What’s New in Foot and Ankle Surgery

Marx, Randall C.; Mizel, Mark S.

doi:10.2106/jbjs.n.00084

Cited by 3 publications

(3 citation statements)

References 44 publications

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“…A via de acesso lateral tem sido a mais utilizada pelos autores (2,10) , embora suas modificações, como lateral em "L" e lateral em "L" amplo estejam se tornando cada vez mais prevalentes. Além do acesso lateral, a literatura descreve também acessos por via medial e pelo seio do tarso (10)(11)(12)(13) . Técnicas minimamente invasivas estão sendo descritas principalmente para pacientes com comorbidades (principalmente doença arterial obstrutiva periférica) que contraindiquem cirurgia aberta (11) .…”

Section: Discussionunclassified

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

2018

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Objective: To perform the correlation between the preoperative tomographic evaluation of patients with calcaneal fracture diagnosis and the access routes of choice, as well as the synthesis materials used.Methods: We reviewed 19 medical records of patients between 23 and 56 years old who underwent calcaneal fracture surgery from 01/01/2014 to 12/31/2015. We evaluated the mechanism of trauma, side, Essex-Lopresti classification, Böhler and Gissane angle in the pre- and postoperative period, Sanders tomographic classification and type of osteosynthesis performed. Angular measurements served as a reference for radiological analysis of the quality of the reduction. Results: 90% of the cases were of joint depression, the other 10% considered extra-articular. The preoperative Böhler angle varied between 5 and 40°, and between 10 and 38° in the postoperative period, and 55% of the fractures had an angular reconstruction considered good (between 20° and 40°). Gissane’s angle, on the other hand, varied between 110 and 170° in the preoperative period, and 102 and 132° in the postoperative period. In the tomographic analysis, Sanders IV classification was predominant (65%), followed by type IIIBC fractures (20%), and fractures type I, IIA and IIIAB (5% each). Osteosynthesis with plate and screw was the most used method (89.47%). Conclusion: Correct use of existing diagnostic imaging resources through radiographic and tomographic results provides the possibility of better preoperative planning in the intra-articular fractures of the calcaneus. However, in this study, there was no difference in the access route and synthesis according to the tomographic classification. Level of Evidence III; Diagnostic Studies; Study of Non-Consecutive Patients.

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Section: Discussionunclassified

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

2018

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“…4,6,7 A V-shaped distal metatarsal osteotomy is used for the correction of mild-to-moderate hallux valgus. 8 Tailor's bunion may present as a hypertrophy of the soft tissue overlying the fifth metatarsal because tailors commonly sit with their legs crossed. This puts pressure on the outer borders of their feet that results a hypertrophic skin callosity over the fifth metatarsal head.…”

Section: Discussionmentioning

confidence: 99%

Radiological Outcome of Patients with Splay Foot following First and Fifth Metatarsal Osteotomies Performed Simultaneously on the Same Foot

Mohammed

Carolina

Attar

et al. 2012

Journal of Orthopaedics, Trauma and Rehabilitation

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a b s t r a c tIntroduction: There have been many operations documented for the treatment of hallux valgus and fifth metatarsal bunionette deformities in patients with splay foot carried out separately, with variable success rates. Our aim was to assess the radiological outcome following combined chevron osteotomy of the first and reverse chevron osteotomy of the fifth metatarsal in symptomatic patients with splay foot. To our knowledge, this procedure has not been described in the literature. Methods: Nine symptomatic patients (12 feet) were included in the study. The preoperative and postoperative angles were assessed on weight-bearing radiographs for statistical significance using nonparametric paired t tests. Results: The postoperative hallux valgus angles, intermetatarsal angles, first and fifth metatarsal head widths, and maximum distance between the first and fifth metatarsal heads decreased significantly (p < 0.05). Conclusion: The results suggest a very good radiological outcome in symptomatic patients following simultaneous first and fifth metatarsal osteotomies. All the angles measured postoperatively, except the distal metatarsal articular angle, showed a statistically significant reduction. IntroductionThe term 'splay foot' connotes an abnormal widening of the forefoot in relation to the heel. Clinically, the splay foot is characterized by valgus of the great toe with bunion formation in association with a relative varus position of the first metatarsal. On the lateral part of the forefoot, there is varus deformity of the fifth toe with a relative valgus position of the fifth metatarsal and resultant bunionette formation. This deformity is often associated with metatarsalgia under the second metatarsal head because of its relative elongation in relation to the first metatarsal bone. Radiologically, splay foot is characterized by an intermetatarsal angle (IMA) between the first and second rays of greater than 12 degrees,

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“…The plantar fascia is the main stabilizer of the medial longitudinal arch of the foot against ground reactive forces, and is instrumental in reconfiguring the foot into a rigid platform before toeoff. [5,6] Treatment for PF is varied and various physiotherapy treatment protocols have been advocated in the past such as rest, taping, stretching, night splint, silicon heel cups and various electrotherapy modalities in the form of ultrasound, laser and iontophoresis. However PF is often slow to respond to these traditional approaches.…”

Section: Introductionmentioning

confidence: 99%

Effect of Low Energy Versus Medium Energy Radial Shock Wave Therapy in the Treatment of Chronic Planter Fasciitis

Fouda

2016

International Journal of Physiotherapy

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Background: Plantar fasciitis (PF) is the most common cause of heel pain and it can often be a challenge for clinicians to treat successfully. Radial shock wave therapy (RSWT) has been introduced recently for treatment of musculoskeletal disorders. Different energy levels of shock wave therapy have been used in the literatures for treatment of PF with no clear settled parameters. Therefore, the purpose of this study was intended to investigate and compare the efficacy of two different energy levels of RSWT on PF patients.Methods: Forty patients having unilateral chronic PF were recruited for the study from orthopedic outpatient clinics of Cairo University hospitals and National Institute of Neuromotor System Cairo Egypt, with a mean age of (47.15±4.57) years. Patients were randomly assigned into two equal groups. Group (A) treated with low intensity level of 1.6 bars (0.16 mJ/mm²) RSWT and group (B) treated with medium intensity level of 4 bars (0.38 mJ/mm²) RSWT. Functional assessment of the foot based on Foot Function Index (FFI) and Present pain intensity was measured during rest by Visual Analogue Scale (VAS).Results: There was as significant decreased in the total FFI scores from (118.42 ±6.51) to (81.37 ±3.46) for group (A) and from (118.93 ±6.85) to (58.50 ±3.22) for group (B). Also regarding VAS Scores there was as significant decreased in the pain intensity from (5.11 ±0.41) to (2.85 ±0.31) for group (A) and from (4.95 ±0.39) to (2.05 ±0.22) for group (B). Conclusion:Radial shock wave therapy is an effective modality that should be considered in the treatment of chronic PF, while the medium energy level RSWT is better than the low energy level RSWT in regarding to the measured treatment outcomes.

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What’s New in Foot and Ankle Surgery

Cited by 3 publications

References 44 publications

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

Pre-operative tomographic evaluation of calcaneum fractures in surgical planning

Radiological Outcome of Patients with Splay Foot following First and Fifth Metatarsal Osteotomies Performed Simultaneously on the Same Foot

Effect of Low Energy Versus Medium Energy Radial Shock Wave Therapy in the Treatment of Chronic Planter Fasciitis

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