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SHO Journal Club Applegate

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23 papers 0 to 25 followers
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
Jenessa Redfern, Scott M Wasilko, Meghan E Groth, Wesley D McMillian, Craig S Bartlett
OBJECTIVES: The purpose of this study was to compare rates of surgical site infection (SSI) in patients with type 3 open fractures who had received cefazolin plus gentamicin versus piperacillin/tazobactam for antibiotic prophylaxis. DESIGN: Retrospective cohort study. SETTING: Level 1 trauma center. PATIENTS: Seven hundred sixty-six patients admitted between January 1, 2004, and December 31, 2012, with open fractures were identified using the National Trauma Data Bank by searching International Classification of Diseases, Ninth Revision (ICD-9) codes...
August 2016: Journal of Orthopaedic Trauma
Judith Tanner, Jo C Dumville, Gill Norman, Mathew Fortnam
BACKGROUND: Medical professionals routinely carry out surgical hand antisepsis before undertaking invasive procedures to destroy transient micro-organisms and inhibit the growth of resident micro-organisms. Antisepsis may reduce the risk of surgical site infections (SSIs) in patients. OBJECTIVES: To assess the effects of surgical hand antisepsis on preventing surgical site infections (SSIs) in patients treated in any setting. The secondary objective is to determine the effects of surgical hand antisepsis on the numbers of colony-forming units (CFUs) of bacteria on the hands of the surgical team...
January 22, 2016: Cochrane Database of Systematic Reviews
Jennifer L Mulhern, Nicole M Protzman, Maxwell J Levene, Scott M Martin, Justin J Fleming, J Randolph Clements, Stephen A Brigido
Tibiotalocalcaneal arthrodesis with intramedullary nailing is traditionally performed with formal preparation of both the subtalar and ankle joints. However, we believe that subtalar joint preparation is not necessary to achieve satisfactory outcomes in patients undergoing tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail. The primary aim of the present retrospective study was to evaluate the outcomes of patients who had undergone tibiotalocalcaneal arthrodesis with an intramedullary nail without formal subtalar joint cartilage resection...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Brian J Schneekloth, Nicholas J Lowery, Dane K Wukich
Charcot neuroarthropathy (CN) of the foot and ankle is a demanding clinical dilemma, and surgical management can be very complicated. Historically, the evidence guiding surgical management of CN has been small retrospective case series and expert opinions. The purpose of the present report was to provide a systematic review of studies published from 2009 to 2014 and to review the indications for surgery. A Medline search was performed, and a systematic review of studies discussing the surgical management of CN was undertaken...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Matthew S Conti, Scott J Ellis, Jeremy Y Chan, Huong T Do, Jonathan T Deland
BACKGROUND: While previous work has demonstrated a linear relationship between the amount of medializing calcaneal osteotomy (MCO) and the change in radiographic hindfoot alignment following reconstruction, an ideal postoperative hindfoot alignment has yet to be reported. The aim of this study was to identify an optimal postoperative hindfoot alignment by correlating radiographic alignment with patient outcomes. METHODS: Fifty-five feet in 55 patients underwent flatfoot reconstruction for stage II adult-acquired flatfoot deformity (AAFD) by 2 fellowship-trained foot and ankle orthopedic surgeons...
August 2015: Foot & Ankle International
S Thomas, A W G Kinninmonth, C Senthil Kumar
BACKGROUND: Rheumatoid arthritis commonly affects the forefoot, causing metatarsalgia, hallux valgus, and deformities of the lesser toes. Various types of surgical correction have been described, including resection of the lesser-toe metatarsal heads coupled with arthrodesis of the great toe, resection arthroplasty of the proximal phalanx or metatarsal head, and metatarsal osteotomy. We report the results at an average of five and a half years following thirty-seven consecutive forefoot arthroplasties performed in twenty patients by one surgeon using a technique involving resection of all five metatarsal heads...
April 2005: Journal of Bone and Joint Surgery. American Volume
Kyle S Peterson, Benjamin D Overley, Thomas C Beideman
Flexible adult acquired flatfoot disorder is commonly treated with the use of osteotomies in the calcaneus and medial column. The combination of these joint-preserving osteotomies with additional soft-tissue procedures allows realignment of the hindfoot with the goal of preventing further deformity or degenerative joint disease. A thorough understanding of each patient's condition allows the surgeon to match the correct osteotomy to the clinical indication, while also successfully executing the planned surgery...
July 2015: Clinics in Podiatric Medicine and Surgery
John M Pinski, Lorraine A Boakye, Christopher D Murawski, Charles P Hannon, Keir A Ross, John G Kennedy
PURPOSE: To examine the level of evidence and methodologic quality of studies reporting surgical treatments for osteochondral lesions of the ankle. METHODS: A search was performed using the PubMed/Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane databases for all studies in which the primary objective was to report the outcome after surgical treatment of osteochondral lesions of the ankle. Studies reporting outcomes of microfracture, bone marrow stimulation, autologous osteochondral transplantation, osteochondral allograft transplantation, and autologous chondrocyte implantation were the focus of this analysis because they are most commonly reported in the literature...
January 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alasdair MacInnes, Sam C Roberts, Jessica Kimpton, Anand Pillai
BACKGROUND: Plantar fasciitis is thought to be a self-limiting condition best treated by conservative measures, but despite this many patients have a prolonged duration of symptoms and surgery may be indicated. Partial plantar fascial release is reported to have a short-term success rate of up to 80%, but anecdotally this was not thought to represent our local experience. METHODS: An audit of long-term patient-reported outcomes following open partial plantar fascia release was performed...
January 2016: Foot & Ankle International
Arturo J Martí-Carvajal, Christian Gluud, Susana Nicola, Daniel Simancas-Racines, Ludovic Reveiz, Patricio Oliva, Jorge Cedeño-Taborda
BACKGROUND: Foot ulcers are a major complication of diabetes mellitus, often leading to amputation. Growth factors derived from blood platelets, endothelium, or macrophages could potentially be an important treatment for these wounds but they may also confer risks. OBJECTIVES: To assess the benefits and harms of growth factors for foot ulcers in patients with type 1 or type 2 diabetes mellitus. SEARCH METHODS: In March 2015 we searched the Cochrane Wounds Group Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations, Ovid EMBASE and EBSCO CINAHL...
2015: Cochrane Database of Systematic Reviews
Eric Ferkel, William Hodges Davis, John Kent Ellington
Posterior tarsal tunnel syndrome is the result of compression of the posterior tibial nerve. Anterior tarsal tunnel syndrome (entrapment of the deep peroneal nerve) typically presents with pain radiating to the first dorsal web space. Distal tarsal tunnel syndrome results from entrapment of the first branch of the lateral plantar nerve and is often misdiagnosed initially as plantar fasciitis. Medial plantar nerve compression is seen most often in running athletes, typically with pain radiating to the medial arch...
October 2015: Clinics in Sports Medicine
Troy J Boffeli, Brett J Waverly
The long leg axial view is primarily used to evaluate the frontal plane alignment of the calcaneus in relation to the long axis of the tibia when standing. This view allows both angular measurement and assessment for the apex of varus and valgus deformity of the rearfoot and ankle with clinical utility in the preoperative, intraoperative, and postoperative settings. The frontal plane alignment of the calcaneus to the long axis of the tibia is rarely fixed in the varus or valgus position because of the inherent flexibility of the foot and ankle, which makes patient positioning critical to obtain accurate and reproducible images...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Neil S Shah, Richard L Needleman, Omaima Bokhari, David Buzas
BACKGROUND: Subtalar arthroereisis (SA) has been a procedure used for the correction of painful flexible flatfoot deformity in adults and children. Clinical studies of patients who had a SA are sparse and with mixed results and variable indications. The purpose of this study was to determine the current practice among orthopaedic foot and ankle specialists regarding SA. METHODS: Web-based questionnaires were e-mailed to members of the American Orthopaedic Foot and Ankle Society (AOFAS)...
June 2015: Foot & Ankle Specialist
Gillian E Cook, Brent D Bates, Paul Tornetta, Michael D McKee, Saam Morshed, Gerard P Slobogean, Emil H Schemitsch
Assessment of fracture union is a critical concept in clinical orthopaedics; however, there is no established "gold standard" for fracture healing. This review provides an overview of the problems related to the assessment of fracture healing, examines currently available tools to determine union, discusses the role of functional outcomes in the assessment of fracture healing, and finally evaluates healing outcome measures as they pertain to fracture trials. Because there is no universally accepted method to determine fracture healing, orthopaedic surgeons must rely on a range of tools that can include: radiographic assessment, mechanical assessment, serologic markers, and clinical evaluation (including functional outcomes)...
December 2015: Journal of Orthopaedic Trauma
Joshua G Hunter, Laura K Dawson, Sandeep P Soin, Judith F Baumhauer
BACKGROUND: Surgical site infection is routinely cited as the most common complication following orthopedic foot and ankle surgery. Our institution uses 4% chlorhexidine gluconate followed by 70% isopropyl alcohol to reduce skin bacterial loads prior to surgery. These solutions have potential synergistic qualities to prevent a postoperative infection. The purpose of this study was to determine if the order of these solutions has a significant effect on the residual bacterial pathogens load following operative site preparation for foot and ankle surgery, as evidenced by positive culture swabs...
May 2016: Foot & Ankle International
John G Kennedy, Keir A Ross, Niall A Smyth, MaCalus V Hogan, Christopher D Murawski
UNLABELLED: Tumors of the foot and ankle are rarely encountered in the general patient population. Even among studies of tumor patients, foot and ankle neoplasms are uncommon. Given the weight-bearing demands of the foot and its relatively small area, even small masses are likely to be symptomatic and/or palpable to both patient and physician. Only 3% of osseous neoplasms are found in this region, while 8% of benign soft tissue tumors and 5% of malignant soft tissue tumors are localized to the foot and ankle...
February 2016: Foot & Ankle Specialist
Christian Plaass, Leif Claassen, Kiriakos Daniilidis, Mariesol Fumy, Christina Stukenborg-Colsman, Andreas Schmiedl, Sarah Ettinger
BACKGROUND: The modified Lapidus procedure is an accepted treatment option for patients with moderate to severe hallux valgus. Placing a plate plantar on the tension side of the arthrodesis has been shown to be biomechanically superior and has provided good clinical results. There is some concern about interference of the plantar placed plates on the tendon insertions. The purpose of this study was to determine a "safe zone" for plantar plate placement without irritation of the tendons...
April 2016: Foot & Ankle International
Ilka Kamrad, Anders Henricson, Håkan Magnusson, Åke Carlsson, Björn E Rosengren
BACKGROUND: In cases with total ankle replacement (TAR) failure, a decision between revision TAR and salvage arthrodesis (SA) must be made. In a previous study, we analyzed revision TAR and found low functional outcome and satisfaction. The aims of the current study were to analyze SA concerning failure rate and patient-related outcome measures (PROMs). METHODS: Until September 2014, a total of 1110 primary TARs were recorded in the Swedish Ankle Registry. Of the 188 failures, 118 were revised with SA (and 70 with revision TAR)...
March 2016: Foot & Ankle International
Rachel Y Goldstein, Ji Hae Park, Sudheer Jain, Nirmal Tejwani
BACKGROUND: Previous studies have demonstrated the efficacy of popliteal block anesthesia in decreasing post - operative narcotic administration, nausea, and length of stay in patients undergoing foot and ankle surgeries. The purpose of this study was to compare the amount of narcotic medication administered, the need for anti-emetic medica - tion, PACU length of stay, and discharge status in patients treated surgically for ankle fractures who received popliteal blocks with those who received general anesthesia alone...
July 2015: Bulletin of the Hospital for Joint Diseases
2016-01-11 19:40:18
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