Biomedical subjects
Publications and source records attributed to B L Scurran.
Stress fractures in athletes are frequently a misdiagnosed and poorly understood clinical entity. As a rule, their occurrence in the tibia is limited to the junction of the middle and distal third. We describe a distal spiral tibial stress fracture in a jogger and review the pathomechanics, diagnosis, and management of such lesions.
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Intra-articular fractures of the calcaneus can result in prolonged or permanent disability. The systematic approach to analysis based on anatomy, mechanism of injury, and x-ray films allows determination of the various elements of the lesion. Management is difficult because treatment is not standardized, and, even when good reduction has been achieved, long-term complications are commonplace. The authors review different types of intra-articular calcaneal fractures, various methods of treatment, and examples of possible complications.
The authors describe a relatively new power staple device for foot surgery. Their preliminary review has been very favorable, as studied in 40 cases of hallux valgus repair. Their discussion includes the indications, contraindications, and potential for future use in the foot.
Tuberculosis of the bones and joints is a rare but treatable disease. This curable condition is frequently overlooked in the differential diagnosis, and often serious cases are not diagnosed until after severe joint destruction has already taken place. The literature on tuberculosis of the bones and joints is reviewed and the incidence, etiology, pathogenesis, diagnosis, and treatment of this condition are discussed. A case history of ankle joint involvement is presented in which antibiotic treatment before clinically significant joint destruction had occurred might have prevented surgery. Tuberculous involvement should thus be considered in any patient with chronic and subacute monoarticular arthritis.
Enchondroma is a commonly encountered bone tumor in the foot, frequently necessitating excision. The calcaneus is a convenient source of bone for a bone graft, should that be required. The patient's own calcaneus offers the advantages of both cortical and cancellous bone, accessibility, dependable bone healing, and the superior osteogenic potential of autologous bone.
Review of the world biomedical literature noted only scant attention to the rare variant of squamous cell carcinoma which can develop in traumatic lesions. Squamous cell carcinoma developed 10 months after a patient was treated for multiple injuries including bilateral ankle and foot trauma. After surgery, attention to the clinical signs of neoplastic transformation is important, even when treating lesions of less than 1 year's duration. When clinical signs and symptoms indicate possible squamous cell carcinoma, a biopsy must be done. Once the diagnosis is confirmed, definitive surgery is mandatory because recurrence and metastatic disease have a low 5-year survival rate.