Posterior Achilles Tendon-Splitting Approach and Intramedullary Nailing versus Lateral Trans-Fibular Approach with Fixed-Angle Plating for Tibiotalocalcaneal Arthrodesis

Category: Ankle, Ankle Arthritis, Hindfoot Introduction/Purpose: A variety of operative approaches and fixation techniques have been described for tibiotalocalcaneal (TTC) arthrodesis. As a durable, load-sharing device with favorable biomechanical properties, the intramedullary (IM) nail is commonly used. Lateral, fixed-angle plating continues to be popular as well, due to ease of use and lack of significant clinical inferiority. A lateral approach with distal fibula resection allows for direct access to the tibiotalar and subtalar joints, but the posterior, Achilles tendon-splitting (PAS) approach offers a robust soft tissue envelope. The purpose of this study was to compare the results of TTC arthrodesis with either PAS approach and IM nailing or lateral, trans-fibular (LTF) approach with lateral, fixed- angle plating. Methods: Following institutional review board approval, all patients who underwent simultaneous tibiotalar and subtalar arthrodesis were identified with minimum one year clinical and radiographic follow up. A retrospective review of all clinic notes, operative details, and radiographs was performed by a fellowship-trained orthopaedic foot and ankle surgeon not associated with the procedures. Patients were excluded if they underwent TTC arthrodesis through an approach other than PAS or LTF, and received fixation without an IM nail or lateral, fixed-angle plate. Primary outcomes examined were union rate and complications. Statistical analysis was performed with student’s t-test for continuous data and Chi-square test for categorical variables. P-values less than 0.05 were considered significant. Results: 38 patients underwent TTC arthrodesis with a PAS approach and IM nailing, and 28 with a LTF approach and lateral plating. The overall union rate for the PAS/IM nail group was 76.3% (29 of 38), and 64.3% (18 of 28) for LTF/lateral plating group (p=0.41). 15.8% (6 of 38) in the PAS/IM nail group underwent revision arthrodesis versus 7.1% (2 of 28) in the LTF/lateral plating group (p=0.45). Nonunion at the subtalar joint occurred in 25.0% (7 of 28) in the LTF/lateral plating group and 5.3% (2 of 38) in the PAS/IM nail group (p=0.03), but there was not a significant difference in tibiotalar union. Patients were allowed to bear weight 3 weeks earlier in the PAS/IM nail group (11.2 vs 14.4 weeks, p=0.01). Conclusion: Despite similar overall union rates, nonunion of the subtalar joint was significantly increased in the LTF/lateral plating group. This could be due to disruption of blood supply during exposure, insufficient stability, or inadequate compression of the arthrodesis site. However, revision arthrodesis rates were similar between groups because some nonunions were not symptomatic enough to warrant correction. Patients were allowed to fully weight bear significantly earlier in the PAS/IM nail group. PAS approach and IM nailing for TTC arthrodesis may allow for quicker recovery and increased likelihood of radiographic union at the subtalar joint.

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Seasonal Variation of Achilles Tendon Injury

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00179 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0017

Author(s):

Jon-Michael Caldwell ◽

Harry Lightsey ◽

Hasani Swindell ◽

Justin Greisberg ◽

J. Turner Vosseller

Keyword(s):

Seasonal Variation ◽

Achilles Tendon ◽

Tendon Rupture ◽

Seasonal Pattern ◽

Achilles Tendon Rupture ◽

Tendon Injury ◽

Categorical Variables ◽

Continuous Variables ◽

Significant Difference ◽

Tendon Ruptures

Category: Sports Introduction/Purpose: Achilles tendon ruptures are increasingly common injuries. There are several known risk factors for Achilles tendon rupture, although little is reported on the seasonal variation of the incidence of these injuries. Of the few studies in the literature touching on this question, the results have been varied. We sought to determine if there is any seasonal pattern of Achilles tendon ruptures. Knowledge of such a seasonal pattern could be advantageous for patient education, risk assessment, and ultimately prevention of these injuries. Methods: We queried billing records for CPT codes 27650, 27652, and 27654 as well as ICD diagnosis codes 727.67, 845.09, and S86.01x pertaining to Achilles tendon injury, repair, and reconstruction. Charts were screened and included if the patient suffered an acute Achilles tendon rupture on a known date. Charts were excluded if the patient had a chronic Achilles tear or underwent reconstruction or debridement for tendonitis, Haglunds deformity, tendon laceration, or any other indication aside from acute rupture. Data was analyzed using a chi-squared test for categorical variables, binomial tests for dichotomous variables and Mann-Whitney-U or Welch t-test for continuous variables. Significance was set at p < 0.05. Results: Our search yielded 499 cases with 245 meeting inclusion criteria. Sixty-six percent (66%) of injuries were identified as sports-related while 34% were non-sports related. When stratified by month, significant peaks occurred in April and July (p = .036, .011 respectively) with significantly fewer injuries occurring in October through December (p = 0.049). The highest rate of injury was seen in Spring (p = .015) and the lowest was seen in Fall (p < .001). There was no significant difference between seasons when only the non-sports related injuries were considered. Basketball was the most common sport involved (n=78) accounting for 51% of injuries (p < .001), followed by soccer and tennis. There was no significant variation between seasons in any particular sport. Conclusion: There was significant seasonal variation in the incidence of Achilles tendon ruptures. Both sports and non-sports-related injuries followed a similar pattern, with most injuries occurring during the Spring and Summer and fewer during Fall and Winter. This increase corresponds to the increase in activity in the recreational athlete population in the region which is often preceded by a time of relative inactivity. Our study confirms that the deconditioned athlete is at particularly elevated risk for Achilles tendon rupture during the Spring season when abrupt increases in sporting activity are common. Targeted education and prevention efforts could help mitigate this risk.

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TL 18097 - Role of bone graft and bone graft substitutes in isolated subtalar joint arthrodesis

Scientific Journal of the Foot & Ankle ◽

10.30795/scijfootankle.2019.v13.1059 ◽

2019 ◽

Vol 13 (Supl 1) ◽

pp. 80S

Author(s):

Alexandre Leme Godoy-Santos ◽

Ibukunoluwa Araoye ◽

Osama Elattar ◽

Sameer Naranje ◽

Cesar de Cesar Netto ◽

...

Keyword(s):

Risk Factors ◽

Bone Graft ◽

Subtalar Joint ◽

Bone Grafts ◽

Union Rate ◽

Subtalar Arthrodesis ◽

Significant Difference ◽

Subtalar Arthritis ◽

Bone Graft Substitutes

Introduction: Subtalar joint (STJ) arthrodesis is a well-established operative procedure in the treatment of subtalar arthritis and hindfoot deformities. Nonunion remains an important complication, with an incidence and role of risk factors varying in the literature. Recent reports have highlighted a decrease in overall union rates between 96% and 100% to 84%, further strengthening the need for an understanding of risk factors that may be implicated in nonunion rates. Some possible factors have been identified, including smoking, revision surgery, the presence and extent of devascularized bone, and previous ankle joint fusion. Current practice suggests that using bone grafts or bone graft substitutes decreases the risk of its occurrence. Objective: To compare union rates of isolated subtalar arthrodesis with and without the use of bone grafts or bone graft substitutes. Methods: We retrospectively reviewed 135 subtalar fusions with a mean follow-up of 18 ± 14 months. The standard approach was used for all operations. Graft materials included β-tricalcium phosphate, demineralized bone matrix, iliac crest autograft and allograft and allograft cancellous chips. Successful subtalar fusion was determined clinically and radiographically. Results: There was an 88% (37/42) union rate without graft and an 83% (78/93) union rate with bone graft use. The odds ratio of union for graft versus no graft was 0.703 (95% CI, 0.237-2.08). The average time to union in the graft group was 3 ± 0.73 months and 3 ± 0.86 in the nongraft group, with no statistically significant difference detected (p = 0.56). Conclusion: Graft use did not improve union rates for subtalar arthrodesis.

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Outcomes and Complications of Open Versus Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Multicenter Study

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00012 ◽

2020 ◽

Vol 5 (2) ◽

pp. 2473011420S0001

Author(s):

Chamnanni Rungprai ◽

Yantarat Sripanich ◽

Aekachai Jaroenarpornwatana

Keyword(s):

Functional Outcomes ◽

Daily Living ◽

Subtalar Joint ◽

Activity Of Daily Living ◽

Union Rate ◽

Sf 36 ◽

Significant Difference ◽

Secondary Outcomes ◽

Joint Arthritis ◽

Return To Activity

Category: Hindfoot; Other Introduction/Purpose: There remains a controversy for treatment of subtalar joint arthritis. Both open and arthroscopic techniques have been reported for successful treatment of subtalar arthritis; however, there is a little evidence to report prospective comparative outcomes between the two techniques. The purpose of this study was to compare clinical and functional outcomes including complications between the two techniques. Methods: A prospective, randomized collected data of 54 consecutive patients who were diagnosed with isolated subtalar joint arthritis and underwent either open (27 patients) or posterior arthroscopic (27 patients) subtalar arthrodesis between 2015 and 2019 in 2 institutions. A minimum follow-up to be included in the study was 12 months (mean, 24.2 months; range, 12 to 41 months). The primary outcome was union time. The secondary outcomes included visual analogue scale (VAS), Short Form-36 (SF-36), and FAAM, union rate, time to return to activity of daily living, sports, work, and complications. Pre- and post-operative SF-36, FAAM, and pain (Visual Analog Scale) were obtained and compared between the two groups using independent t-test and the same group with paired t-test. Results: There were 54 patients (42 male and 12 female) with mean age of 43.7 years (range, 21-68 years) and mean BMI of 25.7 kg/m2 (range, 18.3-33.6 kg/m2). Both techniques demonstrated significant improvement of post-operative functional outcomes (VAS, SF-36, and VAS (<em>p</em> < 0.001 all)) compared to pre-operative period; however, there was no significant difference between the two groups. The secondary outcomes between open and arthroscopic groups were time to return to activity of daily living (8.4 vs 10.8 weeks), works (10.6 vs 12.9 weeks), sports (24.9 vs 32.7 weeks), time to union using CT scan (9.4 vs 12.8 weeks), union rate (100% versus 96.3%), and complications included painful hardware (18.5% vs 22.2%), paresthesia (0 vs 7.4%), and no infection in both groups. Conclusion: Both open and arthroscopic techniques were demonstrated significant improvement in terms of functional outcomes as measured with the FAAM, SF-36, and VAS in patients with subtalar joint arthritis. Although there was no significant difference of short-term of functional outcomes measurement and complications, arthroscopic technique was better in term of fasten recovery time and time to union.

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T1 Relaxation Time of Achilles Tendon at 3 Tesla with Special Reference to Relevant Clinical Score: A Preliminary Study

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666181205130816 ◽

2020 ◽

Vol 16 (2) ◽

pp. 164-173

Author(s):

Zeineb Tbini ◽

Mokhtar Mars ◽

Mouna Bouaziz

Keyword(s):

Relaxation Time ◽

Achilles Tendon ◽

Clinical Score ◽

3 Tesla ◽

Acquisition Time ◽

Short Term ◽

T1 Relaxation Time ◽

T1 Relaxation ◽

Spin Echo Sequence ◽

Significant Difference

Purpose: The purpose of this study was to investigate T1 relaxation time of the human Achilles tendon, to test its short-term repeatability as well as the minimal detectable change, and to assess the extent that correlate with clinical symptoms. Methods: Twenty asymptomatic volunteers and eighteen patients with clinically and sonographically confirmed tendinopathy were scanned for ankle using a 3 Tesla (T) MR scanner. T1 maps were calculated from a variable flip angle gradient echo Ultra-short echo time sequence (VFA-GE UTE) and inversion recovery spin echo sequence (IR-SE) using a self-developed matlab algorithm in three regions of interest of Achilles Tendon (AT). Signal to Noise Ratio (SNR) between the two sequences was evaluated. INTRA-class Correlation Coefficient (ICC), Coefficient of Variation (CV) and the Least Significant Change (LSC) were calculated, to test short-term repeatability of T1. Subjects were assessed by the VISA-A clinical score. P values less than 0.005 were considered statistically significant. Results: Mean T1 values were 427.09 ± 53.37 ms and 528.70 ± 103.50 ms using IR-SE sequence and 575.43 ± 110.60 ms and 875.81 ± 425.77 ms with VFA-GE UTE sequence in the whole AT for volunteers and patients, respectively. : T1 values showed a significant difference between volunteers and patients (P=0.001). Regional variation of T1 in healthy and tendinopathic AT were greater for VFA-GE UTE sequence than for IR-SE sequence. VFA-GE UTE sequence showed clearly higher SNR compared to IR-SE sequence. Short-term repeatability of T1 values for volunteers showed an LSC of 22% and 14% for IR-SE sequence and VFA-GE UTE sequence, respectively. For patients, LSC was 14% and 5% for IR-SE sequence and VFA-GE UTE sequence, respectively. There was no correlation between T1 and VISA-A clinical score (p>0.005). Conclusion: VFA-GE UTE sequence used for T1 mapping calculation demonstrated short acquisition time and clearly high SNR. Results revealed that T1 relaxation time can be used as a biomarker to differentiate between healthy and pathologic Achilles tendon. However, T1 showed no correlation with the VISA-A clinical score.

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288. Follow-Up Blood Cultures in Gram-Negative Bacteremia: How Do They Impact Outcomes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.331 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S144-S144

Author(s):

Azza Elamin ◽

Faisal Khan ◽

Ali Abunayla ◽

Rajasekhar Jagarlamudi ◽

aditee Dash

Keyword(s):

Clinical Outcomes ◽

Antibiotic Treatment ◽

Readmission Rate ◽

Blood Cultures ◽

Categorical Variables ◽

Gram Negative ◽

Number Of Patients ◽

Significant Difference ◽

The Impact

Abstract Background As opposed to Staphylococcus. aureus bacteremia, there are no guidelines to recommend repeating blood cultures in Gram-negative bacilli bacteremia (GNB). Several studies have questioned the utility of follow-up blood cultures (FUBCs) in GNB, but the impact of this practice on clinical outcomes is not fully understood. Our aim was to study the practice of obtaining FUBCs in GNB at our institution and to assess it’s impact on clinical outcomes. Methods We conducted a retrospective, single-center study of adult patients, ≥ 18 years of age admitted with GNB between January 2017 and December 2018. We aimed to compare clinical outcomes in those with and without FUBCs. Data collected included demographics, comorbidities, presumed source of bacteremia and need for intensive care unit (ICU) admission. Presence of fever, hypotension /shock and white blood cell (WBC) count on the day of FUBC was recorded. The primary objective was to compare 30-day mortality between the two groups. Secondary objectives were to compare differences in 30-day readmission rate, hospital length of stay (LOS) and duration of antibiotic treatment. Mean and standard deviation were used for continuous variables, frequency and proportion were used for categorical variables. P-value < 0.05 was defined as statistically significant. Results 482 patients were included, and of these, 321 (67%) had FUBCs. 96% of FUBCs were negative and 2.8% had persistent bacteremia. There was no significant difference in 30-day mortality between those with and without FUBCs (2.9% and 2.7% respectively), or in 30-day readmission rate (21.4% and 23.4% respectively). In patients with FUBCs compared to those without FUBCs, hospital LOS was longer (7 days vs 5 days, P < 0.001), and mean duration of antibiotic treatment was longer (14 days vs 11 days, P < 0.001). A higher number of patients with FUBCs needed ICU care compared to those without FUBCs (41.4% and 25.5% respectively, P < 0.001) Microbiology of index blood culture in those with and without FUBCs Outcomes in those with and without FUBCs FUBCs characteristics Conclusion Obtaining FUBCs in GNB had no impact on 30-day mortality or 30-day readmission rate. It was associated with longer LOS and antibiotic duration. Our findings suggest that FUBCs in GNB are low yield and may not be recommended in all patients. Prospective studies are needed to further examine the utility of this practice in GNB. Disclosures All Authors: No reported disclosures

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SAT0581 SERIOUS INFECTION RATES WITH BIOLOGICAL DISEASE MODIFYING ANTI-RHEUMATIC AGENTS (bDMARDs) AND PREDISPOSING FACTORS: A 5-YEAR RETROSPECTIVE REVIEW

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1137 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1249.1-1250

Author(s):

K. Celkys ◽

J. Ly ◽

M. Soden

Keyword(s):

Rheumatoid Arthritis ◽

Real World ◽

Retrospective Review ◽

Total Duration ◽

Predisposing Factors ◽

Baseline Risk ◽

Categorical Variables ◽

Significant Difference ◽

Disease Modifying ◽

Tract Infections

Background:Biological and targeted synthetic disease modifying anti-rheumatic agents (bDMARDs) increase the risk of serious infections (SIs), however there is limited ‘real-world’ evidence comparing the relative risk of SI for individual bDMARDs. (1,2)Objectives:This study examines the rates of SIs in a non-select Australian Northern Queensland (NQ) cohort of patients with various rheumatic diseases receiving treatment with a bDMARD, to define predisposing factors and directly compare the bDMARDs.Methods:A retrospective review was performed for all patients who received a bDMARD through the Townsville Hospital Rheumatology Department over the 5-year period between June 2013 and May 2018. Episodes of a SI were defined as infection requiring admission or use of intravenous antibiotics. For each bDMARD the rate of SI per 100 patient years (PYs) was calculated and patient demographics and comorbidities were analysed. Between group differences were assessed using independent samples t-tests or ANOVA. Where assumptions were violated, Mann-Whitney U tests or Kruskal-Wallis tests were used. For categorical variables, chi-square tests were used, except when assumptions were violated when Fisher’s Exact tests were used.Results:296 patients received bDMARDs with an overall SI rate of 11.7/100PYs. There was no significant difference in presence of SI by disease type with 24% of patients with rheumatoid arthritis versus 19% with psoriatic arthritis, 14% with ankylosing spondylitis and 29% with “other” (X2=3.11; df=3; p=0.37). Respiratory tract infections were the most common infection (46%) followed by skin and soft tissue infections (23%). The highest incidence rate of SI occurred with rituximab (29.72 SI/100PYs) followed by certolizumab (22.50 SI/100PYs) and tocilizumab (15.00 SI/100PYs). Duration of time on a bDMARD, disease duration and use of methotrexate or leflunomide were not shown to significantly increase the risk of SI for the entire cohort. The characteristics which were shown to significantly increase SI rates were; prednisone use, increasing age, chronic pulmonary comorbidity and specifically in those with rheumatoid arthritis male gender and total duration of bDMARD use.Conclusion:In this real-world NQ cohort of patients treated with a bDMARD for a rheumatic disease, we have identified a number of factors potentially contributing to the risk of the development of SIs. This study provides valuable data on SI rates in an Australian ‘real-world’ cohort that may assist clinicians’ choice of bDMARD in patients with a high baseline risk of infection and highlights the importance of minimising prednisone use in patients on bDMARDs.References:[1]Ramiro S, Sepriano A, Chatzidionysiou K, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2016 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis. 2017;76:1093–1101.[2]Singh J, Wells G, Christensen R, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database Syst Rev. 2011;16:CD008794.Disclosure of Interests: :Kate Celkys: None declared, Jason Ly: None declared, Muriel Soden Speakers bureau: Speaker Fees from Pfizer in 2016

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The predictive value of absolute lymphocyte counts on tumor progression and pseudoprogression in patients with glioblastoma

BMC Cancer ◽

10.1186/s12885-021-08004-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jing Xi ◽

Bilal Hassan ◽

Ruth G. N. Katumba ◽

Karam Khaddour ◽

Akshay Govindan ◽

...

Keyword(s):

Tumor Progression ◽

Predictive Value ◽

Absolute Lymphocyte Count ◽

Categorical Variables ◽

Continuous Variables ◽

Current Standard ◽

Surgical Biopsy ◽

Cell Counts ◽

Significant Difference ◽

True Progression

Abstract Background Differentiating true glioblastoma multiforme (GBM) from pseudoprogression (PsP) remains a challenge with current standard magnetic resonance imaging (MRI). The objective of this study was to explore whether patients’ absolute lymphocyte count (ALC) levels can be utilized to predict true tumor progression and PsP. Methods Patients were considered eligible for the study if they had 1) GBM diagnosis, 2) a series of blood cell counts and clinical follow-ups, and 3) tumor progression documented by both MRI and pathology. Data analysis results include descriptive statistics, median (IQR) for continuous variables and count (%) for categorical variables, p values from Wilcoxon rank sum test or Fisher’s exact test for comparison, respectively, and Kaplan-Meier analysis for overall survival (OS). OS was defined as the time from patients’ second surgery to their time of death or last follow up if patients were still alive. Results 78 patients were included in this study. The median age was 56 years. Median ALC dropped 34.5% from baseline 1400 cells/mm3 to 917 cells/mm3 after completion of radiation therapy (RT) and temozolomide (TMZ). All study patients had undergone surgical biopsy upon MRI-documented progression. 37 had true tumor progression (47.44%) and 41 had pseudoprogression (52.56%). ALC before RT/TMZ, post RT/TMZ and at the time of MRI-documented progression did not show significant difference between patients with true progression and PsP. Although not statistically significant, this study found that patients with true progression had worse OS compared to those with PsP (Hazard Ratio [HR] 1.44, 95% CI 0.86–2.43, P = 0.178). This study also found that patients with high ALC (dichotomized by median) post-radiation had longer OS. Conclusion Our results indicate that ALC level in GBM patients before or after treatment does not have predictive value for true disease progression or pseudoprogression. Patients with true progression had worse OS compared to those who had pseudoprogression. A larger sample size that includes CD4 cell counts may be needed to evaluate the PsP predictive value of peripheral blood biomarkers.

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617 Who Benefits the Most from Burn Camps?

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.267 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S162-S163

Author(s):

Jennifer B Radics-Johnson ◽

Daniel W Chacon ◽

Li Zhang

Keyword(s):

Retrospective Review ◽

Burn Injury ◽

Statistical Significance ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Self Evaluation ◽

Significant Difference ◽

Return Home ◽

The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

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The Percutaneous Surgical Approach for Repairing Acute Achilles Tendon Rupture

Journal of the American Podiatric Medical Association ◽

10.7547/1000270 ◽

2010 ◽

Vol 100 (4) ◽

pp. 270-275 ◽

Cited By ~ 7

Author(s):

Shay Tenenbaum ◽

Niv Dreiangel ◽

Ayal Segal ◽

Amir Herman ◽

Amnon Israeli ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Demographic Data ◽

Achilles Tendon Rupture ◽

Treatment Modalities ◽

Main Concern ◽

Complication Rates ◽

Percutaneous Surgery ◽

Significant Difference ◽

The Mean

Background: Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture. Methods: The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24–58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. Results: All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90°/sec for plantarflexion power between the injured and healthy legs but no difference at 30° and 240°/sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5. Conclusions: Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments. (J Am Podiatr Med Assoc 100(4): 270–275, 2010)

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Determination of Blood Flow in Superficial Arteries of Human Face using Doppler Ultrasonography in Young Adults

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v5i1.339 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Nedal Iqbal ◽

Khubaib Shahid ◽

Muhammad Imtiaz ◽

Faiqua Yasser ◽

Ayesha Ashraf ◽

...

Keyword(s):

Blood Flow ◽

Peak Systolic Velocity ◽

Vascular Diseases ◽

Facial Artery ◽

Categorical Variables ◽

Human Face ◽

Important Indicator ◽

Significant Difference ◽

Health And Disease ◽

Diseased State

Background: Human face is highly vascular region and vascularity to the skin and other organs is an important indicator of health and disease. Change in blood flow is affected by aging, diabetes, high blood triglycerides, cigarette smoking etc. With so many factors that can alter blood flow in the skin, normal blood flow is important to know for comparison to diseased state. Blood flow in superficial arteries of face has not yet been described, therefore this study was designed to establish baseline blood flow values in arteries of face. Materials and Methods: Blood flow of right and left side was assessed at level of facial and infraorbital artery. Categorical variables were presented in form of frequency and percentages was done by using Mann-Whitney U. Wilcoxon Signed Ranks test was used to compare left and right facial and infra orbital arteries. Results: Peak systolic velocity of right and left facial artery had a significant difference having right side mean of 67.02±12.48 and left side mean as 72.67±11.69. Facial artery diameter of right and left side also had significant difference with mean of 0.14±0.02 and 0.15±0.02 respectively. Conclusion: No difference was found between vascularity in male & female and left or right side. The study might be useful to establish normal baseline values of various parameters on both sides of face in male and female adults. This study may become important reference for future studies measuring blood flow and even progression of vascular diseases may be assessed by indexes developed on the basis of these studies.

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