RESUMEN
A neurilemoma is an uncommon, benign, encapsulated neoplasm whose origin is derived from the Schwann cells. Its incidence in the foot is uncommon. A review of the literature, etiology, incidence, clinical presentation, histology, differential diagnosis, and treatment are discussed. The authors present a case of a neurilemoma of the medial plantar nerve of the foot.
Asunto(s)
Enfermedades del Pie , Pie/inervación , Neurilemoma , Neoplasias del Sistema Nervioso Periférico , Neoplasias de los Tejidos Blandos , Anciano , Femenino , Pie/patología , Enfermedades del Pie/diagnóstico , Enfermedades del Pie/patología , Enfermedades del Pie/cirugía , Humanos , Imagen por Resonancia Magnética , Neurilemoma/diagnóstico , Neurilemoma/patología , Neurilemoma/cirugía , Nervios Periféricos/patología , Nervios Periféricos/cirugía , Neoplasias del Sistema Nervioso Periférico/diagnóstico , Neoplasias del Sistema Nervioso Periférico/patología , Neoplasias del Sistema Nervioso Periférico/cirugía , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/cirugíaRESUMEN
The F-Scan system was used to measure peak plantar pressures in 11 diabetics each with a unilateral great toe amputation and an intact contralateral extremity (nonamputated), to evaluate the effectiveness of five footwear-insole strategies: 1) extra-depth shoes without an insole, 2) extra-depth shoes with a Plastizote insole, 3) extra-depth shoes with a Plastizote insole and a metatarsal pad, 4) extra-depth shoes with a Plastizote insole and a medial longitudinal arch pad, and 5) extra-depth shoes with a Plastizote insole and a combination of metatarsal pad and arch pad. When we compared extra-depth shoes with and without insoles, peak pressures were significantly reduced with insoles under the first metatarsal, the lesser metatarsals, and the heel (p < 0.001) in feet with and without an amputation, as well as under the great toe on the contralateral foot (nonamputated, p < 0.001), but not under the lesser toes (giant toe, p = 0.088; nonamputated, p = 0.763). There was no significant difference between the different insole modifications.
Asunto(s)
Amputación Quirúrgica , Diabetes Mellitus/fisiopatología , Pie Diabético/prevención & control , Pie/fisiopatología , Aparatos Ortopédicos/normas , Adulto , Anciano , Complicaciones de la Diabetes , Neuropatías Diabéticas/fisiopatología , Estudios de Evaluación como Asunto , Femenino , Hallux/cirugía , Humanos , Masculino , Persona de Mediana Edad , Presión , ZapatosRESUMEN
The purpose of this study is to report the prevalence of reamputation following resection of the great toe and first ray in adults with diabetes. We abstracted the medical records of 90 diabetic great-toe and first-ray amputees admitted between 1981 and 1991. The most common etiologies of initial amputations were ulcer with soft tissue infection (39%), ulcer with osteomyelitis (32%), and puncture wounds (12%). Sixty percent of all patients had a second amputation, 21% had a third, and 7% had a fourth. Fifteen percent of the patients who had a second amputation had it contralaterally. Seventeen percent subsequently underwent a below-knee amputation and 11% had a Transmetatarsal amputation on the same extremity, 3% had a below-knee amputation, and 2% a transmetatarsal amputation contralaterally. The mean time from the first to the second amputation was approximately 10 months. The results of this study suggest that a large proportion of patients undergoing an amputation at the level of the great toe or first ray have subsequent amputations in the first year following the initial procedure. Additionally, it appears that the contralateral foot may be at significant risk for distal amputation following resection of the hallux or first day.
Asunto(s)
Amputación Quirúrgica , Pie Diabético/cirugía , Hallux/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , ReoperaciónRESUMEN
Lisfranc's fracture-dislocations are relatively infrequent injuries that may result in major debilitation. A review of the literature is presented with focus on the proper evaluation, diagnosis, and management of these injuries. Three cases are presented that illustrate the more common mechanisms of injury.
Asunto(s)
Fracturas Óseas , Luxaciones Articulares , Huesos Metatarsianos/lesiones , Articulaciones Tarsianas/lesiones , Fracturas Óseas/diagnóstico , Fracturas Óseas/fisiopatología , Fracturas Óseas/cirugía , Humanos , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/fisiopatología , Luxaciones Articulares/cirugíaRESUMEN
The authors review rheumatoid arthritis with focus on two pedal manifestations, rheumatoid nodules and digital deformities. The prevalence, presentation, and diagnostic features concerning these entities are discussed, and three case studies are presented.
Asunto(s)
Artritis Reumatoide/complicaciones , Deformidades Adquiridas de la Articulación/etiología , Articulación Metatarsofalángica , Nódulo Reumatoide/etiología , Anciano , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/terapia , Terapia Combinada , Femenino , Humanos , Deformidades Adquiridas de la Articulación/diagnóstico , Deformidades Adquiridas de la Articulación/terapia , Masculino , Persona de Mediana Edad , Nódulo Reumatoide/diagnóstico , Nódulo Reumatoide/terapiaRESUMEN
The authors' previous work on a 50% ethanol extract of Aloe vera was done to evaluate anti-inflammatory activity using the croton oil-induced ear swelling assay. The anti-inflammatory activity was found in the supernatant fraction. The supernatant fraction decreased inflammation, when applied topically, by 29.2%, and the precipitate decreased inflammation by 12.1%. However, in the present work, the precipitate fraction decreased the wound diameter by an average of 47.1% (stimulatory system). Little or no wound healing activity was found in the supernatant. Aloe vera appears to act as a modulatory system toward wounds and inflammation and is a potentially valuable tool for managing lower extremity conditions.
Asunto(s)
Aloe , Antiinflamatorios , Extractos Vegetales/farmacología , Plantas Medicinales , Adulto , Animales , Etanol/farmacología , Humanos , Ratones , Polisacáridos/farmacología , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/fisiologíaRESUMEN
An Aloe vera extract was prepared with 50% ethanol. The resultant supernatant and precipitate were tested for anti-inflammatory activity using the croton oil-induced ear-swelling assay. The supernatant fraction decreased inflammation, when applied topically, by 29.2%, and the precipitate decreased inflammation by 12.1%. The authors have shown that the anti-inflammatory activity (inhibitory system) resides in the supernatant of a 50% ethanol extract.
Asunto(s)
Aloe/fisiología , Edema/terapia , Inflamación/terapia , Extractos Vegetales/fisiología , Plantas Medicinales , Aloe/análisis , Animales , Masculino , Ratones , Extractos Vegetales/análisisRESUMEN
Aloe vera, as a biological vehicle for hydrocortisone 21-acetate, was tested topically and systemically against acute inflammation. Systemically, the combination of A. vera and hydrocortisone produced a maximum 88.1% inhibition of edema. Polymorphonuclear leukocyte infiltration was reduced 91.1%. The topical inhibition of edema peaked at 97%. The possibility that A. vera has significant potential as a biologically active vehicle for steroids is discussed.