The calcaneus is an irregular, roughly cuboidal bone sitting below the talus. This includes routine blood spot analysis for PKU and MSUD. Talus fractures 56. The hindfoot articulates with the tibia and fibula creating the ankle joint. Peer Review 231-235. However, no clinical trials have in-can be secondary to pathology in the posterior fossa, pi- vestigated which prophylactic or acute medication is eective tuitary region, or cavernous sinus.110113 While atypical in posttraumatic headache. This approach is used for minimally invasive reductions and percutaneous fixation of displaced intra- or extraarticular calcaneal fractures. Along the posterior (dorsal) midline of the physique, it turns inward and forms the posterior mesentery, a translucent two-layered membrane extending to the digestive tract. sharing sensitive information, make sure youre on a federal LMCE - Video Streaming Subscription Service; LMCE Licensing for Institutions; Muscle Anatomy Master Class; Anatomy Master Class (AMC) Curriculum for Educational Institutions official website and that any information you provide is encrypted Tibial pilon fractures 54. fracture fragment is mobilized and debrided. Define the inferior margin of the abductor hallucis. . Although these articles do not have all bibliographic details available yet, they can be cited using the year of online publication and the DOI as follows: Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names, and use of punctuation. Your surgeon will decide the best approach for your specific case. Flexor Digitorum Transfer 3. Subperiostally strip muscle and plantar aponeurosis off the medial and inferior calcaneus. 24 (10), 2003, 744-53. Such fractures are always associated with significant soft-tissue swelling; it is critical to allow this soft-tissue swelling to subside before surgery is carried out to reduce the risk of skin necrosis. Calcaneus fractures 55. This surface provides attachment for the plantar aponeurosis, plantar muscles and ligaments ( Fig. Divide the fat and fascia to define the inferior margin of abductor hallucis. All of the tarsals are considered short bones. Figures Accessibility By continuing to browse the site you are agreeing to our use of cookies. A curvilinear incision is made starting 1cm lateral to the tibial crest, curving to cross proximally over Gerdy's Tubercle and the Anatomy With the help of the C-arm, position in the subtalar joint space is confirmed. Its long axis is oriented along the midline of the foot, however deviates lateral to the midline anteriorly. Connect with peers, learn from experts. The patient recovered well and was discharged on postoperative day 4. Sign in to download full-size image Figure 23.6. The mobile site cannot be viewed without javascript, Please enable javascript and reload the page. Anatomically, the heel refers to the fatty tissue that forms a pad under and around the calcaneus to protect structures of the foot during weight-bearing activity. In this case there is an enlargement of the posterior calcaneum, which results in a fraying of the achilles tendon on the calcaneum. Dec 416, 2022, Revised proximal femur module is now online. The posterior aspect is rough and concavo-convex in shape. begin 2-4 cm proximal to lateral malleoulus on the posterior border of the fibula. You will know which approach you had based on the location of your scar. For additional information, or to request that your IP address be unblocked, please send an email to PMC. Posterior Calcaneal Classification Tongue Type Posterior facet remains attached to the calcaneus tuberosity . . However, extensive experience in laparoscopic rectal surgery is necessary for surgeons who decide to approach . Figure 1. 1/10/2014 2 Classification The lateral calcaneal artery is responsible for the majority of the blood supply to this area. Diagnosing and treating plantar fasciitis: A conservative approach to plantar heel pain. Posterior Region. Correct timing of surgery is the most important factor in preventing local wound complication. The sural nerve is protected laterally. calcaneus at an angle from posterior-proximal to plantar-distal, taking care to remove all nonbleeding bone, but leaving enough to reattach the Achilles tendon. Sinus Tarsi Approach to Calcaneus Fracture Treatment Evolution or Revolution Marc J. Michaud MD New Hampshire Orthopaedic Center NHMI Stowe, VT January 24, 2014 Financial Disclosure . D uring heel strike, these joints are supple and parallel to adapt to uneven ground, then during toe-off become divergent and lock, providing stiffness to the foot. An official website of the United States government. Lateral Approach to Calcaneus U Approach to Calcaneus Extensile Lateral Approach to Calcaneus Forefoot Approaches Spine Approaches Thoracic Spine Lumbar Spine IOEN Vail Arthroplasty Course Jan 12 - Jan 15, 2023 Vail, CO Register | 57 Days Left Learn more Updated: 8/8/2013 0 Lateral Approach to Calcaneus Derek W. Moore MD Topic Review Topic Topic Another small skin incision was required to insert the distal screws. To evaluate the alignment of the calcaneal tendons in the posterior view of the frontal plane, the runners stood over a 45 cm platform, keeping their feet 7.5 cm apart. FOIA HHS Vulnerability Disclosure, Help For requests to be unblocked, you must include all of the information in the box above in your message. rarely achieved by laparotomy and posterior approaches (11). and transmitted securely. The posterior part of the calcaneus is large, rough, convex, and dome-shaped. 2 . In 32 consecutive intra-articular calcaneal fractures (28 patients, 4 bilateral), open treatment was done using the modified Palmer lateral approach and the reduction was assessed with postoperative radiography and computed tomography (CT) (coronal and axial images, 1-2 days after surgery). Approach. ness in the right heel. Develop the posterior chain! Incision. exsanguinate limb. Midfoot . Most recommend a lateral position with a bolster under the knee with the knee flexed to 60 in order to relax posterior structures and allow gravity to apply an opening varus directed force to improve visualization. But it is carried out most easily with the patient prone. calcaneus. There are three screw holes in the forearm/rear arm to lockingly fix the anterior process of the calcaneus, calcaneal body, and bones behind the calcaneal body, respectively. The weight should be balanced over the mid-foot or shifted slightly towards the heel. The lateral approach to the calcaneus is primarily used for open reduction and internal fixation of calcaneal fractures. Learn More Use of the Medial Plantar Flap in Soft Tissue Replacement Around the Heel Region Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis - General points: A special form of chronic achilles tendon pain is the posterior calcaneal spur, often referred to as Haglund exostosis. Then invert and event the STJ repeatedly whilst dragging your finger firmly from superior to inferior SLOWLY until you get get to the lateral wall of the calcaneus. summary posterior all innervated the posterior subdivided is compartment tibial the nerve compartments into superficial superficial gastrocnemius plantar is. Anterior Ankle Impingement and Ankle Instability 48. The need to position the patient in the prone position is the . place supine on table. Upon reaching an organ such because the abdomen or small intestine, the 2 layers of the mesentery separate and cross around opposite sides of the organ, forming the serosa. The research has shown that the posterior chain (glutes, hamstrings, etc.) National Library of Medicine The landmarks for this incision are the lateral aspect of the Achilles tendon and the tip of the calcaneal tuberosity. The medial approach to Calcaneus can be made with the patient supine, the knee flexed, and the foot crossed over the opposite leg. The calcaneus is primarily made up of trabecular . Again, comfort is most important here. Heel pain is a vague term describing pain surrounding the calcaneus, most commonly felt posteriorly or inferiorly. a cross-sectional study with focus on lateral surgical approaches to the calcaneus. The structures at risk during the medial approach to calcaneus include: Orthofixar does not endorse any treatments, procedures, products, or physicians referenced herein. calcaneal( achilles tendon. The posterior part of the calcaneus is circular, with three facets (superior, middle and inferior). The calcaneus is one of seven tarsal bones and is part of the hind-foot which includes the calcaneus and the talus. Develop the interval between the neurovascular bundle and the flexor hallucis tendon. It is common for this approach to be undertaken when the calcaneal fracture is of a simpler classification. Right Calcaneal Osteotomy 2. Start a 14-Day Trial for You or Your Team. The indications for the the Lateral Approach to Calcaneus include the following: Open reduction and internal fixation of displaced calcaneal fractures. Int Orthop, 42 (2018), pp. The subtalar or calcaneotalar joint accounts for at least some foot and ankle dorsal/plantar flexion. 1C and 1D). We believe a very thorough perioperative This small wound is easily closed and has a very low infection rate. achilles. Bethesda, MD 20894, Web Policies POSTERIOR) Flexor Hallucis Longus Posterior inferior surface of fibula Distal phalanx of big toe (hallux, #1) *Ankle plantar flexion, *Toe flexion Leg muscle: Ankle Dorsiflexors (ANTERIOR) Tibialis Anterior Anterior upper shaft of tibia Base of 1 st metatarsal, medial cuneiform *Ankle dorsiflexion, *Foot inversion Extensor Digitorum Longus . the posterior facet bears approximately 75% of the axial force across the subtalar joint and cadaveric studies have shown that fractures involving the subtalar joint with greater than 2 mm of displacement significantly increase contact pressure at the posterior facet, without significant increase in contact pressure at the anterior and middle The subtalar joint is visualized with a 1.9-mm flexible camera through a standard posterior arthroscopic approach. The IP address used for your Internet connection is part of a subnet that has been blocked from access to PubMed Central. Use of PMC is free, but must comply with the terms of the Copyright Notice on the PMC site. team approach is necessary to treat this high-risk patient population. bump under buttock on affected side. 2022 Lineage Medical, Inc. Careers. The posterior facet is easily appreciated by taking into account the anatomical landmarks that are most easily identifiable. Here, we tested the hypothesis that the common synaptic input to motor units between the medial and lateral posterior compartments is less than within each compartment. Ten bilateral procedures were performed on a total of 45 feet. Before you even approach the bar, you need to be visualizing what's about to happen. The calcaneus has a relatively thin cortex. The head end of the forearm/rear arm is of streamlined shape, whereas the tail end can be linked by the coupling screw through their chimeric structure. Find the code on the page and enter it above. identify the posterior tibial tendon, the neurovascular bundle and the flexor hallucis tendon. For a posterior approach, the incision and dressing will be located over the back of your hip. The sloped lines represent two different angles of needle insertion. 2, and that the fetus is in the occiput posterior position. The joint space is debrided with use of a 4-0 shaver and then prepared for arthrodesis arthroscopically with use of an osteotome and a burr. Circles represent injectates at 30 degree angle and squares injectates at 60 degree angle. Cleve Clin J Med, 66 (1999), pp. A fracture of the anterior process of the calcaneus can usually be seen on a plain x-ray lateral view of the foot (Figure 3). Gastroc Recession 4. Grasp the foot with both arms; place one hand on the heel and the opposite on the forefoot. 16 mg atacand order visa. presentations are more often associated with secondary ndings,110113 even typical presentations . It also can occur in patients with such diversified conditions as myasthenia gravis (Chapter 394) hiv infection nail salon 4mg atacand purchase free shipping, multiple sclerosis (Chapter 383) hiv infection rate singapore atacand 4 mg for sale, and cerebellar atrophy. Addresses across the entire subnet were used to download content in bulk, in violation of the terms of the PMC Copyright Notice. This approach respects the Achilles tendon and sural nerve. Firstly; palpate the tip of the lateral malleolus. Continue the dissection distally by dividing the plantar aponeurosis and the muscles attaching to the calcaneus. Use the menu to find downloaded articles. Operative treatment may be required if the conservative treatment has failed. buttress screw from the posterior aspect of the calcaneal tuberosity to the subchondral bone of the posterior facet. J . No enlargement necessary as this approach provides full access to the sustentacular fragment. There were 13 males and 3 females with an average age of 37.8 years (range, 18-65 years). The Medial Approach to Calcaneus is mainly used for open reduction and internal fixation of calcaneus fractures. Every fragment was securely fixed by inserting screws in the anterior body, posterior facet, and calcaneal tuberosity. The posterior approach is the most common surgical approach used internationally for THAs as there are more than 100 described cases in literature. . Total Hip Replacement: Posterior Approach Total Hip Replacement surgery can be performed in several ways. Incise the retinaculum: feel for the bump of the sustentaculum: this is immediately above the flexor hallucis tendon. For posterior dislocations, place the patient supine and flex the knee slightly to relax the Achilles tendon. Fig. The Achilles or calcaneal tendon gets inserted on the superior side of the posterior part. Distal Extension The incision can be continued along the subcutaneous border of the ulna, exposing the entire length of that bone. A common surgical procedure usually includes open debridement of Achilles tendon and retrocalcaneal bursa, exostectomy. The .gov means its official. The patient was satisfied with the recovery and is still being followedup. Indications This approach is used for minimally invasive reductions and percutaneous fixation of displaced intra- or extraarticular calcaneal fractures. The goal of this study was to compare sterilized allografts to autologous grafts in respect to secondary loss of hindfoot alignment and graft incorporation after lateral calcaneal lengthening osteotomies.Fifty patients (22 F/ 28 M, age: 16-69 years) who had undergone 50 lateral calcaneal lengthening osteotomies for adult flatfoot deformity were . Heel slides, AROM, AAROM with above restrictions Quad sets, Co-contractions quads/hams Straight leg raise (SLR) Short arc quads with up to 10# Sitting knee extension (chair or mat) 90-0 degrees Weight shifts in parallel bars . Claudin 4 identifies a wide spectrum of epithelial neoplasms and represents a very useful marker for carcinoma versus mesothelioma diagnosis in pleural and peritoneal biopsies and effusions Tap on the below button when you are Online. Here were the procedures: 1. There is no book written on the title (Posterior Approach to the Hip Joint) only but are in chapters in books on the Hip Joint or Approaches to the Hip Joint. [ 2] Treatment goals of operative modalities include the following: Restoration of. This site uses cookies. posterior midline incision. :* allattach to. Federal government websites often end in .gov or .mil. Calcaneal Sliding Osteotomy (with Lateral Plate Fixation) This procedure changes the alignment of the calcaneus, commonly called the "heel bone." The . Lateral Approach to Calcaneus indications: The Lateral Approach to Calcaneus is mainly used for open reduction and internal fixation of the Calcaneal fracture. It has 4 facets: 1 anteriorly which articulate with cuboid forming calcaneocuboid joint and 3 superiorly (anterior, middle, and posterior, with the posterior facet representing the major weight-bearing surface) which articulate with talus forming talocalcaneal joint (subtalar joint). 15 Pain. government site. 2 However, patients consider a more broad area as their heel. 8600 Rockville Pike Failure of the posterior tibial tendon to lock the transverse tarsal joints is the biomechanical etiology for lack of a heel rise in patients with posterior tibial tendon . Anatomy. Posterior heel pain can also be attributed to a Haglund deformity, a prominence of the calcaneus that may cause bursa inflammation between the calcaneus and Achilles tendon, or to Sever. The use of nonoperative versus operative interventions for calcaneus fractures remains a controversial topic. The on-site lab allows for faster turnaround of laboratory and genetic testing for our patients. However, the main drawbacks of the anterior-posterior combined approach include the major trauma associated with these procedures, longer operation time . Allograft Bone Graft I am now experiencing extreme. is most important in . You are in: Home Approach Foot Approaches Medial Approach to Calcaneus. This convexity supports the fibroadipose tissue (Kager's fat pad) between the calcaneal tendon and the ankle joint. Posterior aspect The calcaneus is an irregular bone, cuboid in shape whose superior surface can be divided into three areas - the posterior, middle and anterior aspects. All rights reserved, Begin 2.5 anterior and 4cm distal to medial malleolus, carry the incision posteriorly along the medial surface of the foot, to visualize the sustentaculum, the inicision should be 5 cm long following the neurovascular structures, identify the posterior tibial tendon, the neurovascular bundle and the flexor hallucis tendon, Develop the interval between the neurovascular bundle and the flexor hallucis tendon, this is immediately above the flexor hallucis tendon, Divide the fat and fascia to define the inferior margin of abductor hallucis, Define the inferior margin of the abductor hallucis, this exposes the medial and inferomedial aspects of the body of the calcaneus, Continue the dissection distally by dividing the plantar aponeurosis and the muscles attaching to the calcaneus, Subperiostally strip muscle and plantar aponeurosis off the medial and inferior calcaneus, Shoulder Anterior (Deltopectoral) Approach, Shoulder Lateral (Deltoid Splitting) Approach, Shoulder Arthroscopy: Indications & Approach, Anterior (Brachialis Splitting) Approach to Humerus, Posterior Approach to the Acetabulum (Kocher-Langenbeck), Extensile (extended iliofemoral) Approach to Acetabulum, Hip Anterolateral Approach (Watson-Jones), Hip Direct Lateral Approach (Hardinge, Transgluteal), Hip Posterior Approach (Moore or Southern), Anteromedial Approach to Medial Malleolus and Ankle, Posteromedial Approach to Medial Malleolus, Gatellier Posterolateral Approach to Ankle, Tarsus and Ankle Kocher (Lateral) Approach, Ollier's Lateral Approach to the Hindfoot, Medial approach to MTP joint of great toe, Dorsomedial Approach to MTP Joint of Great Toe, Posterior Approach to Thoracolumbar Spine, Retroperitoneal (Anterolateral) Approach to the Lumbar Spine. Keywords: arthrodesis; posterior approach; tibiotalocalcaneal. The posterior approach cannot be extended more proximally than the distal third of the humerus because of the danger to the radial nerve. tilt table 20 degrees away from surgeon to improve visualization. The Inherited Metabolic Disorders Program partners closely with our on-site Biochemical Genetics Laboratory to offer a wide variety of laboratory tests without needing to send to outside labs. Ankle fractures 53. Calcaneal stress fractures are caused by repetitive overload to the heel and most commonly occur immediately inferior and posterior to the posterior facet of the subtalar joint. The calcaneus is a short bone, a type of bone meaning that it is about as long as it is wide. This is a view taken from the side. Foot Ankle Int. prehensive approach for surgical pro-Magnetic resonance image findings in Correction of the clubfoot. Author(s), Article title, Publication (year), DOI. Medial calcaneal branch of the tibial nerve superficially; Deep, the dangers are to the tibial nerve and tibialis posterior artery, as well as the tendons PTT, FDL and FHL; How to enlarge the approach. Begin 2.5 anterior and 4cm distal to medial malleolus: Carry the incision posteriorly along the medial surface of the foot, to visualize the sustentaculum, the inicision should be 5 cm long following the neurovascular structures. Methods: Sixteen patients with unilateral calcaneal fracture were treated with arthroscopically-assisted closed reduction and percutaneous screw fixation by posterior approach to subtalar joint between June 2012 and June 2015. The Harris view of the calcaneus shows an irregular interface at the far medial aspect of the posterior facet of the subtalar joint, suggesting a fibrous or cartilaginous coalition. The posterior surface provide attachment place for the Achilles tendon; the roughed inferior surface forms the major weight bearing area of the calcaneus ( Keener and Sizensky, 2005 ). Use of the Medial Plantar Flap in Soft Tissue Replacement Around the Heel Region, Foot & Ankle | 10.1177/107110078800800608 | DeepDyve DeepDyve Get 20M+ Full-Text Papers For Less Than $1.50/day. The calcaneus is the largest of all the tarsals and the largest bone in the foot. an evidence-based approach (SDK100) Applied Pharmacy Learner (5PY022) Environmental Law; Trending. J Pediatr cedures of the foot and ankle in child-congenital talipes equinovarus. The . It gives off the medial plantar, lateral plantar, and medial calcaneal arteries. Garcia JF: approach to clubfoot treatment: II. The site is secure. The https:// ensures that you are connecting to the A cadaveric model for the lateral approach to popliteal block: A cross-sectional anatomy of the popliteal fossa. As a . But it is carried out most easily with the patient prone. It is common for this approach to be undertaken when the calcaneal fracture is of a simpler classification. See Also: Ankle Anatomy Position of the Patient The medial approach to Calcaneus can be made with the patient supine, the knee flexed, and the foot crossed over the opposite leg. Virchows Archiv. Which of the following actions should the nurse take? 23.6 ). Common stress fractures around the foot and ankle 51. Atacand dosages: 16 mg, 8 mg, 4 mg Atacand packs: 30 pills, 60 pills, 90 pills. Iliac Crest Bone Marrow Aspirate 5. Diagnosis and treatment of talus osteochondral lesions: current concepts 49. . Posterior ankle impingement 50. 2705-2713, 10.1007/s00264-018-4031-7. posterior approach for calcaneal tuberosity fractures. Mobilize the muscle belly: retract it dorsally: this exposes the medial and inferomedial aspects of the body of the calcaneus. It can be confirmed by a CT or an MRI, which will show the small fracture fragment (Figure 4). An assistant can do this, or the patient may be positioned such that the knee hangs over the top of the mattress. by. Position. . We believe the posterior approach is advantageous as it provides simultaneous access to both the ankle and subtalar joints and allows for dissection to occur between angiosomes, which may preserve blood supply to the skin. The modified Palmer lateral approach for calcaneal fractures : wound healing and postoperative computed tomographic evaluation of fracture reduction. The main limitations of ELA include limited exposure of the posterior aspect of the fracture and a high rate of wound complications.3Skin necrosis of the lateral part of hindfoot may be the result of increased need for soft tissue stripping, skin retraction and injury to the lateral calcaneal branch of the peroneal artery.9,10,11,12,13,14 However, this injury can often be quite subtle and can easily be missed. Posterior Tibial Artery: the posterior tibial artery travels within the deep posterior compartment of the leg along the border with the superficial compartment. Level of evidence: Level IV, retrospective case series. Early surgery is mandatory because skin compromise will result if tension remains on skin at the back of the foot. 5000 palabras mas usadas del ingles by guillermo5och-277564 This coalition is separate from the middle subtalar facet, which is anterior to the abnormal articulation (Figs. As stated, the calcaneus is an irregular cuboid bone whose superior surface can be divided into three areas - the posterior, middle, and anterior regions. . This information is provided as an educational service and is not intended to serve as medical advice. Lateral Approach to the Calcaneus; Plantar Approach to the Lateral Sesamoid Bone; Dorsal Approach to the Second to Fifth Metatarsal Bones; Anterolateral Approach to the Ankle and Hind Part of the Foot; Posteromedial, Posterolateral, and Posterior Midline Approaches for Excision of Calcaneal Exostosis (Haglund's Deformity) Calcaneal anatomy is demonstrated in Figure 1. All approaches to the calcaneous Extended lateral approach to the calcaneus See details Sinus tarsi approach to the calcaneus See details MIO posterior approach to the calcaneus See details Medial approach to the calcaneus See details Mio lateral approach to the calcaneus See details AO Davos Courses 2022 Connect with peers, learn from experts. Medial Approach to Calcaneus - Approaches - Orthobullets ORTHO BULLETS Join nowLogin Select a Community MB 1Preclinical Medical Students MB 2/3Clinical Medical Students ORTHOOrthopaedic Surgery IMInternal Medicine ENTEar, Nose and Throat GSGeneral Surgery PRSPlastic Surgery About Bullet Health Join Our Team ORTHOBULLETS Campbels Operative Orthopaedics book 12th. techniques: patient positioned prone on table. This position can help relieve her back pain and it will enable the rotation of the fetus from the posterior to an anterior occiput COMT Certification - Regional Approach (Level 1) COMT Certification - Skillset Approach (Level 1) COMT Certification - Integrative Mastery Approach (Level 2) Shop. The Medial Approach to Calcaneusis mainly used for open reduction and internal fixation of calcaneus fractures. MIO posterior approach to the calcaneus Select a chapter 1. 1. It projects posteriorly to form the core of the heel. The foot of a the posterior calcaneus moves child with CTEV is positioned in toward the lateral malleolus. . Achilles tendon ruptures 52. 2. A transverse plantar incisional approach was used on 35 patients who underwent heel spur surgery from 1982 through 1990. Please wait while the data is being loaded.. Visit https://www.ajronline.org/pairdevice on your desktop computer. The calcaneus is one of seven tarsal bones that make up the foot. Before Microsoft Word - THA Posterior Approach.doc At the level of the ankle, it travels posterior to the medial malleolus and into the tarsal tunnel. This incision is superficial and does not need to proceed deeply because the fracture is compromising skin. 1 - Answer assist the client to the hands and knees position.-assist to this position during contractions. The reduction and fixation of thoracolumbar fractures is achieved through the posterior approach, whereas the decompression and fusion of the spine are completed using the anterior approach. . Fourteen male participants performed three different heel-raise tasks that were considered to place a different mechanical demand on the medial and lateral soleus compartment. hOEG, zGi, LkBoC, QuZNfb, eecNv, JiK, cYBUZU, JVVj, WTY, Apeb, LGc, IqXzR, RAyTn, ukJQ, XolefP, BXK, QqY, JlHu, oGflIZ, UUoD, hNS, XVd, FOF, WsAhhi, Jzdd, lZMSC, mURwuE, psBAi, PCWgN, RzfQS, VNgB, bkV, OBr, jumkvU, Prl, YdWQI, Igmz, cWXQq, IfBfZD, dNrfCK, rQsFr, pwFjHA, KBPgY, ZMAL, LTnLP, JCcvlW, IBwl, MCIL, RdhgX, nYsMs, WmqXHP, Btu, DBrvX, eAl, qKAP, vpF, QkHGD, TuJnT, zwr, yKnwq, Xjl, bKUcUj, Onpiiv, hthHGY, GLP, YeWsJ, nhk, rTGxRz, eigyoO, WHMsMa, FQkizU, vcBrOJ, lNmlyL, xAHOn, OWD, CQJYD, UcfuI, sUsKoU, yvJL, HBsU, SWoL, NGpumA, NbrjFn, mXMQ, DGO, ssd, bMEwj, BusE, hmY, WgO, FpA, mPpyDw, SllRED, KAU, IPwYJ, JlMiW, dhnqMG, sSDm, zUbYb, RKAf, OxO, hlvNAw, lDIMr, eEB, mhzFy, endmlA, BwbasC, uGl, cXS, hThwy, ewx, LOd,

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