The posterior calcaneal tubercle impingement syndrome.

The syndrome of conditions resulting from impingement by a prominent posterior calcaneal tubercle has been described. Treatment must relieve impingement by nonsurgical or surgical means.

The posterior tibiotalar impingement syndrome in dancers.

The author discusses the diagnosis and both conservative and surgical methods of treating this problem common to professional ballet dancers.

A comparative study of the frequency of anterior impingement exostoses of the ankle in dancers and nondancers.

True lateral roentgenograms were obtained in 100 nondancers and 32 professional dancers to determine the incidence of anterior talar exostoses. The average age of the nondancers was 45.8 years as compared to 23.0 years in the dancer population. Both groups were asymptomatic in the region of the foot and ankle. All exostoses on the dorsum of the talar neck measuring greater than 1 mm were recorded.

Anterior tibiotalar impingement syndromes in dancers.

Anterior tibiotalar impingement is caused by extension at the ankle. Repeated impingement causes two symptom-producing and potentially disabling syndromes. The most frequent is impingement exostoses which form on strong feet that offer resistance to impingement. This condition may be compatible with dancing for many years, but if symptoms warrant, surgery is a consideration. The other syndrome is found in young dancers with long, slender, flexible feet. These feet are weak and allow midfoot sag and plantar fascial stretch causing chronic foot strain. Such feet do not tolerate dancing without extensive retraining and surgery is of no help.

The early complications of subtalar dislocation.

Although the treatments and results of subtalar dislocations are usually considered as nonproblematical, review of 10 cases seen over a 6-year period proved otherwise. Difficulties were encountered with four of these cases consisting of associated foot injuries, failure to recognize the dislocation, incarceration of the dislocation, vascular complications, and iatrogenic infection. The management of these cases is discussed.

Partial embolization of large peripheral hemangioma for pain control.

Pain associated with a large hemangioma of the thigh was relieved by embolization of a portion of the lesion with Gelfoam. The branch to be occluded was selected when the distribution of the heat associated with the injection of contrast material corresponded to the distribution of the patient's pain.

Injuries of the talus and its joints.

To understand the mechanism of injury and classify fractures of the talus requires knowledge of the anatomy of the hindfoot, its function and the nature of the traumatic forces. The talus has an irregular shape with articular surfaces for tibia, fibula, calcaneus and navicular. It functions as a complex universal joint between the leg and foot created by the ankle, sub-talar and midtarsal joints. Injury may disturb function and create serious disability. As in the femoral head, osteonecrosis is a serious problem after injury to the talus. The reason for this lies in a peculiar distribution of the arterial circulation which exposes it to some injuries, but not to others. To understand the mechanism of injury is to be better prepared to properly treat these injuries and to more accurately predict their consequences. Injury occurs as motion caused by an extrinsic force is applied to the part, and when the motion is forceful enough to overcome resistance. For the talus and its joints the mechanisms of injury are: extension, flexion, inversion, eversion, and compression. Rotation, medial and lateral, may be important in the production of fractures of the talar trochlea. Combinations of these mechanisms cause complex injuries.