Diurnal variations in volume of the foot and ankle.

The purpose of the study was to determine if there were any diurnal variations in volumes of the right and left foot and ankle volumes in normal subjects. The study also sought to determine the consistency of volumetric measurements of the human foot. Twenty normal subjects were included in the study. Ten were ambulant, and 10 subjects were bed bound for 9 hours. A commercially available volumeter was used to take volumetric measurements of the subjects. Three readings of each foot and ankle were taken at four different times of the day and used as data. Alpha reliability analysis revealed that the measurements were highly reliable (alpha value for the right leg was .9998 and for the left .9997) and suitable for an objective evaluation of edema. The ANOVA test indicated no statistically significant diurnal change in the foot and ankle volume (p = .000006). These data suggest that it is possible to consider an uninjured foot and ankle of a normal subject as a control limb, at any given time of the day, in an ambulatory or nonambulatory situation and compare its volume with that of the injured side. This can be a valuable piece of information to quantify the amount of swelling on the injured ankle as compared to the normal one and may allow one to assess the effect of a treatment modality on reducing traumatic foot and ankle swelling. The use of such an apparatus for volumetric analysis was recommended in traumatic foot and ankle swellings and in a research scenario because of its accuracy.

Aggressive granulomatous lesion presenting as tumor in cementless long stem total hip arthroplasty.

We describe a patient with an aggressive granulomatous lesion around a cementless total hip prosthesis, which simulated a tumor. The granuloma showed a uniform histopathology, which included mononuclear cells and metal wear particles. Aggressive granulomatous lesions in replaced hips are a distinct condition, different from simple loosening or infection; the lesions may grow rapidly, so that revision surgery is indicated soon after diagnosis.

Acute compartment syndrome of the forearm in association with ulnar shortening osteotomy: a case report.

A 41-year-old man experienced severe pain in the forearm after undergoing ulnar shortening osteotomy to treat positive ulnar variance, a complication of a fracture of the distal end of the radius. The patient had compartment syndrome with compartment pressure of 55 mm Hg. A decompressive fasciotomy of the volar compartment provided total relief of pain and, subsequently, full recovery of all functions. We report the case and discuss the serious nature of compartment syndrome, its associated complications, and methods of diagnosis and management.

Self-surgery: removal of ankle surgical implants--A case report.

Self-surgery is rare, but numerous cases of self-mutilation are reported in the literature (eg, castration, enucleation of an eye, and amputation of a limb).[1] We have found no previous reports in the literature of a patient who has performed self-surgery to remove fracture fixation implants.