No abstract

Purpose The objective of the study is to compare the radiographic and clinical results of two techniques for the treatment of hallux valgus that have the same indication, the open scarf/Akin (SA) technique and the percutaneous Chevron/Akin (PECA). Methods A meta-analysis was performed with the studies found during a systematic review of articles included in electronic databases until 30 May 2020. The pooled analysis was summarized according to clinical outcomes, such as visual analog pain scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) score, radiographic outcomes and complications, with a 95% confidence interval. Results Three studies comparing the open scarf/Akin (SA) versus the PECA techniques were added to the analysis, corresponding to 235 feet, 102 in the PECA group and 133 in the SA. The final mean difference in the hallux valgus angle was 0.80 degrees and in the intermetatarsal angle 0.53, in the last radiographic evaluation. In the AOFAS score, the final mean difference was 4.97 points and in the VAS 0.14 in relation to the last clinical evaluation. Exposure to radiation during the surgical procedure was higher in the PECA group with a mean of 35.53 seconds. Conclusions The PECA surgical technique for the treatment of hallux valgus when compared with SA demonstrated similar radiographic correction, pain and function after six months of follow-up but with a longer radiation exposure time. Register of systematic review (PROSPERO) CRD42018096613.

Leiomyomas are benign tumors of smooth muscle origin. They are most commonly found in the uterus, but cutaneous leiomyomas may be occasionally present in the extremities and cause pain secondary to mass effect. Few studies have reported leiomyoma of the foot, and leiomyoma of the heel is particularly rare. We present a case of a 41-year-old female who presented to our clinic for a tender nodule on the posterior aspect of her right heel. The tumor was surgically excised and biopsied revealing cutaneous leiomyoma.

Introduction. The open, lateral sinus tarsi approach is the most commonly used technique for subtalar arthrodesis. In this cadaver study, we measured the maximum joint surface area that could be denuded of cartilage and subchondral bone through this approach. Methods. Nine fresh frozen above-knee specimens were used. The subtalar joint was accessed through a lateral incision from the fibular malleolus distally over the sinus tarsi area to the level of the calcaneocuboid joint. Cartilage was removed from the anterior, middle, and posterior facets of the calcaneus and talus using an osteotome and/or curette. ImageJ was used to calculate the surface areas of undenuded cartilage. Results. No specimens were 100% denuded of cartilage on all 6 measured surfaces. The greatest percentages of unprepared surface area remained on the middle facet of the talus (18.66%) and the middle facet of the calcaneus (14.51%). The anterior facet of the talus was 100% denuded in 6 specimens, while the middle and posterior facets were 100% denuded in 3 specimens. The anterior facet of the calcaneus was also 100% denuded in 6 specimens, while the middle and posterior facets were 100% denuded in 3 and 4 specimens, respectively. The average total unprepared surface area per specimen was 8.67%. Conclusion. The lateral sinus tarsi approach provides adequate denudation of cartilage of the subtalar joint in most cases. Total percentage of unprepared joint surface may range from approximately 2% to 18%. Future clinical studies are warranted to assess whether this technique results in optimal union rates. Levels of Evidence:V, Cadaveric Study

No abstract