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- Author or Editor: Antonio Córdoba-Fernández x
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Management of Nonreducible Lesser Toe Interphalangeal Dislocation
An Unusual Injury
Interphalangeal joint dislocations of the lesser toes are relatively rare in clinical practice. Most nonreducible interphalangeal joint dislocations occur as a result of rupture or interposition of the plantar plate or of the collateral ligament in the joint space, thus hindering a closed reduction and, in most cases, compelling an open reduction. A post-reduction radiologic exploration is then essential to identify such an entity and proceed consequently. In some cases, such as the one introduced herein, a misdiagnosis, along with an inadequate surgical correction may lead to recurrence of the deformity and, ultimately, to a salvage arthrodesis. (J Am Podiatr Med Assoc 102(3): 252–255, 2012)
Epidermoid cysts of the sole of the foot are rare lesions that must be differentiated from other, more common subcutaneous pathologic abnormalities located on the sole. Cases of epidermoid cysts that extend to the interosseous musculature are rarer still. We report the case of a giant epidermal cyst in a 64-year-old individual that extended to the intrinsic musculature of the third space of the right foot and that was diagnosed after fine-needle aspiration biopsy and subsequent cytologic study. Differential diagnosis of these lesions should be made with the support of additional imaging tests, and diagnostic confirmation should always be obtained after surgical removal and subsequent histopathologic study.
Pseudogout of the First Metatarsophalangeal Joint Associated with Hallux Valgus
An Atypical Bilateral Case
Calcium pyrophosphate dihydrate crystal deposition disease has various clinical features, and pseudogout is one of the six clinical forms. Chondrocalcinosis is the term used to describe the radiographic appearance of the disease. A review of the literature revealed that the appearance of this type of arthropathy in the foot is infrequent. We offer a review of the disease and report an atypical bilateral case of pseudogout in a patient 56 years of age without a history who presented with symptoms of arthritis localized in the first metatarsophalangeal joint associated with hallux valgus and was treated surgically. Radiographic evaluation of the feet did not reveal signs of chondrocalcinosis. The patient had no metabolic abnormalities, except for high uric acid values. Chemical analysis of the surgical samples demonstrated the presence of calcium pyrophosphate dihydrate crystals, confirming the diagnosis. We believe that arthropathy by deposition of calcium pyrophosphate dihydrate in the foot, although rare, must be considered in the podiatric physician’s differential diagnosis when a patient presents with articular pain in the foot associated or not with deformities. (J Am Podiatr Med Assoc 100(2): 138–142, 2010)
Tenosynovial giant cell tumor is the common term used to describe a group of soft-tissue tumors that share a common etiologic link. These tumors are relatively infrequent in the foot and ankle, and occasionally they may be the cause of destruction of the adjacent bone structures. We report the imaging appearance and pathologic findings of two patients with localized tenosynovial giant cell tumor of the forefoot. Both of these patients underwent surgical gross total resection. However, one of the patients experienced a recurrence. Their clinical, radiologic, and pathologic features, with their treatment protocol, are summarized retrospectively, and related literature is reviewed in an attempt to enhance the understanding of these tumor lesions. Clinicians should perform a careful preoperative and postoperative examination and complete tumor surgical resection with the aim of reducing local recurrence.
Background: The growth factors derived from platelets contained in platelet-rich plasma comprise a series of molecules that favor the production of collagen with the proliferation of fibroblasts and new blood vessels. These substances exert their effect on the cells, acting in all the stages of cicatrization, especially in hemostasis and early fibroplasia.
Methods: Thirty-five patients (70 feet) were selected, operated on both sides for ingrown hallux nails, and subjected to two different experimental conditions in a crossover clinical trial with positive control of treatment. Two main variables were analyzed: on one side, the bleeding, according to three preestablished categories, and on the other, the mean time of cicatrization in days.
Results: Significant differences (P < .001) were found between the two groups for bleeding. We observed that cicatrization time did not differ significantly between the two treatments.
Conclusion: The use of platelet gel for the treatment of onychocryptosis by single nonincisional matricectomy can guarantee good hemostasis, with a significant reduction in bleeding, but does not produce a clinically significant reduction in cicatrization time. (J Am Podiatr Med Assoc 98(4): 296–301, 2008)
Myxoinflammatory fibroblastic sarcoma of the soft tissues is a rare low-grade tumor of uncertain origin that most often occurs on the extremities of adults. The tumor predominantly involves the subcutaneous tissues of the hands and feet. Despite being a rare neoplasm, owing to its varied histologic appearance, myxoinflammatory fibroblastic sarcoma should be differentiated from various benign and malignant soft-tissue lesions. Myxoinflammatory fibroblastic sarcoma has been well described in pathology journals but not in the surgical literature. We report a case of myxoinflammatory fibroblastic sarcoma in a 19-year-old man with a plantar ulcer lesion in his left foot. To our knowledge, this is the first reported case in the literature involving the epidermis. (J Am Podiatr Med Assoc 100(6): 497–501, 2010)
