Treatment of Hematomas Using a Synthetic Hybrid-Scale Fiber Matrix.

Effective treatment of traumatic subcutaneous hematomas is important to avoid complications, including skin necrosis, infection, scarring, hyperpigmentation, tissue edema, and prolonged recovery. Hematoma treatment may include evacuation followed by application of a skin substitute. Given the challenges associated with conventional skin substitutes, a fully-synthetic, resorbable, electrospun matrix composed of hybrid-scale fibers may offer a new option for treating hematomas. The present study reports on two clinical case reports assessing the use of the synthetic hybrid-scale fiber matrix for the treatment of hematomas. The hematomas located on the pretibial leg and dorsal foot were debrided in the operating room with evacuation of the hematomas, and the synthetic matrix was applied to the wounds. Following treatment, the wounds were observed for healing progress, including measuring and photographing the wounds and documenting clinical observations. The synthetic hybrid-scale fiber matrix was re-applied as needed based on clinician discretion. In both cases, treatment following the use of the synthetic hybrid-scale fiber matrix resulted in complete healing. Complete closure of all wounds was observed after two to three applications of the synthetic matrix within six to 16 weeks, and no adverse events were noted. In this study, hematomas of the foot and the leg demonstrated successful healing following treatment with the synthetic hybrid-scale fiber matrix. The successful clinical outcomes suggest that this biomaterial may offer benefits as part of a new treatment paradigm for hematomas and warrants further investigation.

Calcaneal Bone Tumors.

Bone tumors of the foot are an uncommon finding. Most tumors are found incidentally on imaging and are benign. Care must be taken although due to the aggressive nature of malignant bone tumors that can occur in the calcaneus. Malignant lesions will more commonly present with symptoms of pain and swelling. Often misdiagnosed as soft tissue injuries, it is critical to be able to diagnose and treat these lesions early. Imaging plays an important role with plain films and advanced imaging. Surgical treatments can range from curettage with grafting to amputation for more aggressive lesions.

Treatment of Hallux Varus After Traumatic Adductor Hallucis Tendon Rupture.

Hallux varus is a deformity of acquired and less commonly congenital etiologies. It can present secondary to the release of the soft tissues surrounding the first metatarsophalangeal joint surfaces during bunion surgery. If the condition is left untreated, it can be debilitating, with progressive pain and destruction of joint surfaces. Many procedures have been described for the treatment of iatrogenic causes of hallux varus; however, little has been reported regarding the success of procedures when used for less typical traumatic causes. In the present report, a case is presented of surgical repair of a traumatic hallux varus using a suture and button fixation device and 3-year patient follow-up data.

Surgical correction of checkrein deformity after malunited distal tibia fracture: a case report.

Checkrein deformities are rare and involve entrapment or tethering of the flexor hallucis longus and, occasionally, flexor digitorum longus tendons. The deformity has typically been secondary to traumatic fractures of the talus, calcaneus, or deep posterior compartment syndrome resulting from fractures of the tibia and fibula and most fractures of the ankle. These result in flexion contractures at the interphalangeal joint of the hallux. Because of the rarity of this deformity, no single surgical technique has been defined as the standard. Previous interventions have included release of adhesions with or without Z-plasty lengthening of the involved tendons. The present study reports a case of checkrein deformity secondary to a malunited distal tibia fracture, with flexion deformities to digits 1 through 3. The patient underwent successful surgical correction with flexor tenotomies to the affected digits with interphalangeal arthrodesis to the hallux.