Mitchell's osteotomy gives very good results but there are still some cases where the original method, as well as its modification, cannot address all aspects of deformity. We modified the original Mitchell's method to address pronation and plantar displacement of the first metatarsal. Modification includes formation of lateral and plantar spur with metatarsal displacement and derotation of distal metatarsal fragment in the frontal and horizontal planes with stable screw fixation. We present midterm results of the first 60 patients compared to the original Mitchell method (30 patients). Differences between the groups postoperatively were in declination angle, postoperative metatarsalgia rate, and first metatarsal pronation angle. The technique described eliminated many of the disadvantages of Mitchell's method.

Intramedullary malleolar screws can yield reliable and effective healing of fifth metatarsal stress fractures in athletes. Varus of the metatarsus and the midfoot were predisposing factors for stress fractures in this population of competitive athletes, and all were recommended to wear orthoses until their competitive careers were completed.

We analysed the functional adaptation of the first and second metatarsal bones to altered strain in flexible flatfoot. Fifty consecutive women (20-40 years of age) were enrolled: 31 patients with a flexible flatfoot and metatarsalgia (59 feet) and 19 controls with asymptomatic feet (37 feet). They were compared for cortical thickness (medial, lateral, dorsal and plantar) of the two bones. The null hypothesis of no overall difference between the deformed and healthy feet with regard to cortical thicknesses of the two bones was rejected in a multivariate test (p=0.046). The groups differed significantly only regarding dorsal cortical thickness of the second metatarsal, which was around 18.1% greater in the deformed feet (95% confidence interval: 7.7-28.4%, p<0.001). Hypertrophy of the dorsal corticalis of the second metatarsal bone appears to be the main metatarsal adaptive reaction to altered strain in the flexible flatfoot.

Despite numerous urban studies that analyzed various aspects of Serbia's urban network, little attention was paid to examining the phenomenon of urban hierarchy and urban primacy. Therefore, the aim of this paper is to examine the nature, level and progression of the urban hierarchy in Serbia, as well as its causes and consequences. In achieving these goals, the paper begins with a review of urbanization in Serbia and the methods of its measurement, followed by a discussion of the results obtained. This paper uses data from the Statistical Office of the Republic of Serbia on the number of inhabitants and active population employed in the tertiary-quaternary sector in the period between 1971 and 2011. This paper tested the Rank-size rule, known also as Zipf's law, Urban Primacy Index, and Schmook and Rochefort methods to display the results. This paper concluded that urban primacy is an obvious phenomenon in Serbia. There is a clear distinction between the polycentric urbanized Vojvodina, a somewhat less urbanized central Serbia, and a large range in Belgrade's functional capacity.

Sesamoid bones play an essential role in first metatarsophalangeal (MTP) joint biomechanics, together with other articular surfaces, joint capsule, plantar fascia, ligaments and tendons. They are prone to different acute and chronic injuries, such as acute fracture, stress fractures, chondromalacia, avascular necrosis, bursitis degenerative changes, inflammation etc., all of which clinically manifest as a painful condition and are often diagnosed under a broad term called sesamoiditis. The mechanism of injury is most commonly associated with overuse of the anterior part of the sole of the foot accompanied by excessive dorsiflexion of the great toe. Sesamoiditis presents with pain and localized swelling in the projection of the tibial sesamoid bone, which is affected more frequently than the fibular one. Diagnostic radiology plays a key role in determination of etiology of the disease, as well as in planning of it's treatment. Typical radiological examination includes weight-bearing dorsoplantar, lateral, oblique medial and oblique lateral radiographs of the foot, together with a direct axial radiograph of sesamoid bones. Computerized tomography is used for distinction of acute fractures and early stage of stress fractures from other pathological conditions. Magnetic resonance imaging allows differentiation between bony pathology and soft tissue conditions. Sesamoiditis management is primarily conservative and it depends on duration and severity of the condition. Orthotic insoles customized according to pedobarographic findings may be useful for solving biomechanical deformities that could have led to development of sesamoiditis. Specific pads placed under the first MTP joint in order to prevent the great toe from dorsiflexion proved to be a very effective conservative treatment option. Surgical treatment is considered if conservative methods fail to provide sufficient management of the condition.