The Foot
Stress fractures of the talus are uncommon and are usually associated with a recent increase in activity due to participation in unaccustomed exercise such as running, dancing, general fitness or military training. The clinical signs and radiological findings are usually subtle in the early stages, which often leads to delay in presentation and reaching an accurate diagnosis. We present an unusual...
The Thomas method of ankle arthrodesis has been used, employing a simplified technique for joint surface resection and deformity correction. The technique is described and discussed. Arthrodesis was successful in 31 of 33 ankles (94%). The two failures were due to avascular necrosis and infection at the time of surgery. Clinical and radiographic review of 21 patients with 22 ankles, at 2 to 20.5 years...
Footprints have been utilized for many years to quantify spatial parameters of gait for the purpose of research and to assist in the recognition of abnormal function in the clinical setting. However, no consensus exists in the literature as to how footprint data should be interpreted. Furthermore, the reliability of footprint evaluation has not been appropriately investigated. As a result of this...
The aim of this research project was to establish the presence of bacteria and/or fungal spores in podiatric drill handpieces. Then, to ascertain if any organisms present could be considered a cross-infection risk to patients and others, and establish a means of controlling that risk. This was assessed by collecting samples of dust from the two different types of handpieces used at the Leaf Hospital,...
Twenty-two patients were treated for achillodynia. Ultrasound study was used for diagnosis and follow-up of treatment. Three pathologies identified ultrasonographically: partial Achilles tendon tear(s) (13 patients); primary tendonitis (four patients), or tendonitis secondary to Achilles tendon partial rupture (eight patients): and peritendonitis (five patients). All patients were treated by physiotherapy,...
Dislocation of the tibialis posterior tendon (TPT) at the ankle level is very rare. The difficult clinical diagnosis frequently causes delay of surgical treatment. Loss of TPT function impairs normal posture and walking stance because of the acquired flat foot deformity. English literature has reported only 16 cases of traumatic TPT dislocation. 1 , 3 - 1 0 Significance...
Fractures of the proximal portion of the fifth metatarsal 1.5 cm distal to the proximal end are called Jone's fractures. They are said to tend to be followed by delayed union or non-union when treated conservatively and surgical treatment is often recommended. There have also been reports of good results from conservative therapy, and, therefore, we decided to review 36 cases of Jones' fracture.Jones'...
The study comprised of 10 patients (nine ballet-dancers and one athelete) who underwent excision of the os trigonum, due to pain on full plantar-flexion. In each case, at surgery the retrotalar fat appeared to be under pressure and bulged through the incision site. Histological examination revealed extensive fibrosis of this fat. It is postulated, therefore, that impingement had occurred between the...
Stress fractures of the proximal phalanx of the great toe are very rare. We have encountered such fractures in four patients with no clear history of injury. The patients consisted of one male and three female high-level athletes. All were in their teens but their epiphyseal line had already closed. The three women exhibited a tendency toward hallux valgus. Three of the four patients were treated...
Haemangiomas in tendons and tendon sheaths are very rare. We report on a 34-year-old man who sustained a rupture of his Achilles tendon. Treatment consisted of suturing the tendon following excision of the pathological region. Full recovery of muscle strength ensued.
Dislocation of the four medial toes at the metatarsophalangeal joint (MTPJ) has not been previously reported. The patient was a 35-year-old man who sustained the injury in a motorcycle accident. Manual reduction was easily performed but maintenance of reduction was difficult. Ten years later, osteoarthritic changes at the MTPJs were present with severe limitation in activities of living.
The closed chain motions of the talus, calcaneus, navicular and cuboid are coupled. Thus, the function of the ankle, subtalar and midtarsal joints are interdependent. The rearfoot complex provides a model of these coupled motions which supersedes the current model of rearfoot function which is based on subtalar joint function alone. The use of a single rearfoot complex model in its present form is...
This is a study of the use of a silicone elastomer ball spacer over a 19-year span. This has proved a useful and safe prosthesis for replacing the damaged first metatarsophalangeal joint.
A number of indirect methods of estimating the height of the medial longitudinal arch of the foot have been devised. 1 The efficacy of the arch index as a valid and convenient predictor of arch height has been questioned. 2 In this study, arch index was measured in 45 elderly subjects and navicular height was measured from weight bearing radiographs. Normalized navicular height was...
Thirty patients with residual, chronic post-sprain ankle pain, with no clinical or radiological signs of instability and inconclusive X-ray findings, were screened by computerized tomography (CT) scan. There were 18 men and 12 women with a ratio of 3:2. The initial lateral ankle sprain was due to recreational sports in 11 (36.7%), military training in seven (23.3%) and walking and climbing stairs...