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Tailor's bunion or bunionette are terms that describe a pathologic enlargement occurring laterally on the fifth metatarsophalangeal joint. Regardless of the etiology that precipitates the deformity, the resulting abnormal protrusion of soft tissue or bone can result in pain for the patient. Symptoms can range from mild discomfort to severe, debilitating pain. The patient may present with pain dorsolaterally, laterally, or plantarly. The symptoms are mechanically induced, and are often associated with hyperkeratotic lesions and adventitious bursae. Patients complain most often that they cannot find comfortable shoes. The authors compare the effectiveness of fixated versus nonfixated distal osteotomies of the fifth metatarsal for the correction of tailor's bunion. This study shows that fixation can help control postoperative dorsal displacement of the fifth metatarsal capital fragment (p < 0.0001) and produce less shortening of the metatarsal resulting in fewer complications.

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint.

Peripheral plasma progesterone (P) levels in the rhesus monkey remain relatively constant both during the latter half of pregnancy and for long periods after fetectomy (removal of the fetus with the placenta left in situ) or ovariectomy. The constancy is maintained despite what appears to be reciprocal changes in the relative contributions of ovary and placenta. Placental regulation of the corpus luteum is likely, but it is not known if the corpus luteum responds to a gonadotropic stimulus in the later stages of pregnancy. In this study, we have investigated the effects of hCG administration in postdelivery monkeys (normally pregnant, fetectomized, ovariectomized and sham ovariectomized animals) and have determined if hCG administration maintains plasma P at pregnancy levels. hCG maintained P at pregnancy levels after surgical removal of the conceptus near term in both normally pregnant and previously fetectomized monkeys over a 7-day treatment period. hCG treatment after normal delivery maintained P levels in sham-ovariectomized but not in ovariectomized monkeys over an 8-day treatment period. The magnitude of the response to hCG declines over the treatment period in all groups except fetectomized monkeys, although hCG levels in the peripheral plasma are quite constant. These results indicate that the ovary of late pregnancy is fully capable of producing P at normal values and is responsive to this gonadotropin.

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