Aim

Bumps and lumps of the hand are a common cause for consultation in general practice. However not all of these lesions are of true neoplastic nature and malignant tumours are a rarity in this location.

Introduction: Tumours of the foot are rare, representing only 4 to 8 per cent of all bone and soft tissue tumours: a negligible number compared to degenerative, posttraumatic, vascular and metabolic diseases of this exposed region. Hence neoplasms of the foot are often diagnosed late and treated inadequately.

Methods: The records of all tumours of the foot and ankle treated surgically at our institution in the period 1993 to 2007 were reviewed. Because of their non-neoplastic nature typical lesions of the foot such as plantar fibromatosis or Morton neuroma as well as ganglion and the like were not included in this study. History, location, radiographic and clinical findings were analysed, malignant tumours were followed up by X-ray and MRI.

Results: Of the eighty-eight cases which were further investigated, there were forty-four bone tumours and forty-four neoplastic soft tissue lesions. Sixty-nine cases (78%) were benign tumours, half of them (35 cases) located in the bone and in the soft tissue (34 cases) respectively. There were forty-four male and female patients each, the mean age being 40 years (range 4 to 85) for all cases, 39 years for benign and 45 years for malign tumours respectively.

There were nineteen malignant lesions, nine of which were bone tumours; the most common being chondrosarcoma (3) and osteosarcoma (3). Malignant soft tissue tumours (10) were very heterogeneous, clear cell sarcoma being the only tumour appearing at least twice.

Out of thirty-four benign soft tissue tumours, pigmented villonodular synovitis (11), fibrous (9) and lipomatous (5) tumours have been the most frequent. Thirty five benign bone tumours included chondroma (10), solitary bone cyst (10), aneurysmatic bone cyst (3), osteoid-osteoma (3) and giant cell tumour (3).

Conclusion: Knowledge of tumour prevalence under consideration of the patient’s age and location of the tumour is an important prerequisite for identifying neoplastic lesions of the foot.

Aims: The aim of this prospective study was to analyse the Ludloff osteotomy for its potential of correcting hallux valgus deformity. Methods: Between September 1998 and October 1999 84 consecutive patients who underwent a Ludloff osteotomy were included in this prospective study. All patients were examined preoper-atively and at a minimum follow up of 2 years according a standardized questionnaire based on the HMIS of the American Foot and Ankle Society. X-rays were taken preoperatively, at 6 weeks and at þnal follow up. Results: 75 patients were available for an average follow up of 33 months (24 to 41). The average preoperative HMIS was 52 points and at follow up 87 points. 78% of the patients rated the outcome as excellent and good. 82% of patients were painfree at follow up. Radiological evaluation revealed a preoperative average hallux valgus angle (HV) of 36û and a preoperative average intermetatarsal angle (IM) of 17û This was corrected by surgery to an average HV of 14û and an average IM of 8û. Preoperatively sesamoidposition Grade III was present I 71%, Garde II in 29%. At follow up Grade 0 was present in 60%m Grade 1 in 37% and Grade2 in 3%. There was no Grade 3 sesamoid position at follow up. Conclusions: The ludloff osteotomy is a good alternative for the correction of severe hallux valgus deformity. In elderly patients and osteoporotic bone early weight-bearing should not be allowed because of poor bone quality.