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Foot and ankle orthopedics

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https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#1
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27915133/novel-reconstruction-technique-for-an-isolated-plantar-calcaneonavicular-spring-ligament-tear-a-5-case-series-report
#2
Ezequiel Palmanovich, Shay Shabat, Yaron S Brin, Sabri Massrawe, Iftach Hestroni, Meir Nyska
BACKGROUND: It is usually accepted that acquired flatfoot deformity after injury is usually due to partial or complete tear of the posterior tibial tendon (PTT), with secondary failure of the other structures which maintain the medial longitudinal arch, such as the plantar calcaneo-navicular (SPRING) ligament. It is unusual to find an isolated Spring Ligament (SL) tear, with an intact TP tendon. METHODS: The medial arch reconstruction technique of an isolated SL tear in 5 patients is presented discussed in this paper...
November 18, 2016: Foot
https://www.readbyqxmd.com/read/27900272/return-to-physical-activity-after-gastrocnemius-recession
#3
Camelia Tang Qian Ying, Sean Lai Wei Hong, Bing Howe Lee, Gowreeson Thevendran
AIM: To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS: Endoscopic gastrocnemius recession (EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36 (SF-36), American Orthopedic Foot and Ankle Society (AOFAS) Hindfoot score and modified Olerud and Molander (O and M) scores respectively...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#4
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/27888842/technical-considerations-best-practices-for-mr-imaging-of-the-foot-and-ankle
#5
REVIEW
Carolyn M Sofka
There are many challenges involved in obtaining diagnostic MR images of the foot and ankle. The complex anatomy and morphology, with curved and angular structures localized to the periphery of the body, make for an inherent challenge, let alone if an added level of complexity, such as orthopedic instrumentation, is added. This review outlines the technical considerations best designed to produce diagnostic images of the foot and ankle, with an emphasis on the postoperative state, including imaging in the presence of metal...
February 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/27871421/mesenchymal-stem-cell-bearing-sutures-for-tendon-repair-and-healing-in-the-foot-and-ankle
#6
REVIEW
Eric W Tan, Lew C Schon
Improving the quality and strength of soft tissue repairs remains an important area of orthopedic research and innovation. The need for immobilization and early motion is an important balance essential for the successful treatment of tendon repair and reconstruction. Mesenchymal stem cell (MSC)-bearing sutures represent an emerging biological augmentation to traditional suture repair. Two previous large studies using stem cell sutures in rat Achilles tendon models have demonstrated early increased biomechanical strength and significantly increased ultimate failure strength...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27871415/autologous-bone-graft-in-foot-and-ankle-surgery
#7
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/27871414/orthobiologics-in-the-foot-and-ankle
#8
REVIEW
H Thomas Temple, Theodore I Malinin
Many allogeneic biologic materials, by themselves or in combination with cells or cell products, may be transformative in healing or regeneration of musculoskeletal bone and soft tissues. By reconfiguring the size, shape, and methods of tissue preparation to improve deliverability and storage, unique iterations of traditional tissue scaffolds have emerged. These new iterations, combined with new cell technologies, have shaped an exciting platform of regenerative products that are effective and provide a bridge to newer and better methods of providing care for orthopedic foot and ankle patients...
December 2016: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/27861131/management-of-open-lower-extremity-wounds-with-concomitant-fracture-using-a-porcine-urinary-bladder-matrix
#9
Bruce A Kraemer, Scott E Geiger, Oliver A Deigni, John Tracy Watson
BACKGROUND: Open wounds of the distal third of the leg and foot with exposed bone, fractures, and hardware are challenging wounds for which to achieve stable coverage. The orthopedic advances in lower extremity fracture management over the last 30 years have allowed a rethinking of the standard operative approach to close these complex wounds. MATERIALS AND METHODS: The ability of extracellular matrix (ECM) products to facilitate constructive remodeling of a wound seemed a reasonable approach for treatment, especially in patients who are often poor surgical candidates for more advanced reconstructive procedures...
November 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/27843949/low-energy-extracorporeal-shock-wave-therapy-in-the-treatment-of-chronic-insertional-achilles-tendinopathy-a-case-series
#10
Vito Pavone, Luca Cannavò, Antonio Di Stefano, Gianluca Testa, Luciano Costarella, Giuseppe Sessa
Introduction. We report the results of a series of 40 patients with chronic insertional Achilles tendinopathy treated with low-energy ESWT after the failure of a 3-month program of eccentric exercises alone. Methods and Materials. 40 patients, 28 (70%) males and 12 (30%) females, were treated between January and December 2014. All patients were previously treated with only eccentric exercises for a 3-month period. The treatment protocol included 4 sessions of ESWT with a 2-week interval, from 800 shots in each one (4 Hz, 14 KeV), together with eccentric exercises...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27842935/surgical-treatment-results-for-flexible-flatfoot-in-adolescents
#11
Necip Selcuk Yontar, Tahir Ogut, Mehmet Fatih Guven, Huseyin Botanlioglu, Gokhan Kaynak, Ata Can
OBJECTIVE: Idiopathic flexible pes planus (IFPP) is a common foot problem in adolescents and young adults. Hypothesis for the present study was that combination of procedures for IFPP can achieve results in adolescents and young adults that are as good as those seen in adult-acquired pes planovalgus (AAPP) treatment in adults. METHODS: A total of 21 feet of 18 patients (10 boys, 8 girls) with mean age of 15.6 years underwent surgical reconstruction for flatfoot deformity...
November 11, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27836255/combined-flexor-hallucis-longus-tendon-transfer-and-gastrocnemius-recession-for-reconstruction-of-gapped-chronic-achilles-tendon-ruptures
#12
Hatem Elsayed Ahmed Elgohary, Nabil A Elmoghazy, Mohammed Serry Abd Ellatif
OBJECTIVE: The aim of this study was to assess the functional outcomes after a combined FHL transfer and a gastrocnemius recession for treatment of chronic ruptures of Achilles tendon with a gap and to investigate the patient's satisfaction about the great toe function after transfer. MATERIAL AND METHODS: 19 patients with chronic rupture of the Achilles tendon with a gap were treated with a flexor halluces longus tendon transfer combined with a gastrocnemius recession, Clinical diagnosis depends on the presence of gap in the tendon on examination, inability of tip toe walking on the affected side and positive calf-squeeze test, MRI was used to confirm the clinical diagnosis...
December 2016: Injury
https://www.readbyqxmd.com/read/27810034/primary-synovial-chondromatosis-of-the-talonavicular-joint-a-case-report
#13
Jun-Beom Kim, In-Soo Song, Sang-Yeop Shin, Ja-Yeong Yoon
Synovial chondromatosis developes by metaplasia of the synovial cells in the synovium of joints, and is a benign synovial tumor with multiple cartilaginous nodules. It is most commonly found in single and large joints, such as the knee, hip, and shoulder. Occurrence in the foot and ankle is uncommon, although there have been previous reports in the orthopedic and radiological literature of primary synovial chondromatosis in the subtalr, calcaneocuboid, naviculocuneiform, and metatarsaophalangeal joints. To our knowledge, occurrence in the talonavicular joint is even rarer, with only one report in the literature to date...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27755599/a-systematic-review-of-the-effects-of-single-event-multilevel-surgery-on-gait-parameters-in-children-with-spastic-cerebral-palsy
#14
Robert P Lamberts, Marlette Burger, Jacques du Toit, Nelleke G Langerak
BACKGROUND: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). PURPOSE: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. METHODS: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review...
2016: PloS One
https://www.readbyqxmd.com/read/27746496/reconstruction-of-kuwada-grade-iv-chronic-achilles-tendon-rupture-by-minimally-invasive-technique
#15
Xudong Miao, Yongping Wu, Huimin Tao, Disheng Yang, Lu Huang
BACKGROUND: Transfer of a flexor hallucis longus (FHL) tendon can not only reconstruct the Achilles tendon but also provide ischemic tendinous tissues with a rich blood supply to enhance wound healing. This retrospective study aims to investigate clinical outcomes in patients who underwent repair of Kuwada grade IV chronic Achilles tendon rupture with long hallucis longus tendons harvested using a minimally invasive technique. MATERIALS AND METHODS: 35 patients who were treated for Kuwada grade IV Achilles tendon injuries from July 2006 to June 2011 were included in this retrospective study...
September 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27726423/plantar-fasciitis-a-comparison-of-treatment-with-intralesional-steroids-versus-platelet-rich-plasma-prp-a-randomized-blinded-study
#16
Carlos Acosta-Olivo, Jorge Elizondo-Rodriguez, Ricardo Lopez-Cavazos, Felix Vilchez-Cavazos, Mario Simental-Mendia, Oscar Mendoza-Lemus
BACKGROUND: Many treatment options for plantar fasciitis currently exist, some with great success in pain relief. The objective of our study was to compare the use of intralesional steroids with platelet-rich plasma (PRP), using pain scales and functional evaluation, in patients with plantar fasciitis who did not respond to conservative treatment. METHODS: A controlled, randomized, blinded clinical assay was performed. Patients were assigned to one of the two groups by selecting a sealed envelope...
October 11, 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27703418/association-between-achilles-tightness-and-lower-extremity-injury-in-children
#17
Raymond W Liu, Katherine K Xie
BACKGROUND: It is unclear whether isolated gastroc/soleus tightness can increase the risk of lower extremity injury in an otherwise healthy child. QUESTIONS/PURPOSES: (1) Is there a difference in gastroc/soleus tightness, as represented by ankle dorsiflexion with the knee extended, in children presenting with upper versus lower extremity complaints? (2) Is there a difference in gastroc/soleus tightness in children presenting with atraumatic versus traumatic lower extremity complaints? METHODS: We performed a cross-sectional study of 206 consecutive walking age children presenting to a county orthopedic clinic with new upper or lower extremity complaints...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27672017/effectiveness-of-headless-bioabsorbable-screws-for-fixation-of-the-scarf-osteotomy
#18
Jin Su Kim, Hun Ki Cho, Ki Won Young, Sang Young Lee, Ji Soo Kim, Kyoungtae Lee
BACKGROUND: Scarf osteotomy has been used in hallux valgus surgery due to its large fixation surface for screws and low postoperative complications. However, screws may cause skin irritation from their head, which may require an additional surgical procedure to remove. METHODS: This study included 115 patients (106 females and 9 males, 115 feet) who underwent hallux valgus correction with a scarf osteotomy using bioabsorbable screws between September 2010 and September 2012...
November 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27649405/type-iv-cell-mediated-hypersensitivity-reaction-caused-by-titanium-implant-following-medial-displacement-calcaneal-osteotomy-and-first-metatarsal-cuneiform-arthrodesis
#19
Stephen J Kriger, Shontal A Behan, Parth J Bhakta, Nicholas G Bruning, Brennan A Menninger, Mark C Razzante
INTRODUCTION AND OBJECTIVES: Due to its inert character and desired biocompatibility, titanium (Ti) implants have been universally accepted as safer alternatives to the previous conventional orthopedic hardware implants. However, a recent emergence of Type IV hypersensitivity reactions to Ti have displayed symptoms that include eczema, contact dermatitis, prolonged fever, sterile osteomyelitis, and impaired fracture and wound healing. The following case presents a patient with postoperative incision dehiscence and devascularization of cortical surfaces in contact with Ti hardware after undergoing a medial displacement calcaneal osteotomy and a first metatarsal-cuneiform arthrodesis...
September 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27627563/long-term-results-of-neurectomy-through-a-dorsal-approach-in-the-treatment-of-morton-s-neuroma
#20
Paweł Reichert, Krzysztof Zimmer, Jarosław Witkowski, Witold Wnukiewicz, Sebastian Kuliński, Jerzy Gosk
BACKGROUND: Morton's neuroma, a painful enlargement of the plantar digital nerve between the metatarsal heads, is a common cause of metatarsalgia. The etiology and treatment are still a controversial matter. OBJECTIVES: The objective of this study was to evaluate the long-term follow-up results of neurectomy through a dorsal approach and to identify prognostic factors that can affect the final outcome. MATERIAL AND METHODS: The study included 41 patients who were treated for Morton's neuroma...
March 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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