Ankle arthroscopy: follow-up study of 33 ankles--effect of physical therapy and obesity

A retrospective analysis was conducted of 32 patients (33 ankles) who had undergone surgical ankle arthroscopy for chronic ankle pain that was recalcitrant to conservative treatment. All patients were examined clinically and completed a written questionnaire. Intraoperative ankle arthroscopy showed hypertrophic synovitis, adhesive bands, chondral bands with synovitis, osteophytes, and abnormalities in the talar dome. Results of treatment after an average follow-up time of 1.4 years (range: 0.33 to 12.5 years) showed ankle scores of 15 excellent, 11 good, 5 fair, and 2 poor. Obesity was significantly related to the outcomes of arthroscopy procedures. Obese patients were more likely to be rated as fair or poor, while nonobese patients were significantly more likely to be rated excellent or good. Those patients who received physical therapy postoperatively for one or more months had significantly better ankle ratings than those who did not elect to have physical therapy.

Longitudinal epiphyseal bracket: associated foot deformities with implications for treatment

The longitudinal epiphyseal bracket is a rare ossification defect of bones of the hands and feet and results in an abnormal epiphysis that is C-shaped, longitudinally oriented, and vertically extends into the diaphysis. The longitudinal epiphyseal bracket may exist as an isolated deformity, but is commonly associated with digital deformities such as polydactyly, duplicated digits, congenital hallux varus, and clinodactyly. Five case histories of children with the longitudinal epiphyseal bracket in different bones of the foot are described with three distinct clinical presentations. The development of the longitudinal epiphyseal bracket and implications for treatment are considered.

Surgical correction of adult neglected clubfoot: three case histories

Surgical correction of the neglected, and severely deformed clubfoot in the adult is necessary to achieve plantigrade, pain free, and cosmetically acceptable feet. Also, it is important that the patient is able to wear shoes and participate in a more active and normal life. Three adult immigrants with neglected clubfoot underwent surgical correction for the first time. Posterior medial plantar soft tissue release and a double arthrodesis involving calcaneal cuboid wedge resection with talonavicular fusion have been effective in removing rearfoot varus, providing minimal shortening, and restoring the foot to a normal plantigrade position.

Combined technique for surgical correction of pediatric severe flexible flatfoot

Ten patients with 12 symptomatic severe flatfeet were treated with a combined surgical technique. Patients 10 years or older were treated with Evan's calcaneal osteotomy, Young tenosuspension, and tendo achillis lengthening. Patients under age 10 were treated with modified Young tenosuspension, talonavicular desmoplasty and subtalar arthroereisis. Eight of the 10 patients had marked relief in pain and fatigue and were able to perform all physical activities. Radiographic criteria showed improvement for all patients in all categories.

First and second metatarsophalangeal joint dislocation. A case report

A case of dislocated first and second metatarsophalangeal joints was reported along with the mechanics and mechanism of injury. The practitioner must be familiar with the mechanism of injury and radiographic classification to determine the proper indications for closed versus open reduction. The authors' review of the literature did not reveal a similar case involving a dislocation of the first and second metatarsophalangeal joints.

Kaposi's sarcoma of the lower extremity as the first sign of AIDS

The authors review four cases of Kaposi's sarcoma that were presented to the Foot Clinics of New York and affiliated North General Hospital during a 1-year period from the fall of 1987 to the fall of 1988. The authors conclude that it is sometimes difficult to diagnose Kaposi's sarcoma and to differentiate between the acquired immunodeficiency (AIDS) form and the classic form. Guidelines for diagnosis and a profile of the AIDS-related and non-AIDS-related Kaposi's sarcoma patient are discussed.

Long-term follow-up of clubfoot surgery: analysis of 44 patients

The purpose of this study was to evaluate the long term results of clubfoot surgery. Forty-four patients were evaluated for periods from one to 41 years. The evaluation was based upon clinical, radiological and functional criteria. Results revealed that in spite of anatomically and radiologically imperfect feet, most patients demonstrated excellent levels of function. The results of other follow-up clubfoot studies were analyzed and compared to the present study.