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Foot and ankle orthopedics

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
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
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
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
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...
September 25, 2016: Foot & Ankle International
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
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
Federico Giuseppe Usuelli, Riccardo D'Ambrosi, Camilla Maccario, Michele Boga, Laura de Girolamo
PURPOSE: Autologous Matrix-Induced Chondrogenesis (AMIC(®)) is known to provide satisfactory clinical results for the treatment of knee, hip, and ankle cartilage lesions. The purpose of this study was to evaluate clinical and radiological outcomes of patients treated with a new all-arthroscopic AMIC(®) (AT-AMIC(®)) technique with autologous bone graft for talar osteochondral defects at a follow-up of 24 months. METHODS: Twenty patients underwent the AT-AMIC(®) procedure and autologous bone graft for type III and IV talar osteochondral lesions...
September 12, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Lian-Hua Li, Yong-Zhi Guo, Hao Wang, Qing-Hua Sang, Jian-Zheng Zhang, Zhi Liu, Tian-Sheng Sun
BACKGROUND: We conducted a prospective randomized clinical trial to compare the clinical and radiological outcomes of the sinus tarsi and extended lateral approaches for the surgical treatment of displaced intraarticular calcaneal fractures. METHODS: Between January 2009 and January 2014, patients with displaced intraarticular calcaneal fracture were randomly assigned to receive surgical treatment by the sinus tarsi approach or the extended lateral approach using block randomization...
September 2016: Medicine (Baltimore)
Sean Lai Wei Hong, Camelia Tang Qian Ying, Lynn Thwin, Gowreeson Thevendran
The primary aim of the present study was to examine the time required and the ability of a consecutive series of patients undergoing open calcaneoplasty with reattachment of the Achilles tendon to return to their preoperative level of sporting activity. The secondary aim was to evaluate the functional outcomes and complication profile of this procedure. Open calcaneoplasty was performed on 22 feet (14 left [63.6%] and 8 right [36.4%]) in 22 consecutive patients, with a mean age of 55.28 ± 9.17 years. The mean postoperative follow-up time was 21...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Murat Daş, Aytun Temiz, Yunsur Çevik
BACKGROUND: The present objective was to assess implementation of the Ottawa ankle rules (OAR) as a method of fracture prediction in the emergency department (ED) of a Turkish state hospital. METHODS: Patients who presented to the ED of our hospital with acute ankle injury were evaluated. All were examined by a general practitioner, after which a series of ankle and foot x-rays (anteroposterior and lateral) were performed. Radiography was examined by a radiologist and an orthopedic surgeon, both of whom were blinded to OAR results...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Anthony Dugarte, Sahil Bharwani, HoJun Yoo, Alexander Vondra Boiwka, Charles C Yu, Navkirat S Bajwa, Jason O Toy, Jonathan E Tang, Uri Ahn, Nicholas Ahn
Surgical models have best shown the relationship between ankle and mid-foot osteoarthritis, although findings regarding the calcaneocuboid joint have varied. To the authors' knowledge, no studies have evaluated the relationship between degenerative changes across the tibiotalar and calcaneocuboid joints. The goal of this study was to determine whether such a relationship exists and which joint degenerates first. A single examiner evaluated 694 tibiotalar and calcaneocuboid joints to determine the presence of osteoarthritis...
August 30, 2016: Orthopedics
Baoyou Fan, Xianhu Zhou, Zhijian Wei, Yiming Ren, Wei Lin, Yan Hao, Guidong Shi, Shiqing Feng
BACKGROUND: Displaced intra-articular calcaneus fractures (DIACFs) are the most common type of calcaneus fracture. The differences in therapeutic effectiveness between cannulated screw fixation (CSF) and plate fixation are still unclear. Thus, in this meta-analysis, we evaluated the therapeutic effectiveness of these two fixation methods. MATERIALS AND METHODS: We searched for all publications on DIACFs fixated with cannulated screws or plates in the following electronic databases: Pubmed, Cochrane, Embase and CNKI...
August 23, 2016: International Journal of Surgery
Oliver Ludwig, Jens Kelm, Michael Fröhlich
BACKGROUND: Peroneus longus acts as a foot evertor and pronator, thus ensuring stability of the talocrural joint by curbing inversion movement of the rearfoot. Increased activation of the peroneus longus muscle in the stance phase could have a stabilising effect on the ankle joint. This study aimed to determine whether the activity of the peroneus longus muscle could be increased by the targeted use of a specially formed lateral pressure element in a customised orthopaedic insole. METHODS: This was a laboratory-based study that utilised a randomised crossover design...
2016: Journal of Foot and Ankle Research
Bryant Ho, Jeff R Houck, Adolph S Flemister, John Ketz, Irvin Oh, Benedict F DiGiovanni, Judith F Baumhauer
BACKGROUND: The use of patient-reported outcomes continues to expand beyond the scope of clinical research to involve standard of care assessments across orthopedic practices. It is currently unclear how to interpret and apply this information in the daily care of patients in a foot and ankle clinic. We prospectively examined the relationship between preoperative patient-reported outcomes (PROMIS Physical Function, Pain Interference and Depression scores), determined minimal clinical important differences for these values, and assessed if these preoperative values were predictors of improvement after operative intervention...
September 2016: Foot & Ankle International
Roslyn J Miller
Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot...
September 2016: Foot and Ankle Clinics
James Amis
We are currently in the process of discovering that many, if not the majority, of the non-traumatic acquired adult foot and ankle problems are caused by a singular etiology: non-neuromuscular equinus or the isolated gastrocnemius contracture. There is no question that this biomechanical association exists and in time much more will be uncovered. There are three basic questions that must be answered: why would our calves tighten as we normally age, how does a tight calf, or equinus, actually cause problems remotely in the foot and ankle, and how do the forces produced by equinus cause so many seemingly unrelated pathologies in the foot and ankle? The purpose of this paper is to address the second question: how does a tight calf mechanically cause problems remotely in the foot and ankle? There has been little evidence in the literature addressing the biomechanical mechanisms by which equinus creates damaging forces upon the foot and ankle, and as a result, a precise, convincing mechanism is still lacking...
2016: Frontiers in Surgery
A A Gusarov, V A Fetisov, Yu O Kucheryavets
This article reports the results of the commission forensic medical expertise undertaken to evaluate the possibility of severe injury to the ankle joint resulting from the road traffic accident as exemplified by the collision of a VAS 21043 car moving backward with a pedestrian. It was shown that the injury to the victim's right lower leg included the tear of the right crural deltoid ligament, the open communicated fracture of the lower third of fibular diaphysis with the displacement of the distal fragment, the lacerated wound in the lower third of the right leg, the rupture of distal tibiofibular synedesmosis, the closed communicated fracture of the posterior edge of the tibia without displacement, and outward subluxation of the right foot...
July 2016: Sudebno-meditsinskaia Ekspertiza
Christoph Knoth, Leonie Carow, Ralph Zettl, JoEllen Welter, Florian Hess
BACKGROUND: Short- and long-term assessments were performed of a modification to the Kramer osteotomy that developed to stabilize the metatarsal head using an angular implant, the LINK(®) internal hallux fixator (Waldemar LINK GmbH & Co. KG, Hamburg, Germany). METHODS: For this retrospective study, radiological assessments were used to measure outcomes in 72 feet with hallux valgus treated from 2006 to 2011. The hallux-valgus angle, the intermetatarsal angle between the first and second intermetarsal shaft axes, and the distal metatarsal articular angle were measured at short- and long-term intervals...
October 2016: Archives of Orthopaedic and Trauma Surgery
Ali Seker, Adnan Kara, Raffi Armagan, Yunus Oc, Ali Varol, Hasan Basri Sezer
OBJECTIVE: Repair of the neglected achilles tendon ruptures can be challenging due to retraction of tendon stumps. Different repair and augmentation techniques were described. This study aims to investigate long-term results of neglected achilles tendon rupture repair with gastrocnemius flaps. PATIENTS AND METHODS: Between 1995 and 2005, 21 neglected achilles tendon rupture reconstructions were performed with using gastrocnemius fascial flaps. Mean age was 32.1 years...
October 2016: Archives of Orthopaedic and Trauma Surgery
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