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Foot & Ankle International

Henrik C Bäcker, Tony T Wong, J Turner Vosseller
BACKGROUND: The extent of tendinosis along the entire tendon in Achilles tendon ruptures (ATRs) has not previously been assessed. MR images of acute ATRs were evaluated to assess this extent, even in areas distant from the rupture. METHODS: Patients who had MR images for an ATR were reviewed. Each tendon was divided into a proximal, middle, and distal segment with the full tendon length defined as the length measured from the myotendinous junction to the insertion...
April 22, 2019: Foot & Ankle International
Michael Matthews, Erin Klein, Alyse Acciani, Matthew Sorensen, Lowell Weil, Lowell S Weil, Adam Fleischer
BACKGROUND: Some US insurance companies have recently started to require minimum angular measurements, for coverage decisions, in patients seeking operative correction for symptomatic hallux valgus. This logic naturally assumes that the magnitude of radiographic bunion deformity is related to the magnitude of patient's presenting symptoms and/or disability. METHODS: We conducted an analysis of existing data in our practice to determine whether patient-reported symptoms and disability prior to bunion surgery correlated with preoperative radiographic measurements commonly used to quantify hallux valgus severity...
April 22, 2019: Foot & Ankle International
Andrew Stith, Debbie Dang, Matthew Griffin, Wesley Flint, Christopher Hirose, Michael Coughlin
BACKGROUND: The purpose of this study was to evaluate outcomes utilizing a low-profile titanium plate and screw construct for rigid fixation of first ray proximal crescentic osteotomies in the treatment of hallux valgus. METHODS: Forty-eight patients (53 feet) with mild to severe hallux valgus were prospectively enrolled and completed 12-month follow-up. All were treated with a proximal crescentic osteotomy, fixed with a low-profile titanium plate, distal soft tissue correction, with or without an Akin osteotomy...
April 17, 2019: Foot & Ankle International
Rachael J Da Cunha, Aoife MacMahon, Mackenzie T Jones, Aleksander Savenkov, Jonathan Deland, Matthew Roberts, David Levine, Andrew Elliot, John Kennedy, Mark Drakos, Scott J Ellis
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been shown to be effective in alleviating pain and correcting deformity in hallux rigidus. However, outcomes in specific sports and physical activities remain unclear. The aim of this study was to assess sports and physical activities in young patients following first MTP joint arthrodesis and to compare these results with clinical outcomes. METHODS: Patients between ages 18 and 55 years who underwent MTP arthrodesis were identified by review of a prospective registry...
April 16, 2019: Foot & Ankle International
Maciej J K Simon, André Strahl, Haider Mussawy, Tim Rolvien, Robert F Schumacher, Marcel Seller, Wolfgang Rüther
BACKGROUND: Rheumatoid arthritis (RA) can cause significant forefoot disorders. If forefoot deformity and pain are severe, surgical treatment can be considered. The aim of this study was to analyze the long-term outcomes of surgical forefoot correction per Tillmann, which involves resection of the metatarsal heads through a transverse plantar approach for the lesser toes and a dorsomedial approach to the great toe. METHODS: This retrospective study used patient-based questionnaires to analyze the revision rate, pain, use of orthoses, walking ability, forefoot function, and patient satisfaction of patients with RA who had undergone a complete forefoot correction of metatarsophalangeal (MTP) I to V...
April 11, 2019: Foot & Ankle International
Gun-Woo Lee, Jong-Keun Seon, Nack-Sung Kim, Keun-Bae Lee
BACKGROUND: Total ankle arthroplasty is often not recommended to younger patients with ankle arthritis because of their high functional demands. The purpose of this study was to compare intermediate-term clinical and radiographic outcomes and survivorship rates of total ankle arthroplasty between patients younger and older than 55 years. METHODS: A total of 117 consecutive patients (123 ankles) who underwent primary total ankle arthroplasty using Hintegra prosthesis with a mean follow-up of 78 months were enrolled and divided into 2 age groups: under 55 years (38 ankles; mean age 45 years) and over 55 years (85 ankles; mean age 65 years)...
April 11, 2019: Foot & Ankle International
Jessica Mandel, Omar Behery, Rajkishen Narayanan, Sanjit R Konda, Kenneth A Egol
BACKGROUND: The purpose of this study was to determine the efficacy of medial malleolar fixation with 1 vs 2 screws. METHODS: Between April 2013 and February 2017, 196 patients who presented at 2 hospitals within one academic institution with an unstable rotational ankle fracture with a medial fracture and were treated operatively by a trained orthopedic surgeon were identified. These patients' charts were reviewed and their injury, radiographic, surgical, and follow-up data recorded...
April 11, 2019: Foot & Ankle International
William F Scully, Jerome M Benavides
Chronic exertional compartment syndrome (CECS) of the leg is a debilitating condition that has previously been characterized in athletes and military personnel. The results of surgical management in these patient populations have previously been published with inconsistencies in surgical methods and patient outcomes noted. While endoscopic and minimally invasive techniques have been described, a detailed description of a "standard" open, 2-incision lateral and single-incision medial technique for the treatment of CECS has not been previously published...
April 9, 2019: Foot & Ankle International
Rosalie C Looijen, Dominique Misselyn, Manouk Backes, Siem A Dingemans, Jens A Halm, Tim Schepers
BACKGROUND: To date, there is no consensus regarding which postoperative imaging technique should be used after open reduction and internal fixation of an intra-articular calcaneal fracture. The aim of this study was to clarify whether Brodén's view is sufficient as postoperative radiologic examination to assess step-offs and gaps of the posterior facet. METHODS: Six observers estimated the size of step-offs and gaps on Brodén's view in 42 surgically treated intra-articular calcaneal fractures...
April 8, 2019: Foot & Ankle International
Chenyu Wang, Min Wook Kang, Hyong Nyun Kim
BACKGROUND: The purpose of this study was to evaluate the clinical results and the safety of arthroscopic microfracture with the ankle suspended on a shoulder-holding traction frame for simultaneous anterior and posterior ankle arthroscopy in the prone position. METHODS: Between May 2010 and January 2016, 31 patients with posterior osteochondral lesions of the talus (OLTs) were treated with arthroscopic microfracture in a suspended position with the patient prone...
April 8, 2019: Foot & Ankle International
Reuben Lufrano, Matt Nies, Beau Ebben, Scott Hetzel, Robert V O'Toole, Christopher J Doro
BACKGROUND: Treatment of compartment syndrome of the foot with fasciotomy remains controversial because of the theoretical risk of infection and soft tissue coverage issues. The purpose of this study was to evaluate the efficacy of compartment decompression with dorsal dermal fascial fenestration compared with fasciotomy in a cadaveric foot compartment syndrome model. We hypothesized that fasciotomies and dorsal dermal fenestrations would provide equivalent compartment decompression. METHODS: Intracompartmental pressure was monitored in the first dorsal interosseous (FDIO), abductor (ABD), and superficial plantar (SP) compartments of 10 fresh frozen cadaveric limbs...
April 1, 2019: Foot & Ankle International
Haley M McKissack, Yvonne E Chodaba, Tyler R Bell, Eva J Lehtonen, Ibukunoluwa B Araoye, Ashish B Shah, Despina Stavrinos, Michael D Johnson
BACKGROUND: For many patients, returning to driving after right foot and ankle surgery is a concern, and it is not uncommon for patients to ask if driving may be performed with their left foot. A paucity of literature exists to guide physician recommendations for return to driving. The purpose of this study was to describe the driving habits of patients after right-sided foot surgery and assess the safety of left-footed driving using a driving simulator. METHODS: Patients who underwent right foot or ankle operations between January 2015 and December 2015 were retrospectively identified...
March 29, 2019: Foot & Ankle International
Rubini Pathy, Daniel R Sturnick, John S Blanco, Emily R Dodwell, David M Scher
BACKGROUND: Fixation of tendon transfers in pediatric feet typically involves passing a suture that is secured to a tendon, through an intraosseous tunnel, and tying it over an external button on the plantar foot, with appropriate tension. After adequate time is allowed for bone-tendon healing, the suture and button are removed. This construct can be complicated by suture breakage with loss of fixation, and/or skin ulceration under the button. Internal suspension systems of tendons and ligaments in adults have demonstrated excellent fixation strength and minimal intraosseous tunnel displacement, with no risk of skin ulceration and no need for suture and button removal...
March 27, 2019: Foot & Ankle International
Ward M Glasoe, Thomas C Michaud
Despite evidence that instability of the first ray (first metatarsal and medial cuneiform) alters the loading mechanics of the foot, surprisingly few studies have linked the condition with disorders of the foot. A factor limiting this research is the difficulty associated with measuring first ray mobility (FRM). To quantify dorsal FRM, clinicians and researchers have devised a variety of methods that impose a dorsally directed load, and record displacement. The methods include manual examination, radiographs, mechanical devices, and handheld rulers...
March 22, 2019: Foot & Ankle International
Eliezer Sidon, Ryan Rogero, Elizabeth McDonald, Annemarie Daecher, Rachel Shakked, David I Pedowitz, Daniel Fuchs, Joseph N Daniel, Steven M Raikin
BACKGROUND: The management of pain in patients with foot and ankle pathology can be challenging. Cumulative data suggest that, in addition to nociceptive mechanisms, other neuropathic mechanisms can contribute to pain in a subset of people with orthopedic conditions, and can be found in 10.5% to 53% of patients with chronic pain, depending on the location of the pathology. Preoperative diagnosis of neuropathic pain (NP) can potentially change decision making and management of foot and ankle pathologies...
March 22, 2019: Foot & Ankle International
James D Brodell, Ashlee MacDonald, James A Perkins, Jonathan T Deland, Irvin Oh
BACKGROUND: A spring ligament tear is commonly present in advanced stages of adult acquired flatfoot deformity (AAFD). Previous anatomic studies have demonstrated that the superficial deltoid ligament blends with the superomedial spring ligament, forming the tibiocalcaneonavicular ligament (TCNL). Adding allograft TCNL reconstruction to osseous correction has been suggested to augment medial peritalar stability in advanced AAFD with large spring ligament tears. We aimed to investigate the clinical and radiographic outcomes of TCNL reconstruction for flexible AAFD with medial peritalar instability...
March 22, 2019: Foot & Ankle International
Richard S Fuld, Pam Kumparatana, Judas Kelley, Nicholas Anderson, Todd Baldini, Alastair S E Younger, Kenneth J Hunt
BACKGROUND: Open metatarsophalangeal (MTP) arthrodesis using locked plates produces good clinical outcomes. However, arthroscopic fusion with new-generation fully threaded compression screws is emerging as an alternative. The purpose of this study was to compare low-profile contoured locked plates with fully threaded compression screws for first MTP fusion, in a biomechanical cadaveric model. METHODS: The first rays of 8 matched pairs of fresh frozen cadaveric feet underwent dissection and dual-energy x-ray absorptiometry (DEXA) scanning to measure bone mineral density (BMD)...
March 17, 2019: Foot & Ankle International
Michael S Pinzur
No abstract text is available yet for this article.
March 17, 2019: Foot & Ankle International
Sameer Desai, Alexander C Peterson, Kevin Wing, Alastair Younger, Trafford Crump, Guiping Liu, Andrea Veljkovic, Murray Penner, Jason M Sutherland
BACKGROUND: Patient-reported outcomes are increasingly used as measures of effectiveness of interventions. To make the tools more useful, therapeutic thresholds known as minimally important differences have been developed. The objective of this study was to calculate minimally important differences for the domains of the Foot and Ankle Outcome Score for hallux valgus surgery. METHODS: The study was based on a retrospective analysis of patients newly scheduled for bunion correction surgery and completing patient-reported outcomes between October 2013 and January 2018...
March 15, 2019: Foot & Ankle International
Sarah Ettinger, Tim Mattinger, Christina Stukenborg-Colsman, Daiwei Yao, Leif Claassen, Kiriakos Daniilidis, Christian Plaass
BACKGROUND: Evans (E) and Hintermann (H) lateral lengthening calcaneal osteotomies (LLCOTs) are commonly used to correct flexible flatfoot deformities. Both methods are well accepted and produce good clinical results. The aim of this study was to compare the postoperative outcomes of both osteotomies. METHODS: We retrospectively examined 53 patients with flatfoot deformities, who received surgery between October 2008 and March 2014. Seventeen E-LLCOT and 36 H-LLCOT procedures were performed during this time period, with a mean follow-up of 67...
March 13, 2019: Foot & Ankle International
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