bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Based Supervision of Banks – Framework for Risk Assessment
Authors: Vallabh Gourav 
Published: March 2013

With progressive deregulation and liberalization of the Indian financial sector, banks are increasingly exposed to various kinds of risk, both financial and non-financial. Efficiency of every bank depends on how effectively it is managing the risks and ensuring a competitive risk adjusted return on capital. For this, it is essential to have in place effective risk management and internal control systems, which are crucial to the conduct of banking business not only to lead the bank more profitably but also in compliance of prudential guidelines. In addition, a supervisor i. e. Reserve Bank of India (RBI) also looks upon the systems and practices in banks in assessing, managing and controlling risks through Risk Based Supervision (RBS), wherein the supervisory resources are directed towards the areas of greater risk to the supervisory objectives which aim at protecting the interest of depositors, stability of the banking system and development of banks as agents of economic growth. Under the RBS approach, the supervisory process would also seek to leverage the work done by internal auditors/inspectors in banks. In this regard, in August 2001, RBI had brought out a discussion paper on “Move Towards Risk-Based Supervision of Banks” in which five significant areas have been identified for action on the part of banks and Risk-Based Internal Audit (RBIA) system is one of them. This paper focuses discussion on RBIA. In this paper, it is attempted to develop the framework for risk assessment as part of RBIA. The suggested framework is easy to understand and based on the on-site audit conducted by the internal auditor/inspector. Since banks are currently busy in preparatory work relating to switch over from internal audit/inspection to RBIA, the suggested framework is lot of relevance. Researchers in Audit and Inspection may like to refine the suggested framework.
Plantar Fascial Spaces of the Foot and a Proposed Surgical Approach
Authors: Loeffler Robert D. , Ballard Anthony 
Published: March 2013

This study identified five plantar fascial spaces of the foot. The first space lies superficial to the calcaneus, the second lies between the plantar aponeurosis and the flexor digitorum brevis, the third lies between the flexor digitorum brevis and the quadratus plantae, the fourth lies above the quadratus, and the fifth lies above the adductor hallucis. A plantar incision is proposed for exploration and drainage of foot injuries and infections. With this incision, the plantar neurovascular bundles, along with the five plantar spaces through which infection spreads, are visualized clearly. In our experience, the incision heals without a sensitive scar.
Amputation of the Great Toe
Authors: Poppen Norman K. , Mann Roger A. , O'Konski Mark , Buncke Harry J. , Jahss Melvin H. 
Published: March 2013

Four patients who had undergone reimplantation of the great toe to create a thumb were studied. The follow-up period ranged from 29 to 62 months. In all cases, the great toe was disarticulated at the metatarsophalangeal joint. The patients felt their feet functioned at approximately 85% of normal, and none had any significant complaint of metatarsalgia. The one patient who participated in sports after the surgery noted that it was difficult to “push off” moving away from the involved foot. X-ray examination demonstrated retraction of the sesamoids, which accounted for the increased plantar flexion of the first metatarsal shaft. The second metatarsophalanageal joint drifted into varus an average of 8°. The Harris mat demonstrated that there was an increase in weightbearing beneath the second and third metatarsal heads. It appears as though, on the basis of this study, the loss of the great toe in this manner does not significantly affect the normal everyday function of an individual's foot.
Dwyer's Operation for the Rheumatoid Forefoot
Authors: MacClean Craig R. , Silver William A. 
Published: March 2013

In 1970, A. F. Dwyer described an operation for severe toe deformities with the objectives of creating a more stable foot and improving toe function, in addition to relieving pain. This was achieved by fusing the metatar-sophalangeal joint of the hallux and the proximal interphalangeal joints of the lateral four toes. The metatarsal heads of the second, third, fourth, and fifth rays were then resected with their respective extensor tendons interposed so as to provide a tenodesis effect. Our study presented in this paper consists of 36 consecutive procedures performed on 22 rheumatoid patients. Follow-up of 33 operations in the 20 patients who were available for recall averaged 42.2 months. Assessment emphasized a subjective report including patient satisfaction, relief of pain, ability to fit shoes, cosmetic result, and walking ability. Objective examination was used to evaluate the presence of a successful arthrodesis of the metatarsophalangeal joint of the great toe, the position of this arthrodesis, the presence of tender callosities, the attitude of the lateral four toes, and symmetry. Results were good or excellent in 76%, satisfactory in 12%, and poor in 12%.
Talonavicular Joint Surface Anatomy and Prototype Resurfacing Prostheses
Authors: Daniels A. U. , Samuelson K. M. , Rusin K. A. 
Published: March 2013

The curvature and extent of a joint surface largely determine the type and range of motion possible. The talonavicular surface anatomy of 10 human foot specimens has been determined quantitatively, and the data have been compared with the design parameters for a prototype prosthetic joint. It was found that, in general, the natural talus as compared with the navicular was slightly larger in surface area and in mean arc length, but slightly smaller in mean radius of curvature. The arc length of the joint was found to be generally slightly longer along an axis positioned from slightly medial of dorsal to slightly lateral of ventral. In contrast, no general orientation of the radius of curvature was observed. Also, it was found that the congruency between the talus and navicular surfaces, as indicated by corresponding radii of curvature, varied widely. In comparison to the human specimens, a previously designed prototype talonavicular prosthesis proved somewhat smaller in radius, arc length, and surface area. Experimental studies related to other prosthesis design parameters, besides type and range of motion, are in progress.
Documenting Your Patient with Photography in Office Practice
Authors: Watanabe Robert S. 
Published: March 2013

The basic requirements for the proper photographic documentation of the foot is a single lens reflex camera, electronic flash unit, and a closeup lens set. Preoperative photographs should be a routine part of the patient workup prior to any treatment or corrective surgery. Clinical photographs should be taken with the patient standing on a plain background and should include the front, side, and back views. The electronic flash unit gives a consistent light and is well balanced with daylight color film. Surgical photographs are best taken with a telephoto macro lens or a telephoto lens with a closeup attachment. An electronic flash unit provides a consistent light. The flash unit is utilized with the AC adapter in order to give a rapid recycling and a consistent light output. Any pathological specimen should be photographed immediately following the case. Excellent specimen photographs can be taken with the use of the electronic flash held at a 30° angle and a sheet of white paper on the opposite of the specimen to act as a reflector. The most important aspect of the photography is to standardize the procedures so that consistent results may be obtained.
Graphing the Adult Foot and Ankle
Authors: Gould Nathaniel 
Published: March 2013

When the patient appears in your office with foot and/or ankle complaints, what will be your standard routine X-rays for those areas and what information can you glean from your careful study of these films? What views portray the areas in question and what are suggestive pathognomonic signs? The author has attempted to outline some of the roentgenological approaches to diagnosis of ailments of the foot and ankle and to point out some of the clues that can be found with their interpretations. Many of the signs have, hitherto, not been recognized or are buried in the voluminous orthopaedic literature.
Development and Evolution of the ICLH Ankle Replacement
Authors: Samuelson Kent M. , Freeman Michael A. R. , Tuke Michael A. 
Published: March 2013

In 1972 the original ICLH ankle was first used clinically, and since then the authors have implanted 75 ICLH ankles. The overall percentage of acceptable results in this series is about 70%. The most frequent complication seen was delayed wound healing. Talomalleolar contact with resultant pain was a significant problem early in the series. Partial collapse of the talus has occurred in five ankles. Our experience has shown that it is possible to replace the ankle and initially achieve a functioning, pain-free arthroplasty. There are many factors that may adversely influence the ultimate outcome; and thus, the procedure should be approached with caution.
Objective Technique for Evaluating Painful Heel Syndrome and Its Treatment
Authors: Katoh Y. , Chao E. Y. S. , Morrey B. F. , Laughman R. K. 
Published: March 2013

The biomechanical evaluation of patients with painful heels has received only limited attention although the potential morbidity and disability associated with such an ailment can be severe. An objective analysis of the patient's foot function during gait can produce useful information to assess the underlying pathology. This method can also help to evaluate the efficacy of various existing treatment protocols. The impulse distribution based on foot-floor vertical reaction force and time under the hind-, mid-, and forefoot was determined in 32 normal subjects while walking in their usual street shoes. Variations related to shoe types were noted, with high heeled shoes causing the most significant deviations from normal. The same technique was applied to 13 painful heel syndrome patients. Characteristic deviations from the normal impulse distribution were noted in these patients which provided the basis for differentiating the pathological condition between the patients with painful heel pads and those with plantar fasciitis. The effectiveness of using heel cups as a therapeutic device was also assessed. Although significant gait changes were not associated with the insertion of heel cups, they did seem to shift the foot-floor impulse forward from the heel region, which made them effective in patients afflicted with localized heel pain, but not in those with plantar fasciitis.
Heel Pain—Operative Results
Authors: Baxter Donald E. , Thigpen C. Mark 
Published: March 2013

In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti qpinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated. Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.
Osteochondritis Dissecans of the Talus (Transchondral Fractures of the Talus): Review of the Literature and New Surgical Approach for Medial Dome Lesions
Authors: Flick A. B. , Gould Nathaniel 
Published: March 2013

A retrospective study of 22 ankles in 22 patients with osteochondral talar dome lesions between 1975 and 1983 has indicated that surgical treatment yields superior results to conservative therapy. Thirteen male and 9 female patients, ages 9 to 72 years, average age 28 years, showed 10 medial lesions (Berndt and Harty classification (stage I (one); stage II/III (nine)) and 12 lateral lesions (stage II/III (5), stage IV (7)). Examination follow-up on 19 patients (86%) has averaged 24 months. The initial diagnosis seen retrospectively on x-rays was missed 43% of the time by emergency room physicians. A history of trauma was verified in 100% of the lateral lesions and 80% of the medial talar dome lesions. Of the 22 ankles, 14 lesions were isolated injuries, while 8 had concomitant fractures, lateral ligament, or peroneal tendon damage. Surgical treatment consisted of removal of the osteochondral fragment, curettage, and drilling of its bed. Two distinct surgical approaches were utilized. Lateral dome lesions were approached through the standard anterolateral incision, while medial dome lesions were approached through the anterior tibial tendon sheath with grooving of the anteromedial distal tibia articular surface. The medial approach allowed the somewhat posteriorly placed medial lesions to be reached, negating the need for a medial malleolar osteotomy and postoperative immobilization. On follow-up, no untoward ankle arthrosis was noted as a result of the grooving of the anteromedial distal tibia. Nineteen of the 22 patients had surgical therapy with 79% excellent or good, 21% fair, and no poor results. Five of the eight patients who elected prolonged conservative therapy finally had surgery. Of the three remaining patients conservatively treated, there were two fair results and one poor result.
Biomechanical Characteristics of Human Ankle Ligaments
Authors: Attarian David E. , McCrackin Hugh J. , DeVito Dennis P. , McElhaney James H. , Garrett William E. 
Published: March 2013

The purpose of this study was to define the biomechanical characteristics of the isolated, individual bone-ligament-bone complexes of the human ankle. Twenty human ankles were dissected of all soft tissues to leave only the tibia, fibula, talus, and calcaneus with their intact anterior talofibular, calcaneofibular, posterior talofibular, and deep deltoid ligaments. Specimens were mounted and tested in a Minneapolis Testing System. Protocol consisted of cyclic loading of each isolated bone-ligament-bone preparation, followed by several constant velocity load-deflection tests at varying deflection rates, followed by a final, extremely rapid load to failure test. All ligaments exhibited nonlinearity and strain rate dependence in their load-deflection data. These properties were correlated with ligament function and trauma. The anterior talofibular ligament, the most commonly injured ankle ligament, had the lowest mean maximum load of the specimens tested, whereas the deep deltoid ligament, the least frequently completely disrupted ankle ligament, had the highest load to failure.
Foot and Ankle Injuries in Theatrical Dancers
Authors: Hardaker William T. , Margello Susan , Goldner J. Leonard 
Published: March 2013

The theatrical dancer is a unique combination of athlete and artist. The physical demands of dance class, rehearsal, and performance can lead to injury, particularly to the foot and ankle. Ankle sprains are the most common acute injury. Chronic injuries predominate and relate primarily to the repeated impact loading of the foot and ankle on the dance floor. Contributing factors include anatomic variation, improper technique, and fatigue. Early and aggressive conservative management is usually successful and surgery is rarely indicated. Orthotics play a limited but potentially useful role in treatment Following treatment, a structured rehabilitation program is fundamental to the successful return to dance.
Computerized Tomography of Talocalcaneal Tarsal Coalition: A Clinical and Anatomic Study
Authors: Herzenberg John E. , Goldner J. Leonard , Martinez Salutario , Silverman Paul M. 
Published: March 2013

Consistently accurate radiographic diagnosis of talocalcaneal tarsal coalitions is difficult because of the complex anatomy of the subtalar articulations. Standard techniques that include special radiographic views and plain tomography are useful but often inconclusive. In this study, computerized tomography (CT) was used to evaluate suspected talocalcaneal coalitions in patients with the clinical diagnosis of peroneal spastic flatfoot. CT demonstrated bony and nonbony coalitions in 14 of 22 patients studied. In the remaining eight patients, CT effectively ruled out the diagnosis of subtalar coalitions. If the coalition is obvious, CT will confirm it; if the clinical syndrome exists but standard radiographic procedures do not document the lesion, CT scan will be helpful in establishing a diagnosis. Anatomic studies of fresh cadaver feet compared CT, plain tomography, and plain radiographs for efficacy in visualizing the three subtalar facet joints. CT was superior to the other modalities for clearly identifying all aspects of the subtalar joint and talocalcaneal coalitions in patients and cadavers.
Fractures of the Base of the Fifth Metatarsal Distal to the Tuberosity: A Review
Authors: Lehman Richard C. , Torg Joseph S. , Pavlov Helene , DeLee Jesse C. 
Published: March 2013

Fractures of the proximal part of the fifth metatarsal can be separated into two types: (1) those involving the tuberosity, and (2) those involving the proximal part of the diaphysis distal to the tuberosity. Recently it has been recognized that the latter group, Jones' fractures, may be difficult to treat. Although reports in the literature have indicated the potential difficulties in the treatment of Jones' fractures, prevailing guidelines for their management are ambiguous. Apparently the varied clinical and roentgenographic manifestations of these fractures have not been correlated with their response to treatment. In this paper we describe a classification of these fractures and a plan of treatment based on clinical and roentgenographic criteria that were developed to define acute fractures, delayed unions, and nonunions. The treatment of choice for acute fractures is immobilization of the limb in a toe to knee cast with nonweightbearing. Fractures with delayed union may eventually heal if they are treated conservatively, but an active athlete with delayed union or an established nonunion will benefit from operative intervention. The procedures of choice are (1) medullary curettage and bone grafting, and (2) closed axial intramedullary screw fixation using a 4.0-mm ASIF malleolar screw.
Achilles Tendon Ruptures—Peroneus Brevis Transfer
Authors: Turco Vincent J. , Spinella Anthony J. 
Published: March 2013

Peroneus brevis tendon transfer has been utilized in 40 individuals during the last 13 years. All cases consisted of complete Achilles tendon ruptures. In 34 cases the rupture was in the distal one-third of the tendon substance, in four cases bony avulsion of the calcaneal tuberosity occurred, and in two cases there was a diffuse tear in the proximal two-thirds of the tendon near the musculotendinous junction. The middle-aged athlete sustained the majority of these injuries during sports. Eleven patients were less than 30 years old, 23 patients were 30 to 40 years old, and six were over 40 years old. Five patients had reruptures that involved prior nonoperative treatment of cast immobilization, and one had undergone simple direct suture. This repair has been used in acute, chronic, and recurrent ruptures of the tendoachillis. Thirty-three patients presented within 1 week of injury, and seven after more than 1 week. A. Perez Teuffer personally described the preferred technique in 1971 and subsequently published in 1978. The transfer of the peroneus brevis is combined with a direct end-to-end suture of the triceps surae tendon that allows a secure reconstruction with the foot at a right angle. The peroneus brevis tendon is detached from the base of the fifth metatarsal and then tunnelled through the distal Achilles tendon stump. The distal portion of the tendon transfer is then drawn proximally along the medial calcaneal tendon border. The proximal triceps surae tendon is pulled distally and secured to the peroneal tendon. The ruptured ends of the Achilles tendon are sandwiched between the U-shaped peroneal tendon transfer, which acts as a biologic scaffold for the reparitive process. Several advantages are apparent when compared to nonoperative care and other operative techniques including simple Achilles tendon repair, plantaris tendon transfers, reconstructive fascial flaps, and synthetic substitutes. A strong repair with the foot at the neutral position is possible even when the Achilles tendon is shredded. The transfer provides an active motor, adds some power to the damaged triceps, and avoids the danger of rerupture. No reruptures have occurred after this surgical procedure. Calf weakness is minimized because the proximal fragment of the damaged Achilles tendon is sutured securely under physiologic tension into the peroneus brevis. Immobilization postoperatively in a short leg cast at a right angle and early weightbearing facilitate the rehabilitation period and avoid the many months necessary to regain dorsiflexion after 6 to 8 weeks of casting in plantarflexion. The bulk and profile of the repaired Achilles tendon is restored. A healthy tendon transfer is an additional benefit. Strength after the peroneus brevis U-shaped tendon transfer is superior to other methods of treatment and is particularly advantageous in the sports-oriented individual.