Scientific Journal of the Foot & Ankle最新文献

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TL 18073 - Medium-term follow-up after surgically treated fifth metatarsal fractures in professional soccer players TL 18073 -职业足球运动员第五跖骨骨折手术后的中期随访
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1012
Luis Paulo Vilela Lemos, T. Baumfeld, Jorge Batista, C. Nery, D. Baumfeld
{"title":"TL 18073 - Medium-term follow-up after surgically treated fifth metatarsal fractures in professional soccer players","authors":"Luis Paulo Vilela Lemos, T. Baumfeld, Jorge Batista, C. Nery, D. Baumfeld","doi":"10.30795/scijfootankle.2019.v13.1012","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1012","url":null,"abstract":"Introduction: Fifth metatarsal fractures are among the most common forefoot injuries, especially in young athletes. The purpose of this paper is to evaluate the functional outcome of professional soccer players undergoing surgical treatment of Dameron’s zones II and III fifth metatarsal fractures with an intramedullary screw with or without bone graft. Methods: Thirty-four professional soccer players underwent operations from July 2001 to June 2016. All of them underwent an evaluation based on AOFAS and VAS scores before and after surgery, with a mean follow-up of 24 months. The need for grafting was evaluated in relation to the time for surgery. Additionally, the influence of time to surgery, fracture union, Torg’s classification and grafting were related to the time to return to sports. In addition, the player's position, age, complications and side of the lesion were also described. Results: There were 10 forwards, 07 center forwards, 06 full-backs, 05 midfielders, 03 defenders, 02 goalkeepers and 01 central defender, with an average of 19 years; the right side was affected in 44% of cases. The AOFAS average pre and postoperatively was 42 and 99, respectively, while the EVA was 6 and 0. The longer delay to operate, the greater was the need for grafting (p = 1.11%), each day increasing by 1,015 times the need for grafting. The return to activities was not influenced by the time to operate, time to union, Torg’s classification or graft use. Conclusion: Surgical treatment of a proximal fifth metatarsal fracture in professional soccer player presents good clinical outcomes and can be performed safely in these cases, with a low rate of complications.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85989307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TL 18206 - Foot and ankle insufficiency fractures among postmenopausal sedentary women tl18206 -绝经后久坐妇女的足和踝关节不全骨折
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1088
M. P. Filho, K. Stéfani, M. Nogueira
{"title":"TL 18206 - Foot and ankle insufficiency fractures among postmenopausal sedentary women","authors":"M. P. Filho, K. Stéfani, M. Nogueira","doi":"10.30795/scijfootankle.2019.v13.1088","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1088","url":null,"abstract":"Introduction: Insufficiency fractures occur in bones with decreased elastic strength. In contrast to fatigue or stress fractures, which affect normal bones and have been extensively studied in the literature, foot and ankle insufficiency fractures have been poorly researched to date. The objective of this study was to identify behavioral, biomechanical and metabolic factors associated with the development of foot and ankle insufficiency fractures. Methods: In total, 53 sedentary postmenopausal female patients who had foot and ankle insufficiency fractures and who were treated at the São Paulo State Civil Servant Hospital (Hospital do Servidor Público do Estado de São Paulo) were included in the treatment group, and 53 individuals were included in the control group. Data were collected on fracture site, body mass index (BMI), corticoid use, femoral and lumbar T-score measured by bone densitometry, and serum 25-hydroxyvitamin D level. The calcaneal angle, the angle between the first metatarsal and the talus and the metatarsus adductus angle were measured in radiographs. Results: The fractures affected the metatarsal bones in 47 patients. Other fracture sites included the lateral malleolus, lateral cuneiform bone, cuboid bone, tibia and calcaneus. All metatarsal bones were affected, most frequently the 5th. The most common fracture was a 5th metatarsal base fracture in zone II. There was no significant difference in mean BMI, serum 25-hydroxyvitamin D levels, alcohol consumption or smoking between the groups. The development of fractures was significantly associated with corticoid use (p<0.0001), low femur (p=0.028) and lumbar spine (p=0.002) bone mineral density and metatarsus adductus angle (p=0.02). When analyzed separately, 4th and 5th metatarsal fractures were associated with smaller angles between the talus and the first metatarsal (p=0.01). Conclusion: Foot and ankle insufficiency fractures among sedentary postmenopausal women are associated with corticoid use, low bone mineral density and biomechanical characteristics, such as pes cavus and metatarsus adductus. The presence of such fractures may be the first sign of bone fragility and should be used as criteria for initiating adequate treatment to prevent other fractures.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85219932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TL 18097 - Role of bone graft and bone graft substitutes in isolated subtalar joint arthrodesis 骨移植物和骨移植物替代品在离体距下关节融合术中的作用
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1059
A. Godoy-Santos, Ibukunoluwa B. Araoye, Osama Elattar, Sameer Naranje, C. Netto, Ashish B. Shah
{"title":"TL 18097 - Role of bone graft and bone graft substitutes in isolated subtalar joint arthrodesis","authors":"A. Godoy-Santos, Ibukunoluwa B. Araoye, Osama Elattar, Sameer Naranje, C. Netto, Ashish B. Shah","doi":"10.30795/scijfootankle.2019.v13.1059","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1059","url":null,"abstract":"Introduction: Subtalar joint (STJ) arthrodesis is a well-established operative procedure in the treatment of subtalar arthritis and hindfoot deformities. Nonunion remains an important complication, with an incidence and role of risk factors varying in the literature. Recent reports have highlighted a decrease in overall union rates between 96% and 100% to 84%, further strengthening the need for an understanding of risk factors that may be implicated in nonunion rates. Some possible factors have been identified, including smoking, revision surgery, the presence and extent of devascularized bone, and previous ankle joint fusion. Current practice suggests that using bone grafts or bone graft substitutes decreases the risk of its occurrence. Objective: To compare union rates of isolated subtalar arthrodesis with and without the use of bone grafts or bone graft substitutes. Methods: We retrospectively reviewed 135 subtalar fusions with a mean follow-up of 18 ± 14 months. The standard approach was used for all operations. Graft materials included β-tricalcium phosphate, demineralized bone matrix, iliac crest autograft and allograft and allograft cancellous chips. Successful subtalar fusion was determined clinically and radiographically. Results: There was an 88% (37/42) union rate without graft and an 83% (78/93) union rate with bone graft use. The odds ratio of union for graft versus no graft was 0.703 (95% CI, 0.237-2.08). The average time to union in the graft group was 3 ± 0.73 months and 3 ± 0.86 in the nongraft group, with no statistically significant difference detected (p = 0.56). Conclusion: Graft use did not improve union rates for subtalar arthrodesis.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83398578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
TL 18050 - Short-term complications, reoperations, and radiographic outcomes of Infinity® total ankle arthroplasty TL 18050 - Infinity®全踝关节置换术的短期并发症、再手术和影像学结果
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1006
G. Saito, A. Sanders, C. Netto, M. O'Malley, S. Ellis, Constantine A. Demetracopoulos
{"title":"TL 18050 - Short-term complications, reoperations, and radiographic outcomes of Infinity® total ankle arthroplasty","authors":"G. Saito, A. Sanders, C. Netto, M. O'Malley, S. Ellis, Constantine A. Demetracopoulos","doi":"10.30795/scijfootankle.2019.v13.1006","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1006","url":null,"abstract":"Introduction: With the increasing use of total ankle arthroplasty (TAA), new implants with varied configurations are being developed every year. This study aimed to assess the early complications, reoperations, and radiographic and clinical outcomes of this novel implant. Methods: A retrospective analysis of 64 consecutive ankles that underwent a primary Infinity® TAA was performed. Patients had an average follow-up of 24.5 (range, 18-39) months. Medical records were reviewed to determine the incidence of complications, reoperations, and revisions. Additionally, patient-reported outcomes were analyzed with the Foot and Ankle Outcome Score (FAOS). Results: Survivorship of the implant was 95.3%. Fourteen ankles (21.8%) presented a total of 17 complications. A total of 12 reoperations were necessary in 11 ankles (17.1%). Revision surgery was indicated for 3 ankles (4.7%) as a result of subsidence of the implant. Tibiotalar coronal deformity was significantly improved after surgery (P < .0001) and maintained at the latest follow-up (P = .81). Periprosthetic radiolucent lines were observed around the tibial component in 20 ankles (31%) and around the talar component in 2 ankles (3.1%). A tibial cyst was observed in 1 ankle (1.5%). Outcome scores were significantly improved for all FAOS components analyzed (P < .0001). Conclusion: Most complications observed in the study were minor and successfully treated with a single reoperation procedure or nonoperatively. Failures and radiographic abnormalities were most commonly related to the tibial implant. Further studies with longer follow-ups are needed to evaluate the survivorship of the tibial implant over the long term.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87962712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PO 18118 - Epidemiological study of ankle fractures 踝关节骨折的流行病学研究
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.995
E. Ribeiro, S. Prata, M. Rizzo
{"title":"PO 18118 - Epidemiological study of ankle fractures","authors":"E. Ribeiro, S. Prata, M. Rizzo","doi":"10.30795/scijfootankle.2019.v13.995","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.995","url":null,"abstract":"Introduction: Ankle fractures account for 10% of all fractures and rank second in frequency among lower limb fractures, behind only hip fractures. The lack of studies on the epidemiology of ankle fractures available in the Brazilian literature motivated a more in-depth study to better describe these fractures. The objective of this study was to analyze the epidemiological characteristics of ankle fractures. Methods: An epidemiological, prospective, descriptive, observational study of ankle fractures in a convenience sample taken from the study hospital. In total, 150 patients were evaluated from March 2016 to March 2017. A questionnaire was prepared to collect patient data and variables for subsequent analysis. The following parameters were analyzed: age, occupation, sex, ethnicity, marital status, education, emergency transport, time of trauma, day of the week of trauma, trauma mechanism, fracture type, affected limb, classification, treatment, associated injury and length of hospital stay. Results: Among the patients with ankle fractures, 33.66% of the fractures occurred in the afternoon. A total of 61.34% of the ankle fracture patients were men, and the right was the most commonly affected side. The mean age was 40.48 years. The most frequent trauma mechanism was fall from height, which accounted for 51.42% of fractures. Weber type B fractures were the most frequent type. Conclusion: Ankle fractures treated at the Department of Orthopedics and Traumatology during the study period primarily affected married, Caucasian patients aged between 40 and 50 years with up to a primary education level; fractures were most frequently on the right side and primarily occurred in the afternoon and on Sundays. Sprain due to fall from height was the most common trauma mechanism, and exposed fracture occurred in 28% of the cases.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"8 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77884841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PO 18079 - Arthroscopic medial and lateral ligament repair for multidirectional ankle instability 关节镜下内侧和外侧韧带修复多向踝关节不稳定
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.990
N. Mansur, A. Lemos, L. Fonseca, T. Baumfeld, D. Baumfeld, C. Nery
{"title":"PO 18079 - Arthroscopic medial and lateral ligament repair for multidirectional ankle instability","authors":"N. Mansur, A. Lemos, L. Fonseca, T. Baumfeld, D. Baumfeld, C. Nery","doi":"10.30795/scijfootankle.2019.v13.990","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.990","url":null,"abstract":"Introduction: The extremely high prevalence of sprains in the population has led to a large number of patients with lateral ankle instability. The persistence of this condition can lead to progressive loosening of the medial containment structures, generating multidirectional rotational instability. Treatment of the deltoid complex through ligamentoplasty of its components has been proposed as a solution for these patients, and the arthroscopic technique is a currently described alternative. Methods: This is a retrospective study of 10 patients (11 ankles) diagnosed with multidirectional instability who underwent ankle arthroscopy with medial and lateral ligament reconstruction (arthroscopic Brostrom technique) from January 2017 to January 2019. All patients filled out an epidemiological questionnaire and were assessed for ankle pain and function using the Pain Visual Analog Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) scale at the last follow-up evaluation, at a mean of 12 months (6-24 months). Results: All patients showed signs of associated medial instability during the arthroscopy. Four ankles had associated osteochondral injuries. One ankle also had associated syndesmotic instability. The mean AOFAS score was 82.6 at the last follow-up evaluation, and the mean VAS score was 2.1. No patient had complications related to surgery or loss of ankle mobility greater than 5 degrees (ankle or subtalar joint). Eight patients described the outcome as excellent, and 2 described it as good. All patients returned to sports after 6 months of follow-up. No complaints of instability or positive ligament tests were observed. Conclusion: Combined medial and lateral arthroscopic ankle ligamentoplasty is an effective and safe alternative for the treatment of multidirectional instability refractory to conservative treatment. The inclusion of the deltoid complex and the reduced invasiveness of this technique may improve the clinical outcomes of these patients.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77122636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TL 18193 - Efficacy of triple surgery for the treatment of pes cavus in Charcot-Marie-Tooth disease tl18193 -三联手术治疗腓骨-玛丽-图斯病腔足的疗效
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1086
N.R.D.A. Neto, L. Moré, R. Ferreira, M. T. Costa, J. Bergamasco, Marcelo Marcucci Chakkour
{"title":"TL 18193 - Efficacy of triple surgery for the treatment of pes cavus in Charcot-Marie-Tooth disease","authors":"N.R.D.A. Neto, L. Moré, R. Ferreira, M. T. Costa, J. Bergamasco, Marcelo Marcucci Chakkour","doi":"10.30795/scijfootankle.2019.v13.1086","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1086","url":null,"abstract":"Introduction: Pes cavus is a deformity characterized by a high longitudinal medial arch. It is classically associated with neurological conditions, among which Charcot-Marie-Tooth (CMT) disease is the most common. Treatment options depend on the flexibility of the deformity. Various procedures are available to correct flexible pes cavus; these procedures can be performed in combination, and there is no standardized technique. There is limited information in the literature on the long-term outcome of treatment, and thus far, there is no consensus on the ideal surgery. The objective of the present study was to assess the efficacy of triple surgery (TS) (plantar fasciotomy, valgising calcaneal osteotomy and first metatarsal extension osteotomy) in the long-term treatment of pes cavus of patients with CMT. Methods: Between 2000 and 2015, 15 patients with CMT and pes cavus who underwent TS were treated at our department, including a total of 18 feet from 8 women and 7 men. The mean age of the patients at the time of the surgery was 21 years (9 to 60 years), and the mean follow-up time was 11 years (4 to 19 years). Of the 18 feet that underwent TS, 14 required an additional procedure. To analyze the outcomes of TS, criteria were stipulated and divided into 3 categories: pain (A), deformity (B) and function (C). The following criteria were analyzed: category A: AOFAS pain subscale, pain visual analog scale; category B: clinical and radiographic pes cavus, clinical and radiographic hindfoot varus; category C: gait, flexibility and AOFAS-function subscale. Each analyzed subitem was scored (total score: 10 points) to determine whether correction was achieved and maintained until the final assessment according to different objective criteria. The outcome was considered good when the score was 8 points or more, fair when the score ranged from 5 to 7 points, and poor when it was 4 points or less. Results: When pre-established criteria were objectively applied, 10 feet had a good outcome, 5 feet had a fair outcome, and 3 feet had a poor outcome; thus, a total of 15 feet (83%) had a satisfactory long-term outcome. Conclusion: Triple surgery was effective for treating patients with CMT, providing good deformity correction of pes cavus in addition to long-term clinical and functional improvement. \u0000 ","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77612995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PO 18072 - Peroneus longus tendon injury associated with the presence of peroneum PO 18072 -腓骨长肌腱损伤与腓骨存在相关
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.987
Rafael da Rocha Macedo, R. Barroco, B. R. Miranda, Dario Putini, Antonio Candido de Paula Neto, Douglas Hideki Ikeuti, L. Rodrigues
{"title":"PO 18072 - Peroneus longus tendon injury associated with the presence of peroneum","authors":"Rafael da Rocha Macedo, R. Barroco, B. R. Miranda, Dario Putini, Antonio Candido de Paula Neto, Douglas Hideki Ikeuti, L. Rodrigues","doi":"10.30795/scijfootankle.2019.v13.987","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.987","url":null,"abstract":"Introduction: The os peroneum is a round or oval sesamoid bone located distally within the substance of the peroneus longus tendon near the cuboid bone. Peacock et al. suggested that the presence of the os peroneum might be associated with tendon rupture due to friction at the junction with the bone; in turn, Brigido et al. developed radiographic criteria that associate sesamoid fracture with mechanical failure of the peroneus longus tendon. Objective: To report an unusual case of peroneus longus tendon injury associated with the presence of os peroneum in a patient with hindfoot varus. Methods: A 55-year-old male patient who engaged in physical activity 3 times a week developed pain on the lateral side of the ankle resulting in decreased physical functioning and sports performance. Radiography showed the presence of os peroneum associated with a proximal injury of the peroneus longus tendon detected by magnetic resonance imaging. Results: The patient was treated conservatively with an analgesic physical therapy program followed by functional rehabilitation. The patient progressed from a score of 9 on the visual analog scale for pain in the first month to a score of 0 at 6 months, with grade 5 final eversion force and a return to sports performance at the preinjury level. Conclusion: Treatment options for this injury range from tendon debridement, fixation or excision of the os peroneum to tenodesis or tendon anchorage to the cuboid or calcaneus. Nonsurgical treatment, including immobilization and the use of anti-inflammatory medication, followed by physical therapy is the initial treatment of choice and, as in the reported case, may provide an excellent outcome.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81699308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PO 18252 - Advanced surgical salvage therapy for infected diabetic feet 先进的外科抢救治疗感染糖尿病足
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1053
C. Freitas, M. Katayama, E. Pires, C. E. Roncatto, R. A. Santin
{"title":"PO 18252 - Advanced surgical salvage therapy for infected diabetic feet","authors":"C. Freitas, M. Katayama, E. Pires, C. E. Roncatto, R. A. Santin","doi":"10.30795/scijfootankle.2019.v13.1053","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1053","url":null,"abstract":"Introduction: Foot infections are common among diabetic patients with peripheral neuropathy and/or peripheral arterial disease and may be the main factor that leads to major or minor lower-extremity amputation. Most deep infections in diabetic feet are preceded by an unnoticed lesion with local penetration of pathogens into deeper tissues. Knowledge of critical issues for diabetic foot management, such as ischemia, wound-healing principles, immunology and microbiology, has changed the traditional approach to the diabetic foot and has led to new advances. The application of tissue engineering, biomedicine and biotechnology with corrective and instrumental surgical techniques for the management of this disease has become an emerging field with demonstrable advantages. This study provides an updated overview of the orthopedic management for extremity salvage of the diabetic foot with deep infection. Methods: Nine patients (10 feet), 7 men and 2 women, whose mean age at hospital admission was 53 years (ranging from 34 to 72), were evaluated retrospectively after salvage therapy of the extremities. We considered the functional clinical outcome good when the patient was able to wear shoes for insensitive feet, acceptable when the patient had residual deformity requiring custom-made orthosis and poor when the patient required extremity amputation. Results: After a mean follow-up of 6 months (ranging from 4 to 14), an average of 7 surgical procedures were performed (ranging from 2 to 23), including angioplasty in 5 patients and amputation at the level of the Lisfranc joint in one patient. Outcomes were good in 9 feet and acceptable in one foot with braceable residual deformity. Conclusion: We believe that an aggressive approach and the use of new technology has numerous attributes that can help to salvage the extremities of seriously ill patients.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86601541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TL 18192 - Perspective on the Ponseti method for the treatment of clubfoot associated with amniotic band constriction syndrome Ponseti法治疗羊膜带缩窄综合征马蹄内翻足的疗效观察
Scientific Journal of the Foot & Ankle Pub Date : 2019-11-11 DOI: 10.30795/scijfootankle.2019.v13.1085
J. Bergamasco, Marcelo Marcucci Chakkour, R. Madeiro, M. T. Costa, R. Ferreira, N.R.D.A. Neto
{"title":"TL 18192 - Perspective on the Ponseti method for the treatment of clubfoot associated with amniotic band constriction syndrome","authors":"J. Bergamasco, Marcelo Marcucci Chakkour, R. Madeiro, M. T. Costa, R. Ferreira, N.R.D.A. Neto","doi":"10.30795/scijfootankle.2019.v13.1085","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1085","url":null,"abstract":"Introduction: Amniotic band constriction syndrome is a rare anomaly with an incidence of approximately 1:15,000 live births. It manifests as fibrous amniotic bands involving the deep fascia and, depending on its depth, can compromise the venous and lymphatic system. The presence of fibrous amniotic bands in the lower limbs is strongly associated with foot malformations, and the prevalence of clubfoot under such conditions ranges from 12 to 56%. Clubfoot associated with amniotic band constriction syndrome is characterized by rigidity and edema and tends to respond poorly to conservative treatment. We present a series of cases of clubfoot associated with amniotic band constriction syndrome that were treated with manipulation and plaster casting using the Ponseti method. Methods: Over the past 10 years, we followed 19 patients with amniotic band constriction syndrome affecting the lower limbs. Of these patients, 6 had clubfoot, including 2 who were bilaterally affected. The 6 children in this series had constriction bands in Hennigan and Kuo zone 2. The 8 affected feet were rigid, with a mean Pirani score of 5.5 and Dimeglio III classification. Four extremities with complete constriction bands initially underwent z-plasty for band release, followed by manipulation and plaster casting. The other four extremities had incomplete bands, which were initially subjected to manipulation using the Ponseti method, followed by band release at the time of the Achilles tenotomy. Results: Over a mean follow-up time of 5 years, 7 of the study feet were plantigrade and painless, with no limitations of activities of daily living; only one foot showed limited dorsiflexion, and that patient is awaiting corrective surgery. This limb showed a double band in zone 2 that was both complete and deep. Conclusion: Despite the rigidity, clubfoot secondary to amniotic band constriction syndrome showed good outcomes when treated using the Ponseti method.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90783103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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