Introduction and purpose: Neuropathy associated with syringomyelia is a relatively rare entity that predominantly affects the glenohumeral joint. It is characterized by joint destruction, which is in many cases severe and which requires a differential diagnosis from other severe conditions. The therapeutic options are based on maintaining function rather than on immobilization. We present our experience of treating this condition in 4 cases.

Materials and methods: The cases were 4 females with a mean age of 53.25 years. One of the cases had both the glenohumeral and carpal joints affected. Only in one case was there a known history of syrinogomyelia associated with Arnold Chari disease, whereas in the other 3 the diagnosis of syringomyelia was established by studying the neuroarthropathy.

Results: Two of the patients were treated by means of joint replacement (one total and the other partial) with a favorable postoperative evolution in the medium term. Acceptable pain control and joint balance were achieved. At the end of 5 and 2 years respectively, the total and partial prosthesis had to be revised due to aseptic loosening of the components and joint instability, respectively. The conservative treatment applied to the two remaining cases achieved a functional range of movement for activities of daily living and one of the cases was able to continue with their usual work activities.

Conclusions: In spite of numerous sources in the literature that advise against joint replacement, there are very few documented cases and series that substantiate that recommendation. In the long run, in our experience joint replacement is not a satisfactory treatment for glenohumeral neuroarthropathy.

Introduction and Objectives: The aim of this report is to present the complications that occur with percutaneous surgery for hallux valgus. Percutaneous surgery is based on a series of combined surgical procedures designed to resolve a deformity.

Materials and Methods: We have reviewed the first 200 cases of percutaneous surgery in our centre. In 136 cases, a diagnosis of hallux valgus was made in association with metatarsalgia and deformity of the toes. There were 40 cases of hallux valgus alone, 24 cases of metatarsal-gias with toe deformities, and 10 cases of toe deformities alone. Patients were treated between February 2001 and February 2002 with a mean follow-up time of 8 months. Complications were analysed clinically and radiographically.

Results: We found the following complications: 4 cases of insufficient bunionectomy, 5 cases of dysesthesia of the first digit, 12 cases of transfer metatarsalgia, 10 cases of asymptomatic metatarsal non-union, 20 cases of superficial infections, 50% of cases with prolonged edema of the foot, and 90% of cases with pain on the dorsum of the foot lasting 3–4 months in cases of meta-tarsalgia. Other less common complications included the following: 1 case of deep vein thrombosis, 1 case of cutaneous necrosis in the area of the anaesthetic block, and 1 case of anterior tibial dysesthesia at the level of the anesthetic block. Repeat treatment was required by 10% of patients.

Discussion and Conclusions: Percutaneous surgery is an alternative to conventional surgery. Advantages included decreased postoperative pain, a rapid return to daily activities, weight-bearing ability in the immediate postoperative period, and the fact that is it a standing surgery. However, it should be remembered that this method is not without its possible complications, which may require repeat treatment.