Foot and Ankle Surgery最新文献

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Integrating weightbearing CT findings into evaluation of conventional radiographs in progressive collapsing foot deformity. 在评估进行性塌足畸形的传统 X 光片时整合负重 CT 结果。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-11-14 DOI: 10.1016/j.fas.2024.11.003
Doria Juric, Ricardo Donners, Dorothee Harder, Arne Burssens, Corina Nüesch, Nicola Krähenbühl
{"title":"Integrating weightbearing CT findings into evaluation of conventional radiographs in progressive collapsing foot deformity.","authors":"Doria Juric, Ricardo Donners, Dorothee Harder, Arne Burssens, Corina Nüesch, Nicola Krähenbühl","doi":"10.1016/j.fas.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.fas.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>Progressive collapsing foot deformity (PCFD) remains challenging to treat. Surgical planning depends on the amount and complexity of the deformity, which requires accurate differentiation through precise imaging. Weightbearing CT (WBCT) imaging has enhanced the three-dimensional (3D) assessment of PCFD. However, it remains unclear how PCFD findings on WBCT are related to the evaluation of conventional weightbearing radiographs. Therefore, we aimed to (1) compare specific X-ray measurements to corresponding WBCT measurements; (2) evaluate the reliability of X-ray measurements of interest; and (3) investigate whether X-ray measurements can infer osseous impingement in the subtalar joint region identified through WBCT.</p><p><strong>Methods: </strong>Two clinically established measurements were assessed on standardized weightbearing radiographs (manually) as well as on the WBCT datasets (auto-generated): (1) talo-calcaneal overlap (TCO, mm) and (2) talo-navicular coverage (TNC, °). In addition to the measurements, osseous impingement in the subtalar joint region was assessed on WBCT using three criteria, compared both inter- and intra-rater: (1) joint obliteration; (2) cyst formation; and (3) signs of secondary instability. Two of the criteria needed to be fulfilled to confirm subtalar impingement.</p><p><strong>Results: </strong>While no significant difference between X-ray and WBCT measurements was evident for TCO, significant differences were found for TNC. Inter- and intra-observer reliability was with an intraclass correlation coefficient > 0.9 excellent for both measurements on X-rays. The mean bias of measurement (between X-ray and WBCT) was 0.2 mm for TCO and -22 degrees for TNC. Cohen's Kappa for inter- and intra-rater reliability to assess patients for subtalar instability was > 0.9. The probability to infer subtalar impingement was ≥ 0.85 if TCO was > 15 mm or TNC was > 25 degrees on X-ray.</p><p><strong>Conclusion: </strong>The examined imaging parameters are reliably assessable through conventional radiographs (TCO/TNC) or WBCT (osseous subtalar impingement). In situations where WBCT is unavailable, X-ray-assessed TCO and TNC can serve as predictors for osseous sinus tarsi impingement. This finding plays a pivotal role in evaluating PCFD patients, aiding in the surgical decision-making process between joint-preserving interventions (e.g., osteotomies) and joint-sacrificing procedures (e.g., realignment fusion).</p><p><strong>Level of evidence: </strong>Level IV, observational study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open and all-inside arthroscopic Brostrom-Gould for chronic lateral ankle instability: A comparative analysis of surgical outcomes and learning curves. 慢性外侧踝关节不稳的开放式和全内侧布鲁斯特罗姆-古尔德关节镜手术:手术效果和学习曲线的比较分析。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-11-10 DOI: 10.1016/j.fas.2024.10.007
Binzhi Zhao, Yang Liu, Hanzhou Wang, Junlin Zhou, Yanrui Zhao
{"title":"Open and all-inside arthroscopic Brostrom-Gould for chronic lateral ankle instability: A comparative analysis of surgical outcomes and learning curves.","authors":"Binzhi Zhao, Yang Liu, Hanzhou Wang, Junlin Zhou, Yanrui Zhao","doi":"10.1016/j.fas.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.007","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to investigate and compare the learning curve and clinical outcomes of all-inside arthroscopic and open techniques in the treatment of chronic lateral ankle instability (CLAI).</p><p><strong>Method: </strong>This was a retrospective cohort analysis of 100 consecutive patients who received all-inside arthroscopic or open Brostrom-Gould surgery. These patients with CLAI were all surgically treated by the same surgeon. We applied the CUSUM analysis to assess the surgeons' learning curves, determine the cut-off point, and subsequently divide the patients into learning and proficiency groups. We recorded and compared baseline data, the preoperative and postoperative clinical function scores (AOFAS, K-P, and Tegner scores), VAS scores, time to full weight-bearing, surgery-related parameters (operation time, and postoperative hospital stays), and complications for both surgical methods during their learning and proficiency phases.</p><p><strong>Result: </strong>The CUSUM analysis identified a learning curve cutoff at 12 cases for open surgery and 22 cases for arthroscopic surgery. In the open surgery group, significant differences were observed in operation time between the learning and proficiency phases (P < 0.05). However, no significant differences were found in clinical function scores and postoperative full weight-bearing time. Similar trends were seen in the arthroscopic surgery group, with significant improvements in operation timeand postoperative hospitalization time in the proficiency phase compared to the learning phase (P < 0.05). However, no significant differences were found in clinical function scores between either surgical method's learning and proficiency stages. Additionally, when comparing the two surgical approaches at the same stage, significant differences emerged in VAS scores, postoperative full weight-bearing time, operation timeand postoperative hospitalization time (P < 0.05), with the arthroscopic technique showing advantages in reduced postoperative discomfort and faster recovery times.</p><p><strong>Conclusion: </strong>Although arthroscopic surgery takes longer to achieve proficiency, it offers the advantages of reduced postoperative discomfort and faster recovery times during both the learning and proficiency phases while achieving comparable clinical outcomes.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of dorsal closing wedge calcaneal osteotomy on hindfoot alignment and biomechanics of patients with insertional achilles tendinopathy; A weightbearing CT-based simulation study. 背侧闭合楔形小腿截骨术对插入性跟腱病患者后足排列和生物力学的影响;基于 CT 的负重模拟研究。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-11-08 DOI: 10.1016/j.fas.2024.11.002
Bedri Karaismailoglu, Matthias Peiffer, Siddhartha Sharma, Arne Burssens, Daniel Guss, Christopher P Miller, Lorena Bejarano-Pineda, Christopher W DiGiovanni, Soheil Ashkani-Esfahani
{"title":"Impact of dorsal closing wedge calcaneal osteotomy on hindfoot alignment and biomechanics of patients with insertional achilles tendinopathy; A weightbearing CT-based simulation study.","authors":"Bedri Karaismailoglu, Matthias Peiffer, Siddhartha Sharma, Arne Burssens, Daniel Guss, Christopher P Miller, Lorena Bejarano-Pineda, Christopher W DiGiovanni, Soheil Ashkani-Esfahani","doi":"10.1016/j.fas.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.fas.2024.11.002","url":null,"abstract":"<p><strong>Purpose: </strong>Dorsal closing wedge calcaneal osteotomy (DCWCO) is purported to enhance both the biological and mechanical aspects of insertional Achilles tendinopathy (IAT) by altering its insertional anatomy. The biomechanical impacts of shifting the Achilles insertion, however, are not fully understood. This study aimed to analyze the effect of DCWCO on hindfoot alignment and gastrocnemius-soleus (G-S) power.</p><p><strong>Methods: </strong>Six weightbearing ankle CTs of patients diagnosed with IAT were segmented and standardized planes were used to conduct DCWCOs with six variations, resulting in a total of 42-foot models including the 6 preoperative original model. Two distinct representations of plantar osteotomy starting points were defined. One was 1 cm anterior to plantar calcaneal tubercle (posterior osteotomy) and the other was 2 cm anterior (anterior osteotomy). The osteotomies were extended to 1 cm anterior of posterosuperior calcaneal tuberosity with 6-, 10-, or 14-mm dorsal wedges. Pre-defined Achilles insertion points were used to create computational Achilles tendon models. Multiple automated measurements were performed to calculate the change in foot alignment and biomechanics.</p><p><strong>Results: </strong>Both anterior and posterior osteotomy locations resulted in decreased lateral talocalcaneal and calcaneal pitch angles, more substantially so with the anterior osteotomy (p = 0.028). Distance change between Achilles and Haglund was much greater with posterior osteotomy using 6- and 10-mm wedges as compared to the anterior alternative (p = 0.028). Anterior osteotomy caused a significant decrease in the Böhler angle (p < 0.001). The subtalar joint orientation was observed to change up to 3.8° in anterior osteotomy and the decrease in G-S power was found to be a maximum of 2-3 %.</p><p><strong>Conclusion: </strong>A posteriorly placed starting point can provide more Achilles decompression while an anteriorly placed starting point can affect foot alignment more significantly. DCWCO can change the subtalar joint orientation predisposing the joint to increased loads. Decrease in G-S power was low and will presumably not have clinical impact.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A systematic review of outcomes of total ankle arthroplasty with INBONE II. 使用 INBONE II 进行全踝关节置换术的疗效系统回顾。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-11-06 DOI: 10.1016/j.fas.2024.11.001
Cody C Ashy, Jared J Reid, Joshua L Morningstar, Emily Brennan, Daniel J Scott, Christopher E Gross
{"title":"A systematic review of outcomes of total ankle arthroplasty with INBONE II.","authors":"Cody C Ashy, Jared J Reid, Joshua L Morningstar, Emily Brennan, Daniel J Scott, Christopher E Gross","doi":"10.1016/j.fas.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.fas.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>This study systematically reviews the literature and reports on outcomes of total ankle arthroplasty (TAA) with the INBONE II fixed-bearing implant.</p><p><strong>Methods: </strong>PubMed, SCOPUS and CINAHL were searched for clinical studies reporting INBONE II specific outcomes from database inception through July 13th, 2024, according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Seven primary TAA studies and 4 revision TAA studies were included with 406 and 114 patients respectively. Survivorship was 96.5 % (mean follow-up 44.8 months) and 93.9 % (mean follow-up=37.3 months) for primary and revision TAA, respectively. The mean reoperation rate was 11.4 % with a 3.2 % rate of major complications for primary TAA. Meanwhile, the reoperation rate was 9.1 % with a major complication rate of 12.2 % for revision TAA.</p><p><strong>Conclusions: </strong>Primary and revision TAA with this implant results in over 93 % survival at mid-term follow-up with an acceptable complication rate, supporting its continued use.</p><p><strong>Level of evidence: </strong>Level IV: Systematic Review of Level I-IV Studies.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative study of subtalar arthroereisis, medializing calcaneal osteotomy and the combination of both techniques for the treatment of symptomatic adult flatfeet. 治疗有症状的成人扁平足的足底关节切开术、小腿内侧截骨术和两种技术联合应用的比较研究。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-29 DOI: 10.1016/j.fas.2024.10.006
Maike Stichnoth, Katja A Lüders, Anna K Hell, Hartmut Stinus
{"title":"Comparative study of subtalar arthroereisis, medializing calcaneal osteotomy and the combination of both techniques for the treatment of symptomatic adult flatfeet.","authors":"Maike Stichnoth, Katja A Lüders, Anna K Hell, Hartmut Stinus","doi":"10.1016/j.fas.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.006","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic adult flatfeet are a common problem that is treated with various therapeutic approaches. In this study, three different surgical approaches, subtalar arthroereisis (SA), medializing calcaneal osteotomy (MDCO) and a combination of both techniques (SA+MDCO) were analyzed.</p><p><strong>Methods: </strong>32 patients (36 feet) with pes planovalgus (mean age 49 +/- 16 years) were surgically treated with either SA (n = 8 feet), MDCO (n = 9 feet) or SA+MDCO (n = 19 feet). The American Orthopaedic Foot and Ankle Society (AOFAS) and the European Foot and Ankle Society (EFAS) questionnaires, as well as radiological parameters were compared before and after surgery within and between groups. At follow up (6 +/- 2 years) patients were additionally invited for dynamic pedobarography and static hindfoot axis examination.</p><p><strong>Results: </strong>Within all three groups AOFAS and EFAS questionnaire values and radiological parameters improved significantly after surgery. Questionnaires did not differ between all groups. Before surgery the SA+MDCO group displayed the most severe radiological flatfeet parameter in comparison to the other cohorts. After surgery, the SA and SA+MDCO groups were greatly improved, while the MDCO group displayed less correction, indicating poorer surgical results with MDCO only. Pedobarography of surgically treated feet revealed similar results in comparison to the contralateral side within all three groups and all feet displayed a normal gait line after surgery.</p><p><strong>Conclusions: </strong>Analyzing questionnaires and radiographs, all three surgical techniques (SA, MDCO and SA+MDCO) significantly improved the severity of flatfoot deformity. Pedobarography revealed similar dynamic properties of treated feet in comparison to the contralateral side. While treatment with SA showed better results than treatment with MDCO alone, the combination of SA+MDCO was most effective. In this study, severe adult flatfeet benefited most from a surgical combination of SA+MDCO with respect to normalization of radiological parameter.</p><p><strong>Level of evidence/clinical relevance: </strong>Therapeutic Level III.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors influencing the speed of correction speed of distal tibial valgus deformity in children with percutaneous epiphyseodesis using transphyseal screw. 使用经皮骺螺钉对儿童胫骨远端外翻畸形进行矫正的速度影响因素。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-29 DOI: 10.1016/j.fas.2024.10.005
Chakravarthy Ugandhar Dussa, Harald Böhm, Florian Meister
{"title":"Factors influencing the speed of correction speed of distal tibial valgus deformity in children with percutaneous epiphyseodesis using transphyseal screw.","authors":"Chakravarthy Ugandhar Dussa, Harald Böhm, Florian Meister","doi":"10.1016/j.fas.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.005","url":null,"abstract":"<p><strong>Introduction: </strong>The distal tibial valgus deformity in children mimics a hindfoot valgus and is observed in several conditions of both non-neurogenic and neurogenic origin. The deformity can only be detected with radiological examination and can be safely and effectively corrected in children with medial percutaneous epiphysiodesis using transphyseal screws (PETS). The aims of the study are: 1. to determine the correction rates of the distal tibial valgus deformity due to different pathologies, 2. to examine the correction rate in relation to the age at implantation, severity of the initial deformity and the duration of implantation, 3. and types of foot deformities associated with the deformity.</p><p><strong>Materials and methods: </strong>A retrospective study was done on children who underwent a PETS for a distal tibial valgus deformity. The lateral distal tibia angle 89° ± 3° on ankle mortice x-rays was taken as normal. An analysis of variance and covariance was done to investigate differences in parameters between aetiologies and relations between parameters respectively.</p><p><strong>Results: </strong>Following exclusion of 191 limbs, 155 limbs in 104 children were included the study, 5 groups could be identified: Idiopathic, ICP (cerebral palsy), MMC (Meningomyelocele), Dysmelia, MHE (multiple hereditary exostosis). The mean age at implantation of all patients was 10.9 ± 1.4 years. The average correction of 0.45° ± 0.08°/month with no significant differences in the correction rates between groups. However, the correction rates were dependent on the age, the initial deformity and the duration of treatment. The incidence of a valgus foot deformity was 86.4 %.</p><p><strong>Conclusion: </strong>The correction rates of the distal tibial valgus deformity following PETS are variable and depend, on the age at implantation, duration of treatment and initial deformity. The spectrum of foot deformities associated with distal tibial valgus deformity, especially a high prevalence of valgus foot deformity warrants an ankle mortice x-ray.</p><p><strong>Level of evidence: </strong>Level III, retrospective study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Innovative surgical treatment of tarsal coalition in flatfoot: Resection and interposition of synthetic membrane, flexible bioresorbable polymers film, as adhesion barrier and subtalar arthroeresis. Up to nine years follow-up. 扁平足跗骨联合的创新手术治疗:切除并植入合成膜(柔性生物可吸收聚合物薄膜)作为粘连屏障和跗骨关节置换术。随访长达九年。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-18 DOI: 10.1016/j.fas.2024.10.003
L Peretto, D Priano, M Laquidara, A Memeo
{"title":"Innovative surgical treatment of tarsal coalition in flatfoot: Resection and interposition of synthetic membrane, flexible bioresorbable polymers film, as adhesion barrier and subtalar arthroeresis. Up to nine years follow-up.","authors":"L Peretto, D Priano, M Laquidara, A Memeo","doi":"10.1016/j.fas.2024.10.003","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.003","url":null,"abstract":"<p><p>Tarsal coalition can be a long term severely disabling condition. For symptomatic cases with flatfoot surgical resection of coalition and subtalar arthroeresis represents the most common treatment. Literature reports variable outcomes and recurrence. The aim was to achieve optimal correction with no recurrence. This retrospective study presents, reporting results, an innovative technique that provides numerous advantages and improved outcomes. Nineteen patients suffering from painful flatfoot from tarsal coalition were, consecutively, surgically treated by resection of tarsal coalition with interposition of a synthetic flexible bioresorbable polymers membrane as an adhesion barrier and by subtalar arthroeresis. AOFAS scores were used to rate the clinical severity and X-ray/ CT to evaluate the extent of tarsal coalition. Patient's age at time of surgery ranged from 12 to 21. The period examined runs from November 2010 to November 2019. Results were evaluated (up to 9 years follow-up) clinically by AFOAS scores and radiologically by X-ray/CT. AOFAS scores improved in all patients with significant (p < 0.01) pain reduction or disappearance, corrected alignment and increased function, biomechanics of the foot and mobility. X-ray showed no recurrence of coalition in all but one case. There were no complications and patients reported a significant improvement in quality of life. Our study shows that surgical resection of coalition, and correction of flatfoot by subtalar arthroeresis, with the innovative use of a flexible bioresorbable polymers membrane as an adhesion barrier, obtained excellent overall results and importantly prevented recurrence. We believe this technique represents a great option. LEVEL OF CLINICAL EVIDENCE: 4.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Automatic Hardy and Clapham's classification of hallux sesamoid position on foot radiographs using deep neural network. 利用深度神经网络对脚部 X 射线照片上的拇指芝麻状突起位置进行 Hardy 和 Clapham's 自动分类。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-16 DOI: 10.1016/j.fas.2024.10.002
Ryutaro Takeda, Akihiro Uchio, Toshiko Iidaka, Kenta Makabe, Taro Kasai, Yasunori Omata, Noriko Yoshimura, Sakae Tanaka, Takumi Matsumoto
{"title":"Automatic Hardy and Clapham's classification of hallux sesamoid position on foot radiographs using deep neural network.","authors":"Ryutaro Takeda, Akihiro Uchio, Toshiko Iidaka, Kenta Makabe, Taro Kasai, Yasunori Omata, Noriko Yoshimura, Sakae Tanaka, Takumi Matsumoto","doi":"10.1016/j.fas.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>There is currently no deep neural network (DNN) capable of automatically classifying tibial sesamoid position (TSP) on foot radiographs.</p><p><strong>Methods: </strong>A DNN was developed to predict TSP according to the Hardy and Clapham's classification. A total of 1554 foot radiographs were used for model development. The validation of the model was conducted using radiographs obtained from 113 consecutive first-visit patients of our foot and ankle clinic. On these 113 radiographs, TSP was independently classified by three foot and ankle surgeons and the DNN, and their results were compared. The weighted kappa value of TSP between the DNN prediction and the median of the three surgeons (K<sub>AI</sub>) was calculated.</p><p><strong>Results: </strong>The K<sub>AI</sub> was 0.95 (95 %CI: 0.85- 1.00), indicating sufficient consistency between the surgeons and the DNN.</p><p><strong>Conclusions: </strong>We have developed a DNN for automated TSP classification that demonstrates sufficient consistency with foot and ankle surgeons.</p><p><strong>Levels of evidence: </strong>Level 3 - Retrospective Cohort Study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The health economics of orthopaedic foot and ankle surgery. 足踝矫形手术的卫生经济学。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-16 DOI: 10.1016/j.fas.2024.10.004
Jill Glasser, Gennaro DelliCarpini, Devin Walsh, Megan Chapter-Zylinski, Shyam Patel
{"title":"The health economics of orthopaedic foot and ankle surgery.","authors":"Jill Glasser, Gennaro DelliCarpini, Devin Walsh, Megan Chapter-Zylinski, Shyam Patel","doi":"10.1016/j.fas.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.fas.2024.10.004","url":null,"abstract":"<p><p>The cost of healthcare spending in foot and ankle surgery continues to rise. Several recent studies about cost effectiveness have been published. These may be difficult to understand and analyze without a background in business and healthcare economics. The goal of this narrative review is to provide the fundamentals for understanding and interpreting healthcare economic studies by defining key terminology and providing examples in the field of foot and ankle surgery. Foot and ankle surgeons should be familiar with the elements that comprise cost-effectiveness for providers, clinicians, researchers, and economists in caring for patients and making healthcare-related decisions.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Favorable change in patient-reported outcomes following peroneus longus to brevis tendon transfer and lateral ankle ligament reconstruction. 腓骨长肌到腓骨肌腱转移和外侧踝关节韧带重建术后患者报告结果的有利变化。
IF 1.9 3区 医学
Foot and Ankle Surgery Pub Date : 2024-10-10 DOI: 10.1016/j.fas.2024.09.008
Anna E Sprinchorn, Gunilla E Frykberg, Jón Karlsson, Karl Michaëlsson
{"title":"Favorable change in patient-reported outcomes following peroneus longus to brevis tendon transfer and lateral ankle ligament reconstruction.","authors":"Anna E Sprinchorn, Gunilla E Frykberg, Jón Karlsson, Karl Michaëlsson","doi":"10.1016/j.fas.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.fas.2024.09.008","url":null,"abstract":"<p><strong>Background: </strong>A peroneus longus to brevis tendon transfer is recommended for a severely torn peroneus tendon, but there is little research on the outcome. We conducted a prospective cohort study to examine patient-reported outcomes after this procedure.</p><p><strong>Methods: </strong>Thirty-two patients underwent a peroneus longus to brevis tendon transfer and lateral ankle ligament reconstruction, 11 had an additional calcaneal osteotomy. The Foot and Ankle Outcome Score (FAOS) and Short Form-36 (SF-36) were assessed preoperatively, six and 12 months after surgery.</p><p><strong>Results: </strong>Preoperative mean FAOS was 51.7 (SD 17.8) compared with 72.7 (SD 21.2) at 12 months, an improvement of 21 (95 % CI 12.7-28.0) (p < 0.0001). SF-36 improved significantly in the three domains involving physical function and bodily pain (p < 0.007).</p><p><strong>Conclusion: </strong>Patient-reported outcomes improved significantly through peroneus longus to brevis tendon transfer. This procedure is worth considering for patients with a severely damaged peroneus tendon.</p><p><strong>Level of evidence: </strong>Level II: Prospective cohort study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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