Correction of metatarsus primus varus associated with hallux valgus deformity using the arthrex mini tightrope: a report of 44 cases.

Metatarsus primus varus must be addressed during correction of moderate to severe hallux valgus deformity. As an alternative to proximal osteotomy or first tarsometatarsal fusion for hallux valgus correction, this study presents a series of patients treated using the Arthrex Mini TightRope. A total of 36 patients (44 operations) with hallux valgus and metatarsus primus varus underwent correction using the Arthrex Mini TightRope. Assessment included measurement of radiographic parameters, the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot outcomes score, and the SF-12. The average hallux valgus angle improved from 32.2° to 15.2° (P < .0001). The average first intermetatarsal angle improved from 14.6° to 8.2° (P < .0001). The average distal metatarsal articular angle improved from 17.0° to 9.6° (P < .0001). The average AOFAS midfoot outcomes scores improved from 45.44 to 84.72 (P < .0001). Postoperative SF-12 physical and mental scores averaged 52.99 and 56.63. Only one patient had recurrence of deformity. Correcting metatarsus primus varus in association with hallux valgus deformity using the Arthrex Mini TightRope should be considered a treatment option. This technique is less invasive and seems capable of maintaining correction while allowing for early weight bearing and avoiding the need for a proximal first metatarsal osteotomy or Lapidus procedure.

Complication of a Portuguese man-of-war envenomation to the foot: a case report.

Jellyfish stings have become more prevalent on account of larger commercial presence along coastal waterways. Stings are referred to as envenomations, due to the process of a neurotoxic venom being injected into the victim at the site of the sting. These events are usually mild, and for the most part, confined to local hypersensitivity reactions at the site of the injury. Certain species of jellyfish, however, have been associated with more severe, systemic insults including muscle cramping, respiratory distress, hypotension, circulatory collapse and death. One such example of a more potent venom is the Portuguese man-of-war. Most case reports of Portuguese man-of-war envenomations do not involve local soft tissue necrosis. The purpose of this case report is to present such a consequence after a jellyfish sting to the dorsum of the foot. A large area of skin necrosis developed after an envenomation that required extensive debridement and skin grafting.