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The authors performed an optic and electron-microscope investigation above the common digital nerve of the foot, whose fragments had been surgically removed from patients suffering from "Morton metatarsalgia" (neuroma). Histological sections were taken from pre-stenotic swelling in patients with clinical symptoms persisting for one year; perineural thickening without evidence of fibroblastic proliferation could be demonstrated, together with an intraneural deposition of an amorphous substance. In other patients suffering from Morton's disease for a longer time, a more pronounced epineural thickening in the pre-stenotic zone could be shown, with partial replacement of nerve fibers by amorphous substance. In the same patients endoneural fibrositis was seen at the level of the stenosis. Electron-microscopy in patients after one year showed an increase in collagenous endoneural fibers and microfibrils. These histopathological findings suggest a compressive mechanism in the pathogenesis of the damage to the common interdigital nerve in Morton's disease, caused by the extrinsic anatomical structures surrounding the nerve. The so-called "neuroma" can be identified with the pre-stenotic swelling.

The authors illustrate the different types of nervous disorders of the foot caused by congenital deformations of the lumbosacral spine. They classify these clinical forms according to the level of the neurological lesions, although emphasizing that more complex neurological damage may cause very atypical deformities that are difficult to classify. Today the treatment of nervous disorders of the foot caused by congenital deformations of the lumbosacral spine seems almost promising when compared to neurological and urological problems which have therapeutic priority. Possible methods of surgical correction, as well as indications that differ according to the age of the patient and the type and extent of the deformity, are discussed. These deformities of the foot evolve very quickly; treatment must be timely or reduction is difficult. Furthermore, their peculiar tendency to relapse necessitates periodic comprehensive follow-up exams and regular maintenance therapy (orthetic and physiatric). Special care must be taken before and during treatment to prevent trophic skin lesions. For this reason, solutions other than casts (external fixation, for example) may be preferable for the maintenance of the correction. The treatment of these deformities, whether conservative or surgical, should aim primarily to achieve adequate plantar support for future aided or autonomous ambulation.

Some aspects regarding the subtalar joint embryology, descriptive anatomy and microscopic anatomy of the various skeletal and capsulo-ligamentous components participating in forming and stabilising this joint are still controversial. In order to clarify these debated aspects, the present review was performed by a macroscopic and microscopic study of feet from embryos and fetuses. The present investigation highlights the subtalar joint as a peculiar single anatomo-functional entity due to its connections with the tibiotalar and Chopart''s joint and the peculiar anatomical features of the talus in which forces are transmitted to structures above and below. [Copyright &y& Elsevier]

Summary The vascular leiomyoma–also called angioleiomyoma or angiomyoma–is a mesodermal benign tumour originating from the smooth muscle cells of blood vessels. It is mainly localized in the subcutaneous tissue and it rarely develops in the intrafascial–intramuscular region. The areas most affected are the lower limbs, especially the legs–the foot is affected, along with the leg, in 49% of cases. Moreover, angioleiomyoma represents about 0.2% of foot benign lesions. A case of vascular leiomyoma is reported here, where diagnosis of vascular leiomyoma was unexpected both because of a preoperative suspicion of cystic neoplasia and because the tumour was found in the intrafascial but extramuscular region, which is unusual for a vascular leiomyoma. Its histological pattern is detailed and the clinical and therapeutical features of this tumour are presented. [ABSTRACT FROM AUTHOR]