Comparative Results of Percutaneous Calcaneal Osteotomy in Correction of Hindfoot Deformities

2018 ◽  
Vol 40 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Natalia Gutteck ◽  
Alexander Zeh ◽  
David Wohlrab ◽  
Karl-Stefan Delank
Keyword(s):  
Wound Healing ◽  
Standard Technique ◽  
Percutaneous Technique ◽  
Level Of Evidence ◽  
Calcaneal Osteotomy ◽  
Scale Scores ◽  
Oblique Incision ◽  
Hindfoot Deformities ◽  
Wound Healing Problems ◽  
The Difference

Background: Calcaneal osteotomies are often required in the correction of hindfoot deformities. The traditional open techniques, which include a lateral or oblique incision, are occasionally associated with wound healing problems and neurovascular injury. Methods: A total of 122 consecutive patients who underwent a calcaneal osteotomy for hindfoot realignment treatment were included. Fifty-eight patients were operated using an open incision technique and 64 patients (66 feet) using a percutaneous technique. Clinical and radiologic assessments were performed preoperatively, at 6 weeks, and 1 year postoperatively. Results: The American Orthopaedic Foot & Ankle Society scale scores and visual analog scale pain scores improved in both groups postoperatively. The difference between the groups was not significant. The results of the radiologic measurements pre- and postoperatively were not significantly different. No pseudarthrosis occurred in either group. The comparison of both groups showed a significantly lower risk for wound healing problems in the percutaneous group. The hospitalization time was significantly shorter in the percutaneous group. Conclusion: Because of the excellent results with the percutaneous calcaneal osteotomy, the authors feel encouraged to establish this procedure as a standard technique for calcaneus osteotomy, especially patients at high risk for wound healing problems. Level of Evidence: Level III, comparative series.

scholarly journals Comparative Results of Percutaneous Calcaneal Osteotomy in Correction of Hindfoot Deformities

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0023
Author(s):  
Natalia Gutteck
Keyword(s):  
Wound Healing ◽  
Standard Technique ◽  
Percutaneous Technique ◽  
Calcaneal Osteotomy ◽  
Oblique Incision ◽  
Hindfoot Deformities ◽  
Wound Healing Problems ◽  
The Difference ◽  
Comparative Results ◽  
Group B

Category: Hindfoot Introduction/Purpose: Calcaneal osteotomies are often required in correction of hindfoot deformities. The traditional open techniques as lateral or oblique incision are occasionally associated with wound healing problems and neurovascular injury. Methods: In a prospective study 122 consecutive patients who underwent a calcaneal osteotomy for hindfoot realignment treatment were included. 58 patients were operated using an open incision technique and 64 patients with 66 feet using a percutaneous technique. Clinical and radiological assessments were performed preoperatively, six weeks and one year postoperatively. Results: The AOFAS score and VAS improved in both groups postoperatively. The difference was not significant. The results of the radiological measurements pre- and postoperatively were not significantly different. No pseudarthrosis occurred in both groups. The comparison of both groups showed a significant lesser risk for wound healing problems in percutaneous group (B). The hospitalisation time was significantly shorter in the percutaneous group. Conclusion: Due to the excellent results with the percutaneous calcaneal osteotomy the authors feel encouraged to establish this procedure as a standard technique for calcaneus osteotomy at our clinic.

scholarly journals A Comparative Study of Two Different Techniques for Calcaneal Displacement Osteotomy

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0023
Author(s):  
Natalia Gutteck
Keyword(s):  
Wound Healing ◽  
Complication Rate ◽  
Operating Time ◽  
Senior Author ◽  
Open Technique ◽  
Displacement Osteotomy ◽  
Osteotomy Technique ◽  
Oblique Incision ◽  
Hindfoot Deformities ◽  
Wound Healing Problems

Category: Hindfoot Introduction/Purpose: The lateral oblique incision is widely used for calcaneal displacement osteotomy in correction of hindfoot deformities. Wound healing problems and neurovascular injury are limitations of this procedure. A technique using a Shannon burr for calcaneal displacement osteotomy was introduced to avoid these complications. The advantages of the percutaneos calcaneus osteotomy have been evaluated in a comperative study. Methods: Lateral oblique incision for calcaneus osteotomy was performed in 58 patients. The senior author changed the osteotomy technique 2014. Further 64 calcaneus osteotomies were performed percutaneously. The main indication for the calcaneus osteotomy was correction of hindfoot deformities. Complementary the number of screws used for the fixation have been axamined in the study. Results: The mean age of the patients was 51,6 (14-72) years. The patients were folled up for 12 months. All cases achieved radiographic union. Wound healing problems have been registrated in the open technique group in 16 patients (27,6%). Six of them (10,3%) required a surgical revision. No wound healing problems appeared in the percutaneous group. N. suralis was affected in the open technique group in 12 patients (20,6%) and in 4 patients (6,2%) in the percutaneous osteotomy group (p 0,02). The operating time was significantly shorter in the percutaneus osteotomy group. The correction of the hindfoot axis succeed in all patients. Risk of complication did not differ significantly between single and double screw in the percutaneous osteotomy group. Conclusion: The clinical and radiological examinations showed outstanding results. There is no evident difference between the two techniques in the radiological results. Use of a single screw in percutaneous osteotomy of the calcaneus did not increased the complication rate. The percutaneous calcaneal osteotomy had a lower complication rate in our study and is probably a useful technique in patients with diabetes and affected perfusion. Further randomised studies should consider this results.

Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Surgical Technique ◽  
Significant Risk ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Wound Healing Problems ◽  
Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity

2017 ◽  
Vol 39 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Stuart M. Saunders ◽  
Scott J. Ellis ◽  
Constantine A. Demetracopoulos ◽  
Anca Marinescu ◽  
Jayme Burkett ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Categorical Variables ◽  
Distributed Data ◽  
Level Of Evidence ◽  
Lateral Column ◽  
Calcaneal Osteotomy ◽  
Outcome Scores ◽  
Lateral Column Lengthening ◽  
Adult Acquired Flatfoot Deformity ◽  
Lateral Pain

Background: The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. Methods: We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant). Results: The Evans group used a larger graft size ( P < .001) and returned more often for hardware removal ( P = .038) than the SLCO group. SLCO union occurred at a mean of 8.77 weeks ( P < .001), which was significantly lower compared with the Evans group ( P = .02). The SLCO group also had fewer nonunions ( P = .016). FAOS scores improved equivalently between the 2 groups. Lateral column pain, ability to exercise, and ambulation distance were similar between groups. Conclusion: Following SLCO, patients had faster healing times and fewer nonunions, similar outcomes scores, and equivalent correction of deformity. SLCO is a viable technique for lateral column lengthening. Level of Evidence: Level III, retrospective cohort study.

A Multicenter, Retrospective Evaluation of Tissue Stabilized-Guided Subcision in the Management of Cellulite

2018 ◽  
Vol 39 (8) ◽  
pp. 884-892 ◽  
Author(s):  
Andreas Nikolis ◽  
Kaitlyn M Enright ◽  
Sheetal Sapra ◽  
Julie Khanna
Keyword(s):  
Patient Satisfaction ◽  
Global Assessment ◽  
First Year ◽  
Level Of Evidence ◽  
Serious Adverse Events ◽  
3 Dimensional ◽  
Physician Review ◽  
Photographic Evidence ◽  
Scale Scores ◽  
Invasive Device

Abstract Background The first FDA-cleared, long-lasting, minimally invasive device for improving the appearance of cellulite was recently launched in Canada as a novel, tissue stabilized–guided subcision (TS-GS) system (Cellfina, Merz North America, Inc., Raleigh, NC). Clinicians from 2 of the first Canadian sites offering this procedure were interested in evaluating treatment efficacy and patient satisfaction after its first year on the market. Objectives The authors sought to evaluate the efficacy of TS-GS and the level of patient satisfaction associated with the procedure. Methods Medical charts of female patients treated with the TS-GS system in 2017 were retrospectively analyzed at 2 Canadian centers. Measurements at baseline and 3 months posttreatment were assessed for patient satisfaction and physician-rated efficacy. Patient satisfaction was assessed using a 5-point Likert-type scale, and efficacy was evaluated through physician review of 2-deminsional and 3-dimensional photography, the Nürnberger-Müller Scale for cellulite, and the Global Assessment of Improvement Scale. Results We reviewed 25 patient charts. At month 3, 95.6% of patients were satisfied with treatment results and physician evaluations revealed that on average, patients displayed a 1-point improvement in their cellulite grades. Moreover, Global Assessment of Improvement Scale scores indicated that all patients had visible improvement in the global appearance of cellulite. No serious adverse events were observed within 3 months postprocedure. Conclusions The physician ratings, patient satisfaction, and photographic evidence support the efficacy of the TS-GS system to manage grades 1 to 3 cellulite in women’s thighs and buttocks. These findings indicate the safety of the TS-GS system. Level of Evidence: 4

scholarly journals ADOLESCENT IDIOPATHIC SCOLIOSIS AND SIMILAR CONDITIONS: NEW TOOL TO MEASURE THE CORONAL PLANE

2018 ◽  
Vol 17 (4) ◽  
pp. 281-285
Author(s):  
Enguer Beraldo Garcia ◽  
Guilherme Brescia Payão ◽  
Liliane Faria Garcia ◽  
Enguer Beraldo Garcia Jr ◽  
Marcos Felipe Camarinha ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Postoperative Period ◽  
Central Line ◽  
Coronal Plane ◽  
Fixation Method ◽  
Preoperative Period ◽  
Level Of Evidence ◽  
Proximal Extension ◽  
The Difference ◽  
Third Line

ABSTRACT Objective: To create a method to measure the overall coronal plane of the spine, called the sacral clavicular angle (SCA). Methods: A line is drawn at the base of the sacrum; a second central line is drawn perpendicular to the first one in the proximal extension of the spine. A third line is drawn passing through the intersections of the superior points of the clavicles with the two second ribs, forming two angles, the greater of which is measured. Therefore, the degrees exceeding 90° are the SCA values. This tool was tested retrospectively in a study of 46 patients with idiopathic scoliosis who underwent short, apical, single or multiple fixations. Third generation instrumentation was used and the SCA was evaluated in the pre- and postoperative periods, which were compared with another group of 46 patients treated with the traditional technique. Results: Patients submitted to the traditional fixation method presented a median SCA of 3° in the preoperative period, and in the postoperative period, the SCA remained in 3°. Therefore, there was a 0% reduction. Patients submitted to short, apical, single or multiple fixation method presented a median preoperative SCA of 6°, and a postoperative median SCA of 1°, a reduction of approximately 83%. Conclusions: The group treated with short, apical, single or multiple instrumentation presented a reduction in the SCA of approximately 83% in the postoperative period compared to the preoperative period. The difference between preoperative and postoperative values was considered statistically significant. Level of Evidence II; Retrospective study.

scholarly journals Duration of smoking cessation for the prevention of surgical wound healing complications

2014 ◽  
Vol 48 (1) ◽  
pp. 170-176 ◽  
Author(s):  
Barbara Vieira Cavichio ◽  
Daniele Alcalá Pompeo ◽  
Graziella Allana Serra Alves de Oliveira Oller ◽  
Lídia Aparecida Rossi
Keyword(s):  
Wound Healing ◽  
Smoking Cessation ◽  
Tobacco Use ◽  
Latin American ◽  
Scientific Evidence ◽  
Perioperative Period ◽  
Caribbean Literature ◽  
Surgical Wound ◽  
Level Of Evidence ◽  
Tobacco Use Cessation

The study aimed to find scientific evidence about the duration of preoperative smoking cessation required to reduce surgical wound healing complications. An integrative review was performed in the databases, Latin American and Caribbean Literature on Health Sciences (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE), from 08/17/2012 to 09/17/2012, using the keywords: tobacco use cessation and wound healing; tobacco use cessation and preoperative period; tobacco use cessation and perioperative period (LILACS) and tobacco use cessation and perioperative period; tobacco use cessation and wound healing (MEDLINE). Out of the 81 eligible studies, 12 were included. The duration of smoking cessation needed to reduce healing complications was at least four weeks (four studies with level of evidence I, three studies with level of evidence II, two studies with level of evidence IV, and one study with level of evidence VII).

scholarly journals The Effect of Aloe Vera Extract to Extensive Lesion and Expression of Transforming Growth Factor (TGF-β) on Alkaline Chemical Trauma Cornea Model

2018 ◽  
Vol 1 (2) ◽  
pp. 1-17
Author(s):  
Fahcreza ◽  
Elsa Iskandar ◽  
Rachmat Hidayat ◽  
Petty Purwanita ◽  
Anang Tribowo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Wistar Rats ◽  
Aloe Vera ◽  
Control Group ◽  
Treatment Groups ◽  
White Rats ◽  
Significant Difference ◽  
The Difference ◽  
In Cells

Abstract Background: Chemical trauma to the cornea is an emergency condition of the eye that requires early diagnosis and good treatment. Alkaline have ability to saponify fatty acids in cells and cell membranes which can make penetration into the stroma and destroy proteoglycans and collagen in cells. Aloe vera (AV) contains several active substances that are reported to have anti-inflammatory, immunomodulatory, and wound healing effects. AV has been reported to accelerate the healing process of corneal epithelial defects by increasing fibroblast proliferation, collagen production and growth factor production. This study aims to determine the difference between the effect of aloe vera extract with a concentration of 10%, 20%, 40% and BSS on the healing of extensive corneal lesions in white wistar rats alkaline trauma models. Method: This study was an experimental study with a pre and posttest only with control group design in vivo approach to 30 Wistar white rats which were divided into 5 treatment groups for 3 days. Comparative analysis of effectiveness using the ANNOVA test or the Kruskal Wallis test and continued by the post hoc test. Results: Based on the one way ANOVA test there was a statistically significant difference in effectiveness between the five treatment groups on the percentage of corneal wound healing area and TGF-β expression with an assessment of p = 0,000 each. The administration of alloevera (AV) concentration of 20% had a significant difference in percentage of healing of corneal lesions and TGF-β expression compared with other treatment groups with p = 0,000 each. Large differences in the area of corneal lesions in the 40% AV group were -0.45 in the BBS group, 0.146 in the 10% AV group, 0.493 in the 20% AV group. The difference in the AV group 10% was 0.30 in the BBS group, -064 in the AV group 20%, and -0.14 in the AV group 40%. However, TGFβ expression in the normal control group that did not receive treatment was 54.94 (53.21-56-12). TGFβ levels in the BSS group were 10.44, the 10% aloe vera group was 25.43, 47.99 for the 20% aloe vera group and 37.95 for the 40% aloe vera group. Conclusion: There is a difference between the effect of aloe vera extract with concentrations of 10%, 20%, 40% and BSS on the extensive healing of corneal lesions in white wistar rats with alkaline chemical trauma models.

scholarly journals Perbedaan Penyembuhan Luka Pasca Ekstraksi Gigi Antara Pasien Perokok Dengan Bukan Perokok Di RSGM Unsrat

e-GIGI ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Lidia A. Kewo ◽  
Damajanty H.C. Pangemanan ◽  
Aurelia Supit
Keyword(s):  
Wound Healing ◽  
Tooth Extraction ◽  
Soft Tissues ◽  
P Value ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Inflammatory Phase ◽  
Significant Difference ◽  
The Difference ◽  
Cross Sectional Design

Abstract: To date, there are lots of documentations about the adverse effects of smoking on the oral cavity. Albeit, smoking is still considered as a casual thing in our community. Chemicals contained in the cigarette smoke can irritate the gums and soft tissues of the mouth, thus inhibiting wound healing after tooth extraction. This study was aimed to determine the difference in post-extraction dental wound healing between smokers and non-smokers. This was a comparative analytical study with a cross sectional design. Samples were obtained by using total sampling method. Subjects consisted of 16 smokers and 16 non-smokers that fulfilled the study eligibility criteria. Their oral cavities were examined to check the signs of inflammation (calor, dolor, rubor, tumor, and functio laesa). The results showed that there was a difference in post-extraction wound healing in inflammatory phase between smokers and non-smokers. As many as 9.4% of smoker patients and 34.4% of non-smoker patients recovered at 7 days post extraction. The Mann Whitney U test showed a p-value of 0.005. In conclusion, there was a significant difference in post-extraction wound healing between smokers and non-smokers.Keywords: smokers, non-smokers tooth extraction, wound healing Abstrak: Kebiasaan merokok bukan merupakan hal asing di masyarakat walaupun banyak dokumentasi mengenai akibat buruk dari merokok terhadap rongga mulut. Bahan kimia yang terdapat dalam asap rokok dapat mengiritasi gusi dan jaringan lunak mulut sehingga menghambat penyembuhan luka pasca ekstraksi gigi. Penelitian ini bertujuan untuk mengetahui perbedaan penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan bukan perokok. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Pengambilan sampel menggunakan total sampling yang memenuhi kriteria penelitian. Terdapat sebanyak 16 orang perokok dan 16 orang bukan perokok sebagai subyek penelitian. Pemeriksaan rongga mulut dilakukan untuk melihat tanda-tanda inflamasi (kalor, dolor, rubor, tumor, dan fungsio laesa). Hasil penelitian menunjukkan terdapat perbedaan penyembuhan luka 7 hari pasca ekstraksi gigi pada fase inflamasi antara pasien perokok dengan yang bukan perokok; sebanyak 9,4% pasien perokok dan 34,4% pasien bukan perokok yang sudah sembuh. Hasil uji Mann Whitney U mendapatkan nilai p=0,005. Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan yang bukan perokokKata kunci: perokok, bukan perokok, ekstraksi gigi, penyembuhan luka

scholarly journals Analysis of the Specificity, Sensitivity and Accuracy of Goniometry Method Compared to Tape Method for Measuring Trunk Mobility in Normal Adults

2021 ◽  
pp. 138-145
Author(s):  
Purvi Patel
Keyword(s):  
Range Of Motion ◽  
Standard Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Spine Mobility ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Normal Adults

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.

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