scholarly journals Correlation between the quality of calcaneal fracture reduction and time to return to work

2018 ◽  
Vol 12 (4) ◽  
pp. 304-09
Author(s):  
Fabielle Patrícia Zanardini Motizuki ◽  
Juliano Rodrigo Martynetz ◽  
Mário Fábio Polati ◽  
Sidney Silva de Paula ◽  
Afonso Klein Júnior ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Return To Work ◽  
Functional Limitation ◽  
Calcaneal Fracture ◽  
Late Complications ◽  
Fracture Reduction ◽  
Joint Involvement ◽  
Calcaneal Fractures ◽  
Level Of Evidence

Objective: The aim of this study is to test the hypothesis that patients with calcaneal fractures who are surgically treated and have Böhler and Gissane angles restored to normal have a faster return to work than patients without restoration of these angles. Calcaneal fractures represent 1-2% of all fractures, and approximately 75% of these are articular, indicating surgical treatment. Joint involvement results in functional limitation and can lead to late complications such as chronic pain, subtalar arthrosis, difficulty walking, and deformities. Methods: Lateral radiographs of the calcaneus of 44 patients who underwent surgical treatment for calcaneal fracture during the period from 2014 to 2016 were analysed to measure the Böhler and Gissane angles and to evaluate the association of their restoration to normal with the time to return to work. Results: Among the patients, 70.2% presented restoration of the Böhler angle and 44.7% presented restoration of the Gissane angle with surgery. The mean time away from work was 8.38 months. A total of 76.6% of patients returned to the same function. Patients who had good fracture reduction had a shorter time to return to work, but this result was not statistically significant. Conclusion: Surgical restoration of angles can positively influence the functional outcomes of patients, but this is not the only variable and thus should not be exclusively used to analyse the functional outcome and time to return to work of patients. Level of Evidence III; Therapeutic Studies; Cases Series.

scholarly journals Patients’ perspective on the surgical treatment of hallux valgus

2020 ◽  
Vol 14 (1) ◽  
pp. 36-40
Author(s):  
Eli Ávila Souza Júnior ◽  
Mateus Cardoso Thiers Vieira ◽  
Tiago Soares Baumfeld ◽  
Daniel Soares Baumfeld
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Surgical Treatment ◽  
Hallux Valgus ◽  
Functional Limitation ◽  
Tertiary Hospital ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Before And After

Objective: To evaluate patients’ perspectives on the risk factors for hallux valgus, and their quality of life before and after surgery. Methods: This is a cross-sectional, retrospective study, conducted in a tertiary hospital with 50 patients undergoing surgical treatment of hallux valgus. Data were tabulated using three methodological figures: central idea, key expressions and collective subject discourse. Results: Regarding the risk factors, most of the patients demonstrated knowledge, expressed through central ideas such as: heredity, and wearing inappropriate shoes. In relation to quality of life before surgery, impairment was noted, inferred by central ideas such as: pain and discomfort, restriction in the use of shoes, functional limitation and aesthetic impairment; and regarding postoperative quality of life, most patients expressed satisfaction with the results. Conclusion: Authentic discourses in the context of a prevalent pathology have expressed, for the first time, the conceptions of risk factors, quality of life before and after hallux valgus surgery. Level of Evidence V; Therapeutic Study; Expert Opinion.

scholarly journals PROFILE OF PATIENTS RECEIVING TOTAL KNEE ARTHROPLASTY: A CROSS-SECTIONAL STUDY

2017 ◽  
Vol 25 (5) ◽  
pp. 202-205 ◽  
Author(s):  
MARCELO JOSÉ CORTEZ BEZERRA ◽  
IGOR MAGALHÃES BARBOSA ◽  
THALES GONÇALVES DE SOUSA ◽  
LARISSA MEIRELES FERNANDES ◽  
DIEGO LEONARDO MENEZES MAIA ◽  
...  
Keyword(s):  
Medical Records ◽  
Severe Disease ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Lequesne Index ◽  
Total Knee ◽  
Epidemiological Profile

ABSTRACT Objective: To describe the epidemiological profile, presented deformities, associated comorbidities, and impact on quality of life in patients with knee osteoarthritis. This study was conducted in a philanthropic hospital in Fortaleza from 2014 to 2015. Methods: Data were collected from medical records, epidemiological forms, and by applying the Lequesne index questionnaire, which contains several questions related to pain, discomfort and functional limitation to assess the severity of symptoms. Results: Females were more prevalent (76.7%), as were patients over 65 years of age (61.6%) and non-whites (81.6%). As for comorbidities, 83.3% had hypertension and 31.7% had diabetes. Of the total, 76.5% cases were genu varum, and 23.5% genu valgum. According to the Lequesne index findings, 61.6% cases were “extremely severe,” and women had higher scores. Conclusion: Females were more prevalent and whites were less prevalent. The most frequent comorbidity was hypertension. Female and elderly patients have more severe disease according to Lequesne index score, and these findings were statistically significant. Level of Evidence II, Prospective Study.

scholarly journals Intra-articular Calcaneus Fractures: Current Concepts Review

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142092733
Author(s):  
Paul R. Allegra ◽  
Sebastian Rivera ◽  
Sohil S. Desai ◽  
Amiethab Aiyer ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Late Complications ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Tarsal Bones ◽  
Calcaneus Fractures

Calcaneal fractures are the most common fracture of the tarsal bones and represent 1% to 2% of all fractures. Roughly 75% of these fractures include intra-articular involvement of the posterior facet of the calcaneus. Intra-articular calcaneal fractures are challenging injuries to manage for both patients and surgeons given their association with both early and late complications. This article aims to review the management, classification systems, surgical approaches, and care regarding intra-articular calcaneal fractures. A review of the current literature yielded treatment strategies that aim to reduce complications such as soft tissue injury or loss of articular reduction while maintaining satisfactory clinical outcomes. The purpose of this article is to review these current concepts in the management of intra-articular calcaneal fractures. Level of Evidence: Level V, expert opinion.

Intramuscular venous malformations of the calf: Surgical treatment outcomes of 57 patients

2020 ◽  
Vol 35 (8) ◽  
pp. 597-604
Author(s):  
Claude Laurian ◽  
Pierre Cerceau ◽  
Nikos Paraskevas ◽  
Claudine Massoni ◽  
Veronique Marteau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Venous Malformation ◽  
Functional Limitation ◽  
Venous Malformations ◽  
Complete Excision ◽  
Muscle Involvement ◽  
Residual Functional

Objectives To report the outcomes of surgical treatment of calf intramuscular venous malformations (IMVMs) on pain, functional limitation, and quality of life. Methods We retrospectively reviewed 57 consecutive patients who had surgery for IMVM of the posterior compartment of the leg between 2010 and 2015. Treatments were all done at a single institution. Results Patients presented with pain (52), muscle contracture (14), or pulmonary embolism (4). Muscle involvement included the soleus muscle (n = 28, 49%), the gastrocnemius muscle (n = 25, 43%), and deep muscles (n = 4, 7%). Complete excision was possible in 52 patients (91%) and partial excision in 5 (9%). Thirty-five of 46 patients who had an MRI follow-up at six months had no residual venous malformation. At the final follow-up (mean 39 months), 32 of 40 patients seen had no residual pain and 37 had no residual functional impairment. Conclusion In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life.

Surgery is no more effective than conservative treatment for Femoroacetabular impingement syndrome: Systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552096669 ◽  
Author(s):  
Robson Massi Bastos ◽  
Jorge Geraldo de Carvalho Júnior ◽  
Suellen Aline Martinez da Silva ◽  
Shirley Ferreira Campos ◽  
Matheus Vieira Rosa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Femoroacetabular Impingement ◽  
Methodological Quality ◽  
Impingement Syndrome ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Quality Evidence

Objective: To summarize the effects of surgical treatment compared to conservative treatment in femoroacetabular impingement syndrome in the short, medium, and long term. Study Design: Systematic review Methods: The following databases were searched on 14/09/2020: MEDLINE, EMBASE, CENTRAL, Web of Science, and PEDro. There were no date or language limits. The methodological quality assessment was performed using the PEDro scale and the quality of the evidence followed the GRADE recommendation. The outcomes pain, disability, and adverse effects were extracted. Results: Of 6264 initial studies, three met the full-text inclusion criteria. All studies were of good methodological quality. Follow up ranged from six months to two years, with 650 participants in total. The meta-analyses found no difference in disability between surgical versus conservative treatment, with a mean difference (MD) between groups of 3.91 points (95% CI –2.19 to 10.01) at six months, MD of 5.53 points (95% CI –3.11 to 14.16) at 12 months and 3.8 points (95% CI –6.0 to 13.6) at 24 months. The quality of the evidence (GRADE) varied from moderate to low across all comparisons. Conclusion: There is moderate-quality evidence that surgical treatment is not superior to conservative treatment for femoroacetabular impingement syndrome in the short term, and there is low-quality evidence that it is not superior in the medium term. Level of evidence: Therapy, level 1a. Registration number: PROSPERO CRD42019134118

Surgical Treatment of Calcaneal Fractures with Use of β-Tricalcium Phosphate Ceramic Grafting

2008 ◽  
Vol 29 (10) ◽  
pp. 1015-1019 ◽  
Author(s):  
Sheng-Dan Jiang ◽  
Lei-Sheng Jiang ◽  
Li-Yang Dai
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Tricalcium Phosphate ◽  
Open Reduction ◽  
Clinical Results ◽  
Statistical Correlation ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
The Mean

Background: The treatment of calcaneal fractures is challenging. Internal fixation and grafting with sintered β-tricalcium phosphate (β-TCP) ceramic is alternative to bone grafting in the treatment of calcaneal fractures. Methods: Seventy-four patients with intraarticular calcaneal fractures were treated with open reduction, internal fixation and grafting with sintered β-TCP ceramic. Followup was performed using the Maryland foot score as well as plain radiography. Results: All patients were followed for 15 (range, 12 to 26) months. Clinical results as assessed by the Maryland foot score were excellent in 40 of 74 cases (54.1%), good in 28 (37.8%), and fair in 6 (8.1%). Immediately after surgery, the mean Böhler angle was improved by 23 degrees, and 1 year after surgery, the mean Böhler angle decreased by 4 degrees. A similar change was also seen in Gissane angles and the height and width of the calcaneus. There was no statistical correlation between the severity of fracture and functional outcome in this series. All fractures healed. Conclusion: These findings suggest that use of β-TCP combined with open reduction and internal fixation is an effective and safe method for the surgical treatment of intra-articular calcaneal fractures. Level of Evidence: IV, Retrospective Case Study

scholarly journals LUMBAR SPINAL STENOSIS: EVALUATION OF PAIN AND LIFE QUALITY AFTER SURGICAL TREATMENT

2019 ◽  
Vol 18 (1) ◽  
pp. 37-42
Author(s):  
Gustavo Alvarenga ◽  
João Otávio Araújo Rotini ◽  
Leonardo Yukio Jorge Asano ◽  
Vinícius Alves de Andrade ◽  
André Evaristo Marcondes Cesar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Life Quality ◽  
Case Series ◽  
Level Of Evidence ◽  
The Mean ◽  
One Year ◽  
Lumbar Spinal

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.

The epidemiology and trends in the surgical management of calcaneal fractures in England between 2000 and 2017

2019 ◽  
Vol 101-B (2) ◽  
pp. 140-146 ◽  
Author(s):  
J. A. Humphrey ◽  
A. Woods ◽  
A. H. N. Robinson
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Calcaneal Fracture ◽  
Recent Change ◽  
Calcaneal Fractures ◽  
Female Ratio ◽  
The United Kingdom ◽  
The Mean ◽  
The Uk ◽  
Male To Female

Aims This paper documents the epidemiology of adults (aged more than 18 years) with a calcaneal fracture who have been admitted to hospital in England since 2000. Secondary aims were to document whether publication of the United Kingdom Heel Fracture Trial (UK HeFT) influenced the proportion of patients admitted to hospital with a calcaneal fracture who underwent surgical treatment, and to determine whether there has been any recent change in the surgical technique used for these injuries. Patients and Methods In England, the Hospital Episode Statistics (HES) data are recorded annually. Between 2000/01 and 2016/17, the number of adults admitted to an English NHS hospital with a calcaneal fracture and whether they underwent surgical treatment was determined. Results During this 17-year period, 62 858 patients were admitted to hospital with a calcaneal fracture. The male-to-female ratio was 2.66:1. The mean annual incidence was 10.5/100 000 for men and 3.8/100 000 for women. The results of the UK HeFT were published in July 2014. The percentage of patients admitted with a calcaneal fracture undergoing internal fixation was 7.31% (3792/51 859) before and 7.38% (534/7229) after its publication. This difference was not statistically significant (p = 0.94). Since 2015, there has been a significant increase in the percentage of calcaneal fractures treated by closed reduction and internal fixation, as opposed to open reduction and internal fixation, from 7.7% (292/3792) to 13.29% (71/534) (p < 0.001). Conclusion This study documents the epidemiology and trends in surgical treatment of calcaneal fractures in England. We established that surgeons did not change their practice in terms of offering surgery to these patients in response to the results of the UK HeFT. There has been a significant (p < 0.001) increase in the number of calcaneal fractures being treated surgically using less invasive procedures.

scholarly journals Inter-rater reliability of Böhler and Gissane angles in different calcaneal fracture according to the Essex-Lopresti and Sanders classifications

2021 ◽  
Vol 15 (2) ◽  
pp. 133-139
Author(s):  
Rui dos Santos Barroco ◽  
Bruno Rodrigues de Miranda ◽  
Herbert Amantéa Fernandes ◽  
Gregory Bittar Pessoa ◽  
Danilo Ryuko Cândido Nishikawa ◽  
...  
Keyword(s):  
Critical Angle ◽  
Correlation Coefficients ◽  
Calcaneal Fracture ◽  
Control Group ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Rater Reliability ◽  
Ankle Surgery ◽  
Essex Lopresti ◽  
Böhler’S Angle

Objective: To evaluate the inter-rater reliability and intra-class correlation coefficients (ICC) of Böhler’s angle and the critical angle of Gissane in calcaneal fractures, stratified by severity and by the Essex-Lopresti and Sanders classifications. Methods: Retrospective study of radiographs obtained from 97 patients: 67 with calcaneal fractures and 30 with normal lateral radiographs (used as a control group). Böhler’s angle and the angle of Gissane were measured by six raters: two orthopedic surgery residents, two musculoskeletal radiologists, a foot and ankle surgery fellow, and a senior consultant in foot surgery. Statistical analysis of inter-rater reliability was performed for the two angles, in the sample overall and stratified by the different radiographic and CT subtypes of calcaneal fractures. Results: For the angle of Gissane, the ICC was at best 0.400 (95% CI: 0.250 to 0.581) for normal radiographs, with poor agreement across all classifications and severity stratifications. For Böhler’s angle, the ICC values indicated weak to moderate agreement, with the best reproducibility obtained for the overall sample (0.740; 95% CI: 0.673 to 0.801). In Sanders type 1 fractures, the ICC was 0.704 (95% CI: 0.397 to 0.940), and in Sanders type 2 fractures, 0.762 (95% CI: 0.634 to 0.870). Conclusion: Böhler’s angle is more reproducible than the critical angle of Gissane, with greater inter-rater reliability among fractures deemed less severe on the Sanders classification, although the overall ICC ranged from weak to moderate at best. Level of Evidence III; Case Control Study; Diagnostic Studies.

Calcaneocuboid Joint Involvement in Calcaneal Fractures

1996 ◽  
Vol 17 (9) ◽  
pp. 563-565 ◽  
Author(s):  
Nabil A. Ebraheim ◽  
Ashok Biyani ◽  
Thomas Padanilam ◽  
Greg Christiensen
Keyword(s):  
Calcaneal Fracture ◽  
Joint Involvement ◽  
Calcaneal Fractures ◽  
Chi Square ◽  
Tomographic Images ◽  
Lateral Column ◽  
Computed Tomographic ◽  
Calcaneocuboid Joint ◽  
Lateral Subluxation ◽  
Chi Square Test

The charts and radiographs of 48 surgically treated patients who underwent surgery for calcaneal fractures (right in 25 patients, left in 22, and bilateral in 1) between 1987 and 1994 were retrospectively reviewed. Coronal computed tomographic scans alone were obtained in 33 patients, and both coronal and axial computed tomographic scans were obtained in 9 patients. Three fractures exiting close to the calcaneocuboid joint (CCJ), but not involving the joint, were excluded. Nineteen patients (38.7%) had involvement of the CCJ. The extension of the fracture to the CCJ was apparent in anteroposterior or oblique radiographs or both in 18 patients. There was intra-articular fracture displacement of ≤1 mm in 6 patients, and 13 patients had a step or a gap of ≥2 mm with or without angulation. Eleven patients had joint depression type fractures, 6 had tongue type fractures, and 2 had comminuted fractures. Extension of the calcaneal fracture into the CCJ was significantly more common with the joint depression type calcaneal fractures (chi-square test; P = 0.008). The coronal computed tomographic images showed significant lateral subluxation of posterior facet fragments in 8 patients and considerable comminution of the lateral calcaneal wall with or without lateral subluxation of posterior facet fragment in 10 patients. These patients also had CCJ involvement, thus establishing a strong correlation between lateral subluxation of the posterior facet fragment or comminution of the lateral calcaneal wall and CCJ involvement. CCJ involvement is more common with joint depression type fractures. Extension of the fracture line into the CCJ should be suspected in presence of significant lateral column comminution or lateral talar subluxation.

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