Foot and Ankle Specialist最新文献_第3页

Calendar for February 2021 2021年2月日历

Foot and Ankle Specialist Pub Date : 2021-02-01 DOI: 10.1177/1938640021992599

引用次数: 0

Calendar for December 2020 2020年12月日历

Foot and Ankle Specialist Pub Date : 2020-12-01 DOI: 10.1177/1938640020980603

引用次数: 1

Tibiotalocalcaneal Arthrodesis Using a Novel Retrograde Intramedullary Nail 采用新型逆行髓内钉进行胫距跟骨关节融合术

Foot and Ankle Specialist Pub Date : 2020-12-01 DOI: 10.1177/1938640019883138

J. Steele, Alexander L. Lazarides, J. DeOrio

{"title":"Tibiotalocalcaneal Arthrodesis Using a Novel Retrograde Intramedullary Nail","authors":"J. Steele, Alexander L. Lazarides, J. DeOrio","doi":"10.1177/1938640019883138","DOIUrl":"https://doi.org/10.1177/1938640019883138","url":null,"abstract":"Background. Tibiotalocalcaneal (TTC) arthrodesis is a common treatment option for complex hindfoot pathology. Overall union rates range from 50% to 86% but can be even lower in certain populations. A novel retrograde intramedullary nail has recently been developed. The purpose of this study was to report fusion rates, time to weight-bearing, and complications with the use of the A3 Fusion Nail. Methods. All patients 18 years or older who underwent TTC arthrodesis with an A3 Fusion Nail at a single institution from 2010 to 2015 with a minimum 3-month follow-up were included in this study. Rates of successful fusion, time to union, time to weight-bearing, and complications were evaluated. A total of 20 patients with an average age of 58.1 years and an average follow-up of 12.5 months met inclusion criteria. Results. Successful TTC arthrodesis was achieved in 14 of 20 patients (70%) overall. Average time to union was 8.1 months, and average time to weight-bearing was 6.8 weeks. Of 20 patients, 17 (85%) required femoral head allograft for bulk bone defects, and the union rate in this subset of patients was 76.5%. The rates of revision surgery (10%) and complications were low. Conclusion. The A3 Fusion Nail demonstrated a favorable safety profile and achieved TTC arthrodesis at a rate consistent with historical data despite being used in a patient population at high risk for nonunion. In patients with bulk bone defects at high risk for nonunion, the A3 Fusion Nail demonstrated superior rates of fusion (76.5%) to those reported in the literature (50%). Level of Evidence: Level III: Retrospective cohort study","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"463 - 469"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019883138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49173397","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: 9

Calendar for October 2020 2020年10月日历

Foot and Ankle Specialist Pub Date : 2020-10-01 DOI: 10.1177/1938640020960838

引用次数: 0

Split Thickness Skin Graft of the Foot and Ankle Bolstered With Negative Pressure Wound Therapy in a Diabetic Population: The Results of a Retrospective Review and Review of the Literature. 用负压伤口治疗糖尿病患者的足、踝裂厚皮肤移植:回顾性回顾和文献回顾的结果

Foot and Ankle Specialist Pub Date : 2020-10-01 Epub Date: 2019-08-02 DOI: 10.1177/1938640019863267

Efthymios Gkotsoulias

{"title":"Split Thickness Skin Graft of the Foot and Ankle Bolstered With Negative Pressure Wound Therapy in a Diabetic Population: The Results of a Retrospective Review and Review of the Literature.","authors":"Efthymios Gkotsoulias","doi":"10.1177/1938640019863267","DOIUrl":"10.1177/1938640019863267","url":null,"abstract":"Split thickness skin graft (STSG) is a versatile procedure performed for the treatment of wounds resulting from varying pathology. This remains very useful because of its ability for quick healing and low complication rate. The surface of the foot and ankle is an area frequently affected by severe skin and soft tissue structure infections (SSTIs) whose treatment results in wounds. These infections and resultant surgical wounds are commonly seen patients with diabetes. The objective of the present study was to retrospectively evaluate initial healing and immediate post-operative outcomes following STSG application in a diabetic population when negative pressure wound therapy (NPWT) was used as a bolster. Ten patients were identified, including 11 surgical wounds, who underwent STSG bolstered with NPWT from January 2016 to October 2018. Mean follow-up was 13 months (range 1-33 months) with an average time to heal of 17 days (range 14-30 days) for 11 surgical wounds averaging 57 cm2 (range 6.3 - 91 cm2). Consistent improved outcomes have been demonstrated when compared to alternative bolstering techniques available in the literature making a STSG bolstered with NPWT a powerful tool in the reconstruction of diabetic foot wounds resulting from the treatment of infection.Levels of Evidence: Level IV.","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"383-391"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019863267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48855097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Fibular Plate Fixation and Correlated Short-term Complications 腓骨钢板固定及相关短期并发症

Foot and Ankle Specialist Pub Date : 2020-10-01 DOI: 10.1177/1938640019873539

H. Bäcker, J. Greisberg, J. T. Vosseller

{"title":"Fibular Plate Fixation and Correlated Short-term Complications","authors":"H. Bäcker, J. Greisberg, J. T. Vosseller","doi":"10.1177/1938640019873539","DOIUrl":"https://doi.org/10.1177/1938640019873539","url":null,"abstract":"Background. The most common method of surgical stabilization of fibular fractures is plate osteosynthesis. Despite its ubiquity, there is a dearth of large series reporting implant-related outcomes and complications. The purpose of this study was to report on short-term complications and hardware removal after plate fixation of distal fibula fractures. Methods. A retrospective chart analysis and review of radiographic images was performed of 461 ankle fractures between 2011 and 2017. In 404 cases, a fibular fracture was treated surgically; 94.1% underwent tubular and 5.9% locking plate fixation. The primary outcome was radiographic union, with a mean follow-up of 11.6 months. Minor, intermediate, and major complications were recorded as well as the rate of hardware removal. Results. The union-rate with plate fixation was 99.5% (402/404). The overall complication rate was 19.3% (n = 78/404). Of these complications, 79.5% (62/78) were considered minor. These complications included erythema, heterotopic ossification, neurapraxia, delayed union, and deep-vein thrombosis; 20.5% (16/78) of the complications were considered intermediate (9/78, 11.5%) or major (7/78, 9.0%). Intermediate and major complications included deep infection, nonunion/malunion, and osteomyelitis. Subsequent surgery was needed in 7 cases (1.7%, 7/404). In another 93 patients, hardware-related symptoms were identified: 23 (5.7%) underwent syndesmosis screw removal and 54 (13.4%) hardware removal. No correlation to the fixation technique was identified. Conclusion. This study shows a relatively low rate of major complications and a high union rate of 99.5% for fibular plate osteosynthesis in a large cohort. Any other treatment, including other fixation techniques, will need to show an equivalent or better complication and reoperation profile. Level of Evidence: Level III: Retrospective, comparative study","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"378 - 382"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019873539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49191699","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: 6

Syndesmotic Fixation Utilizing a Novel Screw: A Retrospective Case Series Reporting Early Clinical and Radiographic Outcomes 一种新型螺钉的联合结缔组织固定术：一个报告早期临床和放射学结果的回顾性病例系列

Foot and Ankle Specialist Pub Date : 2020-10-01 DOI: 10.1177/1938640019866322

Derek S. Stenquist, Brian T. Velasco, P. Cronin, Jorge Briceño, Christopher P. Miller, Matthew D. Riedel, J. Kwon

{"title":"Syndesmotic Fixation Utilizing a Novel Screw: A Retrospective Case Series Reporting Early Clinical and Radiographic Outcomes","authors":"Derek S. Stenquist, Brian T. Velasco, P. Cronin, Jorge Briceño, Christopher P. Miller, Matthew D. Riedel, J. Kwon","doi":"10.1177/1938640019866322","DOIUrl":"https://doi.org/10.1177/1938640019866322","url":null,"abstract":"Background. Syndesmotic disruption occurs in 20% of ankle fractures and requires anatomical reduction and stabilization to maximize outcomes. Although screw breakage is often asymptomatic, the breakage location can be unpredictable and result in painful bony erosion. The purpose of this investigation is to report early clinical and radiographic outcomes of patients who underwent syndesmotic fixation using a novel metal screw designed with a controlled break point. Methods. We performed a retrospective review of all patients who underwent syndesmotic fixation utilizing the R3lease Tissue Stabilization System (Paragon 28, Denver, CO) over a 12-month period. Demographic and screw-specific data were obtained. Postoperative radiographs were reviewed, and radiographic parameters were measured. Screw loosening or breakage was documented. Results. 18 patients (24 screws) met inclusion criteria. The mean follow-up was 11.7 months (range = 6.0-14.7 months). 5/24 screws (21%) fractured at the break point. No screw fractured at another location, nor did any fracture prior to resumption of weight bearing; 19 screws did not fracture, with 8/19 intact screws (42.1%) demonstrating loosening. There was no evidence of syndesmotic diastasis or mortise malalignment on final follow-up. No screws required removal during the study period. Conclusion. This study provides the first clinical data on a novel screw introduced specifically for syndesmotic fixation. At short-term follow up, there were no complications and the R3lease screw provided adequate fixation to allow healing and prevent diastasis. Although initial results are favorable, longer-term follow-up with data on cost comparisons and rates of hardware removal are needed to determine cost-effectiveness relative to similar implants. Level of Evidence: Level IV: Retrospective case series","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"397 - 403"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019866322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48511302","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: 5

Surgical Trends in the Treatment of Lisfranc Injuries Using the American Board of Orthopaedic Surgery (ABOS) Certification Examination Database 使用美国矫形外科委员会(ABOS)认证检查数据库的治疗Lisfranc损伤的手术趋势

Foot and Ankle Specialist Pub Date : 2020-10-01 DOI: 10.1177/1938640019863437

Avais Raja, F. Pena

{"title":"Surgical Trends in the Treatment of Lisfranc Injuries Using the American Board of Orthopaedic Surgery (ABOS) Certification Examination Database","authors":"Avais Raja, F. Pena","doi":"10.1177/1938640019863437","DOIUrl":"https://doi.org/10.1177/1938640019863437","url":null,"abstract":"Background: Lisfranc joint complex injury may be managed surgically by either an open reduction internal fixation (ORIF) or primary arthrodesis (PA). Published literature advocates PA for purely ligamentous injuries, but many surgeons in actuality refrain from performing PA. The purpose of the study is to assess surgeon practices and behavior in managing Lisfranc injuries due to the influence of peer reviewed literature with the help of the American Board of Orthopaedic Surgery (ABOS) database. Methods: Data were requested from the ABOS database of cases on Lisfranc joint injury requiring either an ORIF or PA from examination year 2004 to 2017 for both part II and maintenance of certification (MOC) examinees. Cases with ICD-9 code 838.03 only were considered as primarily ligamentous and all fracture codes classified under 825 with 838.03 were considered as fracture dislocation. The number of PA and ORIF were recorded for both types of examinees and specific type of Lisfranc joint injury (primarily ligamentous and fracture dislocation). Results: A total of 2010 cases of Lisfranc joint injuries managed surgically by 1230 board-eligible orthopaedic surgeons. Open fractures (93) and non-/malunion fractures were excluded. A total of 1016 primarily ligamentous and 474 fracture dislocation cases were performed by part II examinees. Overall, 288 primarily ligamentous and 139 fracture dislocation cases were performed by MOC examinees. A total of 27 PA were performed in the primarily ligamentous and 17 were performed on fracture dislocation cases. Conclusion: ORIF is commonly performed by newly trained and senior orthopaedic surgeons. There was no change in the number of PA performed on primarily ligamentous injuries in spite of the published literature. Levels of Evidence: Not applicable","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"392 - 396"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019863437","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46587671","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: 3

The Modified Subcapital Metatarsal Osteotomy in the Treatment of Hallux Valgus Recurrence 改良跖骨下截骨术治疗拇外翻复发

Foot and Ankle Specialist Pub Date : 2020-10-01 DOI: 10.1177/1938640019875322

A. Scala, M. Cipolla, S. Giannini, G. Oliva

{"title":"The Modified Subcapital Metatarsal Osteotomy in the Treatment of Hallux Valgus Recurrence","authors":"A. Scala, M. Cipolla, S. Giannini, G. Oliva","doi":"10.1177/1938640019875322","DOIUrl":"https://doi.org/10.1177/1938640019875322","url":null,"abstract":"The purpose of the present study is to illustrate the use of a modified subcapital metatarsal osteotomy (MSMO) in the treatment of hallux valgus (HV) recurrence. The article reports the clinical and radiological outcomes of a cohort of 52 consecutive patients presenting with recurrent HV, treated with MSMO. A total of 52 patients (54 feet) underwent operations between May 2010 and November 2015. The mean time of follow-up was 2.5 years (range 5.5-1.0 years), and the mean age was 49 years (range 22-76 years). The patient cohort comprised 46 female and 6 male patients. The results of this research show that MSMO is a reliable technique for the correction of HV recurrence. The postoperative radiographic assessments show a statistically significant postoperative improvement of the HV angle (P < .05) and the intermetatarsal angle (P < .05). The postoperative position of the tibial sesamoid was significantly improved (P < .1). The distal metatarsal articular angle was improved (P < .001), though assessment may be affected by the previous operations performed on the first metatarsophalangeal joint. The statistical analysis shows that the postoperative American Orthopaedic Foot and Ankle Society Hallux Metatarsophalangeal-Interphalangeal Scale parameters were significantly improved (P < 0.001). Results of this study indicate that the minimally invasive MSMO is effective in restoring anatomical alignment and improving patient outcomes in recurrent cases of HV. Levels of Evidence: Level III: Case-control study","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"404 - 414"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019875322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45240883","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: 2

Patient Knowledge Regarding Radiation Exposure From Foot and Ankle Imaging 患者对足部和踝关节成像辐射暴露的认识

Foot and Ankle Specialist Pub Date : 2020-08-01 DOI: 10.1177/1938640019865364

B. Manning, D. Bohl, A. Idarraga, G. Holmes, Simon Lee, Johnny L Lin, K. Hamid

{"title":"Patient Knowledge Regarding Radiation Exposure From Foot and Ankle Imaging","authors":"B. Manning, D. Bohl, A. Idarraga, G. Holmes, Simon Lee, Johnny L Lin, K. Hamid","doi":"10.1177/1938640019865364","DOIUrl":"https://doi.org/10.1177/1938640019865364","url":null,"abstract":"Foot and ankle surgeons routinely prescribe diagnostic imaging that exposes patients to potentially harmful ionizing radiation. It is unclear how well patients understand the radiation to which they are exposed. In this study, 946 consecutive new patients were surveyed regarding medical imaging and radiation exposure prior to their first appointment. Respondents compared the amount of radiation associated with chest X-rays (CXRs) with various types of foot and ankle imaging. Results were compared with actual values of radiation exposure from the published literature. Of 946 patients surveyed, 841 (88.9%) participated. Most had private insurance (82.8%) and a bachelor’s degree or higher (60.6%). Most believed that foot X-ray, ankle X-ray, “low dose” foot and ankle computed tomography (CT) scan (alluding to cone-beam CT), and traditional foot and ankle CT scan contain similar amounts of ionizing radiation to CXR. This contradicts the published literature that suggests that the actual exposure to patients is 0.006, 0.006, 0.127, and 0.833 CXR equivalents of radiation, respectively. Of patients who had undergone an X-ray, 55.9% thought about the issue of radiation prior to the study, whereas 46.1% of those undergoing a CT scan considered radiation prior to the exam. Similarly, 35.2% and 27.6% reported their doctor having discussed radiation with them prior to obtaining an X-ray and CT scan, respectively. Patients greatly overestimate the radiation exposure associated with plain film X-rays and cone-beam CT scans of the foot and ankle, and may benefit from increased counseling regarding the relatively low radiation exposure associated with these imaging modalities. Level of Evidence: Level III: Prospective questionnaire","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"324 - 329"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019865364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46568198","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: 11