Type of study: prospective study. Objective: Demonstration the role of combined bony procedures using triple arthrodesis and soft tissue procedures in correction of cavus foot deformity in adults. Background: Rigid cavus deformity is a complex foot deformity which has different forms and results from different aetiologies. Triple arthrodesis is considered as a golden standard for treatment of such deformities. Combined bony and soft tissue procedures are needed for correction of deformity. Tendon transfer is important to restore the muscle balance around the foot. Patients and Methods: Between 2013 – 2015 fifteen feet with rigid cavus deformity were corrected surgically with Ryerson's triple arthrodesis (five feet) or Lambrinudi triple arthrodesis (10 feet) combined with tibialis posterior tendon or long toes flexor tendons transfer to the dorsum of the foot. Follow up period ranged from 20 to 47 months (mean 32.17 ± 7.62). All patients were assessed clinically and radiologically for determination of the amount of correction. The outcome was graded according to criteria of Angus and Cowell. Results: the outcome was good in two feet, fair in eleven feet and poor in two feet. The correction in the hindfoot alignment and in the range of ankle joint motion was significant. The correction in the radiological parameter was statistically insignificant. Conclusions: Successful treatment of rigid cavus foot deformity requires comprehensive understanding of the nature of the deformity and its pathology. Adding tendon transfer to the corrective bony procedure is mandatory to restore the muscle balance around the foot and to prevent the recurrence.

Background: Cavus foot is one of complex foot deformity. The hindfoot may be in neutral, valgus or varus position. In sagittal plane it may in equinus, neutral or calcaneal position. The forefoot may be pronated or supinated. It has wide variety of etiology. Type of Study: retrospective study. Patient and methods: 20 feet in 15 patients were operated in 2008, in Heidelberg University hospital, Germany. The pre- and post- operative radiographs were reviewed. The patients were called backed for clinical evaluation. AOFAS of the ankle and hindfoot scale and the function index were used for post –operative evaluation. Results : In lateral pre-operative radiographs, the mean values of talo-1st metatarsal angle was 13.12°, calcaneal pitch was 21.75°, tibial-calcaneal angle was 69.14°, talo-calcaneal angle was 51.70° and the calcaneo-1st metatarsal angle was 58.72°. In dorso-plantar pre-operative radiographs, the mean values of talo-1st metatarsal angle was 32.51°, forefoot adductus angle was 41.73° and talo-calcaneal angle was 13.67°. In lateral post-operative radiographs, the mean values of talo-1st metatarsal angle was -7,92°, calcaneal pitch was 12.35°, tibial-calcaneal angle was 73.78°, talo-calcaneal angle was 40° and the calcaneo-1st metatarsal angle was 29.67°. In dorso-plantar post-operative radiographs, the mean values of talo-1st metatarsal angle was 5.67°, forefoot adductus angle was 16.01° and talo-calcaneal angle was 17.60°. The average of AOFAS was 77.67, while the average foot function index was 20.62. Conclusion: The correction of foot deformity is not only correction of foot form but also restoration of foot function. Restoration of soft tissue balance, which is achieved with planned tendon transfer, is essential for patient satisfaction.

Background: Cavus foot is one of complex foot deformity. The hindfoot may be in neutral, valgus or varus position. In sagittal plane it may in equinus, neutral or calcaneal position. The forefoot may be pronated or supinated. It has wide variety of etiology. Type of Study: retrospective study. Patient and methods: 20 feet in 15 patients were operated in 2008, in Heidelberg University hospital, Germany. The pre- and post- operative radiographs were reviewed. The patients were called backed for clinical evaluation. AOFAS of the ankle and hindfoot scale and the function index were used for post –operative evaluation. Results : In lateral pre-operative radiographs, the mean values of talo-1st metatarsal angle was 13.12°, calcaneal pitch was 21.75°, tibial-calcaneal angle was 69.14°, talo-calcaneal angle was 51.70° and the calcaneo-1st metatarsal angle was 58.72°. In dorso-plantar pre-operative radiographs, the mean values of talo-1st metatarsal angle was 32.51°, forefoot adductus angle was 41.73° and talo-calcaneal angle was 13.67°. In lateral post-operative radiographs, the mean values of talo-1st metatarsal angle was -7,92°, calcaneal pitch was 12.35°, tibial-calcaneal angle was 73.78°, talo-calcaneal angle was 40° and the calcaneo-1st metatarsal angle was 29.67°. In dorso-plantar post-operative radiographs, the mean values of talo-1st metatarsal angle was 5.67°, forefoot adductus angle was 16.01° and talo-calcaneal angle was 17.60°. The average of AOFAS was 77.67, while the average foot function index was 20.62. Conclusion: The correction of foot deformity is not only correction of foot form but also restoration of foot function. Restoration of soft tissue balance, which is achieved with planned tendon transfer, is essential for patient satisfaction.

Background: Cavus foot is one of complex foot deformity. The hindfoot may be in neutral, valgus or varus position. In sagittal plane it may in equinus, neutral or calcaneal position. The forefoot may be pronated or supinated. It has wide variety of etiology. Type of Study: retrospective study. Patient and methods: 20 feet in 15 patients were operated in 2008, in Heidelberg University hospital, Germany. The pre- and post- operative radiographs were reviewed. The patients were called backed for clinical evaluation. AOFAS of the ankle and hindfoot scale and the function index were used for post –operative evaluation. Results : In lateral pre-operative radiographs, the mean values of talo-1st metatarsal angle was 13.12°, calcaneal pitch was 21.75°, tibial-calcaneal angle was 69.14°, talo-calcaneal angle was 51.70° and the calcaneo-1st metatarsal angle was 58.72°. In dorso-plantar pre-operative radiographs, the mean values of talo-1st metatarsal angle was 32.51°, forefoot adductus angle was 41.73° and talo-calcaneal angle was 13.67°. In lateral post-operative radiographs, the mean values of talo-1st metatarsal angle was -7,92°, calcaneal pitch was 12.35°, tibial-calcaneal angle was 73.78°, talo-calcaneal angle was 40° and the calcaneo-1st metatarsal angle was 29.67°. In dorso-plantar post-operative radiographs, the mean values of talo-1st metatarsal angle was 5.67°, forefoot adductus angle was 16.01° and talo-calcaneal angle was 17.60°. The average of AOFAS was 77.67, while the average foot function index was 20.62. Conclusion: The correction of foot deformity is not only correction of foot form but also restoration of foot function. Restoration of soft tissue balance, which is achieved with planned tendon transfer, is essential for patient satisfaction.

Background: Cavus foot is one of complex foot deformity. The hindfoot may be in neutral, valgus or varus position. In sagittal plane it may in equinus, neutral or calcaneal position. The forefoot may be pronated or supinated. It has wide variety of etiology. Type of Study: retrospective study. Patient and methods: 20 feet in 15 patients were operated in 2008, in Heidelberg University hospital, Germany. The pre- and post- operative radiographs were reviewed. The patients were called backed for clinical evaluation. AOFAS of the ankle and hindfoot scale and the function index were used for post –operative evaluation. Results : In lateral pre-operative radiographs, the mean values of talo-1st metatarsal angle was 13.12°, calcaneal pitch was 21.75°, tibial-calcaneal angle was 69.14°, talo-calcaneal angle was 51.70° and the calcaneo-1st metatarsal angle was 58.72°. In dorso-plantar pre-operative radiographs, the mean values of talo-1st metatarsal angle was 32.51°, forefoot adductus angle was 41.73° and talo-calcaneal angle was 13.67°. In lateral post-operative radiographs, the mean values of talo-1st metatarsal angle was -7,92°, calcaneal pitch was 12.35°, tibial-calcaneal angle was 73.78°, talo-calcaneal angle was 40° and the calcaneo-1st metatarsal angle was 29.67°. In dorso-plantar post-operative radiographs, the mean values of talo-1st metatarsal angle was 5.67°, forefoot adductus angle was 16.01° and talo-calcaneal angle was 17.60°. The average of AOFAS was 77.67, while the average foot function index was 20.62. Conclusion: The correction of foot deformity is not only correction of foot form but also restoration of foot function. Restoration of soft tissue balance, which is achieved with planned tendon transfer, is essential for patient satisfaction.

Insect can be used as alternative specimens for toxicological analysis when conventional post-mortem samples are not available as drugs that can be detected in severely decomposed tissues of a corpse may still be found in the insects that did feed on the corpse. Several studies illustrate the great potential importance of entomotoxicology for providing additional information on cause of death. This study was aimed to study the effect of intoxication with codeine phosphate in decomposed bodies on the development of carrion flies and on the evaluation of postmortem interval (PMI). The experiment was performed during summer season from last of June to the mid of July. Four rabbits, two control and two injected with lethal dose of codeine phosphate were used. Each one was placed in a cardboard box, floored with muddy soil and protected with a metal cage. Different developmental stages of Chrysomya albiceps were collected and studied for both biological and morphological changes using dissecting light microscopy. There were morphological changes in the form of disfiguring of segments, loss of colouration and abnormalities in the shape of both anterior and posterior spiracles in the larvae, while the adult flies show rudimentary wings, abnormal bands on the undersurface of the abdomen, fading of normal colour to complete loss of it. Also th were biological changes in the form of acceleration in the development during life cycle and incomplete emerge of some adult flies from their pupae in the injected group. These acceleration of development lead to bias in estimation of postmortem interval up to 24h when estimation based on larval development and 48h when estimation based on pupal development. This work should provide data for the use of morphological and biological changes that occur in Chysomya albiceps as indicator for death from lethal dose of codeine phosphate and to estimate the post mortem interval.

Insect can be used as alternative specimens for toxicological analysis when conventional post-mortem samples are not available as drugs that can be detected in severely decomposed tissues of a corpse may still be found in the insects that did feed on the corpse. Several studies illustrate the great potential importance of entomotoxicology for providing additional information on cause of death. This study was aimed to study the effect of intoxication with codeine phosphate in decomposed bodies on the development of carrion flies and on the evaluation of postmortem interval (PMI). The experiment was performed during summer season from last of June to the mid of July. Four rabbits, two control and two injected with lethal dose of codeine phosphate were used. Each one was placed in a cardboard box, floored with muddy soil and protected with a metal cage. Different developmental stages of Chrysomya albiceps were collected and studied for both biological and morphological changes using dissecting light microscopy. There were morphological changes in the form of disfiguring of segments, loss of colouration and abnormalities in the shape of both anterior and posterior spiracles in the larvae, while the adult flies show rudimentary wings, abnormal bands on the undersurface of the abdomen, fading of normal colour to complete loss of it. Also th were biological changes in the form of acceleration in the development during life cycle and incomplete emerge of some adult flies from their pupae in the injected group. These acceleration of development lead to bias in estimation of postmortem interval up to 24h when estimation based on larval development and 48h when estimation based on pupal development. This work should provide data for the use of morphological and biological changes that occur in Chysomya albiceps as indicator for death from lethal dose of codeine phosphate and to estimate the post mortem interval.

Insect can be used as alternative specimens for toxicological analysis when conventional post-mortem samples are not available as drugs that can be detected in severely decomposed tissues of a corpse may still be found in the insects that did feed on the corpse. Several studies illustrate the great potential importance of entomotoxicology for providing additional information on cause of death. This study was aimed to study the effect of intoxication with codeine phosphate in decomposed bodies on the development of carrion flies and on the evaluation of postmortem interval (PMI). The experiment was performed during summer season from last of June to the mid of July. Four rabbits, two control and two injected with lethal dose of codeine phosphate were used. Each one was placed in a cardboard box, floored with muddy soil and protected with a metal cage. Different developmental stages of Chrysomya albiceps were collected and studied for both biological and morphological changes using dissecting light microscopy. There were morphological changes in the form of disfiguring of segments, loss of colouration and abnormalities in the shape of both anterior and posterior spiracles in the larvae, while the adult flies show rudimentary wings, abnormal bands on the undersurface of the abdomen, fading of normal colour to complete loss of it. Also th were biological changes in the form of acceleration in the development during life cycle and incomplete emerge of some adult flies from their pupae in the injected group. These acceleration of development lead to bias in estimation of postmortem interval up to 24h when estimation based on larval development and 48h when estimation based on pupal development. This work should provide data for the use of morphological and biological changes that occur in Chysomya albiceps as indicator for death from lethal dose of codeine phosphate and to estimate the post mortem interval.

Insect can be used as alternative specimens for toxicological analysis when conventional post-mortem samples are not available as drugs that can be detected in severely decomposed tissues of a corpse may still be found in the insects that did feed on the corpse. Several studies illustrate the great potential importance of entomotoxicology for providing additional information on cause of death. This study was aimed to study the effect of intoxication with codeine phosphate in decomposed bodies on the development of carrion flies and on the evaluation of postmortem interval (PMI). The experiment was performed during summer season from last of June to the mid of July. Four rabbits, two control and two injected with lethal dose of codeine phosphate were used. Each one was placed in a cardboard box, floored with muddy soil and protected with a metal cage. Different developmental stages of Chrysomya albiceps were collected and studied for both biological and morphological changes using dissecting light microscopy. There were morphological changes in the form of disfiguring of segments, loss of colouration and abnormalities in the shape of both anterior and posterior spiracles in the larvae, while the adult flies show rudimentary wings, abnormal bands on the undersurface of the abdomen, fading of normal colour to complete loss of it. Also th were biological changes in the form of acceleration in the development during life cycle and incomplete emerge of some adult flies from their pupae in the injected group. These acceleration of development lead to bias in estimation of postmortem interval up to 24h when estimation based on larval development and 48h when estimation based on pupal development. This work should provide data for the use of morphological and biological changes that occur in Chysomya albiceps as indicator for death from lethal dose of codeine phosphate and to estimate the post mortem interval.

Insect can be used as alternative specimens for toxicological analysis when conventional post-mortem samples are not available as drugs that can be detected in severely decomposed tissues of a corpse may still be found in the insects that did feed on the corpse. Several studies illustrate the great potential importance of entomotoxicology for providing additional information on cause of death. This study was aimed to study the effect of intoxication with codeine phosphate in decomposed bodies on the development of carrion flies and on the evaluation of postmortem interval (PMI). The experiment was performed during summer season from last of June to the mid of July. Four rabbits, two control and two injected with lethal dose of codeine phosphate were used. Each one was placed in a cardboard box, floored with muddy soil and protected with a metal cage. Different developmental stages of Chrysomya albiceps were collected and studied for both biological and morphological changes using dissecting light microscopy. There were morphological changes in the form of disfiguring of segments, loss of colouration and abnormalities in the shape of both anterior and posterior spiracles in the larvae, while the adult flies show rudimentary wings, abnormal bands on the undersurface of the abdomen, fading of normal colour to complete loss of it. Also th were biological changes in the form of acceleration in the development during life cycle and incomplete emerge of some adult flies from their pupae in the injected group. These acceleration of development lead to bias in estimation of postmortem interval up to 24h when estimation based on larval development and 48h when estimation based on pupal development. This work should provide data for the use of morphological and biological changes that occur in Chysomya albiceps as indicator for death from lethal dose of codeine phosphate and to estimate the post mortem interval.