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Foot and ankle orthopedics

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https://www.readbyqxmd.com/read/28501960/a-modified-minimally-invasive-technique-for-intra-articular-displaced-calcaneal-fractures-fixed-by-transverse-and-axial-screws
#1
K C Kapil Mani, Parimal Acharya, R C Dirgha Raj, Bandhu Ram Pangeni, Arun Sigdel, Suman Babu Marahatta
The management of displaced, intra-articular calcaneal fracture represents a surgical challenge to even an experienced orthopedic surgeon. Plate osteosynthesis using an extended lateral approach is complicated by soft tissue problems, while those treated by closed reduction and percutaneous pinning cannot address all the intra-articular fragments sufficiently. The objective of our study is to evaluate restoration of subtalar joint and long-term functional outcomes in intra-articular displaced calcaneal fractures treated with transverse subcondral screws through a small incision on lateral aspect of calcaneus and percutaneously placed axial screws through the calcaneal tuberosity...
May 13, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28493041/the-sinus-tarsi-approach-in-displaced-intra-articular-calcaneal-fractures
#2
Jin Park, Jin Ho Che
INTRODUCTION: Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. METHODS: Forty-seven consecutive patients with intra-articular calcaneal fractures treated using the sinus tarsi approach between March 2010 and April 2015 were retrospectively reviewed. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated...
May 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28481385/an-assessment-of-the-safety-of-an-orthopedic-specialty-hospital-a-5-year-experience
#3
Eric M Padegimas, Matthew L Ramsey, Matthew Austin, Javad Parvizi, Gerald R Williams, Kelly Doyle, Michael E West, Richard H Rothman, Alexander R Vaccaro, Surena Namdari
One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer...
May 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/28465006/early-rehabilitation-after-open-repair-for-patients-with-a-rupture-of-the-achilles-tendon
#4
Uk Kim, Yun Seong Choi, Gyu Chol Jang, Young Rak Choi
PURPOSE: As outdoor activities participation increase, Achilles tendon rupture incidence also tends to increase. There are a number of treatment and rehabilitation options for a ruptured Achilles tendon. However, the optimal rehabilitation protocols are still under debate. The purpose of this study is to determine whether early rehabilitation is more effective than conventional rehabilitation. METHODS: Medical records of 56 patients who had been treated with open repair after a ruptured Achilles tendon were retrospectively reviewed...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28464751/minimally-important-change-measurement-error-and-responsiveness-for-the-self-reported-foot-and-ankle-score
#5
Maria C Cöster, Anna Nilsdotter, Lars Brudin, Ann Bremander
Background and purpose - Patient-reported outcome measures (PROMs) are increasingly used to evaluate results in orthopedic surgery. To enhance good responsiveness with a PROM, the minimally important change (MIC) should be established. MIC reflects the smallest measured change in score that is perceived as being relevant by the patients. We assessed MIC for the Self-reported Foot and Ankle Score (SEFAS) used in Swedish national registries. Patients and methods - Patients with forefoot disorders (n = 83) or hindfoot/ankle disorders (n = 80) completed the SEFAS before surgery and 6 months after surgery...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28449701/arthroscopic-treatment-of-focal-osteochondral-lesions-of-the-first-metatarsophalangeal-joint
#6
Ersin Kuyucu, Harun Mutlu, Serhat Mutlu, Baris Gülenç, Mehmet Erdil
BACKGROUND: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment...
April 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28428919/tibial-bone-grafting-for-wrist-reconstruction
#7
Schneider K Rancy, Stephanie D Malliaris, Scott W Wolfe
Background Iliac crest bone graft harvesting is routinely performed for upper extremity orthopedic procedures despite high complication rates associated with sensory nerve injury, hematoma, chronic pain, and fracture. Description of Technique Cancellous bone graft is harvested from the proximal tibia using a medial approach, minimizing donor site morbidity. Patients and Methods A retrospective review was undertaken of 14 patients who underwent cancellous proximal tibia bone graft harvesting to augment healing of wrist reconstruction, with 2 months minimum follow-up...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28419612/delayed-gadolinium-enhanced-mri-of-cartilage-dgemric-and-t2-mapping-of-talar-osteochondral-lesions-indicators-of-clinical-outcomes
#8
Christoph Rehnitz, Benita Kuni, Felix Wuennemann, Dimitrios Chloridis, Anand Kirwadi, Iris Burkholder, Hans-Ulrich Kauczor, Marc-André Weber
PURPOSE: To evaluate the utility of delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping in evaluation of type II osteochondral lesions (OCLs) of the talus and define cutoff values for identifying patients with good/poor clinical outcomes. MATERIALS AND METHODS: 28 patients (mean age, 42.3 years) underwent T2 mapping and dGEMRIC at least 1.5 years (mean duration, 3.5 years) after microfracture (n = 12) or conservative (n = 16) treatment for type II OCL...
April 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28400871/results-of-arthroscopic-ankle-arthrodesis-with-fixation-using-two-parallel-headless-compression-screws-in-a-heterogenic-group-of-patients
#9
Lukas Kolodziej, Boguslaw Sadlik, Sebastian Sokolowski, Andrzej Bohatyrewicz
BACKGROUND: As orthopedic surgeons become skilled in ankle arthroscopy technique and evidence -based data is supporting its use, arthroscopic ankle arthrodesis (AAA) will likely continue to increase, but stabilization methods have not been described clearly. We present a technique for two parallel 7.3-mm headless compression screws fixation (HCSs) for AAA in cases of ankle arthritis with different etiology, both traumatic and non-traumatic, including neuromuscular and inflammatory patients...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28399322/antibiotic-use-and-kirschner-wire-fixation-in-forefoot-surgery-a-national-survey
#10
Gregory Pace, Samuel Dellenbaugh, Brian Stapinski, Umur Aydogan, Jorge Bustillo, Paul Juliano
In foot and ankle patients, the use of Kirschner wires is common, and the population in the typical foot and ankle practice has higher rates of comorbidities associated with infection. This study assessed national trends regarding the use of postoperative prophylactic antibiotic therapy in patients undergoing foot and ankle surgery treated with percutaneous Kirschner wires. Attending physicians at foot and ankle fellowships were mailed a questionnaire that included 3 clinical vignettes containing questions on the use of postoperative antibiotics in patients treated with percutaneous Kirschner wires...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#11
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28371502/comparison-of-posteromedial-versus-posterolateral-approach-for-posterior-malleolus-fixation-in-trimalleolar-ankle-fractures
#12
Sheng Zhong, Lin Shen, Jia-Guo Zhao, Jie Chen, Jin-Feng Xie, Qi Shi, Ying-Hua Wu, Xian-Tie Zeng
OBJECTIVE: To compare clinical and radiographic outcomes of posterior malleolar fractures (PMF) treated with lag screws from anterior to posterior versus posterior to anterior approach. METHODS: We retrospectively analyzed 48 patients with trimalleolar fractures who underwent open reduction and internal fixation (ORIF) with either posteromedial (PM) or posterolateral (PL) approaches between January 2012 and December 2014. Fixation of the posterior malleolus was made with anteroposterior screws in 20 patients using the PM approach and posteroanterior screws in 28 patients using the PL approach...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28358975/age-related-outcome-of-mobile-bearing-total-ankle-replacement
#13
Federico G Usuelli, Camilla Maccario, Riccardo D'Ambrosi, Michele F Surace, Ettore Vulcano
The aim of this study was to investigate clinical and radiographic outcomes in patients 50 years and younger vs patients older than 50 years undergoing total ankle replacement. Seventy consecutive patients who underwent primary total ankle replacement were included in this retrospective study. Patients were assessed clinically and radiographically. There was a statistically significant difference between the 2 groups for the American Orthopaedic Foot & Ankle Society score at final follow-up. The younger group had significantly greater improvement compared with the older group...
May 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28336447/anatomical-reconstruction-of-the-fourth-brachymetatarsia-with-one-stage-iliac-bone-and-cartilage-cap-grafting
#14
Sang Hyun Woo, Chi Young Bang, Hee-Chan Ahn, Sung-Jung Kim, Jun-Young Choi
BACKGROUND: We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis...
May 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28336190/clinical-and-radiological-outcomes-of-midfoot-derotational-osteotomy-for-midfoot-forefoot-varus-deformity
#15
Hong-Geun Jung, Dong-Oh Lee, Sang-Hun Lee, Joon-Sang Eom
BACKGROUND: Moderate to severe midfoot-forefoot varus deformities are commonly found in several conditions. However, few techniques are available to correct these deformities. So, we evaluated the clinical and radiological outcomes of patients who underwent midfoot derotational osteotomy to achieve plantigrade foot. METHODS: From 2006 to 2014, 6 patients (7 feet) underwent midfoot derotational osteotomy. A visual analog scale (VAS) pain and the American Orthopedic Foot & Ankle Society (AOFAS) functional score were evaluated...
March 20, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28336047/posttraumatic-reconstruction-of-the-foot-and-ankle-in-the-face-of-active-infection
#16
REVIEW
Brandon Jonard, Erin Dean
Posttraumatic infection of the foot and ankle is a challenging issue for orthopedic surgeons. Making the diagnosis often requires combining laboratory and radiologic testing, patient examination, and history. Patient comorbidities should be identified and optimized whenever possible. Treatment must combine effective antibiotic therapy with thorough debridement of the infected zone. Reconstruction often requires a 2-staged approach using antibiotic spacers and temporary external fixation, with the goal of obtaining a functional, pain-free limb that is free of infection...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#17
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28288878/outcomes-and-complications-of-percutaneous-versus-open-repair-of-acute-achilles-tendon-rupture-a-meta-analysis
#18
REVIEW
Bo Yang, Yang Liu, Shunli Kan, Di Zhang, Hong Xu, Feifei Liu, Guangzhi Ning, Shiqing Feng
BACKGROUND: Acute Achilles tendon rupture (AATR) is a frequent injury occurring dominantly in young to middle-aged males. Outcomes and complications between percutaneous and open repair are still controversial. Thus, the purpose of this meta-analysis is to evaluate the outcomes and complications of these two operative methods. MATERIALS AND METHODS: We searched multiple databases: PubMed, Web of Science, EMBASE and the Cochrane Library up to October 2016. Two reviewers independently screened the studies for eligibility, evaluated the quality and extracted data from eligible studies, with confirmation by cross-checking...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28268145/accuracy-and-reliability-of-postoperative-radiographic-evaluation-of-first-metatarsal-phalangeal-joint-arthrodesis
#19
Kelly M Pirozzi, Andrew J Meyr
The clinical value of routine postoperative radiographic evaluation after orthopedic procedures has recently been called into question. The objective of the present investigation was to evaluate the ability of foot and ankle surgeons to accurately and reliably assess postoperative radiographs after first metatarsal-phalangeal joint arthrodesis. Thirty sets of digital radiographs from 11 patients who had undergone first metatarsal-phalangeal joint arthrodesis were retrospectively evaluated by 5 podiatric physicians board-certified in foot surgery...
March 3, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28251259/-hallux-valgus-etiology-diagnosis-and-therapeutic-principles
#20
B Zirngibl, J Grifka, C Baier, J Götz
Hallux valgus-the most common forefoot deformity-can cause both pain and decreased mobility. The development and progress of the hallux valgus is a multifactorial process. Different intrinsic and extrinsic causes are responsible. Various conservative and operative treatment options exist and have to been chosen regarding the stage of the disease. Conservative orthopedic measures may prevent a deterioration of hallux valgus only at an early stage of the disease. Concerning operative techniques, more than 150 different surgical procedures are described in the literature, which can be reduced to some common procedures...
March 1, 2017: Der Orthopäde
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