Conservative treatment is generally successful in treating early tarsometatarsal joint arthritis. However, if such treatment fails, invasive arthrodesis or arthroplasty may be needed. Arthroscopy is a less invasive alternative and can provide a precise diagnosis of early osteoarthritis or cartilage injury. Furthermore, arthroscopic treatments such as microfracture, chondroplasty, or loose-body removal are expected to delay progression of the osteoarthritis. We describe a 52-year-old man with early tarsometatarsal joint arthritis after calcaneal fracture healing who underwent a successful arthroscopic microfracture for cartilage defects. Arthroscopic findings show cartilage defects on the fourth and fifth tarsometatarsal joints. The patient underwent shaving and microfracture. The patient continues to experience effective symptom relief 3 months after surgery.
We report a unique case of the total loss of the intermediate cuneiform by posttraumatic avascular necrosis resulting from a left foot open fracture and dislocation of the navicular bone and medial and intermediate cuneiforms at the Chopart and Lisfranc joints in a 64-year-old woman. The injury was managed with open reduction and internal fixation with Kirschner wires and cannulated screws. During postoperative follow-up, we observed avascular necrosis of the intermediate cuneiform and the total loss of the bone. An extensive English literature search revealed only one case report published on this topic. Thus, we provide this case study to help guide clinical decision making in the future.
The causes of late-onset pain after total ankle replacement (TAR) are various, and include infection, subsidence, polyethylene spacer failure, osteolysis, and wear. There are few reports of late-onset pain caused by gouty attacks after total knee and hip arthroplasty. In addition, no research has reported gouty attacks after total ankle arthroplasty. Therefore, we report a case of a gouty attack after total ankle replacement. A 43-year-old man presented with pain after total ankle arthroplasty performed 5 years previously. We found a white-yellow crystalline deposit within the synovial tissue during ankle arthroscopy, confirmed by histologic examination.
The surgical management of distal intra-articular comminuted fracture of the tibia (pilon fracture) is difficult because complications frequently develop. The minimally invasive plate osteosynthesis technique is generally accepted for this type of fracture. In this study, complications developed after open reduction and internal fixation using multiple miniplates for accurate reduction of small fracture fragments. Therefore, when we use this technique, we need to pay attention to the development of complications such as nonunion, avascular necrosis, and osteomyelitis by the disruption of both endosteal blood supply by fracture and periosteal blood supply during approach or reduction.