The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Peroneal tendon dislocation with recurrent subluxation over the lateral malleolus, both acute and chronic, is well documented in the literature. However, there remains a subset of patients who report symptoms similar to peroneal subluxation that do not actually display active or passive displacement of the tendon over the lateral malleolus. In this article, we describe 7 patients who were followed prospectively for the treatment of ultrasound-confirmed, retrofibular, intrasheath subluxation without the typical lateral subluxation or dislocation of the tendon over the malleolus. Six of the 7 patients had either a low-lying peroneal muscle belly or a peroneus quartus muscle and tendon, 6 experienced a tear of either 1 or both of the peroneal tendons, and 1 of the 7 had only a peroneus brevis tendon tear without any other muscle anomaly. Repair of concomitant tendon pathology and resection of the low-lying muscle belly to a point proximal to the fibro-osseous tunnel of the retromalleolar space resulted in elimination of the subluxation symptoms and improvement in American College of Foot and Ankle Surgery ankle scores in 3 patients who were treated operatively. ⋯ 4.
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This article reviews the diagnosis, pathology, and treatment of plantar heel neuroma, an entity that has previously been described and recognized, yet one that we feel warrants further review because of the prevalence of plantar heel pain that does not respond to the usual array of treatments. We feel that neuroma of the medial calcaneal nerve often goes undiagnosed, and may progress to a severely painful condition that requires surgical intervention. In this article, we describe another case of heel neuroma in an otherwise healthy patient with a history of chronic plantar heel pain that was unresponsive to a wide array of nonsurgical treatments. ⋯ 4.
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In this article we describe a method of closed reduction of a supination-eversion stage IV ankle fracture, complete with step-by-step instructions and a video depiction of the reduction maneuver.