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Yasin Yurt, Gül Şener, Yavuz Yakut
BACKGROUND: Foot orthoses are widely used in conservative treatment of painful flexible flatfoot however research is limited to choose the best option in orthotic treatment. AIM: We aimed to compare the effects of computer-aided design/computer-aided manufacturing (CAD-CAM) and conventional insole types in comparison with sham insole, on pain and health related quality of life in patients with painful flexible flatfoot. DESIGN: Randomized controlled trial...
March 16, 2018: European Journal of Physical and Rehabilitation Medicine
Zhongkui Wang, Masamitsu Kido, Kan Imai, Kazuya Ikoma, Shinichi Hirai
Clinically in medializing calcaneal osteotomy (MCO), foot and ankle surgeons are facing difficulties in choosing appropriate surgical parameters due to the individual differences in deformities among flatfoot patients. Traditional cadaveric studies have provided important information regarding the biomechanical effects of tendons, ligaments, and plantar fascia, but limitations have been reached when dealing with individual differences and tailoring patient-specific surgeries. Therefore, this study aimed at implementing the finite element (FE) method to investigate the effect of different MCO parameters to help foot and ankle surgeons performing patient-specific surgeries...
March 15, 2018: Computer Methods in Biomechanics and Biomedical Engineering
Tulio Diniz-Fernandes, Alexandre Leme Godoy-Santos, Maria Cristina Santo, Pedro Pontin, Caio Augusto Alves Pereira, Yuri Justi Jardim, Ana Paula Pereira Velosa, Nicola Maffulli, Walcy Rosolia Teodoro, Vera Luiza Capelozzi
Posterior tibial tendinopathy (PTT) can lead to acquired flatfoot in adults. Many patients develop PTT without any identifiable risk factors. Molecular changes in extracellular matrix (ECM) and matrix metalloproteinase (MMP) polymorphism may influence the risk of developing PTT. We aim to investigate the association between matrix metalloproteinase-1 (MMP-1) and (MMP-8) gene polymorphisms with changes in collagen I, III and V in PTT. A case-control study with 22 patients and 5 controls was performed. The MMP-1 (2G/2G) and MMP-8 (T/T) genotypes were determined by PCR-restriction fragment length polymorphism...
March 13, 2018: Histology and Histopathology
Jichao Yin, Hongmou Zhao, Guihua Zhuang, Xiaojun Liang, Xinglv Hu, Yi Zhu, Rongqiang Zhang, Xiaochen Fan, Yi Cao
BACKGROUND: This cross-sectional study aims to investigate the flexible flatfoot (FFF) prevalence and related factors in school-aged children. METHODS: A total of 1059 children aged 6-13 years were included. Dynamic footprints according to the FootScan system were collected from both feet. The relationship of FFF with age, gender, side, and body mass index (BMI) was investigated. RESULTS: FFF percentage decreased from 39.5% at 6 years to 11...
February 27, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jeffrey Wake, Kevin Martin
Adult acquired flatfoot deformity (AAFD), formerly known as posterior tibial tendon (PTT) dysfunction, is one of the most common problems of the foot and ankle. It was first described as tendon failure but has since been revealed as ligamentous failure in addition. AAFD is a spectrum of deformities that ranges from tenosynovitis (stage I) to AAFD (stages II-IV). Regarding mild stage I and stage II disease, it was once standard to perform an open synovectomy completely removing the inflamed synovium; this procedure required a large 6-cm medial ankle incision...
October 2017: Arthroscopy Techniques
Antonio Viladot Voegeli, Nicolás Fontecilla Cornejo, Juan Andrés Serrá Sandoval, Fernando Alvarez Goenaga, Ramón Viladot Pericé
BACKGROUND: The aim of the study was to evaluate the clinical and radiological results obtained in the treatment of adult flexible flatfoot secondary to posterior tibial dysfunction with subtalar arthroereisis using a Kalix ® endorthesis. METHODS: 35 patients (37 feet) were studied, having been operated between January 2010 and January 2015 for reducible flatfoot secondary to posterior tibial tendon dysfunction stage IIA1 of Bluman. RESULTS: The average follow up was 47...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
P Ceccarini, G Rinonapoli, G Gambaracci, M Bisaccia, A Ceccarini, A Caraffa
BACKGROUND: To report on the functional, biomechanical, and radiographic results of patients who had undergone arthroereisis plus tensioning of the posterior tibial tendon for flexible flatfoot. The hypothesis is that arthroereisis associated to a tensioning of the posterior tibial tendon give a good correction with great satisfaction in patients with flexible flatfoot in grade IIA. METHODS: We evaluated 29 patients (31 feet), mean age of 46.4 years, who had been surgically treated for adult flatfoot grade IIA according to Myerson...
April 14, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Federico Canavese, Alain Dimeglio, François Bonnel
BACKGROUND: Several anatomical studies have shown that the articular facets of the calcaneus can present with different anatomy. This study assessed the 3D anatomy of lateral calcaneal lengthening (LCL) osteotomy in relation to the anterior and middle facet of the calcaneus in a group of skeletally immature patients treated for symptomatic flatfoot deformity. METHODS: During the study period, 14 consecutive patients (10 males, 4 females) presenting symptomatic flatfoot (20 feet) with different aetiologies underwent LCL osteotomy and CT scan with 3D reconstruction of the operated feet...
June 3, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Grace C Kunas, William Probasco, Amgad M Haleem, Jayme C Burket, Emilie R C Williamson, Scott J Ellis
BACKGROUND: The aim of this study was to assess the inferior talus-superior talus (inf-tal-sup-tal) angle (previously proven reliable in multiplanar-weight bearing imaging (MP-WB)) on both computed tomography (CT) and MP-WB scans. We sought to compare the angle between the two modalities in both AAFD and control groups, as well as to compare the groups to each other. METHODS: Inf-tal-sup-tal angles were compared between a stage II AAFD group (n=38) with routine MP-WB and CT scans and a control group (n=20) with preoperative CT scans for lisfranc injuries and normal hindfoot alignment after healing...
June 12, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Charlie Michaudet
Pes planus or pes planovalgus (ie, flatfoot) is a common condition among young children and also is encountered in adults. In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing. In rigid pes planus, the arch remains stiff and collapsed with or without weight bearing. Patients with rigid pes planus should be referred for subspecialist treatment...
February 2018: FP Essentials
Wesley Zhang Yang, Joseph S Park, Seth Robert Yarboro
CASE: A 47-year-old Caucasian woman spontaneously developed an isolated anterior compartment pressure of >100 mm Hg in the left leg. Despite fasciotomies, the musculature was nonviable and required debridement. Following Achilles tendon lengthening, a posterior tibial tendon (PTT) to anterior tibial tendon (ATT) transfer was supplemented with a flexor digitorum longus tendon transfer to the remaining PTT in order to prevent a flatfoot deformity while restoring active dorsiflexion. CONCLUSION: Preservation of the tendinous portion of the ATT during debridement allowed for transfer of the PTT to the ATT using a modified Pulvertaft transfer...
January 24, 2018: JBJS Case Connector
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Giovanni Romeo, Gaetano Bulfamante, Massimo Galia, Luca Maria Sconfienza
OBJECTIVE: To investigate the correlation between MRI, clinical tests, histopathologic features of posterior tibial tendon (PTT) dysfunction in patients with acquired adult flatfoot deformity surgically treated with medializing calcaneal osteotomy and flexor digitorum longus tendon transposition. MATERIALS AND METHODS: Nineteen patients (11 females; age: 46 ± 15 year, range 18-75) were pre-operatively evaluated using the single heel rise (HR) and the first metatarsal rise (FMR) sign tests...
February 2018: European Journal of Radiology
E von Stillfried
Most deformities of the foot are visible at birth and can be diagnosed without imaging. They can be divided into congenital flexible, congenital structural and acquired foot deformities. The most common congenital flexible foot deformity in children is the metatarsus adductus, which usually requires no long-term therapy. Regarding congenital structural deformities, such as the clubfoot and talus verticalis, plaster therapy should be started during the first week of life, so that by the end of the first year of life and the beginning of the verticalization, a pain-free resilient foot with normal function is present...
January 17, 2018: Der Radiologe
Cesare Faldini, Antonio Mazzotti, Alessandro Panciera, Valentina Persiani, Francesco Pardo, Fabrizio Perna, Sandro Giannini
PURPOSE: Results of subtalar arthroereisis in flexible flatfoot have been mainly reported in the literature using clinical or radiographical findings. However, the aim of this study is to evaluate the patient-perceived quality of life using self-reported questionnaires after subtalar arthroereisis using a bioabsorbable implant. METHODS: Italian modified FFI and the SEFAS scores were submitted to a consecutive series of 173 patients who underwent surgical treatment for flatfoot deformity using a bioabsorbable endo-orthotic implant...
January 3, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Andrew J Meyr, Laura E Sansosti, Sayed Ali
This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for elective reconstruction of the midfoot and rearfoot with focus on the flatfoot deformity. Our goal is to demonstrate objective radiographic parameters that surgeons utilize to initially define the deformity, lead to procedure selection, and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries...
June 2017: Journal of Radiology Case Reports
JunNa Zhai, Jue Wang, YuSheng Qiu
BACKGROUND: Orthotic insole is one popular physiotherapy for flatfoot. However, the effects and if flexible flatfoot needs the treatment are not clear and how the plantar pressure change while walking upstairs and downstairs had not been studied. This study observed the plantar pressure of different walking condition to find out the answers. METHODS: Fifteen adults with flexible flatfoot and fifteen adults with normal foot were examined while walking on a level surface, walking up and down 10 cm and 20 cm stairs before treatment...
December 15, 2017: Journal of the American Podiatric Medical Association
Dariusch Arbab, Daniel Frank, Bertil Bouillon, Christian Lüring, Carsten Wingenfeld, Mona Abbara-Czardybon
BACKGROUND: The purpose of this study was to determine the functional outcomes and radiographic results of the talus-stop screw method as minimally invasive subtalar arthroereisis in pediatric and juvenile flexible flatfoot. MATERIAL AND METHODS: We retrospectively evaluated 73 feet from 41 children using the talus stop-screw method, for the period between 2002 and 2011. The age at time of surgery ranged between nine and 14 years. The radiological assessment included measuring the calcaneal pitch, talar declination, talo-first metatarsal angle (Meary) and calcaneal-first metatarsal angle (Costa-Bartani) in the lateral view...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Toshinori Kurashige
In recent years, some authors have reported accessory anterolateral talar facet impingement with flatfoot including peroneal spastic flatfoot. Conversely, to our knowledge, no case report has been published about accessory anterolateral talar facet impingement with tibialis spastic varus foot. We report the first case in a 22-year-old man with intellectual disability, bilateral cleft hands and type 1 diabetes mellitus. Since spraining his left ankle over a year earlier, he experienced left sinus tarsi pain while standing and walking...
2017: SAGE Open Medical Case Reports
Alessio Bernasconi, François Lintz, Francesco Sadile
Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults.It has been described as a standalone or adjunctive procedure, and is indicated in the treatment of flexible flatfoot, tibialis posterior tendon dysfunction, tarsal coalition and accessory navicular syndrome.Different devices for subtalar arthroereisis are currently used throughout the world associated with soft-tissue and bone procedures, depending on the surgeon rather than on standardised or validated protocols...
November 2017: EFORT open reviews
Tulaya Prachgosin, Wipawan Leelasamran, Pruittikorn Smithmaitrie, Surapong Chatpun
BACKGROUND: Total-contact orthosis (TCO) is one kind of foot orthosis (FO) that is used to adjust biomechanics in flexible flatfoot. OBJECTIVE: To determine the effects of a TCO on the MLA moment, MLA deformation angle and lower limb biomechanics. STUDY DESIGN: Cross-sectional study. METHODS: Seven-flatfoot and thirteen-normal foot subjects were recruited by footprint and radiographs. The biomechanics of subjects with normal foot (NF), flatfoot with shoe only (FWOT) and flatfoot with TCO (FWT) were collected in a 3D motion analysis laboratory and force plates...
December 2017: Prosthetics and Orthotics International
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