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- Author or Editor: Daniel K. Lee x
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Metastases to the bones of the lower extremities from prostate carcinomas are rare and are usually associated with diffuse metastatic disease or primary tumors of the abdomen and lungs. I present the case of a patient who presented with lower leg pain and had undiagnosed prostate carcinoma. Unlike previous reports of prostate carcinoma, this rare case includes magnetic resonance imaging, histology, and medical management. This case is unique in its presentation and has not been described previously in the literature. (J Am Podiatr Med Assoc 98(3): 242–245, 2008)
Nasopharyngeal carcinoma is a rare tumor originating from the epithelium of the nasopharynx. Distant metastases involve the lungs, skeleton, liver, and occasionally the choroid. I present the case of a 33-year-old man with stage-IV nasopharyngeal carcinoma and an unusual distant metastasis to the hallux, which has not previously been described in the literature. (J Am Podiatr Med Assoc 98(3): 239–241, 2008)
International Public Health in Third World Country Medical Missions
When Small Legs Walk, We All Stand a Little Taller
Medical and surgical missions in Third World countries are mentally, physically, and financially demanding; however, there are many foot and ankle surgeons volunteering their time because it provides high levels of personal and emotional satisfaction. After many years in the missionary field, we would like to share a compilation study of our long-term experience and outcomes from our international medical and surgical pediatric mission trips to Latin American countries. We hope to instill in others the same passion for this work by sharing our portion of contribution in this vast world of international public health. (J Am Podiatr Med Assoc 99(4): 371–376, 2009)
We report on a patient with a large, painful hypertrophic scar on the plantar aspect of the left foot who was treated with carbon dioxide laser and a skin substitute (Apligraf) and followed up for longer than 1 year. To our knowledge, no other case reports have been published on the use of a skin substitute to gain coverage and resolution after excision of a hypertrophic scar by carbon dioxide laser. (J Am Podiatr Med Assoc 94(1): 61-64, 2004)
Ankle involvement by synovial chondromatosis is unusual. It is unknown whether a post-traumatic event to the ankle induces the formation and development of these lesions. Synovial osteochondromatosis associated with post-traumatic ankle events are rare but suggest trauma to the synovial tissues as being causative, although this has never been statistically confirmed owing to the lack of reports and frequency. We report a case of primary synovial osteochondromatosis involving the tibiotalar joint with painful symptoms after a history of ankle injury, including magnetic resonance imaging findings of this unusual condition. (J Am Podiatr Med Assoc 98(1): 70–74, 2008)
Forefoot Adductus Correction in Clubfoot Deformity with Cuboid-Cuneiform Osteotomy
A Retrospective Analysis
Background: Forefoot adduction is the most common residual deformity in the treatment of pediatric clubfoot. Little documentation exists regarding its late occurrence and early detection. A retrospective analysis was conducted to determine the effect of primary posterior medial release for idiopathic clubfoot that had failed to improve with conservative treatment or had presented after a treatment delay and a subsequent forefoot adduction correction with a cuboid-cuneiform osteotomy.
Methods: Radiographic evaluations were conducted of all of the surgical procedures performed at our institution for idiopathic clubfoot during a specified period. Preoperative and postoperative talo–first metatarsal and talocalcaneal angles were measured radiographically. Of 138 patients with clubfoot deformity who met the inclusion criteria, 51 underwent a primary posterior medial release; of these patients, 18 (26 feet) underwent a subsequent cuboid-cuneiform osteotomy.
Results: The average preoperative and postoperative talo–first metatarsal anteroposterior angles for patients who underwent primary posterior medial release were 44.6° and 26.8°, respectively. The mean reduction in forefoot adduction was 17.8° (P < .05). After the osteotomy, the average talo–first metatarsal anteroposterior angle was 16°, with an average reduction of 10.8° (P < .05). Mean follow-up was 61.2 months. The average patient age was 3.2 years.
Conclusions: Eighteen (35%) of 51 patients who underwent a posterior medial release required a subsequent cuboid-cuneiform osteotomy. The average reduction of 10.8° was statistically significant and has also proved to be clinically significant in the overall correction of the deformity. (J Am Podiatr Med Assoc 97(2): 126–133, 2007)