Radiographic Evaluation of Charcot Foot Involving the Lateral Column

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Hale T ◽  
◽  
Bennett J ◽  
Keyword(s):  
Radiographic Evaluation ◽  
Charcot Foot ◽  
Lateral Column

In the study of Charcot foot, the lateral column has been largely neglected in previous research. The purpose of the current study is to radiographically characterize the lateral column in Charcot midfoot collapse.

A Retrospective Radiographic Evaluation of a Modified Method of Lateral Column Lengthening

2020 ◽  
pp. 193864002091918
Author(s):  
Keith Wapner ◽  
Erik Freeland ◽  
Gregory Kirwan ◽  
Keith Baldwin
Keyword(s):  
Weight Bearing ◽  
Case Series ◽  
Stage Ii ◽  
Radiographic Evaluation ◽  
Retrospective Case ◽  
Lateral Column ◽  
Modified Method ◽  
Radiographic Outcomes ◽  
Alternative Approach ◽  
Lateral Column Lengthening

Background: Lateral column lengthening (LCL) is a commonly performed procedure for patients with stage II adult-acquired flatfoot deformity (AAFD) to correct forefoot abduction. This procedure is frequently completed concomitantly with both soft-tissue and bony procedures, including a medial slide calcaneal osteotomy to further reduce hindfoot valgus. The purpose of this study is to investigate and identify the radiographic outcomes of a modified step-cut LCL utilized as an alternative approach for correction of stage II AAFD. Methods: A retrospective radiographic review was performed on 15 feet in 14 patients who underwent correction of stage II AAFD using a step-cut LCL between August 2009 and January 2012. Two independent examiners utilizing 6 radiographic parameters evaluated preoperative and postoperative weight-bearing radiographs of the foot. Results: At a mean follow-up of 13.4 (range 12-16) weeks, weight-bearing radiographs demonstrated a significant median decrease in the lateral talometatarsal angle of 14.4° (P < .001), lateral talocalcaneal angle of 7° (P < .001), anteroposterior talometatarsal angle of 14.5° (P < .001), anteroposterior talocalcaneal angle of 5.5° (P < .001), and talonavicular coverage angle of 26.5° (P < .001). Additionally, a significant median increase in calcaneal pitch of 8.5° (P < .001) was noted. Conclusion: This study demonstrates statistically significant improvement of radiographic outcomes with use of a modified step-cut LCL as an alternative approach for correction of stage II AAFD. Levels of Evidence: Level IV: Retrospective case series

Early Foot Structural Changes After Lateral Column Exostectomy in Patients With Charcot Foot

2019 ◽  
Vol 18 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Raúl Juan Molines-Barroso ◽  
José Luis Lázaro-Martínez ◽  
Juan Vicente Beneit-Montesinos ◽  
Francisco Javier Álvaro-Afonso ◽  
Esther García-Morales ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Structural Changes ◽  
Sagittal Plane ◽  
Weight Bearing ◽  
Case Series ◽  
Wilcoxon Test ◽  
Charcot Foot ◽  
Lateral Column ◽  
Plantar Ulcer ◽  
Radiographic Alignment

Although exostectomy for chronic midfoot plantar ulcers in Charcot foot is apparently effective, with healing rates of nearly 75%, a subset of patients develop recurrent ulceration and show an unstable foot position, especially after undergoing exostectomy confined to the lateral column. The reasons for this failure have not been investigated. The main objective of this study was to evaluate the early changes in radiographic alignment after an exostectomy in patients with Charcot neuropathic osteoarthropathy (rocker bottom) and plantar ulcer located in the lateral column. The present study evaluated retrospectively changes in radiographic alignment after an exostectomy in 12 Charcot feet (rocker bottom) with plantar ulcer located in the lateral column. Indication for plantar exostectomy was the treatment of ulcer affected by osteomyelitis. We evaluated the early changes in the alignment of the foot on weight-bearing lateral radiographs 6 months after exostectomy. Paired sample Wilcoxon test was used to calculate the differences between preoperative and postoperative measurements. Furthermore, the relationship between revision surgery and early changes in radiographic angular measurements was determined by using the Mann-Whitney U test. After exostectomy, the inclination of the calcaneal bone decreased ( P = .003; r = 0.849) and declination of talus bone increased ( P = .041; r = 0.589). The change in calcaneal inclination was associated with revision surgery ( P = .042; r = 0.586). The present case series demonstrates that exostectomy procedure for the lateral column in patients with Charcot foot results in radiological changes in the hindfoot over the sagittal plane. The inversion of the calcaneal pitch angle suggests the possibility of further adverse events and the need for revision surgery.

Neuropathic ulcerations plantar to the lateral column in patients with charcot foot deformity: A flexible approach to limb salvage

1997 ◽  
Vol 36 (5) ◽  
pp. 360-363 ◽  
Author(s):  
Barry I. Rosenblum ◽  
John M. Giurini ◽  
Leonard B. Miller ◽  
James S. Chrzan ◽  
Geoffrey M. Habershaw
Keyword(s):  
Limb Salvage ◽  
Charcot Foot ◽  
Foot Deformity ◽  
Flexible Approach ◽  
Lateral Column

Motion Analysis of the Cervical Spine

2004 ◽  
Vol 9 (5) ◽  
pp. 1-11
Author(s):  
Patrick R. Luers
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disk ◽  
Radiographic Evaluation ◽  
Ligamentous Injury ◽  
Pattern Of Injury ◽  
Motion Segment ◽  
Single Pattern ◽  
Compensatory Motion ◽  
Loss Of Motion ◽  
Flexion And Extension

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

Dynamic Proximal Ulnar Osteotomy for the Treatment of Ununited Anconeal Process in 17 Dogs

1998 ◽  
Vol 11 (02) ◽  
pp. 76-79 ◽  
Author(s):  
B. M. Turner ◽  
R. H. Abercromby ◽  
J. Innes ◽  
W. M. McKee ◽  
M. G. Ness
Keyword(s):  
Clinical Outcome ◽  
Prospective Study ◽  
Patient Population ◽  
Clinical Results ◽  
Radiographic Evaluation ◽  
Proximal Ulna ◽  
Ulnar Osteotomy ◽  
A Prospective Study

SummaryA prospective study was made of 17 dogs with ununited anconeal process treated by osteotomy of the proximal ulna. The effect of the surgery on lameness was evaluated subjectively and the elbows were assessed radiographically for evidence of anconeal fusion and healing of the osteotomy. Whilst clinical outcome was generally good and complications infrequent, relatively few cases achieved anconeal fusion. These results do not compare well with the results of a previous study but this disparity may be due in part to differences in patient population and radiographic evaluation.Further work is required to establish how best to achieve predictable anconeal fusion.Proximal ulnar osteotomy was used to treat 17 dogs with ununited anconeal process. Clinical results were good but anconeal fusion was not achieved consistently. Further work is needed to determine how best to achieve predictable anconeal fusion.

Evaluation of Positive Contrast Arthrography in Canine Cranial Cruciate Ligament Disease

1996 ◽  
Vol 09 (01) ◽  
pp. 10-3 ◽  
Author(s):  
D.N. Aron ◽  
R. Roberts ◽  
J. Stallings ◽  
J. Brown ◽  
C.W. Hay
Keyword(s):  
Articular Surface ◽  
Cruciate Ligament ◽  
Positive Contrast ◽  
Joint Effusion ◽  
Radiographic Evaluation ◽  
Cranial Cruciate Ligament ◽  
Joint Pathology ◽  
Meniscal Pathology ◽  
Cranial Cruciate Ligament Disease ◽  
Better Than

SummaryArthrographic and intraoperative evaluations of stifles affected with cranial cruciate disease were compared. Arthrography did not appear to be helpful in predicting cranial cruciate ligament pathology. The caudal cruciate ligament was consistently not visualized in the arthrograms and was normal at surgery. The menisci were visualized consistently in the arthrograms, but conclusions could not be made as to the benefit of arthrography in predicting meniscal pathology. Arthrography was not helpful in predicting joint capsule and femoral articular surface pathology. Survey radiographic evaluation was better than arthrography in evaluating joint pathology. When cruciate injury is suspected, after history and physical examination, survey radiographs are better than positive contrast arthrograms at supporting the diagnosis.Positive contrast arthrography was evaluated as a diagnostic aid in canine cranial cruciate ligament disease. It did not appear to be useful in predicting joint pathology. With arthrography, both menisci could be visualized and evaluated for abnormalities. Joint effusion and presence of osteophytes evaluated on survey radiographs was better than arthrography in evaluating joint pathology.

Charcot foot: Early diagnosis and interest in medical care: A case report

2020 ◽  
Author(s):  
Ramla Mizouri ◽  
Radhouene Gharbi ◽  
Sonda Sellami ◽  
Ines Kammoun
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Medical Care ◽  
Charcot Foot

PEID (Percutaneous Endoscopic Interlaminar Discectomy): Cautionary Points Based on the Evidence

2018 ◽  
Vol 1 (2) ◽  
pp. 7
Author(s):  
Jun Ho Lee
Keyword(s):  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Radiographic Evaluation ◽  
Operative Indication ◽  
Endoscopic Techniques ◽  
Bone Removal ◽  
Iatrogenic Trauma ◽  
Minimal Damage ◽  
Surgical Modality ◽  
Endoscopic Lumbar Discectomy

Background: Percutaneous endoscopic lumbar discectomy (PELD) is one of the most sophisticated operative procedures for the treatment of lumbar disc herniation (LDH). Endoscopic techniques are now becoming standard in many areas due to expanded technical possibilities of full-endoscopic transforaminal or interlaminar resection of herniated lumbar discs as well as stenosis. However conventional percutaneous endoscopic interlaminar discectomy (PEID) disc operations may sometimes result in subsequent untoward complications due to unnoticed iatrogenic trauma to neural structures, which is mostly related to an anatomical limitation during endoscope insertion.Methods: An appropriate operative indication of the PEID without bone removal or laminectomy can be used to treat LDH cases with an enough interlaminar space (at least ≥ 20 mm by bi-facetal distance) from the reported evidences. Otherwise, there might be several indications for requirement of bone removal; a narrow interlaminar space, disappearance of the concave shape of the upper vertebral laminae, high-grade migration of LDH, recurrent LDH, obesity, or an immobile nerve root.Conclusion: The significance of PEID lies also in its minimal damage to surrounding structures such as muscle, bone, and ligaments. A discrete radiographic evaluation from the patient preoperatively is mandatory before choosing a proper endoscopic surgical modality for the sake of optimal clinical outcome after PEID. 

Clinical and Radiographic Evaluation of Demineralized Freeze-Dried Cancellous Block Allograft for Ridge Augmentation: A Pilot Study

2016 ◽  
Vol 26 (4) ◽  
pp. 329-336 ◽  
Author(s):  
Amir Moeintaghavi ◽  
Hamid Reza Arab ◽  
Leila Jabbareh ◽  
Farid Shiezadeh ◽  
Morteza Taheri ◽  
...  
Keyword(s):  
Pilot Study ◽  
Radiographic Evaluation ◽  
Ridge Augmentation ◽  
Freeze Dried
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