Leclercia Adecarboxylata and Pseudomonas Oryzihabitans Infection after Achilles Tendon Repair: A Case Report and Literature Review.

Leclercia adecarboxylata and Pseudomonas oryzihabitans are two bacteria rarely seen in human infections. We present an unusual case of a patient who developed a localized infection with these bacteria after repair of a ruptured Achilles tendon. We also present a review of the literature regarding infection with these bacteria within the lower extremity.

Open Tibial Fracture Complicated by Wound Botulism: A Case Study.

Botulism is a neuroparalytic disease most commonly caused by foodborne ingestion of neurotoxin types A, B, and E, and is often fatal if untreated. Clinicians should be able to recognize the classic symptoms of botulinum intoxication (12). Owing to its rarity, there are a limited number of studies evaluating the clinical care of patients with wound botulism (10).

Picture worth a thousand words: Updating repeat photography for 21st century ecologists.

Anthropogenic climate change is altering every ecosystem on Earth. Understanding these changes requires quality baseline measurements of ecosystem states. While satellite imagery provides a coarse baseline for regional-scale changes in vegetation, landscape-scale observations are lacking.

Primary Tumoral Calcinosis in a Pediatric Patient: A Rare Presentation.

Tumoral calcinosis is a benign, progressive disorder characterized by massive periarticular deposition of calcium salts into subcutaneous and deeper tissue layers. While a majority of cases present secondary to underlying metabolic disorders, it can rarely present as a primary, idiopathic phenomenon. We present an atypical case of a pediatric patient with a large, ulcerated pedal soft tissue mass found to be consistent with primary tumoral calcinosis.

Isolated Forefoot Juvenile Xanthogranuloma: Unique Case Study and Treatment in a Pediatric Patient.

Juvenile xanthogranuloma is a benign histiocytic cell proliferative disorder that occurs in early childhood. The most common presentation occurs within the first 2 years of life with papular or nodular changes to the skin on the head, neck or upper trunk. This case study documents the findings and treatment of a single solitary soft tissue mass in the forefoot of a 17-year-old patient.

Arthroscopic Treatment of Osteochondral Lesions of the Talus Utilizing Juvenile Particulated Cartilage Allograft: A Case Series.

The treatment options for osteochondral lesions of the ankle are scarce, and newer modalities are becoming available. We describe a minimally invasive arthroscopic approach with implantation of juvenile particulated allograft to facilitate the growth of true hyaline cartilage in patients with osteochondral lesions of the talus. The purpose of this study was to subjectively review clinical outcomes using the validated Foot and Ankle Outcomes Score in patients who underwent this technique.

Arthroscopic Implantation of a Cartilage Matrix for an Osteochondral Defect of the Talus: A Case Report.

Advances have been made in the treatment for osteochondral defects of the talus, but these injuries continue to be a challenge for foot and ankle surgeons. We present an arthroscopically assisted technique that uses an allogenic cartilage graft in treating an osteochondral lesion of the medial dome of the talus. A brief discussion on current surgical options for osteochondral defects of the talus is also provided.

Leiomyoma of the Foot: A Case Report and Literature Review.

Leiomyomas within the foot are rare occurrences that are difficult to diagnose clinically and radiographically. They are benign and tend to be slow growing, often with minimal or no pain. We present an unusual case of a worker's compensation patient who presented with a new-onset mass within his foot that was thought to be a fibroma, but was later discovered to be a fast-growing leiomyoma after surgical excision.

Stenotrophomonas maltophilia: A Rare Case of Osteomyelitis After an Open Distal Tibial Fracture.

Stenotrophomonas maltophilia is a gram-negative rod rarely associated with osteomyelitis. To date, only 3 cases of osteomyelitis due to this pathogen have been previously referenced. We describe the case of a 77-year-old male who developed osteomyelitis secondary to S.

Surgical Treatment of Bone Marrow Lesion Associated with Recurrent Plantar Fasciitis: A Case Report Describing an Innovative Technique Using Subchondroplasty.

Plantar fasciitis is one of the most common chief complaints seen in the foot and ankle clinic. With a relatively benign course, most cases are self-limiting or amendable to conservative therapy; ~90% of all plantar fasciitis cases will respond to these methods. When conservative treatment and time fail, surgical intervention can be necessary to improve outcomes.

Traumatic Complex Hawkins Type IV Talar Fracture: A Case Report.

Fracture-dislocations of the talus are one of the most complex injuries involving the foot and ankle. These injuries are often accompanied by additional traumatic orthopedic injuries, avascular necrosis, and infection. When approaching limb reconstruction and salvage, the overall prognosis and functionality of the limb are key factors to consider.

Projected changes in climatic suitability for turtles by 2050 and 2070.

Chelonians are expected to be negatively impacted by climate change due to limited vagility and temperature-dependent sex determination. However, few studies have examined how freshwater turtle distributions may shift under different climate change scenarios. We used a maximum entropy approach to model the distribution of five widespread North American species (, , , , and ) under four climate change scenarios.

Rare Presentation of a Marjolin's Ulcer Secondary to a Post-Traumatic Injury.

Marjolin's ulcer is a rare and aggressive cutaneous malignancy arising from previously traumatized skin, most commonly at the site of previous burns. We present a unique case of Marjolin's ulceration secondary to an orthopedic injury and a nonburn history of trauma. The patient had been involved in a motorcycle accident >20 years earlier.

Nontraumatic Osteonecrosis of the Distal Tibia: A Case Presentation and Review of the Literature.

Osteonecrosis, although commonly occurring in the hip, can also affect the leg and foot. In the foot, it most commonly occurs in the talus. The incidence of osteonecrosis occurring in the tibia is relatively rare.

A modified fixation technique for a decompressional shortening osteotomy: a retrospective analysis.

A long metatarsal and/or metatarsophalangeal joint dislocation associated with a digital contracture is a surgical challenge. Without appropriate surgical correction, the patient will be predisposed to numerous complications, including persistent subluxation or dislocation, recurrent metatarsalgia, dorsiflexory contracture of the digit, transfer lesions, and inadequate pain relief. The results of the present surgical treatment options have varied, with the most common complication being a floating toe.

Acute ischemia after revision hallux valgus surgery leading to amputation.

Acute arterial insufficiency after revision hallux valgus surgery is a rare complication. The identification of surgical candidates who are at risk of vascular complications is of utmost importance. The patient-reported symptoms and physical findings combined with noninvasive vascular studies are generally reliable to assess the vascular status but can fail to identify patients with atypical disease patterns.

Transmetatarsal amputation in the setting of antiphospholipid antibody syndrome.

Antiphospholipid syndrome is a hypercoagulable disease that can present foot and ankle surgeons with a unique challenge in treating patients who present with thrombosis and ischemia despite having normal pedal pulses. Appropriate perioperative management is imperative in these patients, because limb- and life-threatening complications can occur postoperatively, despite aggressive anticoagulation. We present the case of a 46-year-old male who underwent a transmetatarsal amputation and, despite aggressive therapy, developed a myriad of complications postoperatively.

Vascularized scapular free bone graft after nonunion of a tarsal navicular stress fracture: a case report.

Nonunion of a tarsal navicular stress fracture, although relatively uncommon, is often amenable to open reduction and internal fixation. Furthermore, avascular necrosis of the navicular whether intact or occurring after fracture is rare, secondary to the adequate blood supply it receives. However, persistent nonunion after primary surgical repair in conjunction with avascular necrosis often results in limited treatment options.

Arthroscopic De Novo NT(®) juvenile allograft cartilage implantation in the talus: a case presentation.

Osteochondral defects of the talus are a challenging subject facing foot and ankle surgeons. The available treatment options have relatively good subjective outcomes; however, they are limited by the ability to reproduce hyaline cartilage, the need for multiple surgeries, and high morbidity. We present a new technique using DeNovo NT(®) juvenile allograft cartilage implantation introduced into a talar lesion arthroscopically in a single procedure to repair a posteriomedial talar osteochondral defects in a healthy, active 30-year-old female.

Lateral leg compartment syndrome caused by ill-fitting compression stocking placed for deep vein thrombosis prophylaxis during surgery: a case report.

Isolated lateral leg compartment syndrome is a relatively rare event, with potentially devastating consequences. We present a case of a 44-year-old man with isolated lateral leg compartment syndrome caused by a compression stocking used for deep vein thrombosis prophylaxis during surgery. It was found to be excessively tight around the patient's proximal calf postoperatively.

Results of modified lapidus arthrodesis procedure using medial eminence as an interpositional autograft.

The Lapidus procedure has received wide acceptance as a valuable operation for correcting moderate to severe hallux valgus, especially in the presence of hypermobility. However, shortening of the first ray inherently occurs as the first metatarsocuneiform joint cartilage and subchondral bone are resected in preparation for arthrodesis. The purpose of this study was to radiographically compare the degree of shortening of the first ray with and without the use of the first metatarsal medial eminence as an interpositional autograft at the site of metatarsocuneiform fusion.

A report of a rare phalangeal periosteal chondroma of the foot.

Periosteal chondroma is a benign, slow-growing cartilaginous tumor that typically occurs at the metaphysis of long tubular bones beneath the periosteal membrane. A case is presented of a 42-year-old male who developed a firm, tender, uneven mass encircling the lateral, dorsal, and medial aspects of the right second proximal phalanx following a traumatic event. The mass was excised en toto and histopathologic findings are presented.

Disseminated intravascular coagulation, meningococcal infection, and ischemic changes affecting the lower extremities: a case study.

A middle-aged woman presented from an outside hospital with a diagnosis of Neisseria meningitidis and meningococcemia. A nonpalpable purpuric skin rash evolved into multiple wounds, with gradual necrosis of bilateral lower and upper extremities. Throughout the course of hospitalization, the patient developed ventricular tachycardia, normocytic anemia, thrombocytosis, Clostridium difficile infection, depression, and transient right eye blindness.

Late hematogenous infection of first metatarsophalangeal joint replacement: a case presentation.

Late hematogenous infection of previously asymptomatic orthopedic implants is extremely rare and usually associated with total joint replacements, such as those of the hip or knee. We present the case of an otherwise healthy female who developed a deep space infection 18 months after a first metatarsophalangeal joint implant arthroplasty. The patient presented with pain and swelling at the site, and over the course of several days developed fever and tachycardia and leukocytosis.