Biomedical subjects
Publications and source records attributed to R J Sollitto.
The Keller arthroplasty has long been the hallmark of first metatarsophalangeal joint corrections. However, in the presence of adverse postoperative effects, numerous modifications have been introduced. They include preoperative evaluation, soft-tissue and osseous techniques in the procedure itself, and postoperative care of the patient. These modifications have created a new and improved Keller arthroplasty.
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In this report, the authors will supplement research performed in 1989 by Sollitto, Napoli, and Gazivoda on the use of intralesional bleomycin for the treatment of verrucae. With various alterations of technique, their original success rate of 32.2% was improved to 65.4%. Thus, bleomycin is a very effective first line treatment for multiple verrucae, particularly of the mosaic variety. An association is also made between patients with pedal hyperhidrosis and the occurrence of multiple verrucae, notably lesions that prove recalcitrant to initial therapy.
In this paper the authors discuss plantar fascial heel pain, including its etiology and treatment. The results of a retrospective study using radiofrequency lesioning on plantar fascial heel pain are presented and discussed. Thirty-nine patients were treated with radiofrequency lesioning, and 92% of the patients experienced complete resolution of symptoms following the procedure.
The authors present a retrospective study of the opening base wedge osteotomy with first metatarsophalangeal joint implant arthroplasty, for the correction of long-standing hallux abducto valgus deformity. Twenty cases involving 23 feet were performed, and the results are discussed. The indications and procedure are described, as well as an in-depth discussion.
Foot lesions in diabetic patients with sensory deficiencies are ignored or not noted by the patients, therefore, leading to major infections of the soft tissue and/or bone. This can be quite devastating with subsequent loss of limb and life-threatening if the extent of the problem is not recognized and prompt treatment initiated. If an amputation is necessary, it should be performed at the lowest level possible. Part I of this series of articles, concerning diabetic foot amputations, will review the pathogenesis, indications, objective vascular criteria, basic surgical principles and complications of diabetic foot amputations. Case reports with various digital amputation procedures and their postoperative care will also be presented in detail. A team approach should be used in the treatment of diabetic foot disorders. The podiatrist, along with admitting internist, leads a team of other specialists including: radiologist, vascular surgeon, infectious disease physicians and plastic surgeon, depending on the progression of foot pathology.
Part II of this series of articles on diabetic foot amputation represents case studies, along with appropriate metatarsal amputation procedures. Misdiagnosis or delayed treatment of these patients can lead to loss of limb and, in some cases, can be life threatening. Diabetic feet have varying degrees of neurovascular compromise, but this should not result in traditional below-the-knee or above-the-knee amputations.
Recently, the approach in management of diabetic foot disorders has undergone critical re-evaluation. Major foot infections, such as plantar space infections and osteomyelitis do not automatically result in Syme's or below-the-knee amputations. When indicated, midfoot amputations should be attempted because of the functional and psychologic advantages compared with more proximal amputation levels of the lower extremity. In Part III of this series of articles concerning diabetic foot amputations, the authors present case studies along with midfoot amputations and muscle-balancing procedures.
The authors present a perspective study using bleomycin sulfate in the treatment of plantar verrucae. Also, they review the literature concerning this modality. Although the effective cure rate obtained in this study was less than that reported previously, the authors found bleomycin to be particularly effective in the treatment of mosaic verrucae.
The authors discuss whether bathing a surgical incision with sutures intact alters the postoperative infection rate. They present a prospective study of 60 patients involving 137 surgical wounds. Results of the study discount the theory that bathing an incision with sutures present leads to an infection.
This report discusses the role of digital subtraction angiography as well as noninvasive vascular testing in the evaluation of the ischemic foot. A case history is described presenting the diagnostic modalities and surgical management of an insulin-dependent diabetic man with gangrene.
The authors present a modification of the Hibbs tenosuspension for the correction of clawtoes associated with flexible cavus deformity. A release of the plantar fascia is performed along with the procedure. The major advantages offered by this procedure are the ease in which it can be performed, the vector of the extensor digitorum longus tendon at the ankle is not disrupted, and the only osseous work necessary is digital arthroplasty.
Contact shoe dermatitis is a common dermatologic problem. Misdiagnosis of this condition can lead to significant disability. An organized and detailed evaluation of the patient with foot lesions leads to proper diagnosis and treatment. Review of the literature and a case study of contact shoe dermatitis, along with a discussion of its complications and resolution, are presented in this report.
The authors present a retrospective study of 47 digits, with an average follow-up of 15 months, using the Silastic Hammertoe Implant H.P. The complications inherent with all implants are reviewed and the specific problems noted with this implant, including dislocation, bony regrowth, and lack of a superior cosmetic result, are discussed.
Silicone shard formation appears to be an unavoidable result of implant arthroplasty. In light of this phenomenon, the authors present a review of the literature and an examination of the causes of microfragmentation of pedal implants.