ABSTRACT
Fifty percent of all nail disturbances result from onychomycosis, with toenails being affected approximately four times as often as those of the fingernails. The overall incidence in the population is not known, but it is reported at about 2%-13% and is presently on the rise. This lengthy paper reviews all facets of onychomycosis. The present-day classification of onychomycosis is presented. Predisposing factors, causative organisms, as well as the differential diagnosis are included. A thorough comparison of the five presently available oral antifungal agents (griseofulvin, ketoconazole, itraconazole, terbinafine, and fluconazole) in an easy-to-read table is presented. A second table presents many studies performed by many researchers in various countries on these same drugs. The author has included her own personal clinical experience using both fluconazole and terbinafine in 22 and 51 patients with pedal onychomycosis, respectively. This is not meant to be a "controlled study," but rather the experience of one podiatrist in an office setting. The newer oral antifungal agents (itraconazole, terbinafine, and fluconazole) are highly recommended even for the most severe cases of onychomycosis.
Subject(s)
Antifungal Agents/therapeutic use , Foot Diseases/drug therapy , Onychomycosis , Administration, Oral , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Humans , Middle Aged , Onychomycosis/classification , Onychomycosis/diagnosis , Onychomycosis/drug therapy , Onychomycosis/etiology , Treatment OutcomeABSTRACT
The author has devised a new type of fixation for the Akin osteotomy. The fixation consists of double-stranded monofilament wire that is threaded through drill holes medially to laterally both proximal and distal to the osteotomy, encompassing four cortices. The fixation is placed prior to the cutting of the osteotomy, resulting in less chance of disruption to the lateral cortical hinge.
Subject(s)
Hallux Valgus/surgery , Metatarsal Bones/surgery , Osteotomy/methods , Bone Wires , Hallux/surgery , Humans , Osteotomy/instrumentationSubject(s)
Foot , Muscle Spasticity/surgery , Arthrodesis , Gait , Humans , Male , Middle Aged , Muscle Rigidity/surgery , Muscle Spasticity/diagnostic imaging , RadiographySubject(s)
Calcinosis/etiology , Foot Diseases/etiology , Lupus Erythematosus, Discoid/complications , Tendons/pathology , Animals , Dogs , Female , HumansSubject(s)
Athletic Injuries , Fractures, Spontaneous/diagnosis , Running , Tibial Fractures/diagnosis , Adult , Female , HumansABSTRACT
Four joggers had early confirmation of clinically suspected stress fractures by radionuclide bone scans. The radioactive bone scan was abnormal as early as six weeks prior to the appearance of conventional roentgenographic changes. The stress fractures involved the bones of the lower extremities and included the femur, tibia, and calcaneus. Radioactive bone scanning also correctly identified stress fractures with bilateral involvement and referred pain. In joggers, when a stress fracture is clinically suspected and the conventional radiographs are negative, a radioactive bone scan is indicated for early confirmation and institution of appropriate treatment.
