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https://www.readbyqxmd.com/read/27458897/a-simple-method-for-fixation-of-proximal-opening-wedge-osteotomy-of-the-first-metatarsal-for-correction-of-hallux-valgus
#1
A Erdem Bagatur, Mehmet Albayrak, Yunus Emre Akman, Merter Yalcinkaya, Utku Erdem Ozer, Mehmet Burak Yalcin
A simple, inexpensive technique for fixation of proximal opening-wedge osteotomy of the first metatarsal for correction of moderate or severe hallux valgus (HV) is described. After the opening-wedge osteotomy and bone grafting of the first metatarsal have been performed, 2 Kirschner wires are introduced for internal fixation and removed 8 weeks postoperatively. Twenty-three patients with symptomatic HV who had a proximal medial opening-wedge osteotomy of the first metatarsal in combination with a distal soft tissue procedure and bunionectomy were evaluated retrospectively...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/26995799/solumatrix%C3%A2-diclofenac-sustained-opioid-sparing-effects-in-a-phase-3-study-in-patients-with-postoperative-pain
#2
Charles Argoff, Bill McCarberg, Jeff Gudin, Srinivas Nalamachu, Clarence Young
OBJECTIVES: To evaluate opioid rescue medication usage and the opioid-sparing effect of low-dose SoluMatrix(®) diclofenac developed using SoluMatrix Fine Particle Technology™ in a phase 3 study in patients experiencing pain following bunionectomy surgery. DESIGN: Multicenter, randomized, double-blind, parallel-group study (NCT01462435). SETTING: Four clinical research centers in the United States. SUBJECTS: Four hundred twenty-eight patients aged 18 to 65 years who experienced moderate-to-severe pain following bunionectomy surgery...
October 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/26792613/effect-of-surgical-shoes-on-brake-response-time-after-first-metatarsal-osteotomy-a-prospective-cohort-study
#3
Dietmar Dammerer, Matthias Braito, Rainer Biedermann, Michael Ban, Johannes Giesinger, Christian Haid, Michael C Liebensteiner, Gerhard Kaufmann
BACKGROUND: The aim of this study is to assess patients' driving ability when wearing surgical shoes following right-sided first metatarsal osteotomy. METHODS: From August 2013 to August 2015, 42 consecutive patients (mean age 54.5 years) with right-sided hallux valgus deformity underwent first metatarsal osteotomy. Patients were tested for brake response time (BRT) 1 day preoperatively (control run) and at 2 and 6 weeks postoperatively. Two different types of foot orthosis were investigated...
January 20, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/26683233/research-design-considerations-for-single-dose-analgesic-clinical-trials-in-acute-pain-immpact-recommendations
#4
REVIEW
Stephen A Cooper, Paul J Desjardins, Dennis C Turk, Robert H Dworkin, Nathaniel P Katz, Henrik Kehlet, Jane C Ballantyne, Laurie B Burke, Eugene Carragee, Penney Cowan, Scott Croll, Raymond A Dionne, John T Farrar, Ian Gilron, Debra B Gordon, Smriti Iyengar, Gary W Jay, Eija A Kalso, Robert D Kerns, Michael P McDermott, Srinivasa N Raja, Bob A Rappaport, Christine Rauschkolb, Mike A Royal, Märta Segerdahl, Joseph W Stauffer, Knox H Todd, Geertrui F Vanhove, Mark S Wallace, Christine West, Richard E White, Christopher Wu
This article summarizes the results of a meeting convened by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) on key considerations and best practices governing the design of acute pain clinical trials. We discuss the role of early phase clinical trials, including pharmacokinetic-pharmacodynamic (PK-PD) trials, and the value of including both placebo and active standards of comparison in acute pain trials. This article focuses on single-dose and short-duration trials with emphasis on the perioperative and study design factors that influence assay sensitivity...
February 2016: Pain
https://www.readbyqxmd.com/read/26683109/a-randomized-phase-2-study-investigating-trv130-a-biased-ligand-of-the-%C3%AE-opioid-receptor-for-the-intravenous-treatment-of-acute-pain
#5
RANDOMIZED CONTROLLED TRIAL
Eugene R Viscusi, Lynn Webster, Michael Kuss, Stephen Daniels, James A Bolognese, Seth Zuckerman, David G Soergel, Ruth Ann Subach, Emily Cook, Franck Skobieranda
Efficacy of conventional opioids can be limited by adverse events (AEs). TRV130 is a structurally novel biased ligand of the μ-opioid receptor that activates G protein signaling with little β-arrestin recruitment. In this phase 2, randomized, placebo- and active-controlled study, we investigated the efficacy and tolerability of TRV130 in acute pain after bunionectomy. We used an adaptive study design in which 144 patients experiencing moderate-to-severe acute pain after bunionectomy were randomized to receive double-blind TRV130, placebo, or morphine in a pilot phase...
January 2016: Pain
https://www.readbyqxmd.com/read/26535968/a-pharmacokinetic-evaluation-of-single-and-multiple-doses-of-extended-release-hydrocodone-bitartrate-in-subjects-experiencing-surgical-or-osteoarthritic-pain
#6
RANDOMIZED CONTROLLED TRIAL
Cynthia Y Robinson, Christopher M Rubino, Stephen J Farr
OBJECTIVES: To assess the single-dose and steady-state pharmacokinetics of a single-entity hydrocodone extended-release (ER) formulation in patients enrolled in two separate phase 2 clinical studies. SETTING: Both studies were multicenter clinical studies. SUBJECTS AND INTERVENTIONS: In study 1, 115 subjects with postsurgical pain (bunionectomy) received single doses of 10, 20, 30, or 40 mg hydrocodone-ER, 10 mg hydrocodone/325 mg acetaminophen immediate-release (IR), or placebo...
September 2015: Journal of Opioid Management
https://www.readbyqxmd.com/read/26472569/liquid-adhesive-contact-dermatitis-after-bunionectomy-a-case-report-and-literature-review
#7
REVIEW
Christopher R Hood, Rhonda S Cornell, Bruce Greenfield
Hypersensitivity reactions to the skin adherents used in postoperative dressings are an uncommon but unfavorable complication that can result in poor wound healing, increased scarring, and surgical wound infections. This unexpected and unforeseen complication is not well documented in the current published data. We present the case of a 39-year-old female who had undergone a bunionectomy procedure and developed allergic contact dermatitis postoperatively. We discuss the clinical findings and treatments administered after application of a commonly used liquid skin adhesive applied intraoperatively...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26364703/the-relationship-between-the-sesamoid-complex-and-the-first-metatarsal-after-hallux-valgus-surgery-without-lateral-soft-tissue-release-a-prospective-study
#8
José María Lamo-Espinosa, Borja Flórez, Carlos Villas, Juan Pons-Villanueva, José M Bondía, Jesús Dámaso Aquerreta, Matias Alfonso
Some investigators have emphasized restoring the relationship between the sesamoid complex and the first metatarsal head to reduce the risk of hallux valgus recurring after surgical reconstruction. In a prospective study, we analyzed whether the first metatarsophalangeal joint could be realigned after scarf-Akin bunionectomy without lateral soft tissue release. A total of 25 feet, in 22 patients, were prospectively enrolled and analyzed using anteroposterior radiographs and coronal computed tomography scans obtained before and 3 months after surgery...
November 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26293513/tapentadol-immediate-release-for-acute-postbunionectomy-pain-a-phase-3-randomized-double-blind-placebo-controlled-parallel-group-study-in-taiwan
#9
RANDOMIZED CONTROLLED TRIAL
Yeung-Jen Chen, Chao-Ching Chiang, Peng-Ju Huang, Jason Huang, Keith Karcher, Honglan Li
OBJECTIVE: To evaluate the efficacy and safety of tapentadol immediate-release (IR) for treating acute pain following orthopedic bunionectomy surgery in a Taiwanese population. METHODS: This was a phase 3, randomized, double-blind, placebo-controlled, parallel-group bridging study in which Taiwanese patients (N = 60) with moderate-to-severe pain following bunionectomy were randomized (1:1:1) to receive tapentadol IR 50 or 75 mg or placebo orally every 4-6 hours over a 72 hour period...
November 2015: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/26004029/low-dose-solumatrix-diclofenac-a-review-of-safety-across-two-phase-iii-studies-in-patients-with-acute-and-osteoarthritis-pain
#10
REVIEW
Allan Gibofsky, Roy Altman, Stephen Daniels, Olaolu Imasogie, Clarence Young
INTRODUCTION: Similar to other NSAIDs, diclofenac is associated with serious dose-related cardiovascular, gastrointestinal, and renal adverse events. Low-dose SoluMatrix diclofenac , containing submicron particles of diclofenac, was developed to provide effective analgesia at lower drug doses compared with currently available NSAIDs. AREAS COVERED: The efficacy and safety of low-dose SoluMatrix diclofenac was evaluated in two randomized, placebo-controlled Phase III studies: a study in patients with acute pain following bunionectomy surgery and a study in patients with osteoarthritis pain of the hip or knee...
August 2015: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/25796986/randomized-double-blind-placebo-controlled-study-of-the-efficacy-and-safety-of-biphasic-immediate-release-extended-release-hydrocodone-bitartrate-acetaminophen-tablets-for-acute-postoperative-pain
#11
RANDOMIZED CONTROLLED TRIAL
Neil Singla, Rachel Margulis, Kenneth Kostenbader, Yanping Zheng, Thomas Barrett, Michael J Giuliani, Yin Chen, Jim L Young
BACKGROUND: A fixed-dose combination biphasic immediate-release (IR)/extended-release (ER) hydrocodone bitartrate (HB)/acetaminophen (APAP) tablet is being developed for the management of acute pain severe enough to require opioid treatment and for which alternative treatment options are inadequate. METHODS: This Phase III, randomized, double-blind, placebo-controlled, parallel-group study evaluated the analgesic efficacy and safety of IR/ER HB/APAP (n = 201) versus placebo (n = 202) over a period of 48 hours in patients with acute moderate to severe pain following unilateral bunionectomy...
May 2015: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/25678812/assessment-of-rescue-opioid-use-in-patients-with-post-bunionectomy-pain-treated-with-diclofenac-potassium-liquid-filled-capsules
#12
Joyce S Willens, Iwona Bucior, Shay Bujanover, Neel Mehta
When used in multimodal analgesia for acute pain, nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the requirement for opioids during the perioperative period. To provide more insight into pain treatment during the outpatient period, we examined the use of opioid rescue medication (RM) and described the relationship between pain intensity and RM use in patients with acute pain after bunionectomy. Patients received placebo or 25 mg of a liquid-filled capsule version of the NSAID diclofenac potassium (DPLFC; n=188 patients/group) every 6 hours during the 48-hour inpatient period through the end of outpatient dosing on day 4...
2015: Journal of Pain Research
https://www.readbyqxmd.com/read/25303454/local-infiltration-of-liposome-bupivacaine-in-foot-and-ankle-surgery-case-based-reviews
#13
REVIEW
Steven A Herbst
Foot and ankle surgical procedures, ranging from simple procedures, such as bunionectomy and correction of hammer toe, to more complex surgery, such as ankle fusion and ankle replacement, are extremely painful. Moreover, there is increasing interest in performing these procedures in an outpatient setting. Nerve blocks are extensively used in foot and ankle surgery, and commonly used techniques include sciatic nerve block with saphenous nerve augmentation; ankle block; and local, digital, or field block. Whereas more extensive blocks are associated with increased medical risk, higher cost, and delayed ambulation, more local approaches may not provide an adequate duration of effect...
October 2014: American Journal of Orthopedics
https://www.readbyqxmd.com/read/25288331/postoperative-pain-and-preemptive-local-anesthetic-infiltration-in-hallux-valgus-surgery
#14
Artur Gądek, Henryk Liszka, Jerzy Wordliczek
BACKGROUND: Several techniques of anesthesia are used in foot surgery. Preemptive analgesia helps to prevent the development of hypersensitivity in the perioperative period. The aim of our study was to assess the role of preemptive local anesthetic infiltration and postoperative pain after hallux valgus surgery. METHODS: We evaluated 118 patients who underwent modified chevron and mini-invasive Mitchell-Kramer bunionectomy of the first distal metatarsal. After spinal anesthesia each patient randomly received an infiltration of local anesthetic or the same amount of normal saline 10 minutes before the skin incision...
March 2015: Foot & Ankle International
https://www.readbyqxmd.com/read/25159356/a-dose-finding-study-of-sufentanil-sublingual-microtablets-for-the-management-of-postoperative-bunionectomy-pain
#15
RANDOMIZED CONTROLLED TRIAL
Neil K Singla, Derek D Muse, Mark A Evashenk, Pamela P Palmer
BACKGROUND: Sufentanil sublingual microtablets (SSMs) at a dose of 15 µg per tablet have been studied for postoperative patient-controlled analgesia with a 20-minute lockout via a bedside handheld system over 2 days to 3 days of use. For more short-term (<24 hours) management of acute moderate-to-severe pain, such as in the ambulatory surgical setting, a single, higher-strength SSM dose administered via a health care provider would be of benefit as it would require less frequent administration and avoid the setup of a drug delivery system...
September 2014: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25157951/assessment-of-the-safety-and-efficacy-of-extended-release-oxycodone-acetaminophen-for-14-days-postsurgery
#16
RANDOMIZED CONTROLLED TRIAL
Neil Singla, Thomas Barrett, Lisa Sisk, Kenneth Kostenbader, Jim Young
OBJECTIVE: To investigate the safety and satisfaction of patients treated ≤ 14 days after unilateral bunionectomy with extended-release oxycodone/acetaminophen (ER OC/APAP), a biphasic (ER and immediate release) fixed-dose combination analgesic being developed for moderate to severe acute pain. RESEARCH DESIGN AND METHODS: This was an open-label extension (OLE) of a randomized, double-blind, placebo-controlled trial (DBRCT) of patients undergoing bunionectomy...
December 2014: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/25128308/a-retrospective-study-of-two-lapidus-groups-each-with-a-different-method-of-rail-application
#17
Thomas A Paulick, Brian J Conley, Robert M Brarens, Renee L Ash
To date, few studies discussing the use of rail external fixation for the Lapidus procedure have presented acceptable complication rates. At least 1 study has suggested the technique is not recommended for routine use with this procedure. We present 2 methods of external fixation application and 2 protocols of early postoperative weightbearing in 25 patients, with a marked decrease in complication rates from previously published studies. A retrospective study of 25 patients (within 2 patient groups) was performed, with a mean follow-up of 20 (range 12 to 38) months...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/25060815/the-radiographic-effects-of-the-scarf-bunionectomy-on-rearfoot-alignment
#18
Nicholas G Argerakis, Lowell Weil, Lowell Scott Weil, Dimitrios Anagnostopoulos, Catherine A Feuerstein, Erin E Klein, Ashley K Boccio
STATEMENT OF PURPOSE: Excessive pronation of the rearfoot has been implicated as a destabilizing force in the progression of hallux abducto valgus. Although the scarf bunionectomy has been shown to effectively correct the intermetatarsal angle associated with hallux valgus deformity, its effect on the rearfoot has yet to be established. The purpose of this case series is to demonstrate the effect of the scarf bunionectomy on rearfoot alignment. METHODOLOGY: Medical records were reviewed to isolate patients who underwent unilateral or bilateral scarf bunionectomies (with or without akin osteotomy) who had complete medical records, follow-up of at least 12 months, and met the inclusion/exclusion criteria...
April 2015: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/24958073/effects-of-the-lapidus-arthrodesis-and-chevron-bunionectomy-on-plantar-forefoot-pressures
#19
Christy M King, Graham A Hamilton, Lawrence A Ford
Hallux valgus with or without first ray insufficiency has been strongly implicated as a contributing factor in lesser metatarsal overload. The principle goals of a bunionectomy are to relieve the pain, correct the deformity, and restore first metatarsophalangeal joint congruity. Until now, little evidence has been available to assess the effects of bunionectomy procedures on forefoot pressure. The primary aim of the present prospective study was to evaluate the preoperative and postoperative plantar pressures after 2 specific bunionectomies: the chevron bunionectomy and Lapidus arthrodesis...
July 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/24901590/incidental-pedal-manifestation-of-primary-bone-lymphoma-a-case-report
#20
REVIEW
Nicole M DeLauro, Shital Sharma, Nrupa Shah, Imtiaz Ahmed
Primary lymphoma of bone (PLB) is an uncommon entity and is extremely rare in the foot and ankle. In this case, PLB was identified from the bone specimen after a bunionectomy of the first and fifth metatarsals. The diagnosis was confirmed with pathologic analysis, genetic karyotyping, positron emission and computed tomography scans, and fluorescence in situ hybridization (FISH). We felt that reporting this case was essential due to the rarity of its pedal occurrence and the lack of preoperative signs or symptoms...
May 2014: Journal of the American Podiatric Medical Association
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