classifications

Posterior tibial tendon rupture is often misdiagnosed. The authors have presented a retrospective study of a new variation to the repair of this tendon. The anatomy, physiology, etiology, clinical manifestations, radiographic and magnetic resonance imaging, and historical methods are reviewed. A classification scheme based on location and appearance is discussed. A review of 17 cases was performed with results of 88% pain relief following the discussed procedure.

A retrospective study of attenuated/ruptured posterior tibial tendons was conducted of all patients who underwent tendon reconstruction over a 4-year period. The study comprised 20 feet in 19 patients having an average age of 53.3 years, with an average follow-up of 2 years. Preoperative magnetic resonance images were taken and graded for assignment to one of three magnetic resonance imaging (MRI)-based groups. The surgical grade was determined intraoperatively based on a previously described classification scheme...

Nineteen patients with the clinical diagnosis of dysfunction of the posterior tibial tendon underwent surgical exploration. Four types of lesions were identified: avulsion of the tendon at the insertion (Group I), mid-substance rupture of the tendon (Group II), an in-continuity tear of the tendon (Group III), and no tendon tear, tenosynovitis only (Group IV). These conditions could not be separated preoperatively by clinical or radiographic means. The patients in Group I were treated by reinsertion of the tendon; in Group II, by flexor tendon transfer; and in Groups III and IV, by synovectomy...

Since Johnson's and Strom's classification system in 1989 an increasingly complex array of deformities of the foot has been recognized in association with PTTR. This wide spectrum of deformity is not completely addressed by the current classification system, nor does it leave sufficient room for variation within a given treatment stage. Taking into account ankle and hindfoot valgus, forefoot supination, forefoot abduction, and medial column instability we present and discuss a refined classification for PTTR...

The author presents a classification system for complete tendo Achillis rupture. The system is based upon experience following 28 repairs and 102 lengthenings and gastrocnemius recessions. Specific surgical procedures based on this system are reviewed.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Fractures through the neck of the talus are an infrequent occurrence. Therefore, a periodic review of vascular supply and fracture classification are imperative for the practicing physician. The most severe sequela, avascular necrosis, should also be studied. A thorough review of vascularity, fracture classification, and complications is presented.

These injuries are associated with considerable morbidity, and successful results depend on understanding the anatomy, understanding pathogenesis, and precise and careful treatment of this injury. Surgical treatment is discussed as well as arguments against the use of conservative treatment.

The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement...

Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techniques of revascularization, it has become increasingly difficult to perform meaningful outcomes analysis for patients with threatened limbs using these existing classification systems...

Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe (accompanied by systemic signs or metabolic perturbations)...

Foot infections are a common and serious problem in persons with diabetes. Diabetic foot infections (DFIs) typically begin in a wound, most often a neuropathic ulceration. While all wounds are colonized with microorganisms, the presence of infection is defined by ≥2 classic findings of inflammation or purulence. Infections are then classified into mild (superficial and limited in size and depth), moderate (deeper or more extensive), or severe (accompanied by systemic signs or metabolic perturbations)...

The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity...

No abstract text is available yet for this article.

The purpose of this new classification compendium is to republish the Orthopaedic Trauma Association's (OTA) classification. The OTA classification was originally published in a compendium of the Journal of Orthopaedic Trauma in 1996. It adopted The Comprehensive Classification of the Long Bones developed by Müller and colleagues and classified the remaining bones. In this compendium, the introductory chapter reviews new scientific information about classifying fractures that has been published in the last 11 years...

Adult acquired flatfoot deformity progresses through well defined stages as set out by Johnson and Strom. Myerson modified this classification system with the addition of a fourth, more advanced stage of the disease. This stage describes the involvement of the tibiotalar joint in addition to the hindfoot malalignment seen in stages II and III. This most advanced stage is comprised of a hindfoot valgus deformity, resulting from degeneration of the posterior tibial tendon, with associated valgus tilting of the talus within the mortise...

No abstract text is available yet for this article.

BACKGROUND: There have been few long-term studies documenting the outcome of surgical treatment of hallux rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of hallux rigidus over a nineteen-year period in one surgeon's practice and to assess a clinical grading system for use in the treatment of hallux rigidus. METHODS: All patients in whom degenerative hallux rigidus had been treated with cheilectomy or metatarsophalangeal joint arthrodesis between 1981 and 1999 and who were alive at the time of this review were identified and invited to return for a follow-up evaluation...