ABSTRACT
The authors differentiate benign rheumatoid nodules from similar subcutaneous lesions based on location and pathologic characteristics. Although many of these lesions spontaneously resolve, recurrence rates may be high. Various therapeutic modalities are therefore suggested. An illustrative case study is presented.
Subject(s)
Foot Diseases/surgery , Granuloma Annulare/diagnosis , Heel , Rheumatoid Nodule/diagnosis , Adult , Diagnosis, Differential , Female , Foot Diseases/diagnosis , Foot Diseases/pathology , Granuloma Annulare/pathology , Granuloma Annulare/surgery , Humans , Recurrence , Reoperation , Rheumatoid Nodule/pathology , Rheumatoid Nodule/surgeryABSTRACT
Intraosseous ganglia are benign cystic lesions usually located in the end of long bones, especially the distal tibia. Patients typically present with mild, localized, aching discomfort in a joint that is aggravated by weightbearing. Pathogenesis is currently unknown with the literature suggesting many valid theories. Surgical excision and curettage is the treatment of choice. A case of a ganglion cyst within a cuboid bone is presented along with a review of the literature and discussion of operative technique.
Subject(s)
Bone Cysts/surgery , Tarsal Bones/surgery , Adult , Bone Cysts/diagnosis , Bone Cysts/pathology , Female , Humans , Magnetic Resonance Imaging , Tarsal Bones/pathology , Tomography, X-Ray ComputedABSTRACT
Plantar fibromas are a disease entity that are encountered by all foot surgeons. When a tentative diagnosis is made, aggressive surgical resection of the mass and the plantar fascia is necessary to prevent recurrence. Presented in this paper is a review of the literature and clinical illustrations of recurrent plantar fibromatosis with long-term follow-up.
Subject(s)
Fibroma , Foot Diseases , Neoplasm Recurrence, Local , Diagnosis, Differential , Fibroma/diagnosis , Fibroma/etiology , Fibroma/pathology , Fibroma/physiopathology , Fibroma/surgery , Foot Diseases/diagnosis , Foot Diseases/etiology , Foot Diseases/pathology , Foot Diseases/physiopathology , Foot Diseases/surgery , Humans , Neoplasm Recurrence, Local/etiology , Neoplasm Recurrence, Local/prevention & controlABSTRACT
One of the most frequent causes of epidermal inclusion cysts is trauma involving the epidermis with subsequent implantation of epidermal cells into the dermis or subcutis. Minimal incision surgery is capable of achieving this because it is performed by using small incisions and rapidly rotating power instruments. The technique requires that the surgeon master a high degree of dexterity and knowledge of the anatomy without the aid of direct visualization. Van Enoo and Cane suggest the use of fresh, sharp skin blades to protect against invagination of skin edges which could lead to epidermal inclusion cysts. They also state that an improper position or an incision that is too small will cause tension, which can lead to heat buildup with subsequent sloughing and dehiscence. It may also drive some epidermal cells underneath the dermis and foster an epidermal cyst. Other surgeons using small incisions suggest thorough and copious irrigation to flush away debris and to avoid potential foreign body reactions. The periosteum should be reflected away from the point where the drill bit exits the bone to prevent bone chips from being forced subperiosteally and potentially causing a foreign body reaction. By virtue of the technique, minimal incision surgery lends itself to a greater risk of causing epidermal inclusion cysts. Surgeons who use these techniques must be aware of this potential complication.
