Lisfranc injuries are complex midfoot injuries that, if inadequately managed, produce lasting pain, deformity and functional loss. Operative management has historically centred on open reduction and internal fixation (ORIF) and primary arthrodesis (PA), and more recently on flexible fixation (FF) constructs such as suture button devices, the InternalBrace and nitinol staples. This narrative review consolidates contemporary evidence on these three strategies to support surgical decision-making. Across direct comparisons, ORIF and PA yield broadly comparable functional outcomes and complication rates, with outcome governed chiefly by the achievement and maintenance of anatomic reduction; PA tends to reduce reoperation and loss of reduction, particularly in purely ligamentous injuries and complete fracture-dislocations, whereas ORIF preserves midfoot motion but commonly requires planned hardware removal. Flexible fixation produces excellent functional scores and minimal planned hardware removal in isolated ligamentous injuries, with early-recovery advantages over rigid fixation that largely attenuate by one year. The evidence base remains limited by short follow-up, small sample sizes and heterogeneity. No single construct is universally superior; anatomic reduction and patient selection by injury pattern are the principal determinants of outcome.

A 91-year-old woman with chronic tophaceous gout presented with worsening left foot pain, swelling, and purulent drainage after several months of presumed gout flares treated with prednisone and antibiotics. At presentation, she was septic with leukocytosis, elevated inflammatory markers, and imaging consistent with first metatarsophalangeal (MTP) osteomyelitis. Blood cultures grew methicillin-sensitive Staphylococcus aureus (MSSA). Further imaging demonstrated T12/L1 discitis and lumbar epidural phlegmon/abscess extending from L3/L4 to L5. Echocardiography showed a small filamentous structure on the mitral valve where vegetation could not be excluded. This case showcases diagnostic uncertainty when infection mimics gout and the need for early reassessment when symptoms fail to respond to conventional treatments.

Currarino syndrome is a rare congenital disorder characterized by a triad of sacral agenesis, presacral mass, and anorectal malformation. Although it is typically diagnosed in infancy or childhood, adult presentation is rare and poses unique diagnostic and surgical challenges. We present the case of a 45-year-old woman diagnosed with Currarino syndrome during pregnancy after incidental discovery of a presacral mass associated with tethered spinal cord and sacral agenesis. Over time, the mass enlarged, causing rectal obstruction and abdominal pain. A combined neurosurgical and gastrointestinal surgical approach was used to perform tethered cord release and mass resection without cerebrospinal fluid leakage, owing to autologous omental flap placement. There were no postoperative complications except for transient urinary retention and numbness in the left foot. Adult cases of Currarino syndrome require individualized, multidisciplinary surgical management. A combined neurosurgical and gastrointestinal surgical approach, incorporating preventive techniques such as autologous omental flap placement, can result in favorable outcomes with minimal complications.

Effective management of early diabetic foot ulcers (DFUs) is essential for reducing the risks of amputation and mortality. Affordable wound dressings are particularly important for low-income patients because wound healing often requires prolonged treatment. This case report describes the effects of a combined intervention on wound status and quality of life in a 54-year-old woman with a Grade 2 DFU located on the right heel. Following six weeks of standard wound care administered twice weekly at a local healthcare facility, together with glycemic self-management, the patient's blood glucose level improved from 380 mg/dL to 130 mg/dL. Despite improved glycemic control, wound healing remained limited, and the patient continued to experience substantial impairment in quality of life due to ulcer-related pain. The intervention consisted of a honey/gotu kola/κ-carrageenan base (HGCB) hydrogel film dressing applied daily in a home-care setting, combined with mechanical debridement and structured glycemic self-management. Quality of life was assessed using the Diabetic Foot Ulcer Scale. A cost analysis comparing HGCB hydrogel dressing with standard wound care was performed over an equivalent treatment duration. By week 12, blood glucose remained controlled, while malodor, firmly adherent slough, and peri-wound maceration had resolved, accompanied by marked improvement in quality of life. Furthermore, the cost of care associated with the HGCB hydrogel dressing was approximately half that of standard wound care. Although derived from a single case, these findings provide preliminary data for future larger-scale investigations. No adverse reactions or treatment-related complications were observed during intervention therapy.

Leucine-rich glioma-inactivated-1 (LGI1) IgG-associated autoimmune encephalitis typically presents with faciobrachial dystonic seizures, hyponatremia, and temporal lobe MRI abnormalities. However, the clinical spectrum of LGI1 IgG-associated AE extends beyond these classical features, with reports of diverse seizure semiologies and atypical presentations challenging traditional diagnostic paradigms. This study reports a male in his late 60s presenting with recurrent episodes of right foot cramping and electric shock-like pain, progressing to generalized tonic-clonic seizures. Initial workup suggested chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but LGI1 IgG antibodies were subsequently detected. Despite treatment with intravenous immunoglobulin (IVIG), the seizures persisted. This case highlights the heterogeneity in LGI1 encephalitis presentations. The patient's proprioceptive-induced reflex seizures represent a rare manifestation of the disease. Treatment with rituximab, a B-cell depleting therapy, resulted in significant improvement, suggesting its potential effectiveness in LGI1 encephalitis with a resistant seizure course. The case also emphasizes the intricate interplay between the mesial temporal lobe, basal ganglia, and frontal regions in LGI1 encephalitis pathophysiology.

Wildlife exposure is a risk that trained divers are fully aware of. Examples of hazardous wildlife that divers may encounter include, but are not limited to, sharks, coral, sponges, eels, and jellyfish. Encountering wildlife can lead to a diver panicking or being forced to surface rapidly or in an uncontrolled manner due to panic or avoidance of the hazard. This may increase the risk of decompression illness (DCI), mainly pulmonary overinflation syndrome (POIS). Injuries caused by hazardous aquatic wildlife can also be distracting, leading dive supervisors and/or medical personnel to overlook unrelated injuries, such as DCI. If this occurs, the affected diver may suffer a grave outcome that could otherwise have been prevented.

Skeletal muscle compartment syndrome (SMCS) and exertional compartment syndrome (ECS) are two distinct conditions. This case report describes a situation in which both conditions resulted from the same triggering events. The importance of this case lies in the fact that the residual neuropathy associated with the SMCS resolved after a single hyperbaric oxygen (HBO2) treatment.