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Advances in Foot Disorders and Its Treatment

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 54679

Special Issue Editor


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Guest Editor
Departament of Podiatry, University of Seville, 41004 Sevilla, Spain
Interests: orthopaedics; biomechanics; physical therapy; foot pathologies; foot orthoses

Special Issue Information

Dear Colleagues,

We are pleased to announce the launch of a new Special Issue entitled “Advances in Foot Disorders and its Treatment”. This Special Issue seeks novel research papers related to foot disorders and its treatments, especially orthopedics and walking aids devices. This Special Issue aims to discuss new knowledge or new developments in the foot disorders field.

Papers could be either research papers or review papers highlighting state-of-the-art developments in this area. We encourage the submission of interdisciplinary work and multinational collaborative research.

We look forward to receiving your excellent work.

Prof. Dr. Gabriel Domínguez-Maldonado
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • foot orthoses
  • biomechanics
  • walking aids device
  • foot pathologies
  • orthopedics

Published Papers (12 papers)

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Research

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9 pages, 14259 KiB  
Article
Effect of Phenol Application Time in the Treatment of Onychocryptosis: A Randomized Double-Blind Clinical Trial
by Juan Manuel Muriel-Sánchez, Manuel Coheña-Jiménez and Pedro Montaño-Jiménez
Int. J. Environ. Res. Public Health 2021, 18(19), 10478; https://doi.org/10.3390/ijerph181910478 - 06 Oct 2021
Cited by 5 | Viewed by 3148
Abstract
Background: In the treatment of Onychocryptosis, chemical matricectomy with 88% phenol solution is one of the most common surgical procedures due to a recurrence rate of less than 5%, but it may produce a delay in healing time. The objective was to compare [...] Read more.
Background: In the treatment of Onychocryptosis, chemical matricectomy with 88% phenol solution is one of the most common surgical procedures due to a recurrence rate of less than 5%, but it may produce a delay in healing time. The objective was to compare the healing time between phenol applications of 30 or 60 s. Methods: A comparative, prospective, parallel, randomized, and blinded clinical trial was registered with the European Clinical Trials Database. Twenty-seven patients (54 feet) with 108 affected nail folds were randomized and treated with chemical matricectomy with phenol. Each hallux was randomly assigned to one of two groups (60 vs. 30 s phenolization). Each patient and one investigator were blinded to the phenol application time in each foot. The outcome measurements were healing time, recurrence, pain, post-surgical bleeding, inflammation, and infection rate. Results: The 30 s application presents a shorter healing time (14.93 ± 2.81 days vs. 22.07 ± 3.16 days; p < 0.001) with a similar recurrence rate (p = 0.99). Post-operatory bleeding, pain, inflammation, and the infection rate did not show significant differences (p > 0.05). Conclusions: The 30 s phenol application time offers a shorter healing time than 60 s without affecting the effectiveness of the procedure, showing the same rate of complications. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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11 pages, 1521 KiB  
Article
Assessment of the Foot’s Longitudinal Arch by Different Indicators and Their Correlation with the Foot Loading Paradigm in School-Aged Children: A Cross Sectional Study
by Beata Szczepanowska-Wołowiec, Paulina Sztandera, Ireneusz Kotela and Marek Zak
Int. J. Environ. Res. Public Health 2021, 18(10), 5196; https://doi.org/10.3390/ijerph18105196 - 13 May 2021
Cited by 7 | Viewed by 2547
Abstract
Background: There are numerous studies assessing the morphological structure of the foot, but there is a notable scarcity of those focused on juxtaposing various longitudinal arch indices with foot loading paradigm. The present study aimed to determine the overall reliability, diagnostic accuracy of [...] Read more.
Background: There are numerous studies assessing the morphological structure of the foot, but there is a notable scarcity of those focused on juxtaposing various longitudinal arch indices with foot loading paradigm. The present study aimed to determine the overall reliability, diagnostic accuracy of respective variables, and their correlation with the foot loading paradigm. Methods: The study group consisted of 336 children, aged 10–15 years (girls 49.1% and boys 50.9%). The morphological structure of the plantar part of the foot in static conditions was assessed with the aid of a 2D podoscan. Individual foot loading paradigm in static conditions was assessed making use of the FreeMed platform. Results: Staheli (SI), Chippaux–Smirak (CSI), and Sztriter–Godunow (KY) indices were strongly correlated with each other (ρ > 0.84, p < 0.001). Own research corroborated an increased pressure of hollow feet, as assessed by the SI, CSI, and KY indices, on the forefoot and the hindfoot, foot zones B, E, F; these correlations being statistically significant. The results yielded by the present study also indicate an increased pressure on the metatarsal, and foot zones C, D of the flat feet. Conclusions: Flatfootedness is not believed to be a common deformity among children and adolescents. The SI, CSI, and KY indices were found to be strongly correlated, as well as proved reliable in assessing the foot’s longitudinal arch. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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8 pages, 920 KiB  
Article
Ultrasound-Guided Popliteal Nerve Block with Short-Acting Lidocaine in the Surgical Treatment of Ingrown Toenails
by Beom Suk Kim, Kyungho Kim, Jonathan Day, Jesse Seilern Und Aspang and Jaeyoung Kim
Int. J. Environ. Res. Public Health 2021, 18(10), 5059; https://doi.org/10.3390/ijerph18105059 - 11 May 2021
Cited by 1 | Viewed by 2265
Abstract
Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery [...] Read more.
Background: Digital nerve block (DB) is a commonly utilized anesthetic procedure in ingrown toenail surgery. However, severe procedure-related pain has been reported. Although the popliteal sciatic nerve block (PB) is widely accepted in foot and ankle surgery, its use in ingrown toenail surgery has not been reported. Therefore, this study aimed to investigate the safety and effectiveness of PB in the surgical treatment of ingrown toenails. Methods: One-hundred-ten patients surgically treated for an ingrown toenail were enrolled. Sixty-six patients underwent DB, and 44 underwent PB. PB was performed under ultrasound-guidance via a 22-gauge needle with 15 mL of 1% lidocaine in the popliteal region. The visual analogue scale was used to assess pain at two-time points: pain with skin penetration and pain with the solution injection. Time to sensory block, duration of sensory block, need for additional injections, and adverse events were recorded. Results: PB group demonstrated significantly lower procedure-related pain than the DB group. Time to sensory block was significantly longer in the PB group (20.8 ± 4.6 versus 6.5 ± 1.6 minutes). The sensory block duration was significantly longer in the PB group (187.9 ± 22.0 versus 106.5 ± 19.1 minutes). Additional injections were required in 16 (24.2%) DB cases, while no additional injections were required in PB cases. Four adverse events occurred in the DB group and two in the PB group. Conclusion: PB was a less painful anesthetic procedure associated with a longer sensory block duration and fewer repeat injections compared with DB. The result of this study implicates that PB can be an alternative anesthetic option in the surgical treatment of ingrown toenails. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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14 pages, 6068 KiB  
Article
Reliability and Repeatability of Pressure Center Analysis with Low-Dye Taping Using Force Platform Podiatry Sensors in Feet with Excessive Pronation
by Óscar Madruga-Armada, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Cesar Calvo-Lobo, David Rodriguez-Sanz, Eva María Martínez-Jiménez, Victoria Mazoteras-Pardo and Marta San-Antolín
Int. J. Environ. Res. Public Health 2021, 18(6), 3265; https://doi.org/10.3390/ijerph18063265 - 22 Mar 2021
Cited by 2 | Viewed by 2205
Abstract
Background: The analysis of the center of pressure (COP) is a method used to assess the foot function, but its reliability and repeatability have not been evaluated. COP can be altered by diverse conditions, like an excessive foot pronation. Low-Dye taping is commonly [...] Read more.
Background: The analysis of the center of pressure (COP) is a method used to assess the foot function, but its reliability and repeatability have not been evaluated. COP can be altered by diverse conditions, like an excessive foot pronation. Low-Dye taping is commonly used for the treatment of symptoms related to an excessive pronation. To date, no study has evaluated the effects of the Low-Dye taping on COP and the duration of its effects. Thus, the main purpose of this manuscript was to assess the reliability and repeatability of the percentage of center of pressure locus area (%CLA) in feet with an excessive pronation, and secondarily, to assess that the Low-Dye taping modifies the %CLA during the immediate 48 h. Methods: An observational study of the reliability and repeatability of the %CLA variable with the Low-Dye taping in feet with excessive pronation was carried out. We used the EPS-Platform to evaluate the results of the variable in 6 conditions in a first session to evaluate the reliability of the results. We compared the results of the first session with the results in a second session to evaluate the repeatability of the results. We also carried out an ANOVA test to evaluate the changes that the taping produced in the variable between without taping with the rest of the 6 conditions. Results: For the %CLA, we observed a reliability greater than 0.80, measured by the interclass ratio index, both in the first session before taping, and in the second session before taping, thus being a repeatability variable. In the following times, with taping, at 10 min with tape, at 20 min with tape, at 24 h with tape and at 48 h with tape; an interclass ratio coefficient (ICC) higher than 0.80 was again obtained, thus being a reliable variable in all measurements made. The Low-Dye taping did not change %CLA from the time the tape was put in until 48 h (p-value = 1.000). Conclusions: The %CLA variable, in feet with excessive pronation, proved to be a reliable variable in all the measurements obtained before putting on the tape and during the following 48 h with the tape, and a repeatable variable. The Low-Dye taping did not change the %CLA from the time the tape was put in until 48 h. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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7 pages, 632 KiB  
Article
A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure
by Jahyung Kim, Sanghyeon Lee, Jeong Seok Lee, Sung Hun Won, Dong Il Chun, Young Yi and Jaeho Cho
Int. J. Environ. Res. Public Health 2021, 18(1), 278; https://doi.org/10.3390/ijerph18010278 - 01 Jan 2021
Cited by 10 | Viewed by 13540
Abstract
(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the [...] Read more.
(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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10 pages, 1392 KiB  
Article
Analysis and Assessment through Mechanical Static Compression Tests of Damping Capacity in a Series of Orthosis Plantar Materials Used as Supports
by Manuel Pabón-Carrasco, María Reina-Bueno, Samuel Vilar-Palomo, Inmaculada C. Palomo-Toucedo, Javier Ramos-Ortega and José María Juárez-Jiménez
Int. J. Environ. Res. Public Health 2021, 18(1), 115; https://doi.org/10.3390/ijerph18010115 - 26 Dec 2020
Cited by 1 | Viewed by 2004
Abstract
High plantar pressure is the cause of multiple types of foot injuries and one of the main reasons for patient visits in podiatry and traumatology. Therefore, there is a need to acquire specific tools to address such injuries. The aim of this study [...] Read more.
High plantar pressure is the cause of multiple types of foot injuries and one of the main reasons for patient visits in podiatry and traumatology. Therefore, there is a need to acquire specific tools to address such injuries. The aim of this study was to determine the absorption capacity of selected materials applied as plantar supports and their response to pressure. The study had a cross-sectional design. A total of 21 materials were chosen and different material families were assessed, including ethylene-vinyl acetate, polyurethane foams, and polyethylene foams. Static compression tests were performed to analyze each material. The system is ideally suited for lower-force applications, small components, biomedical applications, and lower-strength materials. Damping was determined using mathematical calculations performed on the study data. It was found that materials with a low Shore A, or soft materials, exhibited worse absorption capacity than harder materials. Ethyl-vinyl acetates had good absorption capacity, polyurethane foams had a poor absorption capacity, and soft materials provided better adaption to impact. The results suggested that damping is not determined by the hardness of the material, and materials within the same family exhibit different damping capabilities. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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8 pages, 1411 KiB  
Article
Modification of Pronated Foot Posture after a Program of Therapeutic Exercises
by Raquel Sánchez-Rodríguez, Sandra Valle-Estévez, Peñas Albas Fraile-García, Alfonso Martínez-Nova, Beatriz Gómez-Martín and Elena Escamilla-Martínez
Int. J. Environ. Res. Public Health 2020, 17(22), 8406; https://doi.org/10.3390/ijerph17228406 - 13 Nov 2020
Cited by 12 | Viewed by 6224
Abstract
Working on the intrinsic musculature of the foot has been shown to be effective in controlling pronation. However, the potential coadjuvant effect that involving other muscle groups might have on foot posture remains unknown. The aim was, therefore, to assess whether a 9-week [...] Read more.
Working on the intrinsic musculature of the foot has been shown to be effective in controlling pronation. However, the potential coadjuvant effect that involving other muscle groups might have on foot posture remains unknown. The aim was, therefore, to assess whether a 9-week intrinsic and extrinsic foot and core muscle strength program influenced foot posture in pronated subjects. The participants were 36 healthy adults with pronated feet that were randomly assigned to two groups. The experimental group (n = 18) performed a strengthening exercise protocol for 9 weeks (two sessions of 40 min per week), while the control group (n = 18) did not do these exercises. After 9 weeks, the foot posture index (FPI) scores of the two groups were analyzed to detect possible changes. The FPI at the baseline was 8.0 ± 1.5. After the 9 weeks, the experimental group showed significantly reduced FPI from 8.1 ± 1.7 to 6.4 ± 2.1 (p = 0.001), while the control group had the same score as pre-intervention (FPI 8 ± 1.2, p = 1.0). The FPI scores showed no significant differences by sex. Strengthening of the intrinsic and extrinsic foot and core muscles contributed to improving foot posture in adults, reducing their FPI by 1.66 points. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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13 pages, 1320 KiB  
Article
Polyethylene Nail Brace for Ingrown Toenails Treatment: A Randomized Clinical Trial
by Salvador Márquez-Reina, Inmaculada Palomo-Toucedo, María Reina-Bueno, José Manuel Castillo-López, Javier Ramos Ortega, César Calvo-Lobo, Daniel López-López and Gabriel Domínguez-Maldonado
Int. J. Environ. Res. Public Health 2020, 17(21), 7741; https://doi.org/10.3390/ijerph17217741 - 23 Oct 2020
Cited by 5 | Viewed by 4367
Abstract
Background: Onychocryptosis is one of the most prevailing onychopathies and one of the usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the effectiveness of a procedure of nail reeducation technique via a strip of polyethylene in subjects with [...] Read more.
Background: Onychocryptosis is one of the most prevailing onychopathies and one of the usual reasons for visiting podiatry clinics. In this research, we aim to evaluate the effectiveness of a procedure of nail reeducation technique via a strip of polyethylene in subjects with stage I or IIa onychocryptosis, in which pathological toenail curves are present. Methods: This research was a randomized clinical trial (ACTRN12615000834550). The sample was made up of 94 cases of stage I or IIa onychocryptosis, according to the Mozena classification. Briefly, 46 cases were treated with the combination of a spicule technique and nail brace with a polyethylene plastic strip, and 48 were only treated with the spicule technique. Results: The combination of the spicule technique and the nail brace technique with a strip of polyethylene had a significantly lower recurrence rate compared to that achieved with just the spicule technique, twelve months after the beginning of the study (N.S. = 0.000 for α = 0.05). The change in the nail width achieved with the nail brace technique, twelve months after the beginning of the study, was statistically significant (N.S. = 0.000 for α = 0.05). Conclusions: The recurrence rate of the spicule technique alone was significantly higher than the combined technique of spicule with nail brace. A nail brace with a strip of polyethylene reduces the recurrence rate of onychocryptosis. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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Review

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26 pages, 5031 KiB  
Review
Adjusted Indirect and Mixed Comparisons of Conservative Treatments for Hallux Valgus: A Systematic Review and Network Meta-Analysis
by Jianhua Ying, Yining Xu, Bíró István and Feng Ren
Int. J. Environ. Res. Public Health 2021, 18(7), 3841; https://doi.org/10.3390/ijerph18073841 - 06 Apr 2021
Cited by 13 | Viewed by 6406
Abstract
Background: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method [...] Read more.
Background: Hallux valgus (HV) deformity is a common, potentially debilitating deformity. And evidence with high-quality for the conservative treatments of HV deformity is still required.; AIMS: To compare the effects of different conservative treatments for hallux valgus deformity by using the method of network meta-analysis.; Study Design: A systematic review and network meta-analysis of randomized controlled trials identified by searching PubMed, EMBASE, MEDLINE, OVID, and CINAHL. The included studies should have the characteristics that: (1) participants with hallux valgus deformity of any age (2) conservative treatments (3) Reported the hallux valgus (HVA), the intermetatarsal angle (IMA), the score of the Visual Analog Scale, and the score of Foot Function Index.; Results: 11 studies were included in this review. The agreement between reviewers reached a kappa value of 0.75. The results of the network meta-analysis showed that a combination of exercise and toe separator, night splints, and dry needling are most likely to be the best choice for reducing the hallux valgus angle (HVA) and intermetatarsal angle, and toe separators (with or without exercise), dry needling, and manipulation (with or without ice treatment) have advantages in improving the subjective feeling of patients.; Conclusions: Multi-disciplinary conservative treatments have a great potential for hallux valgus deformity. More research with high-quality is needed to give a comprehensive and reasonable scheme of a holistic and long-term treatment protocol. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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Other

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7 pages, 1971 KiB  
Case Report
Cavus Foot Correction Using a Full Percutaneous Procedure: A Case Series
by Rodrigo Schroll Astolfi, José Victor de Vasconcelos Coelho, Henrique César Temóteo Ribeiro, Alexandre Leme Godoy dos Santos and José A. Dias Leite
Int. J. Environ. Res. Public Health 2021, 18(19), 10089; https://doi.org/10.3390/ijerph181910089 - 25 Sep 2021
Cited by 3 | Viewed by 3003
Abstract
Cavus foot is a tri-planar deformity that requires correction in several bones and soft tissue. Minimally invasive surgeries are less aggressive, faster and easier to recover from. Here, we describe the initial results of a technique for percutaneous cavus foot correction. The procedure [...] Read more.
Cavus foot is a tri-planar deformity that requires correction in several bones and soft tissue. Minimally invasive surgeries are less aggressive, faster and easier to recover from. Here, we describe the initial results of a technique for percutaneous cavus foot correction. The procedure consists of calcaneal dorsal/lateral closing wedge osteotomy (with fixation), cuboid, medial cuneiform and first metatarsal closing wedge osteotomy (without fixation), and plantar fascia and tibialis posterior tenotomy with the patient in the prone position. Immediate weight bearing is permitted. Twenty patients were selected to undergo the procedure. The mean follow-up was 4.2 months and mean age 42.3 years. Eight of the 20 patients were submitted to cuboid and first metatarsal osteotomy, and 12 (60%) only calcaneal osteotomy. The median time for complete bone healing was 2.2 months. No wound complications were observed. No cases of non-consolidation of the cuboid or first metatarsal osteotomies were detected. The most common complication was sural nerve paresthesia. This is the first description of cavus foot correction using a minimally invasive technique. Complete bone healing is obtained even with immediate weight bearing and without cuboid and first metatarsal fixation. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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7 pages, 2623 KiB  
Case Report
A Huge Plantar Intramuscular Hemangioma in the Plantar Area Treated Surgically: A Case Report and Literature Review
by Hong Seop Lee, Yong Cheol Hong, Ki Jin Jung, Eui Dong Yeo, Sung Hun Won, Si-Hyong Jang, Jae Young Ji, Dhong Won Lee, Sung Joon Yoon and Woo Jong Kim
Int. J. Environ. Res. Public Health 2021, 18(17), 9088; https://doi.org/10.3390/ijerph18179088 - 28 Aug 2021
Cited by 1 | Viewed by 3756
Abstract
Intramuscular hemangioma (IH) is rare, accounting for only 0.8% of all hemangioma cases. In particular, IH of the foot has only been reported a few times. In such cases, the symptoms typically include tenderness and swelling, often in relation to physical activity, but [...] Read more.
Intramuscular hemangioma (IH) is rare, accounting for only 0.8% of all hemangioma cases. In particular, IH of the foot has only been reported a few times. In such cases, the symptoms typically include tenderness and swelling, often in relation to physical activity, but tingling or impaired function may also be present. Here, we report a patient who presented with a significant IH in the plantar area treated surgically. A 25-year-old female visited our hospital with pain in the plantar aspect of the right foot. She had noticed a mass about 10 years prior. She had previously experienced pain only when pressing the mass, but the pain subsequently became more regular pain and was exacerbated by exercise. In fact, the pain became so intense that she could not sleep well. Upon physical examination, mild swelling and tenderness of the plantar area were noted in the second to the fourth metatarsal. Sensation and motor reflexes were normal and the results of Tinel’s test were negative. Plain radiographs of the right foot revealed phleboliths scattered throughout the first to third intermetatarsal spaces. Magnetic resonance imaging revealed a space-occupying multilobulated mass (5.6 × 2.8 × 2.5 cm) located in the flexor digitorum brevis (FDB) muscle, which penetrated the plantar fascia and spread to the subcutaneous layer. In T2-weighted images, the lesion displayed a hyperintense signal compared to the surrounding skeletal muscle. Based on radiological findings, we suspected IH. The mass surrounded by the FDB muscle was exposed and completely removed via wide excision. IH consisting of cavernous-like vascular structures was diagnosed on pathology. At 1-year follow-up, the patient was almost asymptomatic and had recovered almost full range of motion in the plantar area. Histological analysis and surgery are recommended to remove intramuscular hemangiomas in the plantar area, but if the patient is not suitable for surgery, sclerotherapy or combination treatment should also be considered. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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9 pages, 2695 KiB  
Case Report
Surgical Reconstruction of Nonunion after Iatrogenic Scarf Osteotomy
by Mercedes Ortiz-Romero, Luke D. Cicchinelli, Álvaro Fernández-Garzón and Luis M. Gordillo-Fernández
Int. J. Environ. Res. Public Health 2021, 18(11), 5620; https://doi.org/10.3390/ijerph18115620 - 25 May 2021
Viewed by 3471
Abstract
We present the case of a young patient, 32 years old, with nonunion in the diaphysis of the first metatarsal after scarf osteotomy for correction of hallux valgus. After removal of the failed osteosynthesis material and preparation of the bone fragments, a calcaneal [...] Read more.
We present the case of a young patient, 32 years old, with nonunion in the diaphysis of the first metatarsal after scarf osteotomy for correction of hallux valgus. After removal of the failed osteosynthesis material and preparation of the bone fragments, a calcaneal bone autograft, previously extracted from the patient, was placed in the nonunion area. The new physiological position of the first metatarsal in the three planes was checked intraoperatively, and autograft and fragment fixation was performed using a combination of a low-profile plate with six screws and two interfragmentary screws. The advantage of using an autogenous graft is that it provides corticocancellous bone and great osteogenic capacity with little antigenic capacity. This makes it an excellent option in many situations in foot and ankle surgery. Regarding the fixation method, we used the two most commonly used techniques for osteosynthesis of bone grafts in cases of bone nonunion, combining plates with locking screws and two interfragmentary screws. This provides greater stability of the bone fragments in the three planes and makes it possible to bring forward when the patient starts postsurgical loading. Full article
(This article belongs to the Special Issue Advances in Foot Disorders and Its Treatment)
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