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Foot & Ankle International

Kenneth W DeFontes, Joshua Vaughn, Jeremy Smith, Eric M Bluman
Talar body osteonecrosis can be a devastating, painful condition that is difficult to manage surgically when conservative treatments have failed. With early disease, nonoperative treatments can prolong the need for operative correction in the young patient. Later stage disease with extensive involvement may require a tibiotalocalcaneal (TTC) arthrodesis to retain functionality of the limb. This situation frequently requires a structural bone graft. Using the technique described in this article, the void resulting from collapse of the talar body is filled with talar allograft, which offers a more anatomic and structurally rigid construct than previously described methods using an allograft femoral head...
March 1, 2018: Foot & Ankle International
Daorong Xu, Yibei Wang, Chunyu Jiang, Maoqing Fu, Shiqi Li, Lei Qian, Peidong Sun, Jun Ouyang
BACKGROUND: Ligament repair and augmentation techniques can stabilize syndesmosis injuries. However, little is known about the mechanical behavior of syndesmotic ligaments. The aim of this study was to analyze full-field strain, strain trend under foot rotation, and subregional strain differences of the anterior inferior tibiofibular ligament (AITFL), posterior inferior tibiofibular ligament (PITFL), and interosseous membrane (IOM). METHODS: Eleven fresh-frozen lower limbs were dissected to expose the AITFL, PITFL, and IOM...
March 1, 2018: Foot & Ankle International
Mark C Lawlor, Melissa A Kluczynski, John M Marzo
BACKGROUND: The utility of computed tomography (CT) for measuring medial clear space (MCS) for determination of the stability of supination external rotation (SER) ankle fractures and in comparison to standard radiographs is unknown. We compared MCS on gravity stress (GS) radiographs to GS and weight bearing (WB) cone-beam CT (CBCT). METHODS: An AO SER 44B3.1 ankle fracture was simulated in 10 human cadavers, also serving as controls. MCS was measured on GS radiographs, GS CBCT, and a simulated WB CBCT scan...
March 1, 2018: Foot & Ankle International
Meletis Rozis, Ioannis Benetos, Panagiotis Karampinas, Vasilios Polyzois, John Vlamis, Spyros Pneumaticos
BACKGROUND: Conservative treatment of an acute Achilles rupture remains a viable and acceptable option as does surgical fixation, with open and percutaneous repair consisting the main operative techniques. The purpose of this study was to compare the outcomes and complication rates of open versus percutaneous surgical procedures. METHODS: From 2009 to 2016, 131 patients were admitted to our department with clinically and radiologically confirmed acute Achilles tendon ruptures...
March 1, 2018: Foot & Ankle International
Jasmin Diallo, Joe Wagener, Christine Schweizer, Tamara Horn Lang, Roxa Ruiz, Beat Hintermann
BACKGROUND: An acute ankle sprain can result in a bony avulsion of the lateral ankle ligaments. The extent of concomitant lesions and subsequent instability patterns are not clearly understood. The high incidence of old avulsion fractures found in symptomatic chronic ankle instability may indicate the need for primary fixation. METHODS: Ten patients (5 male, 5 female; mean age, 34 years; range, 15-64 years) with bony avulsion fractures of the fibula after acute ankle sprains were included...
March 1, 2018: Foot & Ankle International
Emilio Wagner, Pablo Wagner, Diego Zanolli, Rubén Radkievich, Gunther Redenz, Rodrigo Guzman
BACKGROUND: Tibialis posterior tendon transfer is performed when loss of dorsiflexion has to be compensated. We evaluated the circumtibial (CT), above-retinaculum transmembranous (TMAR), and under-retinaculum transmembranous (TMUR) transfer gliding resistance and foot kinematics in a cadaveric foot model during ankle range of motion (ROM). METHODS: Eight cadaveric foot-ankle distal tibia specimens were dissected free of soft tissues on the proximal end, applying an equivalent force to 50% of the stance phase to every tendon, except for the Achilles tendon...
March 1, 2018: Foot & Ankle International
Michael S Pinzur
No abstract text is available yet for this article.
March 1, 2018: Foot & Ankle International
Jordi Vega, Albert Baduell, Francesc Malagelada, Jörg Allmendinger, Miki Dalmau-Pastor
BACKGROUND: Haglund syndrome is a common cause of heel pain. Risk for tendon detachment after calcaneoplasty can exist. Open Achilles tendon detachment, calcaneoplasty, bursectomy, pathologic tendon-tissue debridement, and tendon reattachment of the Achilles tendon is a common surgical management of Haglund syndrome combined with insertional Achilles tendinopathy. The aim of this study was to describe the endoscopic calcaneoplasty and anchor suture augmentation of the Achilles insertional area, and the results obtained in patients with an increased risk of Achilles tendon rupture after calcaneoplasty...
March 1, 2018: Foot & Ankle International
Sydney C Karnovsky, Bridget Desandis, Andrea K Papson, Quinn O'Malley, Robert DiGiacomo, Martin J O'Malley, Taylor N Cabe, Mark C Drakos
BACKGROUND: Tibialis anterior tendon ruptures are rare and can cause significant dysfunction. Often, conservative measures are prescribed because of the morbidity of a tendon transfer as an operative solution. We present a novel reconstruction technique using hamstring autograft, which may obviate the need for local tendon transfer and long-term bracing. METHODS: Patients who underwent tibialis anterior reconstruction with hamstring autograft between 2011 and 2015 were screened for inclusion...
March 1, 2018: Foot & Ankle International
Emilio Wagner, Pablo Wagner, Cristian Ortiz, Ruben Radkievich, Felipe Palma, Rodrigo Guzmán-Venegas
BACKGROUND: No clear guideline or solid evidence exists for peroneal tendon tears to determine when to repair, resect, or perform a tenodesis on the damaged tendon. The objective of this study was to analyze the mechanical behavior of cadaveric peroneal tendons artificially damaged and tested in a cyclic and failure mode. The hypothesis was that no failure would be observed in the cyclic phase. METHODS: Eight cadaveric long leg specimens were tested on a specially designed frame...
March 1, 2018: Foot & Ankle International
Oliver J Gagné, Andrea Veljkovic, Mark Glazebrook, Timothy R Daniels, Murray J Penner, Kevin J Wing, Alastair S E Younger
BACKGROUND: People who are affected by end-stage ankle arthritis are as disabled as those suffering from arthritis in other main articulations of the lower extremity. Once these patients become unable to perform their job duties, they leave the workforce and require financial aid from government agencies, which represents a considerable economic burden. Regardless of whether arthrodesis or arthroplasty is performed, we hypothesized that patients younger than 55 years at the time of surgery should be able to return to work within 2 years and require less social assistance...
March 1, 2018: Foot & Ankle International
Young Hwan Park, Won Seok Choi, Gi Won Choi, Hak Jun Kim
BACKGROUND: Although intracompartmental bleeding is one cause of traumatic compartment syndrome, no previous studies have defined the role of hemostatic stability in the development of traumatic compartment syndrome. Therefore, to investigate this issue, we identified the relationship between antiplatelet/anticoagulant medications and the development of traumatic foot compartment syndrome. In addition, as a possible predictor of compartment syndrome, we evaluated the utility of blood-clotting tests in the prediction of traumatic foot compartment syndrome...
March 1, 2018: Foot & Ankle International
Haley M Merrill, Daniel M Dean, Jay L Mottla, Steven K Neufeld, Daniel J Cuttica, Matthew M Buchanan
Background Orthopaedic surgeons frequently prescribe pain medications during the postoperative period. The efficacy of these medications at alleviating pain after foot/ankle surgery and the quantity of medication required (and conversely, leftover) are unknown. METHODS: Patients undergoing foot/ankle surgery during a 3-month period who met inclusion criteria were surveyed at their first postoperative visit. Information collected included gender, number of prescribed pills remaining, satisfaction with pain control, and willingness to surrender leftover opioids to a Drug Enforcement Administration (DEA) disposal center...
March 1, 2018: Foot & Ankle International
Danielle Thomas, David Thordarson
BACKGROUND: Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. METHODS: A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015...
March 1, 2018: Foot & Ankle International
Fred T Finney, Simon Lee, Jaron Scott, Todd A Irwin, James R Holmes, Paul G Talusan
BACKGROUND: Lesser toe metatarsal-phalangeal (MTP) joint instability can be a major source of pain and dysfunction. Instability occurs when there is incompetence of the plantar plate and/or collateral ligaments. Newer operative treatments focus on performing anatomic repairs of the plantar plate. The goal of this study was to compare the biomechanical properties of 3 suture configurations that may be used for plantar plate repairs. METHODS: Biomechanical analysis of 27 lesser toe plantar plates from fresh frozen human cadavers was completed...
February 1, 2018: Foot & Ankle International
Benjamin R Williams, Dylan L McCreary, Michael Chau, Brian P Cunningham, Fernando Pena, Marc F Swiontkowski
BACKGROUND: Orthopedic implant removal following open reduction internal fixation of a fracture is a common procedure, especially in the foot and ankle. The purpose of this study was to evaluate functional change after the removal of symptomatic implants following ankle fracture open reduction internal fixation (ORIF) using the Short Musculoskeletal Function Assessment (SMFA) outcome score. We hypothesized that implant removal after ankle fracture would result in improved functional outcomes...
February 1, 2018: Foot & Ankle International
Daniel D Bohl, Rachel M Frank, Simon Lee, Kamran S Hamid, George B Holmes, Johnny Lin, Simon Lee
BACKGROUND: The saline load test has been used to evaluate for traumatic arthrotomy in orthopaedics. The purpose of this study was to determine the volume of saline required to detect traumatic arthrotomy of the ankle. METHODS: Forty-two patients undergoing elective ankle arthroscopy were prospectively enrolled. For each patient, a standard 4-mm anteromedial portal was established. Next, an 18-gauge needle was inserted at the site of the anterolateral portal. Sterile saline was slowly injected through the needle until saline extravasated from the anteromedial portal...
February 1, 2018: Foot & Ankle International
Alessio Bernasconi, Francesco Sadile, Matthew Welck, Nazim Mehdi, Julien Laborde, François Lintz
BACKGROUND: Stage II tibialis posterior tendon dysfunction (PTTD) resistant to conservative therapies is usually treated with invasive surgery. Posterior tibial tendoscopy is a novel technique being used in the assessment and treatment of posterior tibial pathology. The aims of this study were (1) to clarify the role of posterior tibial tendon tendoscopy in treating stage II PTTD, (2) to arthroscopically classify spring ligament lesions, and (3) to compare the arthroscopic assessment of spring ligament lesions with magnetic resonance imaging (MRI) and ultrasonographic (US) data...
February 1, 2018: Foot & Ankle International
Oliver Nickolaas Schipper, Robert Bentley Anderson, Bruce E Cohen
BACKGROUND: Achilles tendon insertional sleeve avulsions occur when the Achilles distal tendon sleeve ruptures off of its insertion into the calcaneal tuberosity, sometimes with a small bony fragment from calcific tendinosis. Little evidence exists describing the outcomes and rerupture rate after operative management of Achilles tendon sleeve avulsions. METHODS: A retrospective chart review was performed to identify patients who sustained an Achilles sleeve avulsion injury treated with operative repair between October 2005 and July 2014...
February 1, 2018: Foot & Ankle International
John J Marcel, Katherine Sage, Gregory P Guyton
BACKGROUND: Open Achilles tendon surgery with the patient in the supine position potentially avoids the complications of the prone position, but the safety and viability of the supine position for this procedure are not known. The aim of this study was to test the hypothesis that supine positioning for open repair of acute Achilles tendon ruptures would be safe, with low wound and neurologic complication rates. METHODS: Supine position safety in acute Achilles tendon repair was investigated...
February 1, 2018: Foot & Ankle International
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