Treatment of hallux valgus by double-V osteotomy

Thirty three feet in 29 patients with hallux valgus were treated by double-V wedge osteotomy of the head of the first metatarsal. They all had complete relief of pain and acceptable cosmetic appearance. There was occasional discomfort in one foot. The mean postoperative decrease of the intermetatarsal angle was 3, and of the hallux va1gus. angle 20. The surgical procedure described avoids or minimises the complication of Mitchell's operation and of its modifications

Treatment of persistent painful heel syndrome by corrective calcaneal osteotomy

One foot per subject was examined in a control material of 100 individuals, aged 21-65 years, mean 38.7 years, with non-symptomatic heels. Their calcaneus was radiographed in standard lateral and axial projections. The depths of both medial and plantar concavities of the normal calcaneus were measured, and their normal mean and standard deviation obtained. Based on these findings, and according to the radiological deformity of the os calcis, a calcaneal osteotomy was done for thirty one patients [34 heels], aged between 23 and 55 years, complaining of persistent painful heel. All patients were refractory to conservative treatment for at least 6 months prior to operation. They were followed up for an average of 26 months after operation. Complete symptomatic relief was obtained in 24 patients [27 feet]. Four patients had mild pain after long distance walking or running. Wound infection occurred in one case. Sloughing of the skin with exposure of the staples necessitating their removal occurred in another case. Painful neuroma happened in a third ease. It is concluded that calcaneal osteotomy has a beneficial biomechanical and biological effect in selected cases of persistent painful heel that are refractory to conservative treatment

Computed tomography versus plain radiography in diagnosis of bone tumours

25 patients suspected to have bone tumours on clinical examination, were subjected to laboratory and radiological examination including plain X-ray and computed tomography [CT]. Pathological examination after biopsy was done to confirm the final diagnosis. 16 [64%] out of 25 cases were diagnosed by plain x-ray, 15 [60%] of them showed intramedullary extension, while CT was useful in establishing the primary diagnosis in 22 [88%] patients with intramedullary extension in all of them. CT is an effective method in the diagnosis of bone tumours providing excellent data about the exact anatomical locations and intra and extra-osseous extensions of bone tumours

Disorders of the first metatarsal sesamoids

143 cases with metatarsalgia presented with pain, tenderness and sometimes swelling under the head of the first metatarsal bone were examined clinically and radiologically, two cases of which were examined histopathologically and 75 asymptomatic feet were examined as a control. Their assessement revealed that : 16 cases [11.1%] with dysplasia, 32 cases [22.5%] with malformation, 54 cases [37.8%] with malposition, 13 cases [9%] with osteochondritis, 19 cases [13.3%] with sesamoidometatarsal arthritis, 6 cases [4.2%] with osteomyelitis, and 3 cases [2.1%] with fracture. The suggested radiological assessements were noted and discussed