Cutaneous Pedal Manifestations in Patient With Hepatitis C Virus-Associated Cryoglobulinemia: Case Report and Review of Literature.

Cryoglobulinemia is an uncommon blood dyscrasia that can manifest itself in the lower extremity. Due to the insidious nature of this disease, dermatological symptoms and ulcerations can easily be mistaken for more common entities. The authors present an overview of cryoglobulinemia and a case report of a patient with lower extremity manifestations of this disorder. This can provide specific guidance on the steps necessary to accurately establish the diagnosis of cryoglobulinemia or rule it out and pursue other etiologies causing lower extremity ulceration.

Synovial chondromatosis of the ankle joint: 2 cases treated by open arthrotomy and synovectomy.

Synovial chondromatosis is a rare condition consisting of metaplasia of the synovial tissue that usually presents in large joints such as the knee and hip. The reported occurrence of synovial chondromatosis in the foot and ankle joints is rare in the literature. In this case report, the successful surgical management of two patients presenting with this condition using open ankle arthrotomy & synovectomy is described. These two cases are presented to provide added depth to the current literature, as well as presenting a review of published literature to further guide clinicians in the management of this rare condition. LEVEL OF EVIDENCE: 4 (case study).

Circumflex Accessory Branch of the Superficial Fibular Nerve: An Unusual Cause of Nerve Entrapment.

The superficial fibular (peroneal) nerve traditionally courses through the anterolateral deep leg and pierces the deep crural fascia at the lower leg to divide into its terminal branches. Entrapment of the superficial fibular nerve is most commonly documented to occur at where it pierces the deep fascia, and numerous etiologies causing entrapment are described. In this case report, we describe an unusual cause of entrapment from a tertiary branch of the superficial fibular nerve taking a circumflex course and wrapping around the secondary branch of the main nerve. This was successfully treated by surgical excision. To the best of our knowledge, this cause of entrapment has not been described in the literature at the time of this publication.

Surgical repair of abductor hallucis muscle herniation: a case report.

Herniation of the abductor hallucis muscle has rarely been reported in the literature. This condition causes localized pain, especially while weight bearing, as a result of a complex cascade of biomechanical events directly related to loss of integrity of the medial wall of the foot. The authors present a case of a flexor retinaculum tear with subsequent herniation of the abductor hallucis muscle. When conservative treatment options failed to provide significant relief, surgical intervention was performed, which revealed ischemic muscle tissue and a partial flexor retinaculum tear. The nonviable muscle was surgically debrided and the fascial defect was repaired with a polypropylene nonabsorbable synthetic surgical mesh. This herniorrhaphy reestablished medial compartment support, thus allowing the patient to return to pain-free ambulation.

Percutaneous fixation of forefoot, midfoot, hindfoot, and ankle fracture dislocations.

Open reduction with rigid internal fixation is the basic principle for surgical management in foot and ankle trauma. High-risk patients present a surgical dilemma for the foot and ankle surgeon because the possible complications are magnified in this patient population. Percutaneous fixation is a unique alternative for achieving anatomic stabilization without increased physical strain to the patient. The significant advantages of percutaneous fixation include minimizing damage to the vascular supply, maintaining and preserving a stable soft tissue envelope, and decreasing the potential risk for infection. This article provides an overview of percutaneous surgical fixation methods and their role in foot and ankle trauma for the high-risk patient.

Aggressive management of necrotizing fasciitis through a multidisciplinary approach using minimal surgical procedures: a case report.

Necrotizing fasciitis is an aggressive, destructive infection of the soft tissue and fascia and is a life-threatening surgical emergency. A case study is presented of necrotizing fasciitis in the right lower extremity of a 53-year-old male resident of a long-term skilled nursing facility. Limb salvage was achieved through a multidisciplinary approach with early surgical management and aggressive postoperative management. Through 3 surgical procedures, the combined efforts of podiatric surgery, orthopaedic surgery, general/trauma surgery, and infectious disease provided early wound closure and limb salvage. An aggressive multidisciplinary approach to the management of necrotizing fasciitis in the lower extremity is necessary for limb salvage. Use of this multidisciplinary approach will minimize the number of surgical procedures and decrease the potential morbidity and mortality seen in patients with this infection.