Archive for March 2007
Volume 2, No.3
March 2007 (Volume 2, No. 3 )
1. Calcaneal Saucerization using Midus Rex® Pneumatic Instrumentation for the Treatment of Chronic Plantar Heel Ulcers: A case report Al Kline DPM [HTML] [PDF]
Abstract: Plantar heel ulcers are common in the diabetic patient. Very often, the ulcers can become chronic and resistant to closure through conservative means. A case is presented describing the presentation, clinical work up and surgical management to promote closure of the plantar heel ulcer. The Midas Rex pneumatic burr is used to perform a plantar calcaneal saucerization and promote rapid closure of a chronic ulcer.
2. Staphylococcus Simulans Osteomyelitis of the Foot: A case report Al Kline DPM [HTML] [PDF]
Abstract: Staphylococcus simulans, a coagulase-negative pathogen, is not commonly seen in the foot. The pathogen has been isolated in chronic osteomyelitis and infected internal fixation. This case describes a 65 year old, diabetic male with recalcitrant osteomyelitis following partial metatarsal head resection. Staphylococcus simulans was the primary pathogen isolated. This may be the first reported case of Staphylococcus simulans osteomyelitis of the foot.
3. Vancomycin Induced Thrombocytopenia: A case report Al Kline DPM
Abstract: Vancomycin has been implicated as a cause of thrombocytopenia since 1990. In a recent report of The New England Journal of Medicine, the BloodCenter of Wisconsin has identified Vancomycin-Dependent, Platelet-Derived antibodies to detect Vancomycin induced thrombocytopenia. In this case report, a 65-year old male was treated with Vancomycin for osteomyelitis. On the 10th day of treatment, he had a fever and developed a rash. Angiopathic petechiae were most pronounced on his back and arms. His platelet count dropped from 189 x 103/mm3 to 1 x 103/mm3 in 48 hours. This case report supports the use of drug-dependent antibody assays to identify and confirm the cause of thrombocytopenia in patients who show a precipitous drop in platelet levels while receiving vancomycin.
4. Aberrant Tendo-Achilles Tendon in Club Foot: A case report J. Terrence Jose Jerome, MBBS, DNB (Ortho), MNAMS (Ortho), Mathew Varghese, M.S., Balu Sankaran, FRCS,FAMS , Rajendra Kumar Gupta (Ortho), Simon Thomas MBBS,DNB (Ortho), MNAMS (Ortho), Amit Mittal (Ortho)
Abstract: A case report discusses the presentation and treatment of a baby boy with club foot deformity. The baby was initially treated by Ponseti’s method of weekly POP casting. The club foot did not reduce after 6 weeks of serial casting. The boy then underwent percutaneous Achilles tendon lengthening and placed in a Steinbek Splint. After 12 weeks, the equinus persisted and we decided to perform an open Achilles lengthening. An aberrant tendoachilles tendon was discovered during open tenotomy and this was released. Once the aberrant tendon was released, the club foot reduced and at 9 months, the baby could walk with good heel strike and the foot was supple with no residual deformity.
5. Gaenslen’s Heel Incision for Calcaneal Osteomyelitis: A case report J. Terrence Jose Jerome, MBBS, DNB (Ortho), MNAMS (Ortho), Mathew Varghese, M.S., Balu Sankaran, FRCS,FAMS , Simon Thomas MBBS,DNB (Ortho), MNAMS (Ortho)
Abstract: Patients who have a recurrent ulcer of the heel often have a below-the-knee amputation because durable soft tissue coverage cannot be obtained over the calcaneus. Often, even if the ulcer heals satisfactorily or the area appears to be revascularized as a result of a peripheral vascular procedure, the resulting surface is not durable and the ulcer recurs. We report a 40 year old lady who had a chronic osteomyelitis right calcaneum with a large non-healing ulcer and discharging sinus, treated by split heel incision of Gaenslen.
