Current

Abstract: A case report describing the removal of a painful fibular sesamoid is described. This case represents a comminuted fibular sesamoid fracture with radiographic evidence of avascular necrosis. After failed attempts at conservative treatments, the surgical approach, postoperative treatment and prognosis is discussed. Unlike the tibial sesamoid, excision of the fibular sesamoid appears to have a better long-term prognosis.

Abstract: Coccidioides immitis is a fungus endemic to the Southwestern United States, Mexico, and parts of Central and South America. While some populations are more at risk for the infection, most persons infected with the fungus remain asymptomatic. However, up to one percent of these individuals will go on to develop the disseminated form of the disease. Manifestations of this secondary type of infection may involve both soft tissue and bone. We present a case report of a patient presenting with a painful ankle who was found to have diffuse coccidioidal osteomyelitis. After a confirmatory biopsy and culture, long term fluconazole therapy was initiated as the recommended treatment. Although the disseminated form of the disease is relatively uncommon, it is important to include the infection as a differential diagnosis in patients living in endemic areas who present with suspicious bone lesions.

Abstract: An important technical modification in the conventional medial based cross leg flaps is described by the authors. The technique involves resurfacing large triangular defects in the medial lower leg, ankle and foot. This modification, by virtue of narrowing the pedicle, will help the surgeon to maximize the inset avoiding delaying of the flap or flap loss. Secondary defects created by raising the triangular flaps are amenable to considerable narrowing and leaving behind smaller defects that can easily be covered with a split thickness skin graft. Another advantage of the triangular flap is the primary inset portion of the flap provides more than 75-80 % coverage to the injury site. This not only promotes early division of the flap without delay, but also enables the surgeon to maximize the secondary inset during the division of the flap and to cover the recipient area completely with the flap obviating the need for the split skin graft at the crucial triangular area of the original defect.

Abstract: AIDS-Related Kaposi’s sarcoma is an uncommon occurrence of the foot. Two cases of solitary pedal KS are presented of patients who had not been previously diagnosed as HIV positive prior to biopsy. Once histopathology reports returned the diagnosis of Kaposi’s sarcoma, both patients received HIV tests and were found to be positive.

Abstract: The purpose of this article is to report on a technical tip when performing bone block arthrodesis following failed first metatarsophalangeal arthroplasty. Conical reaming of structural allografts permits proper toe positioning, is reproducible, and has a high rate of fusion.