scholarly journals Radiographic study of Böhler and Gissane angles in the Brazilian population

2020 ◽  
Vol 14 (1) ◽  
pp. 57-61
Author(s):  
Eurico Carneiro da Silva Louro ◽  
Thiago Batista Faleiro ◽  
Tiago Miranda Pereira ◽  
Leonardo Donato de Souza Ferreira ◽  
Roberto Guimarães Rezende ◽  
...  
Keyword(s):  
Communication System ◽  
Case Series ◽  
Brazilian Population ◽  
Adult Patients ◽  
Radiographic Study ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Study Case ◽  
Picture Archiving And Communication ◽  
Therapeutic Study

Objective: Determine Böhler and Gissane angles in the Brazilian population and compare them with the data available in the literature. Methods: A total of 800 weightbearing lateral radiographs of the calcaneus were evaluated in adult patients of both sexes. The angles were measured using the digital Picture Archiving and Communication System. Results: The sample consisted of 800 patients; 554 (69.2%) were women and 246 (30.8%), men. In the sample evaluated, the Gissane angle is 110.6±11.9, while the Böhler angle is 32.6±6.1. No differences were observed in the angles in terms of the comparison between sex and age. Conclusion: In the Brazilian population, the Gissane angle is 110.6±11.9, while the Böhler angle is 32.6±6.1. There is no statistically significant difference in the comparison between sex and age. Level of Evidence IV; Therapeutic Study; Case Series.

scholarly journals 4-in-1 and 5-in-1 blocks in percutaneous forefoot surgery

2020 ◽  
Vol 14 (1) ◽  
pp. 79-83
Author(s):  
César Lima Oliveira ◽  
Lucio Carlos de Azevedo Torres Filho ◽  
Luiz Carlos Ribeiro Lara ◽  
Gabriel Lopes de Faria Cervone ◽  
Rafael Nogueira Figueiredo ◽  
...  
Keyword(s):  
Case Series ◽  
Anesthetic Technique ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Nerve Blocks ◽  
Forefoot Surgery ◽  
Ankle Surgery ◽  
Study Case ◽  
Therapeutic Study ◽  
Male Subjects

Objective: To analyze the effectiveness of peripheral nerve blocks in the ankle in percutaneous forefoot surgery and their potential complications. Methods: Retrospective study with a survey of the medical records of patients who underwent percutaneous orthopedic surgery onthe forefoot between 2009 and 2015, performed by the orthopedic foot  and ankle surgery group of our hospital, in which 4-in-1 and 5-in-1 anesthetic nerve blocks were used. We evaluated 239 cases, consisting of 222 female and 17 male subjects with a mean age of 61.2 years, seeking to observe the effectiveness and potential complications of the anesthetic technique. Results: Complications were observed in 3.34% of the 239 patients, with seven cases of neuritis and one case of tachycardia. Regarding the anesthetic technique, there were nine cases of block failure (3.76%), with four cases requiring supplementary local anesthetic, one case spinal anesthesia, and four cases general anesthesia. Conclusion: Having observed the low rate of complications and the almost complete success of 5-in-1 blocks in percutaneous forefoot surgery, we concluded that it is a safe and effective anesthetic technique. Level of Evidence IV, Therapeutic Study; Case Series.

scholarly journals Post-traumatic digital flexion contracture (checkrein deformity)

2021 ◽  
Vol 15 (2) ◽  
pp. 146-149
Author(s):  
Alberto Macklin Vadell ◽  
Enzo Sperone ◽  
Martín Rofrano ◽  
Andrés Bigatti ◽  
Matías Iglesias ◽  
...  
Keyword(s):  
Case Series ◽  
Flexion Contracture ◽  
Unknown Etiology ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
History Of ◽  
Post Traumatic ◽  
Study Case ◽  
Therapeutic Study

Objective: The aim of this study is to present a series of 8 patients, describing their clinical picture and assessing their treatment using plantar approach. Methods: We retrospectively assessed 8 patients, all of which had a history of trauma. The clinical characteristics of these cases and postoperative results were investigated. Results: Seven men and 1 woman with a mean age of 29 years were included. The follow-up period ranged from 6 to 28 months (mean 22 months). The deformity manifested from 5 to 24 months after the triggering injuries (mean 9.8 months). The hallux was the only digit affected in 1 patient, while the others presented with involvement of 1 or more small toes. There were no postoperative complications, and patients showed to be satisfied with functional outcomes. Conclusion: Post-traumatic digital flexion contracture is an infrequent disease of unknown etiology. Lengthening of the flexor hallucis longus using a plantar approach, whether at the level of the midfoot or the toe, represents an alternative with satisfactory outcomes. Level of Evidence IV; Therapeutic Study; Case Series.

Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

scholarly journals Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

2021 ◽  
Author(s):  
Renata Migliardi ◽  
Alessandra Modugno ◽  
Fabrizio Chirico ◽  
Nicola Zerbinati ◽  
Giovanni Francesco Nicoletti ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Case Series ◽  
Outpatient Setting ◽  
Level Of Evidence ◽  
Upper Eyelid ◽  
Filler Injection ◽  
Tear Trough Deformity ◽  
Vasovagal Response ◽  
Superior Sulcus ◽  
Therapeutic Study

Abstract Background One of the primary goals of enucleation and evisceration surgery is the restoration of an adequate orbital volume through the use of appropriately sized alloplastic or autogenous tissues. In patients inadequately treated, post-enucleation or evisceration socket syndrome occurs. Fillers are an ideal alternative for eyelid and eyebrow arcade volume enhancement since their injection is easily performed in an outpatient setting avoiding several complications. The aim of this study is to report the use of hyaluronic acid (HA) fillers to treat volume deficits of the upper and lower eyelids, projecting the brow arcade and reducing the asymmetry. Methods Thirteen patients (2 male, 11 female, mean age 32.7 years) were treated from June 2012 to May 2020. Non-surgical treatment by HA filler injection for aesthetic rehabilitation of deep superior sulcus, inferior tear trough deformity, and scleral show was performed. Results No complications as orbital-ache and/or vasovagal response were reported during the injections. Minor complications such as light swelling at the site of injection, self-resolved within 2 days, were recorded. Stable results were observed at follow-ups. In two cases, two successive treatments were required at 3 and 6 years from the first injection. Conclusions Hyaluronic acid fillers offer a versatile and safe method for replacing soft tissue lost from the upper eyelid/brow complex in cases of post-enucleation or evisceration socket syndrome. Level of evidence: Level IV, therapeutic study.

Effect of Postoperative Ketorolac Administration on Bone Healing in Ankle Fracture Surgery

2018 ◽  
Vol 39 (10) ◽  
pp. 1135-1140 ◽  
Author(s):  
Elizabeth McDonald ◽  
Brian Winters ◽  
Kristen Nicholson ◽  
Rachel Shakked ◽  
Steven Raikin ◽  
...  
Keyword(s):  
Bone Healing ◽  
Case Series ◽  
Ankle Fractures ◽  
High Rate ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Clinical Healing ◽  
Mean Time

Background: In an effort to minimize narcotic analgesia and its potential side effects, anti-inflammatory agents offer great potential provided they do not interfere with bone healing. The safety of ketorolac administration after foot and ankle surgery has not been well defined in the current literature. The purpose of this study was to report clinical healing and radiographic outcomes for patients treated with a perioperative ketorolac regimen after open reduction and internal fixation (ORIF) of ankle fractures. Methods: A retrospective review was performed on all patients that received perioperative ketorolac at the time of lateral malleolar, bimalleolar, and trimalleolar ankle ORIF by a single surgeon between 2010 and 2016 with minimum 4 months follow-up. Patients received 20 tablets of 10 mg ketorolac Q6 hours. Radiographs were evaluated independently by 2 blinded fellowship-trained orthopedic foot and ankle surgeons to assess for radiographic healing. A total of 281 patients were included, with a median age of 51 years and 138 males (47%). Statistical analysis consisted of a linear mixed-effects regression. Results: In all, 265/281 (94%) were clinically healed within 12 weeks and 261/281 (92%) were radiographically healed within 12 weeks. Within the group of patients that did not heal within 12 weeks, mean time to clinical healing was 16.9 weeks (range = 14-25 weeks), and mean time to radiographic healing was 17.1 weeks (range = 14-25 weeks). In patients taking ketorolac, there were no cases of nonunion in our series (n = 281) and no significant difference found between fracture patterns and healing or complications ( P = .500). Conclusions: Perioperative ketorolac use was associated with a high rate of fracture union by 12 weeks. This is the first study to examine the effect of ketorolac on radiographic time to union of ankle fractures. Additional studies are necessary to determine whether ketorolac helps reduce opioid consumption and improve pain following ORIF of ankle fractures. Level of Evidence: Level IV, case series.

scholarly journals NAVIGATED TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS WITH EXTRA-ARTICULAR DEFORMITY

2018 ◽  
Vol 26 (3) ◽  
pp. 170-174 ◽  
Author(s):  
IZUMI TANI ◽  
NAOKI NAKANO ◽  
KOJI TAKAYAMA ◽  
KAZUNARI ISHIDA ◽  
RYOSUKE KURODA ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Computer Assisted ◽  
Level Of Evidence ◽  
Assisted Navigation ◽  
Radiographic Outcomes ◽  
Navigation Group ◽  
Significant Difference ◽  
Total Knee

ABSTRACT Objective It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation. Methods Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed. Seven TKAs were performed with navigation (navigation group) and another 7 were performed without navigation (manual group). Clinical and radiographic outcomes were compared before and two years after surgery. Results The mean postoperative Knee Society function score was significantly higher in the navigation group. No significant difference was found in postoperative range of motion and Knee Society knee score. The rate of outliers in radiographic outcomes tended to be lower in the navigation group. Conclusion Better clinical outcomes were achieved in cases in which navigation was used. Computer-assisted navigation is useful in TKA for patients with EAD. Level of Evidence III; Case control study.

Metacarpal lengthening in children: comparison of three different techniques in 15 consecutive cases

2016 ◽  
Vol 42 (1) ◽  
pp. 51-56
Author(s):  
C. Dana ◽  
J.-C. Aurégan ◽  
A. Salon ◽  
S. Guéro ◽  
C. Glorion ◽  
...  
Keyword(s):  
Case Series ◽  
Single Stage ◽  
The Other ◽  
Extensor Mechanism ◽  
Two Stage ◽  
Level Of Evidence ◽  
Healing Index ◽  
Clinical Series ◽  
Therapeutic Study

Metacarpal lengthening is a useful procedure to address hand deficiencies in children. In this study, we aimed to compare the results of three different techniques from one consecutive clinical series of hand deficiencies. A total of 15 metacarpal lengthenings have been performed in 12 children aged from 9 to 14 years. The callotasis technique was used in seven cases, the two-stage distraction-graft technique in four cases and the single-stage lengthening in four cases. All the metacarpals healed with bone. The lengthening obtained was a mean of 13 mm (range 8–21 mm), a mean of 22 mm (range 13–32 mm) and a mean of 12 mm (range 9–15 mm), respectively, in the three different techniques. The healing index was longer for callotasis (81 days/cm) compared with the other techniques (41 days/cm and 46 days/cm, respectively). We observed one case of fracture after callotasis and one after distraction-graft. One patient underwent tenolysis of the extensor mechanism after single-stage lengthening. In conclusion, distraction graft and single-stage lengthening may be valuable alternatives to callotasis. Level of evidence: IV; therapeutic study; multi-case series

scholarly journals Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study

2021 ◽  
Vol 87 (1) ◽  
pp. 175-179
Author(s):  
Thibault Dewilde ◽  
Sebastiaan Schelfaut ◽  
Sven Bamps ◽  
Matthias Papen ◽  
Pierre Moens
Keyword(s):  
Retrospective Study ◽  
Case Series ◽  
Technical Note ◽  
Coronal Alignment ◽  
Level Of Evidence ◽  
Coronal Balance ◽  
Scoliotic Deformity ◽  
Significant Difference ◽  
The Mean ◽  
The Right

Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Level of evidence : IV – case series

scholarly journals Surgical treatments of patients with periprosthetic humeral fracture and comorbidities

2021 ◽  
Vol 13 (1) ◽  
pp. 1-4
Author(s):  
Jiayong Liu ◽  
Logan J Roebke ◽  
Josh W Vander Maten ◽  
Meaghan Tranovich ◽  
Nabil A Ebraheim
Keyword(s):  
Shoulder Arthroplasty ◽  
Locking Plate ◽  
Rare Complication ◽  
Case Series ◽  
Humeral Fracture ◽  
Humeral Fractures ◽  
Outcome Analysis ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Cerclage Wiring

Background: Periprosthetic humeral fractures represent a complex and rare complication. Currently, there is no standardized procedure for management or classification of these fractures. Questions/purposes: This unique case series purpose was to look at surgical outcomes and comorbidity profiles of 10 PHF patients. Subsequent analysis looked at whether these outcomes could add to the discussion of a proposed standard of care in a patient cohort with significant comorbidities. Patients and methods: All patients with humeral fractures from 2008-2019 were analyzed for inclusion. A total of ten patients met the inclusion criteria; humeral fracture concurrent with a shoulder arthroplasty. Each patient was managed surgically using a locking plate with or without cerclage wiring. Outcome analysis was then performed for each patient. Humoral fractures managed conservatively were removed from the dataset along with periprosthetic fractures around an elbow arthroplasty, IM nail, or supracondylar fracture after shoulder arthroplasty. Results: The average union time in all patients was 13.27±2.90 (9.86-17.29) weeks. There was no significant difference between patients treated with cerclage wiring or without. All patients had successful union except for a patient with Osteogenesis Imperfecta. There were two radial nerve palsies. The average Deyo-Charlson score and BMI was 7.1±.84 (4-13) and 29.89 respectively. Conclusion: The treatment of PHFs using the technique of ORIF with locking plate with or without cerclage wiring provides satisfactory outcomes in a patient population that usually includes significant comorbidities. Level of evidence: Therapeutic Study Level IV Retrospective Review.

scholarly journals “Double-bundle” tibialis anterior tendon transfer for prevention of pes equinus after Chopart amputation

2020 ◽  
Vol 14 (1) ◽  
pp. 52-56
Author(s):  
Daniel Maricondi Massari ◽  
Marcio Gomes Figueiredo ◽  
Helencar Ignácio ◽  
Rafael Guirado ◽  
Wilisson Ribeiro Filho ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Case Series ◽  
Double Bundle ◽  
Level Of Evidence ◽  
Tibialis Anterior Tendon ◽  
Therapeutic Study ◽  
Midtarsal Joint ◽  
Patient Performance

Objective: Assess patient performance and quality of the stump after amputation at the Chopart (midtarsal) joint, with double-bundle transfer of the tibialis anterior muscle tendon to the talar neck. Methods: This study evaluated the medical records of 5 patients who underwent Chopart amputation with double-bundle transfer of the tibialis anterior tendon to the talar neck, assessing pre and postoperative performance and gait. Results: The patients were operated on between January 2008 and December 2018, and the data obtained from the survey allow us to conclude that, after the proposed procedure, all patients reported an improvement in walking, besides noting a significant reduction in the degree of stump equinus. Conclusion: The surgical technique described in this article produced a significant improvement in patient performance as assessed by the AOFAS hindfoot score, and prevented the formation of ulcers in the anterior region of the stump. Level of Evidence IV; Therapeutic Study; Case Series.

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