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Foot and ankle orthopaedics

Paolo Ceccarini, Giuseppe Rinonapoli, Enrico Sebastiani, Michele Bisaccia, Alfredo Ceccarini, Auro Caraffa
The treatment of hammer toe has been advocated for years, and many procedures have been proposed with skeletal and soft tissue intervention. The purpose of the present study was to compare arthrodesis of the proximal interphalangeal joint with shortening osteotomy of the proximal phalanx neck. In most cases, both procedures have been associated with elongation of the extensor apparatus, capsulotomy of the metatarsophalangeal joint, and stabilization with a Kirschner wire. To experiment with a technique that respects the anatomy and joint function, we used a distal subtraction osteotomy of the proximal phalanx neck...
December 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ryosuke Nakagawa, Satoshi Yamaguchi, Seiji Kimura, Aya Sadamasu, Yohei Yamamoto, Yuta Muramatsu, Yasunori Sato, Ryuichiro Akagi, Takahisa Sasho, Seiji Ohtori
BACKGROUND: The purpose of this study was to clarify the 2-year clinical and radiological outcomes of nonoperative treatment using foot orthosis for hallux valgus patients. METHODS: Patients who underwent nonoperative treatment using foot orthosis were surveyed prospectively. Foot orthoses were made by one certified orthotist using the standardized method. Pain and quality of life were evaluated using subjective and objective assessment measures at 3, 6, 12, 18, and 24 months...
November 30, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Dhong Won Lee, In Keun Park, Min Jeong Kim, Woo Jong Kim, Min Soo Kwon, Sung Jin Kang, Jin Goo Kim, Young Yi
INTRODUCTION: Although clinical results of anatomic reconstruction using allograft are reportedly good, studies on how accurately the tunnel has been made after surgery are very rare. The purpose of this study was to analyze the postoperative locations of the tunnels through 3-dimensional computed tomography (3D-CT) after anatomic ligament reconstruction and to evaluate its clinical results. HYPOTHESIS: We hypothesized that anatomic lateral ligament reconstruction could lead to excellent results in clinical outcomes by repositioning anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) accurately...
November 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yoshiharu Shimozono, Eoghan T Hurley, Charles L Myerson, Christopher D Murawski, John G Kennedy
BACKGROUND: Operative treatment is indicated for unstable syndesmosis injuries, and approximately 20% of all ankle fractures require operative fixation for syndesmosis injuries. PURPOSE: To perform a meta-analysis of randomized controlled trials evaluating clinical outcomes between suture button (SB) and syndesmotic screw (SS) fixation techniques for syndesmosis injuries of the ankle. STUDY DESIGN: Meta-analysis. METHODS: A literature search was performed according to the PRISMA guidelines to identify randomized controlled trials comparing the SB and SS techniques for syndesmosis injuries...
November 26, 2018: American Journal of Sports Medicine
Mustafa Urguden, Ismail Ayder Gulten, Osman Civan, Hakan Bilbasar, Cagri Kaptan, Ali Cavit
BACKGROUND: The aim of this study was to evaluate the role of tendoscopy in the diagnosis and treatment of peroneal tendon (PT) pathologies, and to evaluate the results of our technical modification. METHODS: Twenty ankles of 18 patients with retrofibular pain, operated on between 2006 and 2012, were included in this study. Peroneal tendoscopy was performed diagnostically for the patients who were diagnosed as having "peroneal tendinopathy" with physical examination, x-ray, or magnetic resonance imaging (MRI)...
November 22, 2018: Foot & Ankle International
Tao Yu, Yunfeng Yang, Bing Li, Sanjaya Sah, Kai Chen, Guangrong Yu
To report the clinical efficacy of open reduction and internal fixation (ORIF) assisted by medial distraction for intra-articular calcaneus fractures. From September 2010 to November 2013, 151 patients with intra-articular calcaneus fractures were treated at our department by ORIF. They were 95 men and 56 women, 18 to 69 years of age. According to the Sanders classification, there were 24 cases of type II, 76 ones of type III and 51 ones of type IV. Medial distraction was used in 27 cases but not in 124 ones...
June 2018: Acta Orthopaedica Belgica
Kevin J Nickel, Aaron C Van Slyke, Aaron D Knox, Kevin Wing, Neil Wells
Background: Tissue expansion in the lower extremity is controversial, with studies reporting complication rates as high as 83%. Few studies have looked at tissue expansion prior to orthopaedic correction of severe foot and ankle deformities, and those available are restricted to clubfoot in the pediatric population. Here, we report the largest case series on the use of tissue expanders for the reconstruction of severe foot and ankle deformity and the only report in adults. Methods: This is a retrospective chart review of the senior author's practice over a 16-year study period...
November 2018: Plastic Surgery
Alastair G Dick, Baljinder Dhinsa, Roland P Walker, Samrendu Singh
Chlorhexidine-based skin preparations are frequently used in orthopaedic surgery. We report 2 recent cases of patients suffering significant allergic reactions to ChloraPrepTM complicating routine foot and ankle surgery. We advise vigilance for this possible issue and recommend thorough removal of all preparation at the end of the procedure.
November 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
A L Diacon, L A Kimmel, R C Hau, B J Gabbe, E R Edwards
INTRODUCTION: Multitrauma patients suffering hindfoot fractures, including calcaneal and talar fractures, often result in poor outcomes. However, less is known about the outcomes following midfoot fracture in the mutitrauma population. This study aims to describe the epidemiology of midfoot fractures in multitrauma patients and to compare the outcomes of midfoot and hindfoot fractures in this population. METHODS: Data about multitrauma patients (Injury Severity Score >12) sustaining a unilateral midfoot or hindfoot fracture were obtained from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and from retrospective review of medical records at a major trauma centre...
November 12, 2018: Injury
Linzhen Xie, Huanguang Xie, Jinwu Wang, Chunhui Chen, Chuanxu Zhang, Hua Chen, Wenhao Zheng
PURPOSE: This systematic review and meta-analysis was performed to investigate the outcomes of syndesmotic screw fixation versus suture button fixation in the treatment of distal tibiofibular syndesmosis injury from the current literature. METHODS: The electronic literature database of PubMed, Embase, and Cochrane library were searched in August 2018. The data on medial clear space, tibiofibular clear space, tibiofibular overlap, American Orthopaedic Foot and Ankle Society (AOFAS) scores and complications (including wound infection, local irritation or discomfort, screw loosening and screw breakage) were extracted...
November 12, 2018: International Journal of Surgery
J Mason DePasse, Michael I Nzeogu, Chris Travers, Mary K Mulcahey, Mark A Palumbo, Robert A Hart, J Lawrence Marsh, Alan H Daniels
Recent studies have shown that applicants to the American Board of Orthopaedic Surgery Part II examination are performing fewer procedures outside of their chosen subspecialty. In this study, the authors assessed whether trainees are beginning their subspecialization during residency. The authors reviewed the chosen fellowships and case logs of 231 residents graduating from 5 academic orthopedic residency training programs from 2002 to 2017. The number of cases logged by residents who chose a specialty was then compared with the number of cases logged by residents who chose other specialties...
November 13, 2018: Orthopedics
Cem Yalin Kilinc, Baris Kilinc, Ethem Acar, Rabia Mihriban Kilinc, Serkan Aykut, Ali Oznur
To perform an Akin osteotomy using suture anchors to achieve stability of the osteotomy line and avoid the need for a further operation to remove an implant. Akin osteotomy using suture anchors was performed on 35 feet of 30 patients (21 female, 9 male ; mean age 45 years, range 18-60 yrs) diagnosed with hallux valgus. In bilateral cases, surgery was firstly carried out on the foot in the more serious condition, followed by the second foot 2 months later. Preoperative and postoperative clinical evaluation of the patients was made using American Orthopaedic Foot and Ankle Society (AOFAS) scores...
December 2017: Acta Orthopaedica Belgica
Fufeng Qu, Jie Cai, Xiaojun Liang, Jun Lu, Qiu Zeng, Weina Ji
Objective: To evaluate the short-term effectiveness of Scarf osteotomy and Akin osteotomy combined with soft tissue procedures for hallux valgus associated with mild to moderate metatarsus adductus. Methods: The clinical data of 30 patients (48 feet) who were diagnosised hallux valgus associated with mild to moderate metatarsus adductus and treated by Scarf osteotomy and Akin osteotomy combined with soft tissue procedures between February 2013 and May 2015 were analyzed retrospectively...
November 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Jie Cai, Fufeng Qu, Peilong Liu, Hongmou Zhao, Junhu Wang, Yi Li, Qiu Zeng, Weina Ji, Xiaojun Liang
Objective: To evaluate the effectiveness of Scarf osteotomy combined with Akin osteotomy in the treatment of moderate to severe hallux valgus with absorbable screws or metal screws fixation by clinical and radiological data. Methods: Between March 2014 and May 2016, the Scarf osteotomy combined with Akin osteotomy was used to treat 62 patients (83 feet) with moderate to severe hallux valgus. Twenty-five patients (35 feet) were fixed by absorbable screws (group A) and 37 patients (48 feet) were fixed by metal screws (group B)...
November 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Giovanni Vicenti, Giuseppe Solarino, Gianni Caizzi, Massimiliano Carrozzo, Girolamo Picca, Angelo De Crescenzo, Domenico Cotugno, Vittorio Nappi, Biagio Moretti
INTRODUCTION: The treatment of intra-articular calcaneal fractures is still complex and controversial. Although open reduction and internal fixation (ORIF) is favored by many authors, several percutaneous techniques have been introduced to reduce complications and to obtain satisfactory clinical and radiological results. Among these percutaneous treatments, balloon reduction and bone graft augmentation is gaining an increasing popularity. MATERIALS AND METHODS: We retrospectively examined a series of 42 patients treated operatively with a minimally invasive reduction technique using an inflatable bone tamp filled with tricalcium phosphate (calcaneoplasty) for Sander's type II, III and IV calcaneal fractures between 2010 and 2015...
November 2018: Injury
Qiang Ma, Xiaojun Liang, Jun Lu
BACKGROUND: This study intended to investigate the optimal surgical strategy in hallux valgus (HV), and to provide a basis for clinical treatment of HV. METHODS: Studies related to chevron osteotomy and scarf osteotomy for HV were enrolled from online databases. Hallux valgus angle (HVA) was the main outcome variable. Enrolled studies included posttreatment data for intermetatarsal angle (IMA), American Orthopaedic Foot & Ankle Society (AOFAS) score, and complications...
October 6, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Florian Gaul, Luís E P Tírico, Julie C McCauley, Pamela A Pulido, William D Bugbee
BACKGROUND: Fresh osteochondral allograft (OCA) transplantation represents a biologic restoration technique as an alternative treatment option for larger osteochondral lesions of the talus (OLT). The purpose of this study was to evaluate midterm outcomes after OCA transplantation for the treatment of OLT. METHODS: Nineteen patients (20 ankles) received partial unipolar OCA transplant for symptomatic OLT between January 1998 and October 2014. The mean age was 34...
November 1, 2018: Foot & Ankle International
Yong Wu, Qi-Fei He, Liang-Peng Lai, Xia Li, Jun-Lin Zhou
Background: In treatment of ankle fracture, intraoperative stress tests are used to assess the syndesmotic injury and instability. However, the optimized timing of the strees test should be applied whether in pre- or post-bony fixation during operation is seldom be reported in previous studies. The different strategies on stress test timing would exhibit opposite results within a type of pronation-external rotation (PER) fractures with supracollicular medial malleolar (SMM) fractures...
November 5, 2018: Chinese Medical Journal
Cheng-Lin Wang, Jun Zhang, Kai-Xue Cao
OBJECTIVE: To discuss clinical effects of headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture. METHODS: From January 2010 to June 2016, 7 patients with old metatarsal intra-articular fracture treated by open reduction headless compression screw internal fixation by local application PRP, including 5 males and 2 females, aged from 21 to 52 years old, 5 patients injured by falling down and 2 patients caused by crushing, the time from injury to operation ranged from 3 to 6 weeks...
October 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
James M Cottom, Britton S Plemmons, Steven M Douthett
Total ankle replacement can be a viable option for patients with end-stage ankle arthritis associated with coronal plane deformity. With proper ankle balancing, a well-aligned ankle implant can be maintained over time and provide successful patient outcomes. The purpose of this study was to evaluate radiographic and subjective outcomes in patients with ankle arthritis along with coronal plane deformity who underwent total ankle arthroplasty with a 3-piece mobile-bearing implant. Our primary inclusion criterion was patients who demonstrated more than 5° of tibiotalar coronal deformity in either varus or valgus direction...
November 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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