Dislocation of the fifth metatarsal base following partial fourth and fifth ray amputation: a case report.

This case report presents a rare postoperative dislocation of the fifth metatarsal base following a healed open partial fourth and fifth ray amputation of a 62-year-old male veteran with poorly controlled diabetes mellitus. The dislocated fifth metatarsal base subsequently created a chronic ulceration and an inhibition of normal gait. The patient was taken to the operating room where the fifth metatarsal base was resected with transfer of the peroneus brevis tendon to the cuboid to maintain biomechanical stability.

Risk and prevention of reulceration after partial foot amputation.

Partial foot amputations are frequently performed to salvage significant portions of the lower extremity affected by limb-threatening infection. Once healed, the residual foot is at high risk for reulceration. Careful long-term follow-up and appropriate interventions can lower this risk.

Pedal presentation of metastatic invasive squamous cell carcinoma of the bladder.

Squamous cell carcinoma is a malignant tumor of the squamous epithelium and can occur in many different organs. We present a case of a 61-year-old veteran with metastatic squamous cell carcinoma of the bladder with distal metastasis to the middle phalanx of the fourth toe, which is a rare occurrence in the literature.

Percutaneous tendo Achillis lengthening to promote healing of diabetic plantar foot ulceration.

The etiology of ulcerations related to increased plantar pressure in patients with diabetes mellitus is complex but frequently includes a component of gastrocnemius soleus equinus. One viable treatment option is percutaneous tendo Achillis lengthening as a means of increasing dorsiflexory range of motion and decreasing forefoot shear forces. This article presents three case reports illustrating the importance of reducing plantar pressure as a crucial component of treatment of diabetic forefoot ulcerations.

Arthrodesis of the first metatarsophalangeal joint.

Arthrodesis has emerged as the primary salvage procedure for severe osteoarthritis of the first metatarsophalangeal (MTP) joint. Forty-three patients underwent arthrodesis of the first MTP joint with stabilization provided by either 2 crossed lag-screws or a dorsal plate and screws. First MTP joint arthrodesis was the primary procedure for 46 of the 54 treated feet.

Survival of patients with primary pedal melanoma.

Malignant melanoma is increasing at a rate faster than any other cancer in the United States. Location of the primary tumor on the foot is associated with poorer prognosis. This study evaluates a cohort of 148 patients with melanoma of the lower extremity (37 foot or ankle and 111 leg, knee, or thigh) diagnosed at a university medical center during a 32-year period.