Foot & Ankle International

Twenty-seven patients were surgically treated for Achilles tendon rupture using a composite implant. The implant is ribbon-like in configuration and composed of filamentous carbon fiber coated with an absorbable polymer. When used to secure an Achilles repair, the implant acts as a scaffold for the regrowth of collagenous tissue. Rapid attachment of host tissue assures good, early repair strengths which allows for a more vigorous rehabilitation program. Fourteen patients have at least 9 months of follow-up (average follow-up, 14.4 months) and have been objectively and subjectively evaluated on a temporal basis for return of function. To date, complications have been minimal. Results have been very encouraging with 90% return of function at 18 months.

Several different aspects of the subtalar joint are studied. Embryology indicates that it is a recently acquired structure. The anterior subtalar joint does not have a uniform morphology, and it has been subdivided into three anatomical descriptions (ovoid, bean, and two part). To correct the confusion found in other papers, we intend to clearly describe the anatomy of the ligaments. The form and function of the retinacula, cervical ligament, and ligament of the canal are studied. The microscopic anatomy of ligaments is studied, dealing specifically with their innervation and the structure of their fibers.

Several techniques have been suggested for correction of clawtoe deformities in the lateral toes, ranging from multiple arthrodesis of the interphalangeal joints to phalanx resections, partial or total amputation of the impaired toes. An evaluation of the flexor-extensor transfer procedure is the basis of this study.

Between 1977 and 1983, 39 feet were operated on in 31 patients, presenting a wide variation in etiology, degree of deformity, and symptoms. Average age at the time of surgery was 57.5 (16 to 80). All of the patients were available for recall and were able to return for an interview and examination. Average length of follow-up was 38 months (range, 10–80 months). The report includes a general discussion of the deformities, description of the operative technique, and the results obtained in our series. Assessment emphasized a subjective report including patient satisfaction, cosmetic result, relief of pain, and objective examination to evaluate the presence of recurrent callosities, range of movement at the metatarsophalangeal joint, and degree of residual passive mobility of the toes. Reduction of metatarsalgia and callosities with improved shape of the toes was achieved in most cases. Our experience indicates that the treatment can be recommended for use in the elderly, too, in appropriate cases. Radical procedures are rarely accepted for cosmetic as well as for functional reasons.

Bone scintigraphy is of diagnostic value in stress fractures where radiography may not be helpful. Obtaining early blood pool images during scintigraphy for suspected stress fractures may help to identify soft tissue inflammation (plantar fascitis) when delayed images are normal.

Based on a study of 50 subjects seen at the University of Rochester Medical center, a new axial weightbearing radiological technique of the forefoot is described. The technique is simple, inexpensive, and easily reproducible. It has the advantage of not distorting the forefoot, relationships, unlike currently employed techniques. Since it is performed under weightbearing conditions, the results correlate closer to clinical situations. The SUbjects under this study, which excluded those with neuromuscular or malalignment problems, were found to fall into two categories: the pain-free and callous-free feet group, who have a well defined arch in the forefoot, and the group of subjects with pain and/or callous under the forefoot, who have a depressed arch. There is also a statistical significance between the relative heights of the tibial and fibular sesamoids. A new classification for hallux valgus based on observations of this technique is proposed.

This case report of a myxoid chondrosarcoma of the oscalcis is presented because of its rarity. The clinical, roentgenographic, and pathological features are discussed, and the difficulty in diagnosis is elaborated