Bleeding complications in the uremic patient.

Many patients seen in podiatric medicine may have some degree of renal disease. An often neglected and unrecognized complication of renal disease may be abnormal bleeding. Presented in this paper is a review of the etiologies and treatment of uremia-induced bleeding complications. Included is a case presentation in which the authors discuss a patient in acute renal failure who developed postoperative bleeding following an incision and drainage for a diabetic foot infection.

Congenital hypertrophy of an intrinsic muscle of the foot.

Congenital hypertrophic muscles of the foot are rare and a search of the literature revealed only a few select cases on the subject. However, a case did present itself at Saint Michael's Medical Center involving a congenitally hypertrophic abductor digiti minimi muscle of the right foot. Surgical exploration also revealed slight abnormalities of the third and fourth plantar interosseous muscles. These muscles, however, were left intact because they were not symptomatic. There were no other hypertrophic muscles noticed on this foot and none in the opposite foot. Excision of the entire hypertrophic muscle eventually provided complete relief and allowed the patient to wear normal foot gear. This manuscript describes a case presentation of a single congenitally hypertrophic muscle with reference to its clinical evaluation and subsequent treatment.

The minimum effective midthigh tourniquet pressure.

The purpose of this study is to establish a minimum effective midthigh tourniquet pressure for use in lower extremity surgery. By establishing a minimum effective pressure, nerve compression and subsequent nerve damage can best be avoided. Various tourniquet pressures were applied at midthigh of the operated extremity, and the lowest pressure at which adequate hematosis was achieved was determined to be the minimum effective pressure. In this study, the minimum effective pressure was established at 90-100 mm Hg above the preoperative systolic arm pressure. This resulted in an average tourniquet pressure of 210 mm Hg.