Cases reported "Foot Injuries"

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1/88. 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 = wound
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2/88. Treatment of stingray injury with topical becaplermin gel.

    Stingray injuries are most commonly characterized by localized pain, ulceration, and edema; however, potentially serious sequelae may result, including tissue necrosis and life-threatening infection. This case report describes a stingray injury that had progressed to ulceration and was treated with topical application of recombinant human platelet-derived growth factor-BB (becaplermin gel 0.01%) and a standardized regimen of wound care.
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ranking = 0.25
keywords = wound
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3/88. vancomycin-resistant Enterococci infected puncture wound to the foot. A case report.

    vancomycin is often administered empirically to patients with osteomyelitis, septic arthritis, septic throbophlebitis, infected burns, and cellulitis of the lower extremities when methicillin-resistant staphylococci are suspected, or when a staphylococcus organism is suspected in a penicillin-allergic patient. physicians must be aware of the guidelines established regarding the use of vancomycin to avoid bacterial resistance. physicians also must be aware of the procedures that have been developed to help contain nasocomial outbreaks of vancomycin-resistant Enterococci.
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ranking = 1
keywords = wound
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4/88. Soft-tissue reconstruction of sole and heel defects with free tissue transfers.

    Reconstruction of the weight-bearing surface of the foot is a challenging problem for the reconstructive surgeon. Because local tissues are not usually available for reconstruction, distant tissue transfers are often necessary. The authors report 20 patients with sole and heel defects that were reconstructed with free flaps. Two patients had bilateral reconstruction. Three patients were younger than 10 years. Etiological causes were burn scar (N = 7), trauma (N = 7), chronic wound (N = 3), and tumor resection (N = 5). All defects were located at a weight-bearing area. Gracilis muscle (N = 11), neurosensorial radial forearm (N = 7), latissimus dorsi muscle (N = 2), rectus abdominis muscle (N = 1), and posterolateral thigh flaps (N = 1) were used for reconstruction. Muscle flaps were preferred for the deep and irregular defects or chronic, open infected wounds. All flaps survived except for one total and two partial complications of necrosis. recurrence of ulceration was observed in 1 patient with spinal cord trauma. The mean follow-up period was 33.7 months (range, 1-84 months). patients were evaluated by direct gait observation, footprints, pedograms, and the Semmes-Weinstein monofilament test. All patients returned to normal daily activity with individual gait patterns. Functional outcomes of both muscle and fasciocutaneous flaps were satisfactory. Presence of deep sensation, preservation of musculoskeletal integrity, and patient compliance are the main factors for durability of reconstruction.
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ranking = 0.5
keywords = wound
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5/88. replantation of an avulsive amputation of a foot after recovering the foot from the sea.

    A foot avulsion case, with the dismembered body part submerged in sea water for 1 hour, is presented. This report is unique in that it is the first to document the reattachment of a body part that had been submerged in sea water. It was not known how salt-water exposure would affect wound management. Differences in osmolarity and bacterial flora between the sea water and foot tissues have not caused any problems, and the patient has not suffered any vascular or infectious complications after replantation. Neurotization of the plantar surface by the tibial nerve, which was stripped off during amputation and replaced in its original traces, was the most critical part of convalescence. After management of such an interesting case, we conclude that exposure to sea water of the dismembered part should not be a contraindication for replantation surgery.
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ranking = 0.25
keywords = wound
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6/88. The clinical application of a fetal membrane on a diabetic patient's injury.

    A description of the successful use of a fetal membrane in the recovery of a injured patient is presented. A diabetic female patient, 63 years old, was accidentally injured with a winnowing fork, which opened the skin of the front side of her left foot. For first two weeks, she was submitted to a treatment involving antibiotics, analgesics and antiinflammatories, but the infection did not disappear and the pain was almost unbearable. At the end of the third week, the injury underwent surgical washing with epidural blockage; suitable insulin dose and oral antidiabetics controlled the high-glucose concentration. However, due to the intensity of the pain, a risky epidural blockage was administered every four hours for 12 days. Finally, a radiosterilised human fetal membrane, which was collected at HCSAE and processed at ININ, was used as a biological wound dressing. Biological control of the tissue was performed at Facultad de Quimica de la Universidad Nacional Autonoma de mexico (The chemistry faculty of the National Autonomous University of mexico) (UNAM). As a result, the pain first diminished and then stopped. The healing process started in a few days and led to a complete recovery in 2 1/2 months. At present, the patient is in good condition, living a normal life.
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ranking = 0.25
keywords = wound
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7/88. recurrence of pyoderma gangrenosum within a chronic wound following microvascular free-tissue transfer.

    The authors present a 29-year-old woman with a chronic foot wound that failed to heal, despite extensive medical and surgical therapy. The diagnosis of pyoderma gangrenosum was ultimately made, and the patient was started on systemic cyclosporine therapy. In the absence of apparent active disease, surgical debridement and microvascular free flap reconstruction were performed to achieve wound closure. Six weeks postoperatively, recurrence of the pyoderma gangrenosum was identified in the free flap, resulting in partial, superficial, flap necrosis. Laboratory evaluation at that time demonstrated subtherapeutic cyclosporine levels. Once the cyclosporine level was increased to the therapeutic range, the wound healed, and the microvascular free flap was salvaged. Because of the relative lack of precision in both the clinical and pathologic determination of acuity level, as well as the tendency toward pathergy, surgical treatment of any form poses many potential risks for these patients. For this reason, surgery should serve only as an adjunct to medical therapy, which remains the mainstay for treatment of pyoderma gangrenosum.
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ranking = 1.75
keywords = wound
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8/88. Free flap coverage of bilateral frostbite of the feet.

    The indications, principles of management, and outcomes of free flap transfer for limb salvage in four patients with bilateral frostbite of their feet are presented. A fasciocutaneous flap was used for coverage when the wound involved a single surface of the foot. When multiple surfaces of the foot required free flap coverage, a muscle flap was used because it could more easily improve the shape and contour of the defect. Successful coverage was achieved in all four patients.
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ranking = 0.25
keywords = wound
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9/88. Full-thickness burn of the foot: successful treatment with Apligraf. A case report.

    Burn wounds, although uncommon in the foot, present a uniquely challenging opportunity to physicians. The keys to successful management include a proper and specific initial evaluation of the burning agent, the location, the TBSA affected, and the depth. Ultimately, proper recognition and meticulous wound care with skin grafting, when necessary, bring about the desired results. A case report of a patient with a third-degree burn over the dorsum of the left foot is presented. This case is unique in that Apligraf, a human skin equivalent, was used to gain coverage and eventual resolution of the wound. It is the authors' opinion that the use of Apligraf in this application is a viable alternative to traditional methods of skin harvesting and grafting. To the authors' knowledge, there have been no other cases reported of Apligraf use in burn wound coverage of the foot.
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ranking = 1
keywords = wound
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10/88. rubber foreign bodies in puncture wounds of the foot in patients wearing rubber-soled shoes.

    We report 8 cases of puncture wound of the foot associated with rubber foreign bodies in patients who were wearing rubber-soled shoes. The difficulty in making the correct diagnosis and the complications arising from these injuries are reviewed. The morbidity associated with these seemingly innocuous puncture wounds can be serious. Infective complications resolved only with removal of all imbedded rubber foreign bodies. A history of wearing rubber-soled shoes during the injury and a high index of suspicion may prevent complications.
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ranking = 1.5
keywords = wound
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