scholarly journals Functional evaluation of patients undergoing endoscopic calcaneoplasty for Haglund deformity

2021 ◽  
Vol 15 (2) ◽  
pp. 155-160
Author(s):  
Hallan Douglas Bertelli ◽  
Bruno Arvatti Michelin ◽  
Isabela Ferreira Perucci ◽  
Mário Sérgio Paulillo de Cillo ◽  
Carlos Daniel Candido Castro Filho ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Functional Outcomes ◽  
Case Series ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
The Mean ◽  
Haglund Deformity ◽  
American Orthopaedic ◽  
Preoperative Score

Objective: To analyze the functional outcomes of patients undergoing endoscopic calcaneoplasty for the treatment of Haglund deformity. Methods: This study consists of a case series of patients undergoing endoscopic calcaneoplasty. The American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, was used to evaluate patients before and 12 months after the procedure, providing preoperative and postoperative scores. Results: Nineteen patients were evaluated for a total of 24 endoscopic calcaneoplasties. The American Orthopaedic Foot and Ankle Society scale provided a mean preoperative score of 31.4 and a mean postoperative score of 93.3, which shows a significantly increased score after surgery. The mean patient age was 52 years, and the youngest patient was 25 years old and the oldest patient was 73 years old. However, no significant relationship was found between age and change in the American Orthopaedic Foot and Ankle Society score. No complications were observed in the immediate or late postoperative periods. Conclusion: Arthroscopic resection is efficient in the treatment of Haglund deformity given the significant improvement in the American Orthopaedic Foot and Ankle Society score observed after the procedure. Also, no postoperative complications were seen in patients who underwent endoscopic calcaneoplasty. Level of Evidence: IV; Therapeutic Studies; Case series.

Endoscopic Flexor Hallucis Longus Transfer for Achilles Noninsertional Tendinopathy: Description of Surgical Technique and Functional Outcomes

2020 ◽  
pp. 193864001989591
Author(s):  
Juan Bernardo Gerstner G ◽  
Ian Winson ◽  
Jimmy Campo ◽  
Michael Swords ◽  
Juan Camilo Medina ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Case Series ◽  
Functional Results ◽  
Achilles Tendinopathy ◽  
Flexor Hallucis Longus ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Flexor Hallucis Longus Transfer ◽  
The Mean ◽  
American Orthopaedic

Background. The transfer of the flexor hallucis longus (FHL) tendon is an established treatment for replacing a dysfunctional Achilles tendon. Objectives. (1) Describe a new technique for endoscopic FHL transfer for noninsertional Achilles tendinopathy and (2) describe the functional outcomes and complications after endoscopic and open FHL transfer. Materials and Method. Retrospective study of patients who underwent open or endoscopic FHL transfer between 2014 and 2016. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot scale was used preoperatively and postoperatively to measure the functional results. Results. We included 18 endoscopic FHL transfers and 24 open FHL transfers. The mean age of endoscopic and open procedures was 47.5 years (range 25-77 years) and 61.2 years (range 43-72 years), respectively. An improvement on the average AOFAS of 52.8% (31.9 points) was observed in the endoscopy group during the follow-up from the baseline. The mean improvement in AOFAS score for the open group was 41.4% (24.5 points). Four and 7 cases reported complications in the endoscopy and open FHL transfer groups, respectively. Conclusion. While both procedures were effective in treating noninsertional Achilles tendinopathy, the described arthroscopic treatment led to a greater improvement in the AOFAS score and is slightly less prone to lasting complications. Level of Evidence: Level IV: Case series

scholarly journals Functional evaluation of diabetic patients with foot ulcers

2018 ◽  
Vol 12 (2) ◽  
pp. 136-139
Author(s):  
Thiago Santos Fernando ◽  
Vinicius Quadros Borges ◽  
Gabriel Ferreira Ferraz ◽  
Kelly Cristina Stéfani
Keyword(s):  
Comprehensive Evaluation ◽  
Diabetic Patients ◽  
Functional Evaluation ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Plantar Ulcers ◽  
The Mean ◽  
American Orthopaedic

Objective: The objective of this study was to perform a functional evaluation of diabetic patients with plantar ulcers using the American Orthopaedic Foot and Ankle Society (AOFAS) score. Methods: In this prospective cohort study, 50 diabetic patients treated in an outpatient clinic under conservative management were consecutively evaluated for active ulcers on the foot. The ulcer mean progression time, size and classification and the AOFAS score were evaluated. Results: Among the sample, 38 (76%) were men, the mean age was 64 years, and the mean body mass index was 28.27 kg/m2. The mean ulcer progression time was 9 months, and 40 (80%) patients were classified as Wagner grade 1. There was a significant difference in AOFAS scoresbetween ulcer grades. Conclusion: The AOFAS score can be used for functional evaluation in diabetic patients with ulcers. However, due to the peculiarities of this population, it is important to search for new and more comprehensive evaluation instruments. Level of Evidence II; Prognostic Studies; Prospective Study.

scholarly journals PO 18101 - Talar body reconstruction for nonunions and malunions

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 12S
Author(s):  
Alexandre Leme Godoy dos Santos ◽  
Marcos Hideyo Sakaki ◽  
Rodrigo Sousa Macedo ◽  
Rafael Barban Sposeto ◽  
Rafael Trevizan ◽  
...  
Keyword(s):  
Case Series ◽  
Rare Condition ◽  
Foot And Ankle ◽  
Reconstructive Procedure ◽  
Tibiotalar Joint ◽  
The Mean ◽  
American Orthopaedic ◽  
Improved Function ◽  
Preoperative Score

Introduction: Talar body and neck nonunions and malunions may undergo reconstructive surgery when joint cartilage is still viable and no talar collapse or infection has occurred. This is a rare condition, and studies supporting the procedure have a small number of cases. Objective: To report a case series of six patients who underwent talar reconstructions. Methods: Six patients with talar malunions or nonunions who underwent surgical treatment were reviewed in this retrospective study. There were three nonunions and two malunions of the talar body and one malunion of the talar neck. Clinical evaluation included all the parameters used in the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scale. Arthritic degeneration of the ankle joint was assessed according to a modified Bargon scale. Results: The mean follow-up was 86 months (range 24-282 months). There were no cases of postoperative avascular necrosis of the talus. Four of the six patients in our series required a subtalar fusion as part of the reconstructive procedure. The average preoperative AOFAS hindfoot score was 34; at the time of the last evaluation, it was 74. The mean preoperative score on the modified Bargon scale for the tibiotalar joint was 1.17. At the last follow-up, it rose to 1.33. Three different deformities of the talus were identified: (a) flattening of the talus; (b) extra-articular step; (c) intraarticular step. Conclusion: Reconstruction of talar nonunions and malunions improved function in selected patients with a low risk of complications. Three different anatomical patterns of talar nonunions and malunions were identified.

Minimally Invasive Double-Button Fixation of Displaced Lateral Clavicular Fractures in Athletes

2016 ◽  
Vol 45 (2) ◽  
pp. 462-467 ◽  
Author(s):  
Maximiliano Ranalletta ◽  
Luciano A. Rossi ◽  
Hugo Barros ◽  
Francisco Nally ◽  
Ignacio Tanoira ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Closed Reduction ◽  
Functional Outcomes ◽  
Constant Score ◽  
Case Series ◽  
Return To Sport ◽  
Return To Play ◽  
Short Version ◽  
Level Of Evidence ◽  
The Mean

Background: Early union and a rapid return to prior function are the priorities for young athletes with lateral clavicular fractures. Furthermore, it is essential to avoid nonunion in this subgroup of patients, as this is frequently associated with persistent pain, restriction of movement, and loss of strength and endurance of the shoulder. Purpose: To analyze the time to return to sport, functional outcomes, and complications in a group of athletes with displaced lateral clavicular fractures treated using closed reduction and minimally invasive double-button fixation. Study Design: Case series; Level of evidence, 4. Methods: A total of 21 athletes with displaced lateral clavicular fractures were treated with closed reduction and minimally invasive double-button fixation between March 2008 and October 2013. Patients completed a questionnaire focused on the time to return to sport and treatment course. Functional outcomes were assessed with the Constant score and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Pain was evaluated with the visual analog scale (VAS). Radiographs were reviewed to identify radiographic union, malunion, and nonunion. Results: Of the 21 study patients, 20 returned to sport after treatment; 100% returned to the same level. The mean time to return to play was 78 days (range, 41-120 days). Four patients (20%) returned to sport less than 6 weeks after surgery, 14 (70%) returned between 6 and 12 weeks after surgery, and 2 (10%) returned after 12 weeks. The mean Constant score was 89.1 ± 4.2 (range, 79-100), the mean QuickDASH score was 0.4 ± 2.6 (range, 0-7.1), and the mean VAS pain score was 0.4 ± 1.0 (range, 0-3) at final follow-up (mean, 41 months). The only complication was asymptomatic nonunion. Hardware removal was not necessary in any patient. Conclusion: Closed reduction and minimally invasive double-button fixation of displaced lateral clavicular fractures in athletes was successful in terms of returning to the previous level of athletic activity regardless of the type of sport, with excellent clinical results and a low rate of complications.

Application of Computerized Adaptive Testing to the Foot and Ankle Ability Measure

2020 ◽  
pp. 107110072097266
Author(s):  
Joseph T. O’Neil ◽  
Otho R. Plummer ◽  
Steven M. Raikin
Keyword(s):  
Computerized Adaptive Testing ◽  
Case Series ◽  
Adaptive Testing ◽  
Mean Difference ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Patient Reported ◽  
The Mean ◽  
Ability Measure ◽  
The Impact

Background: Patient-reported outcome measures are an increasingly important tool for assessing the impact of treatments orthopedic surgeons render. Despite their importance, they can present a burden. We examined the validity and utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the Foot and Ankle Ability Measure (FAAM), a validated anatomy-specific outcome measure. Methods: A previously developed FAAM CAT system was applied to the responses of patients undergoing foot and ankle evaluation and treatment over a 3-year period (2017-2019). A total of 15 902 responses for the Activities of Daily Living (ADL) subscale and a total of 14 344 responses for the Sports subscale were analyzed. The accuracy of the CAT to replicate the full-form score was assessed. Results: The CAT system required 11 questions to be answered for the ADL subscale in 85.1% of cases (range, 11-12). The number of questions answered on the Sports subscale was 6 (range, 5-6) in 66.4% of cases. The mean difference between the full FAAM ADL subscale and CAT was 0.63 of a point. The mean difference between the FAAM Sports subscale and CAT was 0.65 of a point. Conclusion: The FAAM CAT was able to reduce the number of responses a patient would need to answer by nearly 50%, while still providing a valid outcome score. This measure can therefore be directly correlated with previously obtained full FAAM scores in addition to providing a foot/ankle-specific measure, which previously reported CAT systems are not able to do. Level of Evidence: Level IV, case series.

scholarly journals Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6051-6055
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Surgical Intervention ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
The Mean ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Mean Time

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

scholarly journals RELATIONSHIP BETWEEN THE KNEE AND HINDFOOT AXES IN PATIENTS WITH SEVERE KNEE OSTEOARTHRITIS

2020 ◽  
Vol 28 (5) ◽  
pp. 229-232 ◽  
Author(s):  
HENRIQUE MANSUR ◽  
FELIPE ALMEIDA ROCHA ◽  
PEDRO GUILME TEIXEIRA DE SOUSA FILHO ◽  
ISNAR MOREIRA DE CASTRO JUNIOR
Keyword(s):  
Mean Value ◽  
Foot And Ankle ◽  
Moderate Correlation ◽  
Varus Knee ◽  
Aofas Score ◽  
Level Of Evidence ◽  
The Mean ◽  
American Orthopaedic ◽  
Ankle Function ◽  
Angular Deformities

ABSTRACT Objective: To evaluate the correlation between knee axis and hindfoot axis in patients with advanced gonarthrosis, and the association between ankle function and angular deformities. Methods: 72 patients were enrolled in the study: 66% were women, and mean age was 58.7 years. The anatomical axis of the knee and hindfoot were measured by short knee radiographs and long axial view of the hindfoot. Results: Among the study group, 79.2% presented varus knee (mean 15º ± 7.69º) and 20.8% valgus (mean 15.9º ± 7.7º). 63.9% had hindfoot varus (mean 8.5º ± 6.07º) and 36.1% valgus (mean 3.9º ± 3.92º) (p < 0.05). The mean value for the American Orthopaedic Foot and Ankle Society (AOFAS) score was 74.26 points, and values were significantly higher among patients with hindfoot varus (p < 0.05). We found no correlation between gender or AOFAS score and knee and hindfoot axes, nor between deformities in the knee and hindfoot axes (p > 0.05). The subgroup genu valgum - hindfoot varus presented a moderate correlation (r = 0.564; p < 0.05). Conclusion: We found no association between the anatomical axes of the knee and hindfoot. Patients with gonarthrosis and hindfoot varus presented a better ankle function. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

scholarly journals Medial Ulnar Collateral Ligament Repair With Internal Brace Augmentation: Results in 40 Consecutive Patients

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110142
Author(s):  
Robert O’Connell ◽  
Marcus Hoof ◽  
John Heffernan ◽  
Michael O’Brien ◽  
Felix Savoie
Keyword(s):  
Functional Outcomes ◽  
Case Series ◽  
Ulnar Collateral Ligament ◽  
Return To Play ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Orthopaedic Clinic ◽  
Overhead Athletes ◽  
Internal Brace ◽  
The Mean

Background: Medial ulnar collateral ligament (MUCL) repair has been proven to be effective in nonprofessional overhead-throwing athletes, with faster and higher rates of return to play (RTP) than the more traditional Tommy John reconstruction. Biomechanical studies and clinical data suggest that MUCL repair augmented with a collagen-coated internal brace may be an effective treatment option in this patient population. Purpose: To evaluate the functional outcomes of young nonprofessional athletes who underwent MUCL repair with internal brace augmentation for medial elbow instability. The hypothesis was that these patients will have high rates of RTP and improved functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: Nonprofessional overhead athletes treated with MUCL repair with internal brace augmentation between 2015 and 2017 were prospectively evaluated for a minimum of 1 year. Preoperatively, all patients had evidence of medial elbow pain caused by MUCL insufficiency, as confirmed by signal changes on magnetic resonance imaging and valgus instability on arthroscopic examination. These findings did not allow them to participate in their chosen sport or profession, and each patient had failed nonoperative treatment. Postoperative outcomes were evaluated using the Overhead Athlete Shoulder and Elbow Score of the Kerlan-Jobe Orthopaedic Clinic. Complications were recorded and detailed. Results: A total of 40 nonprofessional overhead athletes were included in this study (35 men and 5 women; mean age, 17.8 years [range, 14-28 years]). The mean follow-up time was 23.8 months (range, 12-44 months). The mean postoperative Kerlan-Jobe Orthopaedic Clinic score was 92.6 (range, 64-100). Overall, 37 athletes (92.5%) returned to play or profession at the same level or higher at a mean time of 6.9 months (range, 2-12 months). Three patients did not RTP: 1 was limited by a concomitant medical diagnosis, and the other 2 chose not to resume athletics after the procedure but remained symptom free. Conclusion: In the nonprofessional athlete, primary MUCL repair with internal brace augmentation is a viable alternative to traditional repair techniques or reconstruction, allowing for a rapid RTP and promising functional outcomes.

scholarly journals Surgical treatment of hallux valgus using a modified Reverdin-Isham technique

2021 ◽  
Vol 15 (1) ◽  
pp. 49-53
Author(s):  
Luiz Lara ◽  
Lúcio Torres Filho ◽  
Gabriel Cervone ◽  
Juan Grajales ◽  
Glaucia Bordignon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Case Series ◽  
Metatarsal Head ◽  
Level Of Evidence ◽  
Valgus Angle ◽  
Significant Correction ◽  
The Mean ◽  
American Orthopaedic

Objective: To evaluate the postoperative results of patients who underwent surgical treatment of hallux valgus with a modified Reverdin-Isham (RI) technique and to compare the achieved correction with that reported by studies using the original technique. Methods: This is a retrospective study with patients with mild to moderate hallux valgus who underwent surgery from June 2010 to July 2019. All patients were operated using the modified RI technique. Data were collected through the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire, in addition to pre and postoperative radiographic studies of the intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA). Results: The mean postoperative follow-up was 30.1 months, and the mean age of patients was 56.4 years. The median AOFAS score in the postoperative period was increased by 56 points. The mean HVA was reduced in 16.5°, the mean IMA was reduced in 4.3°, and the mean DMAA was reduced in 10°. There were no cases of displacement or deviation of the first metatarsal head during the postoperative follow-up. Conclusion: The modified RI technique provided considerable stability to the osteotomy, in addition to a significant correction of the measured angles and an improvement in AOFAS scores, demonstrating itself as an effective technique for correcting mild to moderate hallux valgus. Level of Evidence IV, Therapeutic Studies, Case Series.

scholarly journals Assessment of orthopedist exposure to occupational doses of radiation in foot and ankle surgeries

2019 ◽  
Vol 13 (2) ◽  
pp. 147-153
Author(s):  
Thiago Pavani Zigovski ◽  
Larissa Lopes Endlich ◽  
Aleksei Dickow Sato ◽  
Danielle Filipov ◽  
Janine Nicolosi Corrêa
Keyword(s):  
Protective Clothing ◽  
Case Series ◽  
Whole Body ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Thermoluminescent Dosimetry ◽  
Lead Apron ◽  
The Mean ◽  
Study Case ◽  
Occupational Radiation

Objective: To measure the doses of occupational radiation to which a physician who performs orthopedic surgery of the foot and ankle using a fluoroscopy device is exposed during work and to compare those doses with the values provided in the current legislation and propose measures of radioprotection. Methods: Thermoluminescent dosimetry (TLD) was used to measure radiation in critical target areas (whole-body, lens, thyroid, right and left hands) of the surgeon’s body during all the surgical procedures performed by him between 12/19/2017 and 2/5/2018. From the mean dose values obtained for the procedures, the dose of annual radiation exposure was estimated for each of the regions analyzed and compared with the current legislation. Results: The estimate of the annual radiation dose received by the surgeon to the chest region, above the lead apron, was 5 times higher than that established by the national legislation. However, considering the use of the lead apron, the dose was acceptable. Estimates of equivalent doses for the limbs and thyroid had results within the levels required by the current legislation. The equivalent dose for the lens, on the other hand, was 4 times higher than that established by the legislation. Conclusion: During the workday, the foot and ankle orthopedic surgeon is exposed to doses of radiation higher than those considered acceptable. The data corroborate the need to wear radiological protective clothing, especially a lead apron and goggles. Level of Evidence IV; Prognostic Study; Case Series.

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