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Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons

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https://www.readbyqxmd.com/read/28410782/posterior-arthroscopic-tibiotalar-arthrodesis-anatomic-feasibility-study
#1
Louis Malekpour, Said Rahali, Damien Potage, Fabrice Duparc, Franck Dujardin, Xavier Roussignol
Anterior arthroscopic tibiotalar arthrodesis has been well codified. A posterior approach with the patient in prone position is indicated when the anterior approach is precluded by soft tissue issues or for a 1-step procedure associated with posterior subtalar fusion. In an anatomic study, we assessed the feasibility of posterior arthroscopic tibiotalar fusion and sought to determine the arthroscopy entry points, mortise cartilage freshening quality, and risk of osseous, tendinous, vascular, and neural complications...
April 11, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#2
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28314638/dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-suggested-classification-system
#3
Makram Zrig, Youssef Othman, Zied Bellaaj, Mustapha Koubaa, Abderrazek Abid
Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. We report the case of a young male with dorsal dislocation of the first metatarsophalangeal joint treated by closed reduction. The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested...
March 14, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28284492/posterior-arthroscopic-subtalar-arthrodesis-clinical-and-radiologic-review-of-19-cases
#4
Xavier Martín Oliva, Pedro Falcão, Raul Fernandes Cerqueira, Ricardo Rodrigues-Pinto
Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or post-traumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated...
March 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28283444/comparison-between-simple-radiographic-and-computed-tomographic-three-dimensional-reconstruction-for-evaluation-of-the-distal-metatarsal-articular-angle
#5
Eduardo Pedrini Cruz, Felipe Victora Wagner, Carlo Henning, José Antônio Veiga Sanhudo, Fernando Pagnussato, Carlos Roberto Galia
The hallux valgus is a pathologic condition in the forefoot that often causes pain and functional limitations. Assessing all deformity components, such as the distal metatarsal articular angle (DMAA) is essential to hallux valgus treatment. Nevertheless, interobserver agreement of DMAA is poor on plain radiographs. The present study compared computed tomographic (CT) 3-dimensional (3D) reconstruction with plain radiographic measurements for measuring the DMAA. We included 43 consecutive patients (77 feet), diagnosed with hallux valgus at the orthopedic outpatient clinic at Hospital de Clínicas de Porto Alegre (Porto Alegre, Brazil) from April 2014 to June 2015 in our prospective study...
March 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268145/accuracy-and-reliability-of-postoperative-radiographic-evaluation-of-first-metatarsal-phalangeal-joint-arthrodesis
#6
Kelly M Pirozzi, Andrew J Meyr
The clinical value of routine postoperative radiographic evaluation after orthopedic procedures has recently been called into question. The objective of the present investigation was to evaluate the ability of foot and ankle surgeons to accurately and reliably assess postoperative radiographs after first metatarsal-phalangeal joint arthrodesis. Thirty sets of digital radiographs from 11 patients who had undergone first metatarsal-phalangeal joint arthrodesis were retrospectively evaluated by 5 podiatric physicians board-certified in foot surgery...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268144/total-ankle-replacement-with-severe-valgus-deformity-technique-and-surgical-strategy
#7
John M Schuberth, Jeff C Christensen, Chad L Seidenstricker
Correction of severe valgus deformity of the foot and ankle with ankle replacement is challenging. We describe the controversies and specific issues of surgical management and provide a detailed surgical strategy for management of this common deformity. A reliable technique for deltoid reconstruction is also described and illustrated in detail.
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268143/a-case-report-of-heel-pain-mimicking-plantar-fasciitis-and-osteosarcoma-a-unique-presentation-of-a-nora-s-lesion
#8
Calvin J Rushing, Diana E Rogers, Steven M Spinner, David C Gajzer
Bizarre parosteal osteochondromatous proliferation, otherwise known as "Nora's lesion," is a rare benign neoplasm first described by Nora in 1983. The exact etiology of this neoplasm remains unknown, and its presentation in the lower extremity presents a diagnostic challenge, as both clinical and radiologic features cannot fully differentiate it from other neoplasms. We present the case of a 48-year-old female with plantar heel pain secondary to Nora's lesion mimicking plantar fasciitis and periosteal osteosarcoma...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268142/an-innovative-anchoring-technique-for-anterior-transfer-of-the-tibialis-posterior-tendon
#9
Po-Chih Shen, Shih-Hsiang Chou, Jian-Chih Chen, Shu-Jung Chen, Yin-Chun Tien
Favorable results have been reported for tibialis posterior tendon transfers, which can effectively restore the dorsiflexion of the ankle and normal heel-to-toe gait. However, the commonly used methods for anchoring the transplanted tendon have some drawbacks. Therefore, we developed a new tendon-anchoring method to improve fixation of the transferred tendon and reduce the related complications. The new method entails tying the anchoring suture to the navicular bone instead of the button on the plantar foot to avoid wound complications...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268141/mitigating-risk-of-ankle-valgus-from-ankle-osteochondroma-resection-using-a-transfibular-approach-a-retrospective-study-with-six-years-of-follow-up
#10
Benjamin Appy-Fedida, Elie Krief, François Deroussen, Marie-Christine Plancq, Louis-Michel Collet, Céline Klein, Richard Gouron
To prevent worsening of ankle valgus and functional repercussions, a distal inter-tibiofibular osteochondroma can be removed using a transfibular approach. We evaluated the difference between the preoperative and postoperative tibiotalar tilt at the last follow-up examination and the clinical and radiologic outcomes. We included 10 consecutive ankles that had undergone removal of an osteochondroma using a transfibular approach. The mean patient age was 10.6 years. One ankle was lost to follow-up. The mean postoperative follow-up duration was 5...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28268140/comparison-of-metatarsal-head-resection-versus-conservative-care-in-treatment-of-neuropathic-diabetic-foot-ulcers
#11
Alireza Kalantar Motamedi, Mohammad Ansari
Complications from diabetic foot ulcers often lead to increased patient morbidity. Much debate still ensues concerning surgical versus conservative management of neuropathic diabetic foot ulcerations. The present study assessed and compared the efficacy of metatarsal head resection and medical approach in the treatment of neuropathic diabetic foot ulcers located at the plantar surface of metatarsal heads. In a retrospective cohort study, 24 consecutive neuropathic diabetic foot ulcers in the lower area of the metatarsal heads that had undergone metatarsal head resection were included as the operative group...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28262467/quantitative-assessment-of-peroneal-artery-pressure-at-the-ankle-with-noninvasive-vascular-testing
#12
Whitney Ellis-McConnell, Amanda Taylor, Patrick Kelly, Andrew J Meyr
Although the foot and ankle derives its arterial supply from a combination of the anterior tibial artery (ATA), posterior tibial artery (PTA), and peroneal artery (PA), the focus of clinical examination techniques and noninvasive vascular testing is primarily on the ATA and PTA and not on the PA. The objectives of the present investigation were to evaluate the feasibility of incorporating an assessment of the PA into a noninvasive vascular testing protocol and to collect normative data of pressure measurements of the PA at the ankle...
March 2, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28259443/u-s-state-driving-regulations-relevant-to-foot-and-ankle-surgeons
#13
Laura E Sansosti, Timothy Greene, Todd Hasenstein, Michael Berger, Andrew J Meyr
The effect of lower extremity pathology and surgery on automobile driving has been a topic of contemporary interest, because these conditions can be associated with impaired driving function. We reviewed the U.S. driving laws relative to foot and ankle patients, for the 50 U.S. states (and District of Columbia). We aimed to address the following questions relative to noncommercial driving regulations: does the state have regulations with respect to driving in a lower extremity cast, driving with a foot/ankle immobilization device, driving with acute or chronic lower extremity pathology or disability, those who have undergone foot and/or ankle surgery, and those with diabetes? Full state-specific answers to the preceding questions are provided...
March 1, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28258949/foot-and-ankle-reconstruction-using-the-distally-based-sural-artery-flap-versus-the-medial-plantar-flap-a-comparative-study
#14
Wael Hussein Mahmoud
Soft tissue defects around the foot and ankle region often present an awkward problem for plastic surgeons. The medial plantar artery flap raised from the non-weightbearing instep of the plantar foot offers a thick, sensorial, durable, and glabrous skin. The reversed sural artery flap offers a reliable option for coverage with the advantages of a wide arc of rotation, adequate dimensions, and a reliable blood supply. The present study compared the outcomes of the medial plantar artery flap and the distally based sural artery flap in foot and ankle reconstruction...
February 28, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28258948/distal-oblique-metatarsal-osteotomy-for-hallux-valgus-deformity-a-clinical-analysis
#15
Olcay Guler, Barıs Yilmaz, Serhat Mutlu, Mehmet Halis Cerci, Nurettin Heybeli
We compared the outcomes of the distal oblique metatarsal (DOM) osteotomy, which is parallel to the articulation surface of the proximal phalanx, with those of the Chevron osteotomy and evaluated whether displacement and shortening of the first metatarsal have any effect on the incidence of metatarsalgia and patient satisfaction. Patients treated with the DOM osteotomy (n = 30) or distal Chevron osteotomy (n = 31) were evaluated retrospectively. The Chevron and DOM osteotomies both provided significant improvement in the first intermetatarsal angle (p < ...
February 28, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28258947/an-approach-to-transmetatarsal-amputation-to-encourage-immediate-weightbearing-in-diabetic-patients
#16
Michael B Canales, Maureen E Heurich, Ashley M Mandela, Mark C Razzante
Transmetatarsal amputation remains the standard treatment for the unsalvageable diabetic forefoot; however, this operation is often complicated by wound dehiscence, ulceration, and the need for additional surgery and tendon balancing. The technique described in the present report provides an uncomplicated suturing method for closure of a standard transmetatarsal amputation. A drill hole is created through the first, second, and fourth metatarsals, which facilitates added stability to the plantar flap of the residual metatarsals...
February 28, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28258946/achilles-impingement-tendinopathy-on-magnetic-resonance-imaging
#17
Mark J Bullock, Jan Mourelatos, Alice Mar
Haglund's syndrome is impingement of the retrocalcaneal bursa and Achilles tendon caused by a prominence of the posterosuperior calcaneus. Radiographic measurements are not sensitive or specific for diagnosing Haglund's deformity. Localization of a bone deformity and tendinopathy in the same sagittal section of a magnetic resonance imaging scan can assist with the diagnosis in equivocal cases. The aim of the present cross-sectional study was to determine the prevalence of Haglund's syndrome in patients presenting with Achilles tendinopathy and note any associated findings to determine the criteria for a diagnosis of Haglund's syndrome...
February 28, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28245975/evaluation-of-fixation-techniques-for-metatarsocuneiform-arthrodesis
#18
Eric A Barp, John G Erickson, Hayden L Smith, Katrina Almeida, Kelsey Millonig
First metatarsocuneiform joint arthrodesis has been used in foot and ankle surgery for the treatment of hallux abductovalgus deformity, among other pedal pathologic entities. The goal of the present retrospective study was to compare the fusion rates and complications of an intraplate compression screw fixation, crossing solid core screw fixation, and a single interfragmentary screw with a simple locking plate. All procedures were performed by a single surgeon, and all patients received an identical postoperative protocol...
February 25, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28245974/involvement-of-residents-does-not-increase-postoperative-complications-after-open-reduction-internal-fixation-of-ankle-fractures-an-analysis-of-3251-cases
#19
Philip K Louie, William W Schairer, Bryan D Haughom, Joshua A Bell, Kevin J Campbell, Brett R Levine
Ankle fractures are common injuries frequently treated by foot and ankle surgeons. Therefore, it has become a core competency for orthopedic residency training. Surgical educators must balance the task of training residents with optimizing patient outcomes and minimizing morbidity and mortality. The present study aimed to determine the effect of resident involvement on the 30-day postoperative complication rates after open reduction and internal fixation of ankle fractures. A second objective of the present study was to determine the independent risk factors for complications after this procedure...
February 25, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28242216/ankle-lead-arthropathy-and-systemic-lead-toxicity-secondary-to-a-gunshot-wound-after-49%C3%A2-years-a-case-report
#20
Zahra Ramji, Mélissa Laflamme
Intra-articular bullet wounds have been found to cause both local and systemic consequences, in particular, when retained over many years. Only a few such cases have been described in published reports, each with different implications, depending on the joint involved and whether the patient experienced lead toxicity. We report the rare case of a 63-year-old male with lead arthropathy of the ankle secondary to a gunshot wound 49 years earlier. In addition to his severe tibiotalar arthritis, he presented with significantly elevated blood lead levels...
February 24, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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