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Foot & Ankle Specialist

Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
: Introduction Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
September 23, 2016: Foot & Ankle Specialist
Martin Sullivan, Ethan J Fraser, James Linklater, Craig Harris, Kieran Morgan
: Background Talar osteochondral lesions represent challenging clinical entities, particularly in high-demand athletes. Surgical treatment of large lesions often requires a 2-step procedure, or the use of osteotomy in the case of autologous osteochondral transfer, which can delay return to sport. Methods A professional rugby league player underwent surgery for a complex injury to the ankle. A talar osteochondral lesion with a maximal diameter of 15 mm was treated in an arthroscopic fashion using the cartilage taken from the completely displaced osteochondral fragment...
September 22, 2016: Foot & Ankle Specialist
Lauren K Szolomayer, Paul G Talusan, Wayne F Chan, Dieter M Lindskog
: Leiomyoma is a benign soft-tissue tumor that can arise in any soft tissue; however, in the extremities, it is usually a subcutaneous mass. Masses in the foot and ankle in general are rare, and few reports in the literature describe leiomyoma in this region of the body. We present a series of 8 cases of leiomyoma of the foot and ankle, 4 of which are subclassified as angioleiomyomas. The characteristic patient presentation, imaging, and histological findings are presented here to increase awareness of this soft-tissue mass in the foot and ankle...
September 20, 2016: Foot & Ankle Specialist
John A Karbassi, Andrew Braziel, Peter K Garas, Abhay R Patel
: Open reduction internal fixation of posterior malleolus fractures from a posterior approach is gaining popularity. One concern that has not been studied is the risk of iatrogenic injury to anatomical structures on the anterior ankle. The purpose of this study is to determine the proximity of these anterior structures with relation to K-wires advanced through the anterior cortex. A total of 10 cadaver ankles were utilized in the study. A posterolateral approach to the ankle was used...
September 20, 2016: Foot & Ankle Specialist
Sarang Desai
: Freiberg's infarction is a well-known condition that most commonly effects the second metatarsophalangeal joint. The etiology of Freiberg's infarction is not entirely clear and there is no consensus on treatment. The case report presents a patient successfully treated with a metatarsal shortening osteotomy, marrow stimulation, and micronized allograft cartilage matrix. This is to my knowledge the first reported case using the described technique for Freiberg's infarction. LEVELS OF EVIDENCE: Therapeutic, Level V: Expert opinion...
September 19, 2016: Foot & Ankle Specialist
David Pomarino, Juliana Ramírez-Llamas, Stephan Martin, Andrea Pomarino
: The idiopathic toe walking (ITW) gait pattern is characterized in children for walking since the beginning on their first steps on the forefoot; however, these children are able to support their whole foot on the ground. ITW can only be diagnosed in the absence of any orthopaedic or neurological condition known to cause tiptoe walking. The aim of this article is to review other references and provide an outline of the different treatment options, including the 3-step-pyramid insole treatment concept for children with ITW...
September 19, 2016: Foot & Ankle Specialist
Justin D Orr, John C Dunn, Kenneth A Heida, Nicholas A Kusnezov, Brian R Waterman, Philip J Belmont
INTRODUCTION: Structural fresh osteochondral allograft transfer is an appropriate treatment option for large osteochondral lesions of the talus (OLTs), specifically lesions involving the shoulder of the talus. Sparse literature exists regarding functional outcome following this surgery in high-demand populations. MATERIALS AND METHODS: Over a 2-year period, a single surgeon performed 8 structural allograft transfers for treatment of large OLTs in an active duty US military population...
September 13, 2016: Foot & Ankle Specialist
Marie-Lyne Nault, Laurence Gascon, Jonah Hébert-Davies, Stéphane Leduc, G Yves Laflamme, Dennis Kramer
BACKGROUND: The hypothesis of this study is that a sprain or tear of 1 or more of the 3 syndesmotic ligaments will result in a significant change in the osseous anatomy relationship when comparing injured to uninjured syndesmosis. Our secondary objective was to determine whether injuries to the syndesmosis as diagnosed on magnetic resonance imaging (MRI) could be found using static imaging. METHODS: This is a descriptive radiological study of ankle MRI reports over a 12-year period, from 2 different institutions, and divided in two groups: normal and injured syndesmotic ligaments...
September 13, 2016: Foot & Ankle Specialist
Douglas E Lucas, B Collier Watson, G Alex Simpson, Gregory C Berlet, Christopher F Hyer
: Ankle fractures are a common injury treated by orthopaedic surgeons. The distal tibiofibular syndesmosis can be injured during these fractures as well as in isolation. They pose a significant challenge with regard to the diagnosis of instability as well as evaluating reduction after fixation. Multiple studies have demonstrated that traditional radiographic analysis fails to accurately identify syndesmotic diastasis, instability, or malreduction. Ankle arthroscopy has been proposed as an alternative way to evaluate the syndesmosis...
September 9, 2016: Foot & Ankle Specialist
Brian Dix, Lisa Grant-McDonald, Alan Catanzariti, Karl Saltrick
: This is a retrospective study (n = 39) evaluating the postoperative outcomes of patients with mild to moderate preoperative anemia who underwent a hindfoot and/or ankle arthrodesis. In the study, 32 patients did not have preoperative anemia, and 7 had preoperative anemia. Mortality, length of hospital stay, blood transfusions, deep-vein thrombosis, infection, time to union, malunion, delayed union, nonunion, and ulceration were of particular interest. Comparative analyses between patients with preoperative anemia and those without were performed utilizing the independent samples t-test or by the nonparametric Mann-Whitney U-test...
September 9, 2016: Foot & Ankle Specialist
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
: Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
September 9, 2016: Foot & Ankle Specialist
David Pomarino, Juliana Ramírez Llamas, Andrea Pomarino
: In the literature, there have been several studies that have analyzed and explained the characteristics of physiological gait in association with pathologies; however, finding information about normal gait pattern while barefoot is difficult. This study focuses on the differences in the barefoot gait between children and adolescents. A total of 320 healthy children and adolescent were recruited and divided into groups according to age: G1 (1-6 years), G2 (7-10 years), G3 (>11 years)...
September 9, 2016: Foot & Ankle Specialist
Toshinori Kurashige, Seiichi Suzuki
: Some authors reported the results from percutaneous distal metatarsal osteotomy for hallux valgus recently. On the other hand, there are few reports of percutaneous proximal metatarsal osteotomy. The purpose of the present study was to evaluate the radiographic results of percutaneous proximal closing wedge osteotomy with Akin osteotomy for correction of severe hallux valgus and increasing longitudinal arch height. Consecutive 17 feet (mean age = 70.8 years) were investigated. The mean follow-up was 22 months...
September 9, 2016: Foot & Ankle Specialist
Jeffrey E McAlister, Christopher F Hyer, Trevor E Black
: First metatarsophalangeal joint arthritis can stem from a biomechanical imbalance as in hallux abducto valgus, metabolic arthritidies such as rheumatoid or gout, and even in posttraumatic cases. Advanced arthritis in the foot and ankle can often become debilitating. Surgical intervention is often necessary. Revision of failed first metatarsophalangeal joint arthroplasty is often in the setting of bony erosion and lysis, cystic changes, and loss of bone stock. In this article, we describe first metatarsophalangeal distraction arthrodesis technique using tricortical calcaneus autograft with the aim of simplifying donor site graft harvesting and decreasing donor site morbidity while attaining successful osseous union...
September 9, 2016: Foot & Ankle Specialist
Christos Koutserimpas, George Magarakis, Grigoris Kastanis, George Kontakis, Kalliopi Alpantaki
: Calcaneal fractures are complex injuries with high complication rates and they can lead to serious disability. The proper management remains controversial and complications may occur regardless of the chosen type of treatment (operative or nonoperative). The present article reviews the studies that are related to the complications of calcaneal fractures. The incidence, the diagnosis, the prevention and the treatment of these complications were researched and analyzed, with the use of PubMed database, abstracts and original articles in English than investigate the etiology...
September 9, 2016: Foot & Ankle Specialist
Jessica Lee, Chad Williams, Charles Lowrey, Greg Gould, Ronald Markert, Richard Laughlin
: Introduction Flexor hallucis longus (FHL) tendon transfer to the calcaneus is commonly used in the surgical treatment of chronic Achilles tendinopathy. This study assesses the integrity of FHL tendon biotenodesis screw fixation with respect to 2 variables: incorporation of a terminal whipstitch and tunnel depth. Materials and methods A total of 60 fresh-frozen cadaver FHL tendons and 28 calcanei were harvested for analysis in 4 sets of fixation constructs; 14 whipstitched tendons were compared against their nonwhipstitched paired tendon via pull-out strength load testing, and 16 tendon pairs were randomized for fixation in either a full-depth tunnel (bicortical) or a 25-mm partial tunnel (unicortical)...
September 7, 2016: Foot & Ankle Specialist
Anil Agarwal, Anubrat Kumar, Abbas Shaharyar, Madhusudan Mishra
BACKGROUND: The aim of the study is to create awareness in the practicing health care workers toward the problems encountered during casting and bracing of clubfoot following Ponseti method, and in turn avoid them. MATERIAL AND PATIENTS: Retrospective audit of 6 years' clubfoot clinic records to analyze problems associated with Ponseti method. OBSERVATIONS: Problems were encountered in 26 cast and in 6 braced patients. Just 4 patients out of 71 syndromic (5...
September 7, 2016: Foot & Ankle Specialist
Rishin J Kadakia, Briggs M Ahearn, Shay Tenenbaum, Jason T Bariteau
: Introduction Ankle fractures are the third most common orthopaedic injury seen in the geriatric patient. Studies have identified mortality benefits with operative management, but treatment must be considered on a case-by-case basis. In the era of value-based analysis, a thorough of understanding of outcomes and costs of treatment is required. The purpose of this study was to analyze the inpatient and readmission costs associated with operative and nonoperative management of geriatric ankle fractures...
September 7, 2016: Foot & Ankle Specialist
Eric M Padegimas, David M Beck, David I Pedowitz
: The authors present a case of a previously healthy and athletic 17-year-old female who presented with a 3.5-year history of medial left ankle pain after sustaining an inversion injury while playing basketball. Prior to presentation, she had failed prior immobilization and physical therapy for a presumed ankles sprain. Physical examination revealed a dislocated posterior tibial tendon (PTT) that was temporarily reducible, but would spontaneously dislocate immediately after reduction...
September 7, 2016: Foot & Ankle Specialist
Christopher E Gross, Samuel B Adams, Mark Easley, James A Nunley, James K DeOrio
: Background Impingement may be an underreported problem following modern total ankle replacements (TARs). The etiology of impingement is unclear and likely multifactorial. Because of the lack of conservative treatment options for symptomatic impingement after TAR, surgery is often necessary. Methods We retrospectively identified a consecutive series of 1001 primary TARs performed between January 1998 and December 2014. We identified patients who required a secondary surgery to treat soft-tissue and bony impingement by either an open or arthroscopic procedure...
September 5, 2016: Foot & Ankle Specialist
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