Recurrence Rate After Wide Resection of Plantar Fibromatosis: A Case Series and Systematic Literature Review

2021 ◽  
pp. 193864002110320
Author(s):  
Helen Anwander ◽  
Florian Weichsel ◽  
Jennifer Cullmann ◽  
Angela Seidel ◽  
Annabel Hayoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Recurrence Rate ◽  
Case Series ◽  
Local Resection ◽  
Wide Resection ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
American Orthopaedic ◽  
Plantar Fibromatosis

Background The aim was to assess the recurrence rate and clinical outcome after wide resection for plantar fibromatosis. Methods A total of 12 patients, 2 to 13 years after wide resection, were assessed for local and magnetic resonance imaging tomographic signs of recurrence at the clinical follow-up. In addition, a systematic review of the literature was conducted. Results After 7.8 years (2-13), 2 patients (17%) suffered a recurrence. At the last follow-up, median Foot Functional Index was 1 (0-66) and American Orthopaedic Foot and Ankle Society score was 95 (44-100). Six studies with 109 feet (92 patients) were included in the systematic review. The recurrence rate depends on the width of the resection: 67% after local resection, 42% after wide resection, and 27% after fasciectomy. Conclusion In patients with symptomatic plantar fibromatosis, we recommend a wide resection or fasciectomy over a local resection because of the inferior recurrence rate. Levels of Evidence Level IV: Retrospective case series

scholarly journals Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

2021 ◽  
Author(s):  
Gabriele Colo’ ◽  
Mattia Alessio Mazzola ◽  
Giulio Pilone ◽  
Giacomo Dagnino ◽  
Lamberto Felli
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Deformity Correction ◽  
Tibialis Posterior ◽  
Open Wedge ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

A 10-min novel technique for involutional entropion: Mini-incisional continuous ligation everting sutures

2021 ◽  
pp. 112067212110500
Author(s):  
Yong M Choi ◽  
Namju Kim
Keyword(s):  
Recurrence Rate ◽  
Surgical Outcome ◽  
Case Series ◽  
Interquartile Range ◽  
Retrospective Case ◽  
Novel Technique ◽  
Time To Recurrence ◽  
Involutional Entropion ◽  
Surgical Modality

Purpose To introduce a novel technique of mini-incisional continuous ligation everting sutures for correction of involutional entropion and report the surgical outcome. Methods A retrospective case series. Eighty-five eyelids of 77 patients who underwent correction of involutional lower lid entropion using mini-incisional continuous ligation everting sutures were included in this study. The medical records of patients with at least 24 months of follow-up after surgery were reviewed. We collected information on demographic and clinical characteristics, including sex, age at surgery, duration of follow-up, horizontal lid laxity, surgical outcomes, and complications. Main outcome measures were success of surgery, recurrence rate, time to recurrence, and risk factors for recurrence. Results The median (interquartile range) age at the time of surgery was 72.0 (65.5–78.0) years and the median (interquartile range) follow-up duration was 24.0 (24.0–42.5) months. Thirty-seven eyelids (43.5%) showed horizontal eyelid laxity on a lid distraction test The surgical outcome was successful in the majority of patients (94.1%) with a recurrence rate of 5.9% in the 2 years after surgery. Only female sex was significantly correlated with recurrence of entropion (odds ratio 9.466, 95% confidence interval 1.022 to 87.670, P  =  0.048). Conclusion This novel technique is a promising surgical modality for correction of lower lid involutional entropion because of its ease of application, simplicity, compatibility with anticoagulants, and low recurrence rate.

Efficacy of Calcaneus Osteotomy for Treatment of Symptomatic Müller-Weiss Disease

2016 ◽  
Vol 38 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Shu-Yuan Li ◽  
Mark S. Myerson ◽  
Manuel Monteagudo ◽  
Ernesto Maceira
Keyword(s):  
Case Series ◽  
Stage Iv ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Vas Score ◽  
Calcaneal Osteotomy ◽  
Alternative Treatment Option ◽  
American Orthopaedic ◽  
Hindfoot Arthrodesis

Background: Various methods of midfoot and hindfoot arthrodesis for treating symptomatic Müller-Weiss disease (MWD) have been reported in the literature. In this study, we present the results of a previously unreported method of treatment using a calcaneal osteotomy incorporating a wedge and lateral translation. Methods: Thirteen patients (14 feet) with MWD were treated with a calcaneal osteotomy and retrospectively reviewed. These included 7 females and 6 males, with an average age of 56 years (33-79 years), and an average symptoms duration of 10.6 years (1-16 years). The disease was staged according to Maceira, which included 5 feet in stage II, 4 feet in stage III, 4 feet in stage IV, and 1 foot in stage V. Pre- and postoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS), radiologic examination, and patients’ satisfaction rate of the surgery were evaluated at an average of 3.7 years (range, 1-8.5 years) following surgery. Results: The final follow-up visit showed satisfactory outcomes, with VAS score reducing from the preoperative 8 (7-9) to postoperative 2 (0-4), whereas the AOFAS score improved from the preoperative 29 (20-44) to the postoperative 79 (70-88). The patient’s subjective ratings showed excellent results in 4 feet, good results in 8 feet, and fair outcomes in 2 feet. The hindfoot range of motion remained unchanged, as did the extent of the navicular complex arthritis, and no patient required an arthrodesis since surgery. Conclusion: A calcaneal osteotomy can be used as an alternative treatment option for selected MWD patients regardless of the radiologic stage of the disease. Level of Evidence: Level IV, retrospective case series.

Use of Local Flaps for Soft-Tissue Closure in Diabetic Foot Wounds: A Systematic Review

2018 ◽  
Vol 12 (3) ◽  
pp. 286-293 ◽  
Author(s):  
Crystal L. Ramanujam ◽  
Thomas Zgonis
Keyword(s):  
Systematic Review ◽  
Diabetic Foot ◽  
English Language ◽  
Wound Closure ◽  
Revisional Surgery ◽  
Data Extraction ◽  
Case Series ◽  
Cochrane Library ◽  
Retrospective Case

“A systematic review was undertaken to assess the outcomes of local random flaps in diabetic foot wound closure. The review was conducted using the following databases: Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Excerpta Medica dataBASE, Google Scholar, MEDLINE, Ovid, and PubMed. Search terms were local random flap, diabetes, foot, wound, ulceration, neuropathy, tissue transfer, V-Y, bilobed, monolobed, rotational, advancement, transpositional, rhomboid, and Limberg. English language studies, studies published from 1997 to 2017, patients with diabetes mellitus treated for foot wounds, use of local random flaps, follow-up period of 6 months or more postoperatively, documentation of healing rates, complications, and need for revisional surgery were included. Isolated literature reviews and descriptions of only surgical technique and/or cadaveric studies were excluded. The initial search identified 53 eligible studies with 28 being excluded. The remaining 25 studies used for data extraction had a total of 512 patients in which 199 of these underwent 204 local random flap procedures. Average follow-up for the flaps was approximately >2 years, and successful wound closure at last follow-up was demonstrated in 75.5% of the studied population. Studies were found to be of generally low quality, with the majority composed of retrospective case series. Based on current available evidence found in this systematic review, local random flaps demonstrated a relatively high success rate when utilized for the definitive closure of diabetic foot wounds. However, because of a lack of high-quality evidence and substantial heterogeneity among the studies, the results should be interpreted with caution. Levels of Evidence: Level III: Systematic review

Percutaneous Bunionette Correction: Retrospective Case Series

2020 ◽  
pp. 193864002093750
Author(s):  
Gustavo Nunes ◽  
Tiago Baumfeld ◽  
Caio Nery ◽  
Daniel Baumfeld ◽  
Paulo Carvalho ◽  
...  
Keyword(s):  
Case Series ◽  
Distal Region ◽  
Pain Scale ◽  
Invasive Technique ◽  
Visual Analogue Pain Scale ◽  
Retrospective Case ◽  
Visual Analogue Pain ◽  
Significant Difference ◽  
American Orthopaedic

Introduction. Bunionette is a deformity of the fifth metatarsal in which there is a painful lateral bony prominence of the distal region of this bone caused by various anatomical and biomechanical changes. The aim of this study is to report on a minimally invasive technique without the use of hardware to treat these deformities. Methods. This is a case series of 18 patients, 25 feet, who underwent bunionette percutaneous surgical treatment. All patients answered the American Orthopaedic Foot and Ankle Society (AOFAS) scale and the visual analogue pain scale (VAS) preoperatively and at the last follow-up. Standard radiological evaluation included measurement of intermetatarsal (4-5 IMA) and fifth toe metatarsophalangeal (5-MTTP) angles. Time to radiographic consolidation, complications, and satisfaction rate were also documented. Results. The average follow-up was 15.9 months, the AOFAS increased from 49.6 to 92.4 and the VAS decreased from 7.7 to 1.2. It was observed that average 5-MTTP decreased from 15° to 2.7° and that 4-5-IMA decreased from 9.1° to 3.3°. These outcomes showed a statistically significant difference ( P < .001). The most common observed complication was the formation of a hypertrophic bone callus in the third postoperative month in three operated feet (12%). One patient had algodystrophy, which improved after conservative treatment. There were no cases of infection, neuropraxis, or recurrences. Fifteen patients rated the result as excellent, 2 as good, and 2 as regular. Conclusion. Percutaneous osteotomy of the fifth metatarsal without the use of hardware is a safe, reproducible technique and presents good clinical and radiographic results for the treatment of bunionette. Levels of Evidence: Therapeutic studies, Level IV: Case series

Mid-Term Outcome of Talocalcaneal Coalition Treated with Interposition of a Pedicle Fatty Flap After Resection

2012 ◽  
Vol 33 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Yukari Imajima ◽  
Masato Takao ◽  
Wataru Miyamoto ◽  
Shinji Imade ◽  
Hideaki Nishi ◽  
...  
Keyword(s):  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Talocalcaneal Coalition ◽  
A New Technique ◽  
Final Followup ◽  
American Orthopaedic

Background: We have previously reported a new technique to treat symptomatic talocalcaneal coalition. The purpose of the present study was to evaluate the mid-term outcome of the interposition of a pedicle fatty flap after the resection of a talocalcaneal coalition. Methods: Six feet of 5 patients with persistently symptomatic talocalcaneal coalition were treated with this method. We investigated the clinical outcome using the visual analog scale (VAS) for hindfoot pain including around coalition and the American Orthopaedic Foot and Ankle Society (AOFAS) score pre- and postoperatively, and investigated whether or not recurrence was present using computed tomography (CT) at the final followup. Results: The VAS score was significantly improved from 5.5 ± 1.0 (mean ± SD) to 9.7 ± 0.5 points ( p = 0.0006). The AOFAS hindfoot score was also improved significantly (from 73.3 ± 26.7 points to 96.7 ± 7.1 points). No recurrence was detected by CT at the final followup. Conclusion: The interposition of a pedicle fatty flap after resection has been a durable procedure for treating a symptomatic talocalcaneal coalition. Level of Evidence: IV; Retrospective Case Series

scholarly journals Clinical and Radiological Outcomes of Operative Therapy in Insertional Achilles Tendinopathy With Debridement and Double-Row Refixation

2021 ◽  
pp. 107110072110028
Author(s):  
Fabian Greiner ◽  
Hans-Jörg Trnka ◽  
Michel Chraim ◽  
Elena Neunteufel ◽  
Peter Bock
Keyword(s):  
Case Series ◽  
Operative Therapy ◽  
Achilles Tendinopathy ◽  
Retrospective Case ◽  
Double Row ◽  
Postoperative Result ◽  
Foot Function ◽  
American Orthopaedic ◽  
Insertional Achilles Tendinopathy

Background: Insertional Achilles tendinopathy (IAT) is a painful pathology in which the strongest and thickest tendon of the human body is affected. Different conservative and operative treatments have been described to address this pathology. This study aimed to evaluate the medium-term clinical and radiological outcomes of patients who underwent a surgical therapy via a longitudinal tendon-splitting approach with debridement and double-row refixation. Methods: All patients were assessed pre- and postoperatively using a visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Score, the Foot and Ankle Outcome Score (FAOS), and the Foot Function Index (FFI). Additionally, a lateral radiograph of the foot was performed to assess the postoperative result. Forty-two patients with confirmed IAT who underwent surgery between 2013 and 2017 with a longitudinal tendon-splitting approach and tendon refixation using a double-row refixation system were evaluated. The average follow-up was 32.8 (range, 18-52) months. We included 26 female and 16 male patients with an average age of 56.8 (range, 27-73) years. Results: The mean VAS improved from 8.91 ± 1.0 preoperatively to 1.47 ± 2.5 postoperatively ( P < .01). AOFAS scores improved significantly from 51.0 ± 12.5 preoperatively to 91.3 ± 14.3 postoperatively ( P < .01). All total and subscores of the FFI and FAOS saw a significant improvement at follow-up ( P < .01). Lateral radiographs showed recurrent calcification in 30 patients (71.4%). Conclusion: We found that, at an average of 33 months posttreatment, insertional Achilles tendinopathy via a longitudinal tendon-splitting approach resulted in good outcomes for patients after failure of initial conservative therapy. Recurrent calcification seems to be very common but shows no association with inferior outcomes or the return of symptoms. Level of Clinical Evidence: Level IV, retrospective case series.

scholarly journals Wies procedure for correcting involutional entropion of the lower lid in geriatrics

2021 ◽  
Vol 3 (1) ◽  
pp. 21-29
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh
Keyword(s):  
Recurrence Rate ◽  
Tertiary Care ◽  
Case Series ◽  
Successful Outcome ◽  
Care Hospital ◽  
Retrospective Case ◽  
Geriatric Population ◽  
Involutional Entropion ◽  
Anatomic Results

Objective: To evaluate the anatomic outcome and recurrence rate of the Wies procedure for treating involutional entropion of the lower lid in geriatrics. Materials and methods: This retrospective case series was conducted in the Ophthalmology department of a tertiary care hospital from January 1, 2016 to December 31, 2017. Geriatric patients (≥ 65 years) who had undergone the Wies procedure, i.e., transverse lid split and everting sutures for correction of involutional entropion of the lower lid were included. All the surgeries were done under local anaesthesia by a single ophthalmologist. The follow-up period was 12 months. A successful outcome was defined as restoration of lid margin to its position with no lash touching the cornea and no recurrence within 12 months. Results: Eighteen eyes of 13 patients with a mean age of 67.6 ± 2.2 SD years were included. There were 11 males (61%) and 7 females (39%). Bilateral entropion correction was done in five patients. Nine right eyes and nine left eyes were included. Anatomical success was 94.4% at 12 months. Recurrence was seen in one (5.6%) patient at 12 months. Conclusion: The Wies procedure for correction of involutional entropion with horizontal lid laxity in the geriatric population provided good anatomic results in our study. The recurrence rate was minimal within 1 year. The recurrence rate can be reduced by an accurate initial entropion assessment.

scholarly journals Medium-term results of the HINTEGRA total ankle arthroplasty

2020 ◽  
Vol 14 (3) ◽  
pp. 231-238
Author(s):  
Mohammadali Khademi ◽  
Paulo Ferrao ◽  
Nikiforos Saragas
Keyword(s):  
Case Series ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Foot And Ankle ◽  
Medium Term ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Secondary Objective ◽  
American Orthopaedic

Objective: The aim of this study was to determine patient satisfaction, survivorship, and revision rate of the HINTEGRA total ankle arthroplasty (TAA). Our secondary objective was to assess hindfoot function. Methods: All patients who underwent a HINTEGRA TAA between 2007 and 2014 were evaluated. We included a total of 69 patients (69 ankles), who were subjected to clinical and radiological examination and completed a visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and the self-reported foot and ankle score (SEFAS). Hindfoot function was assessed using the AOFAS hindfoot score. Mean follow-up was 62 (57–101) months. Results: The mean VAS score was 2 (0–3) and the SEFAS was 37 (26–48) at the most recent follow-up, while the AOFAS ankle score improved from 57 (52–62) to 87 (82–93). The AOFAS hindfoot score improved from 82 to 92 postoperatively. Eight patients had periprosthetic osteolysis and 5 underwent bone grafting of cysts. We detected polyethylene and hydroxyapatite particles in specimens obtained from the cysts. Eight patients had their procedures converted to an ankle arthrodesis. Conclusion: In select patients, TAA improved quality of life. Our medium-term follow-up of the HINTEGRA TAA observed a survivorship of 89% at 5 years with an improvement in the AOFAS score and a mean SEFAS score of 37. We recommend that large periprosthetic cysts, which may be caused by the hydroxyapatite coating and polyethylene particles, be bone grafted prophylactically. We found hindfoot function to be preserved. Level of Evidence IV; Therapeutic Studies; Case Series.

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