Cases reported "Foot Diseases"

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11/33. Cuboid oedema due to peroneus longus tendinopathy: a report of four cases.

    OBJECTIVE: To highlight focal bone abnormality in the cuboid due to tendinopathy of the adjacent peroneus longus. DESIGN: A retrospective review was carried out of the relevant clinical and imaging features. patients: Two male and two female patients were studied, mean age 51.5 years (range 32-67 years), referred with foot pain and imaging showing an abnormal cuboid thought to represent either tumour or infection. RESULTS: A long history of foot pain was usual with a maximum of 8 years. Radiographs were normal in two cases and showed erosion in two, one of which exhibited periosteal new bone formation affecting the cuboid. Bone scintigraphy was undertaken in two patients, both of whom showed increased uptake of isotope. MRI, performed in all patients, showed oedema in the cuboid adjacent to the peroneus longus tendon. The tendon and/or paratendinous tissues were abnormal in all cases, but no tendon discontinuity was identified. One patient possessed an os peroneum. Unequivocal evidence of bone erosion was seen using MRI in three patients, but with greater clarity in two cases using CT. Additional findings of tenosynovitis of tibialis posterior, oedema in the adjacent medial malleolus and synovitis of multiple joints in the foot were seen in one patient. Imaging diagnosis was made in all cases avoiding bone biopsy, but surgical exploration of the peroneal tendons was performed in two cases and biopsy of ankle synovium in one. CONCLUSIONS: Oedema with erosion of the cuboid bone, simulating a bone lesion (cuboid "pseudotumour"), may be caused by adjacent tendinopathy of peroneus longus. It is vital to be aware of this entity to avoid unnecessary biopsy of the cuboid.
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ranking = 1
keywords = tibia
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12/33. Post-traumatic compartment syndrome of the foot.

    Post-traumatic compartment syndrome in the foot is an unusual but well-recognized entity. If there is an awareness of the condition at the time of presentation it can be diagnosed and treated effectively. A case of compartment syndrome in the foot of a 17-year-old boy after massive lower-extremity trauma is described. The simple and readily available diagnostic techniques are emphasized and an alternative approach to plantar decompression, which avoids exposure of and potential damage to the posterior tibial neurovascular bundle, is presented.
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ranking = 1
keywords = tibia
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13/33. Free posterior tibial perforator-based flaps.

    Free posterior tibial perforator-based flaps, fed by a perforator from the posterior tibial artery, were applied in 2 patients. The advantages of this flap are that they are reliable, relatively large and thin flaps, making it possible to use an innervated flap without sacrificing the posterior tibial artery. This flap provides great advantages for the reconstruction of skin defects at the extremities.
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ranking = 7
keywords = tibia
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14/33. Reverse-flow posterior tibial island flap: preliminary report of a new fasciocutaneous flap.

    Septocutaneous vessels constitute an important source of skin circulation in the leg and form the basis of various fasciocutaneous flaps that have useful clinical applications. In 1978, Goufan and Baogui described a flap from the forearm based on the radial artery (Chinese forearm flap). With this in mind, the reverse-flow posterior tibial fasciocutaneous flap (Thai leg flap, or TLF) was designed and successfully transferred clinically to cover lower leg and foot defects in 2 patients. The factors that permit a distally based flap to be raised in the lower leg against the direction of the venous valves, and the backflow of arterial blood, are also described. The versatility, advantages, and disadvantages of this new flap in the reconstruction of defects of the lower leg and foot are discussed.
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ranking = 5
keywords = tibia
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15/33. The use of adjunctive hyperbaric oxygen in treatment of orthopedic infections and problem wounds: an overview and case reports.

    We summarize indications, contraindications, and therapeutic guidelines for the use of adjunctive hyperbaric oxygen therapy (HBO) in problem wounds and selected orthopaedic infections. Three typical cases that all were successfully treated with HBO are presented: a chronic osteomyelitis which was a sequela to an open tibia fracture, a second- and third-degree burn injury of the entire lower extremity, and a case of chronic osteomyelitis in an insulin-dependent diabetic.
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ranking = 1
keywords = tibia
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16/33. hemangiosarcoma of the left foot and tibia: case report.

    A case of a hemangiosarcoma involving the bones of the foot in a diabetic patient who had swelling of the left foot is reported. Radiographs demonstrated multiple lytic areas throughout the bones of the foot. Clinically and radiographically, infection was suspected, but the biopsy revealed the presence of tumor. Metastases to the tibia were found and an above the knee amputation was performed. Chemotherapy was given, but 6 months later the patient died. hemangiosarcoma is known to involve the different bones of the foot in a "multicentric" fashion and should be considered in the differential diagnosis of lytic lesions of multiple bones of the lower extremities.
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ranking = 5
keywords = tibia
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17/33. A new approach to heel ulcers: dorsalis pedis neurovascular trans-interosseous island flap.

    The most important requisite in the care of ulcers in the heel region is replacement skin cover with adequate sensation. The dorsalis pedis flap appears adequate, but the anterior subcutaneous approach gives a pedicle of inadequate length to enable the flap to reach the most important posterior weight-bearing area. It was therefore decided to short-circuit the course of the pedicle by passing the whole flap through the interosseous membrane between the tibia and the fibula to enable the flap to reach the weight-bearing area without tension. After 10 meticulous cadaver and two post-traumatic limb dissections with angiographic confirmation, it appeared that such a flap was feasible and would satisfy all basic requirements. Clinically this technique was tried in two patients who were provided with sensate, well padded skin cover for the whole of the heel region.
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ranking = 1
keywords = tibia
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18/33. Talar compression syndrome.

    Ballet dancers frequently stand on the tips of their toes in the en pointe and demi-pointe positions, resulting in compression of the posterior structures of the ankle during repeated plantar flexion of the foot, producing the talar compression syndrome. This mechanism may result in posterior block or impingement of an os trigonum or Stieda's process. When the dancer attempts to force the foot into plantar flexion, the os trigonum or the Stieda's process may be impinged between the calcaneus and the posterior edge of the tibia. pain and tenderness are localized at the posterolateral aspect of the ankle behind the peroneal tendons. In nondancing members of the population, these conditions are usually asymptomatic. It is the requirement of the classical dance for a well-pointed foot that produces symptoms. We are reporting up to 7 years follow-up of six professional ballet dancers in whom we removed the os trigonum for symptomatic talar compression syndrome, caused by the trauma of the en pointe position of toe dancing. Two patients had bilateral operations. All six patients returned to professional dancing within a few months and remained asymptomatic. The anatomy of this condition is reviewed, as well as the diagnosis and treatment.
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ranking = 1
keywords = tibia
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19/33. Tarsometatarsal amputation and tibialis anterior tendon transposition to cuneiform I.

    Tarsometatarsal amputation often results in dropfoot followed by pressure points problems and making prosthetic fitting difficult. To avoid the dropfoot deformity and retain mobility of the ankle, the amputation was modified by transposing the tibialis anterior from metatarsal I to cuneiform I.
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ranking = 5
keywords = tibia
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20/33. Instep island flaps.

    The instep island flap is safe and useful. It is based on branches of the posterior tibial artery and can be a musculocutaneous or a direct fasciocutaneous island flap. Sensory branches of the digital nerves may be transposed with the flap. There is a wide arc of transposition and the flap has survived even in very difficult circumstances.
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ranking = 1
keywords = tibia
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