The Foot
We report a case of unilateral reflex sympathetic dystrophy (RSD) syndrome of the lower leg following tenolysis of the tendo Achillis. This syndrome has not been described following such a procedure. In the present case, preoperative bone scan was performed to exclude neoplastic or inflammatory causes of this pain. Retrospectively, signs of RSD syndrome were noticed in the bone scan in spite of the...
A 53-year-old man underwent triple arthrodesis of his right foot at the age of 13 for a traumatic drop foot. He subsequently developed severe varus deformity of his right hindfoot with 90 o of supination of the forefoot. A new technique involving a simultaneous double wedge excision osteotomy of the os calcis and tarsal fusion mass was performed. A pain-free plantigrade functional foot was...
State registered chiropodists/podiatrists may be considered to be 'the experts' in the successful treatment of verruca pedis: the common wart found on the feet. They are taught a wide range of treatments during their undergraduate teaching, ranging from simple chemical applications to removal in toto under local injected anaethesia.This paper looks at the dire outcome of an inopportune mixture of...
We report the first case of unilateral sequential Freiberg's disease in an adolescent girl with no predisposing factors.
Osteoarthritis (OA) is the most common joint disease and is reported to be seen first in the foot at an early age. While there have been controlled comparison studies of non-steroidal anti-inflammatory medications (NSAIDs) in the treatment of OA, these are mostly limited to the knee and hip. This randomized, double-blind parallel trial of 8 weeks duration compared piroxicam (Feldene, 20 mg daily)...
This is a case study of a 17-year-old female student who presented complaining of bilateral pain over the posterior tibial tendon following aerobics. The immediate diagnosis was that of 'shin splints' which is a vague term but will be defined. This study defines the syndrome, revises the relevant anatomy, summarizes the biomechanical diagnosis, attempts to explain why this foot type should contribute...
This paper describes the technique and outcome of the manipulation and straping of idiopathic clubfoot, using malleable aluminium finger splints in the neonatal period. We report the results of treating 103 feet, over a consecutive 9-year period. Surgery was required in 59 feet (57%) over a follow-up period of 4 years and 10 months. The splint complication rate was 4%. The advantages of the splinting...
POEMS syndrome is a rare multisystem disorder. We present a patient suffering from neuropathic changes in both ankles and hindfeet associated with this syndrome.
Dupuytren's contracture typically affects the fingers, usually in males, and occasionally accompanies Peyronie's disease. We report a rare case of a female patient with Dupuytren's contracture affecting the toes of both feet.
It is very easy to reassure patients with soft painless swellings on the sole of their foot that they have a lesion of no importance. We present a case report in which modern imaging techniques with magnetic resonance iamging and digital subtraction angiography prompted a diagnosis of malignancy and made excision biopsy mandatory.
An unusual case of idiopathic hallux varus is reported. An 84-year-old Japanese woman presented with bilateral hallux varus deformity accompanied by pain during a 2-year period. A Keller arthroplasty resulted in good alignment of the great toes and relief of pain. It is postulated that the elongated lateral capsule and collateral ligament of the great toe in combination with a small first and second...
This paper outlines the rationale for the provision of foot orthoses for paediatric patients with biomechanical foot disorders. It examines the gait and normal morphology of children and then presents some of the more common foot deformities. These are presented together with their effects on the whole of the weightbearing chain to reinforce the value of correction of such deformities in the developing...
Proximal interphalangeal joint fusion using a Kirschner wire technique is common, but little critical evaluation of it has been published. The procedure was undertaken in 19 patients, in a total of 42 toes. The results were assessed at 6 weeks and at a special review clinic more than 6 months after surgery. Infection rate was low at 7%. Fusion occurred in 83% and was not related to operator seniority...
Six fresh-frozen, below-knee cadaveric specimens had the tendons of the posterior tibialis, flexor digitorum longus, and flexor hallucis longus tendons secured to force transducers. The specimens were sequentially mounted in a testing machine with the ankle in neutral position. Inversion torque acting upon the calcaneus was transmitted via a pin placed through the calcaneus. The posterior tibial tendon...
A patient presented with swelling over the dorsal and lateral aspects of the foot, complaining of severe pain and some neuropathy. Radiological investigations revealed a fracture of the neck of the fourth metatarsal with evidence of healing. The patient had been suffering from Cushing's syndrome for 2 years.
Delayed or non-union of a mid-diaphyseal metatarsal fracture is not uncommon. However, when complicated by a serious overlying medical emergency, in this case a pulmonary embolism, treatment alternatives become limited. This case reviews the use of electrical bone stimulation as a treatment alternative for delayed union of a metatarsal fracture.