Uses of Grafton for reconstructive foot and ankle surgery.

Grafton is a demineralized allogenic bone grafting substance supplied in gel form. The gel consistency allows simple application of this osteoinductive substance. Possible applications and cases are presented.

Enlargement of the entire posterior aspect of the calcaneus: treatment with the Keck and Kelly calcaneal osteotomy.

Painful enlargement of the entire posterior aspect of the calcaneus can be difficult to effectively treat and must be differentiated from a classical Haglund's deformity. Clinical, radiographic, and surgical treatments of this deformity will be discussed. An illustrative case presentation is also included.

Fractures of the proximal phalanx of the hallux: the use of plates with displaced multifragment fractures.

Fractures of the proximal phalanx of the hallux are a common injury. Due to the important biomechanical function of the first ray, these injuries must be treated properly. Incorrectly treated, a fracture of the hallux can be debilitating. These injuries will be discussed, and several illustrative cases will be presented with the use of plate fixation.

The use of an ankle joint distractor in ankle arthroscopy.

Joint distraction, whether manual or mechanical, is a common practice in orthopedic surgery for knee and shoulder arthroscopy and can be extrapolated to include ankle joint arthroscopy. Manual joint distraction involves manipulation of the ankle joint by gravity or manual traction applied by an assistant. Mechanical distraction can be achieved by joint infiltration with solution or a joint distractor. Although the use of a joint distractor in arthroscopy of the ankle is not a new technique, podiatric literature has rarely reported on its use to allow for easier access and implementation of arthroscopic instruments. The ankle joint distractor allows the surgeon to take advantage of pathologic ligamentous laxity, thus increasing the joint space from an average 3.4 to 7.8 mm.

Implant failure with particulate silicone synovitis (detritic synovitis).

The authors present a case of particulate synovitis due to a silicone hemi-implant. Other names for this condition are silastic detritic synovitis and silastic foreign body synovitis. Small, free pieces of silastic cause inflammation of the synovial tissues. A literature review also is presented.

Relationships among defensive styles, cognitive styles, processing styles, and attentional styles of normal adolescents.

Cognitive and psychodynamic theorists agree that an individual's personality and behavior are determined by both cognitive and dynamic processes. This study examined the relationship among three cognitive approaches--cognitive style, attentional style, and processing style--and examined their relations to defensive style. Adolescents from Grades 11 and 12 (146 boys, 164 girls) were examined in groups for cognitive style (Group Embedded Figures Test), attentional style (Test of Attentional and Interpersonal Style), processing style (a sequential/simultaneous processing test battery), and defensive style (Defense Mechanism Inventory). Least squares completely randomized two-way analyses of variance (or analyses of covariance where applicable) were employed to assess the relations among the three cognitive measures and/or between the cognitive measures and defensive style. While most comparisons were nonsignificant, a significant relationship was observed between sequential processing and field-dependence and between simultaneous processing and field-independence. Also, a trend was noted between field-independence and ideational defenses and between field-dependence and repression-based defenses.

Melorheostosis: a case report and literature review.

Melorheostosis is a rare form of cortical hyperostosis that resembles wax dripping down the side of a candle. This disease usually affects the long and short bones of an extremity. Literature review and a case report will be discussed with respect to incidence, clinical presentation, radiographic appearance, and treatment.

Traumatic dislocations of the tibialis posterior tendon: a review of the literature and two case reports.

Dislocation of the tibialis posterior tendon from behind the medial malleolus is a very rare lesion. The authors present two cases of this pathology with special reference to surgical correction. Historical review, mechanism of injury, diagnosis, and treatment will also be discussed.

Os peroneum fracture with sural nerve entrapment neuritis.

The os peroneum is a sesamoid bone contained in the peroneus longus tendon. When present, it usually is located at the plantar lateral aspect of the cuboid. The author presents a case of os peroneum fracture causing sural nerve entrapment. A review of literature is also presented.

Traumatic classifications of the foot and ankle.

Many authors have presented classification systems for traumatic injuries to the foot and ankle. These systems of classification have been based on many factors (e.g., mechanism of injury, fracture pattern, fracture position and location). The most commonly used traumatic classification systems of the foot and ankle are reviewed. The staging, mechanism of injury, radiologic appearance, diagrammatic and radiologic examples are discussed.

Osteochondromatosis (diaphyseal aclasis): a case report and literature review.

An unusual case of osteochondromatosis is presented with a review of the literature. Osteochondromatosis, also known as hereditary multiple exostoses or diaphyseal aclasis, are inherited, benign, cartilaginous neoplasms that consist of a pedicle of normal bone covered with proliferating cartilage cells. Pathologic, clinical, and radiographic findings will be discussed.

Unicameral bone cyst of the first metatarsal.

An unusual case of a unicameral bone cyst located in the head of the first metatarsal is presented with a review of the literature. This benign bone tumor is rarely found in the metatarsal bones. Pathologic, clinical, and radiographic findings, as well as a differential diagnosis will be discussed.

Enchondroma: a case report and literature review.

An unusual case of enchondroma located in the distal phalanx of the left third toe is presented with a review of literature. An enchondroma is a benign tumor centrally located in a bone. This osseous dysplasia is characterized by an excess of mature hypertrophic hyaline cartilage that has not resorbed or ossified in the normal fashion. Pathologic, clinical, and radiographic findings will be discussed.

Usage of radiopaque contrast media in the foot and ankle.

The author presents a wide variety of uses of radiopaque contrast media in the foot and ankle. Dye studies can aid the physician in diagnosing pathology of the soft tissues and joints without surgical intervention. The results of these tests aid in determining the course of treatment.

Talipes equinovarus: two case reports and literature review.

Clubfoot, or talipes equinovarus, was introduced into the medical literature by Hippocrates in 400 B.C. The clubfoot deformity is a pathologic condition consisting of inversion and adduction of the forefoot, equinus of the ankle, and inversion of the heel. The condition has also been described as a congenital subluxation of the talocalcaneonavicular joints. This manuscript will review the literature with respect to history, incidence, etiology, anatomy, classification, radiology, and treatment. Two case reports are also presented.

Fibrous dysplasia: a case report and literature review.

The unusual case of fibrous dysplasia located in the distal phalanx of the hallux is presented with a review of literature. Fibrous dysplasia is a benign disorder that can affect one or many bones in any particular case. The bone involvement is characterized by the presence of fibro-osseous tissue within the interior of the affected bone. Pathologic, clinical, and radiographic findings will be discussed.

Usage of long-term steroid therapy.

This report will discuss the different aspects of long-term steroid therapy. The five major areas of interest are indications for treatment, complications, withdraw, monitoring, and surgical adjustment of dosage.