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The author introduces a case demonstrating pedal involvement of osteochondroma. Clinical, radiographic, and histologic characteristics are illustrated. Several years following tumor excision, the patient has returned to unrestricted activities.

Ewing's sarcoma is a rare, malignant neoplasm that is most common in children and adolescents. It is common in both the axial and appendicular skeleton but has been rarely reported in the foot. Historically, treatment has consisted of chemotherapy and radiation therapy. The roll of surgery in the management of these lesions have recently been "rediscovered" and depends on the anatomic location. The purpose of this paper is to discuss five consecutive cases of Ewing's Sarcoma of the forefoot treated with below-the-knee amputation for local tumor control. Four of the five patients also underwent some systemic chemotherapy. After comparing the various forms of therapy for this tumor, the benefits of below-the-knee amputation make it an excellent primary treatment for Ewing's sarcoma of the foot.

The following is a report of a giant cell tumor of a metatarsal, description of treatment, and review of the literature. Giant cell tumors comprise approximately 5-8% of the primary bone tumors. Metatarsal bones are a very rare primary site of involvement. Clinically aggressive or benign behavior cannot be predicted histologically. Treatment should be aggressive, as in this case where en bloc resection and bone graft were performed. Results were excellent with 4 yr follow-up.

A case of mandibular metastasis of angiosarcoma is described, along with its clinical manifestations and histopathological features. This is the 5th case ever reported of metastasis of angiosarcoma to the mandible.

High-resolution sonography was used to study eight patients with suspected plantarflexed metatarsals and associated painful pedal callousities to determine metatarsal head position as the etiology of the pressure keratosis. Ultrasonography demonstrated a plantarflexed metatarsal head in all eight patients. Using both 5 and 10 MHz transducers, the plantarflexed metatarsal position could be accurately assessed and thus could aid in determining the degree of surgical correction necessary to properly realign the depressed metatarsal. Ultrasonography also allowed a noninvasive and accurate assessment of the surgical correction postoperatively in five of the eight patients. This preliminary study suggests that high-resolution sonography has applicability in accurately assessing metatarsal position. In addition, this new technique is noninvasive and presents insights concerning the amount of surgical correction necessary for realignment without increased risk or pain to the patient.

Fibrous dysplasia is a benign, nonfamilial disorder of the skeleton, characterized by expanding fibroosseous lesions occupying single or multiple bones with possible extraskeletal anomalies. Fibrous dysplasia begins in childhood and is not usually recognized until adolescence or adulthood. When fibrous dysplasia affects the foot, it is often the expression of the polystotic form of the disease. This paper will review the pathology of the disease and monostotic involvement of the first metatarsal.

This paper reported the result of clinicoradiologic analysis of 37 patients with diabetic osteopathy. The site of predilection was the bony ends of the extremities, especially the foot (91.9%). The main clinical manifestation was the presence of a non-healing chronic ulcer, whereas diabetic gangrene of bone constituted the chief x-ray finding, which was characterized by osteolytic destruction at the bony ends of metatarsals and phalanges, with minimal periosteous reaction if any. The bony articular surfaces were usually preserved. The chief distinction to be made is osteomyelitis. The mechanism of diabetic osteopathy is most probably systemic metabolic disorders resulted from disturbance of carbohydrate metabolism with secondary neurovascular changes. Infection probably plays the role of enhancing effect in gangrene of bone.

An 11-month old male infant presented with dry idiopathic peripheral gangrene (IPG) of both feet. Subsequently spontaneous autoamputation occurred and the stump healed. Including this patient, 8 cases of IPG under 12 years of age seen at the Kenyatta National Hospital between 1978 and 1986 were analysed. 5 were males and 3 were females. All the 8 children except one had an illness preceding IPG. The literature is reviewed and the management is discussed.

Neuroarthropathy involving the feet is seen most commonly in patients with diabetes mellitus. Chronic alcoholism has been implicated as a cause of neuroarthropathy, but many alcoholics have coexistent diabetes mellitus, which may not be detected by measuring blood glucose levels alone. We report five chronic alcoholic patients with neuroarthropathic alterations of the feet in whom coexistent diabetes mellitus was excluded by using laboratory methods that are more sensitive than those employed in previously reported series of alcoholic neuroarthropathy. The radiographic features of neuroarthropathy in our five cases consisted of hypertrophic changes at the tarsal joints in four, bony fragmentation at the tarsal and metatarsal regions in three, fracture dislocation at the tarsometatarsal joint in two, and multiple pathologic fractures in one. We conclude that alcoholism can result in neuroarthropathy in the absence of diabetes mellitus.