Stress fracture of the os peroneum.
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Keratotic lesions on the plantar aspect of the foot develop beneath an osseous prominence and can result in substantial disability. This occurs because, during normal gait, the metatarsal head area is subjected to more prolonged stress than any other area on the plantar aspect of the foot. In the treatment of this disorder, it is imperative to establish the etiology, among many possibilities, and then address the specific pathology accordingly.
Drs. Mitchell et al. have provided a valuable radiologic perspective of trauma to the ankle and foot. Previous articles in this series consisted of analyzing ankle fractures, ligamentous injuries, trauma to the talus, calcaneus, and midfoot. Plain x-ray films and sophisticated studies will assist in recognizing conditions described in this series of papers. The following represents the final part of this discussion.
Modifications of the Wilson bunionectomy and osteotomy procedure enable the surgeon to address multiple, individual abnormalities associated with the hallux abductor valgus deformity.
The foot and ankle is one of the most imaged parts of the body. Although most plain radiographs reveal no bony injury, subtle fractures can be overlooked. Because it is important to detect these fractures at the time of injury, a review of the most commonly missed foot and ankle fractures is presented.
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The source of a previously described radiolucent crescent in the flexor cortex of the distal sesamoid (navicular) bone on the palmaro45 degrees proximal-palmarodistal oblique (Pa45 degrees Pr-PaDio) clinical radiographic projection was investigated in 48 forelimb navicular bones from 24 Thoroughbreds by use of high-detail radiography and x-ray computed tomography (CT). Twenty-five of these bones also were evaluated, using microradiography and histologic examinations. Of these 25 bones, 5 had been labeled in vivo with fluorochrome markers. Tetrachrome-stained 100-microns-thick nondecalcified sections of these 5 bones were examined, using epifluorescence microscopy. A reinforcement line of compacted cancellous bone, parallel and several millimeters deep to the flexor cortex in the region of the flexor central eminence, was visualized by CT in 42 of 48 navicular bones and by microradiography in 23 of 25 navicular bones investigated. Variable degrees of compaction were observed in the cancellous bone between the flexor cortex and the reinforcement line. High-detail skyline radiographic projections and reconstructed CT images indicated a crescent-shaped lucency within the flexor central eminence of the flexor cortex in the bones in which the reinforcement line was identified, but the cancellous bone between the reinforcement line and the flexor cortex had not been compacted. The radiolucent crescent seen in the flexor central eminence of the navicular bone on the Pa45 degrees Pr-PaDiO projection was not caused by the concave defect or synovial fossa of the flexor central eminence overlying the flexor cortex, as was described.(ABSTRACT TRUNCATED AT 250 WORDS)
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