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Ding W, Han T, Gu J, Xue X. Bizarre parosteal osteochondromatous proliferation of the metatarsal bone: A case report. Asian J Surg 2024; 47:1195-1196. [PMID: 37993312 DOI: 10.1016/j.asjsur.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Wenqiang Ding
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu Province, China.
| | - Ting Han
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, 225001, Jiangsu Province, China.
| | - Jiaxiang Gu
- Department of Hand and Foot, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98, Nantong West Road, Yangzhou, 225000, Jiangsu Province, China.
| | - Xiaowei Xue
- Department of Hand and Foot, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, No.98, Nantong West Road, Yangzhou, 225000, Jiangsu Province, China.
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Kanemitsu M, Nakasa T, Ikuta Y, Sumii J, Nekomoto A, Kawabata S, Deie M, Adachi N. Morphology and deformity of the distal phalanx in hallux valgus. J Orthop Sci 2023:S0949-2658(23)00269-5. [PMID: 37852898 DOI: 10.1016/j.jos.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/07/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Studies have shown that the first metatarsal contributes to hallux valgus. The proximal phalanx, another factor that defines the hallux valgus angle, also contributes to the development of hallux valgus. There have been no reports on the use of computed tomography to evaluate bone morphology of the proximal phalanx. The purpose of this study was to analyze the morphology and deformity of the proximal phalanx and its relationship to hallux valgus using computed tomography, and to consider the indications for proximal phalanx surgery in hallux valgus. METHODS Patients who consulted at our clinic for foot and ankle disorders and underwent both weight-bearing radiography and computed tomography between May 2019 and March 2022 were included in the study. The hallux valgus angle, sesamoid subluxation, first metatarsal length, proximal phalanx length, metatarsal-proximal phalanx ratio, proximal phalanx valgus angle, metatarsal-proximal phalanx angle, proximal phalanx rotation angle, and distal phalanx-proximal phalanx angle were measured. These parameters were compared between the hallux valgus and control groups. In the hallux valgus group, the hallux valgus and proximal phalanx valgus angles were measured and compared using weight-bearing radiographs. RESULTS A total of 83 feet in 65 patients were diagnosed with hallux valgus (hallux valgus group; mean age of 68.0 ± 13.8 years) and 30 feet in 22 patients without hallux valgus (control group; mean age of 67.0 ± 25.8 years) were included in the study. The proximal phalanx length, metatarsal-proximal phalanx ratio and angle, and distal phalanx-proximal phalanx angle were significantly greater in the hallux valgus group than in the control group. However, the proximal phalanx valgus and rotation angles were not significantly different between the groups. CONCLUSION Since there was no significant difference in the proximal phalanx morphology, except length, between the hallux valgus and control groups, the indications for osteotomy of the proximal phalanx should be carefully considered.
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Affiliation(s)
- Munekazu Kanemitsu
- Department of Orthopaedic Surgery, Akiota Hospital, 236, Shimotonogouchi, Akiota-chou, Yamagata-gun, Hiroshima, 731-3622, Japan.
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan; Sports Medical Center, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Junichi Sumii
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Akinori Nekomoto
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shingo Kawabata
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Masayoshi Deie
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Daghighi MH, Mahmoudpour M, Akhavi Milani A. Osteoid osteoma of the second metatarsal bone diagnosed on MRI: A case report and literature review. Radiol Case Rep 2021; 17:423-426. [PMID: 34917221 PMCID: PMC8666446 DOI: 10.1016/j.radcr.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Osteoid osteoma is a relatively common benign bone tumor that is most frequently seen on the appendicular skeleton in adolescents and young adults. Here we present the case of a 14-year-old boy presenting with a 10 month history of pain in his left foot which had been misdiagnosed as stress fracture due to its unusual clinical presentation. Magnetic resonance imaging of the left foot revealed a bone lesion with typical features of the osteoid osteoma on the distal part of the second metatarsal bone. The lesion was surgically removed and the diagnosis of osteoid osteoma was confirmed by post-surgical histopathologic examination of the resected section. The patient reported a substantial relief in his pain 4 weeks following the surgical operation.
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Affiliation(s)
| | - Masoud Mahmoudpour
- Radiology Department, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akhavi Milani
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Neretin AS, Menshchikova TI. Value of ultrasonography and radiography for the study of bone regeneration in lengthening of the fourth ray in brachymetatarsia. Foot Ankle Surg 2021; 27:432-438. [PMID: 32561159 DOI: 10.1016/j.fas.2020.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Distraction osteogenesis is frequently used for brachymetatarsia. METHODS Brachymetatarsia of the fourth ray was treated with the Ilizarov method in 10 females. Distraction rate was 1.00-0.75mm a day. Radiography and ultrasonography were used to study the regeneration course throughout the distraction and fixation phases. RESULTS Mean lengthening achieved was 2.28cm in the average distraction period of 30.2 days and average fixation phase of 50.2 days. Ultrasonography detected the regeneration signs and zonal structure of the regenerate earlier than radiography. It confirmed slow regeneration in two patients and their distraction rate was corrected. One patient had premature consolidation on distraction day 10 and needed re-osteotomy. CONCLUSIONS Combination of radiography and ultrasonography to study bone regeneration in brachymetatarsisa provides a better monitoring of distraction callus progression. Ultrasonography is of great value to detect regeneration problems during early stages of lengthening.
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Affiliation(s)
- A S Neretin
- National Ilizarov Medical Research Centre for Traumatology and Orthopeadics of the Ministry of Health of Russia, orthopaedic department 6, Russia.
| | - T I Menshchikova
- Laboratory of limb length and deformity correction, National Ilizarov Medical Research Centre for Traumatology and Orthopeadics of the Ministry of Health of Russia, Russia
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Guler O, Cerci MH. A comparative overview of metatarsal stress fractures in premenopausal and postmenopausal women: our single-centre experience with eighty-one patients. Int Orthop 2020; 44:2407-12. [PMID: 32607794 DOI: 10.1007/s00264-020-04528-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 03/04/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the demographic, clinical, and laboratory features of metatarsal bone stress fractures encountered in premenopausal and postmenopausal women. METHODS This retrospective study was carried out in the orthopaedics and traumatology department of our tertiary care centre. Data were collected from the hospital records of a total of 81 women (average age 42.65 ± 12.97) allocated in premenopausal (n = 36) and postmenopausal (n = 45) groups. These two groups were compared in terms of age, body mass index, side, and level of the metatarsal stress fracture, serum levels of vitamin D, duration of complaint and treatment, and T-scores of femur and vertebra as measured by dual-energy X-ray absorptiometry. RESULTS The average body mass index (BMI) was 27.00 ± 2.49 kg/m2 (range 21.8 to 31.2). The right side was involved in 44 cases (54.3%), while the left side was affected in 37 patients. DXA T-scores were significantly high for group 2 for both femur and vertebra (p < 0.001 for both). Two groups did not exhibit any significant differences in terms of BMI, side of the stress fracture, level and location of the fracture, seasonal distribution, smoking habits, comorbidities, serum levels of vitamin D, durations of complaints, and treatment. CONCLUSION Our results indicated that there was no difference between 2 groups in terms of serum vitamin D levels; however, postmenopausal women had higher T-scores of femur and vertebra. Identification of patients under higher risk for stress fractures and elucidation of the possible role of menopause necessitate further controlled, randomized trials on larger series.
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Hartog C, Centmaier-Molnar V, Patzwahl R, Pfofe D, Wiewiorski M. [Bizarre parosteal osteochondromatous proliferation of the metatarsal bone]. Orthopade 2016; 45:901-5. [PMID: 27562128 DOI: 10.1007/s00132-016-3317-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A bizarre parosteal osteochondromatous proliferation (BPOP), also known as a Nora lesion, is a rare benign bone formation. It emanates mainly from the intact cortex of the metaphysis of short tubular bones (hands or feet). Conventional radiographs should be complemented using cross-sectional imaging modalities (CT/MRI). In the absence of symptoms a non-operative regime with radiological and clinical controls is possible. If symptomatic, excision biopsy is the treatment of choice, though a high recurrence rate has been reported. Histopathological examination confirms the diagnosis and typically shows an endochondral ossification zone and an unusually mineralized cartilaginous matrix referred to as "blue bone".
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Affiliation(s)
- C Hartog
- Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Schweiz
| | - V Centmaier-Molnar
- Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Schweiz
| | - R Patzwahl
- Institut für Radiologie und Nuklearmedizin, Kantonsspital Winterthur, 8401, Winterthur, Schweiz
| | - D Pfofe
- Institut für Pathologie, Kantonsspital Winterthur, 8401, Winterthur, Schweiz
| | - M Wiewiorski
- Klinik für Orthopädie und Traumatologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Schweiz.
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Siddiqui B, Faridi S, Faizan M, K Sherwani R. Cytodiagnosis of ChondromyxoidFibroma of the Metatarsal Head: A Case Report. Iran J Pathol 2016; 11:272-275. [PMID: 27799977 PMCID: PMC5079461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/07/2016] [Indexed: 06/06/2023]
Abstract
Chondromyxoid fibroma (CMF) is a rare benign cartilaginous tumor with a predilection for the bones of lower extremities and about one fourth of the tumors involve the foot. Radiologically, an eccentric lytic lesion with well-defined margins is seen in the metaphysis of the bone. We hereby, report an 18 yr old young male who presented to Orthopedic Outpatient Department, JN Medical College, Aligarh Muslim University, India diagnosed with giant cell tumor of the third metatarsal bone of right foot on radiography but on fine needle aspiration cytology (FNAC) the diagnosis of CMF was made. Preoperative diagnosis of this benign condition helped in doing minimum surgical intervention in the form of curettage along with bone grafting. Histopathology further confirmed the diagnosis of CMF. The case is being discussed to highlight the importance of FNAC to diagnose these uncommon benign bone lesions.
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Affiliation(s)
- Bushra Siddiqui
- Dept. of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - ShahbazHabib Faridi
- Dept. of Surgery, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohd Faizan
- Dept. of Orthopaedics, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Rana K Sherwani
- Dept. of Pathology, JN Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Tahririan MA, Momeni A, Moayednia A, Yousefi E. Designing a prognostic scoring system for predicting the outcomes of proximal fifth metatarsal fractures at 20 weeks. Iran J Med Sci 2015; 40:104-9. [PMID: 25821289 PMCID: PMC4359929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 08/28/2013] [Accepted: 09/15/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fractures of the proximal fifth metatarsal bone are among the most common fractures observed in the foot and their classification and management has been subject to much discussion and disagreement. In this study, we aim to identify and quantify the effect of possible predictors of the outcome of the treatment of proximal fifth metatarsal fractures. METHODS Patients with established proximal fifth metatarsal fractures were enrolled in this prospective cohort and the outcome of their treatment was assessed using the AOFAS mid foot scale at 6 and 20 weeks. RESULTS 143 patients were included in the study. Our study showed that displacement, weight and type III fractures were significant independent predictors of poor outcome at 6 weeks while at 20 weeks in addition to these factors, gender and diabetes mellitus were also shown to be significant independent predictors of poor outcome. A scoring system was designed by assigning weight to these factors and it was shown to be a strong predictor of outcome at 20 weeks. CONCLUSION We recommend that our scoring system would help surgeons to decide whether patients' prognostic factors are significant enough for him/her to opt for a surgical approach to treatment rather than a conservative approach.
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Affiliation(s)
- Mohammad Ali Tahririan
- Department of Orthopaedic Surgery, Kashani University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Amir Momeni
- Department of Orthopaedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Amir Moayednia
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Yousefi
- Department of Orthopaedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran;
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