Long-standing nonhealing charcot foot ulcers that fail conservative care: is major amputation always the solution?

Charcot arthropathy represents a potentially devastating complication in patients with diabetes; this is most significant when an ulcer and/or infection are present. When conservative therapies fail to relieve symptomatology, amputation usually represents the next step in the treatment algorithm. However, in appropriate patients, reconstructive procedures performed by specially trained surgeons may change this paradigm and prevent amputation.

Tibial sesamoid fracture in a softball player.

A single case of a tibial sesamoid fracture in a softball player is reported here. A review of the literature confirms that this is an unusual and difficult problem to treat in the athletic population given the significant loads placed on the sesamoids during athletic activity. In the case presented, conservative care was not effective, and the athlete underwent surgical excision of the fractured sesamoid.