The crucial diagnostic tool for decision-making in diabetic foot syndrome was MRI, which normally shows osteomyelitis with high sensitivity and specificity. In patients with Charcot-neuro-osteoarthropathy, the bone marrow oedema of the involved parts of the skeleton might misleadingly suggest the diagnosis of osteomyelitis. If amputation is inevitable in severe abscess formation combined with instability and perforation of the dislocated and destroyed bones in Charcot-neuro-osteoarthropathy, these patients might benefit from a foot amputation according to the technique Syme described. For this procedure the blood supply of the posterior tibial artery is essential. All these patients were able to walk without support. The material presented helps to generate hypotheses for further prospective studies.
Rupture of the pectoralis major muscle is a rare injury. In total 125 cases of complete and uncomplete ruptures are reported. This injury is the result of excessive muscle tension, a direct blow or a combination of both. In a case study the aetiology, diagnostic, treatment and functional outcome of complete muscle ruptures are shown. The reported results of 14 cases who underwent conservative and 51 cases with surgical treatment were classified and analysed. Conservative management is recommended for partial and proximal ruptures. Distal ruptures of the musculo-tendinous or tendinous insertion in active patients should be treated surgically to return previous muscle strength and contour.
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