The Foot
We describe a traumatic bony avulsion of the extensor hallucis longus in a young soccer player after a hyperflexion injury to his great toe. To our knowledge, this injury has not previously been reported.
Fracture of the sustentaculum tali is a rare injury. Although treatment of acute injuries is well documented, subsequent treatment of delayed or non-union has not been previously described. We present the case reports of three patients who sustained injuries to the sustentacum tali associated with delayed union. The varied symptoms and treatments provided to these patients are described, and the treatment...
We report a very rare tumour of the distal fibula in a 3-month-old female infant. This tumour, which we have called 'fibular fasciitis', gives the radiographic and pathological appearances of an aggressive lesion and therefore its recognition as a benig entity needs to be appreciated to avoid overtreatment.
High resolution ultrasound scanning of the plantar surface of the foot was performed on 60 patients with symptoms suggesting Morton's neuroma. Sixty-four feet underwent ultrasound examination prior to surgery and 70 intermetatarsal clefts were reported on. The clinical outcome in 15feet with normal scans is unknown, since they remain unoperated. Of the remaining 51 clefts reported positive for a neuroma,...
In the first part of the interobserver error study, 40 independent podiatrists observed ten different slides of common foot and leg conditions. Each observer was supplied with text describing the patient's subjective symptoms and the anatomical level of the condition to be diagnosed. They were then asked to make a diagnosis of the patient's condition from the slides. Later, the diagnosis was classified...
We report a rare site for the old chestnut of a digital neoplasm mimicking infection. Although metastatic lesions to the nail-bed of the hallux have been documented, there are few reports of squamous carcinoma arising as primary disease at this site. This case is additionally interesting in that initial biopsy was unhelpful in establishing the definitive diagnosis.
The clinical manifestations of chronic venous insufficiency are reviewed. These include venous stasis, stasis dermatitis and venous ulceration. The pathophysiology of these manifestations is discussed in detail. The changes seen in chronic venous insufficiency result from interstitial microedema and successful treatment of these problems requires reduction of interstitial edema. Compression is the...
We report a case of Freiberg's disease of the second metatarsal head in an 18-year-old man, diagnosed 1 year after fracture of the second to fourth metatarsals. A definite history of minor foot trauma is not uncommon in Freiberg's disease but we believe this to be the first reported case consequent to major fracture of the affected metatarsal.
In this study, the incidence of long second toe in university students aged 17-25 was examined. In male students the incidence of long second toe in 155 right feet was 9.03% and in 154 left feet 11.03%. In female students the incidence of long second toe in 150 right feet was 6.66% and the incidence in 150 left feet was 8.00%. The length difference of the second toes between males and females was...
Necrobiosis lipoidica diabeticorum (NLD) is an unusual dermatological condition with a characteristic clinical appearance, unusual histopathological features, unknown aetiology and a strong association with diabetes mellitus. A case history is presented with a review of the clinical features, histopathological findings, theories on pathogenesis, differential diagnosis; and reported therapeutic options...
We present a technique for correction of overriding fifth toe, involving Z-plasty of the dorsal skin. We reviewed 20 toes in 19 patients at a mean of 73 months after surgery. There were 12 good, 4 fair and 4 poor results.
Osteochondroma, the most frequently encountered benign bone tumour, is generally seen in the long bones. It is rarely found in the distal extremities. The following case is reported because it arises from a very rare site with atypical radiological features.
Three cases of medial subtalar dislocation, a rare injury, and the clinical outcome are reported here. Prompt recognition of these injuries followed by early closed reduction and cast immobilization for 3 weeks is recommended.
A glomus tumour of the lesser toes is very rate. We present a case of glomus tumour arising in the third toe in a 21-year-old man. Microscopically, mast cells were found to be close to nerve fibres in the connective tissue adjacent to the tumour. This suggests that mast cells may play an important role in the generation of pain in glomus tumours.
Numerous factors may be implicated in the low cure rate of onychomycosis. 1 , 2 This study evaluates the contact time necessary to achieve a fungicidal effect, using 28% Tioconazole solution. The test organisms were Trichophyton rubrum and Candida albicans, these organisms being isolated commonly as the cause of fungal foot infections. 3 , 4 The methodology is an adaptation...