Rare Case of a Very Large Angioleiomyoma of the Dorsum Foot.

Angioleiomyomas are relatively rare benign smooth muscle soft tissue tumors which often occur on the extremities. They are rarely diagnosed preoperatively as clinical and radiological examination is often nonspecific and inconclusive. An 80-year-old male presented with a 10-year history of a progressively growing and symptomatic lesion on his right dorsal foot within the first intermetatarsal space.

Efficacy of a single botulinum toxin A injection for distal tarsal tunnel syndrome: A protocol for a randomized, double-blinded trial.

Introduction: Distal tarsal tunnel syndrome (DTTS) is characterised by compression of the tibial nerve as it passes underneath the abductor hallucis muscle belly. There is no current consensus on treatment for DTTS. This study was conducted to compare and evaluate the effect of ultrasound-guided botulinum toxin A (BTX-A) versus ultrasound-guided corticosteroid injection (CSI) for the treatment of DTTS.

A Case of Polymetatarsia Without Polydactyly.

Polymetatarsia is an atavistic anomaly characterised by one or more additional metatarsals. Usually found with a supernumerary digit (polydactyly), polymetatarsia without polydactyly is a rare variant. We report a case of a 34-year-old male with polymetatarsia within the first intermetatarsal spaces of both feet without polydactyly.

Radical Cheilectomy as an Alternative to Arthrodesis for Hallux Rigidus.

Hallux rigidus (HR) is a painful condition involving osteoarthrosis and reduced range of motion of the first metatarsophalangeal joint (MTPJ). It is associated with significant morbidity and reduced quality of life. We report a case of a 42-year-old female who had been referred to our surgical clinic regarding the progressively worsening chronic pain, stiffness and long-term shoe-fitting difficulties associated with her right HR pathology.

Plantar vein thrombosis masquerading as plantar fasciitis: A case report.

Plantar vein thrombosis is an uncommon and under-diagnosed cause of plantar foot pain characterised by the formation of a blood clot (thrombus) within one of the plantar veins. There is no current diagnostic guideline for this condition however compression ultrasound and magnetic resonance imaging appear suitable. Treatments range from rest and non-steroidal anti-inflammatory drugs to six months of anticoagulant therapy.

Surgical Realignment of a Dorsiflexed Metatarsal Fracture.

Metatarsal fractures are common injuries that routinely present to outpatient clinics. Whilst usually amenable to conservative care, there is controversy regarding treatment when the fracture results in significant misalignment. In this case report, a 54-year-old female recreational basketball player who sustained a second metatarsal fracture that had healed in a dorsiflexed position in relation to the adjacent metatarsals was referred for a surgical opinion.

Surgical management of an enchondroma of the proximal phalanx of the foot: An illustrative case report.

Enchondromas are benign tumours that may become symptomatic due to expansive pressure on the surrounding bone. In this case, a 27-year-old male developed a symptomatic enchondroma within the proximal phalanx of his left fourth toe. Resection and insertion of a bone graft were considered optimal management.

A Morton's Neuroma Invading the Proper Digital Nerve.

We report a case of a 55-year-old female with extreme right fourth toe pain of unknown origin that was resistant to conservative care. Resection confirmed invasion of the neuroma into the fourth digit with hypertrophy and herniation of the proper digital nerve. The patient experienced an uneventful recovery with some minor neurogenic symptoms experienced at six months postoperatively that resolved with off-loading padding and heat massage.

Plantar vein thrombosis.

Plantar vein thrombosis is an uncommon and under-diagnosed cause of plantar foot pain. It is characterized by the formation of a blood clot (thrombus) within one of the plantar veins. Factors leading to this condition are unclear and multiple potential causes have been proposed.

Capsular Interposition Arthroplasty With Percutaneous Suture Anchoring: A Pragmatic and Novel Surgical Technique for Hallux Rigidus.

There is support for the use of capsular interposition arthroplasty (CIA) as an alternative to arthrodesis in the surgical treatment of hallux rigidus. In this technical report, the authors describe novel technical variations to the traditional capsular interposition arthroplasty that are anatomically rational, reproducible, and efficient. This technique was developed by the primary author and has been the preferred approach to CIA for over 10 years.

Venous Thromboembolism in Podiatric Foot and Ankle Surgery.

Background: The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis.

Methods: Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed.

Surgical management of extensive hypertrophic scarring of the halluces secondary to a decade of untreated onychocryptosis: An illustrative case report.

Extensive hypertrophic scarring of the halluces secondary to chronic onychocryptosis is a rare condition, which causes significant physical and psychosocial effects. In this case, a 31-year-old male developed large lesions on both great toes after he delayed treatment of chronic hallucal onychocryptosis for over a decade. Current treatment options for hypertrophic and keloid lesions in the foot and ankle vary considerably and differentiation is critical for appropriate treatment planning.

Angioleiomyoma of the Plantar-Medial Arch: A Case Report.

An angioleiomyoma is a benign soft tissue tumour that arises from smooth muscle layer of blood vessels. The true aetiology of these masses is largely unknown and quite often may not be associated with pain. This paper illustrates the occurrence of an angioleiomyoma in the medial arch of the foot, a previously unreported location.

Minimally invasive surgery for pedal digital deformity: an audit of complications using national benchmark indicators.

Background: There is increasing global interest and performance of minimally invasive foot surgery (MIS) however, limited evidence is available in relation to complications associated with MIS for digital deformity correction. The aim of this prospective audit is to report the surgical and medical complications following MIS for digital deformity against standardised clinical indicators.

Methods: A prospective clinical audit of 179 patients who underwent MIS to reduce simple and complex digital deformities was conducted between June 2011 and June 2013.

Autogenous capsular interpositional arthroplasty surgery for painful hallux rigidus: assessing changes in range of motion and postoperative foot health.

The autogenous capsular interpositional arthroplasty procedure can be a motion-sparing alternative to arthrodesis for the treatment of recalcitrant hallux rigidus deformity. Previous studies have reported positive results; however, many had small samples or lacked comparable preoperative measures. The present study used a prospective cohort study to assess the benefit of this technique for increasing range of motion, and comparative data to assess the reduction of pain and improvements in perceived foot health status for a consecutively drawn sample of patients.

Integration of podiatric surgery within an orthopaedic department: an audit of patient satisfaction with labour force implications.

Background: Podiatric surgery is well established in the National Health Service (NHS) in the UK with over 50 podiatric surgery units. This paper aimed to evaluate patient experience and satisfaction following foot surgery within a NHS orthopaedic department before and after the appointment of a podiatric surgeon. It highlights relevant labour force issues.

Bone and wound healing augmentation with platelet-rich plasma.

Over the past two decades, autologous platelets that have been sequestered, concentrated, and mixed with thrombin to generate growth factor-concentrated platelet-rich plasma for application to bone and wounds to aide healing have been a subject of great interest. This article reviews the literature related to the use of autologous platelet-rich plasma in bone and wound healing, and reviews the processes necessary to secure a high concentration of viable platelets. Although not yet definitive, autologous platelet-rich plasma has been shown to be safe, reproducible, and effective in mimicking the natural process of bone and wound healing.

A technique for isolated arthrodesis of the second metatarsocuneiform joint.

Arthrodesis for primary osteoarthrosis of the second metatarsocuneiform joint has received little attention in the literature when compared to salvage of posttraumatic osteoarthrosis after Lisfranc fracture dislocation. The use of screw or plate fixation is commonly advocated for such in situ arthrodesis, and the use of trephine/dowel plugs has also been described. The authors present an alternate approach for addressing primary osteoarthrosis of the second metatarsocuneiform joint with the use of Kirschner wires fashioned into staples with cancellous bone graft interposition.

A comparison of radiographic foot measurements taken in two different positions.

The purpose of this study was to ascertain if positioning of the feet for radiographic assessment produces significant variations in measured angles, and if measurements taken from radiographs taken on two separate occasions are reproducible. Weightbearing x-rays were taken of both feet of ten male healthy subjects in two standardized positions: 1) the angle and base of gait and 2) the feet together and straight-ahead positions. The radiographs were repeated 2 weeks later.