Techniques in Foot and Ankle Surgery最新文献

{"title":"Arthrodesis of the Distal Tibiofibular Joint: A Review of the Literature and Evidence-based Guidelines","authors":"Jade Pisaniello, B. Beamond, A. Alder-Price, C. Proudman, Matthew D. Rackham","doi":"10.1097/BTF.0000000000000336","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000336","url":null,"abstract":"Distal tibiofibular joint (DTFJ) arthrodesis has been proposed as a motion-preserving salvage option in cases of chronic syndesmotic disruption and degeneration. It is an uncommonly performed procedure with few cases reported in the literature. The aim of this study was to conduct a review of the literature in order to examine the appropriate indications, operative techniques, and outcomes. The authors’ also present a case for inclusion. Twenty cases of DTFJ arthrodesis were identified for inclusion. Nine operations were performed in males and 11 in females. The average patient age was 41.1 years. The indication for all arthrodeses was chronic pain±instability. Symptoms were a result of disruption of the DTFJ secondary to: (a) previous fracture malunion (n=12), (b) soft tissue injury (n=6), or (c) osteochondroma (n=2). DTFJ arthrodesis has been successfully utilized in cases of syndesmosis disruption secondary to osteochondroma, fracture and soft tissue injury in low-demand and high-demand adult patients of any age and activity level. Arthrodesis can be performed through an anterior or lateral ankle approach. Fixation with 2×3.5 mm screws across the DTFJ impacted with autologous bone graft provides sufficient fixation. Patient should nonweight bear on an immobilized ankle for a minimum of 6 weeks, or until bony union is evident on imaging. Level of Evidence: Diagnostic Level IV.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"146 - 150"},"PeriodicalIF":0.3,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46391406","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":"Provisional Reduction and External Fixation of Acute Displaced Intra-articular Calcaneus Fractures: Surgical Technique and Clinical Results","authors":"Alan Y. Yan, B. Shafiq, Stephen P. Canton, Joshua T. Olson, P. Cole","doi":"10.1097/BTF.0000000000000353","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000353","url":null,"abstract":"The treatment of calcaneus fractures has been a topic of ongoing debate with controversies regarding the best treatment options and algorithms. Sparse literature exists examining the role of external fixation in initial reduction and the maintenance of bony alignment. The authors describe a technique of a medially based 3-pin provisional external fixation for the treatment of a displaced intra-articular calcaneus fractures with the review of 26 patients with an average follow-up of 26 months. A fourth pin utilized in the case of tongue-type fractures is introduced as an important adjunct to this treatment paradigm. Level of Evidence: Diagnostic Level IV—therapeutic. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"22 1","pages":"35 - 43"},"PeriodicalIF":0.3,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47724449","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":"Patient-Specific Instruments for Resection and Reconstruction of Osteoblastoma in the Talus","authors":"J. B. Gerstner, Tito L. Funes, C. Lores, Jochen Gerstner-Saucedo","doi":"10.1097/BTF.0000000000000354","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000354","url":null,"abstract":"Osteoblastoma of the talus is a rare and challenging pathology both to diagnose and treat successfully. Treatment of an inadequate osteoblastoma resection is usually a wide resection, however, achieving the desired margins in the foot and ankle bones can lead to complications such as fractures or joint loss. We present a case of an incomplete talar neck Osteoblastoma resection and a novel technique that was followed for 3 years after surgery. Level of Evidence: Diagnostic Level V—technique description. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"22 1","pages":"50 - 54"},"PeriodicalIF":0.3,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47169997","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":"Results in 7 Cases of Neurectomy With a Transverse Plantar Approach for Primary Morton’s Neuroma","authors":"Guillermo Araujo Espinoza, Johannes Bazan Alvarez, Anibal Alvarado Zegarra","doi":"10.1097/BTF.0000000000000352","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000352","url":null,"abstract":"Surgery is often performed for Morton’s neuroma when conservative treatment is ineffective. This study aimed to describe the surgical results of Morton’s neuroma. Six patients (7 feet) underwent neurectomy via a transverse plantar incision in the forefoot. Changes in perceived pain, function, and patient satisfaction were measured with a Visual Analog Scale, the American Orthopaedic Foot and Ankle Surgery Scale, and the Coughlin score, respectively. Six feet had neuromas in the third intermetatarsal space and 1 foot had neuromas in the third and second spaces. The mean preoperative and postoperative Visual Analog Scale scores were 7.14±0.69 and 1.86±0.69, respectively. The mean preoperative and postoperative American Orthopaedic Foot and Ankle Surgery scores were 69.71±6.73 and 94.86±3.93, respectively. Four patients were very satisfied, and 2 patients were just satisfied. The plantar surgical approach for the treatment of Morton’s neuroma has few complications with good functional results and patient satisfaction in this case series. Level of Evidence: Diagnostic Level IV—retrospective case series. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"54 - 61"},"PeriodicalIF":0.3,"publicationDate":"2022-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61625332","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":"Patient-reported Outcomes of Revision Ankle Open Reduction Internal Fixation","authors":"Muhammad Y. Mutawakkil, R. Gulati, A. Zaidi, Joshua E. Barrett, Milap S. Patel, A. Kadakia","doi":"10.1097/BTF.0000000000000372","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000372","url":null,"abstract":"Ankle fractures may require revision surgery for malunion or suboptimal joint congruence results after initial surgical or nonsurgical treatment. There is limited literature on the outcomes of patients undergoing such revision surgery for ankle fracture malunion. In this retrospective case series, we determined clinical and functional outcomes of revision ankle open reduction internal fixation (ORIF) for 7 patients with ankle fracture malunion through patient-reported and radiographic outcomes. Patient-reported Outcomes Measurement Information System physical function and pain interference scores prerevision and postrevision procedure were obtained from 7 patients treated from January 2017 to October 2020. Postoperative complications including persistent pain, infection, hardware removal, hardware failure, and conversion to ankle arthrodesis were analyzed. Seven patients who underwent revision ORIF surgery for ankle fracture malunion between January 2017 and October 2020 were included. The average age was 46.3 ± 12.2 years old; 85.7% of the patients were female; 14.3% were male. The average amount of time between revision ORIF procedure and collection of postoperative Patient-Reported Outcomes Measurement Information System scores was 19.3±5.9 months. Each of the 7 patients showed an increase in physical function after revision surgery (average preoperative physical function score: 30.7; average postoperative physical function score: 48.9). All patients showed a decrease in pain after revision surgery (average preoperative pain interference score: 64.8; average postoperative pain interference score: 55.7). Of the 7 participants who underwent revision ORIF, a majority did not experience any complications at least 1 year postprocedure, including infection, reoperation, or hardware removal. One participant underwent hardware removal for persistent pain and developed overlying cellulitis. For patients with ankle fracture malunion without significant post-traumatic degenerative changes of the ankle joint, revision ankle ORIF can be an effective method for improving physical function, decreasing pain, and preserving ankle joint motion. Level of Evidence: Level IV—case series.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"22 1","pages":"55 - 63"},"PeriodicalIF":0.3,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42036775","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 Novel Operative Approach to the Treatment of Posterior Malleolus Fractures","authors":"E. Fahey, Shane P. Russell, C. Ní Fhoghlu, Niamh Curran, T. Bayer, J. McKenna","doi":"10.1097/BTF.0000000000000350","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000350","url":null,"abstract":"Background: Posterior malleolar fractures are a common subtype of ankle fractures. The management of these fractures remains controversial, though there has been a move toward more operative management in recent years. The operative approach most commonly used to treat these fractures is posterolateral. This method has several drawbacks including the amount of retraction required on already traumatized skin, the risk of damaging the posterior interosseous tibio-fibular ligament, and the difficulty visualizing both the distal fibular and posterior malleolar fractures. We describe a novel operative approach for visualizing and treating these fractures and report on our results. Method: This was a retrospective review of prospectively collected data. Data from 2 orthopedic trauma units where this technique is used was analyzed. Demographic and radiographic data was recorded, and a chart review was conducted to identify any noted complications. Results: On analysis of medical records, 50 patients were identified who had been operated on using this technique. When classified using the Bartonicek classification, 46% were type II, 36% were type III and 18% were type IV. Analysis of final x-rays showed that there was no incidence of implant failure or loss of reduction in this cohort. There were 2 complications recorded: 1 early wound dehiscence and 1 late infection giving an overall complication rate of 4%. Discussion: The technique described in this paper is a novel approach, which we feel offers several benefits. We demonstrated that this technique is safe with an incidence of early complications lower than figures commonly quoted for standard care of this cohort of patients. Level of Evidence: Level IV—case series","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"228 - 232"},"PeriodicalIF":0.3,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46221704","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":"Polyvinyl Alcohol Hydrogel Hemiarthroplasty of the First Metatarsophalangeal Joint Augmented With 3D-printed Baseplate","authors":"Naji S. Madi, Amandeep Chopra, S. Parekh","doi":"10.1097/BTF.0000000000000351","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000351","url":null,"abstract":"Hallux rigidus is the most common arthritic pathology of the foot and is a debilitating disease that causes pain, swelling, and reduced range of motion. Although arthrodesis is the gold standard treatment option, a soft hemiarthroplasty implant, the polyvinyl alcohol (PVA) hydrogel, has been designed to preserve motion in the first metatarsophalangeal joint and alleviate pain. Made from synthetic PVA and saline, the index noninferiority trial showed satisfactory clinical outcomes. However, this result was not reproducible by others with implant subsidence being a common concern. In this surgical technique, we describe a novel modified approach which involves PVA hemiarthroplasty of the first metatarsophalangeal joint, 3-dimensional-printed baseplate and Akin osteotomy to ultimately prevent likely implant failure.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"22 1","pages":"27 - 34"},"PeriodicalIF":0.3,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44719834","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":"The Lapidus Procedure: The Evolution From Suture Fixation to Rigid Multiplanar Correction","authors":"Kevin A. Schafer, J. Mccormick","doi":"10.1097/BTF.0000000000000348","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000348","url":null,"abstract":"After nearly 30 years of performing first tarsometatarsal joint fusions in the treatment of hallux valgus deformity, Paul Lapidus described his career experience with this procedure as “most gratifying and warranting continuation.” Modified versions of his original procedure remain effective for treating large transverse plane deformities, but are also a powerful tool for simultaneous correction of sagittal and frontal plane rotational deformities. Recent investigations with weight-bearing computed tomography scan demonstrate that hallux valgus deformities are multiplanar and can have variable subcomponents between patients, suggesting a patient specific approach may yield the most predictable outcomes. We describe our preferred use of the modified Lapidus procedure for treating hallux valgus deformity, and discuss surgical indications, techniques, and complications.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"20 - 29"},"PeriodicalIF":0.3,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45429102","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":"Arthroscopic Reduction and Internal Fixation of Talus Fractures: An All-inside Soft-tissue Preserving Technique","authors":"Kevin D. Martin, Cuyler Dewar, A. Groth","doi":"10.1097/BTF.0000000000000345","DOIUrl":"https://doi.org/10.1097/BTF.0000000000000345","url":null,"abstract":"Talus fractures, although rare, can lead to devastating complications. The most common of which is posttraumatic osteoarthritis involving the subtalar and tibiotalar joints which can be a result of malunion, nonunion, and avascular necrosis. The timing and method of fixation of these injuries has been controversial. Most experts recommend a dual incision approach to facilitate anatomic reduction. We present an alternative technique for talus fracture management that may reduce soft-tissue stripping and further vascular compromise using a posterior talus arthroscopic reduction internal fixation technique. With this method, talus fractures are reduced arthroscopically and fixed percutaneously while preserving vascularity to the talus and limiting further stress to the soft-tissue envelope. Level of Evidence: Diagnostic Level V—expert opinion. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"223 - 227"},"PeriodicalIF":0.3,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45680060","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":"High Ankle Syndesmosis Disruption","authors":"Kevin D. Martin, Nathan W. Callender, Craig Luplow, A. Groth","doi":"10.1097/btf.0000000000000346","DOIUrl":"https://doi.org/10.1097/btf.0000000000000346","url":null,"abstract":"","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41724242","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}