Biomedical subjects
J Pontious
Publications and source records attributed to J Pontious.
Contact coral dermatitis affecting the ankle.
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Ganglions of the foot and ankle. A retrospective analysis of 63 procedures.
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.
Lesser metatarsal V-osteotomy for chronic intractable plantar keratosis. Retrospective analysis of 40 procedures.
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.
Autogenous calcaneal bone graft repair of a closing base wedge osteotomy nonunion.
The authors present a case report showing successful autogenous calcaneal bone graft stabilization of a first metatarsal closing base wedge osteotomy nonunion. The authors discuss the complications and clinical sequelae associated with first metatarsal base wedge osteotomy nonunions. The patient's clinical presentation, surgical procedure, and postoperative course are discussed. Comparative preoperative and postoperative objective gait analyses are presented. This approach to first metatarsal nonunion salvage appears to be clinically successful with a 15-month follow-up period.
Role of the plantar fascia in digital stabilization. A case report.
The plantar aponeurosis is a ligamentous structure that extends from the calcaneus to the proximal phalanges. Under tension, it functions to support the longitudinal arch, supinate the rearfoot, and stabilize the digits against the ground. The anatomy and biomechanics of the plantar fascia and plantar aponeurosis, particularly their role in digital stabilization, are reviewed. A case is presented showing a patient who developed hammer toes as a postoperative complication after having a portion of the plantar aponeurosis removed.
Tailor's bunion. Is fixation necessary?
Tailor's bunion or bunionette are terms that describe a pathologic enlargement occurring laterally on the fifth metatarsophalangeal joint. Regardless of the etiology that precipitates the deformity, the resulting abnormal protrusion of soft tissue or bone can result in pain for the patient. Symptoms can range from mild discomfort to severe, debilitating pain. The patient may present with pain dorsolaterally, laterally, or plantarly. The symptoms are mechanically induced, and are often associated with hyperkeratotic lesions and adventitious bursae. Patients complain most often that they cannot find comfortable shoes. The authors compare the effectiveness of fixated versus nonfixated distal osteotomies of the fifth metatarsal for the correction of tailor's bunion. This study shows that fixation can help control postoperative dorsal displacement of the fifth metatarsal capital fragment (p < 0.0001) and produce less shortening of the metatarsal resulting in fewer complications.
Characteristics of adolescent hallux abducto valgus. A retrospective review.
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.
Digital dissecting hematoma. A differential diagnosis.
The dissecting hematoma, a little mentioned postoperative complication following digital surgery, occurs when there is damage to the blood vessels intraoperatively. Accurate and immediate diagnosis is essential for providing early and appropriate treatment.
Talonavicular coalition. Objective gait analysis.
Talonavicular coalitions, a rarely reported fusion between the talus and navicular, are often an incidental radiographic finding that may be asymptomatic or associated with peroneal spasm. The authors present a review of literature and case report based on clinical evaluation and instrumented gait analysis. Specifically, a patient presenting with a bilateral talonavicular coalition was objectively evaluated with kinetic, kinematic, muscle dynamometry, and pedobarographic testing to understand the biomechanical limitations related to this pathology. An excessive passive component of ankle torque, a high first metatarsophangeal joint plantar pressure, and a diminished time in the midstance portion of stance phase were measured and compared to those of healthy individuals.
Quantifying magnification in pedal radiographs.
Morphometric comparison between metatarsals on pedal radiographs and preserved bone specimens provides a method to quantify the amount of magnification imparted on a radiographic image. Conversion factors are presented for dorsoplantar and lateral projection images, which are of value in the preoperative assessment of patients. Factors that influence radiographic quality are discussed, with an emphasis on the geometry of projecting an accurate image.
Piezogenic pedal papules extending into the arch. Case report and discussion.
A unique presentation of a painful piezogenic papule in the medial longitudinal arch has been presented. This lesion puts pressure on nearby structures, causing pain. Walking without pain is achieved through orthopedic padding. It is essential that these papules be differentiated from similar-appearing lesions of a systemic etiology, so that appropriate treatment can be rendered.