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Mark A Prissel, Christopher F Hyer, Gregory C Berlet
Total ankle replacement (TAR) is an accepted treatment for end-stage ankle arthritis. When concurrent subtalar joint pathologic features exist, ipsilateral subtalar joint arthrodesis (STJA) can be performed either simultaneous with TAR or as a staged procedure. Limited data exist on the effect of talar component subsidence and prosthesis survivorship. The present study purpose was to evaluate the effect of STJA on talar component subsidence after primary TAR and its effect on TAR survivorship. All patients, a minimum of 18 years old, from a single institution with modern-generation TAR and 1-year minimum follow-up data available were evaluated...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Justin Daigre, Gregory Berlet, Bryan Van Dyke, Kyle S Peterson, Robert Santrock
BACKGROUND: Implant survivorship is dependent on accuracy of implantation and successful soft tissue balancing. System instrumentation for total ankle arthroplasty implantation has a key influence on surgeon accuracy and reproducibility. The purpose of this study was to determine the accuracy and reproducibility of implant position with patient-specific guides for total ankle arthroplasty across multiple surgeons at multiple facilities. METHODS: This retrospective, multicenter study included 44 patients who received a total ankle implant (INBONE II Total Ankle System; Wright Medical Technology, Memphis, TN) using PROPHECY patient-specific guides from January 2012 to December 2014...
December 5, 2016: Foot & Ankle International
Douglas E Lucas, B Collier Watson, G Alex Simpson, Gregory C Berlet, Christopher F Hyer
: Ankle fractures are a common injury treated by orthopaedic surgeons. The distal tibiofibular syndesmosis can be injured during these fractures as well as in isolation. They pose a significant challenge with regard to the diagnosis of instability as well as evaluating reduction after fixation. Multiple studies have demonstrated that traditional radiographic analysis fails to accurately identify syndesmotic diastasis, instability, or malreduction. Ankle arthroscopy has been proposed as an alternative way to evaluate the syndesmosis...
September 9, 2016: Foot & Ankle Specialist
Christopher W Reb, Christopher F Hyer, Christy L Collins, Corey M Fidler, B Collier Watson, Gregory C Berlet
BACKGROUND: The "tibiofibular line" is a new axial computed tomography parameter for assessing syndesmosis reduction, which references the flat anterolateral surface of the fibula and anterolateral tibial tubercle. These same bony landmarks are easily visualized via a lateral approach to the fibula. This cadaveric study assessed the practical aspects of measuring the tibiofibular line intraoperatively. METHODS: Three observers simulated the tibiofibular line using operative rulers in 3 measurement series utilizing 10 cadaveric specimens: intact syndesmosis, syndesmosis reduction, and fixation after application of lateral plate and screws to the fibula, and post syndesmosis reduction and fixation without plate and screws...
November 2016: Foot & Ankle International
Mark A Prissel, Gregory C Berlet, Ryan T Scott, Justin L Daigre, Patrick E Bull, Kyle S Peterson, Christy L Collins, Christopher F Hyer
: Total ankle replacement (TAR) is a viable alternative to ankle fusion in certain patients with end-stage ankle arthritis. Despite the importance of understanding alignment and movement of the prosthesis, there is no standardized radiographic method for evaluating the position and movement of the INBONE 2 prosthesis. The aims of this study were to describe a radiographic measurement protocol for INBONE 2 for clinical practice and research while determining the interobserver and intraobserver reliability using standard weightbearing radiographs...
July 13, 2016: Foot & Ankle Specialist
Christopher W Reb, Jeffrey E McAlister, Christopher F Hyer, Gregory C Berlet
Total ankle replacement studies have focused on reporting complications that are directly observed clinically or radiographically, including wound problems, technical errors, implant loosening, subsidence, infection, bone fractures, and heterotopic ossification. However, patients can still experience unresolved pain even when these problems have been ruled out. We initiated a study to more clearly define the relative risk of injury to the anatomic structures in the posterior ankle during total ankle replacement using a third-generation implant system...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kyle S Peterson, W Drew Chapman, Christopher F Hyer, Gregory C Berlet
Tibiotalocalcaneal arthrodesis is a salvage procedure for severe hindfoot/ankle deformities, arthritis, avascular necrosis of the talus, failed total ankle replacement, and Charcot neuroarthropathy. The methods for fixation include anterior and lateral plates, screws, retrograde intramedullary nails, and external fixation. The purpose of the present report was to describe the short-term radiographic outcomes and technique using a posterior approach with an anatomic-specific locking plate for tibiotalocalcaneal arthrodesis...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Thomas Berlet, Mathias Marchon
This study compared the leakage characteristics of different types of dual-cannula fenestrated tracheostomy tubes during positive pressure ventilation. Fenestrated Portex® Blue Line Ultra®, TRACOE® twist, or Rüsch® Traceofix® tracheostomy tubes equipped with nonfenestrated inner cannulas were tested in a tracheostomy-lung simulator. Transfenestration pressures and transfenestration leakage rates were measured during positive pressure ventilation. The impact of different ventilation modes, airway pressures, temperatures, and simulated static lung compliance settings on leakage characteristics was assessed...
2016: Anesthesiology Research and Practice
Jeffrey E McAlister, Shyler L DeMill, Christopher F Hyer, Gregory C Berlet
In ankle arthroplasty, little attention has been given to intraoperative nerve injury and its postoperative sequelae. The aim of the present anatomic study was to determine the relationship of the superficial peroneal nerve to the standard anterior approach for total ankle arthroplasty. The superficial peroneal nerve was dissected in 10 below-the-knee cadaver specimens. The medial and intermediate dorsal cutaneous branches were identified. A needle was placed at the ankle joint. The following measurements were recorded: bifurcation into the medial and intermediate dorsal cutaneous branches, reference needle to the branches of the medial and intermediate superficial peroneal nerve, and the crossing branches of the medial dorsal cutaneous nerve...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Patrick E Bull, Gregory C Berlet, Cameron Canini, Christopher F Hyer
BACKGROUND: Access to the medial half of the talus can be challenging even with an osteotomy. Although several techniques are presented in the literature, critical evaluation of fixation, union, and alignment is lacking. The chevron medial malleolar osteotomy provides advantages of perpendicular instrumentation access and wide exposure to the medial talus. Postoperative displacement resulting in malunion, and possibly provoking ankle osteoarthritis, is a known complication. The present study describes our experience with the osteotomy...
June 2016: Foot & Ankle International
Gregory C Berlet
No abstract text is available yet for this article.
December 2015: Foot & Ankle Specialist
Brian Steginsky, Aimee Riley, Douglas E Lucas, Terrence M Philbin, Gregory C Berlet
BACKGROUND: There is limited data on functional outcomes after primary repair of partial peroneal tendon tears. Previous reports have been limited by small cohorts, duration of follow-up, and often included both tenodesis and primary repair. The purpose of this study was to report the functional outcomes and return to activity in the largest cohort to date with partial peroneal tendon tears treated with primary repair. METHODS: A chart review identified all patients who underwent primary repair of the peroneus brevis tendon from 2008 to 2012...
February 2016: Foot & Ankle International
Thomas Berlet
No abstract text is available yet for this article.
2015: Respiratory Research
T Berlet
BACKGROUND: The human resources situation in the healthcare system is characterized by a manpower shortage. Recruiting medical staff is of great importance for hospitals and particularly in anesthesiology. Approaching and recruiting staff usually happens through external personnel marketing (PM); however, up until now the efficacy of these PM measures has barely been empirically investigated. AIM: The goal of this empirical study was to examine how familiar hospital physicians at varying career levels are with the different tools employed by external PM and how frequently they used as well as rated these tools in terms of benefits...
September 2015: Der Anaesthesist
Jaymes D Granata, Gregory C Berlet, Terrence M Philbin, Grant Jones, Christopher C Kaeding, Kyle S Peterson
UNLABELLED: Nonunion, delayed union, and refracture after operative treatment of acute proximal fifth metatarsal fractures in athletes is uncommon. This study was a failure analysis of operatively managed acute proximal fifth metatarsal fractures in healthy athletes. We identified 149 patients who underwent operative treatment for fifth metatarsal fractures. Inclusion criteria isolated skeletally mature, athletic patients under the age of 40 with a minimum of 1-year follow-up. Patients were excluded with tuberosity fractures, fractures distal to the proximal metaphyseal-diaphyseal region of the fifth metatarsal, multiple fractures or operative procedures, fractures initially treated conservatively, and medical comorbidities/risk factors for nonunion...
December 2015: Foot & Ankle Specialist
Gregory C Berlet
No abstract text is available yet for this article.
August 2015: Foot & Ankle Specialist
B Collier Watson, Douglas E Lucas, G Alex Simpson, Gregory C Berlet, Christopher F Hyer
BACKGROUND: Ankle fractures are among the most common lower extremity injuries. Proper care requires evaluation for syndesmotic ligament disruption. Ankle arthroscopy has been proposed as an intraoperative tool that can evaluate stability. Our focus was to evaluate the amount of displacement produced in the coronal, sagittal, and transverse planes visualized through ankle arthroscopy in a cadaveric model. METHODS: Seven below-knee specimens were mounted in a traction tower...
November 2015: Foot & Ankle International
Shyler L DeMill, Jeffrey E McAlister, Christopher F Hyer, Gregory C Berlet
Total ankle arthroplasty is an evolving treatment of ankle arthritis. One implant uses intramedullary guidance to enhance accuracy by accessing the tibial canal through the inferior aspect of the foot, potentially placing the subtalar joint articulation at risk. The purpose of the present cadaveric anatomic evaluation was to identify posterior subtalar articular facet joint involvement during intramedullary guidance to the tibial canal. Ten below-the-knee cadaveric specimens were used. After drilling into the tibial medullary canal with a 6-mm drill bit and using the standard targeting jig, the specimens were dissected, and the posterior facet was evaluated...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jeffrey E McAlister, Christopher F Hyer, Gregory C Berlet, Christy L Collins
The use of biologics, namely demineralized bone matrix, bone marrow aspirate (BMA), and other growth factors, has gained popularity in foot and ankle surgery for use in compromised hosts or high-risk situations. Our research has shown the concentration of these pluripotent cells was greatest in the iliac crest. A medical record and radiographic review was performed to compare the effect of BMA harvest site osteogenic progenitor cells on the incidence of fusion. Radiographs were reviewed for radiographic evidence of trabecular bridging in 2 or more views...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Berlet Thomas
STUDY OBJECTIVE: The aim of this study was to compare the speed of anesthetic recovery and the perioperative analgesic requirements in patients who received total intravenous anesthesia (TIVA) with either remifentanil-propofol or fentanyl-propofol for lumbar spine surgery. DESIGN: Retrospective cohort study. SETTING: Operating room, postanesthesia care unit, and general surgical ward. PATIENTS: One hundred six patients (53 in each group) with American Society of Anesthesiologists status I, II, or III who received either remifentanil-propofol TIVA or fentanyl-propofol TIVA for elective lumbar vertebral disc surgery...
August 2015: Journal of Clinical Anesthesia
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