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Foot & Ankle Specialist

Mario I Escudero, Michael Symes, Thomas Bradford Bemenderfer, Maximiliano Barahona, Robert Anderson, Hodges Davis, Kevin J Wing, Murray J Penner
INTRODUCTION: Patient-specific instrumentation (PSI) has been developed for total ankle arthroplasty (TAA), with proven benefits. One concern regarding PSI is the need for more soft tissue dissection in order to accurately position the PSI guides, which has the theoretical disadvantage of increased osteolysis. The purpose of our study is to compare the incidence and magnitude of osteolysis for the INFINITY Total Ankle System between PSI and standard referencing (SR) techniques. METHODS: Sixty-seven patients who underwent primary TAA using Prophecy (PSI) or SR technique between 2013 and 2015 were reviewed in a retrospective observational study...
February 13, 2019: Foot & Ankle Specialist
James M Cottom, Steven M Douthett, Kelly K McConnell, Britton S Plemmons
The purpose of this study was to compare wound complication rates after total ankle replacement in 3 groups of patients based on tobacco status. The total cohort was divided into 3 groups based on tobacco history. Group 1 included patients who were actively tobacco users. Group 2 included patients with a history of tobacco user. Group 3 served as the control group and included patients who had never used tobacco. Available charts were reviewed for patients who underwent primary total ankle arthroplasty by 1 surgeon...
February 5, 2019: Foot & Ankle Specialist
Eva J Lehtonen, Martim C Pinto, Harshadkumar A Patel, Nicholas Dahlgren, Eildar Abyar, Ashish Shah
OBJECTIVES: The objective of this study was to describe the anatomic variations in the saphenous nerve and risk of direct injury to the saphenous nerve and greater saphenous vein during syndesmotic suture button fixation. METHODS: Under fluoroscopic guidance, syndesmotic suture buttons were placed from lateral to medial at 1, 2, and 3 cm above the tibial plafond on 10 below-knee cadaver leg specimens. The distance and position of each button from the greater saphenous vein and saphenous nerve were evaluated...
February 2, 2019: Foot & Ankle Specialist
Nacime Salomão Barbachan Mansur, Tiago Baumfeld, Fernando Villalon, Bruno Takeshi Aoyama, Fabio Teruo Matsunaga, Paulo Roberto Dias Dos Santos, Bruno Schiefer Dos Santos, Marcel Jun Sugawara Tamaoki
BACKGROUND: The usual initial treatment for insertional Achilles tendinopathy is nonsurgical. Yet there is no standard conservative treatment for Achilles insertional tendinopathy. Shockwave therapy (SWT) has become a reliable option for the management of this illness over the past years. The aim of this study is to report the effectiveness of low-energy SWT associated with an eccentric strengthening protocol in 19 consecutive patients. METHODS: This is a prospective study with 19 patients aged between 26 and 72 years diagnosed with insertional Achilles tendinopathy...
February 2, 2019: Foot & Ankle Specialist
Jack Xie, Azeem Tariq Malik, Carmen E Quatman, Thuan V Ly, Laura S Phieffer, Safdar N Khan
INTRODUCTION: Metabolic syndrome (MetS) is associated with significant postoperative morbidity. Despite an increasing prevalence of MetS in the US population, its impact on postoperative outcomes following ankle fractures remains limited. MATERIALS AND METHODS: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program database was queried for patients undergoing open reduction with internal fixation (ORIF) for ankle fractures using Current Procedural Terminology codes: 27766, 27769, 27792, 27814, 27822, and 27823...
February 2, 2019: Foot & Ankle Specialist
Direk Tantigate, Gavin Ho, Joshua Kirschenbaum, Henrik C Bäcker, Benjamin Asherman, Christina Freibott, Justin K Greisberg, J Turner Vosseller
BACKGROUND: Fracture dislocation of the ankle represents a substantial injury to the bony and soft tissue structures of the ankle. There has been only limited reporting of functional outcome of ankle fracture-dislocations. This study aimed to compare functional outcome after open reduction internal fixation in ankle fractures with and without dislocation. METHODS: A retrospective chart review of surgically treated ankle fractures over a 3- year period was performed...
February 2, 2019: Foot & Ankle Specialist
Matthew T Pigott, Ronit Shah, Jason Chan, Todd A Irwin, James R Holmes, Paul G Talusan
We sought to determine whether significantly displaced Lisfranc injuries had a higher rate of loss of reduction after fixation compared to those with low displacement. Forty-five patients who had fixation of an acute Lisfranc injury from 2005 to 2014 were retrospectively reviewed. All patients underwent subsequent hardware removal at 3 to 15 months after their index procedure. Radiographs were reviewed from the time of injury, 2 weeks, and 6 months postoperative. Lisfranc joint reduction was assessed using criteria previously described in the literature and graded as malreduced if displacement was >2 mm...
January 22, 2019: Foot & Ankle Specialist
Wajeeh Bakhsh, Sean Childs, Irvin Oh, Sam Flemister, Judy Baumhauer, John Ketz
BACKGROUND: Elective surgical procedures necessitate careful patient selection. Insurance level has been associated with postoperative outcomes in trauma patients. This study evaluates the relationship insurance level has with outcomes from elective foot and ankle surgery. METHODS: Retrospective chart review was performed on patients who underwent elective surgery at a single center with 1-year follow-up. Patients were classified by insurance: under-/uninsured (Medicaid, Option plans) versus fully insured...
January 10, 2019: Foot & Ankle Specialist
Colin Graney, Naohiro Shibuya, Himani Patel, Daniel C Jupiter
Ultrasound-guided popliteal blocks for postoperative pain management have grown in popularity within foot and ankle surgery. The purpose of this study was to evaluate the efficacy of popliteal block in preventing postoperative emergency department visits after foot and ankle surgery. We compared rates of presentation to the emergency department for pain following foot and ankle surgery between surgeries with a popliteal block and those with local field block alone. We identified 101 charts, of which 26 presented to the emergency department for postoperative pain following popliteal block...
January 10, 2019: Foot & Ankle Specialist
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
The anterior lateral malleolar artery (ALMA), which usually originates from the anterior tibial artery (ATA), courses transversely and laterally, passing under the extensor digitorum longus and peroneus tertius tendons. Variations in the origin of the ALMA from the ATA can occur. Branches of the ATA, such as the ALMA, are prone to pseudoaneurysm. This study reviewed the origin of the ALMA from the ATA and aimed to identify problems in anterior ankle arthroscopy that might cause injury to the ALMA. Enhanced computed tomography scans of 24 feet of 24 fresh cadavers (13 males, 11 females; average age 78...
January 4, 2019: Foot & Ankle Specialist
Kempland C Walley, Tyler A Gonzalez, Sreeharsha V Nandyala, Alec Macauley, Youssef Elnabawi, Edward K Rodriguez, Paul T Appleton
BACKGROUND: While biomechanical characteristics of locking screw fixation versus traditional plating has been studied extensively in orthopaedic literature, clinical outcome studies are lacking. The goal of this study was to evaluate the efficacy and complications rate of locking versus traditional nonlocking screws in complex ankle fractures employing distal fibula internal fixation with 1/3 semitubular small fragment plates. METHODS: A retrospective review was performed between January 2010 and June 2013 of all patients in whom internal fixation of the fibula in an ankle fracture (open or closed) was performed using only 1/3 semitubular small fragment fibular plates...
January 4, 2019: Foot & Ankle Specialist
Kaissar Yammine, Marc Nahed, Chahine Assi
Diabetic foot ulcers (DFUs) are usually treated with conservative management based on debridement, topical agents, and nonsurgical off-loading; however, the recurrence rate following such standard care is reported to be high. In the case of recalcitrant or recurrent ulcers, a surgical off-loading technique such as the metatarsal osteotomy (MO) is indicated. Thus, the aim of this study is to conduct a meta-analysis evaluating the efficacy of MO in treating DFUs. Four relevant studies were identified, including 119 patients with 129 DFUs; all wounds were refractory to a previous conservative treatment of a mean duration of 10...
December 19, 2018: Foot & Ankle Specialist
Edmund Ieong, Michael Rafferty, Monica Khanna, Miny Walker, Peter Rosenfeld
INTRODUCTION: Peroneal tendon disorders pose a diagnostic conundrum to the clinician. Magnetic resonance imaging (MRI) is widely used to assess tendon pathology. A recognized artifact of MRI, the magic angle effect (MAE), can lead to spurious results and inappropriate management. The aim of this study is to assess whether T2 fat-suppressed sequences (T2FSs) reduce the frequency of MAE compared with proton density fat-suppressed (PDFS) images. METHODS: MRI scans of 18 patients were prospectively assessed for MAE...
December 19, 2018: Foot & Ankle Specialist
Henrik C Bäcker, Adrian J Yenchak, David P Trofa, J Turner Vosseller
The goal of treatment after Achilles tendon rupture (ATR) is to restore appropriate tension to the tendon, so that normal baseline strength and functional soft-tissue length can be achieved. The assessment of plantarflexion strength has shown widespread variability. The purpose of this study is to document variations in strength assessment after the treatment of ATR in the literature. A comprehensive literature review was performed. In total, 2758 articles were found on Achilles tendon rupture and Achilles tendon strength measurement...
December 17, 2018: Foot & Ankle Specialist
Ki Won Young, Hong Seop Lee, Ki Chol Park
BACKGROUND: We hypothesized that the cause of second-ray pathology with hallux valgus is excessive relative length of the second metatarsal and performed Weil osteotomy to shorten it, with correction of hallux valgus. The purpose of this study is to evaluate the outcome of second-ray pathology after distal chevron osteotomy (DCO) with Weil osteotomy to correct metatarsal parabola. METHODS: We performed concomitant Weil osteotomy of the second metatarsal with DCO of the first metatarsal as part of hallux valgus with second-ray pathology correction surgery in 45 feet (40 patients)...
December 17, 2018: Foot & Ankle Specialist
Junho Ahn, Katherine M Raspovic, George T Liu, Lawrence A Lavery, Javier La Fontaine, Paul A Nakonezny, Dane K Wukich
Chronic kidney disease (CKD) is a major concern in patients with foot disease because it is associated with high rates of neuropathy, peripheral vascular disease, and poor wound healing. The purpose of this study was to evaluate renal dysfunction as a risk factor for reamputation after initial transmetatarsal amputation (TMA). Patients who underwent a TMA were retrospectively identified in the American College of Surgeons National Surgical Quality Improvement Program database. Of 2018 patients, reamputation after TMA occurred in 4...
December 12, 2018: Foot & Ankle Specialist
Chahine Assi, Camille Samaha, Moussa Chamoun Moussa, Tony Hayek, Kaissar Yammine
INTRODUCTION: Soft tissue defects in the distal leg and foot are challenging conditions for reconstruction. The widely used reverse sural fascio-cutaneous flap (RSFCF) has been reported with large variation in complication frequency. Some authors reported higher complications in the diabetic population when compared with trauma patients. We compared the reliability of the RSFCF in treating such defects among both populations. METHODS: This is a retrospective series with a prospective data collection of 24 patients (11 with type 2 diabetes and 13 in trauma settings) treated with an ipsilateral RSFCF for soft tissue defects of the distal leg and the rear foot...
December 7, 2018: Foot & Ankle Specialist
Jeffery S Hillam, Neil Mohile, Niall Smyth, Jonathan Kaplan, Amiethab Aiyer
INTRODUCTION: Obesity is an increasingly common comorbidity that may negatively affect outcomes following orthopaedic surgery. It is valuable to determine whether obese patients are vulnerable for postoperative complications. The purpose of this study was to analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) to determine the effect of obesity on surgical treatment of Achilles tendon ruptures. METHODS: Patients who underwent a surgical repair of the Achilles tendon were retrospectively identified through the ACS NSQIP...
December 5, 2018: Foot & Ankle Specialist
Are Haukåen Stødle, Marius Molund, Fredrik Nilsen, Johan Castberg Hellund, Kjetil Hvaal
BACKGROUND: Lateralizing calcaneal osteotomy (LCO) is a common procedure used to correct hindfoot varus. Several complications have been described in the literature, but only a few articles describe tibial nerve palsy after this procedure. Our hypothesis was that tibial nerve palsy is a common complication after LCO. METHODS: A retrospective study of patients undergoing LCO for hindfoot varus between 2007 and 2013 was performed. A total of 15 patients (18 feet) were included in the study...
November 30, 2018: Foot & Ankle Specialist
Shane Hollawell, Brendan Kane, Christopher Heisey, Patricia Greenberg
Allogenic bone graft has long been accepted as a standard of care in the surgical arthrodesis of the foot and ankle and treatment of certain high-risk, comminuted fracture types that have greater potential for delayed union or nonunion. It has been shown in multiple studies to be equivalent to autograft in regard to union rates without the morbidity associated with bone graft harvest. We present a retrospective study on the efficacy of an allogenic cancellous/periosteal cellular bone matrix with mesenchymal stem cells and angiogenic growth factors...
November 28, 2018: Foot & Ankle Specialist
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