BackgroundThere is a need for a patient-relevant instrument to evaluate outcome after treatment in patients with a total Achilles tendon rupture. The purpose of this study was to undertake a cross-cultural adaptation of the Achilles Tendon Total Rupture Score (ATRS) into Brazilian Portuguese, determining the test-retest reliability and construct validity of the instrument.MethodsA five-step approach was used in the cross-cultural adaptation process: initial translation (two bilingual Brazilian translators), synthesis of translation, back-translation (two native English language translators), consensus version and evaluation (expert committee), and testing phase. A total of 46 patients were recruited to evaluate the test-retest reproducibility and construct validity of the Brazilian Portuguese version of the ATRS. Test-retest reproducibility was performed by assessing each participant on two separate occasions. The construct validity was determined by the correlation index between the ATRS and the Orthopedic American Foot and Ankle Society (AOFAS) questionnaires.ResultsThe final version of the Brazilian Portuguese ATRS had the same number of questions as the original ATRS. For the reliability analysis, an ICC(2,1) of 0.93 (95 % CI: 0.88 to 0.96) with SEM of 1.56 points and MDC of 4.32 was observed, indicating excellent reliability. The construct validity showed excellent correlation with R = 0.76 (95 % CI: 0.52 to 0.89, P < 0.001).ConclusionThe ATRS was successfully cross-culturally validated into Brazilian Portuguese. This version was a reliable and valid measure of function in patients who suffered complete rupture of the Achilles Tendon.Electronic supplementary materialThe online version of this article (doi:10.1186/s13102-016-0034-0) contains supplementary material, which is available to authorized users.

Objective: To present the clinical and radiographic results of surgical treatment of patients with moderate to severe hallux valgus (HV) by minimally invasive Chevron - Akin osteotomy (MICA). Methods: The case series comprises 25 patients (30 feet) with diagnoses of moderate to severe HV treated surgically with the MICA technique. All patients answered the American Orthopedic Foot and Ankle Score (AOFAS) and rated pain on visual analogue scale (VAS) at preoperative assessment and at the last follow-up consultation. Radiological assessment included measurement of the valgus angles of the hallux (HVA) and the 1st and 2nd ray intermetatarsal angle (IMA). Complications and satisfaction ratings were also documented. Results: Mean follow-up was 14.6 months. Mean AOFAS increased from 42.8 to 90 and VAS reduced from 8.6 to 1.7. Mean HVA reduced from 31.7o to 8.4o and IMA from 14o to 5o. All these improvements were statistically significant (p<0.001). The most common complication observed was discomfort caused by hardware, affecting five feet (16.6%). Two patients (6.6%) had transitory neurapraxia and one patient (3.3%) developed reflex sympathetic dystrophy. There were no cases of infection, relapse, pseudarthrosis, or malunion of osteotomies. Subjective satisfaction ratings classified 93.3% of results as good or excellent. Conclusion: Minimally invasive Chevron-Akin osteotomy is a safe and reproducible technique that achieves good clinical and radiographic results for treatment of moderate to severe hallux valgus. Level of Evidence IV; Therapeutic Studies; Case Series.

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Objective: The purpose of this study is to present the surgical outcomes of twelve patients undergoing arthroscopic subtalar arthrodesis using two lateral portals (anterior and medial) in the sinus tarsi. Methods: A retrospective study was conducted with twelve patients (7 men and 5 women) with a mean age of 55.1 (36-74) years who underwent arthroscopic subtalar arthrodesis through the sinus tarsi between May 2015 and December 2016. The post-surgical follow-up was 12 months. Consolidation time and postoperative complications were evaluated, and a validated functional questionnaire from the American OrthopedicFoot and Ankle Society (AOFAS) and the visual analog scale (VAS) for pain were applied both before and after surgery. Results: The mean bone fusion time was 11.5 weeks. Bone consolidation was observed in all analyzed patients. Four patients developed late complications, three of which were related to screw positioning in the calcaneus, while one was related to residual hindfoot varus deformity. Screw-related complications are common with all subtalar arthrodesis techniques, and such complications are considered less relevant when evaluating the effectiveness of the presented technique. The mean preoperative AOFAS score was 42.3 (27-66) points, while the mean postoperative score was 83 (73-94) points. The mean preoperative VAS score for pain was 8.1 (5-10) points, and the mean postoperative score was 2.1 (0-5) points. The above data are similar to those reported in other published studies and reflect high bone consolidation rates. Conclusion: Arthroscopic subtalar arthrodesis through two lateral portals in the sinus tarsi is a safe and effective technique for the treatment of primary and secondary disorders of the subtalar joint. Correct positioning of screws and hindfoot alignment must be carefully ensured to avoid complications related to the synthesis material and hindfoot varus deformity. Level of Evidence IV; Therapeutic Studies; Case Series.

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