Long-term effects of toe transfers on the donor feet

2014 ◽  
Vol 39 (9) ◽  
pp. 966-976 ◽  
Author(s):  
T. Kotkansalo ◽  
P. Elo ◽  
T. Luukkaala ◽  
S. K. Vilkki
Keyword(s):  
Weight Bearing ◽  
Donor Site ◽  
Functional Testing ◽  
Long Term Effects ◽  
Cold Intolerance ◽  
Patient Reported ◽  
Functional Scores ◽  
First Ray

The purpose of this study was to assess the long-term consequences to the donor site of microvascular transfer of one or two toes. This was achieved retrospectively by patient-reported, clinician-based and functional testing. Weight-bearing radiographs were taken of both feet. Seventy-four patients (80 feet, 84 transferred toes) participated in this study. After a median of 16 years follow-up, most patients reported no or only minor complaints concerning the donor site. Cold intolerance and pain during exertion were the most commonly reported complaints. According to the two functional scores used, 92% of patients reported no or minor complaint and 83% of patients received a good result at the donor feet. Maintaining first ray alignment and avoiding early postoperative complications predicted a better outcome. Even though donor site ramifications should be expected after microvascular transfer of toes, patient satisfaction remains high.

scholarly journals Percutaneous Chevron Akin (Peca) Osteotomy for Treatment of Hallux Valgus Deformity: The Long- Term Results

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0007
Author(s):  
Peter W. Robinson ◽  
Robbie Ray ◽  
Thomas A. Goff ◽  
Paul M. Dearden ◽  
Clare Watt ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Patient Reported Outcome Measures ◽  
Long Term Results ◽  
Consecutive Series ◽  
Satisfaction Scale ◽  
Hallux Valgus Deformity ◽  
Patient Reported

Category: Bunion Introduction/Purpose: Little is known about the long-term results of percutaneous hallux valgus correction, particularly the recurrence rate and factors leading to recurrence. Methods: We retrospectively reviewed a single surgeon consecutive series of percutaneous chevron and akin osteotomies (PECA) performed between 2012-14 on 127 feet in 86 patients. Mean age was 52+-13 years at surgery and mean follow up (FU) was 69+-7 months. Patient reported outcome measures (PROMs) were completed by 65 patients (MOXFQ, VAS pain (0-100)) and Likert satisfaction scale by 86 patients. Pre-operative, 6 month and final follow up weight bearing radiographs were available for 68 feet. Radiological parameters measured were the hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA). The data was normally distributed and presented as mean+-SD. Paired t-test was used to compare pre- and post-operative angles. Ordinal logistic regression was used to test for significant dependent variables on PROMs. Results: Mean MOXFQ was 10+-16 and mean VAS pain was 6+-13 out of 100 at a mean FU of 69+-7 months. 99% (85/86) patients were highly satisfied or satisfied. Mean HVA improved from 28.3+-8.1º to 8.4+-5.6º at final FU (p<0.001). No clinically relevant difference in HVA was seen between 6 months and final FU. Mean IMA improved from 12.7+-2.9º to 6.2+-2.7º at final FU (p<0.001). 2.9% (2/68) had an HVA >20º at final FU, these both started with a pre-operative HVA >40°. Pre-operative HVA >40º was significantly more likely to have an HVA >20º at final FU than those with pre-operative HVA <40º (22% vs 0%, p<0.001). There were 5 re-operations for removal of screws. 1 foot had hallux varus, but was still satisfied. Conclusion: The 5 year results for PECA hallux valgus correction show high levels of patient satisfaction, function and pain relief, with low complication and re-operation rates. Radiological correction is maintained at long term FU.

scholarly journals Case Report

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. NP38-NP40 ◽  
Author(s):  
Sanjay Naran ◽  
Joseph E. Imbriglia
Keyword(s):  
Case Report ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
No Donor ◽  
Metacarpophalangeal Joints ◽  
Active Function ◽  
Patient Reported ◽  
Long Term Follow Up

Background: A case is discussed in which a young girl was born with symbrachydactyly of multiple digits in whom nonvascularized proximal toe phalanges were transferred to the aphalangic digits at the age of four. At 39 years of age, she presented incidentally to our clinic and was observed to have a very functional hand with mobile metacarpophalangeal joints in all reconstructed digits. Methods: We present a case report which is discussed in the context of long-term follow-up, and phalangeal growth in the absence of distraction, and a review of the current literature in regards to outcomes for this modality of treatment. Results: We document growth of the transplanted phalanges, despite surgery occurring after the reported optimum age of before 18 months, and the patient not undergoing distraction. The patient reported no donor site morbidity in regards to function or psychosocial impact. Furthermore, we observed active function at the metacarpophalangeal joints of all operated digits. Conclusions: We report the longest follow-up (35 years) following nonvascularized proximal toe phalangeal transfer for short finger type symbrachydactyly. We highlight the long-term functional outcome of nonvascularized toe phalangeal transfers, and present an overview of the current outcome literature for this type of procedure, advocating that nonvascularized toe phalangeal transfers remain a viable treatment option for select cases of symbrachydactyly.

Survivorship after lower gastrointestinal cancer: Patient reported outcomes and planning for care.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 695-695
Author(s):  
Melissa Frick ◽  
Carolyn Vachani ◽  
Margaret K. Hampshire ◽  
Christina Bach ◽  
Karen Arnold-Korzeniowski ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Cancer Survivors ◽  
Anal Cancer ◽  
Patient Reported Outcomes ◽  
Long Term Effects ◽  
Gi Cancer ◽  
Patient Reported ◽  
Radiation Induced

695 Background: There is significant need for quality follow-up care to optimize long-term outcomes for the growing population of lower gastrointestinal (GI) cancer survivors. Patient-reported outcomes (PROs) provide valuable information regarding late- and long-term effects. Methods: Using a convenience sample from 1,129 colon, rectal and anal cancer survivors (n=792, 218, and 119, respectively) who utilized an Internet-based survivorship care plan (SCP) tool, we examined patient-reported demographics, treatment, and toxicity data. Responses from a follow-up survey were reviewed. Results: Median age of diagnosis was 51 years and median current age was 54 years. 81% of respondents were Caucasian and 58% were female. The most commonly reported late- and long-term effects for all survivors were neuropathy (65%), fatigue (56%), cognitive changes (49%), changes in GI function (43%), sexual dysfunction (22% in males, 43% in females), and radiation-induced dermatologic effects including changes in color/texture of skin (39%) and loss of flexibility in radiated areas (31%). The prevalence of these effects varied with length of time since treatment and treatment modality. Anal cancer patients reported a high prevalence of sexual dysfunction and radiation-induced dermatologic effects. Over 87% of users reported satisfaction levels of "good" to "excellent" using this tool, and 69% reported they intend to share SCP with their healthcare team. Conclusions: For lower GI cancer survivors, it is feasible to obtain PROs from an Internet-based survivorship tool. Survivors report a wide spectrum of late- and long-term side effects, which can be used to inform counseling at time of diagnosis, as well as help anticipate and respond to disease- and treatment-related sequelae during follow-up. We are among the first to report on PROs in anal cancer survivors. Further investigation on the impact of SCPs on healthcare communication and use is needed.

scholarly journals Patient-reported Outcome Measures After Hospitalization During the COVID-19 Pandemic, a Survey Among COVID-19 and Non-COVID-19 Patients.

2021 ◽  
Author(s):  
Matan Elkan ◽  
Ayana Dvir ◽  
Ronit Zaidenstein ◽  
Maly Keller ◽  
Dana Kagansky ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Medical Center ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Patient Reported ◽  
Related Quality

Abstract Background: Many people recovering from COVID-19 suffer from long-term sequelae. The objective of this study was to assess health-related quality of life (HRQoL) in COVID-19 patients a few months after discharge. Methods: We conducted a retrospective cross-sectional case-control study on COVID-19 and non-COVID-19 pneumonia patients admitted to Shamir Medical Center, Israel (03-07/2020). In the months following discharge, patients were invited to participate in a survey and fill the RAND-36 questionnaire. Patient's characteristics and comorbidities were extracted from electronic charts. Results: Among 66 COVID-19 participants, the median age was 58.5 (IQR 49.8-68.3), 56.1% were female, and more than a third were obese (36.4%). The median length of stay was 7 days (IQR 4-10). Patient-reported outcome measures were reported at a median follow-up of 9-months (IQR 6-9). Pain, general health, vitality, and health change had the lowest scores (67.5, 60, 57.5, and 25 respectively). Matching to patients hospitalized with pneumonia due to other pathogens was performed on 42 of the COVID-19 patients. Non-COVID-19 patients were more frequently current or past smokers (50% vs 11.9%, p<0.01) and suffered more often from chronic lung disease (38.1% vs 9.5%, p=0.01). The score for health change was significantly lower in the COVID-19 group (25 vs 50, p<0.01). Conclusions: Post COVID-19 patients continue to suffer from an assortment of symptoms and perceive a deterioration in their health many months after hospitalization. This emphasizes the importance of prolonged medical follow-up in this population, and the need for additional research to better understand this novel's disease long-term effects.

scholarly journals Internal Fixation of Osteochondritis Dissecans of the Knee Leads to Good Long-Term Outcomes and High Degree of Healing without Differences between Fixation Devices

2019 ◽  
Vol 8 (11) ◽  
pp. 1934 ◽  
Author(s):  
Simone Perelli ◽  
Agustín Rubén Molina Romoli ◽  
Matías Costa-Paz ◽  
Juan Ignacio Erquicia ◽  
Pablo Eduardo Gelber ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Osteochondritis Dissecans ◽  
Second Look ◽  
Fixation Devices ◽  
Patient Reported ◽  
Functional Scores ◽  
High Degree ◽  
Radiographic Union

The aim of the present study is to describe results at long-term follow-up of internal fixation of unstable Osteochondritis Dissecans (OCD) achieved with three different fixation devices in skeletally mature knees. A retrospective cohort study was performed at 5 to 19 years follow-up. Patient-reported questionnaires were collected at the final follow-up. Postoperative X-rays and MRIs were evaluated for healing of the lesion and articular degeneration. An arthroscopic second look was performed in 74.3% of the cases. Failures were reported as reintervention to address the osteochondral lesion or poor functional outcomes at the last follow-up. A total of 39 subjects with a median follow-up of 10.7 years were included. Herbert screws were used in 51.2% of the cases, bioabsorbable nails in 25.7% of the cases and cannulated screws in 23.1% of the cases. No differences were observed in terms of the clinical score (International Knee Documentation Committee (IKDC) p = 0.211; Lysholm p = 0.197), radiographic union (p = 0.102) or radiographic degeneration (p = 0.238) between the three different fixation devices. Arthroscopic second look found complete stability of the lesions in all 29 cases evaluated. The mean postoperative Lysholm score was 83 (range = 33–100) and IKDC score was 79 (range = 39–100). Radiographic union was seen in 74% of the cases. Lack of radiographic union was correlated with worst functional scores. A failure rate of 20.5% was found: four reinterventions were performed, and four patients had poor scores at last follow up. This study shows that internal fixation of condylar OCD in skeletally mature patients provides good long-term clinical results and a high degree of healing regardless of the dimensions of the lesion and type of fixation.

scholarly journals The course of subjective and objective chemosensory dysfunction in hospitalized patients with COVID-19: a 6-month follow-up

2021 ◽  
Author(s):  
Mattis Bertlich ◽  
Clemens Stihl ◽  
Enzo Lüsebrink ◽  
Johannes C. Hellmuth ◽  
Clemens Scherer ◽  
...  
Keyword(s):  
Long Term Effects ◽  
Initial Examination ◽  
Initial Cohort ◽  
Negative Controls ◽  
Chemosensory Function ◽  
Analogue Scales ◽  
Smell Identification ◽  
Snot 22

Abstract Purpose It has been established that the infection with SARS-CoV-2 may cause an impairment of chemosensory function. However, there is little data on the long-term effects of SARS-CoV-2 infection on chemosensory function. Methods Twenty three SARS-CoV-2-positive patients diagnosed in spring 2020 with subjective hyposmia (out of 57 positive patients, 40.3%) were compared to SARS-CoV-2-positive patients without hyposmia (n = 19) and SARS-CoV-2-negative patients (n = 14). Chemosensory function was assessed by the Brief Smell Identification Test (BSIT), Taste Strips (TS), Visual Analogue Scales (VAS), and the SNOT-22. The initial cohort with hyposmia were also examined at 8 weeks and 6 months after initial examination. Results There were no differences between the SARS-CoV-2-positive cohort without hyposmia and negative controls in terms of BSIT (8.5 ± 2.6 vs. 10.2 ± 1.8), TS (3.4 ± 0.6 vs. 3.9 ± 0.3) or VAS (2.1 ± 1.3 vs. 1.1 ± 0.5); yet the SNOT-22 was significantly elevated (27.7 ± 11.2 vs. 16.4 ± 10.8). The SARS-CoV-2-positive group with hyposmia performed significantly poorer in BSIT (4.0 ± 1.7 vs. 8.5 ± 2.6/10.2 ± 1.8), TS (2.6 ± 1.3 vs. 3.4 ± 0.6/3.9 ± 0.3), and VAS (7.9 ± 2.2 vs. 2.1 ± 1.3/1.1 ± 0.5) compared to both control groups. At week 8 and month 6 control, six and five patients, respectively, still suffered from subjectively and objectively impaired chemosensory function. The other patients had recovered in both respects. Conclusion SARS-CoV-2 patients with subjectively impaired chemosensory function regularly perform poorly in objective measurements. About 70% of patients suffering from olfactory dysfunction in SARS-CoV-2 quickly recover—the rest still suffers from considerable impairment 6 months after infection.

scholarly journals Long-term effects of a modified, low-protein infant formula on growth and body composition: Follow-up of a randomized, double-blind, equivalence trial

2021 ◽  
Author(s):  
Stefanie M.P. Kouwenhoven ◽  
Nadja Antl ◽  
Martijn J.J. Finken ◽  
Jos W.R. Twisk ◽  
Eline M. van der Beek ◽  
...  
Keyword(s):  
Body Composition ◽  
Infant Formula ◽  
Long Term Effects ◽  
Double Blind ◽  
Equivalence Trial ◽  
Low Protein

scholarly journals Long-term effects of the Dutch Schoolgruiten Project – promoting fruit and vegetable consumption among primary-school children

2009 ◽  
Vol 12 (8) ◽  
pp. 1213-1223 ◽  
Author(s):  
Nannah I Tak ◽  
Saskia J te Velde ◽  
Johannes Brug
Keyword(s):  
Primary School ◽  
Vegetable Consumption ◽  
Primary School Children ◽  
Secondary Outcome ◽  
Fruit Intake ◽  
Long Term Effects ◽  
Intervention Effects ◽  
Parent Reports

AbstractObjectivesTo evaluate the long-term effects of the Schoolgruiten Project, a Dutch primary school-based intervention providing free fruit and vegetables (F&V). In addition, we assessed whether children’s appreciation of the project mediated these intervention effects.Design and methodsParticipating schoolchildren (mean age 9·9 years at baseline) and their parents completed parallel questionnaires at baseline, at 1-year and at 2-year follow-up, including questions on usual F&V intake of the child, potential behavioural determinants, their appreciation of the project and general demographics. Primary outcomes were usual F&V intakes as assessed by parent and child self-reported food frequency measures. Secondary outcome measures were taste preference, knowledge of daily recommendations, availability and accessibility for fruit intake. Multilevel linear regression analyses were used to assess differences at second follow-up adjusted for baseline values between control and intervention groups.SubjectsReports were available for 346 intervention children (148 parents) and 425 control children (287 parents).ResultsBoth child and parent reports indicated that the intervention group had a significantly higher fruit intake at 2-year follow-up (difference, servings/d: 0·15; 95 % CI 0·004, 0·286 for child reports; 0·19; 95 % CI 0·030, 0·340 for parent reports). No significant effects on vegetable intake were observed. Significant positive intervention effects were also found for knowledge of fruit recommendations among boys. Some evidence was found for partial mediation analyses of the effects on fruit intake.ConclusionThe present study indicates that the Schoolgruiten scheme was effective in increasing children’s fruit intake and that appreciation of the project partially mediated this effect.

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