Humans ; Leprosy, Tuberculoid ; diagnosis ; pathology ; Male ; Middle Aged ; Toes ; pathology

Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.
Adult ; *Fibroma ; *Glomus Tumor ; Humans ; Male ; *Osteochondroma ; *Toes/pathology/surgery

Humans ; Carcinoma, Verrucous/pathology* ; Carcinoma, Squamous Cell/pathology* ; Bone Neoplasms ; Toes/pathology* ; Skin Neoplasms/pathology*

OBJECTIVETo investigate difference between the appearance and the bony structure in the polysyndactyly of the fifth toe fused with the fourth toe.

METHODSFrom Jan. 2009 to Jan. 2014, 54 patients (65 feet) with polysyndactyly of the fifth toe fused with the fourth toe were treated. The appearance, X-ray and intraoperative finding were recorded and compared to classify the deformity. Then the extra toe was excised and syndactyly was separated. The malalignment and brachydactyly of the sixth toes were corrected simultaneously.

RESULTSAccording to the bone and joint type, the fifth toes were neoplastic toes without joints in 17 feet, or had poor bony and joint alignment with the sixth toes in 48 feet. So the fifth toes were excised in all the cases. The patients were followed up for 1 month to 4 years. The oblique deformity of sixth toes were corrected completely with improved length.

CONCLUSIONSThe polysyndactyly of the fifth toe fused with the fourth toe should be classified to design the excised toe (usually fifth toe) and correction procedure. The appearance and bony joint recovery are both important.

Humans ; Polydactyly ; pathology ; surgery ; Syndactyly ; pathology ; surgery ; Toe Phalanges ; abnormalities ; surgery ; Toes ; abnormalities ; surgery

Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, which commonly manifests as muco-cutaneous papulonodules and inflammatory erosive polyarthropathy. In this research, we report the clinical manifestations and management of a rare case of MRH with destructive arthropathy of bilateral hip joints and arthritis mutilans presenting with characteristic deformities. Disabling hip arthropathy that occurs secondary to MRH can be successfully managed with bilateral total hip arthroplasty (THA). Osteopenia and acetabular bone defects must be anticipated during THA. This case is reported due to its rare occurrence and because little literature has been published regarding THA in such patients.
*Arthroplasty, Replacement, Hip ; Fingers/pathology ; Hip/pathology/radiography/surgery ; *Histiocytosis, Non-Langerhans-Cell ; Humans ; Skin/pathology ; Toes/pathology

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

Desmoplastic fibroma is a rare benign primary bone tumor that is histologically similar to the soft tissue desmoid tumor. It most often involves the mandible, large long bone or iliac bone. Desmoplastic fibroma in a toe has been extremely rarely reported. Authors report a rare case of desmoplastic fibroma of bone occurring in the distal phalanx of a foot, with descriptions of the radiographic and MRI findings, correlation of the radiologic and pathologic findings, and discussion on the differential diagnosis of the tumor.
Adolescent ; Bone Neoplasms/*diagnosis ; Diagnosis, Differential ; Female ; Fibroma, Desmoplastic/*diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Toes/*pathology

So a considerable amount of work on the cerebral edema has been done by numerous investigator hat it is difficult to summarize the research works of cerebral edema on this paper. Cerebral edema is a well-recognized clinical entity. It was also quite obvious around many cerebral tumors and injured brains of the post-mortem materials. Further, in 1937, Stewart-Wallace considered that the fluid increase of the cerebral edema was in the intercellular or interstitial space. This was accepted by histologic using the light microscope and biochemists for the next two decades. Since 1957 electron microscope has been used to study, the concept of cerebral edema has been changes. So the author selected and introduced the following experimental studies and their occlusions from number of different clinical and experimental research works of cerebral edema that have been carried out since 1957. 1) Cold induced cerebral edema. 2) Experimental cerebral swelling produced by supratentorial extradural compression (implanted balloons). 3) Triethyltin-induced cerebral edema. 4) Cerebral edema due to implantation of foreign substances. 5) Cerebral edema associated with experimental intracerebal tumors. 6) Experimental ischemic brain swelling and experimental intracranial hypertension due toe vascular blockade. 7) Ouabeininduced cerebral edema. 8) Serotonin-induced cerebral edema. 9) Cerebral edema due to radiofrequency lesion. 10) The effect of laser irradiation. By these experimental cerebral edema numerous conclusions were reported, but the important results were as follows: 1) In the cortex there is enlargement of astrocytes. 2) Axonal and myeline changes occur. 3) Ultrastuructural studies indicate that edema was entirely intracellular. 4) Basically cerebral edema is an extracellular phenomenon of the white matter accompanied by marked swelling of the astrocytes. 5) An increase in water and sodium and decrease in potassium content of white matter, resulting in a sharp rise of Na: K ratio is evident. 6) Radioactive amino acid incorporation into protein of edematous brain is increased. 7) The depressed respiratory control, depressed P:O radio and accelerated state 4 respiration are present. Moreover, it has become apparent that these are some disadvantages in the experimentally induced cerebral edema. It may not involve the entire brain uniformly: different agents produce different types of edema; patterns are subject to variations of animal species and cerebral topography; the extent of damage is not controllable and reproducible; consistency of damage is uncertain no all experimental edema are artificial and not completely analogous to those occurring in human pathology. Nonetheless, cold induced edema and extradural compression method can be considered as a prototype of traumatic brain swelling. And the experimental intracerebral tumors can be exact counterparts in human pathology also. The laser irradiation and radio frequency lesion can produce standardized lesion and edema, further they will be appreciable to study the efficacy of various agents in reducing intracranial damage and edema.
Animals ; Astrocytes ; Axons ; Brain ; Brain Edema* ; Edema ; Humans ; Intracranial Hypertension ; Myelin Sheath ; Pathology ; Potassium ; Research Personnel ; Respiration ; Sodium ; Toes ; Water

OBJECTIVETo study the methods and therapeutic effect of repairing deformity of nasal columella and tip by anastomosing its blood vessels with those of the great/second toe web flap.

METHODSThe donor site was the great/second toe web flap. Sewing the great/second toe web flap and nasal columella and tip together by using 5-0 silk thread, anatomizing facial artery and facial vein for three centimeters long behind submaximal, protecting lower jaw branch of facial nerve, separating a subcutaneous layer tunnel between nasal columella and one of facial artery and facial vein behind submaximal. Dorsal artery of foot, saphenous vein in the flap were anastomosed with the facial artery and facial vein behind submaximal through the tunnel under the subcutaneous layer.

RESULTSAll flaps survived, satisfactory therapeutic effect was obtained. Postoperative follow-up was 0.5-1 year. The reconstructed columella showed satisfactory contour, good texture and color, and good resistance to injury.

CONCLUSIONSGreat/second toe web flap is a ideal skin flap for repairing deformity of nasal columella and tip.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nose ; pathology ; surgery ; Skin Transplantation ; Surgical Flaps ; Toes ; surgery ; Young Adult

OBJECTIVETo explore clinical effect of minimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision.

METHODSFrom January 2013 to June 2016, 168 hallux valgus patients with deformity of little toe varus were treated by minimally corrective osteotomy through small incision. Among them, 7 males and 161 females were aged from 22 to 75 years old with an average of(59.3±3.5) years old. Preoperative clinical manifestation mainly focus on red and swollen of bunion, pain around with metatarsal bones, and diagnosed as hallux valgus with deformity of little toe varus through small incision. Operative time, postoperative complications, pre and post-operative IMA(angle between the first and the second metatarsal bones), HVA (hallux valgus angle), LDA(valgus angle of the fifth metatarsal bones), MPA(valgus angle of little toe), IM4-5 (angle between the forth and the fifth metatarsal bones) and PASA(fixed angle of proximal joint), postoperative AOFAS score were used to evaluate foot function.

RESULTSOne hundred and sixty-eight patients were followed up for 6 to 48 months with an average of (28.6±3.2) months. All wounds were healed well without infection, sinus tract and other complications. Operative time ranged from 16 to 28 min with an average of (18.3±2.1) min. IMA, HVA, LDA, MPA and IM A 4-5 were (10.1±2.1)°, (32.6±4.2)°, (6.9±2.3)°, (18.5±5.2)°, (15.1±2.9)°preoperatively, improved to (8.3±2.2)°, (10.9±2.9)°, (2.7±0.4)°, (6.5±1.6)°, (8.9±1.8)° postoperatively, and had significant differences before and after operation. While there was no difference in PASA before (9.1±2.1)°and after operation(8.7±1.9)°. AOFAS score were improved from (31.6±3.9) before operation to(83.7±5.2) after operation, but no significant difference(>0.05). According to AOFAS score, 147 patients obtained excellent results, 13 good, 6 moderate and 2 poor.

CONCLUSIONSMinimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision could obtain satisfied clinical effect, and has advantages of small incision, no stitches, beautiful appearance, shorter operation time, and rapid recovery. It is worth popularization in clinical practise.

Adult ; Aged ; Female ; Hallux Valgus ; surgery ; Humans ; Male ; Metatarsal Bones ; pathology ; Middle Aged ; Minimally Invasive Surgical Procedures ; Osteotomy ; methods ; Postoperative Period ; Radiography ; Toes ; pathology ; Treatment Outcome ; Young Adult