Foot and Ankle Surgery最新文献_第3页

Ankle instability in pediatric and adolescent patients diagnosed with lateral malleolus avulsion fracture: Analysis of clinical and functional outcomes of ligament injury repair surgery 被诊断为外侧踝骨撕脱性骨折的儿童和青少年患者的踝关节不稳：韧带损伤修复手术的临床和功能结果分析

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.013

{"title":"Ankle instability in pediatric and adolescent patients diagnosed with lateral malleolus avulsion fracture: Analysis of clinical and functional outcomes of ligament injury repair surgery","authors":"","doi":"10.1016/j.fas.2024.03.013","DOIUrl":"10.1016/j.fas.2024.03.013","url":null,"abstract":"<div><h3>Background</h3><p><span>Some children and adolescents can develop persistent pain and instability following inversion injuries of the ankle. In these cases, imaging exams could reveal small bone fragments distal to the </span>lateral malleolus<span>. For these patients, regular conservative treatment may not be successful, requiring additional management, which can include surgical treatment. This study aimed to present the short-to-midterm functional and clinical outcomes of a series of 12 pediatric and adolescent patients who underwent ligament repair surgery due to chronic instability associated with the presence of osseous components in the lateral ligaments.</span></p></div><div><h3>Methods</h3><p><span>A review of 12 patients treated with surgical ligament reconstruction<span> of the ankle was evaluated. Clinical and functional evaluations were based on comparing the Visual Analogue Scale (VAS), </span></span>AOFAS ankle-hindfoot score, and residual symptoms before and after the surgical intervention.</p></div><div><h3>Results</h3><p>Before the reconstructive approach, the mean VAS was 2.41 and the mean AOFAS score was 74.16. After the procedure, the standard VAS declined to zero, and the AOFAS score was 100 in all patients. The mean follow-up was 6.33 months.</p></div><div><h3>Conclusion</h3><p>The surgical approach in children and adolescents with symptomatic ankle instability due to the presence of osseous fragments after an initial inversion trauma provided adequate clinical and functional results at short-to-midterm follow-up.</p></div><div><h3>Level of evidence</h3><p>Level IV, retrospective case series.</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630215","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

Sequential bilateral total ankle replacements: No difference in patient-reported outcomes between the first and second ankle 连续双侧全踝关节置换术：第一踝关节和第二踝关节的患者报告结果无差异

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.005

{"title":"Sequential bilateral total ankle replacements: No difference in patient-reported outcomes between the first and second ankle","authors":"","doi":"10.1016/j.fas.2024.04.005","DOIUrl":"10.1016/j.fas.2024.04.005","url":null,"abstract":"<div><h3>Background</h3><p>Total ankle replacement is an established treatment for end-stage arthritis. However, there is little data examining outcomes in sequential bilateral replacements. This study aimed to compare outcomes between first and second ankles in sequential replacement.</p></div><div><h3>Methods</h3><p>Patients were retrospectively contacted to complete a follow-up questionnaire including the Manchester-Oxford Foot Questionnaire (MOXFQ), EQ-5D-3 L, and a question assessing satisfaction. Electronic records identified demographics, procedural details, and complications.</p></div><div><h3>Results</h3><p>Twenty patients underwent sequential bilateral ankle replacement over the study period. At a mean follow-up of four years, 18 patients completed the follow-up questionnaire. There was no statistically significant difference between first and second ankles in terms of MOXFQ score, EQ-5D-3 L or satisfaction. Eleven complications were noted.</p></div><div><h3>Conclusions</h3><p>We report excellent outcomes after sequential bilateral ankle replacement with no difference in outcomes between first and second ankles. These results can be used to counsel patients in the future and manage expectations.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140803466","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

Defining the patient acceptable symptom state using PROMIS following reconstruction of the progressive collapsing foot deformity 使用 PROMIS 界定患者在进行性塌足畸形重建后可接受的症状状态

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.002

{"title":"Defining the patient acceptable symptom state using PROMIS following reconstruction of the progressive collapsing foot deformity","authors":"","doi":"10.1016/j.fas.2024.04.002","DOIUrl":"10.1016/j.fas.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>The patient acceptable symptom state (PASS) represents the threshold beyond which patients are satisfied with their outcome. This study aimed to define PASS thresholds for progressive collapsing foot deformity (PCFD) reconstruction using Patient-Reported Outcomes Measurement Information System (PROMIS) scores and anchor question responses.</p></div><div><h3>Methods</h3><p>This retrospective study consisted of 109 patients who underwent flexible PCFD reconstruction, had preoperative and 2-year postoperative PROMIS scores, and 2-year postoperative anchor question responses. ROC curve analyses were performed to quantify PASS thresholds.</p></div><div><h3>Results</h3><p>PASS thresholds for the PROMIS Physical Function (PF) and Pain Interference (PI) domains were found to be lower and higher, respectively, than population norms. Furthermore, patients with higher preoperative PROMIS PF scores or lower preoperative PROMIS PI scores had a significantly higher likelihood of achieving the PASS thresholds.</p></div><div><h3>Conclusion</h3><p>In addition to guiding future outcomes research, these results may help surgeons optimize treatment for PCFD and better manage patient expectations.</p></div><div><h3>Level of evidence</h3><p>III, retrospective cohort study</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626099","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

Response to letter to editor: “Effect of chronic heavy tobacco smoking on ankle fracture healing” 解决长期大量吸烟对踝关节骨折愈合的多方面影响。

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.06.006

引用次数: 0

The association of ASA score and outcomes following total ankle arthroplasty ASA 评分与全踝关节置换术后疗效的关系

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.011

{"title":"The association of ASA score and outcomes following total ankle arthroplasty","authors":"","doi":"10.1016/j.fas.2024.03.011","DOIUrl":"10.1016/j.fas.2024.03.011","url":null,"abstract":"<div><h3>Background</h3><p>This study seeks to evaluate the relationship between American Society of Anesthesiologist (ASA) score and postoperative outcomes following TAA.</p></div><div><h3>Methods</h3><p>The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried from 2007 to 2020 to identify 2210 TAA patients. Patients were stratified into low (n = 1328; healthy/mild systemic disease) or high (n = 881; severe/life-threatening systemic disease) ASA score cohorts.</p></div><div><h3>Results</h3><p><span>There was no statistically significant difference in complications, readmission, or reoperation rate based on ASA score. Increased ASA score was significantly associated with longer length of stay (low = 1.69 days, high = 1.98 days; </span><em>p <</em> .001) and higher rate of adverse discharge (low = 95.3 %, high = 87.4 %; <em>p <</em> .001).</p></div><div><h3>Conclusion</h3><p>Higher ASA scores (3 and 4) were statically significantly associated with increased length of stay and non-home discharge disposition. These findings are valuable for physicians and patients to consider prior to TAA given the increased utilization of resources and cost associated with higher ASA scores.</p></div><div><h3>Level of Evidence</h3><p>Level III, Retrospective cohort study</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140401301","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 modified lateral column lengthening for the treatment of flexible flatfoot: From clinical applications to finite element analysis 治疗柔性扁平足的改良侧柱延长术：从临床应用到有限元分析

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.008

{"title":"A modified lateral column lengthening for the treatment of flexible flatfoot: From clinical applications to finite element analysis","authors":"","doi":"10.1016/j.fas.2024.03.008","DOIUrl":"10.1016/j.fas.2024.03.008","url":null,"abstract":"<div><h3>Background</h3><p>Finite element (FE) analysis and clinical follow-up were used to evaluate the efficacy of a modified lateral column lengthening (H-LCL) for treating flexible flatfoot.</p></div><div><h3>Methods</h3><p><span>By applying inclusion and exclusion criteria, we selected patients who underwent H-LCL surgery at our institution from January 2019 to January 2023. We compared the Visual Analog Scale (VAS) scores, American </span>Orthopaedic Foot and Ankle Society (AOFAS) scores, Pain Interference (PI), and Physical Function (PF) scores in Patient-Reported Outcomes Measurement Information System (PROMIS) between preoperative and final follow-up assessments of patients, as well as FE submodels. Furthermore, evaluate the H-LCL’s biomechanical characteristics and clinical outcome before and after surgery.</p></div><div><h3>Results</h3><p>A total of 66 patients met the criteria. The average surgery time was 69.47 ± 13.22 min, and the follow-up duration was 15.18 ± 6.40 months. In the last follow-up, VAS and PI decreased compared to before surgery, while AOFAS and PF increased compared to before surgery. Meary’s angle (dorsoplantar image and lateral image), calcaneal valgus<span><span> angle, and talonavicular coverage angle decreased compared to before surgery, while the pitch angle increased compared to before surgery. In FE analysis, postoperative tension on the plantar fascia (PF), spring ligament (SL), and </span>posterior tibial tendon<span><span> (PTT) decreased compared to before surgery, pressure on the talonavicular joint and </span>subtalar joints also decreased compared to before surgery, and there was no significant change in pressure on the calcaneocuboid joint.</span></span></p></div><div><h3>Conclusion</h3><p>H-LCL in correcting flexible flatfoot resulted in a significant improvement of clinical outcome scores and led to good radiological correction of flatfoot deformities. It can reduce the soft tissue and interosseous pressure in maintaining the foot arch.</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140196432","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

Dorsal calcaneal wedge removal in zadek osteotomy: A cadaveric study Zadek 截骨术中的钙楔背侧切除：尸体研究

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.004

{"title":"Dorsal calcaneal wedge removal in zadek osteotomy: A cadaveric study","authors":"","doi":"10.1016/j.fas.2024.04.004","DOIUrl":"10.1016/j.fas.2024.04.004","url":null,"abstract":"<div><h3>Background</h3><p><span>Insertional Achilles tendinopathy (IAT) is a common pathology with multiple surgical interventions available for treatment. The Zadek, dorsal closing wedge calcaneal </span>osteotomy (ZO) has been demonstrated to be effective treatment of IAT. There have been various recommendations in the literature as to what measurement of wedge removal should be considered ideal to produce greatest postoperative range of motion (ROM), thus postoperative biomechanical potential. Accordingly, the purpose of this cadaveric study was to assess the range of motion achieved after various measurements of wedge removal by ZO.</p></div><div><h3>Methods</h3><p>The ZO was performed on six cadaveric specimens. A 7.5 mm and 15 mm wedge osteotomy was marked and sequentially completed on each specimen. Lateral fluoroscopic imaging was utilized to take preoperative and postoperative ROM measurements for each osteotomy. Dorsiflexion (DF) and plantarflexion (PF) ROM arcs were measured for each wedge size and compared by t-test. Effect sizes were calculated by Cohen’s d analysis.</p></div><div><h3>Results</h3><p>Maximal DF was 110.87 ± 12.97 deg in the pre-osteotomy state. Removal of a 7.5 mm wedge improved DF by 8 deg to a mean 102.93 ± 13.81 deg (p = 0.08). Removal of a 15 mm wedge improved DF by 16 deg to a mean 95.96 ± 11.41 deg (p = 0.003). Cohen’s d and effect size calculation demonstrated a 7.5 mm wedge to have a small effect on DF, while a 15 mm wedge had a medium effect (0.29, 0.52 respectively). Maximal PF did not change significantly amongst the pre-osteotomy, 7.5 mm wedge, or 15 mm wedge positions. ICC was 0.96.</p></div><div><h3>Conclusion</h3><p>Based on the results presented in this study, removal of a 15 mm wedge with ZO yields significant and greater improvement in ROM than a 7.5 mm wedge. We hope the current study will better inform preoperative planning for ZO.</p></div><div><h3>Study type</h3><p>Prospective Cadaver Study.</p></div><div><h3>Level of evidence</h3><p>V.</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794109","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

Role of insole material in treatment of plantar fasciitis: A randomized clinical trial 鞋垫材料在治疗足底筋膜炎中的作用：随机临床试验

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.006

引用次数: 0

Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees 使用分类和回归树预测住院糖尿病足患者下肢截肢的模型

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.007

{"title":"Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees","authors":"","doi":"10.1016/j.fas.2024.03.007","DOIUrl":"10.1016/j.fas.2024.03.007","url":null,"abstract":"<div><h3>Background</h3><p>The decision to perform amputation of a limb in a patient with diabetic foot ulcer (DFU) is not an easy task. Prediction models aim to help the surgeon in decision making scenarios. Currently there are no prediction model to determine lower limb amputation during the first 30 days of hospitalization for patients with DFU.</p></div><div><h3>Methods</h3><p>Classification And Regression Tree analysis was applied on data from a retrospective cohort of patients hospitalized for the management of diabetic foot ulcer, using an existing database from two Orthopaedics and Traumatology departments. The secondary analysis identified independent variables that can predict lower limb amputation (mayor or minor) during the first 30 days of hospitalization.</p></div><div><h3>Results</h3><p>Of the 573 patients in the database, 290 feet underwent a lower limb amputation during the first 30 days of hospitalization. Six different models were developed using a loss matrix to evaluate the error of not detecting false negatives. The selected tree produced 13 terminal nodes and after the pruning process, only one division remained in the optimal tree (Sensitivity: 69%, Specificity: 75%, Area Under the Curve: 0.76, Complexity Parameter: 0.01, Error: 0.85). Among the studied variables, the <em>Wagner classification</em> with a cut-off grade of 3 exceeded others in its predicting capacity<em>.</em></p></div><div><h3>Conclusions</h3><p>Wagner classification was the variable with the best capacity for predicting amputation within 30 days. Infectious state and vascular occlusion described indirectly by this classification reflects the importance of taking quick decisions in those patients with a higher compromise of these two conditions. Finally, an external validation of the model is still required.</p></div><div><h3>Level of evidence</h3><p>III</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1268773124000687/pdfft?md5=f3c5f52e3d9789958c7965a27a9f57bf&pid=1-s2.0-S1268773124000687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses. 慢性踝关节不稳的治疗和预防：荟萃分析综述。

IF 1.9 3区医学

Foot and Ankle Surgery Pub Date : 2024-07-30 DOI: 10.1016/j.fas.2024.07.010

Dahai Hu, Hongyan Sun, Shengli Wang, Huajun Wang, Xiaofei Zheng, Hui Tang, Huige Hou

{"title":"Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses.","authors":"Dahai Hu, Hongyan Sun, Shengli Wang, Huajun Wang, Xiaofei Zheng, Hui Tang, Huige Hou","doi":"10.1016/j.fas.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.fas.2024.07.010","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) is a common and highly disabling condition. Although several studies have evaluated and analyzed prevention and treatment strategies for CAI, an unbiased and systematic synthesis of evidence is required to provide the most powerful and comprehensive evidence-based measures for the its prevention and treatment of CAI. This study aimed to synthesize evidence from the existing literature addressing the treatment and prevention of CAI.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant studies from inception to December 12, 2023. Data on effect sizes and corresponding 95 % confidence intervals for selected intervention measures were extracted. Systematic reviews were assessed for quality of included studies using a measurement tool (i.e., \"AMSTAR 2\").</p><p><strong>Results: </strong>In total, 37 studies were included, among which 21 (57 %) were of high or moderate quality. Strong evidence suggested that lower weight (P < 0.001), lower body mass index (P = 0.002), and non-stability defects (P = 0.04) significantly reduced the risk of developing CAI. Strong evidence supported exercise and moderate evidence supported manual therapy, acupuncture, and surgery for improving CAI. Additionally, external support plays an active role in the treatment process of CAI.</p><p><strong>Conclusion: </strong>This is the first study synthesizing evidence supporting interventions for the treatment and prevention of CAI. Low body weight and body mass index were effective preventive measures against CAI. Exercise, manual therapy, acupuncture, and surgery can improve ankle function in patients with CAI. Plantar sensory treatment and neuromuscular training may be good therapeutic options for patients with CAI.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898716","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