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Scott A Vincent, Paul A Anderson
Instability of the spine is a complex clinical entity that exists on a wide spectrum encompassing many aspects of spinal pathology including traumatic, neoplastic, infectious, and degenerative processes. The importance of determining stability is paramount in the decision-making process regarding the need for operative or nonoperative care. Defining clinical instability can be a challenging and requires careful attention to the pathology involved, findings of necessary imaging, and a thorough clinical exam...
December 2018: Seminars in Ultrasound, CT, and MR
Jessica Zanovello, Barbara Bertani, Redento Mora, Gabriella Tuvo, Mario Mosconi, Luisella Pedrotti
Metatarsal fractures make up the greatest portion of foot fractures in children. Most of them are treated with closed reduction and non-weightbearing cast immobilization.Usually, these fractures heal uneventfully and delay union and pseudoarthrosis are rare. We report a case of a 10-year-old child with non-union of the second metatarsal following a traumatic fracture, caused by an accident 10 months before, and treated successfully by osteosynthesis with plate and screws. Good clinical outcome was achieved at 2 years follow-up...
October 19, 2018: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
Mark Glazebrook, Chris M Blundell, Dominic O'Dowd, Dishan Singh, Gwyneth de Vries, Ian L D Le, Dominic Nielsen, M Elizabeth Pedersen, Anthony Sakellariou, Matthew Solan, Guy Wansbrough, Alastair S E Younger, Judith F Baumhauer, Timothy R Daniels
BACKGROUND: A prospective, randomized, noninferiority clinical trial of synthetic cartilage implant hemiarthroplasty for hallux rigidus demonstrated functional outcomes and safety equivalent to first metatarsophalangeal (MTP) joint arthrodesis at 24 months. We prospectively assessed safety and efficacy outcomes for synthetic cartilage implant hemiarthroplasty at a minimum of 5 years. METHODS: Of 135 eligible patients from the original trial, 112 (83.0%) were enrolled (mean age, 58...
December 3, 2018: Foot & Ankle International
Nidhi Jain, Phillip A Bauman, William G Hamilton, Alexander Merkle, Ronald S Adler
Dancers exert tremendous stresses on the lower extremities rendering them prone to injuries that can curtail training and performance. The goal of this study was to evaluate clinical improvement in a population of elite dancers following treatment with ultrasound-guided platelet-rich plasma (PRP) injections of various lower extremity sites by assessing when they were able to return to dance. Nineteen dancers (13 female, 6 male; ages 15 to 42) were treated between 2009 and 2016 at sites that included: hamstring tendon (1), proximal iliotibial band (1), patellar tendon (3), posterior tibial tendon (5), peroneus brevis tendon (3), plantar fascia (3), and the first metatarsophalangeal (MTP) joint capsule (3)...
December 1, 2018: Journal of Dance Medicine & Science
Andrew DeWolf, Alyssa McPherson, Kathryn Besong, Claire Hiller, Carrie Docherty
While an important step in a young dancer's ballet career is the transition to pointe work, there is much controversy as to when her body is physically prepared to meet the increased demands of this development. Pointe screening protocols are being used by many in both the dance studio and dance science communities, but these protocols have not yet been standardized. The purpose of this study was to evaluate objectively the attributes of ballet dancers who are pre-pointe compared to those who have recently begun pointe training, and secondarily to correlate these quantitative findings with qualitative evaluations by the dancers' teachers...
December 1, 2018: Journal of Dance Medicine & Science
Nicole Blanshan, Maren L Mahowald, Christopher Dorman, Sandra Frizelle, Hollis E Krug
PURPOSE: We previously reported the efficacy of intraarticular (IA) rimabotulinumtoxinB (BoNT/B) in a murine model of chronic degenerative arthritis pain. This study aimed to measure the analgesic effects of onabotulinumtoxinA (BoNT/A) on collagenase induced chronic degenerative arthritis joint pain. METHODS: Chronic degenerative arthritis was produced by IA injection of 10 μl collagenase (Col) (10 IU) into the left knee of C57BL/6J female mice 4 weeks prior to pain assessment...
November 21, 2018: Toxicon: Official Journal of the International Society on Toxinology
Cesar de Cesar Netto, Delaram Shakoor, Lauren Roberts, Apisan Chinanuvathana, Alireza Mousavian, Francois Lintz, Lew C Schon, Shadpour Demehri
BACKGROUND: Clinical assessment of hindfoot alignment (HA) in adult acquired flatfoot deformity (AAFD) can be challenging and weightbearing (WB) cone beam CT (CBCT) may potentially better demonstrate this three-dimensional (3D) deformity. Therefore, we compared clinical and WB CBCT assessment of HA in patients with AAFD. METHODS: In this prospective study, we included 12 men and 8 women (mean age: 52.2, range: 20-88) with flexible AAFD. All subjects also underwent WB CBCT and clinical assessment of hindfoot alignment...
November 5, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Gaoyang Chen, Qing Han, He Liu, Hanyang Zhang, Zhende Jiang, Naibo Feng, Fei Chang
Polydactyly is a common congenital deformity of the foot that can be categorized as preaxial, central, or postaxial. Current treatments involve resecting the supernumerary toe(s) and repairing the normal toe(s) and soft tissue. Here, we present the first published report describing a very rare case of polydactyly of the foot, in which the supernumerary toe originated from a deformed calcaneus, which formed an abnormal bony bump. Preoperatively, 3-dimensional (3D) computed tomography reconstruction images revealed the morphology of the deformed toe and calcaneus, and gait analysis showed an abnormal weightbearing zone in the left foot...
November 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Greg M Osgood, Delaram Shakoor, Jakrapong Orapin, Jianzhong Qin, Iman Khodarahmi, Gaurav K Thawait, James R Ficke, Lew C Schon, Shadpour Demehri
BACKGROUND: To investigate the reliability and reproducibility of syndesmosis measurements on weightbearing (WB) cone-beam computed tomography (CBCT) images and compare them with measurements obtained using non-weightbearing (NWB) images. METHODS: In this IRB-approved, retrospective study of 5 men and 9 women with prior ankle injuries, simultaneous WB and NWB CBCT scans were taken. A set of 21 syndesmosis measurements using WB and NWB images were performed by 3 independent observers...
October 31, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Sh Azizi, A H Rasooli, M Soleimani, A Irani, A Shahrokhi, M M Mirbagheri
We aimed to investigate the effects of an antigravity treadmill (AlterG) on the balance and structure of the vestibulospinal tract. The AlterG can reduce the weightbearing of patients and hence can facilitate their locomotion. Three children with cerebral palsy (CP) received AlterG training three days per week for eight weeks with each session lasting 45 minutes. The balance of children was evaluated using the Berg balance test and the Timed Up and Go (TUG) test. The diffusion tensor imaging (DTI) method was employed to quantify changes of the structure of the vestibulospinal tract...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Peter Z Du, Keith L Markolf, Daniel V Boguszewski, David R McAllister
PURPOSE: To measure contact forces (CFs) at standardized locations representative of clinical articular cartilage defects on the medial and lateral femoral condyles during robotic tests with simulated weightbearing knee flexion. METHODS: Eleven human knees had 20-mm-diameter cylinders of native bone/cartilage cored from both femoral condyles at standardized locations, with each cylinder attached to a custom-built load cell that maintained the plug in its precise anatomic position...
November 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alice S Ha, Susan X Cunningham, Alan S Leung, Jennifer L Favinger, Daniel S Hippe
OBJECTIVE: Foot and ankle arthritis is common and debilitating. Weightbearing radiography is the reference standard for evaluating alignment, but overlapping bones and hardware limit evaluation for osteoarthritic bony detail. The purpose of this study was to evaluate whether digital tomosynthesis (DTS) can yield reliable quantitative alignment values, as radiography does with its weightbearing capability, and good qualitative osteoarthritic detail, as CT does. SUBJECTS AND METHODS: Adults with foot or ankle arthritis referred for simulated weightbearing CT were recruited to undergo weightbearing radiography and DTS...
November 1, 2018: AJR. American Journal of Roentgenology
Willem A Kernkamp, Axel J T Jens, Nathan H Varady, Ewoud R A van Arkel, Rob G H H Nelissen, Peter D Asnis, Robert F LaPrade, Samuel K Van de Velde, Guoan Li
PURPOSE: To elucidate the effects of various tibial and femoral attachment locations on the theoretical length changes and isometry of PCL grafts in healthy knees during in vivo weightbearing motion. METHODS: The intact knees of 14 patients were imaged using a combined magnetic resonance and dual fluoroscopic imaging technique while the patient performed a quasi-static lunge (0°-120° of flexion). The theoretical end-to-end distances of the 3-dimensional wrapping paths between 165 femoral attachments, including the anatomic anterolateral bundle (ALB), central attachment and posteromedial bundle (PMB) of the PCL, connected to an anterolateral, central, and posteromedial tibial attachment were simulated and measured...
October 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jean-Charles Giunta, Camille Tronc, Gael Kerschbaumer, Michel Milaire, Sébastien Ruatti, Jerôme Tonetti, Mehdi Boudissa
PURPOSES: Open reduction and internal fixation (ORIF) in osteoporotic acetabular fractures is quite difficult with high risk of implant failure. Total hip arthroplasty (THA) may be an effective option for treating acetabular fractures in appropriately selected patients, with immediate full weightbearing. The aim of the study was to evaluate the functional outcomes of primary THA for acetabular fractures in elderly patients. METHODS: Between 2010 and 2015, 27 elderly patients operated for acetabular fractures by primary THA were included...
October 18, 2018: International Orthopaedics
Cesar de Cesar Netto, Delaram Shakoor, Eric J Dein, Hanci Zhang, Gaurav K Thawait, Martinus Richter, James R Ficke, Lew C Schon, Shadpour Demehri
BACKGROUND: Our purpose was to assess the reliability of measurements of adult-acquired flatfoot deformity (AAFD) taken by investigators of different levels of clinical experience using weightbearing computed tomography (WBCT). METHODS: Nineteen AAFD patients underwent WBCT. Three investigators with different levels of clinical experience made AAFD measurements in axial, coronal, and sagittal planes. Intra- and interobserver reliability were assessed. Mean values for each measurement were compared between investigators...
March 12, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Oliver Chan, Karan Malhotra, Olatunbosun Buraimoh, Nick Cullen, Matthew Welck, Andy Goldberg, Dishan Singh
BACKGROUND: Gastrocnemius tightness is believed to be associated with multiple musculoskeletal pathologies such as back pain, plantar fasciitis and metatarsalgia. Although surgical treatment of gastrocnemius tightness is gaining popularity the objective definition of a gastrocnemius contracture has not been determined. The aim of our study was therefore to quantify gastrocnemius tightness in a normal population. METHODS: Adult participants with no obvious foot and ankle pathology were recruited...
April 12, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Caspar Samuel Steiner, Andrea Gilgen, Lukas Zwicky, Christine Schweizer, Roxa Ruiz, Beat Hintermann
BACKGROUND: A challenge in treating acquired flatfoot deformities is the collapse of the medial arch at the level of the naviculocuneiform (NC) joint. Triple fusions, being a treatment option, may lead to problems such as increased foot stiffness. We thus established a method that combines subtalar (ST) fusion with NC fusion while preserving the Chopart joint. We analyzed the radiographic correction, fusion rate, and patient satisfaction with this procedure. METHODS: 34 feet in 31 patients (female, 23; male, 8; age 67 [45-81] years) were treated with a ST and NC joint fusion...
October 13, 2018: Foot & Ankle International
Amanda L Killeen, Kara M Brock, Rosabel Loya, Cece S Honculada, Phyllis Houston, Jodi L Walters
INTRODUCTION: Chronic ulcerations on weightbearing surfaces of the lower extremities are uniquely challenging and can lead to complications such as infection or amputation. OBJECTIVE: This 3-patient case series of 4 chronic wounds of various etiologies outlines the use of a fully synthetic bioengineered nanomedical scaffold that exhibits durability and allows for cell migration and angiogenesis while resisting enzymatic degradation. MATERIALS AND METHODS: The nanomedical scaffold was rehydrated in sterile saline at room temperature for 3 to 5 minutes until translucent and pliable, then it was fenestrated with a scalpel...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Kajsa Lindberg, Britt Sundekilde Møller, Klaus Kirketerp-Møller, Morten Tange Kristensen
PURPOSE: To examine a non-weightbearing exercise program for persons with severe peripheral neuropathy (PN) and a diabetic foot ulcer in terms of feasibility and safety. MATERIALS AND METHODS: Five men (mean (SD) age of 68.2 (7.1) years) with diabetes, severe peripheral neuropathy and an active foot ulcer, participated in a 10-week exercise program. Program adherence, patient satisfaction, healing of foot ulcers, adverse advents, ability to perform activities of daily life, and changes in muscle strength were assessed...
October 7, 2018: Disability and Rehabilitation
Jae Hwang Song, Chan Kang, Deuk Soo Hwang, Dong Hun Kang, June Woo Park
BACKGROUND: We compared the radiographic results and clinical outcomes of patients operated on via the extended sinus tarsi approach (ESTA) and the extended lateral approach (ELA) for treatment of displaced intraarticular calcaneal fractures. METHODS: We retrospectively studied the utility of the ELA (46 patients, 52 feet) and the ESTA (56 patients, 64 feet) in patients operated on between January 2009 and March 2015. We evaluated pre- and postoperative x-rays and computed tomography (CT) data...
October 5, 2018: Foot & Ankle International
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