are clearly intertwined in ways that are only now being discovered. In the orthopaedic world, injuries and diseases are often classified and described in a very organized, discrete fashion-The radius is fractured, the ACL or meniscus or rotator cuff is torn, the ankle is sprained, and/or the lumbar spine has a disc herniation. Although it is, in many ways, almost comforting to think about injuries or orthopaedic issues in this manner, what about the many patients who fail to fall into this classification? What about the thousands of patients with severe unexplained chronic pain or patients who just are not improving with the typical treatment algorithm. What about patients who present with multiple overlapping symptoms that do not fall into any of the classic diagnosis patterns? The mismatch between the actual health needs of typical patients and the standard acute medical response produces an immense waste of medical resources and incredible frustration for both the patient and the provider and creates a real risk that acute conditions will go untreated and become chronic. After more than a decade of traditional orthopaedic and musculoskeletal practice, its tremendous benefits as well as its limitations have become apparent. These limitations have sparked a search for integration of mind-body considerations to fill some of these gaps. Although this can prove to be quite challenging in today's healthcare world of maximizing volume and decreasing costs, it has proven to be an invaluable resource for both personal growth and patient and family satisfaction. The goals of this 2-part article are to dissect the relatively new concept of the mind-body connection in orthopaedics. The article aims to provide a framework that illustrates how the mind will predictably create objective observable phenomena in the body. The central focus of this framework is the role of the sympathetic nervous system and its effect on the chemistry, biomechanics, and appearance of various tissues in the body. Further identified are factors contributing to the aberrant emotional response as a means to empower practitioners and patients in recognizing the link between negative perception and observable symptoms. Our hope is to ultimately introduce a model of empowerment that when presented to a patient/family can produce a proactive response and, in turn, enhance current orthopaedic and pain management practices.
[Mh] Termos MeSH primário: Traumatismos do Pé/terapia
Psicofisiologia/métodos
Estresse Psicológico/prevenção & controle
[Mh] Termos MeSH secundário: Criança
Feminino
Traumatismos do Pé/diagnóstico
Seres Humanos
Ortopedia
Manejo da Dor/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170331
[St] Status:MEDLINE
[do] DOI:10.1097/NOR.0000000000000330



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