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Mika T Nevalainen, Johannes B Roedl, Adam C Zoga, William B Morrison
Arthroereisis is a rare and disputed procedure, where an implant screw is inserted into the sinus tarsi to treat flatfoot deformity. Weight-bearing radiographs are the most essential examinations to assess the correct localization and related measurements. Hardware loosening is the most common complication seen as localized lucency and as dislocation of the implant. Computed tomography yields superior resolution with reconstruction capabilities. On magnetic resonance imaging, the implant appears as a dark signal focus on T1 and T2-weighted images with a hyperintense T2-signal rim...
December 2016: Radiology case reports
Youichi Yasui, Ichiro Tonogai, Andrew J Rosenbaum, David M Moore, Masato Takao, Hirotaka Kawano, John G Kennedy
PURPOSE: Early stage adult acquired flatfoot deformity (AAFD) is traditionally treated with osteotomy and tendon transfer. Despite a high success rate, the long recovery time and associated morbidity are not sufficient. This study aims to evaluate the functional and radiological outcomes following the use of the arthroereisis screw with tendoscopic delivered PRP for early stage AAFD. METHODS: Patients with stage IIa AAFD who underwent the use of the arthroereisis screw with tendoscopic delivered PRP with a minimum follow-up time of 24 months were retrospectively evaluated...
November 24, 2016: International Orthopaedics
Amol Saxena, Rajan Patel
Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Yang Xu, Xing-Chen Li, Xiang-Yang Xu
BACKGROUND: The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS: Data were analyzed for 16 patients (20 feet) who had flatfoot without tibialis posterior tendon dysfunction and were treated by calcaneal Z osteotomy combined with arthroereisis between October 2011 and February 2015...
November 2016: Foot & Ankle International
C Lux-Battistelli, C Muller, J Moragny, T Henquinet
BACKGROUND: Formic acid 85% constitutes the active substance of a new wart removal agent marketed in France under the name of Objectif ZeroVerrue(®), a product sold over-the-counter for adults and children aged over four years, and on a doctor's recommendation for children aged under four years. Its mechanism of action may involve cellular destruction through dehydration. PATIENTS AND METHODS: Herein we report two cases of cutaneous necrosis following application of formic acid 85%...
August 2016: Annales de Dermatologie et de Vénéréologie
James B Carr, Scott Yang, Leigh Ann Lather
Flatfoot (pes planus) is common in infants and children and often resolves by adolescence. Thus, flatfoot is described as physiologic because it is usually flexible, painless, and of no functional consequence. In rare instances, flatfoot can become painful or rigid, which may be a sign of underlying foot pathology, including arthritis or tarsal coalition. Despite its prevalence, there is no standard definition for pediatric flatfoot. Furthermore, there are no large, prospective studies that compare the natural history of idiopathic, flexible flat feet throughout development in response to various treatments...
March 2016: Pediatrics
Amol Saxena, Alessio Giai Via, Nicola Maffulli, Haywan Chiu
Subtalar joint arthroereisis (STA) can be used in the management of adult acquired flatfoot deformity (AAFD), including posterior tibial tendon dysfunction. The procedure is quick and normally causes little morbidity; however, the implant used for STA often needs to be removed because of sinus tarsi pain. The present study evaluated the rate and risk factors for removal of the implant used for STA in adults treated for AAFD/posterior tibial tendon dysfunction, including patient age, implant size, and the use of endoscopic gastrocnemius recession...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ettore Vulcano, Camilla Maccario, Mark S Myerson
The most difficult aspect regarding treatment of the pediatric flatfoot is understanding who needs surgery, when it is necessary, and what procedure to be done. A thorough history, clinical examination, and imaging should be performed to guide the surgeon through an often complex treatment path. Surgical technique can be divided in three categories: Soft tissue, bony, and arthroereisis. This paper will describe the joint preserving techniques and their application to treat the pediatric flatfoot deformity.
January 18, 2016: World Journal of Orthopedics
Fırat Ozan, Fatih Doğar, Kürşat Gençer, Şemmi Koyuncu, Fatih Vatansever, Fuat Duygulu, Taşkın Altay
Flexible flatfoot is a common deformity in pediatric and adult populations. In this study, we aimed to evaluate the functional and radiographic results of subtalar arthroereisis in adult patients with symptomatic flexible flatfoot. We included 26 feet in 16 patients who underwent subtalar arthroereisis for symptomatic flexible flatfoot. Radiographic examination included calcaneal inclination angle, lateral talocalcaneal angle, Meary's angle, anteroposterior talonavicular angle, and Kite's angle. The clinical assessment was based on the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale and a visual analog scale (VAS)...
2015: Therapeutics and Clinical Risk Management
Cesare Faldini, Matteo Nanni, Francesco Traina, Daniele Fabbri, Raffaele Borghi, Sandro Giannini
PURPOSE: During growth, hallux valgus could present associated with flatfoot. Considering the current disagreement about correction of hallux valgus during growth and the lack of reports about simultaneous correction of hallux valgus associated with flexible flatfoot, we present simultaneous treatment of both deformities during growth combining subtalar arthroeresis and SERI first metatarsal osteotomy, reporting results at an average five-year follow-up. METHODS: Thirty-two children (64 feet, age range 8-12 years) affected by hallux valgus associated with flexible flatfoot underwent surgical treatment combining SERI first metatarsal osteotomy and subtalar arthroereisis with bioabsorbable endorthotic implant...
April 2016: International Orthopaedics
Nicolò Martinelli, Giovanni Romeo, Carlo Bonifacini, Marco Viganò, Alberto Bianchi, Francesco Malerba
PURPOSE: The purpose of this study was to translate the Oxford Ankle Foot Questionnaire (OAFQ) into Italian, to perform a cross-cultural adaptation and to evaluate its psychometric properties. METHODS: The Italian OAFQ was developed according to the recommended forward/backward translation protocol and evaluated in pediatric patients treated for symptomatic flatfoot deformity. Feasibility, reliability, internal consistency, construct validity [comparing OAFQ domains with Child Health Questionnaire (CHQ) domains] and responsiveness to surgical treatment were assessed...
January 2016: Quality of Life Research
David Y Chong, Bruce A Macwilliams, Theresa A Hennessey, Noelle Teske, Peter M Stevens
We prospectively compared subtalar arthroereisis with lateral column calcaneal lengthening for the treatment of painful flatfeet. Twenty-four feet (mean age of patients 12.8 years) were treated. Kinematic motion analysis, pedobarometry, and radiography were performed, and the Oxford Ankle-Foot Questionnaire for Children was administered for each patient before surgery and at the 1-year follow-up. We found statistically significant improvements in both groups, with no difference in their outcomes. Both groups showed significantly improved hindfoot and midfoot motion and positioning...
July 2015: Journal of Pediatric Orthopedics. Part B
Neil S Shah, Richard L Needleman, Omaima Bokhari, David Buzas
BACKGROUND: Subtalar arthroereisis (SA) has been a procedure used for the correction of painful flexible flatfoot deformity in adults and children. Clinical studies of patients who had a SA are sparse and with mixed results and variable indications. The purpose of this study was to determine the current practice among orthopaedic foot and ankle specialists regarding SA. METHODS: Web-based questionnaires were e-mailed to members of the American Orthopaedic Foot and Ankle Society (AOFAS)...
June 2015: Foot & Ankle Specialist
K Trieb, T Fingernagel, A Petershofer, S G Hofstaetter
Flexible flatfoot is a common malalignment in the paediatric population. Arthroereisis with a calcaneo-stop screw is an effective surgical procedure for treating juvenile flexible flatfoot after conservative measures have been fully exploited. In the present report, we describe the case of a loosening of a calcaneo-stop screw in a 12-year-old youth after excessive trampolining.
June 2015: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
E Toullec
Adult flatfoot is defined as a flattening of the medial arch of the foot in weight-bearing and lack of a propulsive gait. The 3 lesion levels are the talonavicular, tibiotarsal and midfoot joints. The subtalar joint is damaged by the consequent rotational defects. Clinical examination determines deformity and reducibility, and assesses any posterior tibialis muscle deficit, the posterior tibialis tendon and spring ligament being frequently subject to degenerative lesions. Radiographic examination in 3 incidences in weight-bearing is essential, to determine the principal level of deformity...
February 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
N Tarissi, A Vallée, F Dujardin, F Duparc, X Roussignol
INTRODUCTION: Subtalar arthroereisis corrects childhood and adult reducible valgus flat-foot in certain indications. Inserting an expansion screw in the sinus tarsi simultaneously corrects the calcaneal valgus of the talocalcaneal divergence and first-ray pronation if these are reducible. The displacement induced in the posterior subtalar joint (decoaptation, translation, rotation) is, however, poorly known. The present study involved arthroscopic assessment of posterior subtalar joint surface displacement during insertion of a talocalcaneal arthroereisis screw, with the hypothesis that displacement varies in three dimensions according to screw size...
December 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
Maurizio De Pellegrin, Désirée Moharamzadeh, Walter Michael Strobl, Rainer Biedermann, Christian Tschauner, Thomas Wirth
PURPOSE: The aim of this study was to describe a subtalar extra-articular screw arthroereisis (SESA) technique for the correction of flexible flatfoot (FFF) in children and report the outcome. METHODS: From 1990 to 2012, data were collected on 485 patients who underwent SESA at the San Raffaele Hospital. The average age of the patient cohort was 11.5 ± 1.81 years (range 5.0-17.9 years; median 11.5 years). Inclusion criteria were FFF and marked flexible hindfoot valgus, and the exclusion criterion was rigid flatfoot...
December 2014: Journal of Children's Orthopaedics
Vishwajeet Kumar, T M Clough
Subtalar arthroereisis is a technique for treating symptomatic flexible flatfeet by means of inserting an implant or stent into the sinus tarsi. The goals are to reduce pain, deformity and instability of the foot. However, there are recognised complications associated with this technique which include malposition of the implant, undercorrection/overcorrection of the deformity, persistent sinus tarsi pain, deep medial heel pain, foreign body synovitis, avascular necrosis of the talus, intraosseous cystic formation in the talus, migration of the implant, device extrusion and subtalar joint arthrosis...
December 2014: Foot
Yuan Zhu, Xiang-Yang Xu
UNLABELLED: The role of arthroereises in the treatment of adult acquired flatfoot deformity (AAFD) has been controversial. This study aims to evaluate the outcome of subtalar arthroereisis in treating stage II AAFD. A total of 24 feet with stage II AAFD were treated surgically between 2009 and 2011 using subtalar arthroereisis. The average follow-up was 29.7 months (range = 24 to 35 months). The average postoperative AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot Scale score was 85...
June 2015: Foot & Ankle Specialist
James Flynn, Allison Wade, Jorge Bustillo, Paul Juliano
BACKGROUND: The bridle procedure is a tritendon anastomosis between the tibialis posterior, peroneus longus, and tibialis anterior, utilized in the treatment of drop foot. Concerned about the potential for acquired flatfoot deformity following the bridle procedure, the authors hypothesized that placing a sinus tarsi implant would prevent this potential sequela. MATERIALS AND METHODS: Over a 10-year period, 15 patients (16 feet) were treated with a bridle procedure for drop foot, and 9 of these feet also had a subtalar arthroereisis implanted; 8 patients (9 feet) positively responded to requests for long-term follow-up evaluation and returned for subjective evaluation with the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Scale and Short Form (SF)-36 forms and objective clinical and radiographic measurements...
February 2015: Foot & Ankle Specialist
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