Revista Espanola de Podologia最新文献

Lichen planus is a relatively common papulosquamous eruption in middle age and characterized by small, purple, polygonal, pruritic papules very flat surface. The etiology of lichen planus is unknown hence the interest in describing the clinical, histopathological, and laboratory results. We present a rare case of a caucasian man with generalized lichen longstanding plane whose diagnosis was consistent with lichenoid adverse drug reaction. Involvement in hands and feet is another unusual sign that can lead to confusion with the presence of secondary syphilis. The slow but inexorably atypical clinical presentation similar to other large clinical entities aspect necessitated a thorough physical examination and complementary. Surgical biopsy and histologic confirmation that stood in the papillary dermis lymphocytic inflammatory infiltrate in band contacted the basal layer of the epidermis that had determined the diagnosis apoptotic keratinocytes. Lichen planus may present diagnostic difficulty, biopsy of the lesion in atypical presentations allows diagnosis, has a favorable prognosis, and healing.

Historically first metatarsophlangeal joint fusion has been used to treat patients with joint arthritis or as a salvage procedure for iatrogenic deformities. For the past 20 years the author has used this procedure in older patients with hallux valgus deformity, and it has proven to be a safe and reliable technique. The paper describes the rationale for use of joint fusion as a primary option for hallux valgus repair in this patient population as opposed to other procedures. The surgical technique, fixation, and aftercare are also described.

Introduction

Pincer nail is a disorder that have a difficult aesthetic and podiatric solution. The necessity of finding a definitive solution has fueled the appearance of new surgical approaches for this condition. The author presents the results of a new surgical technique named teguloplasty.

Patients and method

Surgical reconstruction of the nail was carried out in patients with a painful pincer nail condition. Inclusion criteria included patients with pincer nail deformity of at least 5 years of evolution in which conservative treatment had fail and pain was still present. Surgeries were performed under local anesthesia and consisted in exeresis of the nail plate followed by dissection of the nail bed to obtain a flap that includes nail bed and matrix. Afterwards, a flattening of the dorsal part of the distal phalange was performed including the condyles and the flap was finally sutured in with a frontal lifting. Pain was measured preoperatively, one month post and one year postoperatively with a visual analog scale (VAS).

Results

A total of 19 cases were treated. Preoperative VAS was 8,42. This value lowered to 1,79 at one month operatively (P<.001) and to 0,00 at 1 year postoperatively (P<.001). The only complication was the need a removal of a residual spike edge on the nail of one patient.

Conclusion

The present study shows teguloplasty as a valid technique for the treatment of pincer nail showing its efficacy in pain relief in patients with pincer nail deformity.

Trial registration: The study was registered at clinicaltrials.gov (Registry number NCT02939521).

Background

The onychocryptosis, commonly known as ingrown toenail, is a condition of the nail apparatus in which damages the nail fold. This causes pain and inflammation and has serious alterations person's quality of life, causing inability to perform daily activities. So, is very important to choose a good treatment.

Material and methods

A literature review was conducted to assess which surgical technique for the treatment of onychocryptosis was the most frequently used in the period (2007-2014), and which has lower rate of relapse and / or recurrence presented. The selection resulted in 13 articles evaluating chemical matrixectomies techniques and wedge resection technique, Suppan I or similar.

Results

The chemical matrixectomies was the most employed techniques to treat ingrown toenails, mainly employing phenol as caustic agent. In the same way, had significantly lower rates of relapse and / or recurrence (2.02%) than wedge resection techniques or Suppan technique

Conclusions

Chemical matrixectomies are currently the most widely used surgical techniques, which provide good results and low recurrence rates presented, so are considered the most effective technique for the treatment of onychocryptosis.

Historically first metatarsophalangeal joint fusion has been used to treat patients with joint arthritis or as a salvage procedure for iatrogenic deformities. For the past 20 years the author has used this procedure in older patients with hallux valgus deformity, and it has proven to be a safe and reliable technique. The paper describes the rationale for use of joint fusion as a primary option for hallux valgus repair in this patient population as opposed to other procedures. The surgical technique, fixation, and aftercare are also described.

Introduction

There is not enough evidence in form of clinical studies regarding the behavior of the midfoot joints in dynamic situations such us walking or running. The present work aims to study the mechanical behavior of midfoot joints with a multisegmented foot model with special interest in joint moments and their clinical significance.

Subjects and methods

A computerized 3-dimensional gait study was performed on healthy male adult subjects with a neutral Foot Posture Index (FPI) (from 0 to +5) during walking. Joint angle and external moments were estimated with a multisegment foot model that considers three separate segments (forefoot, rearfoot and hallux) and graphs and values of midfoot joint (joint connecting forefoot to rearfoot) were analyzed for the right foot of all participants.

Results

A total of 30 subjects (27.13 ± 3.82 years) were included in the study. Highest external moments were observed in the sagittal plane in dorsiflexion direction which tend to collapse the longitudinal arch during the stance phase. Moments registered in frontal and transverse planes were much lower than those observed in the sagittal plane and seems to have lower clinical relevance.

Discussion

The present study provides data about the mechanical behavior of midfoot joints in a healthy adult population with a neutral FPI. This work shows that plantar soft tissues are subjected to important tensional stress during the stance phase of walking.

Introduction

There is not enough evidence in form of clinical studies regarding the behavior of the midfoot joints in dynamic situations such us walking or running. The present work aims to study the mechanical behavior of midfoot joints with a multisegmented foot model with special interest in joint moments and their clinical significance.

Subjects and methods

A computerized 3-dimensional gait study was performed on 30 healthy male adult subjects (27.13 ± 3.82 years) with a neutral Foot Posture Index (FPI) (from 0 to +5) during walking. Joint angle and external moments were estimated with a multisegment foot model that considers three separate segments (forefoot, rearfoot and hallux) and graphs and values of midfoot joint (joint connecting forefoot to rearfoot) were analyzed for the right foot of all participants.

Results

Highest external moments were observed in the sagittal plane in dorsiflexion direction which tend to collapse the longitudinal arch during the stance phase. Moments registered in frontal and transverse planes were much lower than those observed in the sagittal plane and seemed to have lower clinical relevance.

Discussion

The present study provides data about the mechanical behavior of midfoot joints in a healthy adult population with a neutral FPI. This work shows that plantar soft tissues are subjected to important tensional stress during the stance phase of walking.

Cutaneous larva migrans is a disease caused by nematode larvae found in cat and/or dog feces and it is transmitted to humans when walking barefoot in contaminated ground. Human beings are only accidental hosts of this parasite, so the disease is self-limiting, although it is necessary to treat the infection in order to relieve the itching and cutaneous alterations that may develop.

Lesions are more often found in feet. Diagnosis is essentially clinic and the treatment commonly applied is ivermectin oral monodose. Preventive measures are called for and physicians and podologists should be in charge of implementing them.