Technique Tip: Single-Incision Endoscopic Plantar Fasciotomy

2016 ◽  
Vol 10 (3) ◽  
pp. 240-241
Author(s):  
Zachary M. Thomas ◽  
Kristin J. Thomas
Keyword(s):  
Surgical Technique ◽  
Expert Opinion ◽  
Plantar Fasciitis ◽  
Single Incision ◽  
Smooth Transition ◽  
New Technique ◽  
Foot And Ankle ◽  
Levels Of Evidence ◽  
Evidence Level ◽  
Plantar Fasciotomy

Two-incision endoscopic plantar fasciotomy (EPF) is an accepted surgical technique in the treatment of recalcitrant plantar fasciitis. Single-incision plantar fasciotomy is a relatively new technique in the surgeons’ armamentarium; however, it is not without pitfalls, specifically poor visualization. This article aims to help the foot and ankle surgeon make a smooth transition from 2-incision EPF to single-incision EPF while maintaining optimum visualization. Levels of Evidence: Level V: Expert opinion

scholarly journals The Virtual Foot and Ankle Physical Examination

2020 ◽  
Vol 41 (8) ◽  
pp. 1017-1026
Author(s):  
Stephanie K. Eble ◽  
Oliver B. Hansen ◽  
Scott J. Ellis ◽  
Mark C. Drakos
Keyword(s):  
Physical Examination ◽  
Expert Opinion ◽  
Orthopedic Surgery ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Patient Instruction ◽  
Evidence Level ◽  
Virtual Visits ◽  
Routine Physical Examination

The COVID-19 pandemic has necessitated a rapid and drastic shift for clinicians and patients away from traditional in-person visits and toward internet-based virtual visits. The adoption of telehealth services is likely to persist in some capacity even as in-person visits resume, given the convenience and efficiency of telehealth consultations for patients and perhaps surgeons. A primary challenge of virtual visits, particularly in the field of orthopedic surgery, is the physical examination. However, for the foot and ankle, routine physical examination maneuvers can be completed virtually with little modification given proper patient instruction. We present a comprehensive virtual foot and ankle examination for telehealth visits, including instructions that can be provided to patients verbatim and a corresponding checklist for provider documentation. Level of Evidence: Level V, expert opinion.

Gunshot-Related Injuries to the Foot & Ankle: Review Article

2020 ◽  
Vol 41 (4) ◽  
pp. 486-496 ◽  
Author(s):  
Tyler Gonzalez ◽  
Jorge Briceno ◽  
Brian Velasco ◽  
Philip Kaiser ◽  
Derek Stenquist ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Current Literature ◽  
Scientific Literature ◽  
Review Article ◽  
The Body ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Evidence Level

Gunshot-related injuries remain a significant and important cause of global morbidity and cost. The foot and ankle has certain anatomic and functional considerations that make gunshot-related injuries challenging to manage. While the scientific literature regarding gunshot-related injuries is extensive, little of the existing literature focuses on the foot and ankle. While principles of management can be somewhat extrapolated from the current literature, an understanding of the body of work specific to the foot and ankle is valuable. Therefore, this review provides an overview of ballistic injuries to the foot and ankle as well as specific guidelines to aid surgeons in treating these difficult injuries. Level of Evidence: Level V, expert opinion.

The Mini C-Arm Sock: A Novel and Simple Technique for Draping to Prevent Contamination and Penetration

2019 ◽  
Vol 12 (4) ◽  
pp. 380-381
Author(s):  
Bonnie Y. Chien ◽  
Matthew D’Antuono ◽  
Christopher W. DiGiovanni
Keyword(s):  
Simple Technique ◽  
Foot And Ankle ◽  
Levels Of Evidence ◽  
Evidence Level ◽  
Ankle Surgery ◽  
Surgical Field

The mini C-arm is frequently used in foot and ankle surgery. However, its continuous manipulation introduces potential means of contaminating the sterile surgical field. A simple and effective draping technique of the mini C-arm is described to minimize risk of contamination and sharps penetration that can damage the C-arm. Levels of Evidence: Level V

Surgical Treatment of Severe Hallux Abductovalgus With Dislocation of the First Metatarsophalangeal Joint: A Case Presentation and Surgical Technique

2019 ◽  
Vol 12 (3) ◽  
pp. 281-285 ◽  
Author(s):  
Kevin Tootle ◽  
JennaLou Hollnagel ◽  
Kyle Kinmon
Keyword(s):  
Rheumatoid Arthritis ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Case Presentation ◽  
Levels Of Evidence ◽  
Evidence Level

Severe hallux abductovalgus deformity with dislocation and contracture at the first metatarsophalangeal joint is difficult to manage, especially in the presence of concomitant, long-standing rheumatoid arthritis. This article highlights a novel surgical technique that may be used to successfully address this challenging condition while minimizing the likelihood of complications. Levels of Evidence: Level IV

Getting the Starting Point Right: Prevention of Skiving and Fibular Cortical Breach During Suture Button Placement for Syndesmotic Ankle Injuries

2020 ◽  
Vol 13 (4) ◽  
pp. 351-355
Author(s):  
Philip B. Kaiser ◽  
Patrick Cronin ◽  
Derek S. Stenquist ◽  
Christopher P. Miller ◽  
Brian T. Velasco ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Expert Opinion ◽  
Screw Fixation ◽  
Hardware Removal ◽  
Ankle Injuries ◽  
Illustrative Case ◽  
Levels Of Evidence ◽  
Suture Button ◽  
Evidence Level ◽  
Starting Point

The use of suture button (SB) devices in the treatment of syndesmotic ankle injuries is increasing. These constructs have demonstrated better syndesmotic reduction, improved clinical outcomes, and lower rates of hardware removal compared with screw fixation. However, placing a SB device without a fibular plate can be technically challenging. In this technique tip, we use an illustrative case to demonstrate a technique tip that minimizes the risk of anterior or posterior cortical breach of the fibula and helps facilitate more accurate placement of a SB device. Levels of Evidence: Level V: Expert opinion

scholarly journals Experience of Using Telehealth for Foot and Ankle Examination During The SARS-COV-2 Crisis

2021 ◽  
pp. 193864002110093
Author(s):  
Su Ryeon Jeong ◽  
Shangzhe George Lin ◽  
Paul Hamilton ◽  
Andrea Sott ◽  
Sohail Yousaf
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Foot And Ankle ◽  
Orthopaedic Practice ◽  
Future Role ◽  
Social Distancing ◽  
Levels Of Evidence ◽  
Evidence Level ◽  
The Future

The era of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is rapidly evolving. To comply to the guidelines for social distancing and reducing travel to prevent the spread of disease, many centers made rapid adjustments to conduct follow-up appointments through telehealth mediums. We explore our center’s adaptation to the pandemic, reflecting on how we formulated telehealth clinics for our patients. We share our experience, discuss the challenges encountered, the feedback received, as well as consider the future role of telehealth in everyday orthopaedic practice. Levels of Evidence: Level V

scholarly journals Outcomes of plantar fasciotomy to treat plantar fasciitis

2019 ◽  
Vol 13 (1) ◽  
pp. 42-48
Author(s):  
Rodrigo Guimarães Huyer ◽  
Cíntia Kelly Bittar ◽  
Carlos Daniel Candido de Castro Filho ◽  
Carlos Augusto Mattos ◽  
Mário Sérgio Paulillo De Cillo ◽  
...  
Keyword(s):  
Plantar Fasciitis ◽  
Case Series ◽  
Treatment Level ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Patient Health ◽  
Plantar Fasciotomy

Objective: This study sought to evaluate the effectiveness of a surgery (plantar fasciotomy) to treat plantar fasciitis using the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire. Methods: Patients were retrospectively identified using their postoperative orthopedic (medical) records after receiving medial plantar fasciotomy for plantar fasciitis between 1997 and 2009. Results: A significant difference was observed between the pre- and postoperative AOFAS score; this result indicates that patient health improved after the fasciotomy to treat plantar fasciitis. Conclusions: A strength of this study was its long follow-up time of patients undergoing plantar fasciotomy to treat plantar fasciitis. This surgery is indicated for patients with chronic plantar fasciitis after 6 months without response to conservative treatment. Level of Evidence IV; Therapeutic Studies; Case Series.

Use of Small-Pin Distraction and Low-Speed, High-Torque Burring for Talar Osteochondral Allografts: Technique Tip

2021 ◽  
pp. 107110072110031
Author(s):  
Ryan O’Leary ◽  
Ian M. Foran ◽  
David J. Dalstrom
Keyword(s):  
Expert Opinion ◽  
Level Of Evidence ◽  
Low Speed ◽  
Evidence Level ◽  
High Torque ◽  
Osteochondral Allografts

Level of Evidence: Level V, expert opinion.

scholarly journals Telemedicine Foot and Ankle Visits in the COVID-19 Era

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142199406
Author(s):  
Sameh A. Labib ◽  
Rahul Goel ◽  
Wesley Manz ◽  
Jason Bariteau
Keyword(s):  
Patient Experience ◽  
Expert Opinion ◽  
Foot And Ankle ◽  
Office Visits ◽  
Level Of Evidence ◽  
Excellent Care ◽  
Musculoskeletal Care

Background: The COVID-19 pandemic created a difficult environment to provide musculoskeletal care to patients with foot and ankle pathology given the limitations placed on in-office visits. Telemedicine offered a unique avenue to reach these patients; however, the efficacy of telemedicine visits in patients with foot and ankle pathology is not well studied. We propose a telemedicine protocol that has allowed us to effectively see and treat patients with foot and ankle pathology. Methods: A 12-step standardized telemedicine protocol was created within the Foot and Ankle division that was used for seeing patients through telemedicine. Also included in this is previsit preparation and follow-up recommendations. Press Ganey surveys were retrospectively reviewed to understand patient experience with telemedicine. Results: 85.2% of patients surveyed responded with scores indicating excellent care. When comparing patients who were seen in-office and through telemedicine, 89.2% and 83.4% responded with scores indicating excellent care, respectively ( P = .37). Conclusion: Telemedicine offers an effective and convenient way to provide excellent musculoskeletal care to patients affected with foot and ankle pathology. This is the first study that evaluated a comprehensive protocol for telemedicine encounters and can be used to implement telemedicine by others using this approach. Level of Evidence: Level V, expert opinion.

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

2019 ◽  
Vol 41 (2) ◽  
pp. 187-192
Author(s):  
Ricardo E. Colberg ◽  
Monte Ketchum ◽  
Avani Javer ◽  
Monika Drogosz ◽  
Melissa Gomez ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Plantar Fasciitis ◽  
Case Series ◽  
Successful Outcome ◽  
Oral Steroid ◽  
Tarsal Tunnel ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

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