James L. Thomas, A. Kopiec, K. Mark, L. Mae Chandler
{"title":"Radiographic Value of the Lisfranc Diastasis in a Standardized Population","authors":"James L. Thomas, A. Kopiec, K. Mark, L. Mae Chandler","doi":"10.1177/1938640019890738","DOIUrl":"https://doi.org/10.1177/1938640019890738","url":null,"abstract":"Introduction. Injury to the Lisfranc’s joint, in particular to the second metatarsal–medial cuneiform (second MMC) joint, can be difficult to evaluate, especially in subtle Lisfranc injuries. The purpose of this study was to determine the value of the Lisfranc joint width (diastasis) of the adult foot in a standardized population thereby establishing a potential reference range when investigating this area for potential injury. Methods. The 2nd MMC joint in 50 men and 50 women was evaluated. Individuals with a history of foot/ankle pain, previous foot/ankle operation or fracture, or a history of systemic disease were excluded from the study. Bilateral weightbearing digital anterior-posterior and lateral radiographs were taken using a standardized method. Results. The mean 2nd MMC diastasis in 200 feet was 5.6 mm (95% CI 5.39-5.81). In the female population, the mean 2nd MMC diastasis was 5.8 mm (95% CI 5.51-6.09) as compared with 5.6 mm (95% CI 5.31-5.89) in males. The mean distance between the fifth metatarsal base and first cuneiform in the entire study population was 16.3 mm (95% CI 15.57-17.03). Conclusion. This study helps define baseline measurements of the Lisfranc joint for the general population, which can provide a standard measurement against which suspected foot injuries can be compared. Level of Evidence: Level IV.","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"65 4","pages":"494 - 501"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019890738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41301583","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}
{"title":"Comparing the Temperature Effect of Dedicated Minimally Invasive Motor System to the Discontinuous Use of Rotatory Burrs in the Correction of Hallux Valgus","authors":"D. Robinson, E. Heller, M. Yassin","doi":"10.1177/1938640019890225","DOIUrl":"https://doi.org/10.1177/1938640019890225","url":null,"abstract":"The purpose of this study was to compare 2 motor systems for percutaneous osteotomy. The study consisted of 2 stages. In the first stage, bone temperatures during osteotomy using burrs or saw was measured using a thermal camera. In the second stage, the tissue and burr temperature elevation during surgery in 80 consecutive patients (96 feet) with hallux valgus undergoing distal first metatarsal and phalangeal osteotomies (hallux and in 61/96 feet lesser digits) were measured. The burr osteotomy procedure included the use of irrigated 2- or 4.1 mm rotary wedge burrs in discontinuous cutting bursts of less than 20 seconds. Tissue surface temperature was measured with a thermal camera. The temperature generated during the procedure was found to be significantly associated with the burr diameter used but was not affected by the type of motor. At the 6-week visit, thickness of the soft tissues over the first metatarsal head was similar in both groups. Temperature control using a noninvasive thermal camera is recommended to prevent tissue damage associated with heat generated during the use of rotary burrs. A dedicated low-speed high-torque system does not seem to be necessary and standard orthopaedic equipment can be used. Levels of Evidence: Level II: Comparative prospectively collected series","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"478 - 487"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019890225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47786446","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}
{"title":"A Clinicoradiological and Functional Evaluation of Lapidus Surgery for Moderate to Severe Bunion Deformity Shows Excellent Stable Correction and High Long-Term Patient Satisfaction","authors":"V. Jagadale, R. Thomas","doi":"10.1177/1938640019890716","DOIUrl":"https://doi.org/10.1177/1938640019890716","url":null,"abstract":"Background. Lapidus surgery involving arthrodesis of the first metatarsocuneiform (MTC) joint is an effective procedure for the correction of moderate to severe hallux valgus. The aim of this study was to collect and analyze radiographic data from our institution and determine the extent of first metatarsal shortening associated with the Lapidus procedure. Materials and Methods. A total of 53 patients (54 feet) who underwent arthrodesis of the first MTC joint combined with modified McBride bunionectomy for correction of moderate to severe hallux valgus deformity, between 2010 and 2015 were included in this study. Complete radiographic evaluation and AOFAS (American Orthopaedic Foot and Ankle Surgery) scoring was available for 54 feet. The average preoperative hallux valgus angulation (HVA) was 32° and the average intermetatarsal angle (IMA) was 16°. Results. Excluding 2 patients with postoperative hallux varus the average postoperative HVA correction at last follow-up was 14°. Average postoperative IMA was 9°. Although there was minimal bone resection during preparation of the MTC joint, no significant shortening of the first metatarsal was observed with this procedure. The relative length of the first metatarsal to the second metatarsal changed only 1.3%. Nonunion of the first MTC joint occurred in 10.3%, but only 1 foot was symptomatic requiring revision. The average postoperative hallux AOFAS score was 80.8. In sum, 63% of patients were very satisfied, 27% satisfied with reservations, and 10% were dissatisfied. Conclusion. The Lapidus bunion procedure offers excellent stable correction of moderate to severe hallux valgus deformity with minimal shortening of the first metatarsal and thereby higher patient satisfaction. Levels of Evidence: Level IV: Retrospective case series","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"488 - 493"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019890716","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49329973","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}
Olivia D. Perez, Hasani W. Swindell, Carl L. Herndon, P. Noback, David P. Trofa, J. T. Vosseller
{"title":"Assessing the Readability of Online Information About Achilles Tendon Ruptures","authors":"Olivia D. Perez, Hasani W. Swindell, Carl L. Herndon, P. Noback, David P. Trofa, J. T. Vosseller","doi":"10.1177/1938640019888058","DOIUrl":"https://doi.org/10.1177/1938640019888058","url":null,"abstract":"The American Medical Association (AMA) and National Institutes of Health (NIH) currently suggest that health care materials be written at a sixth-grade reading level. Our study investigates the readability of online information on Achilles rupture and reconstruction. Achilles tendon rupture, Achilles tendon repair, and Achilles tendon reconstruction were queried using advanced search functions of Google, Bing, and Yahoo!. Individual websites and text from the first 3 pages of results for each search engine were recorded and categorized as physician based, academic, commercial, government and nongovernmental organization, or unspecified. Individual readability scores were calculated via 6 different indices: Flesch-Kincaid grade level, Flesch Reading Ease, Gunning Fog, SMOG, Coleman-Liau index, and Automated Readability Index along with a readability classification score and average grade level. A total of 56 websites were assessed. Academic webpages composed the majority (51.8%), followed by physician-based sources (32.1%). The average overall grade level was 10.7 ± 2.54. Academic websites were written at the highest-grade level (11.5 ± 2.77), significantly higher than physician-based websites (P = .040), and only 2 were written at, or below, a sixth-grade reading level. Currently, online information on Achilles tendon rupture and reconstruction is written at an inappropriately high reading level compared with recommendations from the AMA and NIH. Level of Evidence: Level IV","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"13 1","pages":"470 - 477"},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019888058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42727724","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}
J. Jastifer, W. Manson, Bertil W. Smith, M. Cooper, Stephen A. Brigido
{"title":"Perioperative Management of Foot and Ankle Surgical Patients","authors":"J. Jastifer, W. Manson, Bertil W. Smith, M. Cooper, Stephen A. Brigido","doi":"10.1177/1938640019880685","DOIUrl":"https://doi.org/10.1177/1938640019880685","url":null,"abstract":"","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"12 1","pages":"458 - 460"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019880685","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46874707","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}
{"title":"Calendar for October 2019","authors":"","doi":"10.1177/1938640019882509","DOIUrl":"https://doi.org/10.1177/1938640019882509","url":null,"abstract":"","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"12 1","pages":"488 - 490"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019882509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41733713","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}
Kaitlin C. Neary, E. Chang, Christopher Kreulen, E. Giza
{"title":"Tarsal Tunnel Syndrome Secondary to Accessory Musculature: A Case Report","authors":"Kaitlin C. Neary, E. Chang, Christopher Kreulen, E. Giza","doi":"10.1177/1938640019863277","DOIUrl":"https://doi.org/10.1177/1938640019863277","url":null,"abstract":"Tarsal tunnel syndrome (TTS) is a relatively uncommon compression neuropathy caused by impingement of the tibial nerve or one of the terminal branches. The presence of accessory musculature at the posteromedial aspect of the ankle has been identified as a rare cause of this condition. Despite the rarity of this condition, it must be considered in patients with refractory symptoms consistent with tibial nerve dysfunction. The accurate diagnosis of this condition relies heavily on a detailed history and physical examination, adequate imaging read by both surgeon and trained musculoskeletal radiologist, as well as a high level of suspicion for such pathology. In this case report, we describe a 46-year-old male with history, examination, and imaging all consistent with TTS secondary to accessory musculature. Following excision of an accessory soleus and flexor digitorum accessorius longus, as well as simultaneous tarsal tunnel release, the patient experienced full resolution of his symptoms. This highlights the importance of considering accessory musculature as a potential cause of TTS in patients presenting with tibial compression neuropathy. Levels of Evidence: Level V: Case Report","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"12 1","pages":"549 - 554"},"PeriodicalIF":0.0,"publicationDate":"2019-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019863277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43787768","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}
{"title":"Before and After","authors":"W. B. Smith","doi":"10.1177/1938640019876424","DOIUrl":"https://doi.org/10.1177/1938640019876424","url":null,"abstract":"","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"12 1","pages":"310 - 310"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019876424","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240623","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}
{"title":"Calendar for August 2019","authors":"","doi":"10.1177/1938640019877063","DOIUrl":"https://doi.org/10.1177/1938640019877063","url":null,"abstract":"","PeriodicalId":39271,"journal":{"name":"Foot and Ankle Specialist","volume":"12 1","pages":"384 - 386"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1938640019877063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43941982","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}