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https://www.readbyqxmd.com/read/28343329/stress-fractures-of-the-foot-and-ankle-part-2-site-specific-etiology-imaging-and-treatment-and-differential-diagnosis
#1
Jacob C Mandell, Bharti Khurana, Stacy E Smith
Stress fractures of the foot and ankle are a commonly encountered problem among athletes and individuals participating in a wide range of activities. This illustrated review, the second of two parts, discusses site-specific etiological factors, imaging appearances, treatment options, and differential considerations of stress fractures of the foot and ankle. The imaging and clinical management of stress fractures of the foot and ankle are highly dependent on the specific location of the fracture, mechanical forces acting upon the injured site, vascular supply of the injured bone, and the proportion of trabecular to cortical bone at the site of injury...
March 25, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#2
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#3
REVIEW
Bruno Battiston, Davide Ciclamini, Jin Bo Tang
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#4
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28325064/diabetic-foot-complications-despite-successful-pancreas-transplantation
#5
Dong-Kyo Seo, Ho Seong Lee, Jungu Park, Chang Hyun Ryu, Duck Jong Han, Sang Gyo Seo
BACKGROUND: It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. METHODS: This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28324204/tibial-nerve-neuropathy-following-medial-opening-wedge-high-tibial-osteotomy-case-report-of-a-rare-technical-complication
#6
Young-Soo Shin, Hyun-Bo Sim, Jung-Ro Yoon
A 63-year-old woman developed tibial nerve injury caused by an overlong K wire and 4.5-mm cortical lag screw through the first distal hole below the osteotomy during medial opening-wedge high tibial osteotomy (HTO), leading to a lack of sensation on the sole of the foot with no disturbances in motor functions. The temporary lag screw in the first distal hole below the osteotomy is often inserted by an excessive length in order to compress the potentially fractured opposite cortex. By doing so, posterior neurovascular structures including the tibial nerve and the popliteal vessels can be injured...
March 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#7
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#8
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28306181/total-ankle-replacement-in-patients-with-haemophilic-arthropathy-primary-arthroplasty-and-conversion-of-painful-ankle-arthrodesis-to-arthroplasty
#9
M Preis, T Bailey, M Jacxsens, A Barg
INTRODUCTION: There are two general surgical approaches for operative treatment of end-stage haemophilic ankle arthropathy: ankle arthrodesis and total ankle replacement (TAR). AIM: The aim of this study was to determine intraoperative and postoperative complications and evaluate the mid-term clinical and radiographic outcomes of TAR in patients with haemophilic arthropathy. METHODS: Fourteen patients with a mean age of 51.4 ± 10.2 years (range = 32...
March 17, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28303210/stereotactic-spine-radiosurgery-review-of-safety-and-efficacy-with-respect-to-dose-and-fractionation
#10
REVIEW
Michael Huo, Arjun Sahgal, David Pryor, Kristin Redmond, Simon Lo, Matthew Foote
BACKGROUND: Stereotactic body radiotherapy (SBRT) is an emerging treatment option for spinal metastases with demonstrated efficacy in the upfront, postoperative, and re-treatment settings, as well as for tumor histologies considered radioresistant. Uncertainty exists regarding the optimal dose and fractionation schedule, with single and multifraction regimens commonly utilized. METHODS: A literature search of the PubMed and Medline databases was conducted to identify papers specific to spine SBRT and the effect of varying dose/fractionation regimens on outcomes...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28295608/incidence-and-anatomical-variations-of-accessory-navicular-bone-in-patients-with-foot-pain-a-retrospective-radiographic-analysis
#11
Heba Kalbouneh, Omar Alajoulin, Mohammad Alsalem, Noor Humoud, Jamil Shawaqfeh, Mohammad Alkhoujah, Hana Abu-Hassan, Waleed Mahafza, Darwish Badran
INTRODUCTION: The accessory navicular (AN) is an accessory ossicle anatomically located on the medial side of the foot, proximal to the navicular and continuous with the tibialis posterior tendon. It is occasionally a source of pain and local tenderness. Knowledge of the AN and its morphological variations can help identify the source of a patient's symptoms and prevent misinterpreting them as fractures. MATERIALS AND METHODS: Foot radiographs from 1240 patients who presented in two centers with chronic foot pain, or persistent pain developed after trauma, were retrospectively reviewed to determine the incidence and variations of the AN in relation to gender...
March 13, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28282537/a-large-solitary-fibroma-of-the-deep-compartment-of-the-sole
#12
T H Lui
A 50-year-old lady presented with a right foot mass and pain for 1year. Magnetic resonance imaging showed a 3.9×3.2×5cm mass on plantar side of the forefoot deep to the major flexor tendons and plantar aponeurosis and inferior to 1st-4th metatarsals. The mass extended dorsally through the intermetatarsal space to the foot dorsum. Ultrasound guided biopsy was performed, which confirmed it was a fibroma. This case was further complicated by pathological fracture of the 3rd metatarsal. It was resected through a dorsal incision and surgical dislocation of the 2nd and 3rd tarsometatarsal joints...
December 7, 2016: Foot
https://www.readbyqxmd.com/read/28279428/nadroparin-or-fondaparinux-versus-no-thromboprophylaxis-in-patients-immobilised-in-a-below-knee-plaster-cast-protect-a-randomised-controlled-trial
#13
Marlieke M Bruntink, Yannick M E Groutars, Inger B Schipper, Roelf S Breederveld, Wim E Tuinebreijer, Robert J Derksen
BACKGROUND: The immobilisation of the lower leg is associated with deep vein thrombosis (DVT). However, thromboprophylaxis in patients with a below-knee plaster cast remains controversial. We examined the efficacy and safety of nadroparin and fondaparinux to ascertain the need for thromboprophylaxis in these patients. METHODS: PROTECT was a randomised, controlled, single-blind, multicentre study that enrolled adults with an ankle or foot fracture who required immobilisation for a minimum of four weeks...
February 22, 2017: Injury
https://www.readbyqxmd.com/read/28278253/reduced-bone-formation-markers-and-altered-trabecular-and-cortical-bone-mineral-densities-of-non-paretic-femurs-observed-in-rats-with-ischemic-stroke-a-randomized-controlled-pilot-study
#14
Karen N Borschmann, Sarah S Rewell, Sandra Iuliano, Ali Ghasem-Zadeh, Rachel A Davey, Heidi Ho, Peta N Skeers, Julie Bernhardt, David W Howells
BACKGROUND: Immobility and neural damage likely contribute to accelerated bone loss after stroke, and subsequent heightened fracture risk in humans. OBJECTIVE: To investigate the skeletal effect of middle cerebral artery occlusion (MCAo) stroke in rats and examine its utility as a model of human post-stroke bone loss. METHODS: Twenty 15-week old spontaneously hypertensive male rats were randomized to MCAo or sham surgery controls. Primary outcome: group differences in trabecular bone volume fraction (BV/TV) measured by Micro-CT (10...
2017: PloS One
https://www.readbyqxmd.com/read/28276651/realignment-surgery-for-malunited-ankle-fracture
#15
Chang-Jun Guo, Xing-Cheng Li, Mu Hu, Yang Xu, Xiang-Yang Xu
OBJECTIVE: To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture. METHODS: Thirty-three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (TAS), the tibiotalar tilt angle (TTA), the malleolar angle (MA), and the tibial lateral surface angle (TLS) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28276650/comparison-of-arthrodesis-and-non-fusion-to-treat-lisfranc-injuries
#16
Yu-Sen Qiao, Jun-Kun Li, Hao Shen, Hai-Yan Bao, Ming Jiang, Yan Liu, Wasim Kapadia, Hong-Tao Zhang, Hui-Lin Yang
OBJECTIVE: "Lisfranc joint injury" is comprised of a tarsometatarsal joint-complex injury. The Lisfranc complex injury is always a challenge for orthopedists, and the optimum treatment is still up for debate. Anatomic reduction and stable internal fixation prove to have no satisfactory outcomes. This research aims to compare the clinical curative effects, complications and radiographic features of arthrodesis and non-fusion of the Lisfranc joint in the follow-up of the patients who suffered Lisfranc injuries...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28276647/clinical-comparison-of-extensile-lateral-approach-and-sinus-tarsi-approach-combined-with-medial-distraction-technique-for-intra-articular-calcaneal-fractures
#17
Hai-Chao Zhou, Tao Yu, Hao-Yang Ren, Bing Li, Kai Chen, You-Guang Zhao, Yun-Feng Yang
OBJECTIVE: To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via the sinus tarsi approach using the medial distraction technique for intra-articular calcaneal fractures. METHODS: We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015. Patients were divided into two groups: 28 were in the sinus tarsi approach group and 37 were in the extensile lateral approach group...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28271945/metastatic-melanoma-of-a-metatarsala-case-report
#18
Gary Friend, Jeffrey Mitchell
A 53-year-old woman presented with painful swelling of the right forefoot presenting clinically as a metatarsal stress fracture. Radiographs showed destructive changes, and diagnostic imaging revealed an aggressive neoplasm. The lesion was biopsied, and the pathologic diagnosis was metastatic melanoma. A thorough physical examination and advanced imaging did not reveal a primary tumor. Ray resection was performed with en bloc resection of the neoplasm. The patient continues to receive long-term immune stimulation chemotherapy 34 months after the ray resection...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28271932/mid-term-results-of-minimally-invasive-plate-osteosynthesis-and-circular-external-fixation-in-the-treatment-of-complex-distal-tibia-fractures
#19
Yunus Imren, Engin Eren Desteli, Mehmet Erdil, Hasan Hüseyin Ceylan, Ibrahim Tuncay, Cengiz Sen
BACKGROUND: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. METHODS: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20)...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28269397/hardness-map-of-human-meta-tarsals-and-phalanges-of-toes
#20
Irfan Manarvi
Predicting location of fracture in human bones has been a keen area of research for the past few decades. A variety of tests for hardness, deformation and strain field measurement have been conducted in the past; but considered insufficient due to various limitations. Researchers therefore have proposed further studies due to inaccuracies in measurement methods, testing machines and experimental errors. Advancement and availability of hardware, measuring instrumentation and testing machines can now provide remedies to these limitations...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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