Rohit Bansal, Mansur Halai, Jennifer Lk Matthews, Christopher Ryan Martin
Although replantation of an amputated extremity has been successfully performed, occasionally the surgeon is forced to amputate in the case of an unsalvageable open fracture. These appendages can theoretically act as an autologous 'bone and tissue bank' for patients if they have reconstructable contralateral injuries. We present a case of an athlete who sustained a Gustilo and Anderson IIIC injury on 1 leg resulting in a below knee amputation. Her other lower leg had a traumatic amputation of the heel pad, partial amputation of the calcaneus, and complete Achilles tendon loss...
September 3, 2020: Journal of Foot and Ankle Surgery
Paul Matuszewski, Eric Abbenhaus, Andrew Chen, Madhav Karunakar
OBJECTIVE: Restoration of hindfoot alignment correlates with improved clinical and biomechanical outcomes after fracture care and reconstruction. Intraoperative assessment of alignment with fluoroscopy is challenging. This study was designed to determine the effect of rotation on the measurement of hindfoot alignment and to determine if any radiographic landmarks can be utilized to help surgeons identify appropriate rotation during intraoperative imaging. METHODS: Ten unmatched cadaveric limbs that had been disarticulated at mid-tibia were used and placed supine in a radiolucent jig...
December 2020: Bulletin of the Hospital for Joint Diseases
Miguel Viana Pereira Filho, Kelly Cristina Stéfani, Gabriel Ferraz Ferreira, Monica Paschoal Nogueira
BACKGROUND: Insufficiency fractures occur in bones with low elastic resistance. In contrast to stress fractures, which affect normal bones and have been extensively studied, insufficiency fractures of the foot and ankle have been the subject of little research. The objective of this study was to identify risk factors associated with the development of foot and ankle insufficiency fractures. METHODS: The study included 55 postmenopausal sedentary women with foot and ankle insufficiency fractures and 51 women in the control group...
November 17, 2020: Foot & Ankle International
Tom P Walsh, Greg B Merlo, Cameron Rutter, Bridget Abell, Simon R Platt, John B Arnold
OBJECTIVE: Musculoskeletal conditions of the foot and ankle are common, yet the cost-effectiveness of the variety of treatments available is not well defined. The aim of this systematic review was therefore to identify, appraise and synthesise the literature pertaining to the cost-effectiveness of interventions for musculoskeletal foot and ankle conditions. METHODS: Electronic databases were searched for studies presenting economic evaluations of non-surgical and surgical treatments for acute or chronic musculoskeletal conditions of the foot and ankle...
November 17, 2020: Arthritis Care & Research
Konrad F Fuchs, Philipp Heilig, Miriam McDonogh, Sebastian Boelch, Uwe Gbureck, Rainer H Meffert, Stefanie Hoelscher-Doht, Martin C Jordan
BACKGROUND: The role of cement-augmented screw fixation for calcaneal fracture treatment remains unclear. Therefore, this study was performed to biomechanically analyze screw osteosynthesis by reinforcement with either a calcium phosphate (CP)-based or polymethylmethacrylate (PMMA)-based injectable bone cement. METHODS: A calcaneal fracture (Sanders type IIA) including a central cancellous bone defect was generated in 27 synthetic bones, and the specimens were assigned to 3 groups...
November 14, 2020: Journal of Orthopaedic Surgery and Research
Christian Rodemund, Ronny Krenn, Carl Kihm, Iris Leister, Reinhold Ortmaier, Werner Litzlbauer, Angelika M Schwarz, Georg Mattiassich
BACKGROUND: A fracture of the calcaneus can be a painful and disabling injury. Treatment modalities may be conservative or operative. Surgical treatment strategies include open reduction and internal fixation (ORIF) techniques, as well as a variety of minimally invasive methods. The aim of this study was to evaluate the treatment options and post-treatment complication rates for intra-articular calcaneal fractures at the Traumacenter Linz over a 9-year period. METHODS: All patients with calcaneal fractures treated at the Traumacenter Linz between 2007 and 2015 were included in this study...
November 14, 2020: BMC Musculoskeletal Disorders
Rajendra Kumar Sahoo, Philip W H Peng, Santosh Kumar Sharma
Plantar heel pain is a common pain condition encountered in clinical practice. The common etiologies include plantar fasciitis, calcaneal spur, calcaneus stress fracture, systemic causes, and trauma. Neurogenic causes, including entrapment at the tarsal tunnel or Baxter's nerve entrapment, can contribute to the heel pain and should not be overlooked. In this case report, we describe a patient with severe heel pain, presenting with overlapping features of plantar fasciitis and neuropathic pain. Magnetic resonance imaging suggested Baxter's nerve entrapment, and a subsequent ultrasound-guided hydrodissection of Baxter's nerve provided long-lasting pain relief...
November 2020: A&A Practice
Yoshihito Tomita, Kazuhiko Arima, Satoshi Mizukami, Ritsu Tsujimoto, Shin-Ya Kawashiri, Takayuki Nishimura, Takuhiro Okabe, Natsumi Tanaka, Yuzo Honda, Kazumi Nakahara, Naoko Yamamoto, Izumi Ohmachi, Hisashi Goto, Maiko Hasegawa, Youko Sou, Itsuko Horiguchi, Mitsuo Kanagae, Yasuyo Abe, Fumiaki Nonaka, Mami Tamai, Hirotomo Yamanashi, Yasuhiro Nagata, Atsushi Kawakami, Takahiro Maeda, Kiyoshi Aoyagi
BACKGROUND: Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older. DESIGN; CROSS-SECTIONAL STUDY: Setting and Participants; The survey population included 1008 postmenopausal women 50-92 years of age residing in rural communities...
November 11, 2020: BMC Geriatrics
Martin S Davey, Peter Staunton, Laura Ann Lambert, Matthew G Davey, James C Walsh
Management of intra-articular calcaneal fractures remains a debated topic in orthopedics, with operative fixation often held in reserve due to concerns regarding perioperative morbidity and potential complications. The purpose of this study was to identify the characteristics of patients who developed surgical complications to inform the future stratification of patients best suited to operative treatment for intra-articular calcaneal fractures. All patients who underwent open reduction and internal fixation of calcaneal fractures utilizing the Sinus Tarsi approach between March 2014 and July 2018 were identified using theatre records...
October 7, 2020: Journal of Foot and Ankle Surgery
Ahmed Shams, Osama Gamal, Mohamed Kamal Mesregah
This prospective study sought to assess the functional and radiological outcomes of minimally invasive osteosynthesis using cannulated screws and to examine the effect of different parameters on the functional outcome. The Maryland foot score and the visual analog scale of pain were used to assess the functional outcomes and postoperative patient's satisfaction rate. Preoperative and postoperative Böhler's angle, angle of Gissane, calcaneal width, and height, were compared. The study included 46 fractures in 40 patients; 38 (95%) males and 2 (5%) females with a mean age of 34...
June 25, 2020: Journal of Foot and Ankle Surgery
Ming Li, Xiaodong Lian, Weijie Yang, Kai Ding, Lin Jin, Zhenqin Jiao, Lijie Ma, Wei Chen
BACKGROUND We investigated the outcomes of displaced intra-articular calcaneal fractures (DIACFs) treated by percutaneous reduction and hollow screw fixation (PRHCF) versus open reduction and internal fixation (ORIF). MATERIAL AND METHODS Seventy-one patients were randomly allocated to group A (by PRHCF) and group B (by ORIF). Operative time, visual analogue scale (VAS) score, time from injury to operation, postoperative hospital stay, preoperative and postoperative radiographic measurements, and complications were recorded...
November 4, 2020: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Amir Reza Vosoughi, Afrasiab Tamadon, Saeid Gholamzadeh, Mehran Fereidooni
During extensile lateral approach to the calcaneus, in order to see all fractured fragments and subtalar joint, all soft tissues including insertion site of superior peroneal retinaculum (SPR) on the calcaneus should be released. The aim of this study was to evaluate the probability of peroneal tendon dislocation by releasing all soft tissues attached to the calcaneus. In 10 fresh cadavers, after standard extensile lateral approach to the calcaneus in right side, all soft tissues attached to the lateral wall of the calcaneus were excised...
September 20, 2020: Journal of Foot and Ankle Surgery
Hiroshi Ninomiya, Makito Watanabe, Kazunari Kamimura
Avulsion fractures of the calcaneal tuberosity, although relatively uncommon, occur more frequently in patients with osteoporosis and in the elderly. The results of closed manipulation are poor in these fractures, usually requiring open reduction and internal fixation. However, it is difficult to fix the bone fragment rigidly, because the avulsed bone fragment is small and thin, and the bone quality of the calcaneal body in the elderly is poor. Hence, it is necessary to limit prolonged weight-bearing after the operation...
September 5, 2020: Journal of Foot and Ankle Surgery
Amy Touzell
BACKGROUND: The prevalence of acute and chronic conditions of the Achilles tendon is increasing among an ageing, active population. These conditions are a common cause of presentation to general practitioners and allied health practitioners. Achilles tendon injuries have a bimodal demographical presentation, with acute injuries commonly occurring in younger people and chronic conditions presenting in patients who are elderly. OBJECTIVE: The aims of this article are to discuss management of acute Achilles tendon ruptures in the primary care setting, explain the risks associated with calcaneal tuberosity fracture and discuss non-operative and surgical management of acute and chronic overload conditions of the Achilles tendon...
November 2020: Australian Journal of General Practice
Dominique Misselyn, Aaron Caeyman, Harm Hoekstra, Stefaan Nijs, Giovanni Matricali
The use of the 3D orientation angle of the calcaneal posterior subtalar (PTC) joint facet might be superior to the Böhler's angle to evaluate the quality of reduction after performing an open reduction and internal fixation (ORIF) of displaced intra-articular calcaneal fractures (DIACFs). Methods : Three-Dimensional segmentations of the preoperative, postoperative and uninjured calcaneus of 54 patients with a DIACF were assessed by 4 observers with different medical backgrounds. After the delineating of the PTC on the 3D images, a MeVisLab™ software calculated the 3D orientation angle of the PTC, which was determined as the average of the angles between the normal vectors of the PTC and the main axis of the calcaneus, calculated by principal component analysis...
October 29, 2020: Computer Methods in Biomechanics and Biomedical Engineering
Sebastian Fischer, Magalie Meinert, Oliver Neun, Christian Colcuc, Yves Gramlich, Reinhard Hoffmann, Sebastian Manegold
INTRODUCTION: Calcaneal fractures account for 60-75% of all tarsal fractures and represent surgical challenges because of their frequency and complexity. Despite standardized procedures and new implants, literature reports high revision rates and unsatisfactory results. The study aims to describe the role of the surgeon with respect to the clinical outcome. METHODS: Between 2014 and 2017, 94 calcaneal fractures (all type AO C1-3) were re-examined in 86 patients (67 male and 19 female; mean age: 51 years)...
October 27, 2020: Archives of Orthopaedic and Trauma Surgery
Ping Huang, Xian-Jin Chen, Yan-Xing Guo, Dao-Ping Zhang, De-Lin Wu, Lei Shi
OBJECTIVE: To evaluate clinical effect of poking reduction cannulated screw based on Pingle orthopedic muscle-bone interoperability balance theory in treating Sanders Ⅱ calcaneal fracture. METHODS: From October 2014 to December 2017, 28 patients with Sanders Ⅱ calcaneal fracture were treated with poking reduction cannulated screw guided by Pingle orthopedic muscle-bone interoperability balance theory, including 20 males and 8 females, aged from 24 to 55 years old with an average of (37...
October 25, 2020: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Gang Zheng, Fan Xia, Shuang Yang, Jun Cui
BACKGROUND: There are many types of treatments for calcaneal fractures, including conservative treatment, conventional surgical treatment, and minimally invasive surgery. The choice of specific treatment options is still controversial. Open reduction and internal fixation are currently the most commonly used surgical procedures in the clinic. A good fracture reduction effect can be achieved by using the lateral extension incision of the calcaneus; however, many studies have reported a high incidence of postoperative incision complications...
October 6, 2020: World Journal of Clinical Cases
Rajeev Dwivedi, Mandir Khatri, Arjun Kc
INTRODUCTION: Calcaneum fractures constitute about 60% of all tarsal bone fractures. Intra-articular fractures account for 70% of all calcaneal fractures. There are controversies regarding the operative treatment of calcaneum fractures. Therefore this study aimed to estimate the functional outcomes of calcaneum fractures treated by open reduction and internal fixation with plate and screws. METHODS: This descriptive, cross-sectional study was carried out at the tertiary care center in the western region of Nepal among the patients with displaced intra-articular calcaneum fractures from February 2017 to July 2020 after approval from the Institutional review committee...
September 27, 2020: JNMA; Journal of the Nepal Medical Association
Bogdan Veliceasa, Alexandru Filip, Roxana Pinzaru, Mihaela Pertea, Bogdan Ciuntu, Ovidiu Alexa
OBJECTIVES: To assess the outcome of the sinus tarsi approach and C-Nail fixation of displaced intra-articular calcaneal fractures (DIACFs). DESIGN: Prospective study. SETTING: University Trauma Department. PATIENTS: Sixty-four patients (mean age 44.3 years, 48 men and 16 women) with 75 DIACFs were treated between October 1, 2016 and December 31, 2018. INTERVENTION: In all cases, the posterior facet was reduced through the sinus tarsi approach and fixed with one or 2 screws...
November 2020: Journal of Orthopaedic Trauma
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