Cases reported "Foot Diseases"

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1/75. Bone cyst of a fishy origin: from an old catfish spine puncture wound to the foot.

    A rare first metatarsal unicameral-type bone cyst with a deceptive radiographic appearance and size and an unusual pathological etiology was identified in a female patient. This eccentric cyst was observed only postoperatively by radiograph. review of the patient's history documented a foot injury from a catfish spine as the etiology of this chronically inflamed cyst.
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keywords = operative
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2/75. Recurrent plantar keloid.

    Keloids of the plantar foot present a unique challenge to the surgical dermatologist. Many of the established regimens often fall short of their desired goals. Some of the obstacles to overcome include the repetitive nature of ambulation, the inability to primarily close the plantar foot, and the exquisite tendency for even fine suturing of skin grafts to form keloids. The use of excision, postoperative electron beam therapy, and secondary intention healing provides a useful approach in the management of plantar keloids.
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keywords = operative
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3/75. Plexiform schwannoma of the foot.

    The present report describes a plexiform schwannoma involving the subcutis of the foot in an 8-year-old boy. Gross findings revealed thin fibrous septa in a multilobulated tumor that was partly separated into free body-like nodules in the subcutis. Preoperative CT and MRI failed to delineate this multinodular architecture or free bodies. This is a case presentation including the CT and MR findings associated with plexiform schwannoma.
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keywords = operative
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4/75. factor xi deficiency: literature review and case presentation.

    factor xi deficiency is a rare hereditary bleeding disorder affecting the intrinsic pathway. Understanding the pathophysiology and clinical significance of this disease entity can help avoid potentially hazardous sequelae. This case presentation discusses laboratory criteria and serum assaying techniques utilized to appropriately manage preoperative or post-traumatic patients suffering from factor xi deficiency.
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ranking = 1
keywords = operative
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5/75. Management of foot pain associated with accessory bones of the foot: two clinical case reports.

    STUDY DESIGN: Case study. OBJECTIVES: To discuss the differential diagnosis, the nonsurgical and postoperative management of common accessory bones of the foot. BACKGROUND: Accessory bones of the foot that are formed during abnormal ossification are commonly found in asymptomatic feet. Two of the most common accessory bones are the accessory navicular and the os peroneum. Their painful presence must be considered in the differential diagnosis of any acute or chronic foot pain. The optimal treatment for the conservative and postoperative management of painful os peroneum and accessory navicular bones remains undefined. methods AND MEASURES: Therapeutic management of the fractured os peroneum included bracing, taping, and foot orthotics to allow healing of involved tissues, and stretching. The focus of the postoperative management of the accessory navicular was joint mobilization and progressive strengthening. Dependent variables included level of pain with provocation and alleviation tests of joint and soft tissue; girth and sensory tests of the foot and ankle; goniometric measures of foot and ankle; strength of ankle and hip muscles; functional tests; and patient's self-reported pain status. RESULTS: The patient with the fractured os peroneum was treated in 13 visits for 10 weeks. At discharge from physical therapy, the patient had the following outcomes relative to the noninvolved side: 100% return of normal sensation tested by light touch and vibration; pain decreased from 6/10 to 1/10; 100% reduction of swelling with ankle girth to normal; 100% range of motion of ankle and subtalar joints. Strength in plantar flexion and eversion remained 20% impaired (80% return to normal) secondary to pain. Upon discharge, he still reported mild pain when walking but was able to return to previous leisure activities. The second patient with the accessory navicular was treated in 18 visits over 9 weeks. Relative to the uninvolved side, she was discharged with the following: 70% return of range of motion in the foot and ankle, 100% of strength in hip and ankle, and 100% return of balance. She could squat and jump without pain and she returned to full premorbid activity level. CONCLUSIONS: Rehabilitative management of both cases addressed specific impairments and was successful in improving the patients' activity limitation. Clinicians should be aware that these accessory bones are possible sources of disability, secondary to foot pain.
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ranking = 3
keywords = operative
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6/75. Venous aneurysm of the dorsal venous arch.

    Clinically, a venous aneurysm is seen as a nonpulsatile mass with shrinkage upon elevation and enlargement with dependency. Confirmation of the diagnosis is best made by venography. In the case presented here of a rare aneurysm of the dorsal venous arch, the diagnosis of venous aneurysm was based on the histopathologic and intraoperative findings. If a venous aneurysm is symptomatic, it should be excised, with ligation of all feeder veins. In all cases, accurate preoperative diagnosis and evaluation allows for appropriate surgical planning.
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ranking = 2
keywords = operative
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7/75. Plantar fibromatosis: use of magnetic resonance imaging in diagnosis.

    For patients presenting with classic features of plantar fibromatosis, a presumptive diagnosis may be made on clinical grounds alone. In less clear cases, a biopsy may allow confirmation of the diagnosis; however, a biopsy exposes the patient to operative complications. magnetic resonance imaging (MRI) offers a noninvasive method for confirmation of the clinical diagnosis that may obviate the need for a biopsy. We describe a case that demonstrates the potential of this technique.
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ranking = 1
keywords = operative
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8/75. Compartment syndrome of the calf and foot following a displaced Salter-Harris type II fracture of the distal tibia: a review of the literature and a case report.

    A 14 year-old boy with an epiphyseal fracture of the distal right tibia and fibula developed compartment syndrome of the calf and foot. The diagnosis of compartment syndrome was delayed and a fasciotomy resulted in uncontrolled infection, which ultimately resulted in an above knee amputation. Constant vigilance is necessary in uncooperative or non-complaining patients to detect the signs and symptoms of compartment syndrome, even where the injury is not often associated with this complication. The difficulties in management, following a fasciotomy for delayed diagnosis of compartment syndrome, are discussed.
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ranking = 1
keywords = operative
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9/75. bone marrow edema of the forefoot after chevron osteotomy--a rare cause of metatarsalgia: a case report.

    Treatment options of bone marrow edema syndrome, which is associated with vascular disturbances, are protracted nonoperative treatment or core decompression which still demands several weeks until complete recovery. We obtained excellent results by the use of the vasoactive drug iloprost, a stable prostacyclin analogue, leading to a complete relief of symptoms in cases of bone marrow edema which had initially suggested early avascular necrosis of the second metatarsal head. The bone marrow edema of the second metatarsal bone was thought to be due to altered biomechanics following a distal first metatarsal chevron osteotomy. During the five days of iloprost infusion, the patient reported relief of rest pain. After therapy, the pedobarogram was normalized. The AOFAS forefoot score improved from 44 to 85 points after one month, and to 95 points after three months. At that time, the marrow showed normal signals. Without additional intervention the patient was able to resume normal activities.
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ranking = 1
keywords = operative
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10/75. Intraosseous epidermoid inclusion cyst in a great toe. A case report and review of the literature.

    Epidermoid inclusion cysts are benign lesions that occasionally occur in the distal phalanges of the fingers but are less frequently identified and underreported in the toes. We describe a 55-year-old man with a history of work-related trauma followed by painful expansion of his right great toe, resulting in great anxiety. Imaging studies revealed a radiolucent lesion in the distal phalanx of his right hallux. Clinical differential diagnoses included the possibility of an intramedullary inclusion cyst and other various radiolucent lesions. During surgery, a cystic lesion that contained creamy material was discovered. Frozen section diagnosis of the lesion was an intraosseous epidermoid inclusion cyst. The lesion was removed and the patient recovered uneventfully. Although it has been reported that an unduly large number of phalangeal cysts have been treated by amputation, the judicious use of intraoperative frozen sections can prevent this scenario.
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ranking = 1
keywords = operative
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