Use of the Semmes-Weinstein 5.07/10 gram monofilament: the long and the short of it.

The Semmes-Weinstein monofilament has been developed for the detection of patients at risk of neuropathic ulceration. In this study we evaluated how the physical characteristics of the monofilaments can impact on their performance. Commercially purchased monofilaments from the Hansen's Disease Center (HDC) and a batch produced 'in-house' (RPAH) were calibrated using a Mettler Balance. To assess the effects of varying lengths on buckling force, the monofilaments were tested repeatedly while the length of the filament was reduced stepwise from 4.1 to 3.1 cm. The correct length of the monofilament to generate a buckling force of 10 g was also determined theoretically by applying the Euler's Buckling Equation. Results showed neither batch of monofilaments buckled at a strength of 10 g (HDC 6.8 g, CI 5.7-7.9, and RPAH 7.2 g, CI 7.1-7.3). In addition HDC showed a wide interfilament variation range, 4.1-10.3 g with CV 29% versus corresponding figures of range 7.1-7.9 g, CV 4.9% for the RPAH monofilaments. As predicted by Euler's Buckling Theory, buckling force can be increased by reducing the length of the filament. These results demonstrate that the physical characteristics of the monofilament are important determinants of buckling force and are not necessarily uniform in commercial filaments. The clinical relevance of variance in buckling force remains to be determined.

Mal perfurante plantar: estudo de 50 casos / Plantar perforating injury: study of 50 cases

Os autores apresentam um trabalho inédito sobre o mal perfurante plantar (MPP). Reuniram-se os dados colhidos da revisäo dos prontuários do serviço de dermatologia dos últimos cinco anos com uma amostra de 50 casos e deu-se a eles um tratamento estatístico. Os autores apresentam os resultados obtidos valorizando a revisäo literária das causas e destacando as principais encontradas na amostra: A neuropatia hansênica, a seguir a alcoólica e em terceiro lugar a diabética.

Neuroartropatía. Reporte de 10 casos / Neuroarthropathy. Report of 10 patients

Se presentan 10 pacientes con neuroartropatía que afecta sus articulaciones de carga, principalente rodilla, tobillo y pie, en quiens el diagnóstico de origen, que dió lugar a la artropatía fue sífilis tardía, diabetes mellitus, lepra y mielomeningocele. Se hace énfasis en la importancia del diagnóstico de neuroartropatía, ya que en un alto porentaje de los enfermos este cuedro pasa inadvertido puesto que se trata de un proceso no doloroso.

Acquired flatfoot in adults.

The main causes of the acquired flatfoot deformity in adults are reviewed. This condition can be extremely disabling; however, careful analysis combined with thoughtful conservative management or surgical treatment can usually enable the patient to maintain a functional level.