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1) Two cases of medial peritalar dislocation with accompanying foot injuries considerably altering prognosis are presented. 2) Although most cases of this uncommon injury respond well to treatment, a careful investigation for accompanying injuries should be performed. 3) The mechanism of injury is discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
AIMS: This study was undertaken to identify significant physical, social and psychological problems resulting from injuries caused to the feet by air cushion mowers. METHODS: Thirty-four patients seen with air cushion mower injuries were reviewed, either by personal assessment, or by questionnaire. RESULTS: A large number of patients had significant symptoms relating to their soft tissue or bone injuries, the majority experiencing some pain, and those who had amputations difficulty in some aspects of walking. CONCLUSIONS: Better education of the dangers of the misuse of these mowers may reduce the incidence of significant forefoot injuries.
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In 1988, a total of 990 work-related injuries to the foot of employees from private-sector companies were characterized in an occupational injury/illness surveillance system maintained by a network of occupational health centers. The mean age of the worker with a foot injury was 34.2 years (+/- 12.0), with 83% occurring among men; 22.3% of the cases were fractures or sprains/strains. Jobs involving extensive manual material handling or vehicular operations were the most often listed occupations among those with work-related foot injuries. Across occupational groups, being struck by an object accounted for 58.4% of the foot injuries. Regardless of industry group, metal items and vehicles were related to 50.7% of all work-related foot injuries. Specifically, foot injuries were found to be associated with being struck by boxes, metals, or vehicles, or to being caught in, under, or between vehicles or machinery. A peak of work-related injuries involving the foot is observed during the summer months.
Tendon injuries are often caused by direct trauma or overuse. Pathology may consist of inflammatory lesions external to the tendon sheath or inflammation of either the peritenon, sheath, or tendon. This article reviews the diagnosis and treatment of injuries to the peroneal, peroneus brevis, peroneus longus, anterior tibial, flexor hallucis longus, and posterior tibial tendons.
Tendon sheath injuries of the foot and ankle are a common clinical entity secondary to trauma and abnormal biomechanics. These injuries are often misdiagnosed and/or inappropriately treated. This article presents an historic review, etiology, classification, diagnosis, and treatment protocol for these injuries.
In the article is analyzed the experience of treatment of 211 patients with traumata, which are the results of thermal and irradiation foot injuries. 30 patients were subjected to microsurgical reconstruction with application of complex of tissular transplants. There were differentiated 3 types of foot tissue injuries, determining transplants and operative technique selection. It has been determined that the closure of ulcerous defects in case of post-thrombotic disease is possible with utilization of radial graft of forearm on long venous pedicle. Prevention of venous anastomosis thrombosis is contributed to by formation of peripheral arteriovenous anastomosis in the transplant. Impartment of the points of fixation of the muscular part with the locomotive nerve suture contributes to the increase of adequate reliability of musculocutaneous graft. Utilization of osseous transplant of iliac crest allows to perform an orthopaedic correction of the lost anterior part of foot and prevents limb amputation.
The authors present several cases of gunshot injury to the foot. Classification of wounds according to weapon type and caliber is discussed, as well as treatment rationale. Emphasis is placed on the need for detailed wound history and classification as precursors to adequate therapy. The low-velocity, high-energy wound type is introduced, and its variation from the current low- and high-velocity classifications discussed.
In a randomized prospective study among 390 recruits, the hypothesis that improved shoe shock attenuation could lessen the incidence of overuse injuries was tested. During the 14 weeks of training, 90% of the recruits sustained overuse injuries. Recruits training in a modified basketball shoe had a statistically significant lower incidence of metatarsal stress fractures and foot overuse injuries, compared with standard infantry boots, but their overall incidence of overuse injuries was not reduced. The effect of improved shoe shock attenuation was limited to those overuse injuries resulting from vertical impact loads.
Stingrays, found predominantly in warm coastal waters, are responsible for at least 1,500 human injuries in this country each year. These occur most often in the lower extremity. The authors discuss the symptoms and treatment of stingray injuries and present two case reports.
A series of 27 successful Superficial Inferior Epigastric Artery free flaps were analysed for a number of clinical and surgical variables. The anatomy and surgical technique of the flap are detailed and its advantages and disadvantages relative to other free flaps used for soft tissue contour are considered. Analysis of the variety of recipient sites of this flap is presented, as are details of the vascular pedicle and our experience with its constancy. It has been found to be a safe flap in experienced hands, with an aesthetic donor site scar, no functional loss and it lends itself to subsequent recontouring with suction assisted lipectomy or open techniques.
Emergency treatment of foot injuries can be made less painful by regional block anesthesia. There is limited medical literature on these techniques and many physicians, while familiar with regional anesthesia of the upper extremity, are not experienced with nerve blocks in the lower extremity. Infiltration anesthesia of the plantar structures of the foot and toes can be very painful and may inhibit healing. Regional anesthesia avoids both of these problems and can prove effective and useful. This paper discusses the techniques and possible complications of nerve block anesthesia of the foot.
A revolution in wound management has occurred over the past 3 decades. A plethora of wound care dressings appear to enhance the wound repair process in acute and chronic wounds. However, extensive research is needed to discriminate between the beneficial effects of increased attention to all aspects of patient care, including wound management, and the salutary effects of dressing materials.
An open cross-sectional study of elderly (age greater than 65 yr) patients with insulin-requiring diabetes mellitus (n = 57) was undertaken to audit safety of self-management. Levels of knowledge and management skills of hypoglycaemia, hyperglycaemia, and foot care were determined. The prevalence of hypoglycaemia, visual impairment, and at-risk feet and the ability to perform practical procedures (insulin injection and self-monitoring) were assessed. Drawing up insulin and self-injection was correct in 84% and 76% of patients, but 53% of self-monitored urine or blood tests were performed incorrectly. Twenty-six per cent experienced hypoglycaemia at least monthly and 25% had been seen at the hospital with hypoglycaemia in the last year. Eighteen per cent did not know what action to take with hypoglycaemia. Forty-six per cent did not know any hyperglycaemic symptoms or signs. Prompted with symptoms, 35% still did not know what to do and 21% would take inappropriate action when self-monitored tests read high. Fifty-one per cent had impaired vision, 61% peripheral neuropathy and 24% peripheral vascular disease, with the result that 78% had at-risk feet. Fifteen percent inspected or washed their feet infrequently, 40% walked barefoot occasionally, and 47% would take potentially dangerous action in the event of foot injury. This study demonstrates serious deficiencies in the basic education and management skills in our elderly insulin-requiring diabetic population that could result in morbidity and mortality. Greater effort and vigilance by health care professionals must be directed towards this group.