Bilateral congenital peroneal tendon subluxation.

Congenital subluxation of the peroneal tendons is an uncommon, but not rare condition. In almost all cases, it will spontaneously resolve without requiring any treatment. Presented is a case report of the condition affecting the patient bilaterally.

Prospective analysis of postoperative wound infections using an early exposure method of wound care.

The management of operative wounds in most surgical procedures is important in preventing many complications, most notably, infection. Among most surgical subspecialties, postsurgical dressings vary in type of materials utilized as well as duration left in place. The authors propose that the contemporary method of postoperative wound management (i.

A comparison of the efficacy of injectable dexamethasone sodium phosphate versus placebo in postoperative podiatric analgesia.

Forty-two patients undergoing identical bilateral foot surgery were evaluated in a double-blind study designed to evaluate the efficacy of injectable dexamethasone sodium phosphate versus placebo as an analgesic. Patients who had elective foot surgery on an outpatient basis received an injection of dexamethasone sodium phosphate in one foot and an equivalent injection of normal sterile saline in the contralateral foot. Both the patients and the surgeons were unaware of which foot was injected with each agent.

Sonographic evaluation of interdigital neuromas.

The purpose of this study is to evaluate the effectiveness of sonography to accurately identify interdigital neuromas. Twenty patients, all complaining of interdigital neuroma type pain, underwent sonographic evaluation of the symptomatic intermetatarsal space and adjacent interspaces. Each patient subsequently had surgical exploration of the symptomatic site.

Bilateral os peroneum fractures: comparison of conservative and surgical treatment and outcomes.

Acute fracture of the os peroneum without concurrent rupture of the peroneus longus is a rarely cited injury. Sudden violent contraction of the peroneus longus muscle and direct trauma are documented mechanisms of injury. This injury can easily be overlooked due to its infrequency, and it may lead to chronic pain and impairment of function.

Intravascular fasciitis in the foot.

Intravascular fasciitis is a rare benign condition characterized by reactive fibroblastic proliferation arising from the superficial or deep fascia and involving arteries and/or veins. Intravascular fasciitis is a distinct variant of a more common condition called nodular or pseudosarcomatous fasciitis, which possesses clinical and histologic features similar but lacks vascular invasion. The fibroblastic violation of the vascular network suggests a malignant component and often leads to an inappropriate diagnosis for this benign condition.

Major arthrodeses in patients with neuropathic arthropathy.

Neuropathic arthropathy is a complex deformity found in a multitude of disease processes. Various forms of conservative and surgical treatment options have been reported throughout the literature; however, a limited number of such treatments address the underlying deformity. This article reviews the indications and surgical criteria necessary to perform successful arthrodesis procedures in patients afflicted with this problem.

Antibiotic prophylaxis and tourniquet application in podiatric surgery.

The use of prophylactic antibiosis in podiatric surgery is common, especially in patients undergoing endoprosthetic procedures, major arthrodeses, lengthy procedures, or in immunocompromised patients. The goal of prophylaxis is to prevent infection. For this to occur, there must be an adequate concentration of the antimicrobial agent in the tissue at the time of the incision.

Retrospective analysis of operative ankle fractures.

Closed-ankle fractures presenting to the podiatric service between 1978 and 1991 are reviewed. Patients able to return for follow-up were tested through Cybex isokinetic testing, proprioception, and radiographic studies. All patients reviewed had equal or greater strength and endurance on the involved side when compared to the uninvolved side.

Reconstruction of an Achilles tendon defect utilizing an Achilles tendon allograft.

Acute ruptures of the Achilles tendon are common. Treatment for such ruptures is well documented. Treatment for chronic ruptures with a significant defect poses a surgical dilemma.

Aeromonas hydrophila--its implications in freshwater injuries.

Lacerations or puncture wounds sustained in freshwater environments are susceptible to contamination by Aeromonas hydrophila. Numerous cases have been reported of cellulitis secondary to water-related injuries requiring hospitalization where A. hydrophila was the isolated organism.

Surgical considerations for hematogenous osteomyelitis.

Surgical treatment of hematogenous osteomyelitis is uncommon in the literature. Indications for surgical decompression, along with a review of the literature, is presented. A case history of a 7-year-old male with hematogenous osteomyelitis of the first metatarsal treated by surgical decompression and 12-month follow-up is discussed.

Tibiofibular arthrodesis for malunion of the talocrural joint.

Reconstruction of malunited or an incongruous talocrural articulation is relatively unrecognized within the literature and few procedures have been described. This article reviews a case of a 36-year-old male who presented with chronic ankle pain, secondary to a malunion of the ankle joint. The case presentation, including surgical treatment and follow-up care, is presented.

The role of endoscopy in treatment of stenosing posterior tibial tenosynovitis.

Some foot and ankle pathologic conditions can be treated by an endoscopic approach. Its effectiveness has been reported in the treatment of plantar fasciitis. The authors have used an endoscopic approach in the treatment of posterior tibial tenosynovitis resistant to nonsurgical treatment.

Synovitis secondary to silicone elastomeric joint implant.

The authors present a case study of synovitis after an arthroplasty of the first metatarsophalangeal joint and placement of a hemisilicone joint implant. This was an unusual presentation because excision of the prosthesis was necessary 1 month after placement. Also, a review of the literature is presented on silicone synovitis and other complications that arise after silicone joint implantation.

Polymetatarsia as an etiology for Tailor's bunion deformity: a surgical approach.

Congenital pedal deformities are well documented within the literature. The following article reviews a case history of a 4-year-old girl with a unique case of polymetatarsia and the complications associated with the resultant deformity. The history, case presentation, surgical treatment rendered, and follow-up care are presented.

Primary repair of lateral collateral ligaments of the ankle utilizing the Mini-Statak device.

Ankle sprains are among the most commonly treated injuries that present to the emergency room, and often most inadequately diagnosed and treated. When diagnosed properly, the appropriate treatment is easily determined. When indications point to surgical repair of the lateral collateral ligaments of the ankle, the following technique, utilizing the Mini-Statak device, offers a simplified and timesaving alternative.

Three-dimensional computerized tomography: a quantum leap in diagnostic imaging?

Ever since the discovery of radium by Madame Curie, men and women of vision and science have labored to improve radiation technology. Over a period of approximately 85 years, we have gone from this initial discovery to three-dimensional computerized transmission tomography; one of the latest techniques in modern day x-ray imaging. Its uses are vast and unparalleled in many facets of medicine and surgery, outlining pathology as never before seen, and possibly, never before completely understood.

Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study.

A comparative study of endoscopic plantar fasciotomy versus traditional type heel spur surgery has been performed involving 76 patients and 92 procedures. Sixty-six of those procedures consisted of endoscopic fasciotomy, whereas 26 involved traditional type surgery. Those patients in which the endoscopic fasciotomy was performed had significantly less postoperative pain, returned to regular activities 4 weeks earlier, and had fewer complications postoperatively than those patients involving traditional heel spur surgery.

First metatarsophalangeal joint arthrodesis utilizing a mini-Hoffman External Fixator.

Arthrodesis was initially indicated for severe hallux valgus and hallux rigidus. Today, it is primarily a salvage procedure, which provides a painless first metatarsophalangeal joint. This manuscript reviews the various procedures for arthrodesis of the first metatarsophalangeal joint.

Subluxing peroneals: a review of the literature and case report.

Subluxing peroneal tendons is an uncommon entity that can be acute or chronic. Presented is a literature review of etiology, classifications, diagnosis, and treatments of peroneal tendon subluxation. A case report is also presented illustrating a modification of the Jones procedure for treating peroneal tendon subluxation.

Giant cell tumor of the talus with secondary aneurysmal bone cyst.

Giant cell tumors of the talus are very uncommon. Secondary aneurysmal bone cyst changes are well documented in the literature with giant cell tumors being one of the most common underlying lesions. However, no previous case of this combination has been documented in the podiatric literature.

Close range shotgun wounds to the foot.

Presented in a case report of a close range shotgun wound. The nature, description, management, and long-term treatment of these wounds are discussed. Also presented are the reasons for the differences in short- versus long-range shotgun wounds.

A new method of repair for rupture of the Achilles tendon.

Rupture of the Achilles tendon requires prompt and appropriate treatment to prevent prolonged or permanent disability. Although the literature abounds with evidence supporting both conservative and surgical treatment, more recent studies report lower rerupture and complication rates with surgical repair. The development of ligament anchoring devices has led to new methods of repair for ligament and tendon injuries.

A unique osteochondral fracture of the first metatarsophalangeal joint.

Presented is a case report of an osteochondral fracture occurring at the base of the proximal phalanx of the hallux secondary to trauma. Initial radiographic and clinical examination did not reveal the diagnosis. However, prolonged symptoms of pain, swelling, and limitation of first metatarsophalangeal joint range of motion led to further radiographic evaluation, which confirmed a suspected diagnosis of an osteochondral fracture.