ABSTRACT
For the past 15 years, a procedure the authors have termed proximal metatarsal segmental resection has been used for the treatment of intractable, painful, submetatarsal plantar keratoses which have failed nonoperative treatments. This simple procedure basically is the resection of a cylindrical segment of proximal metatarsal bone approximately 0.5 cm long. Fifty-four patients (70 metatarsals) underwent the procedure and were followed a mean of 6 years. Good to excellent results were reported in 89% of these patients. Transfer lesions occurred in 18% of feet and were responsible for all fair and poor results. When the procedure was carried out in association with a bunion correction, transfer lesions occurred in 23%; whereas when performed as an isolated metatarsal procedure, transfer lesions followed in 12%. Recurrent keratoses developed in 7%. This technically simple procedure is associated with minimal patient morbidity and should be considered an option in the surgical management of metatarsalgia.
Subject(s)
Keratoderma, Palmoplantar/surgery , Metatarsal Bones/surgery , Female , Follow-Up Studies , Humans , Keratoderma, Palmoplantar/diagnostic imaging , Keratoderma, Palmoplantar/physiopathology , Male , Metatarsal Bones/diagnostic imaging , Metatarsal Bones/physiopathology , Middle Aged , Pain/physiopathology , Radiography , RecurrenceABSTRACT
Cysts of the medial meniscus are rare. They may present as a local tumor or may mimic signs of an internal derangement. The pathology may be treated by arthroscopic subtotal meniscectomy alone if the meniscal tear and cyst communicate, by local cyst excision and reattachment of the meniscus, or total meniscectomy. Two cases are presented with a review of the literature.
Subject(s)
Knee Joint/surgery , Menisci, Tibial/surgery , Synovial Cyst/diagnosis , Adult , Arthroscopy , Humans , Male , Synovial Cyst/surgeryABSTRACT
One hundred and forty-four solitary bone cysts were treated by curettage and packing with freeze-dried crushed cortical-bone allograft. One hundred and eight healed primarily. There was a higher rate of recurrence in young patients (less than ten years old), in active cysts, in females, and in incompletely packed cysts. However, of the cysts that were completely packed, 88 per cent healed. These data show that freeze-dried allogeneic crushed cortical bone is superior to similiarly processed cancellous bone and gives results similar to those achieved with fresh autogenous cancellous bone. Orthopaedic surgeons should therefore consider the use of freeze-dried allogeneic crushed cortical bone instead of autogenous grafts to avoid the morbidity and increased risk of complications associated with the procedure to obtain the autogenous bone.
