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Seth H Richman, Marcelo Bogliolo Piancastelli Siqueira, Kirk A McCullough, Mark J Berkowitz
BACKGROUND: K-wire fixation has been the most common method of fixation for hammertoe deformity. However intramedullary devices are gaining ground in both number of available choices and in procedures performed. This study aimed to compare the outcomes of hammertoe correction performed with K-wire fixation versus a novel intramedullary fusion device (CannuLink). METHODS: A retrospective review of hammertoe correction by a single surgeon was performed from June 2011 to December 2013...
October 18, 2016: Foot & Ankle International
Gary M LiMarzi, Kurt F Scherer, Michael L Richardson, David R Warden, Christopher W Wasyliw, Jack A Porrino, Christopher R Pettis, Gideon Lewis, Christopher C Mason, Laura W Bancroft
A variety of surgical procedures exist for repair of both traumatic and degenerative osseous and soft-tissue pathologic conditions involving the foot and ankle. It is necessary for the radiologist to be familiar with these surgical procedures, so as to assess structural integrity, evaluate for complicating features, and avoid diagnostic pitfalls. Adequate interpretation of postoperative changes often requires access to surgical documentation to evaluate not only the surgery itself but the expected timeline for resolution of normal postoperative changes versus progressive disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Caitlin K Gribbin, Scott J Ellis, Joseph Nguyen, Emilie Williamson, Elizabeth A Cody
BACKGROUND: Hallux valgus is frequently associated with additional forefoot pathologies, including hammertoes and midfoot osteoarthritis (OA). However, the pathogenesis of these concurrent pathologies remains to be elucidated. We sought to determine whether there is a relationship between demographic and radiographic parameters and the incidence of secondary pathologies in the setting of a bunion, with an emphasis on second tarsometatarsal (TMT) OA and hammertoes. METHODS: A total of 153 patients (172 feet) who underwent reconstruction for hallux valgus were divided into 3 groups: (1) bunion only (61 patients), (2) bunion with hammertoe without second TMT joint OA (78 patients), and (3) bunion with second TMT joint OA (14 patients)...
September 12, 2016: Foot & Ankle International
Richard M Jay, D Scot Malay, Adam S Landsman, Nathan Jennato, James Huish, Melissa Younger
We undertook a multicenter, parallel treatment arm, randomized controlled trial to compare the outcomes after surgery for the treatment of lesser digital hammertoe using either a Kirschner wire or a 2-piece intramedullary, stainless steel implant for fixation of the proximal interphalangeal joint. Our primary aim was to compare the incidence of arthrodesis and complications, and our secondary aim was to compare the subjective foot-related outcomes measured using the Bristol Foot Score and the Foot Function Index, stratified by fixation group...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Christopher R Hood, Douglas K Blacklidge, Scott M Hoffman
UNLABELLED: Digital arthrodesis is one of the most common surgical procedures performed by the foot and ankle surgeon. The market offers a variety of devices available to the surgeon to accomplish solid, permanent, and safe fusion for the patient. However, with these new devices come high surgical costs, adding to the burden on the already strapped health care system. We offer a simple technique updating the way in which a Kirschner wire is utilized for interphalangeal digital arthrodesis that employs the benefits of the newer implantable devices at a fraction of the cost...
October 2016: Foot & Ankle Specialist
Kathie J Whitt, Sarah A Rincker, Christopher F Hyer
Ninety percent of patients with rheumatoid arthritis will display foot and ankle pathologic features, including hallux valgus, lesser metatarsophalangeal (MTP) joint subluxation/dislocation, and hammertoe deformity. Recently, a trend has ensued toward joint preservation with distal metatarsal osteotomies and various bunion corrective procedures. However, the reference standard remains first MTP joint fusion, lesser metatarsal head resection, and lesser proximal interphalangeal joint fusion. The present retrospective study followed the results of 4 different surgeons who had performed the reference standard rheumatoid forefoot reconstruction from August 2008 to August 2012 on patients with rheumatoid arthritis...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Marcelo Back Sternick, Pierina Kaneno Ishida Formentini, Gustavo Moreira Costa de Souza, Eduardo Cembranelli Teixeira, Ildeu Afonso de Almeida Filho, Sérgio Moreira da Costa
BACKGROUND: Inherited epidermolysis bullosa is a rare disease characterised by mechanical fragility of the skin when under insignificant stress. The main consequences of epidermolysis bullosa, mainly the dystrophic type, despite pseudosyndactyly, are joint contractures and deformities in hands and feet. In this study, we describe our experience treating patients suffering from epidermolysis bullosa, as far as feet deformities are concerned. METHODS: This is a retrospective analysis of a consecutive series of patients presenting feet deformities related to epidermolysis bullosa...
July 2016: International Orthopaedics
Vanessa Dinoá, Felipe von Ranke, Flavia Costa, Edson Marchiori
OBJECTIVE: To present findings of plantar plate (PP) lesions from MRI with administration of gadolinium and to differentiate PP lesions from others causes of metatarsalgia. MATERIALS AND METHODS: Two musculoskeletal radiologists reviewed 249 contrast-enhanced forefoot MRI scans from patients with metatarsalgia between June 2012 and June 2013. Evaluations focused on hyper-vascularized/fibrous tissue and other findings associated with PP tears. RESULTS: Fifty-nine patients had PP tears, 59 % were female...
May 2016: Skeletal Radiology
Troy J Boffeli, Jonathan C Thompson, Jessica A Tabatt
Single-pin external Kirschner wire (K-wire) fixation has traditionally been a mainstay in proximal interphalangeal joint fusion for central hammertoe repair. Concerns over cosmesis, inconvenience, pin tract infection, hardware failure, nonunion, and early hardware removal have led to the development of implantable internal fixation devices. Although numerous implantable devices are now available and represent viable options for hammertoe repair, they are costly and often pose a challenge in the event removal becomes necessary...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Joost C Schrier, Noel L Keijsers, Giovanni A Matricali, Jan Willem K Louwerens, Cees C P M Verheyen
BACKGROUND: It is unclear whether proximal interphalangeal joint (PIPJ) resection or fusion leads to superior clinical outcome in patients undergoing hammertoe surgery. The purpose of this study was to prospectively evaluate a series of patients undergoing this surgery. METHODS: Patients with one or more toes with rigid PIP flexion deformity were prospectively enrolled. These patients were randomly assigned to undergo either PIPJ resection or PIPJ fusion. In addition to the PIPJ procedure, a metatarsophalangeal joint (MTPJ) release was performed if deemed necessary...
June 2016: Foot & Ankle International
Syed Haque, Rajesh Kakwani, Caroline Chadwick, Mark Bowen Davies, Chris M Blundell
BACKGROUND: As in all fields of surgery, advances in orthopaedic surgery develop toward less invasive surgical techniques. The advantages of smaller incisions include minimal soft tissue dissection allowing procedures to be performed as outpatient surgery. There is the assumption that this leads to a quicker recovery time permitting an earlier return to work. As with any new surgical technique, there is an associated learning curve. This study looked into the outcome of minimally invasive distal metatarsal metaphyseal osteotomy (DMMO) performed at a University Hospital...
January 2016: Foot & Ankle International
Christophe Averous, Frederic Leider, Hubert Rocher, Patrice Determe, Stephane Guillo, Christophe Cermolacce, Patrice Diebold
BACKGROUND: Interphalangeal arthrodesis is a very common surgical treatment of rigid hammertoe and claw toe deformities. The K-wires habitually used in this procedure are sometimes complicated by pin tract infection, migration, discomfort, and breakage. The aim of this study is to evaluate the results of an interphalangeal arthrodesis with a new radiolucent angulated intramedullary implant. METHODS: A total of 377 implants were placed in 297 patients between October 1, 2011, and October 1, 2012...
December 2015: Foot & Ankle Specialist
David Redfern, Joel Vernois, Barbara Piclet Legré
This article describes some of the common techniques used in percutaneous surgery of the forefoot. Techniques such as minimally invasive chevron Akin osteotomy for correction of hallux valgus, first metatarsophalangeal joint cheilectomy, distal minimally invasive metatarsal osteotomies, bunionette correction, and hammertoe correction are described. This article is an introduction to this rapidly developing area of foot and ankle surgery. Less invasive techniques are continually being developed across the whole spectrum of surgical specialties...
July 2015: Clinics in Podiatric Medicine and Surgery
Matteo Guelfi, Andrea Pantalone, Janos Cambiaso Daniel, Daniele Vanni, Marco G B Guelfi, Vincenzo Salini
BACKGROUND: Proximal inter-phalangeal (PIP) joint arthrodesis today represents the standard treatment for structured hammertoes; however, recently, a lot of new intramedullary devices for the fixation of this arthrodesis have been introduced. The purpose of this work is to look at the currently available devices and to perform a review of the present literature. MATERIALS AND METHODS: A literature search of PubMed/Medline and Google Scholar databases, considering works published up until September 2014 and using the keywords: hammertoe, arthrodesis, PIP joint, fusion, intramedullary devices, and K-wire, was performed...
December 2015: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Attilio Basile, Francesco Albo, Alessio Giai Via
Hammertoe is one of the most common foot deformities. Arthrodesis or arthroplasty of the proximal interphalangeal joint using temporary Kirschner wire fixation is the most widespread method of surgical stabilization. However, this type of fixation is associated with some potential complications that can be obviated if percutaneous fixation is avoided. The purpose of the present study was to prospectively collect clinical and radiographic outcomes of operative correction of hammertoe deformity using a permanently implanted 1-piece intramedullary device...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Luís Negrão, Luciano Almendra, Joana Ribeiro, Anabela Matos, Argemiro Geraldo, Jorge Pinto-Basto
INTRODUCTION: CMT4B2 is a rare subtype of CMT caused by pathogenic mutations in the myotubularin-related protein-13/set binding factor 2 (MTMR13/SBF2) gene. Nerve conduction velocities are markedly reduced and focally folded myelin sheaths are present on nerve biopsies. We presented two patients from two related Portuguese families with peripheral neuropathy caused by a novel mutation in the MTMR13/SBF2 gene. CASE REPORT: Family 1: Patient 1: A 30-year-old woman, with disease onset in early childhood presented pes cavus and hammertoes and walked with a steppage gait...
December 2014: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
William C Kramer, Michael Parman, Richard M Marks
BACKGROUND: Kirschner wire (K-wire) fixation for correction of hammertoe deformity is a common, low-cost method for fixation of hammertoes after proximal interphalangeal (PIP) arthroplasty or fusion. Complications of this procedure include pin-tract infection, pin migration, pin bending or breakage, and recurrence of deformity. The investigators reviewed a large experience using K-wire stabilization for hammertoe correction. METHODS: All hammertoe corrections performed by a single surgeon from 1999 to 2013 were retrospectively reviewed...
May 2015: Foot & Ankle International
William Arrington, Matthew Britt
Few studies exist investigating surgical hammertoe correction salvage procedures regarding poor outcomes secondary to silastic implant failure. We present a case of a patient who presented to our clinic with a grossly deformed digit after undergoing several silastic implant procedures. The patient wanted to salvage the toe and elected for surgical intervention. Surgical planning consisted of a V-Y skin plasty with interposition of calcaneal autograft. This allowed restoration of anatomic dimensions and function of the patient's digit...
January 2015: Journal of the American Podiatric Medical Association
Seung Eun Lee, Seung Won Park, Sam Yeol Ha, Taek Kyun Nam
To present a case of cauda equina syndrome (CES) caused by chronic inflammatory demyelinating polyneuropathy (CIDP) which seemed clinically similar to Charcot-Marie-Tooth disease type1 (CMT1). CIDP is an immune-mediated polyneuropathy, either progressive or relapsing-remitting. It is a non-hereditary disorder characterized by symmetrical motor and sensory deficits. Rarely, spinal nerve roots can be involved, leading to CES by hypertrophic cauda equina. A 34-year-old man presented with low back pain, radicular pain, bilateral lower-extremity weakness, urinary incontinence, and constipation...
June 2014: Journal of Korean Neurosurgical Society
Amiethab A Aiyer, Raheel Shariff, Li Ying, Jeffrey Shub, Mark S Myerson
BACKGROUND: Metatarsus adductus (MA) is a congenital condition in which there is adduction of the metatarsals in conjunction with supination of the hindfoot through the subtalar joint. It is generally believed that MA precedes the development of hallux valgus. Historically, studies have demonstrated that patients with a history of MA were ~3.5 times more likely to develop hallux valgus. The purpose of this study was to identify the relative prevalence of MA in patients undergoing surgery for symptomatic hallux valgus...
December 2014: Foot & Ankle International
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