A retrospective study was conducted to evaluate treatment of foot and ankle ganglion cysts seen at the Foot and Ankle Institute at the Pennsylvania College of Podiatric Medicine (now Temple University School of Podiatric Medicine). From 1990 to 1997, 63 patients (63 ganglion cysts) were treated by conservative or surgical means. Statistical analysis of data collected showed a significant relationship between type of treatment received and recurrence of the cyst. Surgical intervention resulted in significantly less recurrence (11%) than conservative treatment (63%). Regardless of whether treatment was conservative or surgical, there was no significant relationship between location of the cyst and recurrence. The type of conservative treatment was not significantly related to recurrence of the cyst. The surgical recurrence rate reported here is comparable to that reported in other studies of foot and ankle ganglion cysts. The number of foot and ankle ganglion cysts evaluated in this study is the largest in the literature.
The authors present a case of a traumatic extensor hallucis longus tendon rupture sustained 2 days after hallux valgus and hammer toe correction. The ruptured tendon, separated by a 6-cm defect, was repaired using a fascia lata allograft. This case demonstrates a serious complication of a commonly performed procedure and a salvage technique useful for dealing with large tendon defects.
The authors review 63 surgical cases of adolescent hallux abducto valgus in 54 patients from the Foot and Ankle Institute of the Pennsylvania College of Podiatric Medicine over a 7-year period. Twenty-five closing base wedge and capital osteotomies were evaluated for radiographic changes. Three quarters of a group of 65 patients with adolescent hallux abducto valgus were found to have an abnormally high metatarsus adductus angle. Patients who had a closing base wedge osteotomy had higher preoperative radiographic angles for the intermetatarsal, metatarsus adductus, hallux abductus, and proximal articular set angles as well as the tibial sesamoid position. Those patients had 4.49 degrees more intermetatarsal angle correction than the patients who had a capital osteotomy. Implications for evaluation and treatment are discussed.
The authors studied 40 V-osteotomies of the lesser metatarsal performed for chronic intractable plantar keratosis. They discuss the effectiveness of the V-osteotomy for this deformity as well as other findings such as whether or not fixation of the osteotomy yields a better result (i.e., a lower incidence of complications). The results show that the V-osteotomy had limited effectiveness for this condition and resulted in a high complication rate.
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