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E Sanchis-Sales, J L Sancho-Bru, A Roda-Sales, J Pascual-Huerta
A detailed description of the kinematics and kinetics of the ankle, midtarsal and metatarsophalangeal joints of the feet of a healthy adult male population during barefoot walking is provided. Plots of the angles and moments in each plane during the stance phase are reported, along with the mean and standard deviation values of 87 different parameters that characterise the 3D dynamics of the foot joints. These parameters were used to check for similarities between subjects through a hierarchical analysis that allowed three different gait patterns to be identified, most of the differences corresponding to the frontal and transverse planes...
May 19, 2017: Computer Methods in Biomechanics and Biomedical Engineering
Patrick A DeHeer
Equinus is linked to most lower extremity biomechanically related disorders. Defining equinus as ankle joint dorsiflexion less than 5° of dorsiflexion with the knee extended is the basis for evaluation and management of the deformity. Consistent evaluation methodology using a goniometer with the subtalar joint in neutral position and midtarsal joint supinated while dorsiflexing the ankle with knee extended provides a consistent clinical examination. For equinus deformity with an associated disorder, comprehensive treatment mandates treatment of the equinus deformity...
April 2017: Clinics in Podiatric Medicine and Surgery
H Zwipp
About 90 % of all cases of painful posttraumatic ankle arthritis can be very successfully treated with a minor invasive ankle arthrodesis technique by using a small anterior approach and a fixation with four 6. 5 mm screws of which the posteromedial and transfibular one are inserted percutaneously. The results with this standardized procedure have been reported previously as excellent and good in a mid-term run of 6 years (34). This technique leads to a high union rate of 99% (92 of 93) with rapid bone healing within 8 ± 2 weeks, it causes a low minor complication rate of 8 % and enables a significant increase of the AOFAS ankle/hindfoot score (17) from 36 preoperatively to 85 postoperatively as well as a midtarsal movement of 24° ± 16°...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Tun Hing Lui
A too-long anterior process (TLAP) of the calcaneus is an elongated anteromedial process of the calcaneus impinging the navicular or the talar head. TLAP can cause recurrent ankle sprain, peroneal muscle spasm, or persistent tarsal pain in adolescents. Arthroscopic resection is indicated if the symptoms do not respond to conservative treatment. It has the advantage of assessment of completeness of bone resection and treatment of associated lesions of the adjacent joints. The purpose of this technical note is to report an arthroscopic approach of the resection of the TLAP with the lateral midtarsal portal as the viewing portal...
October 2016: Arthroscopy Techniques
Andrew P Harris, Joseph A Gil, Avi D Goodman, Christopher R Nacca, Todd R Borenstein
The midtarsal joint, also known as the Chopart or the transverse tarsal joint, is composed of the talonavicular and calcaneocuboid articulations.(1) Midtarsal joint dislocations are rare injuries given the strong periarticular ligamentous support.2, 3 Medial, lateral, dorsal, and rarely plantar dislocations have been reported from multiple high-energy mechanisms.4, 5 We describe the case of a 24-year-old male who sustained talonavicular and calcaneocuboid plantar dislocations associated with a middle and lateral intercuneiform dislocation, open proximal 5th metatarsal fracture, 2nd-4th metatarsal base fractures, and lateral cuneiform fracture...
March 2017: Journal of Orthopaedics
Saravanaraja Muthusamy, Sheila A Conway, J David Pitcher, H Thomas Temple
Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Tiago M Malaquias, Carolina Silveira, Wouter Aerts, Friedl De Groote, Greta Dereymaeker, Jos Vander Sloten, Ilse Jonkers
Multibody simulations of human motion require representative models of the anatomical structures. A model that captures the complexity of the foot is still lacking. In the present work, two detailed 3D multibody foot-ankle models generated based on CT scans using a semi-automatic tool are described. The proposed models consists of five rigid segments (talus, calcaneus, midfoot, forefoot and toes), connected by five joints (ankle, subtalar, midtarsal, tarsometatarsal and metatarsophalangeal), one with 15DOF and the other with 8DOF...
February 2017: Computer Methods in Biomechanics and Biomedical Engineering
A Thiounn, C Szymanski, C Lalanne, K Soudy, X Demondion, C Maynou
INTRODUCTION: Foot and ankle injuries (FAI) are very common, with about 6000 cases per day in France. Unlike lateral ankle sprain (LAS), the diagnosis of midtarsal joint sprain (MJS, also known as Chopart's joint sprain) is not widely known. This prospective study aims to detail the epidemiology of MJS and compare it to LAS. PATIENTS AND METHOD: The study was conducted within our institution over a period of 16 months. Patients with clinical signs predictive of MJS without radiographic bone lesion underwent ultrasound assessment...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Dustin A Bruening, Timothy E Cooney, Matthew S Ray, Gregory A Daut, Kevin M Cooney, Stephanie M Galey
BACKGROUND: Foot and ankle movement alterations following ankle arthrodesis are still not well understood, particularly those that might contribute to the documented increase in adjacent joint arthritis. Generalized tarsal hypermobility has long been postulated, but not confirmed in gait or functional movements. The purpose of this study was to more thoroughly evaluate compensation mechanisms used by arthrodesis patients during level and uphill gait through a variety of measurement modalities and a detailed breakdown of gait phases...
October 2016: Foot & Ankle International
Enrique Sanchis-Sales, Joaquin L Sancho-Bru, Alba Roda-Sales, Javier Pascual-Huerta
BACKGROUND: Dynamic stiffness can be used for studying foot pathologic abnormalities and for developing prostheses and orthoses. Although previous works have studied the role of ankle joint stiffness during gait, other foot joints have not yet been analyzed. We sought to characterize the dynamic stiffness of the ankle, midtarsal, and metatarsophalangeal joints during normal walking. METHODS: Kinematics and contact data from four healthy individuals during walking were registered with a three-dimensional motion analysis system and a pressure platform...
January 2016: Journal of the American Podiatric Medical Association
Alexander T Mehlhorn, Hagen Schmal, Maria Anna Legrand, Norbert P Südkamp, Peter C Strohm
Fractures and dislocations of the cuneiform bones are rare injuries to the midtarsal foot. The injury severity is often unclear, and the prognostic factors are unknown. The purpose of the present study was to characterize our insights of the diagnostics, therapy, and fracture patterns. We questioned whether the number of involved cuneiform bones and the type of injury would affect the clinical outcome. With this information, we aimed to develop a classification system for injuries of the cuneonavicular joint...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Thomas C Prang
The hominin talus has figured prominently in previous studies of the functional morphology of the talocrural joint, but the talocalcaneal and talonavicular joints have received comparatively less attention despite their functional importance as components of the subtalar joint complex. An associated complete talus and calcaneus attributed to the Malapa Hominin 2 (MH2) individual of Australopithecus sediba offers the opportunity to evaluate the subtalar joint complex in an early hominin. Furthermore, detailed morphological comparisons of A...
January 2016: Journal of Human Evolution
Thomas C Prang
The longitudinal arch is one of the hallmarks of the human foot but its evolutionary history remains controversial due to the fragmentary nature of the fossil record. In modern humans, the presence of a longitudinal arch is reflected in the angular relationships among the major surfaces of the human talus and calcaneus complex, which is also known as the rearfoot. A complete talus and calcaneus of Australopithecus sediba provide the opportunity to evaluate rearfoot posture in an early hominin for the first time...
2015: Scientific Reports
Ezio Faglia, Giacomo Clerici, Robert Frykberg, Maurizio Caminiti, Vincenzo Curci, Francesco Cetta, Vincenzo Prisco, Rosaria Greco, Marco Prisco, Alberto Morabito
The purpose of the present retrospective study was to evaluate the outcomes (ie, ulcer recurrence, major amputation, death) in diabetic patients undergoing Chopart amputation because of deep infection or gangrene extending to the midfoot. From 2009 to 2011, 83 patients, aged 71.4 ± 9.3 years, underwent a midtarsal amputation and were followed up until December 31, 2012 (mean follow-up 2.8 ± 0.8 years). Of the 83 patients, 26 were female, 61 required insulin, 47 had renal insufficiency, 19 underwent hemodialysis, 65 had hypertension, 34 had a history of cardiac disease, and 4 had a history of stroke...
March 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Seungbum Koo, Kyoung Min Lee, Young Joo Cha
Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects...
October 2015: Gait & Posture
Zeeshan S Husain, Stephen Schmid, Nicholas Lombardo
The peer-reviewed, clinical data focusing on foot and ankle gunshot wounds are limited. The present study aimed to evaluate functional outcomes in a case series according to the area of injury, articular involvement, and the presence of infection. From January 2003 through February 2011 (8 years), 37 patients treated at Sinai-Grace Hospital (Detroit, MI) for civilian gunshot wounds localized to the foot and/or ankle were reviewed. Of these, 27 (72.97%) met the inclusion criteria. All acute wounds were thoroughly irrigated in the emergency room (8 of 27, 29...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Takumi Matsumoto, Selene G Parekh
UNLABELLED: Reconstructive surgeries for Charcot foot are challenging due to complicated conditions and comorbidities including poor bone quality, sensory abnormalities, poor vascularity, and immunity impairment. Although various fixation devices, including screws, plates, and external fixators, have been used in the surgical reconstruction of the Charcot midfoot, all of these devices are associated with some disadvantages. This study aims to evaluate the outcome of the Multi-Axial Correction (MAC) monolateral external fixation system for the reconstructive surgery of midfoot Charcot neuroarthropathy...
December 2015: Foot & Ankle Specialist
Catherine Patla, Janice Lwin, Laura Smith, Eric Chaconas
BACKGROUND AND PURPOSE: Posterior tibialis tendinopathy is a prevalent musculoskeletal condition often resulting in gait abnormalities along with medial ankle and foot pain. The purpose of this case report is to describe the treatment of a patient with a three year history of posterior tibialis tendinopathy utilizing a combination of cuboid manipulation and exercise. CASE DESCRIPTION: The patient was a 23-year old female recreational runner and collegiate basketball player reporting a three year history of chronic left ankle and lower leg pain...
June 2015: International Journal of Sports Physical Therapy
Kemal Erol, Ali Yavuz Karahan, Ülkü Kerimoğlu, Banu Ordahan, Levent Tekin, Muhammed Şahin, Ercan Kaydok
Posterior tibial tendon dysfunction (PTTD) is an important cause of acquired pes planus that frequently observed in adults. Factors that play a role in the development of PTTD such as age-related tendon degeneration, inflammatory arthritis, hypertension, diabetes mellitus, obesity, peritendinous injections and more rarely acute traumatic rupture of the tendon. PTT is the primary dynamic stabilizer of medial arch of the foot. Plantar flexion and inversion of the foot occurs with contraction of tibialis posterior tendon, and arch of the foot becomes elaveted while midtarsal joints are locked and midfoot-hindfoot sets as rigid...
January 28, 2015: Clinics and Practice
Cesare Faldini, Francesco Traina, Matteo Nanni, Antonio Mazzotti, Carlotta Calamelli, Daniele Fabbri, Camilla Pungetti, Sandro Giannini
Charcot-Marie-Tooth disease is the single most common diagnosis associated with cavus foot. The imbalance involving intrinsic and extrinsic muscles has been suggested as the main pathogenetic cause of cavus foot in this disease. The goal of surgical treatment is to correct the deformity to obtain a plantigrade foot. In the presence of a flexible deformity and the absence of degenerative arthritis, preserving as much as possible of the overall range of motion of the foot and ankle is advisable. Twenty-four cavus feet in twelve patients with Charcot-Marie-Tooth disease were included in the study...
March 18, 2015: Journal of Bone and Joint Surgery. American Volume
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