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- Author or Editor: Vincenzo Denaro x
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Metatarsus adductus is a structural foot deformity that is rarely associated with hallux valgus deformity. Surgical treatment is challenging, and multiple osteotomies are often required to correct both deformities. However, surgical impact must be considered, especially in elderly patients. We present a clinical case of a 76-year-old woman affected by hallux valgus and metatarsus adductus deformity. Multiple distal oblique osteotomies were performed on the first, second, and third metatarsals, coupled with Z-lengthening of the extensor digitorum longus tendons. (J Am Podiatr Med Assoc 100(3): 204–208, 2010)
Triplanar distal osteotomy is a safe procedure for mild-to-moderate hallux valgus deformity. It allows shortening and plantar displacement of the first metatarsal while correcting the intermetatarsal angle. However, complications such as dorsiflexion and excessive shortening of the first metatarsal have been associated with distal osteotomy. We describe a new device, designed by one of the authors (P.R.), that enables precise positioning of the Kirschner guide wire for the osteotomy cuts. (J Am Podiatr Med Assoc 99(6): 536-540, 2009)
We report the clinical features, radiographic findings, management and results of a patient with a post-traumatic synovial sarcoma of the anterior tibialis tendon. Our patient was managed operatively and with radiotherapy with good clinical results. No evidence of recurrence or metastatic disease was seen at 3-year follow-up. (J Am Podiatr Med Assoc 102(2): 157–160, 2012)
We report the clinical features, radiographic findings, management, and results of a patient with bilateral hallux valgus and associated bilateral tibial hallux sesamoid agenesis and fibular hallux sesamoid hypoplasia. Our patient was managed operatively with good clinical results. Combined tibial sesamoid agenesis and fibular sesamoid hypoplasia do not seem to negatively influence the management of hallux valgus. (J Am Podiatr Med Assoc 101(5): 452–455, 2011)
Nonunion of the first metatarsal after hallux valgus surgery is a rare complication that often results in significant pain and disability requiring surgical management. We report the case of a 42-year-old woman who developed a pseudarthrosis of the first metatarsal after percutaneous retrocapital distal osteotomy of the first metatarsal for a mild hallux valgus deformity. The operative treatment consisted of debridement of fibrous nonunion with plating followed by application of pulsed electromagnetic fields (PEMF) with an external device. (J Am Podiatr Med Assoc 102(1): 78–82, 2012)
Background:
Sesamoid bones and accessory ossicles of the foot and ankle, although mostly asymptomatic, can be sources of pain or degenerative changes in response to overuse and trauma. We investigated the prevalence of accessory ossicles and sesamoid bones in a population of Italian women with hallux valgus.
Methods:
A single-center study was performed to determine the prevalence of accessory ossicles and sesamoid bones in the ankle and foot. A total of 505 women with hallux valgus aged 26 to 80 years at the time of hallux valgus correction were examined. Anteroposterior, oblique, lateral foot radiographs and a Muller view were examined regarding the presence, prevalence, coexistence, and distribution of accessory ossicles and sesamoid bones in both feet. The radiographs were analyzed independently by three experienced specialists in foot and ankle surgery. Disagreements were discussed in a consensus meeting, where the radiographs were reevaluated and a final decision was made.
Results:
There was no statistically significant difference between data of the accessory ossicles and sesamoid bones according to the χ2 test. Sesamoid bones were detected in 404 of the 505 patients. The fifth metatarsal sesamoid bone was found in 97 patients. All of the patients presented hallucal sesamoid bones.
Conclusions:
This is the first detailed report of the prevalence of accessory ossicles and sesamoid bones of the feet in Italian women with hallux valgus. These findings could help clinicians in the diagnosis and management of disorders of accessory ossicles and sesamoid bones, which are often undiagnosed, painful foot syndromes. (J Am Podiatr Med Assoc 103(3): 208–212, 2013)
