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Foot and ankle surgery

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https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#1
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27903299/arthroscopic-arthrodesis-for-ankle-arthritis-without-bone-graft
#2
Xiaojun Duan, Liu Yang, Li Yin
BACKGROUND: Ankle arthrodesis is considered by many to be the standard operative treatment for end-stage ankle arthritis. The purpose of this study was to perform a new technique for ankle joint surface and determine the outcome for the union rates of ankle arthroscopic arthrodesis. METHODS: A total of 68 patients with posttraumatic arthritis, primary osteoarthritis, and rheumatoid arthritis were treated by ankle arthroscopic arthrodesis between May 2007 and December 2012...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#3
Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27899356/donor-site-morbidity-after-lateral-ankle-ligament-reconstruction-using-the-anterior-half-of-the-peroneus-longus-tendon-autograft
#4
Chul Hyun Park, Woo-Chun Lee
BACKGROUND: The anterior half of the peroneus longus tendon (AHPLT) has been reported to be an effective autograft for ligament reconstruction with respect to strength and safety. However, there is little information regarding donor site morbidity after harvesting the AHPLT. Furthermore, to the best of our knowledge, there has not been a study on the isokinetic evaluation of ankle plantar flexion and eversion after AHPLT harvesting. PURPOSE: To evaluate the clinical and radiographic results after lateral ankle ligament reconstruction using the AHPLT...
November 29, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27890836/microcirculation-evaluated-by-intraoperative-fluorescence-angiography-after-tibial-bypass-surgery
#5
Ulrich Rother, Werner Lang, Raymund E Horch, Ingo Ludolph, Alexander Meyer, Susanne Regus
OBJECTIVE: Intact microperfusion of the foot in the critical ischemic limb remains a crucial condition for ulcer healing. Aim of this clinical study was to evaluate the immediate effect of tibial bypass surgery on the microcirculation by usage of fluorescence angiography. METHODS: Prospective analysis of 33 patients presenting with critical limb ischemia (Rutherford 4 to 6) undergoing tibial bypass surgery was performed. Macroperfusion was investigated by measurement of ankle-brachial index...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#6
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27888848/postoperative-foot-and-ankle-mr-imaging
#7
REVIEW
Samuel D Madoff, Jeffrey Kaye, Joel S Newman
MR imaging has an important role in the evaluation of the postoperative foot and ankle. In this article, a variety of operative techniques and postoperative findings in the foot and ankle are described, including tendon and ligament reconstruction, as well as the treatment of tarsal coalition and Morton neuroma. The role of MR imaging in the assessment of complications of foot and ankle surgery is also detailed.
February 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/27888792/case-study-an-intraoperative-finding-of-black-bone-disease-in-a-podiatric-surgery-patient
#8
Robyn L Carter-Wale, Trevor D Prior
Black bone disease has been recognised as a potential consequence of long-term treatment with tetracycline antibiotics. Largely documented affecting structures in the head and skull, there are few reported cases of black bone disease in the foot and ankle. The case of a 55 years old patient, who as a teenager, had undergone treatment with minocycline hydrochloride for chronic acne, and was found to have bone discolouration consistent with minocycline induced black bone disease (MIBBD) during the course of hallux valgus corrective surgery some 40 years later, is presented...
September 20, 2016: Foot
https://www.readbyqxmd.com/read/27881830/repair-of-chronic-achilles-ruptures-has-a-high-incidence-of-venous-thromboembolism
#9
Mark J Bullock, William T DeCarbo, Mark H Hofbauer, Joshua D Thun
: Background Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis. Methods One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. For elective repair of insertional or noninsertional Achilles tendinopathy, parameters examined included lateral versus prone positioning and the presence versus absence of a flexor hallucis longus transfer...
November 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27881742/association-of-abnormal-metatarsal-parabola-with-second-metatarsophalangeal-joint-plantar-plate-pathology
#10
Adam E Fleischer, Erin E Klein, Maheen Ahmad, Shivang Shah, Fernanda Catena, Lowell Scott Weil, Lowell Weil
BACKGROUND: Plantar plate pathology is common, yet it is unclear whether, and to what extent, the length of the second metatarsal contributes to this problem. METHODS: We conducted a retrospective case-control (1:2) study to examine radiographic risk factors for plantar plate tears. One hundred patients (age 55.7 ± 12.3 years) with plantar plate injuries and 200 healthy controls (age 56.3 ± 11.3 years) were included. Cases were defined as patients with nonacute, isolated, plantar plate pathology of the second metatarsophalangeal joint confirmed by intraoperative inspection at a single foot and ankle specialty practice from June 1, 2007, to January 31, 2014...
November 22, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27871521/functional-outcome-and-cost-effectiveness-of-outpatient-vs-inpatient-care-for-complex-hind-foot-and-ankle-surgery-a-retrospective-cohort-study
#11
Justin Oh, Anahi Perlas, Johnny Lau, Rajiv Gandhi, Vincent W S Chan
STUDY OBJECTIVE: To compare the postoperative functional outcome and the total cost associated with outpatient vs inpatient care following complex hind-foot and ankle surgery. DESIGN: Retrospective, cohort study. SETTING: Tertiary care center. PATIENTS: Forty patients, American Society of Anesthesiologists 1-3, of either sex undergoing elective complex hind-foot and ankle surgery (fusion, osteotomy, or multiple ligament repair)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871423/the-science-behind-surgical-innovations-of-the-forefoot
#12
REVIEW
Judith F Baumhauer, Michele Marcolongo
One of the areas of foot and ankle surgery that has had particular attention over the last 5 years has been forefoot surgery. Common procedures include correction of the lessor metatarsophalangeal joints and hammertoe deformities, specifically metatarsal shortening osteotomies and proximal interphalangeal joint fusions. The goals of these surgeries are to improve patient function and allow patients to fit into shoes more comfortably in metatarsal shortening and hammertoe.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871418/efficacy-of-a-cellular-allogeneic-bone-graft-in-foot-and-ankle-arthrodesis-procedures
#13
REVIEW
Travis J Dekker, Peter White, Samuel B Adams
A cellular allogeneic bone graft can be used in patients at high risk for nonunion after arthrodesis surgery. This study explores the utility and efficacy of MAP3 in foot and ankle arthrodesis procedures. Map3 is a cellular allogeneic bone graft that contains osteogenic, osteoconductive, osteoinductive, and angiogenic properties. A total of 23 mostly high-risk patients were included in this study. The overall fusion rate was 83%. Univariate analysis demonstrated diabetic patients remain at risk of recurrent nonunion (P<...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871416/bone-marrow-aspirate-concentrate-for-bone-healing-in-foot-and-ankle-surgery
#14
REVIEW
Joshua S Harford, Travis J Dekker, Samuel B Adams
Autologous bone marrow aspirate concentrate (BMAC) has become a popular orthobiologic to augment bone healing. The potential benefit comes from osteoprogenitor cells and growth factors that can lead to new bone formation in the setting of foot and ankle arthrodesis procedures. BMAC has an excellent safety record and has demonstrated efficacy in animal models of bone healing. Although scant, the literature on the use of BMAC in foot and ankle surgery does demonstrate promise for this orthobiologic adjuvant.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871415/autologous-bone-graft-in-foot-and-ankle-surgery
#15
REVIEW
Christopher P Miller, Christopher P Chiodo
Bone graft is a common adjunct procedure in orthopedic surgery used for fusions, fracture repair, and the reconstruction of skeletal defects in the foot and ankle. Autologous graft, or autograft, involves the transport of bone from a donor site to another location in the same patient. It is considered by many to be the gold standard of bone grafting, as it is provides all biologic factors required for functional graft. Further, autograft is 100% histocompatible with no risk of disease transmission.
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871017/predicting-postoperative-gait-in-cerebral-palsy
#16
Omar A Galarraga C, Vincent Vigneron, Bernadette Dorizzi, Néjib Khouri, Eric Desailly
In this work, postoperative lower limb kinematics are predicted with respect to preoperative kinematics, physical examination and surgery data. Data of 115 children with cerebral palsy that have undergone single-event multilevel surgery were considered. Preoperative data dimension was reduced utilizing principal component analysis. Then, multiple linear regressions with 80% confidence intervals were performed between postoperative kinematics and bilateral preoperative kinematics, 36 physical examination variables and combinations of 9 different surgical procedures...
November 9, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27865317/revisional-surgery-of-the-diabetic-charcot-foot-and-ankle
#17
REVIEW
Patrick R Burns, Spencer J Monaco
Charcot neuroarthropathy (CN) is a difficult problem for the foot and ankle surgeon. If surgery is required, little is known or available regarding the best methods and timing. When the initial attempt of reconstruction fails, revision of CN is even more demanding. One must take in to account all aspects, including nutrition, vascular status, infection control, short- and long-term blood glucose management, as well as other factors requiring laboratory monitoring and consult services. Once optimized, the biomechanics of the deformity can be addressed and decisions can be made on fixation devices...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#18
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27856802/optimization-of-hindfoot-alignment-radiography
#19
Chonglin Yang, Xiangyang Xu, Mu Hu, Bibo Wang, Yuan Zhu, Jinhao Liu
BACKGROUND: Cobey and Buck described methods to evaluate hindfoot alignment, but it is still unclear which method is better and easier to perform in clinical practice. PURPOSE: To evaluate the optimal method for radiography of hindfoot alignment. MATERIAL AND METHODS: We randomly selected 50 patients visiting the foot and ankle surgery outpatient department who underwent hindfoot alignment radiography between 1 July and 31 August 2015. Radiographs were taken using both Cobey's and Buck's methods...
November 17, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27852902/overlapping-surgery-in-the-ambulatory-orthopaedic-setting
#20
Alan L Zhang, David C Sing, Debbie Y Dang, C Benjamin Ma, Dennis Black, Thomas P Vail, Brian T Feeley
BACKGROUND: The practice of a surgeon performing procedures in two operating rooms during overlapping time frames has been described as concurrent surgery if critical portions occur simultaneously, or overlapping surgery if they do not. Although recent media reports have focused on the potential adverse effects of these practices, to our knowledge, there has been no previous research investigating outcomes of overlapping procedures in orthopaedic surgery. METHODS: A retrospective review of an institutional clinical database from 2012 to 2015 was utilized to collect data from all surgical cases (including sports medicine, hand, and foot and ankle) performed at an ambulatory orthopaedic surgery center...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
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