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A survey of patients treated at the Foot and Ankle Institute at the Temple University School of Podiatric Medicine in Philadelphia, Pennsylvania, was conducted regarding their satisfaction with thermoplastic prescription foot orthoses. Two hundred seventy-five completed questionnaires from patients who had had their orthoses for 1 year or more were analyzed. Overall, the majority of respondents indicated that they were satisfied with their devices, obtaining significant (60% to 100%) relief of symptoms. Very few patients indicated total dissatisfaction; only 9% reported 0% relief of their symptoms. The data strongly suggest that custom-molded foot orthoses are an effective and viable treatment modality associated with a high level of patient satisfaction.

Most complications of calcaneal fractures are due to the combination of the dynamic nature and the mechanism of the injury itself. Complications are usually secondary to three integral parts of this complex fracture pattern: 1) fracture and depression of the subtalar joint, 2) loss of the height of the calcaneal body with varus rotation, and 3) expansion of the lateral wall of the calcaneus. Other complications occur with less frequency. This article describes the complications and sequelae of old, malunited intra-articular calcaneal fractures in relation to the nature and the components of these unique fractures.

A rare, large pediatric aneurysmal bone cyst with pathologic fracture of the distal tibia of a 4-year-old female was presented. Classic radiographic and magnetic resonance imaging findings have been discussed. In a comprehensive review of the literature, aneurysmal bone cysts are an infrequently reported neoplasm of the foot and ankle bones. Lesions are characteristically seen in patients younger than 20 years of age, but rarely younger than 5 years. The benign cyst has a 2:1 female-to male predilection. In long bones, the lesion is typically metaphyseal in nature. Although the pathogenesis is still unknown, there exists the possibility of two types of aneurysmal bone cysts: a primary type without preexisting lesion and a secondary form associated with some other lesion. The diagnosis of aneurysmal bone cyst can be strongly suspected by correlating the radiographic and magnetic resonance imaging findings. For definitive diagnosis, accurate histologic evaluation is imperative to rule out any confusion or possibility with a malignant tumor.

Although pigmented villonodular synovitis is a benign process, the potential of osseous destruction makes it a difficult case to manage. The treatment of pigmented villonodular synovitis often necessitates multiple surgical procedures with prolonged periods of nonweightbearing. Recalcitrant pain is often a sequela, secondary to nerve impingement.

Arthritis, in one form or another, is one of the most common disorders that affect man. Whether the etiology is systemic, neurologic, or traumatic, the one common finding is the destruction of joint cartilage. Although there have been massive amounts of literature concerning osteoarthritis, little has been written about arthritis of the ankle joint. Current concepts in the pathology, terminology, symptomatology, and treatment of the arthritic ankle are discussed.

The syndesmotic area in the ankle joint is analyzed by reviewing the literature and by examining its gross anatomy and histology. Seventy-five ankles were dissected and examined, with an emphasis on the syndesmotic area. The gross anatomical results of this study differ somewhat with those of other authors. The average height, attachments, consistency, color, and shape are reported. In addition to gross examination, four ankles were examined histologically, and the findings are discussed. The results of this study define in detail the anatomy of the syndesmotic area.