Journal of the American Podiatric Medical Association最新文献

{"title":"Combined Open and Percutaneous Plating for the Treatment of Pilon Fracture.","authors":"Jin Park, Seung Jin Lee, Hyo Beom Lee, Sung Yup Hong, Gab Lae Kim","doi":"10.7547/21-228","DOIUrl":"10.7547/21-228","url":null,"abstract":"<p><strong>Background: </strong>With the advent of percutaneous plating techniques and anatomical locking plates, open plating combined with percutaneous plating may be a feasible option to reduce pilon fracture soft-tissue complications. The purpose of this study was to evaluate the outcomes of a combined open and percutaneous plating approach for the treatment of pilon fracture.</p><p><strong>Methods: </strong>Forty-two consecutive patients treated with a combined open and percutaneous plating approach between March of 2010 and February of 2020 for pilon fracture were reviewed retrospectively. The study population consisted of four female patients and 38 male patients with an average age of 47.5 years (range, 15-71 years). The mean follow-up duration was 25.7 months (range, 12-48 months). The combination of a small anterolateral approach and a small anteromedial approach (or a small direct medial approach) was used in all cases. A small posterolateral approach or a small posteromedial approach was added as necessary.</p><p><strong>Results: </strong>The average ranges of ankle sagittal motion and hindfoot coronal motion at 1 year postoperatively were 43.3° (range, 30°-60°) and 47.7° (range, 40°-55°), respectively. The mean 1-year postoperative visual analogue scale score and American Orthopaedic Foot and Ankle Society score were 0.90 (range, 0-4.0) and 94.5 (range, 78-100), respectively. All patients except one achieved bony union. The mean time to union (except in the one case of nonunion) was 4.5 months (range, 3-8 months). Minor wound breakdown occurred in five cases using combined approaches, but these eventually healed with local wound care. There were no major soft-tissue complications and no instances of deep infection.</p><p><strong>Conclusions: </strong>A combined open and percutaneous plating approach is a feasible option for the treatment of pilon fracture. This combined plating technique involving a combination of a small anterolateral approach and a small anteromedial approach (or a small direct medial approach) yielded satisfactory outcomes without major soft-tissue complications.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Radiographic Analysis of the Width of the Lesser Digit Proximal Phalangeal Heads.","authors":"Kushkaran Kaur, Asher Cherian, Russell J Hill, Andrew J Meyr","doi":"10.7547/21-211","DOIUrl":"10.7547/21-211","url":null,"abstract":"<p><strong>Background: </strong>Digital deformities represent a common presenting abnormality and target for surgical intervention in podiatric medicine and surgery. The objective of this investigation was to compare the radiographic width of the heads of the lesser digit proximal phalanges.</p><p><strong>Methods: </strong>One hundred fifty consecutive feet with a diagnosis of digital deformity and performance of weightbearing radiographs were analyzed. The maximum width of the heads of the lesser digit proximal phalanges were recorded from the radiographs using computerized digital software.</p><p><strong>Results: </strong>The mean ± standard deviation of the head of the second digit proximal phalanx was 9.74 ± 0.87 mm (range, 7.94-11.78 mm); the head of the third digit proximal phalanx, 9.00 ± 0.91 mm (range,7.27-10.94 mm); the head of the fourth digit proximal phalanx, 8.49 ± 1.01 mm (range, 5.57-10.73 mm); and the head of the fifth digit proximal phalanx, 8.67 ± 0.89 mm (range, 6.50-11.75 mm). The width of the head of the proximal phalanx decreased from the second digit to the third digit (P < .001), decreased from the third digit to the fourth digit (P < .001), and then increased from the fourth digit to the fifth digit (P = .032).</p><p><strong>Conclusions: </strong>The results of this investigation provide evidence in support of an anatomical and structural contribution to digital deformities. The width of the heads of the lesser digit proximal phalanges decreased from the second to the third to the fourth toes, and then subsequently increased with the fifth proximal phalangeal head.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73077507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Necrotizing Fasciitis in Charcot-Marie-Tooth Treated with Debridement, Free Flap, and Extra-Articular Reconstruction.","authors":"Joshua Yoon, Selim Gebran, Arthur Nam, Roberto Brandao, Jacob Wynes","doi":"10.7547/20-281","DOIUrl":"10.7547/20-281","url":null,"abstract":"<p><p>Necrotizing fasciitis of the foot is a relatively rare diagnosis and has traditionally been treated with distal amputation. A 30-year-old diabetic man with Charcot-Marie-Tooth muscular atrophy developed necrotizing fasciitis of the dorsal foot and underwent surgical debridement resulting in a significant wound with exposed tendons. Serial debridements were performed, eventually followed by a staged free flap reconstruction using an anterolateral thigh fasciocutaneous flap. After allowing time for flap healing, subsequent staged equinovarus reconstruction was also performed successfully. There were no flap or postoperative complications, and the patient is progressing as expected. Flap refinement procedures have been used to enhance cosmetic and functional outcomes. This report not only showcases the success of a procedure high on the reconstructive ladder in a patient at high risk for complications but also highlights an approach in which functional recovery is also optimized successfully in a planned staged multidisciplinary manner.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Excision of Intractable Plantar Keratoses (Corns) of the Foot: A Scoping Review.","authors":"Ian N Reilly, Belinda Longhurst, Tracey C Vlahovic","doi":"10.7547/22-044","DOIUrl":"10.7547/22-044","url":null,"abstract":"<p><strong>Background: </strong>Hyperkeratosis is a hypertrophic thickening of the skin. A callus (tyloma) is considered diffuse thickening, whereas a corn-also known as a clavus, heloma durum, or intractable plantar hyperkeratosis (IPK)-is a more focal, circumscribed hyperkeratotic lesion with a central conical core of keratin. Treatment (including surgical excision) of plantar keratoses is often sought because of pain and discomfort. The aim of this study was to collect and chart data regarding the surgical excision of plantar corns. The emerging themes were then mapped so that suggestions for areas of future research could be made.</p><p><strong>Methods: </strong>A scoping review of the literature was performed using the six-stage methodologic framework (minus stage 6) proposed by Arksey and O'Malley incorporating the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews reporting guideline. A database search by means of the United Kingdom National Health Service Care Advanced Database Search yielded 1,056 articles, 12 of which appeared to be of potential relevance. After removing five duplicate articles, this total was reduced to seven, which were retrieved as full texts. Three were excluded. Thirteen further articles were found through Google Scholar and reference lists from the full texts retrieved to give 17 articles for review. One was discounted as not being in English/irrelevant; and one article did not relate to IPK excision, leaving 15 articles for data extraction.</p><p><strong>Results: </strong>Iterative charting of the included articles yielded overlapping codes and two main themes. The first theme was closure: by primary intention (with or without a skin flap) or by secondary intention. The second theme was whether excision was performed in combination with IPK excision with other (bony) surgery.</p><p><strong>Conclusions: </strong>There is modest evidence that excision of the lesion with either primary closure or healing by means of secondary intention can be useful for the management of IPKs. A further consideration is an emerging hypothesis that many of these IPKs are viral in origin, rather than mechanical, which implies that prospective studies are required with cross-reference to lesion excision by anatomical site and histopathologic confirmation of the diagnosis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Recalcitrant Isolated Congenital Fibular Pseudarthrosis: Fibular Segment Transfer and Tibiofibular Synostosis with Unilateral External Fixator.","authors":"Damla Fidan Yamanel, Bedri Karaismailoglu, Turgut Nedim Karaismailoglu","doi":"10.7547/21-255","DOIUrl":"10.7547/21-255","url":null,"abstract":"<p><p>Isolated congenital pseudarthrosis of the fibula is a rare entity with a limited number of cases reported in the literature. Treatment is challenging because of recalcitrant nonunion and because no consensus about the best treatment plan exists. We report a case of isolated congenital fibular pseudarthrosis with valgus deformity of the ankle. The patient had a history of two failed operations. We used a novel surgical plan that combined tibiofibular synostosis with fibular segment transfer through a unilateral external fixator. The patient showed good early results with fibular union. We advocate the combination of tibiofibular synostosis and fibular segment transfer to restore the integrity and stability of the ankle in recalcitrant isolated congenital fibular pseudarthrosis cases with a history of failed surgery.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failed Bilateral Total Silastic First Metatarsophalangeal Joint Implant Reconstructed with Osteochondral Allograft Implantation.","authors":"Thomas S Poynter, Timothy Ford","doi":"10.7547/22-072","DOIUrl":"10.7547/22-072","url":null,"abstract":"<p><p>First metatarsophalangeal joint (MPJ) arthritis is a very common form of arthritis seen in the foot. Some signs and symptoms include pain, swelling, decreased passive and active range of motion, difficulty with shoe gear, and so forth. Surgically, options for alleviating symptomatic hallux limitus and arthritis fall into two broad categories: joint sparing and joint sacrificing. In this case study, we present a patient with a bilateral failed total silastic implant of the first MPJ and our proposed revision using an osteochondral bone allograft to fill the deficit left behind from silastic implant removal. The ability for immediate weightbearing and to perform this procedure bilaterally is an advantage to this surgical treatment option compared with other described revision techniques. Postoperatively, the patient has adequate range of motion and no pain when ambulatory. We believe this osteochondral allograft implant may be a viable option for revision first MPJ arthroplasty in select patient populations.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage First Metatarsophalangeal Joint Fusion with a Three-Dimensional-Printed Implant for Osseous Defects: A Case Series.","authors":"Lance J Johnson, Paul R Leatham, Coleman O Clougherty, Peter D Highlander","doi":"10.7547/21-148","DOIUrl":"https://doi.org/10.7547/21-148","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to describe a case series of revision first metatarsophalangeal joint fusion with a three-dimensional (3-D)-printed implant for osseous deficits of the first metatarsophalangeal joint. Bone defects of the first ray are a common problem in foot and ankle surgery. Etiologies include nonunion, avascular necrosis, osteomyelitis, failed first metatarsophalangeal joint implant arthroplasty, and failed hemijoint resection arthroplasty. Treatment options include acute shortening, block allograft, block autograft, distraction osteogenesis, vascularized free fibula, Masquelet technique, and partial first-ray amputation. Three-dimensional printing provides an opportunity to improve outcomes, with less donor site morbidity and less extensive recovery time than an external fixation device. It has been used in other facets of foot and ankle surgery with encouraging results.</p><p><strong>Methods: </strong>Three patients (four feet) underwent revision first metatarsophalangeal joint fusion with a 3-D-printed implant. Reasons for revision included avascular necrosis after distal metatarsal osteotomy in one patient and bone deficit after failed first metatarsophalangeal joint implant in two patients.</p><p><strong>Results: </strong>All patients had a minimum follow up of 12 months. Two patients had painful hardware and had to undergo revision due to implant design. At most recent follow up all patients were pain free with improved pain scores.</p><p><strong>Conclusions: </strong>In revisional first metatarsophalangeal joint surgery with osseous deficits, the goal is to restore length and alignment, which improves function of the medial column. Custom 3-D-printed implants for first metatarsophalangeal joint revision can provide an opportunity for improved outcomes and healing.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139403423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-Based Information About Plantar Fasciitis Reflects Current Treatment Guidelines.","authors":"Özlem Feyzioğlu, Özgül Öztürk, Selim Muğrabi","doi":"10.7547/22-105","DOIUrl":"10.7547/22-105","url":null,"abstract":"<p><strong>Background: </strong>Online health-related information has become increasingly popular. Social media platforms have great potential to support and change patients' perspective. Plantar fasciitis (PF) is a common disease that is one of the most frequently researched subjects among foot problems. This study aimed to assess the content, quality, and reliability of YouTube videos related to PF and to evaluate whether they reflect current PF treatment guidelines.</p><p><strong>Methods: </strong>The descriptive cross-sectional study analyzed the most viewed 79 YouTube videos retrieved by using the keyword \"plantar fasciitis.\" The quality, reliability, and content of the videos were analyzed using Global Quality Scale (GQS), the modified DISCERN instrument, the Journal of the American Medical Association instrument, and a content scoring system by two independent physiotherapists. The analyzed videos were divided into three groups according to their GQS score as high, intermediate, and low quality. Also, video parameters were compared between the useful and misleading groups.</p><p><strong>Results: </strong>Of the 79 analyzed videos, 26 (32.9%) were of low quality, 29 (36.7%) were of intermediate quality, and 24 were of (30.3%) high quality. Most high-quality videos were uploaded by allied health professionals (39.4%). The view ratio and video power index scores were highest in patients. There were significant differences between useful and misleading videos in terms of DISCERN, GQS, and Journal of the American Medical Association scores (P = .000, P = .000, and P = .020, respectively). Almost all of the evaluated videos contain at least one treatment approach.</p><p><strong>Conclusions: </strong>This study demonstrates that the vast of majority of YouTube videos on PF are useful and comprehensive; also, our results may lead us to propose that the vast majority of the videos reflect current treatment guidelines. Video-based information about PF may provide valuable insight to patients, especially in the absence of direct access to health care by stakeholders.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndesmosis Injuries in Lateral Malleolar Fractures Accompanied by a Posterior Malleolar Fracture: A Nonfixed Posterior Fracture Fragment May Not Affect Postoperative Tibiofibular Joint Malreduction Rates.","authors":"Ali Yüce, Abdulhamit Misir, Mustafa Yerli, Tahsin Olgun Bayraktar, Ali Çağrı Tekin, Süleyman Semih Dedeoğlu, Yunus İmren, Hakan Gürbüz","doi":"10.7547/21-105","DOIUrl":"10.7547/21-105","url":null,"abstract":"<p><strong>Background: </strong>The fact that lateral malleolar fracture is accompanied by posterior malleolar fracture may adversely affect syndesmosis malreduction rates. We aimed to compare syndesmosis malreduction rates determined on postoperative radiographs between isolated lateral malleolar fractures and lateral malleolar fractures accompanied by posterior malleolar fractures.</p><p><strong>Methods: </strong>We retrospectively examined 128 operative patients: 73 with isolated lateral malleolar fractures (group L) and 55 with lateral + posterior malleolar fractures (group LP). In group LP, no patients received posterior fragment fixation. In both groups, indirect syndesmosis fixation was performed with a single screw after open reduction and internal fixation of the lateral malleolus. Patient age, sex, fracture side, fracture type (Lauge-Hansen and Danis-Weber classifications), Kellgren-Lawrence osteoarthritis classification, syndesmotic incongruency on postoperative radiographs, syndesmotic malreduction of postoperative fibula fracture, fracture union time, complication rates, accompanying injuries, and preoperative and postoperative radiographic syndesmotic measurements (tibiofibular overlap, tibiofibular clear space, medial clear space) were recorded, and the groups were compared.</p><p><strong>Results: </strong>Mean ± SD age was 44.32 ± 15.66 years in group L and 48.93 ± 14.03 years in group LP (P = .087). There were no significant differences in preoperative and postoperative tibiofibular distance, tibiofibular overlap, and medial clear space values between groups (P > .05). The prevalence of grade 2 fractures according to the Kellgren-Lawrence classification was significantly higher in group LP (P = .047). Postoperative syndesmosis malreduction was detected in 12 patients in group L and in nine in group LP (P = .991).</p><p><strong>Conclusions: </strong>In lateral malleolar fractures accompanied by small-fragment posterolateral or avulsion-type posterior malleolar fractures, closed syndesmotic screw fixation does not cause syndesmosis malreduction.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rare Presence of an Asymptomatic Os Sustentaculum in a Young Athlete.","authors":"James A Wright, Jessica A Wenz, Andrea Petrow","doi":"10.7547/21-198","DOIUrl":"10.7547/21-198","url":null,"abstract":"<p><p>The presence of an os sustentaculum bone is extremely rare. Given the scarcity of clinical literature reporting such a finding, the condition may be misdiagnosed as a fracture of the sustentaculum tali. We describe such an incident in a 16-year-old male athlete presenting for a recent ankle sprain with no other history of trauma or pain on the medial aspect of the ankle. The original computed tomographic scan reported a possible nonunion of a sustentaculum fracture, or peripherally corticated ossification in association with a possible talocalcaneal fibrocartilaginous coalition. Given no history of high-level trauma to the area, the clinical presentation, and the radiographic findings, the more likely diagnosis was confirmed to be an os sustentaculum. The goal of the authors of this article is to report such findings to raise awareness of a rare clinical presentation to avoid misdiagnosis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139087273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}