Retrospective analysis of operative ankle fractures.

Closed-ankle fractures presenting to the podiatric service between 1978 and 1991 are reviewed. Patients able to return for follow-up were tested through Cybex isokinetic testing, proprioception, and radiographic studies. All patients reviewed had equal or greater strength and endurance on the involved side when compared to the uninvolved side. Proprioceptive deficits were noted in all patients with lateral malleolar involvement regardless of time of follow-up.

Binding of Co(III) to a DNA oligomer via reaction of [Co(NH3)5(OH2)]3+ with (5medC-dG)4.

The interaction specificities of cobalt(III) ammines with the self-complementary eight-base pair DNA oligomer (5medC-dG)4 have been investigated. Standard protocol for preparing DNA samples calls for heat annealing the DNA oligomer in phosphate buffer in the absence or presence of cobalt(III) ammine complex for 2 min at 80 degrees C, followed by slow cooling to 25 degrees C. An alternative method for DNA preparation is incubation of the oligomer in the presence of the cobalt(III) complex at 37 degrees C followed by exhaustive dialysis. The conformational properties of the thus-treated DNA oligomer were determined by inspection of the UV and CD spectra at 25 and 95 degrees C and thermal denaturation studies. With heat annealing in the absence of any cobalt(III) complex, (5medC-dG)4 assumes a double-stranded, right-handed B conformation at 25 degrees C. Upon heat annealing in the presence of 200 microM [Co(NH3)6]3+, (5medC-dG)4 assumes a double-stranded, left-handed Z conformation at 25 degrees C. In contrast, the CD and UV spectra of (5medC-dG)4 heat annealed in the presence of 200 microM [Co(NH3)5(OH2)]3+ are consistent with a distorted B-like conformation at 25 degrees C. Incubation of the oligomer in the presence of [Co(NH3)5(OH2)]3+ results in modification of the conformational properties of the oligomer at both 25 and 95 degrees C relative to the untreated oligomer. The extent of modification depends upon the incubation concentration of [Co(NH3)5-(OH2)]3+ and the reaction time. Atomic absorption (AA) analyses of these treated DNA samples indicate a high degree of cobalt association to the oligomer.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgical considerations for hematogenous osteomyelitis.

Surgical treatment of hematogenous osteomyelitis is uncommon in the literature. Indications for surgical decompression, along with a review of the literature, is presented. A case history of a 7-year-old male with hematogenous osteomyelitis of the first metatarsal treated by surgical decompression and 12-month follow-up is discussed.

The clinical spectrum of actinic elastosis.

A plethora of literature promoting our understanding of the differences between intrinsic (chronologic) aging versus extrinsic aging of the skin has been published during the last two decades. The predominant extrinsic factor is UV radiation; the functional, histologic, and clinical consequences are referred to as photoaging, or dermatoheliosis. Actinic elastosis refers specifically to the degenerative histologic alterations seen by light microscopy in sun-damaged skin. Multiple factors, including anatomic site, extent of sun exposure, and other physical or environmental factors affect the clinical appearance of these changes. We review the clinical spectrum of the actinic elastotic variants.

The role of endoscopy in treatment of stenosing posterior tibial tenosynovitis.

Some foot and ankle pathologic conditions can be treated by an endoscopic approach. Its effectiveness has been reported in the treatment of plantar fasciitis. The authors have used an endoscopic approach in the treatment of posterior tibial tenosynovitis resistant to nonsurgical treatment. A review of the pathology, terminology and the diagnosis of tenosynovitis is provided. The case report demonstrates a technique using an endoscope to incise the posterior tibial tendon sheath.

Eccrine angiomatous hamartoma.

BACKGROUND: Eccrine angiomatous hamartoma (EAH) is a rare benign lesion that mimics a capillary ("strawberry") hemangioma (CH) in appearance. EAH slowly grows and becomes symptomatic whereas CH typically regresses over time. OBJECTIVE: To increase awareness of this rare hamartoma and emphasize the need for histopathologic evaluation of similar appearing lesions and thus prompt excision versus observation. METHODS: Literature review and report of an illustrative case. RESULTS: Histopathologic confirmation of EAH in a lesion clinically indistinguishable from CH and successful surgical extirpation. CONCLUSION: EAH is a rare hamartomatous neoplasma clinically similar to CH in appearance. Histopathologic examination of suspected lesions is recommended for delineation as CH generally involutes spontaneously whereas EAH may require surgical excision due to pain and hyperhidrosis.

Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study.

A comparative study of endoscopic plantar fasciotomy versus traditional type heel spur surgery has been performed involving 76 patients and 92 procedures. Sixty-six of those procedures consisted of endoscopic fasciotomy, whereas 26 involved traditional type surgery. Those patients in which the endoscopic fasciotomy was performed had significantly less postoperative pain, returned to regular activities 4 weeks earlier, and had fewer complications postoperatively than those patients involving traditional heel spur surgery. An overview of the surgical technique involving endoscopic fasciotomies is presented, as well as factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity.

First metatarsophalangeal joint arthrodesis utilizing a mini-Hoffman External Fixator.

Arthrodesis was initially indicated for severe hallux valgus and hallux rigidus. Today, it is primarily a salvage procedure, which provides a painless first metatarsophalangeal joint. This manuscript reviews the various procedures for arthrodesis of the first metatarsophalangeal joint. A case report is presented utilizing arthrodesis as a salvage procedure for a painful first metatarsophalangeal joint, after previously failed procedures.