Foot & ankle surgery (New York, N.Y.)最新文献_第8页

Erratum regarding missing Informed patient consent statements in previously published articles 关于先前发表的文章中缺少知情患者同意声明的勘误

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-29 DOI: 10.1016/j.fastrc.2024.100451

引用次数: 0

Erratum regarding missing Declaration of Competing Interest statements in previously published articles 关于先前发表的文章中缺少竞争利益声明的勘误表

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-29 DOI: 10.1016/j.fastrc.2024.100450

引用次数: 0

Surgical outcomes of forefoot amputations on 122 patients and the role of random fasciocutaneous flaps in forefoot infections and revision surgery: A retrospective analysis 122例前足截肢患者的手术结果及随机筋膜皮瓣在前足感染和翻修手术中的作用：回顾性分析

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-28 DOI: 10.1016/j.fastrc.2024.100444

Efthymios Gkotsoulias DPM, FACFAS

{"title":"Surgical outcomes of forefoot amputations on 122 patients and the role of random fasciocutaneous flaps in forefoot infections and revision surgery: A retrospective analysis","authors":"Efthymios Gkotsoulias DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100444","DOIUrl":"10.1016/j.fastrc.2024.100444","url":null,"abstract":"<div><div>Deep tissue coverage in the management of high-risk limb salvage cases poses a challenge to surgeons. Local fasciocutaneous flaps are utilized for coverage of forefoot amputations when the soft tissue equilibrium does not permit primary closure. The aim of this study is to report the mid-term safety and efficacy outcomes of patients who underwent fasciocutaneous flap for limb salvage and analyze the base procedures recruited for partial ray and transmetatarsal amputations.</div><div>A review of 122 consecutive patients who underwent forefoot amputation between May 2016 and December 2021 with a minimum of 12 months follow-up was performed. Fasciocutaneous flap closure was recruited in 21 patients (17%), all of whom demonstrated successful wound closure with a mean follow-up period > 3 years (range 19 to 67 months). The Incidence of recurrent breakdown following transmetatarsal amputation (TMA) was 11 limbs (15.4%), and below-the-knee (BKA) incidence was 7 limbs (9.8%), with a 90% limb salvage rate. In this cohort, the risk of breakdown is 112.3% higher when comparing a partial ray amputation to a TMA.</div><div>At a mean follow-up greater than 3 years, the incidence of recurrent breakdown resulting in higher-level amputation was no different between closure via random fasciocutaneous flap (9.5%) and traditional closure methods (9.8%). These outcomes justify using fasciocutaneous flaps for closure and the procedures they're indicated for, such as a TMA. They provide a reliable option while maintaining the integrity of local tissue needs, with minimal morbidity, from an expendable donor site while attaining primary wound closure.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100444"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164168","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: 0

Integrating domain-specific resources: Advancing AI for foot and ankle surgery 整合特定领域的资源：推进足部和踝关节手术的人工智能

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-28 DOI: 10.1016/j.fastrc.2024.100445

Steven R. Cooperman DPM, MBA, AACFAS , Roberto A. Brandão DPM, FACFAS

{"title":"Integrating domain-specific resources: Advancing AI for foot and ankle surgery","authors":"Steven R. Cooperman DPM, MBA, AACFAS , Roberto A. Brandão DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100445","DOIUrl":"10.1016/j.fastrc.2024.100445","url":null,"abstract":"<div><div>Large language models like ChatGPT offer significant potential for applications in medicine, including patient education and clinical support. This study evaluates the performance of ChatGPT-4, ChatGPT-4 enhanced with retrieval-augmented generation (RAG), and Gemini AI in responding to clinical vignette questions regarding Hallux Rigidus, a condition requiring specialized knowledge in foot and ankle surgery. The ChatGPT-4 + RAG model, enhanced with the 2024 ACFAS clinical consensus statements, demonstrated the highest agreement with surveyor majority responses (83.26 %) compared to ChatGPT-4 (59.54 %) and Gemini AI (53.02 %). All models provided clinically appropriate responses to most questions, with the ChatGPT-4 + RAG model excelling in accuracy, despite the rationale for answers being deemed most difficult to read. These findings highlight the limitations of generic AI models, which may propagate misinformation if used by patients seeking health information. By incorporating domain-specific resources, the RAG-augmented model showed enhanced reliability and contextual accuracy, suggesting their potential as tools for both clinical decision-making and patient education. This study emphasizes the importance of integrating verified medical resources to advance AI in healthcare, addressing critical gaps in existing capabilities while minimizing risks of misinformation.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100445"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103306","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}

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Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report 第一跖骨头孤立性骨软骨缺损：手术治疗方案回顾及病例报告

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-23 DOI: 10.1016/j.fastrc.2024.100443

James Craven FRCPodS, MSc, Andy Naismith FRCPodS, BSc

{"title":"Isolated Osteochondral defect of the first metatarsal head: A review of surgical treatment options & case report","authors":"James Craven FRCPodS, MSc, Andy Naismith FRCPodS, BSc","doi":"10.1016/j.fastrc.2024.100443","DOIUrl":"10.1016/j.fastrc.2024.100443","url":null,"abstract":"<div><div>Osteochondral defects (OCD) are a focal pathology affecting the sub-chondral bone and overlying cartilage. The presence of Osteochondral defects (OCD) within the foot and ankle are well established. Despite this, they are often regarded as an insidious finding, prone to misdiagnosis which can result in significant debilitation to the affected individual. The mechanisms underlying the formation of these lesions remain disputed. Moreover, the incidence of isolated Osteochondral defects affecting the first Metatarsophalangeal joint in the absence of any additional pathology is unknown.</div><div>There are a range of surgical treatment modalities described to treat Osteochondral defects. Strategies typically involve cartilage regeneration or replacement of the articular surface: however there are no consensus guidelines regarding the optimum surgical management when applied to the first Metatarsophalangeal joint. The following concepts review aims to explore the literature pertaining to the surgical management of Osteochondral defects including an innovative approach case study employing subchondral drilling technique.</div><div>Osteochondral defects are managed with a variety of surgical procedures. Surgical outcomes are often derived from literature relating to the knee and hindfoot with little or no study on the forefoot. The included case study demonstrates positive patient satisfaction (PSQ-10) score, improved foot function (MOXFQ) and pain reduction with a novel antegraded Osteochondral drilling technique when applied to the first metatarsal. Further study into the application of contemporary cartilage regeneration and replacement strategies in this location is warranted.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100443"},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757065","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: 0

A case of erenumab, a new migraine medication, and delayed wound and bone healing after foot and ankle surgery 偏头痛新药艾伦单抗与足踝手术后伤口和骨愈合延迟的一个案例

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-16 DOI: 10.1016/j.fastrc.2024.100442

Timothy Cheung DPM, PhD, CPT , Zachary Korwek DPM , Arij Rashid DPM, AACFAS , Rumzah Paracha MD , Ashley Bruno DPM, FACFAS

{"title":"A case of erenumab, a new migraine medication, and delayed wound and bone healing after foot and ankle surgery","authors":"Timothy Cheung DPM, PhD, CPT , Zachary Korwek DPM , Arij Rashid DPM, AACFAS , Rumzah Paracha MD , Ashley Bruno DPM, FACFAS","doi":"10.1016/j.fastrc.2024.100442","DOIUrl":"10.1016/j.fastrc.2024.100442","url":null,"abstract":"<div><div>Patient selection and optimization are crucial components of successful surgery outcomes. Erenumab is a Calcitonin Gene-Related Peptide (CGRP) antagonist that was recently approved by the FDA for the treatment of migraines. CGRP is a neuropeptide implicated in migraines, but is also essential in osteotomy healing. This case reports a pathologic fracture suspected secondary to an elusive side effect of a migraine medication with subsequent delayed wound and osteotomy healing in a healthy patient that underwent an index midfoot arthrodesis and revision. The delayed wound healing lasted approximately 9 months, but once erenumab was identified as the cause of nonunion and delayed wound healing, the medication was stopped and the wound healed 2 weeks later at the next appointment. After withholding of erenumab, there were no significant changes to the foot from serial radiographs. The joint surfaces were stable with manual manipulation and the patient did not have pain with direct palpation to the surgical sites, suggesting fibrous union. This case substantiates the need for considering erenumab, a specific migraine medication, in the preoperative planning and optimization in elective foot and ankle surgery.</div><div><em>Level of evidence</em>: IV, case study</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"4 4","pages":"Article 100442"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697801","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: 0

Open and closed pantalar dislocations: A systematic review 开放性和闭合性髋臼脱位：系统回顾

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-13 DOI: 10.1016/j.fastrc.2024.100435

Joseph R Brown DPM , Zachary P Hill DPM , Tucker Peabody DO , Benjamin C Taylor MD

{"title":"Open and closed pantalar dislocations: A systematic review","authors":"Joseph R Brown DPM , Zachary P Hill DPM , Tucker Peabody DO , Benjamin C Taylor MD","doi":"10.1016/j.fastrc.2024.100435","DOIUrl":"10.1016/j.fastrc.2024.100435","url":null,"abstract":"<div><div>Pantalar dislocations are a relatively rare traumatic condition of the foot and ankle, and outcomes are overall unknown for these patients. A systematic review was performed to identify articles evaluating outcomes following treatment of pantalar dislocations. Studies with a minimum of 1 year follow-up, with mention of patient reported outcome measures (PROMs) and complications were included. The mean complication rate, secondary operation rate, and PROM scores were calculated based on the included articles. 203 articles were initially identified. 15 articles met the inclusion criteria, for a total of 62 pantalar dislocations. All studies were level 4 evidence (i.e., case study or series). Open dislocations (40/62; 65%) were more common than closed dislocations (22/62; 35%). The most common form of treatment of open reduction with external fixation (<em>n</em> = 12). The average follow-up was 43.02 months for the entire cohort. The mean age was 37.3 (19-81) years and most patients were male (<em>n</em> = 43). Complication rates were relatively high, with 30.6% (19/62) having osteonecrosis, 17.7% (11/62) having arthritis, and 11.3% (7/62) experiencing an infection. 19.4% (12/62) of patients required a secondary operation. At a minimum 1 year follow up, the pooled mean AOFAS and FFI scores were 75.8 and 37.5, respectively. High complication rates can be expected with relatively poor functional outcomes at short term follow up with pantalar dislocations secondary to the traumatic nature of these injuries. Surgeons managing lower extremity trauma should be aware of this pathology and treatment strategies.</div><div>Level of Evidence: Level 3 Systematic Review</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"4 4","pages":"Article 100435"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721481","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: 0

Cerebrotendinous Xanthomatosis in the achilles tendon: A Case study 跟腱脑膜黄瘤病：病例研究

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-12 DOI: 10.1016/j.fastrc.2024.100441

Rahul Mishra DPM, PGY-3 , John T. Marcoux DPM, FACFAS

引用次数: 0

The modified Boyd fusion: An uncommon limb salvage procedure 改良博伊德融合术：不常见的肢体挽救术

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-08 DOI: 10.1016/j.fastrc.2024.100437

Zachary J Washburn DPM , Adena Mahadai DPM , James Hayes DPM , Lahari Madulapally DPM , Stephen J Frania DPM, FACFAS

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Treatment of foot and ankle nonunions using supplemental allograft-derived proteins: A case series 使用补充性异体移植衍生蛋白治疗足踝非腱鞘炎：病例系列

Foot & ankle surgery (New York, N.Y.) Pub Date : 2024-11-07 DOI: 10.1016/j.fastrc.2024.100439

Brian Burgess DPM, FACFAS , Amber Kavanagh DPM, AACFAS , Paul DeFrino MD , David Garras MD

{"title":"Treatment of foot and ankle nonunions using supplemental allograft-derived proteins: A case series","authors":"Brian Burgess DPM, FACFAS , Amber Kavanagh DPM, AACFAS , Paul DeFrino MD , David Garras MD","doi":"10.1016/j.fastrc.2024.100439","DOIUrl":"10.1016/j.fastrc.2024.100439","url":null,"abstract":"<div><div>Arthrodesis of joints in the foot and ankle is a common treatment for end-stage arthritis, however the risk of nonunion remains apparent. The use of various orthobiologic agents to aid in bony union has shown to be beneficial due to ease of use, wide availability, and lack of autograft-associated donor site morbidity. The purpose of this study was to evaluate the use of bone graft combined with supplemental allograft-derived proteins in subjects who underwent surgical treatment for nonunion. A retrospective chart review of three surgeons was completed and found 16 patients undergoing revision fusion procedures for confirmed nonunion at 29 total articulation sites in the foot and ankle with an average follow up time of 12.7 months. Fusion across each joint was assessed using serial radiographs independently reviewed by a single, independent radiologist. Successful fusion was demonstrated in 28 out of 29 articulations (96.6 %) by six months, with an average time of 2.9 months to full fusion. No adverse events related to the graft, procedure, or hardware were reported. Supplemental allograft-derived proteins may be a safe and effective additive to support bony remodeling in arthrodesis procedures in the foot and ankle.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"4 4","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142697798","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: 0