This case study presents a novel technique of end-to-end implantation of cadaver graft for the repair of a complete transversely torn peroneus brevis tendon and partially torn peroneus longus tendon in a 58-year-old woman with chronic lateral ankle instability and associated lateral collateral tears. She had a history of multiple ankle sprains and had previously undergone a failed peroneus brevis tendon retubularization procedure. The use of cadaver graft is well documented in the literature for tendon repairs but not well documented in end-to-end repair of the peroneal tendons. A review of the literature revealed only one 2013 study reporting on the benefits and clinical outcomes of cadaver allograft use in peroneal reconstruction.
Fibrosarcoma is an uncommon, malignant soft-tissue tumor that is rarely found as a primary neoplasm in the foot. A case report is presented that demonstrates a large, locally invasive fibrosarcoma of the plantar aspect of the foot with initial symptoms consistent with plantar fasciitis. Below-the-knee amputation was performed as curative treatment. (J Am Podiatr Med Assoc 92(9): 507-511, 2002)
The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised.
Diagnosis and treatment of longitudinal tears of the tibialis anterior tendon are not well documented in the surgical literature. Described here is successful primary surgical repair of a longitudinally torn tibialis anterior tendon in a 60-year-old woman. (J Am Podiatr Med Assoc 95(4): 390–393, 2005)
Norwegian, or crusted, scabies can be defined as a generalized severe scabies (Sarcoptes scabiei var. hominis) infestation usually affecting the immunocompromised patient that is most commonly seen with the leukemia-lymphoma group of neoplasms. The diagnosis is commonly missed, which can lead to mismanagement. We describe a patient with Norwegian scabies involving the lower extremities. The patient circumstances and treatment, as well as a review of the literature, are presented. The diagnosis of scabies should always be considered in patients with advanced malignancies and associated pruritus. (J Am Podiatr Med Assoc 94(6): 583–586, 2004)
Rhabdomyolysis is a debilitating condition that promotes muscle breakdown and eventually leads to renal dysfunction if not properly managed. The initial presentation may involve lower-extremity muscles, making the foot and ankle specialist one of the first specialists to recognize and diagnose this condition. Proper management of renal function is the primary concern; however, the underlying muscle breakdown needs to be addressed and the condition managed to prevent future problems. In this article we discuss treatment of a patient with exercise-induced rhabdomyolysis; a rehabilitation regimen is presented whose purpose is to condition muscles in order to prevent recurrence of exercise-induced muscle destruction after an acute event. (J Am Podiatr Med Assoc 97(3): 234–237, 2007)
Macrodystrophia lipomatosa is a rare disorder characterized by three-dimensional enlargement of one or more fingers or toes with predominantly fibroadipose tissue. Radiographically, it appears as hypertrophy of soft tissues and bones. The pathologic findings are infiltration and hypertrophy of adipose tissue in subcutaneous tissue, nerve sheaths, and periosteum. Macrodystrophia lipomatosa is usually diagnosed during childhood. The case presented here involves the most elderly patient with the condition ever reported, to our knowledge. As such, it may advance current knowledge of macrodystrophia lipomatosa. Special emphasis is given to the unique “bridge” formation seen radiographically in this case. (J Am Podiatr Med Assoc 95(5): 486–490, 2005)
During examination of an 11-year-old boy who had injured his right ankle, a benign tibial bone tumor was incidentally discovered. The bone tumor was initially treated with conservative care. When the patient returned with pain and an enlarging lesion, surgery was performed to prevent pathologic fracture. This case demonstrates the use of an allograft and synthetic bone graft material with growth factors in the treatment of a benign tibial bone tumor, avoiding the comorbidity and risk factors associated with autogeneic grafting. (J Am Podiatr Med Assoc 96(4): 351–355, 2006)
Painful legs and moving toes syndrome is characterized by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the lower extremities, especially the toes and feet. The pain is diffuse, intractable, aching, and deep. The movements consist of persistent writhing movements in the digits that cannot be limited voluntarily. The syndrome has been observed after a variety of abnormalities affecting the posterior nerve roots, the spinal ganglia, and the peripheral nerves. This article reviews commonly reported findings and current concepts in the etiology and management of this condition. (J Am Podiatr Med Assoc 91(7): 361-364, 2001)
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.