We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.
Marjolin's ulcer is a squamous cell carcinoma that develops in posttraumatic scars and chronic wounds. It was first noted to be associated with chronic osteomyelitis in 1835 and is usually described occurring in lower extremity wounds. Suspicion of such lesions should be raised in chronic wounds demonstrating characteristic changes. Impaired immunologic activity in chronic wounds has also been shown to contribute to the pathologic process. Definitive treatment in the past has been amputation proximal to the tumor, however; recently, wide resection and radiation therapy have been used. According to Lifeso et al., wide local excision is unreliable and they recommend amputation in grade II or III disease and wide local excision in very small lesions that can be radically excised or in grade I lesions. We report a case of a Marjolin ulcer that developed at the elbow. Physicians should have a high index of suspicion in chronic wounds that are recalcitrant to therapy and should remember to biopsy all suspected lesions. Early recognition and definitive treatment are the mainstays ensuring the best prognosis.
An indirect groove deepening technique is an effective way of treating peroneal tendon dislocation with good results. Patients with Worker's Compensation claims or other associated pathology have poorer outcomes.
Underestimation of the amount of depression and rotation of the posterior facet fragment was seen on the coronal CT scan. We attribute this finding to the combined rotation and depression of the posterior facet which may not be measured accurately with the typical semicoronal CT orientation. While sagittal reconstructed images would show this depression better, if they are unavailable we recommend using lateral radiographs to better gauge the amount of fracture displacement.
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