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David R W MacDonald, David Neilly, Joseph Littlechild, Fraser Harrold, Sam C Roberts
Acute Achilles tendon rupture is frequently treated conservatively using functional rehabilitation protocols in which the ankle is held in equinus. Equinus is achieved using a variety of means including equinus casts and rigid boots with heel wedges. Concerns have been raised that rigid boots with heel wedges do not achieve adequate equinus. Patients presenting to our institutions with an acute Achilles tendon rupture were randomised to treatment with an equinus cast or rigid boot with heel wedges. After application of these lateral radiographs of the hindfoot and ankle were taken, and these used to measure tibiotalar angle (TTA), tibio-1st metatarsal angle (TMA) and posterior malleolar to calcaneal tip height (PCH)...
October 12, 2018: Foot
Laurence Wicks, Radwane Faroug, Danielle Richler-Potts, Ashley Bowden, Jitendra Mangwani
BACKGROUND: Should pre-manipulation radiographs be obtained in ankle fracture-dislocations? This question remains controversial. The twelfth British Orthopaedic Association Standard for Trauma (BOAST-12) published in August 2016 states that 'Reduction and splinting should be performed urgently for clinically deformed ankles. Radiographs should be obtained before reduction unless this will cause an unacceptable delay'.2 We quantify the delay caused by obtaining a pre-manipulation radiograph, and additionally determine whether a pre-manipulation radiograph influences the adequacy of initial reduction...
September 20, 2018: Foot
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
August 22, 2018: Foot
Angela Blasimann, Patric Eichelberger, Nicole Lutz, Lorenz Radlinger, Heiner Baur
BACKGROUND: The lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND). METHODS: Twenty healthy participants (mean age 30.2±8.1years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded...
August 22, 2018: Foot
Marabelle L Heng, Priathashini Krishnasamy, Pui W Kong
BACKGROUND: While posterior tibial tendon dysfunction (PTTD) commonly presents with flat feet and has been thought to be associated with first ray mobility, many flat-footed individuals are asymptomatic and do not experience any symptoms of PTTD. Thus, there is a need to control for foot type when studying factors related to PTTD. This study aimed to clarify if first ray mobility differed between flat-footed individuals with and without symptoms of PTTD. It was hypothesized that PTTD patients would display higher mobility of the first ray than asymptomatic flat-footed controls...
August 3, 2018: Foot
Neil A Segal, Lauren N Neuman, Maria C Hochstedler, Howard L Hillstrom
INTRODUCTION: Anthropometric changes to the feet with pregnancy may increase risk for musculoskeletal disease. Customized arch-supportive orthoses to prevent anthropometric changes could potentially provide an inexpensive means to prevent musculoskeletal impairments and improve quality of life for women during their post-reproductive years. The objective of this prospective, randomized controlled trial was to determine whether customized foot orthoses can prevent arch collapse during pregnancy...
July 27, 2018: Foot
Tiago Baumfeld, Daniel Baumfeld, Marcelo Prado, Caio Nery
INTRODUCTION: Various procedures have been used to treat osteochondral lesions of the talus. Among the new alternatives to treat these lesions, Autologous Matrix-Induced Chondrogenesis (AMIC® ) has proven to provide satisfactory results through medium-term follow-up. The aim of this study is to report early post-operative clinical results of patients submitted to the AT-AMIC® technique and autologous bone graft, when necessary, for OLT's at a eight-month minimum follow-up. METHODS: This is case series of 17 consecutive patients that were submitted to AT-AMIC® , between January of 2016 and April of 2017...
July 25, 2018: Foot
Albert H Vette, Joe M Watt, Justin Lewicke, Beth Watkins, Lee M Burkholder, John Andersen, Gian S Jhangri, Sukhdeep Dulai
Initial heel contact is an important attribute of gait, and failure to complete the heel rocker reduces gait stability. One common goal in treating toe-walking is to restore heel strike and prevent or reduce early heel rise. Foot floor angle (FFA) is a measure of toe-walking that is valuable for quantifying foot orientation at initial contact when using ankle dorsiflexion angle alone is misleading. However, no age-standardized FFA norms exist for clinical evaluation. Our objectives were to: (1) obtain normative FFA in typically developing children; and (2) examine its utility in the example of toe-walking secondary to unilateral cerebral palsy...
July 11, 2018: Foot
S E Johnson-Lynn, J Ramaskandhan, M S Siddique
Total Ankle Replacement is an established technique for the management of end-stage ankle arthritis. However, there are few studies focussing on patient-reported outcomes in the medium and long term related to age or arthritis type. We compared demographic data and patient-reported outcomes preoperatively and at five years postoperatively for patients who underwent total ankle replacement with the aim of establishing whether differences exist in outcome depending on patient age or diagnosis. The Foot and Ankle Score (FAOS) and 36-item Short-Form (SF-36) Health Survey were analysed by diagnosis (osteoarthritis, rheumatoid arthritis, post-traumatic arthritis) and age (under or over 60 years)...
July 11, 2018: Foot
Mehmet Erdogan, Mustafa Kulaksizoglu, Asli Tetik, Soner Solmaz, Ali Sahin Kucukaslan, Zuhal Eroglu
OBJECTIVET: his study aims to evaluate the influence of eNOS G894T and VEGF C936T gene polymorphism in diabetic foot ulcers. METHOD: We studied 50 patients with diabetic foot ulcers and 57 diabetic patients without diabetic foot ulcer and as a control group of 75 healthy individuals. RESULTS: The genotype eNOS distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele in Type 2 Diabetic Patients were significantly higher than the control group (42...
June 26, 2018: Foot
Jordan J Ernst, Dalton Ryba
Drug eruptions represent a wide spectrum of cutaneous reactions to various pharmaceutical agents. Given their complexity and varied patterns of presentation, these phenomena are the subject of study of many fields of medicine. Gabapentin is a widely prescribed medication, with numerous drug reactions previously reported. We present what we believe to be a unique presentation of a gabapentin-induced drug eruption primarily affecting the feet.
June 18, 2018: Foot
Raymond Klumpp, Riccardo Compagnoni, Marco Zeppieri, Carlo Lauro Trevisan
The Cunéo and Picot fracture-dislocation is an atypical trimalleolar fracture-dislocation of the ankle with unique anatomopathologic and radiographic features, which has not been reported in English literature. We report a case of a 42-year-old woman that was diagnosed a trimalleolar fracture-dislocation and treated surgically with an open reduction and osteosynthesis of the lateral and medial malleolus. At the one-month follow-up, X-rays showed secondary displacement of the medial malleolus requiring revision surgery...
June 18, 2018: Foot
Mohamed E Al-Ashhab, Amr Salem Elgazzar
BACKGROUND: Sustentaculum tali fractures are rare foot fractures accounting for 1% of all calcaneal fractures, which accounts for about 1-2% of all bone fractures. Since the importance of sustentaculum tali in maintaining the medial foot arch, its fractures should be dealt with anatomical fixation to avoid post-traumatic arthrosis. OBJECTIVE: Is to delineate the importance of sustentacular tali fractures fixation mentioning operative technique and the post-operative outcome...
June 2018: Foot
Noor Azzizah Omar, John C McKinley
INTRODUCTION: There has been growing interest in minimally invasive foot surgery due to the benefits it delivers in post-operative outcomes in comparison to conventional open methods of surgery. One of the major factors determining the protocol in minimally invasive surgery is to prevent iatrogenic thermal osteonecrosis. The aim of the study is to look at various drilling parameters in a minimally invasive surgery setting that would reduce the risk of iatrogenic thermal osteonecrosis...
June 2018: Foot
Florian Ebrecht, Freddy Sichting
PURPOSE: The purpose of this study was to investigate the effect of an eight-week neuromuscular electrostimulation program on the intrinsic foot muscle strength. The results were compared with those from a passive and an active control group. METHODS: 74 healthy participants were recruited and divided into three groups: a neuromuscular electrostimulation group (n=19), a passive control group (n=15) with no further intervention, and an active control group following a running protocol with minimal shoes (n=40)...
June 2018: Foot
Kar Hao Teoh, Robert Whitham, Jenny F Wong, Kartik Hariharan
BACKGROUND: There are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures. METHODS: A retrospective review of patients who were treated with LIPUS following a delayed union of fifth metatarsal fracture was conducted over a three-year period. RESULTS: There were thirty patients (9 males, 21 females) in this cohort...
June 2018: Foot
Samuel K K Ling, Vincent Chan, Karen Ho, Fona Ling, T H Lui
AIM: Develop the first reliable and validated open-source outcome scoring system in the Chinese language for foot and ankle problems. METHODS: Translation of the English FAOS into Chinese following regular protocols. First, two forward-translations were created separately, these were then combined into a preliminary version by an expert committee, and was subsequently back-translated into English. The process was repeated until the original and back translations were congruent...
June 2018: Foot
Derek Santos, Graeme Morrison, Andrea Coda
An intermetatarsal neuroma is a plantar digital neuritis causing metatarsalgia of the affected inter-metatarsal space. At present the evidence to support the management of the condition is poor with only some quality evidence supporting the short-term management of intermetatarsal neuromas using steroid injections. Some authors have supported the use of alcohol sclerosing intra-lesional injections to treat intermetatarsal neuromas. Following a search of the evidence 11 articles were identified. The systematic review found that alcohol injections appear to be safe although some papers report a short-term side effect of a flogistic reaction and there are variances in the alcohol concentration used and guiding verses not guiding the injection using ultrasound imaging...
June 2018: Foot
Erin M Mannen, Stuart J Currie, Elizabeth C Bachman, Amira Otmane, Bradley S Davidson, Kevin B Shelburne, Thomas G McPoil
BACKGROUND: The intent of this pilot study was to determine the feasibility of using high-speed stereo radiography (HSSR) to assess the effectiveness of footwear and foot orthoses in controlling the change in the position of the midfoot during walking in individuals with a flexible pes planus foot type. METHODS: Four individuals (1 female; 3 male) with a mean age of 25 years (range 22-29) and a bilateral flexible pes planus foot type participated in the study. The HSSR system was used to measure 3-dimensional changes in the longitudinal arch angle (LAA) with each participant walking barefoot, shoe only and shoes with orthoses...
June 2018: Foot
S Ntuli, S Nalla, A Kiter
BACKGROUND: The dorsalis pedis artery is responsible for blood supply to the dorsal aspect of the foot and is vital in the clinical assessment of the arterial supply thereof. Clinical assessment should consider anatomical variations of dorsalis pedis artery. Clearly, a thorough understanding of the potential variations of the vasculature in the area is important for a precise clinical assessment of arterial supply to the foot. The aim of this study was to investigate the different branching patterns of the dorsalis pedis artery that exist in a South African population...
June 2018: Foot
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