In a prospective randomized study of plantar heel pain, 44 patients were treated with injection of 1 mL of 2% prilocaine using the peppering technique, 1 mL of 2% prilocaine combined with 2 mL of autologous blood, or 1 mL of 2% prilocaine mixed with 40 mg of methylprednisolone acetate. At 6-month follow-up, clinical improvement was evaluated by using a 10-cm visual analog scale and the rearfoot score of the American Orthopaedic Foot and Ankle Society. Results were analyzed using sample t-tests within groups and repeated-measures analyses of variance between groups. Mean +/- SD visual analog scale scores in the peppering technique, autologous blood injection, and corticosteroid injection groups improved from 6.4 +/- 1.1, 7.6 +/- 1.3, and 7.28 +/- 1.2 to 2.0 +/- 2.2 (P < .001), 2.4 +/- 1.8 (P < .001), and 2.57 +/- 2.9 (P < .001), respectively. Mean +/- SD rearfoot scores in the same groups improved from 64.1 +/- 15.1, 71.6 +/- 1, and 65.7 +/- 12.7 to 78.2 +/- 12.4 (P = .018), 80.9 +/- 13.9 (P = .025), and 80.07 +/- 17.5 (P = .030), respectively. There were no statistically significant differences among the groups. Good outcomes have been documented using the peppering technique and autologous blood injection for the treatment of lateral epicondylitis. Although the curative mechanisms of both injection modalities are based on a hypothesis, they seem to be good alternatives to corticosteroid injection for the treatment of plantar heel pain.

Amniotic membrane is easily prepared, and because of its cost effectiveness, its use in the prevention and treatment of adhesions should always be kept in mind.

Preaxial polydactyly is a common limb malformation in humans with variable clinical expression. Different types of triphalangeal thumb-preaxial polydactyly phenotypes were mapped to the chromosome 7q36 region. We studied a large Turkish family of 69 individuals, of whom 22 individuals were affected. In all, 11 affected family members were clinically and radiologically evaluated. All affected individuals had a triphalangeal thumb and a preaxial (hypoplastic) extra digit bilaterally, with minimal intrafamilial variation. No feet involvement was observed. Linkage and haplotype analyses using 20 informative meioses confirmed the 7q36 region contained the LIMBR1 gene. Maximum logarithm of the odds (LOD) scores were obtained with DNA markers D7S550 and D7S2423. We have further identified a novel C to T alteration at position 4909 bp in the critical zone of polarizing activity regulatory sequence (ZRS) region, in the intron 5, of the LMBR1 gene. One affected male with homozygous status and no phenotypic difference from affected family members with heterozygous status represented the first homozygote case of the triphalangeal thumb-preaxial polydactyly phenotype.

No abstract

No statistically significant pattern of metatarsophalangeal sesamoid distribution has been reported in the literature in relation to genetic pool or group, unilaterality or bilaterality, or sesamoid division. A study was undertaken to evaluate the presence and distribution of the metatarsophalangeal sesamoid bones of the foot in Turkish subjects. A total of 602 foot radiographs from 371 patients without forefoot complaints other than those of the hallux were included in the study. Absence or hypoplasia of the first-ray sesamoids was seen on 0.7% of the radiographs, and second-, third-, fourth-, and fifth-ray sesamoids were present on 2.8%, 0.5%, 1.0%, and 15.1% of the radiographs, respectively. Fifth-ray sesamoids were more prevalent in men (odds ratio, 2.71; 95% confidence interval, 1.52-4.84). The frequency of a normal foot profile (two sesamoids in the first ray) was 83.2%. Divisions of the sesamoids were seen on 4.0% of the radiographs at the first ray and on 20.9% at the fifth ray. Distribution and division of sesamoids were predominantly bilateral (kappa = 0.91, 0.91, and 0.95 for the first, second, and fifth digits, respectively; P < .001).