Stress fractures of the fifth metatarsal have been reported with increasing frequency, especially in athletes. Prolonged healing time and the risk of refracture following conservative treatment have led to recommendations for operative treatment including bone grafting of these fractures. An axial intramedullary screw, inserted without opening the fracture site, was used in 10 athletes with stress fractures of the fifth metatarsal. Union was obtained in all patients in an average of 7.5 weeks. All patients returned to their sports in an average of 8.5 weeks postoperatively. There were no operative complications or refractures after screw insertion. Complaints of local pain over the screw head and/or the fifth metatarsal head, seen in 7 of the 10 patients, were relieved by local shoe modifications.
We present a detailed map of regional LN involvement in patients treated with radical cystectomy and lymph node dissection for transitional cell cancer of the bladder. Extensive LN dissection is essential for the complete removal of disease and accurate staging.
Glyceryl trinitrate paste heals the majority of chronic anal fissures. However, a significant minority have little improvement or develop side effects and require conventional surgical treatment. Poor compliance with prescribed treatment often contributes to nonhealing. In addition, some fissures which initially heal with glyceryl trinitrate paste recur and require further treatment. Glyceryl trinitrate treatment is labor intensive for patients and physicians and has not been shown to be superior to lateral sphincterotomy.
Medullary CRC is more common than previously reported, frequently presents with locally advanced disease, and may be associated with higher mortality at 30 days after resection. Despite this, when strict criteria are used for diagnosis, the overall survival is favorable when compared with CRCs with equivalent demographic and pathological characteristics.
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