scholarly journals Current Trends in the Treatment of Hallux Valgus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey

2021 ◽  
Vol 25 (4) ◽  
pp. 157-164
Author(s):  
Jaeho Cho ◽  
Byung-Ki Cho ◽  
Hyun-Woo Park ◽  
Ki-Sun Sung ◽  
Su-Young Bae ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Foot And Ankle ◽  
Current Trends

Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans

2021 ◽  
pp. 107110072110030
Author(s):  
Matthew S. Conti ◽  
Tamanna J. Patel ◽  
Kristin C. Caolo ◽  
Joseph M. Amadio ◽  
Mark C. Miller ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Computer Aided Design ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
3 Dimensional ◽  
3D Cad ◽  
First Metatarsal ◽  
Hallux Valgus Deformity ◽  
Second Metatarsal ◽  
Α Angle

Background: There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other. Methods: Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study. Pronation of the first metatarsal was measured on weightbearing computed tomography (WBCT) scans using the α angle with reference to the floor, a 3-dimensional computer-aided design (3D CAD) calculation with reference to the second metatarsal, and a novel method, called the triplanar angle of pronation (TAP), that included references to both the floor (floor TAP) and base of the second metatarsal (second TAP). Pearson’s correlation coefficients were used to determine if the 3 calculated angles of pronation correlated to each other. Results: Preoperative and postoperative α angle and 3D CAD had no correlation with each other ( r = 0.094, P = .626 and r = 0.076, P = .694, respectively). Preoperative and postoperative second TAP and 3D CAD also had no correlation ( r = 0.095, P = .624 and r = 0.320, P = .09, respectively). However, preoperative and postoperative floor TAP and α angle were found to have moderate correlations ( r = 0.595, P = .001 and r = 0.501, P = .005, respectively). Conclusion: The calculation of first metatarsal pronation is affected by the reference and technique used, and further work is needed to establish a consistent measurement for the foot and ankle community. Level of Evidence: Level III, retrospective cohort study.

Minimally Important Difference in the Foot and Ankle Outcome Score Among Patients Undergoing Hallux Valgus Surgery

2019 ◽  
Vol 40 (6) ◽  
pp. 694-701 ◽  
Author(s):  
Sameer Desai ◽  
Alexander C. Peterson ◽  
Kevin Wing ◽  
Alastair Younger ◽  
Trafford Crump ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Hallux Valgus ◽  
Daily Living ◽  
Patient Reported Outcomes ◽  
Minimally Important Difference ◽  
Foot And Ankle ◽  
Outcome Score ◽  
Patient Reported ◽  
Bunion Correction ◽  
Correction Surgery

Background: Patient-reported outcomes are increasingly used as measures of effectiveness of interventions. To make the tools more useful, therapeutic thresholds known as minimally important differences have been developed. The objective of this study was to calculate minimally important differences for the domains of the Foot and Ankle Outcome Score for hallux valgus surgery. Methods: The study was based on a retrospective analysis of patients newly scheduled for bunion correction surgery and completing patient-reported outcomes between October 2013 and January 2018. This study used anchor- and distribution-based approaches to calculate the minimally important difference for the instrument’s 5 domains. Confidence intervals were calculated for each approach. There were 91 participants included in the study. Results: Using anchor- and distribution-based approaches, the minimally important difference for the pain domain ranged from 5.8 to 10.2, from 0.3 to 6.9 for the symptoms domain, 8.3 to 10.3 for the activities of daily living domain, 7.4 to 11.1 for the quality of life domain, and from 7.0 to 15.7 for the sports and recreation domain. Small differences in the activities of daily living domain may be more clinically important for patients with better function. Discussion: The range of minimally important difference values for each domain indicate how the Foot and Ankle Outcome Score corresponded to bunion correction surgery. The sports and recreation domain showed considerable variability in the range of values and may be associated with the domain’s lack of responsiveness. Overall, most minimally important difference values for the domains of FAOS ranged from above 4 to below 16. Level of Evidence: Level III, retrospective comparative series.

Interdigital vs Transarticular Lateral Release With Scarf Osteotomy

2021 ◽  
pp. 107110072110353
Author(s):  
Florian Hartenbach ◽  
Brigitta Höger ◽  
Karl-Heinz Kristen ◽  
Hans-Jörg Trnka
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Rating Scale ◽  
Lateral Release ◽  
Soft Tissue Release ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Scarf Osteotomy ◽  
Radiographic Outcomes

Background: We compare the clinical and radiographic outcomes of the interdigital approach vs the medial transarticular approach for lateral release combined with scarf osteotomy. Methods: Seventy-seven feet with moderate to severe hallux valgus underwent scarf osteotomy and lateral soft tissue release, using an interdigital approach (n = 36) vs medial transarticular approach (n = 41). The clinical measurements (range of motion, American Orthopaedic Foot and Ankle Society [AOFAS] score) and radiographic data were evaluated preoperatively and at final follow-up (93-124 months postoperatively). Additionally, the numeric pain rating scale and Foot and Ankle Outcome score [FAOS] were assessed postoperatively. Results: The AOFAS score improved from 60 (q1 = 54, q3 = 70) to 93 (q1 = 85, q3 = 98) in the transarticular group, and from 59 (q1 = 50, q3 = 64) to 95 (q1 = 85, q3 = 100) in the interdigital group. The hallux valgus angle improved from 35.7±6.5 degrees to 15.5±7.6 degrees in the transarticular group, and from 36.0±6.8 degrees to 12.9±13.0 degrees in the interdigital group. The intermetatarsal angle improved from 16.5±2.5 degrees to 6.5±2.7 degrees within the transarticular group and from 17.2±2.5 degrees to 7.3±4.3 degrees in the interdigital group. None of the clinical or radiographic parameters showed any significant differences between the treatment groups. Conclusion: Comparison of outcomes between the interdigital approach and the transarticular approach for lateral soft-tissue release with scarf osteotomy are equally successful. The transarticular approach can thus be considered safe and effective, with the additional benefits of just one scar as opposed to 2. Level of Evidence: Level III, therapeutic.

scholarly journals Foot and ankle deformities in children with Down syndrome

2018 ◽  
Vol 12 (3) ◽  
pp. 218-226 ◽  
Author(s):  
L. R. Perotti ◽  
O. Abousamra ◽  
M. del Pilar Duque Orozco ◽  
K. J. Rogers ◽  
J. P. Sees ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Down Syndrome ◽  
Hallux Valgus ◽  
Body Mass ◽  
Weight Bearing ◽  
Foot And Ankle ◽  
Children With Down Syndrome ◽  
Radiographic Measurements ◽  
Group I ◽  
Significant Difference

Purpose Foot and ankle deformities are common orthopaedic disorders in children with Down syndrome. However, radiographic measurements of the foot and ankle have not been previously reported. The aim of this study is to describe the foot and ankle deformity in children with Down syndrome. Methods Children who had foot and ankle radiographs in the standing weight-bearing position were selected. Three groups of patients were identified. The relationship of radiographic measurements with age, body mass index and pain is discussed. In all, 41 children (79 feet) had foot radiographs and 60 children (117 ankles) had ankle radiographs, with 15 children overlapping between Groups I and II. Results In Group I, hallux valgus deformity was seen before ten years of age and hallux valgus angle increased afterwards. Metatarsus adductus angle showed a significant increase (p = 0.006) with obesity and was higher in patients who had foot pain (p = 0.05). In Group II, none of the ankle measurements showed a significant difference with age or body mass index percentiles. Tibiotalar angle (TTA) and medial distal tibial angle (MDTA) were higher in patients who had ankle pain. In Group III, correlation analysis was performed between the different measurements with the strongest correlations found between TTA and MDTA. Conclusion In children with Down syndrome, radiographic evaluation of the foot and ankle reveals higher prevalence of deformities than clinical examination. However, foot and ankle radiographs are needed only for symptomatic children with pain and gait changes. Level of Evidence Level IV - Prognostic Study

Current Trends in Thromboprophylaxis in Surgery of the Foot and Ankle

2007 ◽  
Vol 28 (10) ◽  
pp. 1069-1073 ◽  
Author(s):  
Aniruth Gadgil ◽  
Rhys H. Thomas
Keyword(s):  
Best Practice ◽  
Significant Proportion ◽  
Foot And Ankle ◽  
Thromboembolic Prophylaxis ◽  
Current Trends ◽  
Published Evidence ◽  
Ankle Surgery ◽  
Hip And Knee Arthroplasty ◽  
Wide Variability ◽  
Common Situation

Background: Few studies exist to guide the best practice in thromboprophylaxis after foot and ankle surgery. A survey of foot and ankle surgeons was performed to assess current trends in thromboprophylaxis. Methods: An email-based survey of American and British foot and ankle surgeons was conducted. Surgeons were questioned as to their use and type(s) of thromboprophylaxis as well as reasons for not using prophylaxis. Surgeons also were asked about their use of thromboprophylaxis in hip and knee arthroplasty, if they did these surgeries. Results: Nearly one-fifth (19%, 27) of surgeons routinely used thromboprophylaxis in both elective and trauma foot and ankle surgery. The most common situation for use was in a postoperative patient who was immobilized and nonweightbearing. A lack of published evidence and a low rate of thromboembolism were the most commonly cited reasons for not using thromboprophylaxis. Conclusions: This survey showed a wide variability in thromboembolic prophylaxis. It suggests that despite the literature indicating to the contrary, a significant proportion of foot and ankle surgeons routinely use thromboprophylaxis. Confusion remains regarding the appropriateness of thromboprophylaxis and what type(s)(if any) should be used. This study has identified a need for more in-depth evaluation of the importance of, and possible prophylaxis against, thromboembolic problems after foot and ankle surgery.

Reliability of Clinical Tests of Foot and Ankle Characteristics in Older People

2003 ◽  
Vol 93 (5) ◽  
pp. 380-387 ◽  
Author(s):  
Hylton B. Menz ◽  
Anne Tiedemann ◽  
Marcella Mun-San Kwan ◽  
Mark Dominic Latt ◽  
Catherine Sherrington ◽  
...  
Keyword(s):  
Older People ◽  
Hallux Valgus ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Foot And Ankle ◽  
Clinical Tests ◽  
First Metatarsophalangeal Joint ◽  
Intraclass Correlation Coefficients ◽  
Coefficients Of Variation ◽  
Severity Grading

Lower-extremity problems are common in older people; however, the reliability of clinical tools used to assess foot and ankle characteristics has not been rigorously evaluated. This study evaluated the test–retest reliability of a battery of simple clinical tests of foot and ankle characteristics (tactile sensitivity of the first metatarsophalangeal joint, navicular height, foot length and width, hallux valgus severity, an overall foot problem score, ankle flexibility, ankle dorsiflexion strength, and foot pain) in 31 individuals (13 men and 18 women) aged 76 to 87 years recruited from the community. Three examiners performed the tests on two occasions approximately 2 weeks apart. Intraclass correlation coefficients and coefficients of variation were calculated for continuously scored tests, and the kappa statistic (κ) was used to determine the reliability of hallux valgus severity grading. All of the continuously scored tests had acceptable reliability (intraclass correlation coefficients of 0.64 to 0.98; coefficients of variation of 0.6% to 15.0%), as did hallux valgus severity grading (κ = 0.77; absolute percentage agreement, 84%). These simple clinical tests can now be used with confidence in clinical and research settings to provide reliable and functionally important information regarding foot and ankle characteristics in older people. (J Am Podiatr Med Assoc 93(5): 380-387, 2003)

scholarly journals Comparative study of the FAOS and FAAM questionnaires as functional assessment instruments for patients with hallux valgus

2020 ◽  
Vol 14 (2) ◽  
pp. 144-147
Author(s):  
Alesson Filipi Bernini ◽  
Silvia Iovine Kobata ◽  
Alexandre Cassini de Oliveira ◽  
Rubens Trabbold Aguiar ◽  
Antônio César Mezêncio da Silveira
Keyword(s):  
Hallux Valgus ◽  
Functional Assessment ◽  
Case Series ◽  
Assessment Instruments ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Functional Scores ◽  
The Right ◽  
Relationship Of

Objective: To compare the Portuguese translations of the Foot and Ankle Activity Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS) questionnaires as functional assessment instruments for patients with hallux valgus and assess correlations between scores and severity of deformity. Methods: A total of 28 patients were assessed and the functional scores provided by the FAAM and FAOS questionnaires were compared and their correlations with clinical and radiological severity were analyzed. Results: Mean age was 46.88 years (range: 18 to 64). Laterality was distributed as follows: 57.1% had the deformity on the right foot (16 cases) and 42.9% on the left (12 cases). The deformities identified were graded as follows: 26.1% of patients had mild deformity (6 cases), 45.3% had moderate deformity (14 cases), and 28.6% had severe deformity (8 cases). It was observed that the distribution of scores for the different grades of deformity was the same for both questionnaires. Conclusion: There was no significant difference between the results obtained using the FAAM or the FAOS questionnaire or in the relationship of proportionality between radiological deformity grade and the functional scores obtained using the two tests. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Trends in Foot and Ankle Publications

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0045
Author(s):  
Brian T. Sleasman ◽  
Alexander Caughman ◽  
Christopher E. Gross
Keyword(s):  
Hallux Valgus ◽  
Ankle Fracture ◽  
Current Practice ◽  
Scientific Publication ◽  
Small Subset ◽  
Foot And Ankle ◽  
Primary Method ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
Number Of Citations

Category: Ankle; Other Introduction/Purpose: Scientific publication and original articles remain the primary method of sharing scientific findings and thus advancing the knowledge base of that subject. These articles have the potential to reinforce or change current practice. Despite the value of these publications, little research has gone into surveying what topics are being published. Our goal was to identify and characterize the most common topics of publication in current foot and ankle literature. Methods: To determine the rate of publications in the literature, we reviewed all published articles in a 3.5-year period (January 2016 - June 2019) in three foot and ankle specific journals: Foot and Ankle International, Foot and Ankle Orthopaedics, and Foot and Ankle Surgery. We then sorted these articles into the topic of the article to identify the four most common domains of publication. These domains were further characterized by level of evidence as well as citations/year. Results: A total of 845 articles were published in the 3.5-year study period. During this time, the four most published topics in foot and ankle literature were hallux valgus (10%), arthroplasty (9%), ankle fracture (7.5%), and achilles pathology (6.4%). These four subjects accounted for 280/845 articles (33%). The average level of evidence for articles on hallux valgus, arthroplasty, ankle fracture, and Achilles pathology were 3.3 (3.1, 3.4, 3.4, and 3.4 respectively), and the average number of citations/year for these articles was 2.6 (2.3, 3.0, 2.3, and 3.1 respectively). Based on our study there is no correlation between level of evidence and number of citations. Conclusion: Despite the wide variety of cases (176 unique CPT codes) performed by an orthopedically trained foot and ankle surgeons, a small subset of publications represent a significant portion of scientific publication within the field.

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