جراحة العظام / علاج العظام في الاردن / افضل دكتور عظام في الاردن / افضل اخصائي عظام في الاردن / استشاري عظام/ افضل استشاري عظام في الاردن / عمليات تطويل العظام في الاردن / اطباء العظام في الاردن / دكتور عظام في الاردن / الاطباء في الاردن / خلع ورك / عمليات اليزاروف في الاردن /علاج الكسور / خلع الولادة / تركيب المفاصل الاصطناعيه للركبه والورك / اوجاع العظام / افضل طبيب عظام اطفال في الاردن / استشاري اطفال عظام في الاردن / علاج خلع الكتف / علاج التواء الكاحل / التواء الكاحل / علاج الام العظام / علاج هشاشة العظام / ارقام اطباء عظام في الاردن / مشاكل العظام والمفاصل /مستشار جراحة العظام والمفاصل والكسور / مستشار جراحة عظام الأطفال.

1. 11/07/14
Professor Freih Abuhassan - University of
Jordan 1

2. Freih Abu Hassan, F.R.C.S.(Tr & Orth.),
Akram Shannak, F.R.C.S (Orth.)
Mr. Frank McManus, F.R.C.S.I.
Professor Freih Abuhassan - University of
11/07/14 Jordan
2

3. * Originally designed by Butler in Cambridge,
* Described by Cockin in 1968.
Professor Freih Abuhassan - University of
11/07/14 Jordan
3

4. 1- The toe is small, hyper extended,
externally and medially rotated
2- Overlaps on the 4th toe.
3-The MTPJ is subluxed dorsomedialy.
Professor Freih Abuhassan - University of
11/07/14 Jordan
4

5. 4-The volar capsule adhered to the
head of the metatarsal.
5-The extensor tendon is short, and
displaced medially.
6-The 4th web space is contracted
Professor Freih Abuhassan - University of
11/07/14 Jordan
5

6. A- Cosmetic concern
B- Shoe wear problems
C- Pain due to friction bursitis 50%
D- Both
Professor Freih Abuhassan - University of
11/07/14 Jordan
6

7. PATIENTS
1980 - 2000
36 patients
48 Butler’s procedure
Professor Freih Abuhassan - University of
11/07/14 Jordan
7

8. Professor Freih Abuhassan - University of
11/07/14 Jordan
8

9. Professor Freih Abuhassan - University of
11/07/14 Jordan
9

10. Professor Freih Abuhassan - University of
11/07/14 Jordan
10

11. The assessments depends
1-overlapping.
2- rotation
3- scaring .
4- range of movement of the 5th toe.
Each foot was given a grade
excellent, good, or poor .
Professor Freih Abuhassan - University of
11/07/14 Jordan
11

12. An excellent result
1- absent overlap.
2-normal toe rotation, faint scar.
3- full range of movement.
Good results
1- mild overlap, mild rotation , slight scar.
2- subnormal movement.
Poor results
1- severe overlap, severe rotation , contracture in the scar,
or restricted movement
Professor Freih Abuhassan - University of
11/07/14 Jordan
12

13. Professor Freih Abuhassan - University of
11/07/14 Jordan
13

14. Professor Freih Abuhassan - University of
11/07/14 Jordan
14

15. 18 patients (22 feet, 59.46%)
graded good , their mean age 9.3 years.
11 patients (13 feet, 35.1%)
graded excellent ,their mean age 8.6 years.
1 patient with bilateral feet (5.4%)
graded poor due to recurrence.
Professor Freih Abuhassan - University of
11/07/14 Jordan
15

16. 7 patients (11 feet)
chart follow- up 1-2 Y.
satisfactory, straight toe, a symptomatic,
no deformity or scaring.
6 patients (10 feet)
graded good, their (mean age 8.53 years) one patient graded
poor due to recurrence in the first 6 M P.Op.
Professor Freih Abuhassan - University of
11/07/14 Jordan
16

17. 16
14
12
10
8
6
4
2
0
Age
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Consecutive feet
Good group
Excellent group
Poor group
Age at operation of different groups.
Professor Freih Abuhassan - University of
11/07/14 Jordan
17

18. 16
14
12
10
8
6
4
2
0
Age
Chart follow up feet
1 2 3 4 5 6 7 8 9 10
Feet
Good group
Poor group
Professor Freih Abuhassan - University of
11/07/14 Jordan
18

19. Good
67%
Excellent
27%
Poor
6%
Excellent
Good
Poor
Outcome of all feet
Professor Freih Abuhassan - University of
11/07/14 Jordan
19

20. 1-A useful surgical technique
2-A significant high rate of success
3- Safe, very effective for all age group.
4- No serious complications.
Professor Freih Abuhassan - University of
11/07/14 Jordan
20

21. 11/07/14
Professor Freih Abuhassan - University of
Jordan 21