Slipped Capital Femoral Epiphysis: Causes, Symptoms And Treatment

by Administrator 19. February 2017 12:17

Slipped Capital Femoral Epiphysis or SCFE is a hip condition that mostly occurs in teenagers.  The hip is a ball and socket joint in which the head of the thigh bone fits into the socket of the large pelvic bone called acetabulum. The thigh bone grows along two growth plates (physis) that are found at each end of the femur. The growth head located at the upper end of the femur solidifies to become the femoral head and is also referred to as the epiphysis. In case of SCFE, this epiphysis gets displaced as the head of the thigh bone slips backwards. The condition may take some time to develop and is more prevalent in teenage boys. Timely diagnosis and appropriate treatment is necessary to prevent future complications like Hip Arthritis.

SCFE can be classified as follows:

  • Stable SCFE - The joint feels slightly unstable and the patient may be able to move around with some help
  • Unstable SCFE - The patient is unable to bear body weight even if walking aids such as a walker or crutches are used. This condition may also become a potential cause of Avascular Necrosis in the hip bone.

Causes

  • A sudden fall
  • Major trauma caused to the hip or pelvis joint
  • Hereditary factors
  • Being obese or over weight
  • Metabolic disorders such as hyperthyroidism
  • In some cases, a person may develop SCFE over a period of time even with no previous record of physical injury

Symptoms

  • Pain may be felt in the hip, groin, knee or thigh post injury
  • Stiffness
  • Unstable joint
  • Inability to bear body weight
  • In most cases, only one side of the hip joint is affected. However, in patients below the age of 10 years, the chances of both sides being affected are higher
  • The affected leg may appear shorter and turned outwards compared to the normal one
  • Change in gait
  • Physical activity may exaggerate the symptoms

Diagnosis

  • Medical history, family traits and symptoms may be taken into account
  • Detailed clinical evaluation may be required to check range of motion in the affected leg
  • The patient’s gait may be observed
  • X-ray imaging may be conducted to analyze bone structure and locate the femoral head

Treatment

The femoral head or epiphysis is stabilized through a surgical procedure in all cases. It may be carried out as follows:

  • In case of stable SCFE, in situ fixation is carried out by fixing the femoral head using a metal screw. As the growth plate grows and the screw gets fused within it
  • In case of unstable SCFE, a large incision is made in the hip joint and the displaced bone head is brought back to the correct anatomical position. It is held in place using two screws which eventually fuse within the joint
  • In cases where in the patient is likely to develop SCFE in the opposite hip as well, in situ fixation may be preformed to eliminate the risk
  • Physical therapy may be recommended post surgery
  • The patient may be advised to use crutches for a few weeks to allow the joint to heal
  • Regular follow ups and some repeat X-rays may be required to monitor the joint condition for 1-2 years after surgery

Visit the joint doctors at OrthoTexas for complete treatment of Slipped Capital Femoral Epiphysis and other disorders of the hip. To schedule an appointment with the orthopedic surgeons in Denton, TX, call at (940) 382-1577.

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Chronic Shoulder Instability: Orthopedic Denton

by Administrator 18. January 2017 18:40

The shoulder is one of the most mobile joints of the body which is made up of three main bones, the upper arm bone (humerus), shoulder blade (scapula) and collar bone (clavicle). However, the extensive range of motion of the joint makes it prone to injuries and instability. The upper end of the humerus fits into a cavity within the shoulder blade known as glenoid. It is held in place by strong ligament structures but an external trauma or overuse may push the humeral head out of the socket, leaving the joint unstable. Once it occurs, the shoulder tends to become susceptible to repeated incidences of injury. This condition is medically termed as Chronic Shoulder Instability. It may lead to partial or complete displacement of the humeral head.

Causes

  • Injury or trauma- A sudden injury to the shoulder or arm may push the humerus out of the glenoid. This occurs as a result of damage to the ligaments, tendons and cartilage structures that support the bones. Weak connective tissues make the joint prone to repeated episodes of instability
  • Bankart Lesion-  Damage to the cartilage lining between the humeral head and glenoid may make the shoulder unstable
  • Stress caused due to activities that require repeated overhead movement of the arm, such as swimming, playing tennis, painting etc., may loosen the ligaments
  • Inherent weakness of the muscles and soft tissue structures that support the shoulder joint. They tend to suffer from multi-directional instability and the bone may slip out from the glenoid in different directions
  • Double jointed- Excessive flexibility of the shoulder joint may also increase the risk of instability

Symptoms

  • Pain in the upper arm, neck and shoulder
  • Weakness
  • Feeling that the shoulder may give away
  • Frequent subluxations may occur

Diagnosis

  • Patient’s medical history and shoulder injuries may be taken into consideration by the orthopedic doctor
  • The patient may be asked to move the arm in different directions to check for the range of motion
  • X-ray imaging may be conducted to assess the extent of damage to the joint
  • MRI scan may be required to study the condition of the soft tissue structures

Treatment

Chronic Shoulder Instability can be treated through conservative methods initially but if the symptoms do not subside or the condition weakens, surgery may be required. Treatment may include the following:

  • Some lifestyle changes and modification of the daily activities may be suggested to relieve the symptoms. Any task that requires overhead movement of the arm should be avoided
  • Physical therapy program may be initiated to increase the strength of the supporting muscles in the joint.
  • A sling may be worn to provide support to the joint and allow the bone to get back to its original position
  • Non-steroidal anti-inflammatory medicines may also be prescribed by the orthopedic doctor
  • In severe cases, cortisone injections may be administered directly into the joint
  • Surgical repair of weak or torn ligaments and reattaching them to the bone to increase stability
  • Arthroscopic surgery may be performed to remove damaged cartilage and any loose fragments within the joint

OrthoTexas provides effective treatment for Chronic Shoulder Instability and other medical conditions. To schedule an appointment with the orthopedic doctors in Denton, TX, you can call at (940) 382-1577.

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Haglund’s Deformity: Causes, Symptoms And Treatment

by Administrator 20. December 2016 09:02

Haglund's Deformity, also known as Mulholland Deformity or Pump Bump, refers to the abnormal growth in the bony structure behind the heel bone. The condition eventually causes the bursae (located between this bone and Achilles tendon) to become irritated and swollen. Haglund’s Deformity can affect any person although it is more commonly observed in women.

Causes

  • Prolonged wearing of hard shoes with a closed back that rubs against the heel bone
  • Genetic deformity in the shape or structure of the heel bone
  • Presence of a high-arched foot
  • Tightness of the Achilles tendon
  • Unusual gait such as walking on the outer side of the heel
  • Running on hard surfaces
  • Excess body weight can stress the heel bone and the tendons
  • Past injuries to the foot or heel

Symptoms

  • Visible outgrowth of the bone behind the heel
  • Considerable pain while walking or wearing shoes
  • The back of the heel feels swollen and tender when touched
  • Redness
  • Tightness in the heel or at the back of the foot while moving

Diagnosis

  • Clinical evaluation of the affected foot
  • X-ray imaging may be required to analyze changes in foot structure
  • Analysis of the patient’s gait
  • The symptoms reported by the patient, daily activities as well as type of shoes worn may be taken into consideration to establish the cause and diagnosis

Treatment

Non-surgical Treatment

  • Using customized orthotic supports may allow even distribution of pressure on the foot and prevent the bone from rubbing
  • Non-steroidal anti-inflammatory medicines may be prescribed by the doctor
  • Use of heel pads may be recommended to prevent pressurizing the heel
  • Ice packs may be help to reduce swelling
  • Wearing open shoes may help to reduce pain while walking
  • In severe cases, an immobilizing boot or temporary cast may be recommended

Surgical Treatment

If the Achilles tendon is tight or damaged, surgery may be required to reduce the pressure on the joint. During the procedure, the orthopedic doctor removes the outgrowth and smoothens the bone.

Post-surgery, the patient may be recommended to wear soft padded shoes and use crutches to prevent weight bearing.

For complete treatment of Haglund's Deformity, visit the orthopedic foot doctors at OrthoTexas. To schedule an appointment, call at (940) 382-1577.

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Acromioclavicular Joint Separation: Orthopedic Denton

by Administrator 24. September 2016 09:30

The acromioclavicular (AC) joint is the point where the clavicle (collar bone) meets the acromion (shoulder blade). Injury to the ligaments that support this joint and connect these two bones is referred to as Acromioclavicular Joint Separation. The two main ligaments that may be affected are the acromioclavicular (AC) ligament and the coracoclavicular (CC) ligament.

The injury can range from mild to severe depending on the extent of damage to the ligament and bones. Mild injuries involve slight stretching of the ligaments whereas severe injuries witness complete tearing of one or both ligaments besides the separation of the two bones.  Such injuries make the joint prone to Arthritis in the future.

Timely medical treatment can prevent chances of permanent shoulder deformity.

Causes

  • A direct fall on an outstretched arm or hand
  • Sudden trauma to the arm, elbow, shoulder or hand
  • Sports injuries

Symptoms

  • Pain in the upper part of the shoulder/collar bone which may get worse when the joint is moved
  • Swelling and tenderness
  • Loss of function and difficulty in raising the arm overhead
  • Redness
  • A lump may form above the shoulder
  • Some cases may have visible shoulder deformity

Diagnosis

  • Clinical evaluation of the injured shoulder through palpation and range of motion tests
  • Evaluation of the mode of injury, symptoms reported by the patient and the medical history
  • X-ray may be done and in some cases, the patient may be asked to hold a weight in the injured hand during the scan for better view of the injury

Treatment

The treatment for AC joint separation may include:

  • Resting the injured arm and avoiding any stress to it
  • Applying ice packs at regular intervals may curb swelling and pain
  • Keep the arm elevated above chest level
  • Immobilization using a removable sling to provide support to the shoulder
  • Soft compression may be used for relief
  • Use of a shoulder brace
  • Prescription of anti-inflammatory medications to relieve pain and discomfort
  • Taping of the joint may be done for 2-3 weeks to improve stability
  • Specific exercises may be done to improve strength, mobility and flexibility
  • Surgical trimming of the collar bone to avoid it from getting in contact with the shoulder blade
  • Surgical reconstruction of the damaged ligaments

The shoulder specialists at OrthoTexas provide effective treatment for Acromioclavicular Joint Separation and other orthopedic conditions. Patients in Denton, TX can call at (940) 382 – 1577 to schedule an appointment with the shoulder surgeons.

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Plantar Fasciitis: Orthopedic Treatment In Denton, TX

by Administrator 29. August 2016 01:39

Plantar Fascia refers to the band of ligaments that connect the heel bone (calcaneus) to the toes. It is the largest ligament in the foot and spreads out in the shape of a web. It absorbs external shocks and also lends support to the foot arch. This ligament undergoes a lot of stress in the day to day life while walking and due to excessive body weight, leading to Plantar Fasciitis. The condition may result in inflammation and micro tearing of the ligament. It may affect one or both feet and is more commonly observed in women.

Causes

  • Being overweight may stress the ligament
  • Increase in weight during latter stages of pregnancy
  • Running long distances
  • Occupations that require standing for long hours
  • Structural problems in foot structure, i.e. Flat Feet or high arches
  • Tightness of the Achilles Tendon may pull the Plantar Fascia
  • Wearing shoes that do not offer cushioning for the soles
  • Injury caused by jumping or landing on hard surface
  • Reactive Arthritis
  • Ankylosing Spondylitis
  • Tightening of ligaments with age

Symptoms

  • Pain at the base of the foot which may vary from a dull ache to a burning pain
  • Stiffness
  • Pain may increase after long periods of rest or physical activity
  • Redness and swelling
  • Change in gait
  • The foot may feel warm and tender
  • Walking barefoot may be painful

Diagnosis

  • The orthopedic doctor may perform detailed physical examination of the foot
  • Symptoms may be analyzed by moving the foot or palpation
  • Evaluation of the muscle strength and nerve coordination
  • X-ray imaging to check for fractures and rule out structural problems
  • MRI and CT scan may be done to analyze soft tissue damage

Treatment

  • Reduce the amount of physical activity and takerest
  • Apply ice packs for 15-20 minutes to reduce pain and swelling
  • Use foot supports and arches in the shoes
  • Pain killers and non-steroidal anti-inflammatory medicines are prescribed
  • Injecting corticosteroids into the foot for immediate relief
  • Physical therapy is required especially in case the Achilles Tendon is causing the problem
  • Surgical detachment of the plantar fascia ligament
  • Special splints that stretch the foot to lengthen the Achilles Tendon and the ligaments can be worn overnight for a specified period of time
  • Removable boot to immobilize the foot and reduce stress on it

For treatment of Plantar Fasciitis and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the foot and ankle specialists in Denton, TX, you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Bennett's Fracture: Orthopedic Treatment In Denton

by Administrator 27. July 2016 12:24

Bennet’s fracture can be defined as a crack or break in the first carpometacarpal joint at the base of the thumb. This is the point where the metacarpal bone of the thumb meets one of the eight carpal bones, trapezium, that forms the wrist. The cartilage that covers it helps in the extensive movement of the thumb and maintains joint stability. In most cases, Bennet’s fracture causes this ligament to get detached from the bones, leading to a dislocation of the carpometacarpal joint. If not treated properly, the injury may result in loss of functionality, thumb weakness and the development of Osteoarthritis at the base of the thumb.

Causes

  • Thumb injury due to punching something hard
  • Falling on the hand with the thumb partially flexed
  • Work related injuries
  • Motor vehicle accidents
  • Contact sports injuries, such as in boxing, rugby and soccer

Symptoms

  • Pain
  • Swelling and tenderness at the base of the thumb
  • Difficulty grasping objects
  • Visible deformity in the thumb and wrist
  • Joint instability
  • Bruising

Diagnosis

To diagnose a Bennett’s fracture, the orthopedic doctor may physically examine the site of injury to look for visible deformity and signs of dislocation. He may conduct certain imaging tests, such as X-ray, CT scan or MRI, to confirm the exact location of injury and extent of dislocation of the carpometacarpal joint.

Treatment

Conservative treatment is not usually recommended as the fracture involves displaced joint surfaces that need to be aligned back to their normal position. However, in case of a hairline fracture without any significant displacement, the orthopedic doctor may perform closed reduction procedure. In this, the thumb may be manually manipulate the joint to restore the original position of the bone. The patient may be advised to wear a splint or cast to immobilize the thumb and promote a faster healing.

Surgical intervention may be required for a major Bennett’s fracture. It may also be required to treat a shortened or abnormally rotated thumb as a result of the injury. Metal screws, wires and plates may be inserted to hold the broken bone fragments in place. Physical therapy may be recommended post-surgery to reinstate complete functionality of the thumb.

We, at OrthoTexas, specialize in the diagnosis and treatment for Bennett’s fracture as well as other hand injuries. To schedule an appointment with our hand and wrist surgeons in Denton, TX, you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Ankle Dislocation: Causes, Symptoms and Treatment

by Administrator 24. June 2016 13:23

The ankle is a hinge joint which connects the foot bones to the leg. It bears the maximum body weight which makes it prone to injuries. The two leg bones, fibula and tibia, are connected to the talus (ankle bone) and supported by many tendons, ligaments, connective tissues as well as muscles. These enable the joint to function and remain stable. A strong force may damage the connective tissues and lead to the displacement of the constituent bones. This condition is termed as Ankle Dislocation.

In most cases, the injury occurs in association with other foot injuries such as fractures and sprains.

Causes

  • Sports injury
  • Sudden change in direction while running or exercising
  • Inward or outward rolling of the ankle
  • Sprain
  • A direct fall on the foot
  • Vehicular accident

Symptoms

  • Pain which can be severe at the time of injury
  • Inability to walk, stand or bear body weight
  • Swelling which may get aggravated with time
  • Limping
  • Visible deformity
  • Numbness
  • Pins and needles sensation
  • Redness of skin or warmth around the ankle
  • Ecchymosis and bruising
  • The foot may turn cold after injury, if blood supply is obstructed

Diagnosis

  • Clinical examination by the doctor
  • The symptoms, mode of injury and patient’s medical history may be analyzed
  • MRI and CT scan may be recommended to assess soft tissue damage

Treatment
Non-surgical options include the following:

  • Rest the injured foot with the leg elevated at chest level
  • Weight bearing should be avoided for 4-6 weeks. Crutches or a walking stick may be used for support while walking
  • Anti-inflammatory medicines may be prescribed to relieve pain
  • Wearing a specifically designed boot for a few days to restrict the movement of the ankle
  • Cryotherapy- ice packs may help curb pain and swelling
  • Anatomical reduction or manual re-alignment of the displaced (ankle) bone. The doctor may administer local anesthesia before the procedure
  • Use of a splint or cast to keep the foot stable post-reduction
  • Physical therapy may help to restore motion and strengthen the supporting muscles

Surgery may be required in case of torn or damaged ligaments and tendons. The following procedures may be recommended:

  • Surgical fixation using screws and plates may be required in case dislocation is accompanied with a bone fracture
  • Ankle replacement surgery may be performed in case of severe damage to the joint

OrthoTexas provides effective treatment for Ankle Dislocation and other various orthopedic conditions. To schedule an appointment with our ankle surgeons in Denton, TX, you can call at you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Hammer Toe: Orthopedic Denton

by Administrator 26. May 2016 13:31

Hammer Toe is a deformity which causes one or more toes to bend downwards. The condition may occur in any toe but mostly affects the second or the third toe. A balance is maintained between the tendons, bones, muscles and ligaments which enable the toes to remain straight. Any factor that disrupts this balance may lead to Hammer Toe. Some people are born with this deformity while others may acquire it over a period of time due to various reasons. Hammer Toe is classified into two categories:

  • Flexible Hammer Toe- It refers to the initial phase of the condition during which the toe can be straightened or moved with support
  • Rigid Hammer Toe- This is the severe or final phase of deformity when the toe is permanently bent and cannot be moved

Causes

  • Arthritis or age related degeneration of the bones
  • Wearing tight, pointy, high heeled or uncomfortable shoes
  • Damage to the spine or peripheral nerves
  • Bunion growth on the big toe may force the second to bend downwards
  • Tightening of the tendons and ligaments in the foot or toes
  • Muscular imbalance
  • Direct injury to any part of the toe
  • Genetically inherited weak muscular structure
  • Nerve damage in the foot
  • Diabetes
  • Certain foot structures are predisposed to developing Hammer Toe. For example, if the second toe is bigger than the big toe, chances of its bending are higher

Symptoms

  • Pain in the ball of the foot
  • Visibly deformed shape of toe
  • Growth of corns or calluses on the upper part of toe
  • Pain and irritation while wearing shoes
  • Difficulty in Moving the toe
  • Redness on the upper part of the toe

Diagnosis

  • Physical examination of the affected toe
  • X-ray imaging to assess the changes in bone structure or ligaments
  • Evaluation of the patient’s medical and family history
  • The neurovascular functioning may be checked by palpation of pulses

Treatment

  • Wear soft and comfortable that have a sufficiently wide toe box
  • Doing exercises that make the toes more flexible and strengthen the muscles
  • Wearing a brace to keep the toe in a straightened position
  • Use of shoe inserts for even distribution of pressure
  • Surgical removal of a bone to flatten the toe
  • Surgical correction of tightened muscles, ligaments and tendons relieve pressure from the toe
  • Using a tape or toe sling to reposition the affected toe

The foot doctors at OrthoTexas specialize in the treatment of Hammer Toe and other medical conditions. To schedule an appointment with our orthopedic doctors in Denton, TX, you can call at (940) 382 – 1577 or visit 2535 W. Oak Street, Denton, TX 76201.

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Turf Toe: Causes, Symptoms And Treatment

by Administrator 28. April 2016 12:57

Turf Toe is a condition in which the joint of the big toe gets sprained. The injury affects the “plantar complex’ a group of various ligaments, small bones and soft tissues that enclose as well as support the big toe. The condition is mainly seen in footballers, high jumpers, gymnasts, basketballers and ballet dancers.

Depending on the severity of the injury, the condition can be categorized as following:

  • Grade 1: mild swelling at the big toe joint with minimal tenderness occurring due to stretching of the plantar complex.
  • Grade 2: Tender joint with limited movement, moderate swelling and bruising may be seen. It occurs due to tear in the plantar complex.
  • Grade 3: Complete tearing of the plantar complex, painful movement of the joint, severe swelling and tenderness. Patient may be unable to perform routine activities.

Causes:

  • Stretching of the joint
  • Hyperextension of the joint
  • Repetitive trauma or stress injury
  • Wearing shoes that do not provide proper support to the feet

Symptoms:

  • Mild to moderate pain
  • Swelling at the joint
  • Bruising
  • Difficulty moving the big toe
  • Limited range of motion

Treatment:

  • First Aid treatment: The doctor may advise the patient to follow the RICE protocol, which is as follows:

Rest:Taking rest to allow the muscles to heal.
Ice: Applying ice packs to compress swelling
Compression: Compression bandages may be worn to prevent further damage.
Elevation: The leg should be kept elevated above the heart level to reduce swelling.

  • Keeping the joint immobile for a few days may be recommended for patients with Grade 2 Turf Toe.
  • Wearing a walking boot or braces may be recommended to restrict the movement of the joint
  • Anti-inflammatory drugs may be prescribed to provide relief from pain and inflammation.
  • Surgical treatment may require if there is a severe tear in the plantar complex. Following complications may also call for a surgical intervention:
Fracture of the sesamoid bones
Unstable big toe
Damaged cartilage of the joint
Severe symptoms

We, at OrthoTexas, provide treatment for Turf Toe and various other foot conditions. To schedule an appointment with our orthopedic surgeons in Denton, TX, you can call at (940) 382 – 1577.

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Wrist Fracture: Orthopedic Denton

by Administrator 13. April 2016 12:54

Wrist fracture or Distal Radius Fracture is a medical term used to denote a broken wrist. The human wrist comprises of 8 small bones which are together joined with the two bones of the forearm, ulna and the radius. Breakage or crack in any of these ten bones is referred to as a wrist fracture. Most of the wrist fractures involve the breaking of the radius bone and are termed as the Distal Radius Fracture. Fractures increase the risk of Osteoarthritis in the affected joint if not treated properly. 

Causes

  • A direct fall on an outstretched hand
  • Physical combat
  • Automobile accident
  • Sports related injuries
  • Weak bone structure due to calcium deficit diet
  • Osteoporosis

Symptoms

  • Severe pain
  • Visible deformity
  • Bruising and redness 
  • Swelling and tenderness in the arm and wrist
  • Inability to move the hand or loss of function
  • A piece of bone may protrude out of skin
  • The hand and fingers may go numb or turn white
  • Stiffness

Diagnosis

  • The orthopedic doctor may ask questions about the cause of injury
  • Evaluation of the patient’s medical history and previous injuries, if any
  • Thorough physical examination of the injured hand
  • X-ray imaging may be done to assess bone damage
  • MRI scan may help to detect minute fractures and ligament tears
  • CT scans show damage to nerves, blood vessels and soft tissues

Treatment

  • The doctor may recommend to support the injured wrist with a splint
  • Applying ice packs for a few days following the injury 
  • Anti-inflammatory medications may be prescribed by the doctor
  • Taking rest and avoiding strenuous activities that may aggravate pain 
  • Fracture reduction- The doctor may manually put the displaced and broken pieces of bones together. The patient is generally given local anesthetic before the treatment
  • The patient may be advised to undergo physical therapy for a couple of months after removing the cast to restore joint function
  • Surgical fixation in case of compound fracture may be done by implanting screws, rods and plates
  • External fixation- The surgeon may immobilize the broken joint by holding it between two metal plates and passing a rod across the bone

We, at OrthoTexas, provide comprehensive treatment for wrist fracture and other injuries. To schedule an appointment with our orthopedic surgeons in Denton, TX, you can call at (940) 382 – 1577.

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