Nontraumatic bony abnormalities of the foot occur at different rates, according to the literature. However, it is uncommon to see rare variations presenting together in one patient. This article discusses two less common anomalies: fused os intermetatarseum and polymetatarsia without polydactyly. Etiology, symptomology, diagnosis, and treatment are reviewed, in addition to the relationship of the two conditions to each other. We then discuss a case where both anomalies are present at the same time in a 17-year-old patient.
Despite the importance to patients of driving, no well-established guideline exists to help either the patient or the physician determine when it is safe for the patient to return to driving. Previous studies have recommended 6 weeks postoperatively before patients can return to driving safely. Several scientific studies have found the nationally recommended safe brake time standard to be 1.25 sec (1,250 msec), looking at brake reaction time (BRT) in all types of patients, surgical and nonsurgical.
This is a prospective study assessing BRT after individuals are placed in various forms of immobilization (controlled action motion [CAM] boot, surgical shoe). The study also tested whether BRT is different when using the left foot to brake, with immobilization of the right foot.
All 29 male and 71 female participants in this study (mean age, 35.49 years) were capable of driving and were not currently being treated for any foot or ankle conditions. No differences were found regarding age, sex, and use of assistive devices. The mean BRT while wearing a CAM boot was 713 msec, while using the left foot to brake (CAM boot on the right foot) was 593.86 msec, and while wearing a surgical shoe was 626.32 msec.
Although most of the study participants were below the nationally recommended safe brake time standard, it was found that not all of the participants fell within these parameters.