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Foot & Ankle Specialist

Joseph Tracey, Danny Arora, Christopher E Gross, Selene G Parekh
BACKGROUND: Third generation total talar prostheses (TTPs) are viable options for talar avascular necrosis (AVN) in the absence of neighboring joint pathology. The use of modern three-dimensional (3D) printing allows the production of custom implants that exactly mimic the patient's anatomy. The aim of this study is to determine the accuracy of 3D printing in reproducing a synthetic talus and, in doing so, restoring more normal anatomical relationships. We hypothesize that this mode of replication will restore and maintain normal radiographic alignment of the ankle, subtalar, and forefoot joints in the setting of talar AVN...
March 1, 2018: Foot & Ankle Specialist
Bradley Wills, Sung Ro Lee, Parke William Hudson, Bahman SahraNavard, Cesar de Cesar Netto, Sameer Naranje, Ashish Shah
BACKGROUND: Calcaneal osteotomy is a commonly used surgical option for the correction of hindfoot malalignment. A previous cadaveric study described a neurological "safe zone" for calcaneal osteotomy. We performed a retrospective chart review to evaluate the presence of neurological injuries following calcaneal osteotomies and the location of the osteotomy in relation to the reported safe zone. METHODS: In this retrospective study, we reviewed charts of patients who underwent calcaneal osteotomy at our institution from 2011 to 2015...
March 1, 2018: Foot & Ankle Specialist
Valerie S Marmolejo, Jonathan F Arnold
Heel ulcerations are a significant burden of care in both hospital and long-term care settings. The presence of peripheral arterial disease as a contributing factor to delayed healing is often not recognized, resulting in prolonged healing and high patient morbidity and mortality. Formal vascular evaluation and intervention is often not performed as these patients can have palpable pedal pulses while having localized ischemia of the heel. As routine noninvasive vascular studies can be affected by medial calcinosis and collateralization and do not specifically assess tissue perfusion to the heel, a false sense of security of adequate perfusion for healing can result...
March 1, 2018: Foot & Ankle Specialist
Takumi Matsumoto, Christopher E Gross, Selene G Parekh
Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively...
March 1, 2018: Foot & Ankle Specialist
Peter Kameel Garas, Steven Thomas DiSegna, Abhay R Patel
BACKGROUND: Arthrodesis of the first tarsal metatarsal joint can be accomplished in many ways. The compressive force attained between various constructs remains unclear. This study compares compression achieved through a locking/compression Lapidus plate both with and without the addition of a lag screw. METHODS: A dorsal medial Lapidus/locking compression plate (Total Compression Plate System, OrthoPro, Salt Lake City, UT, now Wright Medical) was applied to one cadaveric limb, while the same plate with the addition of a 4...
February 1, 2018: Foot & Ankle Specialist
James Gwosdz, Lattisha Bilbrew, Daniel Jupiter, Vinod Panchbhavi
BACKGROUND: Ankle blocks are used in the ambulatory surgery setting to control postoperative pain, which is often worst in the first 24 hours after surgery. We conducted a trial to determine whether the timing of ankle block administration in relation to ankle tourniquet inflation has an effect on perceived pain and narcotic consumption. METHODS: A prospective randomized study was conducted between August 2015 and January 2016. Patients were assigned to three groups...
January 1, 2018: Foot & Ankle Specialist
Mark A Prissel, Justin L Daigre, Roberto A Brandão, Terrence M Philbin, Christopher F Hyer, Gregory C Berlet
Fractures of the distal fibula secondary to rotational ankle injuries are one of the most common injuries requiring surgical intervention. The aim of this study was to describe the anatomy of the distal fibular medullary canal as a means of aiding in surgical management with an intramedullary device. Twenty fresh cadaveric below-knee specimens (group 1, 10 in 2015, group 2, 10 in 2016) were dissected to expose the distal fibular. Fifteen (10 mm each) segments were sectioned with a sagittal saw from the distal tip proximally and measured with a digital caliper...
January 1, 2018: Foot & Ankle Specialist
Ali A Anaim
BACKGROUND: Ankle tendon augmentation with biological matrixes has been shown to be beneficial, especially for Achilles tendon rupture as it adds to the integrity of the repair. Biologic matrix augmentation has been used increasingly in chronic and complex injuries where reinforcement is required. The objective of this study was to present outcomes of a series of patients who underwent tendon repair augmented with a new biologic matrix. METHODS: Sixteen patients underwent ankle tendon repair, augmented with Proformix biologic tissue matrix...
January 1, 2018: Foot & Ankle Specialist
Cpt Zachary L McBeth, Maj Joseph W Galvin, Ltc Justin Robbins
When insertional Achilles tendinopathy is addressed surgically via a central-Achilles splitting approach, the calcaneal osteotomy has classically been performed from distal to proximal. We describe a simple proximal to distal technique that allows optimal resection of both the calcaneal exostosis and Achilles enthesophyte, minimizes risk to the soft tissues and skin, provides a bony attachment surface parallel to the axis of the Achilles tendon, and avoids the risk of osteotomy extension into the subtalar joint...
January 1, 2018: Foot & Ankle Specialist
Elisabeth Ellingsen Husebye, Marius Molund, Kjetil Harald Hvaal, Are Haukåen Stødle
BACKGROUND: Chronic Achilles tendon ruptures can lead to reduced power of plantar flexion in the ankle with impaired gait ability. The open 1- or 2-incision technique for flexor hallucis longus transfer has proven good functional outcome but has the disadvantage of relatively extensive surgery performed at a vulnerable location. To reduce the risk of soft tissue problems, the flexor hallucis longus transfer can be performed endoscopically. MATERIAL AND METHOD: An endoscopic technique for flexor hallucis longus transfer is presented together with the experiences from the first six patients operated with this method...
January 1, 2018: Foot & Ankle Specialist
Jemma H Matthews, Alexander J Terrill, Alex L Barwick, Paul A Butterworth
BACKGROUND: The extent to which podiatric surgeons follow venous thromboembolism guidelines is unknown. The aim of this study therefore, was 2-fold: (a) to determine the rate of venous thromboembolism following podiatric surgery and (b) to investigate the factors that influence the use of thromboprophylaxis. METHODS: Data from 4238 patients who underwent foot and ankle surgery over 2 years were analyzed. Venous thromboembolism within the first 30 days following surgery was recorded using the Australasian College of Podiatric Surgeons surgical audit tool...
January 1, 2018: Foot & Ankle Specialist
Steven K Neufeld, John J Marcel, Michael Campbell
BACKGROUND: A Ludloff osteotomy is a common procedure used to correct hallux valgus deformities. Traditionally, the osteotomy is stabilized with screws only, thus requiring the patient to be non-weight bearing until healed. There have been no outcome studies analyzing immediate weight bearing after Ludloff osteotomy for hallux valgus. METHODS: Of the 350 patients (390 feet) who underwent a Ludloff osteotomy fixed with a locking plate and prescribed an immediate weight-bearing postoperative protocol, 288 patients (326 feet) were included in the analysis...
January 1, 2018: Foot & Ankle Specialist
Shi Ming Tan, Hamid Rahmatullah Bin Abdul Razak, Inderjeet Singh Rikhraj
BACKGROUND: Few studies have outlined the outcomes and complications in Asians undergoing total ankle arthroplasty. This study reports the functional, radiological outcomes and satisfaction rates in our Asian population. METHODS: Patients who underwent primary total ankle arthroplasty from 2007 to 2013 were recruited. Outcomes evaluated were the AOFAS Ankle-Hindfoot Score (AHS), Visual Analogue Scale(VAS), and the Short Form 36 (SF-36)questionnaire. Outcome scores were collected prospectively up to 2 years...
January 1, 2018: Foot & Ankle Specialist
Paul Carroll, Robert M Henshaw, Caitlin Garwood, Katherine Raspovic, Dhruv Kumar
Plantar fibromatosis (morbus Ledderhose), an extra-abdominal desmoid tumor of the plantar foot, is a rare benign hyperproliferative disorder of the plantar fascia with an unknown etiology. The main clinical characteristics include slow growing nodules on the medial and central bands of the plantar fascia, which may become painful and negatively affect ambulation. Most established conservative therapies today target symptomatic relief. As symptoms progress, therapies such as injections, shockwave ablation, radiation, and/or surgery may be required...
January 1, 2018: Foot & Ankle Specialist
Xavier Paredes-Carnero, Antonio María Fernández-Cebrián, Silvia Villardefrancos-Gil
PURPOSE: To determine if the postoperative alignment of the hallux influences the final clinical outcome of hallux metatarsophalangeal joint (first MTPJ) arthrodesis. METHODS: A total of 71 consecutive cases (hallux rigidus) were studied in stages 3 and 4. They were operated through arthrodesis between 2008 and 2014. The follow-up mean was 7.3 years. The AOFAS (American Orthopaedic Foot and Ankle Society) test was performed preintervention and per annum. In radiology, both the hallux valgus angle and the dorsiflexion angle of the first MTPJ were studied...
January 1, 2018: Foot & Ankle Specialist
Ercan Şahin, Mahmut Kalem
OBJECTIVES: To evaluate the costs and efficacy of radiographs taken in the third week after fixation of bimalleolar and trimalleolar fractures. PATIENTS AND METHOD: A retrospective evaluation was made of patients who underwent surgical fixation because of bimalleolar and trimalleolar fractures between January 1, 2008, and October 1, 2013. Patient demographics (age, gender, body mass index), fracture type, follow-up periods, and fixation methods were recorded, and the radiographs taken on postoperative day 1, at 3 weeks, 6 weeks, and the final follow-up were examined by 2 orthopedists...
January 1, 2018: Foot & Ankle Specialist
Harry M Lightsey, Peter C Noback, Jon-Michael E Caldwell, David P Trofa, Justin K Greisberg, J Turner Vosseller
BACKGROUND: Substantial progress has been made in characterizing the benefit of early functional rehabilitation following Achilles tendon repair (ATR). However, standardized ATR rehabilitation guidelines have yet to be produced. Furthermore, as patients increasingly use the Internet to independently retrieve health care content, access to standardized, clinically effective rehabilitation protocols is necessary. METHODS: Online ATR physical therapy protocols from US academic orthopaedic programs were reviewed...
January 1, 2018: Foot & Ankle Specialist
Silvia Valisena, Gianfranco John Petri, Andrea Ferrero
BACKGROUND: Several techniques for repair of tibialis anterior tendon ruptures (TATRs) are reported, although it is a rare lesion. We describe a case of TATR, discuss our treatment, and review the criteria for the choice of treatment. METHODS: In November 2015, a 61-year-old woman presented to our department 13 days after an injury to her left ankle, with avulsion of TAT. Because of the stump retraction, we performed a Zancolli-like plasty, anchoring the tendon to the navicular bone...
January 1, 2018: Foot & Ankle Specialist
Sabine Krenn, Sascha Albers, Peter Bock, Clemens Mansfield, Michel Chraim, Hans-Joerg Trnka
BACKGROUND: Minimally invasive surgery has a shorter surgical time, and in this study we focus on minimally invasive distal metatarsal metaphyseal osteotomy (DMMO). The operation seems to be less complex but requires a high learning curve. We report on our first patients to underline the need for extensive training and great awareness for the risks in the early learning stages. METHODS: We evaluated 27 patients (mean age = 60.9 years) with a mean follow-up time of 7...
January 1, 2018: Foot & Ankle Specialist
Kenneth J Hunt, Peter Mangone, Minton Truitt Cooper, Stephen A Brigido, Minton Truitt Cooper
No abstract text is available yet for this article.
February 2018: Foot & Ankle Specialist
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