This report highlights an unusual case of an atypical melanocytic proliferation in a pediatric patient and the surgical method used to repair the defect. I describe a 10-year-old boy with hallux irregular discoloration that was present from birth and rapidly enlarging. A biopsy led to the diagnosis of atypical melanocytic proliferation, which may represent an unusual manifestation of early melanoma in situ. Complete excision of the patch was performed, and the hallux was repaired using a double advancement flap for closure, thus curing the patient.
A 55-year-old man with poliomyelitis presented with a plantarflexed foot and painful ulceration of the sub–first metatarsophalangeal joint present for many years. A two-stage procedure was performed to bring the foot to 90°, perpendicular to the leg, and resolve the ulceration. The first stage corrected only soft-tissue components. It involved using a hydrosurgery system to debride and prepare the ulcer, a unilobed rotational skin plasty to close the ulcer, and a tendo Achillis lengthening to decrease forefoot pressure. The second stage corrected the osseous deformity with a dorsiflexory wedge osteotomy of the first metatarsal. The ulceration has remained closed since the procedures, with complete resolution of pain.
The purpose of this case study was to highlight a potential limitation of magnetic resonance imaging in diagnosing longitudinal tendon tears and to emphasize the importance of clinical examination for peroneal tendinopathy. We describe a 15-year-old female with lateral ankle pain, who was negative for peroneal tendon tear on magnetic resonance imaging. Owing to high clinical suspicion of peroneal tendon pathology, we opted to take the patient to the operating room and found a 6.5-cm longitudinal tear and a low-lying muscle belly of the peroneus brevis tendon. A low-lying muscle belly of the peroneal tendon has been shown to be associated with increased tendon tears.
This report discusses an unusual case of a 23-year-old woman with a painful bipartite medial cuneiform and severe arthritic and cystic changes at the partition with no history of trauma. Magnetic resonance imaging confirmed a large cyst with subchondral erosions at the dorsal and plantar segments with significant bone marrow edema. Definitive treatment consisted of arthrodesis on the dorsal to plantar segments using one lag screw, demineralized bone matrix grafting, and a bone stimulator.
This case report highlights a novel approach to strengthening the repair of a split peroneus brevis tendon tear with a peroneus quartus muscle autograft. We describe a 51-year-old woman with a longitudinal split tear of the peroneus brevis tendon confirmed by magnetic resonance imaging. Intraoperatively, a peroneus quartus muscle was appreciated, resected, and used as an autograft in the repair of the peroneus brevis tendon. Use of a peroneus quartus muscle as an autograft in peroneal tendon repair has not been documented in the literature, to our knowledge.