OBJECTIVETo observe and evaluate the clinical effects of surgical treatment for the accessory navicular syndrome with simple excision.

METHODSFrom November 2006 to December 2008, 23 patients (twenty-five feet) with accessory navicular syndrome received simple excision of the accessory navicular bone. The chief complains were intermittent pain of feet after running or walking. Physical examination showed local tenderness on palpation in the region of the navicular bone. X-ray or CT showed there was an accessory navicular bone. The present history ranged from 6 months to 12 years. There were 14 males and 9 females. The mean age was 14.6 years, ranging from 8 to 35 years. About 2 cm long incision was made at the tip of the medial prominence of the navicular bone. After partial dissection of the posterior tibial tendon, the accesssory navicular bone was exposed and excisied. The prominence of the tuberosity of the navicular bone was cut and shaved. The posterior tibial tenden was repaired before closing the wound. The foot was immobilized with cast or brace in inversion position and no weight-bearing for 2 weeks. Strenuous jumping or dancing must be avoided in 3 months after surgery. The patients with residual symptoms and signs received physical therapy and an arch support for shoes without flatfoot deformity.

RESULTSThe average clinical follow-up during was 12 month (ranged, 3 to 18 months). The excellent results in 21 feet and good in 4 feet (3 feet with mild flat deformity and 1 foot with old sprain injury). The average hospital stay was 5 days and no wound infection occurred. All patients resumed the normal life and study after operation.

CONCLUSIONSurgical treatment of the accessory navicular syndrome with simple excision has the advantages of less invasive to the posterior tibial tenden and the medial longitudinal arch of the foot, shorter time of immobilization of the foot and stay in hospital, small incision and good clinical results. This procedure is one of the best selective treatments for the accessory navicular syndrome, especially for the patients without flatfoot deformity and old sprain injury.

Adolescent ; Adult ; Bone Diseases ; pathology ; surgery ; Child ; Female ; Foot Diseases ; pathology ; surgery ; Humans ; Male ; Young Adult

BACKGROUNDThe choice for the surgical approach of interdigital neuroma in the foot is controversial. Plantar approach can leave a painful scar on weight bearing area; hence, some prefer dorsal approach. The aim of the current study was to measure the outcome of interdigital (Morton's) neurectomy performed by a single surgeon using dorsal and plantar approaches.

METHODSA retrospective review of the patient records of one orthopaedic foot and ankle surgeon identified thirty-six patients (42 feet) who had been treated operatively for a primary, persistently painful interdigital neuroma. The mean follow-up was 18 months. Pain, weight bearing, wound problems and rehabilitation period were studied.

RESULTSThe duration to full weight bearing, return to work, driving and recreational activities were at least one week shorter in the dorsal group. The overall satisfaction for surgery was rated as excellent or good in 85% of the thirty six patients. Scar problems were more troublesome and common in the plantar group. There was residual numbness noticed in twenty feet, the pattern of numbness was quite variable and it was bothersome in only seven feet. There was one recurrence in the plantar group.

CONCLUSIONSResection of a symptomatic interdigital neuroma through a dorsal or a plantar approach can result in a good outcome. Dorsal approach, however, is associated with better rehabilitation and less scar problems.

Adult ; Aged ; Female ; Foot ; pathology ; physiopathology ; surgery ; Foot Diseases ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neuroma ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome ; Weight-Bearing

Actins ; metabolism ; Female ; Fibroma ; metabolism ; pathology ; surgery ; Foot Diseases ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Inclusion Bodies ; metabolism ; pathology ; Infant ; Toes

OBJECTIVE: To analyze radiological characteristics of Muller-Weiss disease, evaluate the clinical value of the imaging examination in diagnosis of Muller-Weiss disease. METHODS: The imaging data of 26 patients with Muller-Weiss disease were collected from September 2015 to August 2020, including 7 males and 19 females, aged 43 to 68 years old with an average of (52.7±4.6) years old. In the X-ray examination observed the shape and position of the navicular bone. The talar-first metatarsal angle(TFM) was measured on the weight-bearing anteroposterior radiograph. The arch angle and angle between mid-axis of talus and mid-axis of the first metatarsal(Meary angle) were measured on the weight-bearing lateral radiographs. The morphology, density, adjacent joint space and position of the navicular bone were evaluated by computed tomography(CT), and magnetic resonance imaging(MRI) was used to observe the shape, signal, cartilage and surrounding soft tissue changes of the navicular bone. RESULTS: Among 26 patients, 21 cases were unilateral and 5 cases were bilateral;X-ray examination showed that the lateral part of navicular bone of foot was compressed and flattened, showing"comma like"or"drop like", navicular moved to the medial side, partial fragmentation of bone, peripheral articular hyperplasia, uneven density and narrowing of relationship gap. According to Meary angle and deformity degree of the affected foot on the lateral X-ray of the load-bearing foot, Maceira staging was performed. There were 0 cases in stageⅠ, 2 cases in stage Ⅱ, 11 cases in stage Ⅲ, 9 cases in stage Ⅳand 4 cases in stage Ⅴ. CT examination showed bone fragmentation, medial displacement of navicular bone and formation of the talocalcaneal joint. MRI examination showed the irregular shape and uneven signal of navicular bone, narrowing of joint space, talocalcaneal joint surface hyperplasia and cartilage destruction, tarsal joint effusion and swelling of surrounding soft tissue. CONCLUSION Muller-Weiss disease has specific imaging manifestation, and an accurate diagnosis can be made based on the patient's age, gender, and clinincal history. Preoperative imaging examination can stage the disease, help clinicians to formulate better surgical plans, and postoperative imaging examination can better evaluate the surgical effect.
Adult ; Aged ; Bone Diseases/diagnostic imaging* ; Cartilage Diseases ; Female ; Foot Diseases/diagnostic imaging* ; Humans ; Hyperplasia/pathology* ; Male ; Middle Aged ; Talus/pathology* ; Tarsal Bones/surgery* ; Tarsal Joints

Reflex sympathetic dystrophy (RSD) is a common rheumatic disorder manifesting painful swelling, discoloration, stiffening and atrophy of the skin. Radiographic alterations include small, spotty subperiosteal bone resorption (SBR) and diffuse porosis, and MR imaging shows bone and soft-tissue edema. The purposes of current investigation were to assess 99mTc HDP pinhole SPECT (pSPECT) findings of RSD, to correlate them with those of radiography and MRI and to speculate about causative mechanism of SBR which characterizes RSD. pSPECT was performed in five patients with RSD of the foot. pSPECT showed small, discrete, spotty hot areas in the subperiosteal zones of ankle bones in all five patients. Diffusely increased tracer uptake was seen in the retrocalcaneal surface where the calcaneal tendon inserts in two patients with atrophic RSD. pSPECT and radiographic correlation showed spotty hot areas, that reflect focally activated bone turnover, to closely match with SBR. Further correlation with MRI showed both spotty hot areas and SBR to coincide in location with the insertions of ligaments and tendons, onto which pulling strain is constantly exerted. In contrast, the disuse osteoporosis in unstrained bones did not show any more significantly increased tracer uptake than normal cancellous bones.
Adult ; *Bone Resorption ; Bone and Bones/pathology ; Edema ; Female ; Foot Bones/pathology ; Foot Diseases/pathology ; Human ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Osteoporosis/pathology ; Reflex Sympathetic Dystrophy/*pathology ; Technetium/*pharmacology ; Tomography, Emission-Computed, Single-Photon/*methods

OBJECTIVETo evaluate therapy effect of radiofrequency in the treatment of painful heel syndrome under arthroscopy.

METHODSFrom January 2006 to December 2011, 13 patients with painful heel syndrome being admitted into our hospital were studied. There were 5 males and 8 femals, ranging in age from 35 to 68 years. All these surgeries were performed under local anesthesia. After constructing a man-made lacouna in the subcutaneous tissue above plantar fascia, a medial and a lateral portal were established on both sides of plantar fascia and at the anterior edge of calcaneal tuberosity. Hyperplasia and torn fiber tissue of plantar fascia, and plantar calcaneal bursa were removed with radiofrequency probe under arthroscopy. Then penetration of the plantar fascia was carried out in a reticulation-shaped pattern with a special radiofrequency probe TOPAZ. Each patient was assessed with VAS pain evaluation criteria and AOFAS ankle-hindfoot score system (AOFAS-AH) before and after operation. All the patients were followed up, and the duration ranged from 6 to 12 months.

RESULTSAll the 13 patients got excellent recovery with their heel pain relieved significantly. VAS score was 8.71 +/- 1.64 before operation, 6.27 +/- 2.53 at the 1st month after operation, and 2.30 +/- 2.69 at the 6th month after operation. AOFAS-AH score was 56.43 +/- 3.72 preoperation, 68.15 +/- 7.38 at 1st month post operation, and 84.51 +/- 2.93 at 6th month after operation. There were no perioperative and postoperative complications related to the procedure, such as blood vessel and nerve injury, and infection.

CONCLUSIONPlantar fasciitis and plantar calcaneal bursitis are main factors of painful heel syndrome. Due to advantages of being easy to operate, having definite effect and no use to do spur removal or plantar fasciotomy. Endoscopy assisted plantar calcaneal bursa removal and plantar fascia penetration by radiofrequency technique can be a satisfactory treatment method for painful heel syndrome.

Adult ; Aged ; Arthroscopy ; methods ; Bursa, Synovial ; pathology ; surgery ; Bursitis ; pathology ; surgery ; Female ; Foot Diseases ; surgery ; Heel ; pathology ; surgery ; Humans ; Male ; Metatarsalgia ; pathology ; surgery ; Middle Aged ; Radio Waves

This study describes the expression of heat shock protein70 (HSP70) and alpha-basic-crystallin (alpha-BC) and their association with apoptosis and some related adaptor proteins in the pathogenesis of foot-and-mouth disease virus (FMDV)-induced myocarditis in lambs. HSP70 was generally overexpressed in the myocardial tissues and inflammatory cells of FMDV-induced myocarditis with differential accumulation and localization in same hearts when compared to non-foot-and-mouth disease control hearts. alpha-BC immunolabeling showed coarse aggregations in the Z line of the cardiomyocytes in FMDV-infected hearts in contrast to control hearts. Overall, the results of this study show that the anti-apoptotic proteins, HSP70 and alpha-BC, were overexpressed with increased apoptosis in FMDV-infected heart tissues. Both proteins failed to protect the cardiomyocytes from apoptosis as defense mechanisms to the FMDV during the infection, suggesting that the virus is able to increase apoptosis via both downregulation and/or upregulation of these anti-apoptotic proteins.
Animals ; Apoptosis Regulatory Proteins/metabolism ; Foot-and-Mouth Disease/*complications/*virology ; Foot-and-Mouth Disease Virus/*classification ; Gene Expression ; HSP70 Heat-Shock Proteins/*metabolism ; Myocarditis/complications/pathology/*veterinary/virology ; Myocardium/pathology ; Sheep ; Sheep Diseases/*virology ; Turkey ; alpha-Crystallin B Chain/*metabolism

Angioma serpiginosum is an uncommon, acquired vascular nevoid disorder with capillary dilation and proliferation in the papillary dermis. The eruptions are asymptomatic and characterized by grouped, erythematous to violaceous, serpiginous and punctate macules. The condition usually appears in females during adolescence on unilateral lower extremities and the buttocks. We report a rare case with a late onset and atypical distribution of lesions in a 48-year-old female patient who had groups of punctate lesions on her left foot for four to five years. Histopathological examination showed hyperkeratosis and multiple dilated and proliferated capillaries in the papillary dermis. Inflammation and extravasation of red blood cells were not found. According to the clinical and pathological findings, we established a diagnosis of angioma serpiginosum. She was treated with a pulsed dye laser, and the angiomatous lesions subsequently improved.
Female ; Foot Diseases/diagnosis/surgery ; Humans ; Lasers, Dye/therapeutic use ; Middle Aged ; Skin/blood supply/pathology/surgery ; Skin Diseases, Vascular/*diagnosis/surgery ; Telangiectasis/*diagnosis/surgery ; Treatment Outcome

A rare case of laminitis was recorded in an adult camel that was kept in confinement without giving any exercise and fed daily with considerable quantity of pearl millet grains (Pennisetum typhoideus) for more than five months.
Animal Feed/adverse effects ; Animals ; *Camels ; Cereals ; Dietary Fiber/deficiency ; Foot Diseases/etiology/pathology/surgery/*veterinary ; Lameness, Animal/*etiology/pathology/surgery ; Male

Adult ; Diagnosis, Differential ; Foot Diseases ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Male ; Myxosarcoma ; metabolism ; pathology ; surgery ; Neoplasms, Muscle Tissue ; pathology ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Tenosynovitis ; pathology ; Vimentin ; metabolism