scholarly journals Radiographic analysis of Hallux valgus. A study on foot arch by severity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Yamada Takahiro ◽  
Norio Usami ◽  
Ikezawa Hiroko ◽  
Naoko Takatori ◽  
Eiichi Hiraishi ◽  
...  

Category: Bunion Introduction/Purpose: X-ray measurement for hallux valgus has been conducted with various results in the evaluation. However, it was not quite clarified yet and it still remains questionable why a mild case shifts to a severe case during the course. We report about the difference between the severity and the foot shape. Methods: The study subjects were 206 feet of 138 patients. Mild case: 80 feet, mean age 53 y.o (A) Moderate case: 61 feet, 62 y.o (B) Severe case: 65 feet, 67 y.o (C) For the examination items, HVA, M1-2 angle, and M1-5 angle were measured with the x-ray frontal radiograph for loading position, and First, Second, Fifth intermetatarsal angle (M1Y/M2Y/M5Y) on sagittal plane were also measured. We also evaluated the foot arch ratio with Yokokura Method, then compared/examined those results after dividing the cases into the mild, moderate, and severe group with age bracket. Results: The age of Group C were older than Group A, B. M1-2 angle: In younger generation, three is significant difference between Group A and B. M1-5 angle: Significant in 60 s between A and B. In 70 s, significant: all group. Navicular height: all group is low arch with aging. Significant between A and C It is becoming low arch at Lisfranc level with aging in all group. There is significantly low height at M5 with aging in all group. On sagittal plane, bone axis of M1 and M2 is lowered at 40 s in Group A and B and 70 s in Group C. Conclusion: In hallux valgus, the foot shape was changed in coronal and sagittal plane. It means the collapse of bone structure at foot and ankle. It may possibly be shifting to a severe case with aging. However, we could not find any result definitely suggesting such condition.

2021 ◽  
pp. 112067212110233
Author(s):  
Marcelina Sobczak ◽  
Magdalena Asejczyk ◽  
Malwina Geniusz

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.


2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
Author(s):  
Martin Kaipel ◽  
Lukas Reissig ◽  
Lukas Albrecht ◽  
Stefan Quadlbauer ◽  
Joachim Klikovics ◽  
...  

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.


2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.


2013 ◽  
Vol 83 (5) ◽  
pp. 885-891 ◽  
Author(s):  
Matteo Zanarini ◽  
Antonio Gracco ◽  
Monica Lattuca ◽  
Silvia Marchionni ◽  
Maria Rosaria Gatto ◽  
...  

ABSTRACT Objective: To evaluate whether the debonding procedure leads to restitutio ad integrum of the enamel surface by investigating the presence of enamel within the bracket base remnants after debonding. Materials and Methods: Sixty patients who completed orthodontic treatment with fixed appliances were included. A total of 1068 brackets were microphotographed; the brackets presenting some remnants on the base (n  =  818) were selected and analyzed with ImageJ software to measure the remnant area. From this population a statistically significant sample (n  =  100) was observed under a scanning electron microscope to check for the presence of enamel within the remnants. Energy dispersive x-ray spectrometry was also performed to obtain quantitative data. Results: Statistically significant differences in the remnant percentage between arches were observed for incisor and canine brackets (P &lt; .0001 and P  =  .022, respectively). From a morphologic analysis of the scanning electron micrographs the bracket bases were categorized in 3 groups: group A, bases presenting a thin enamel coat (83%); group B, bases showing sizable enamel fragments (7%); group C, bases with no morphologic evidence of enamel presence (10%). Calcium presence was noted on all evaluated brackets under energy dispersive x-ray spectrometry. No significant difference was observed in the Ca/Si ratio between group A (16.21%) and group B (18.77%), whereas the Ca/Si ratio in group C (5.40%) was significantly lower than that of the other groups (P &lt; .323 and P  =  .0001, respectively). Conclusion: The objective of an atraumatic debonding is not achieved yet; in some cases the damage could be clinically relevant.


2019 ◽  
Vol 12 (03) ◽  
pp. 177-182
Author(s):  
Sonya Khurana ◽  
Kevin K. Chen ◽  
Jeffrey J. Brooks

Abstract Background Osteoarthritis at the thumb carpometacarpal joint can have a profound impact on quality of life. Here, we evaluate radiographic outcomes in patients who have had open complete trapeziectomy, ligament reconstruction with tendon interposition, and acellular dermal matrix (GraftJacket) interposition—Group A, and compare them with those without GraftJacket interposition—Group B. Materials and Methods Thirty patients who had undergone operative treatment for thumb basal joint arthritis by a single surgeon from 2009 to 2016 were identified, and charts were retrospectively reviewed for demographic data, surgical and radiographic outcomes, and complications. Results There was no significant difference in pre- and postoperative radial abduction or pre- and postoperative palmar abduction. The difference in intraoperative joint space was significant (p = 0.006), but the difference in postoperative joint space was not (p = 0.310). The average amount of metacarpal settling was 6.9 versus 3.7 mm (p = 0.035) (Groups A and B, respectively). Three patients in Group A developed an inflammatory reaction to the GraftJacket, and one required reoperation for allograft removal. Conclusion This study suggests that thumb basal joint arthroplasty with GraftJacket interposition does not lead to more favorable radiographic outcomes at long-term follow-up. The increased costs associated with GraftJacket use may not be justified in light of these outcomes.


2014 ◽  
Vol 32 (1) ◽  
pp. 12-16 ◽  
Author(s):  
Mohsen Foroughipour ◽  
Amir Reza Golchian ◽  
Mohsen Kalhor ◽  
Saeed Akhlaghi ◽  
Mohammad Taghi Farzadfard ◽  
...  

Background Migraine is one of the most common types of headache, with significant socioeconomic effects. Prophylactic drugs are used to prevent migraine headaches but are unpromising. Objective To assess the effects of adding acupuncture to conventional migraine prophylaxis. Methods One hundred patients with migraine (41 male, 59 female), in whom prophylactic drugs had not produced a fall of at least 50% in the number of attacks, entered the study. The patients were randomised into two groups, sham and true acupuncture. The patients in both groups continued their prophylactic treatment and received 12 sessions of either true or sham acupuncture. Each session was 30 min and was repeated three times a week. The number of headaches in the two groups was compared at baseline, and at the end of four successive months. Results There was no significant difference in the frequency of attacks between the two groups before intervention. After 1 month, the frequency of attacks each month decreased from 5.1 (0.8) to 3.4 (1.2) in the true acupuncture group, and from 5.0 (0.8) to 4.4 (1.1) in the sham acupuncture group (a significant difference, p<0.001). The frequency continued to decrease in month 2 but increased in months 3 and 4; however, it was still significantly lower than baseline, and the difference remained significant after month 4. Conclusions Acupuncture is applicable as an adjunct to prophylactic drugs in migraineurs in whom the number of attacks does not fall with prophylactic medication.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3732-3732 ◽  
Author(s):  
Mohsen Saleh Elalfy ◽  
Iman Abdin

Abstract The liver is the main body site for iron storage. Iron chelators as DFo and L1 had problems of compliance and intolerance respectively. This prospective study enrolled 76 BTM patients aged from 9–33 years, mean of 14±4.4 to evaluate the effectiveness of both chelators judged by serum ferritin (sf) and liver iron content (LIC) using repeated liver biopsies. Fifty patients were on DFo 35 mg/kg/day 5 days per week and twenty-six were on L1 75 mg/kg/day on daily bases. Mean baseline sf values were 3678±1922 and 3573±1879 ng/ml while mean baseline LIC was 19.2±7.9 and 18.9±8.1 mg fe/g dw, while 12% and 14% showed evidence of liver fibrosis (score ≥ 3) respectively. Twenty-four months later; a decline in sf by 287±837 in Dfo (In Dfo compliant group [number = 30]who had received ≥ 75% of planned dose; sf dropped by 890±437 while increased in DFo non compliant by 621±513). While falling by 729±633 in L1 group. A decrease in LIC by 3.9±2.8 mg fe/g dw (−5.8±3.1 in Dfo compliant,+2.6±3.3 in Dfo non compliant) and falling by 2.2±3.4 mg fe/g dw in L1 group, the difference was statistically significant P< 0.05 between compliant and non compliant DFo and insignificant difference between Dfo and L1.The mean iron excretion: intake was 1.61,0.86 and 1.48 in Dfo compliant, non compliant and L1 respectively. A positive correlation was found between sf and LIC in both groups. Fibrosis was improved in Dfo compliant group better than L1 but no statistically significant difference was observed, while progressive fibrosis in 10% of Dfo non compliant group. All Dfo compliant group completed study, 18 out of 20 Dfo non compliant while six L1 patients discontinued the drug prematurely (3 severe gastrointestinal disturbances, 2 severe arthralgia and one repeated neutropenia). Conclusion: Both Dfo and L1 are effective iron chelators evident by drop in sf, LIC and improved fibrosis, however compliance and intolerance are still troublesome.


2016 ◽  
Vol 94 (6) ◽  
pp. 458-462
Author(s):  
L. K. Brizhan’ ◽  
A. V. Boichenko ◽  
D. V. Davydov ◽  
L. N. Solomin ◽  
A. A. Kerimov ◽  
...  

Background. The aim of the present article was to report our experience with the treatment ofpatients with hallux valgus and to perform comparative analysis of the results of the newly proposed and standard methods for its surgical correction. Methods. The data on 70patients (101 feet) with hallux valgus that were operated on between 2011 and 2015 in St. Petersburg Hospital No 2 using the new and standard methods were analysed. The functional assessment (AOFAS score) and X-ray examination were performed preoperatively, 3 and 12 months after the procedure. Comparative analysis between patients undergoing surgical correction by the new and standard methods has been undertaken. Results. We did not find any significant difference between the two groups in mean AOFAS score 12 months after surgery. Nevertheless, the function score of the patients treated by the newly proposed method (79.4±6.5 in 3 months) was significantly better than in those given the standard treatment (72.2±7.6 in 3 months). Mean intermetatarsal angle 12 months after surgery by standard and new methods was 9,7±0,7° and 8,6±0,7° (p<0.05), mean metatarsophalangeal angle 13,6±0,9° and 13,0±1,1° (p<0,05) respectively. Conclusion. According to the data obtained, the original method of hallux valgus surgical correction allows to improve its functional and x-ray results.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0028
Author(s):  
Olcay Güler ◽  
Mahir Mahirogulları ◽  
Serhat Mutlu ◽  
Mehmet Halis Çerci ◽  
Ali Şeker ◽  
...  

Objectives: Our aim is to compare graft angles and tibial tunnel insertion in patients undergone single bundle ligament reconstruction using anatomical anteromedial (AM) and transtibial (TT) method with the contralateral healthy knee by using MR imaging. And to investigate correlation of this evaluation with functional results. Methods: We investigated 96 knees of 48 patients undergone anterior cruciate ligament (ACL) reconstruction with AM or TT method. 23 of 48 patients were operated with AM method. These patients were named as Group A. 25 patients were operated with TT method and named as group B. MRI was taken for both knees in each group postoperatively at the mean 10.47 (9-15) and 11.72 (9-17) months, respectively. Angle between ACL graft and anatomical axis of tibia in coronal and sagittal plane, [Sagittal ACL graft angle (SAGA), Frontal ACL graft angle (FAGA)], middle insertion point on tibial articular surface, [ Sagittal ACL middle point (SGMP), Frontal ACL tibial tunnel middle point (FTMP), and Sagittal ACL tibial tunnel middle point(STMP)] was assessed by three orthopaedic surgeons. Values in both groups, inter observer, values between operated and healthy knees and differences between two groups were statistically evaluated. Functional scores between operated and healthy knees were evaluated with the Lysholm scoring system. Results: Inter observer results were statistically significant in group A between operated and healthy knees for 1st and 2nd observers in SAGA values and for 1st and 3rd, and 2nd and 3rd observers in FAGA values (p<0.05). In group B there was statistically significant difference in SAGA values for 1st and 2nd, and for 2nd and 3rd observers and in FTMP values for 1st and 3rd, and 2nd and 3rd observers (p<0.05). Statistically significant difference was detected between SAGA, FAGA and SGMP values of operated and healthy knees of A and B groups in all three observers’ evaluation (p<0.05). No statistically significant difference was detected between STMP values of operated knees and SGMP values of healthy knees in both groups (p>0.05). Statistically significant difference was detected between SAGA and FAGA values of operated knees in both groups (p<0.05). There was statistically significant difference in Lysholm scores between group A and B (p<0.05). Nonetheless there was no statistically significant difference between the Lysholm scores of operated knees in A and B groups (p>0.05). Conclusion: ACL reconstruction surgery with TT and AM methods do not provide anatomical reconstruction in Sagittal plane. Moreover, functional results were not as good as contralateral healthy knees. Although tibial tunnel was in anatomical position in both TT and AM methods, the posterior insertion of graft is thought to be the result of anterior placement of interference screw.


1994 ◽  
Vol 15 (9) ◽  
pp. 495-497 ◽  
Author(s):  
Michael E. Brage ◽  
James R. Holmes ◽  
Bruce J. Sangeorzan

The purpose of this study was to determine whether the first metatarsocuneiform (MC) joint angle is affected by the orientation of the x-ray beam, whether it can be reliably measured, and, therefore, whether it is a valid indication of tarsometatarsal fusion as an adjunct to hallux valgus surgery. Each of seven cadaver feet were loaded to 350 newtons in a Plexiglas apparatus that maintained the foot in a plantigrade position. The loading apparatus was positioned to simulate a 10°, 20°, and 30° dorsal angulation of the x-ray beam. At each position, simulated weightbearing radiographs were obtained for each foot. Three observers independently measured the first MC angle and the first intermetatarsal (IM) angle on all the radiographs. The data collected were analyzed by the components of variance. The inclination of the first MC joint lessens significantly as the orientation of the x-ray beam changes from a 10° to a 20° tilt. The three examiners' mean MC angles and mean IM angles from the three sets of radiographs were not statistically different from each other, implying that there were minimal examiner-to-examiner differences in measuring these angles. There were no significant differences in measurements between examiners, suggesting that the first MC and first IM angles can be measured reliably. There was a significant difference in the first MC angle, with different orientations of the foot with respect to the x-ray beam, suggesting that this angular measurement should not be used as an indication for tarsometatarsal arthrodesis.


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