2008 Archive

Pigmented Villonodular Synovitis of the Ankle with Extensive Bone Involvement: A Case Report Remco J.A. van Wensen, MD, Michel P.J. van den Bekerom, MD, Thomas W. Patt, MD, Herman M. Peters, MD, Eric Breemans, MD [HTML] [PDF]

Abstract: We describe a case of a 49 year old man who presented with swelling of his left ankle for two months. After standard X-ray, ultrasound investigation, MRI and histological examination, the patient was diagnosed with pigmented villonodular synovitis and bone involvement of the ankle. A complete resection of the tumour was performed. A large bone defect after the resection was filled with cancellous bone graft. In pigmented villonodular synovitis, symptoms are often remarkably discrete for long periods. The course of the disease is slow, but progressive and destructive. This warrants awareness of this entity, early diagnosis, and aggressive management.

A Massive Foot Ganglion: Case Report Vasu Pai MS, D (Orth), National board (Orth), FICMR, FRACS, MCh (Orth), Vishal Pai, M.B., Chb[HTML] [PDF]

Abstract: Ganglion is one of the most common benign soft tissue swellings. The most common location is dorsum of the hand. However, it is not uncommon in the foot, but a massive ganglion is very rare. The case presented is one of a large, expanding ganglion over the dorsal aspect of the foot. This was successfully removed surgically. The foot is a relatively uncommon site of neoplastic and non-neoplastic soft tissue tumors. Although it contains a relatively small amount of somatic soft tissue elements, the foot is considerably rich in tendons, fasciae, retinaculae, and synovium.

A Unique Method of Plantar Forefoot Ulcer Closure using the Ilizarov Device: Series of 11 Patients with Leprosy
B. Jagannath Kamath, M.S. (Ortho), Praveen Bhardwaj, M.S., (Ortho) [HTML] [PDF]

Abstract: Recurrent plantar ulcer is a common and serious problem of anesthetic feet in leprosy. There are many methods described in the literature to deal this problem, but it still remains a great challenge for the treating surgeon. The problem lies not only in attaining the coverage and healing of the ulcer but also to prevent its recurrence. The skin of the forefoot is a specialized one and hence procedures aimed at providing skin from elsewhere will tend to fail. The local flaps described in the literature are effective, but forms a major surgery for this group of patients, requires an expert to perform and are not devoid of complications, which if occur can be disastrous. We are herein describing a technique of closure of these forefoot ulcers, which makes use of the biomechanical properties of the skin and provided closure of these ulcers by slow and sustained stretching of the surrounding natural skin. It thus provides the specialized plantar skin coverage for the ulcers.

Orthosphere® Zirconia Ceramic Implant for Arthroplasty in Fifth Tarso-Metatarsal Joint Arthritis of the Foot: A Case Presentation Brian Carpenter, DPM, FACFAS, Travis Motley, DPM, FACFAS , Kalieb Pourciau, DPM [HTML] [PDF]

Abstract: A case describing the use of the Orthosphere® Zirconia Ceramic Implant (Wright Medical Technology, Arlington, TN) is presented. The tarso-metatarsal joints in the foot are common sites for degenerative arthritis and pain secondary to trauma and biomechanical abnormalities. Often, conservative treatment is unsuccessful in relieving symptoms, and surgical intervention is required. The clinical presentation and surgical indications for use of the implant is described. A case is presented describing the indications and surgical technique. This implant has practical and promising implications for use in tarsal-metatarsal joint arthritis.

The Foot & Ankle Journal, Volume 1, No. 2 (2), 2008

Abstract: A case report describes an acute allergic contact dermatitis (ACD) to Mastisol® following foot surgery. A patch test was used to determine whether the patient was allergic to the DuraPrep™ skin prep, Steri-Strips™ or Mastisol® skin adhesive. Reaction to all patch sites with Mastisol® was observed. The contact allergy resolved within 3 to 5 days after starting oral Benadryl®, Medrol® and topical saline compresses. Initial presentation, patch testing and treatments are presented.

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The Foot & Ankle Journal, Volume 1, No. 2 (3), 2008

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Delayed Primary Closure of Diabetic Foot Wounds using the DermaClose™ RC Tissue Expander
David L. Nielson, DPM, Stephanie C. Wu, DPM, MSc, David G. Armstrong, DPM, PhD [HTML] [PDF]

Abstract: Closure of large wounds has been a challenge in podiatric surgery, especially after large defects created by ulcer debridement, metatarsal resection and amputation. The DermaClose™ RC tissue expander allows for closure of large defects without the need for traditional complex skin closure, tissue grafting or creation of skin and tissue flaps. Skin anchors made of surgical steel clips are used with a tension controller to allow for gentle skin stretching on the subcutaneous planes of the wound or defect. It also has special application in the closure of chronic wounds. Two case reports are presented to describe this technique.

Abstract: A case of ulcerated, classic Kaposi Sarcoma (KS) of the foot is described. This is a tumor of vascular endothelial origin which most commonly present in men 50-70 years of age. This case report includes presentation and discussion of differential diagnosis, surgical removal, histopathology interpretation, incidence of metastasis and treatment.

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The Foot & Ankle Journal, Volume 1, No. 3 (2), 2008

Abstract: The case of a 52 year-old man with a persistent ganglion cyst of the dorsolateral aspect of the ankle is presented. At excision, the ganglion communicated to a cystic region within the bone of the lateral malleolus. The patient was treated with curettage of the lateral malleolus and cancellous bone grafting.

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The Foot & Ankle Journal, Volume 1, No. 3 (3), 2008

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Clear Cell Sarcoma of the Foot: A Case Report of Malignant Melanoma of Soft Parts
Al Kline, DPM[HTML] [PDF]

Abstract: A case report is presented describing a clear cell sarcoma of the foot (malignant melanoma of soft parts). Melanoma is most commonly associated with pigmented lesions and nodules of the skin. Clear cell sarcoma (CCS) is an anaplastic tumor consisting of cells derived from melanoblasts not forming melanin in the skin, but rather mitotic changes more consistent with malignant melanoma in subcutaneous tissue, tendons and aponeuroses. The tumor is very rare and can pose clinical challenges in early diagnosis since the tumor lacks pigment and obvious color changes and can clinically appear as a benign soft tissue tumor. A case report including surgical excision, histologic features, and survival prognosis is presented.

Abstract: A case of ulcerated, classic Kaposi Sarcoma (KS) of the foot is described. This is a tumor of vascular endothelial origin which most commonly present in men 50-70 years of age. This case report includes presentation and discussion of differential diagnosis, surgical removal, histopathology interpretation, incidence of metastasis and treatment.