Metastatic malignant melanoma to the foot and ankle: a review of the literature and case report.

The lower extremity is a frequent site for malignant melanomas. However, skeletal metastases involving the foot and ankle are a rarity. Nearly all documented cases of secondary pedal bone metastasis have originated from a primary subungual melanoma. The following case study illustrates an unusual skeletal metastasis to the foot and ankle arising from a primary malignant melanoma of the torso.

Polymicrobial septic arthritis due to Clostridium species: case report and review.

Clostridium species are capable of producing several types of infectious processes, many of which have proven to be life-threatening. Septic arthritis caused by Clostridium, however, is not a very frequent finding. Currently, only 37 cases of infectious arthritis due to Clostridium species have been reported. We report a case of septic arthritis in which Clostridium perfringens, Clostridium sordellii, and Clostridium tertium were each isolated from the synovial aspirate. In addition, the 37 previously reported cases are summarized to compare the similarities and differences of the clinical course, treatment, and outcome, in order to help establish guidelines for the proper management of this infectious process.

Retrospective analysis of neurapraxia and axonotmesis injuries of select peripheral nerves of the foot and ankle and their conservative and surgical treatment (external neurolysis and neurectomy).

There is a paucity of scientific literature that has reviewed the conservative and surgical treatment efficacy for the management of injuries causing neurapraxia and axonotmesis. This retrospective study evaluates the clinical outcomes of certain treatments for these injuries. Twenty-seven patients fulfilled the inclusion/exclusion criteria for the study, and represented both genders and a wide variety of ages, weights, levels of education, and backgrounds. Surgical intervention resulted in a slightly better clinical outcome when compared to conservative therapies. Patients undergoing surgery for a single nerve problem improved more than those who underwent surgery when three or more nerves were involved. Failure was most often associated with: 1) multiple nerve injuries, 2) a previous history of psychopathology, and 3) application of conservative therapy without surgical intervention for single nerve injury.

Peripheral nerve surgery of the foot and ankle. A review of current principles.

Planning for peripheral nerve surgery requires consideration of a multitude of factors, as well as a surgeon's meticulous skill and experience. With so little room for error, every advantage must be taken to optimize repair. Peripheral nerve surgery of the foot and ankle is an underappreciated area of neurosurgery with comparatively limited published reports and data. The authors reviewed the current trends in the surgical management of peripheral nerve injuries of the foot and ankle in the hope that an understanding of the basic principles involved will allow for future study of the results of such surgery by more surgeons who deal with these problems.

Accessory soleus muscle: a review of the literature and case report.

The accessory soleus is a rare anatomic variant that must be considered in the differential diagnosis of all posteromedial soft tissue masses of the ankle. The authors review and discuss the pertinent findings of the previously reported 70 cases of accessory soleus muscles cited in English literature. A case report is presented that highlights the diagnosis of the accessory soleus muscle with magnetic resonance imaging studies and surgical excision of the mass in a symptomatic patient.

Complications of the Kalish bunionectomy.

The Kalish osteotomy has become a popular method for the correction of mild-to-moderate hallux abducto valgus deformities associated with metatarsus primus adductus. This paper reviews the common pitfalls associated with this procedure, including failure to observe the indications for the procedure, technical failures when performing the procedure, and the most frequent postoperative complications.

Tarsal coalitions. A surgical classification.

The surgical alternatives for the treatment of tarsal coalitions include procedures as diverse as arthroplasty and arthrodesis. Traditional classifications of tarsal coalitions are primarily descriptive and afford little information regarding preferred treatment. For this reason, the author introduces the Articular Classification System, which is based on the patient's osseous age, the articular involvement of the coalition, and the associated secondary arthritic changes. This classification system can be used as a framework to discuss recommended surgical procedures and their long-term results.

Postoperative infections: general principles and considerations.

Every surgeon should have a thorough knowledge and awareness of the general principles of postoperative infections. The key to postoperative infections is in their prevention. Even with the most prudent and ardent regimens, however, postoperative wound infections will occasionally occur. Thus, the aforementioned knowledge will allow an improved clinical acumen and permit the early diagnosis of postoperative infection. Early and vigorous local wound care combined with systemic antibiotics are necessary to minimize the potentially debilitating sequelae of the postoperative wound infection.

Gastrocnemius recession in the treatment of nonspastic ankle equinus. A retrospective study.

An updated and thorough review of the gastrocnemius equinus deformity and its surgical correction is presented. For the first time, a long-term retrospective study documents the overall improvement in the symptoms and architecture of the lower extremity and foot following gastrocnemius recession. Additionally, numerous associated concerns and the surgical procedure are examined retrospectively.