scholarly journals Correction of pediatric flexible flatfoot using arthroereisis

2019 ◽  
Vol 13 (2) ◽  
pp. 112-118
Author(s):  
Leandro Paes de Brito ◽  
Cíntia Kelly Bittar ◽  
Mário Sérgio Paulillo de Cillo ◽  
Carlos Daniel Cândido De Castro Filho ◽  
Renê André Reinig Carvalho ◽  
...  
Keyword(s):  
Linear Regression Analysis ◽  
Case Series ◽  
Deformity Correction ◽  
Multiple Linear Regression Analysis ◽  
Implant Loosening ◽  
Level Of Evidence ◽  
Radiographic Images ◽  
Angle Correction ◽  
Flexible Flatfoot ◽  
Selection Of

Objective: The aim of this study was to evaluate the effectiveness of arthroereisis using synthetic polyethylene implants as a method to correct deformities of excessive valgus in pediatric patients with flexible flatfoot (FF). Methods: This was a study of 20 patients between 5 and 12 years of age with symptomatic FF who received surgery between January 2011 and July 2016. Evaluations were made on the basis of the Valenti podoscopic classification, radiographic images, and AOFAS criteria. Patients with preoperative Valenti classification grades of III and IV were selected for the study. These patients received surgical treatment by arthroereisis with the interposition of a synthetic implant in the sinus tarsi, with or without stretching of the Achilles tendon (Vulpius surgery). A multiple linear regression analysis was performed with backward selection of the following variables: Valenti preoperative classification and the preand postoperative Bordelon, Kite, Gould, Meary and Pitch angles that were measured from the radiographic images of the patients who received arthroereisis. Results: Arthroereisis with synthetic material interposition was satisfactory, with 21 of the feet (91% of cases) showing clinical and radiographic improvement with angle correction and improved degree of deformity based on the Valenti classification. Two cases experienced implant loosening. The Bordelon and Pitch angle variables had a significant effect (p<0.05) on the improvement in degree of deformity correction based on the Valenti classification. Conclusion: Arthroereisis resulted in significant improvements in the patients who were studied, with pronounced clinical improvement and high degrees of satisfaction. Level of evidence IV; Therapeutic Studies; Case Series.

scholarly journals PEDIATRIC FLEXIBLE VALGUS FLATFOOT CORRECTION BY ARTHROEREISIS

2020 ◽  
Vol 28 (5) ◽  
pp. 212-215
Author(s):  
CÍNTIA KELLY BITTAR ◽  
ALBERTO CLIQUET JÚNIOR ◽  
ALEXANDRA MAURIEL DOS REIS ◽  
BRUNA MADELEINE DA SILVA SIMPLÍCIO FLÔR ◽  
DÉBORA PENNA CHAVES BERTAZZO ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Valgus Deformity ◽  
Level Of Evidence ◽  
Radiographic Images ◽  
Clinical Evaluations ◽  
Selection Of Variables ◽  
Flexible Flatfoot ◽  
American Orthopaedic

ABSTRACT Objective: This article aimed to evaluate the efficacy of arthroereisis using synthetic polyethylene implants to correct excessive valgus deformity in pediatric patients with flexible valgus flatfoot. Methods: Retrospective study of 20 pediatric patients with flexible valgus flatfoot, totaling 23 feet, between five and 14 years old, operated between January 2009 and July 2016. Clinical evaluations were performed by the Valenti podoscopic classification and the American Orthopaedic Foot & Ankle Society criteria, based on radiographic images and podoscopic analysis. These patients underwent surgical treatment with the introduction of a synthetic implant in the sinus tarsi. Multiple linear regression analysis with Backward selection of variables, angles of pre and postoperative of radiographic images of the patients submitted to arthroereisis were performed. Results: The arthroereisis with interposition of synthetic material was satisfactory, considering that 91% of the cases presented clinical and radiographic improvement, with correction of angles and improvement in deformity degrees. Two cases presented implant loosening. The variables of the Bordelon and Pitch angles significantly influenced (p < 0,05) the improvement of the correction of deformity degrees. Conclusion: The arthroereisis with the interposition of synthetic polyethylene material showed to be an effective technique for flexible flatfoot in symptomatic pediatric patients. Level of Evidence II, Prognostic studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

scholarly journals EVALUATION OF THE VEPTR SYSTEM IN THE MANAGEMENT OF SPINAL DEFORMITIES BETWEEN 2008 AND 2014 AT THE ROOSEVELT INSTITUTE

2018 ◽  
Vol 17 (4) ◽  
pp. 266-269
Author(s):  
Carlos Segundo Montero ◽  
David Meneses ◽  
Fernando Alvarado ◽  
Wilmer Godoy ◽  
Maria Margarita Acosta ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Early Onset ◽  
Case Series ◽  
Deformity Correction ◽  
Congenital Scoliosis ◽  
Neuromuscular Scoliosis ◽  
Three Dimensions ◽  
Thoracic Wall ◽  
Level Of Evidence ◽  
Radiographic Images

ABSTRACT Objective: Traditional surgical treatments, such as on-site fusion and hemiepiphysiodesis, have not addressed chest deformity in its three dimensions, and are usually insufficient and unpredictable for the management of congenital and neuromuscular scoliosis. The application of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) is a technique developed to treat early-onset progressive scoliosis that elongates the spine and thoracic wall, allowing adequate lung development. Methods: A case series retrospective study was conducted. We included 23 patients, including fifteen females and eight males diagnosed with congenital and neuromuscular scoliosis, who were treated with VEPTR type implants between January 2008 and May 2014. We obtained data about the implant and pre and postoperative radiographic images to assess the magnitude of the curve, and we measured the Cobb angle and length after lengthening, as well as evaluating the complications found. Results: There was an improvement in the postoperative Cobb angle. In patients with congenital scoliosis, deformity correction was 8.6% (p=0.014), and in neuromuscular scoliosis, we observed deformity correction of 19.5% (p=0.009). Likewise, we found gains in thoracic height through the device, which results in an average 10% lengthening of the spine in congenital scoliosis. In this study, we identified complications such as material migrations, rib synostosis, pressure zones, rib fracture, hemothorax, and deep wound infection. Conclusion: The natural history of progressive spinal deformity was improved in most of the minors, through the use of VEPTR. This allows us to continue managing patients in the future, in order to make a deeper assessment of its performance in treatment of early onset scoliosis. Level of Evidence III; Therapeutic studies - Investigating the results of a treatment.

First-Ray Radiographic Changes After Flexible Adult Acquired Flatfoot Deformity Correction

2021 ◽  
pp. 107110072110345
Author(s):  
Chien-Shun Wang ◽  
Yun-Hsuan Tzeng ◽  
Tzu-Cheng Yang ◽  
Chun-Cheng Lin ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hallux Valgus ◽  
Reconstructive Surgery ◽  
Case Series ◽  
Deformity Correction ◽  
Level Of Evidence ◽  
Factors Affecting ◽  
Radiographic Parameters ◽  
Case Series Study ◽  
Adult Acquired Flatfoot Deformity

Background: Adult acquired flatfoot deformity (AAFD) and hallux valgus (HV) are common foot and ankle deformities. Few studies have reported the changes in radiographic parameters of HV after reconstructive surgery for AAFD. This study aimed to evaluate the changes in radiographic parameters of HV and analyze the risk factors for increased HV after correction of AAFD. Methods: Adult patients with flexible AAFD who underwent similar bony procedures including medializing calcaneal osteotomy and Cotton osteotomy were included. Radiographic parameters were measured on weightbearing radiographs preoperatively, postoperatively, and at the final follow-up. Patients were divided into hallux valgus angle (HVA) increased and HVA nonincreased groups; logistic regression analysis was performed to identify risk factors affecting increased HV. Results: Forty-six feet of 43 patients were included. After AAFD reconstructive surgery, the tibial sesamoid position improved by 1 grade, but the HVA increased 4 degrees in average. Further, 21 of 46 feet (46%) showed an HVA increase ≥5 degrees immediately after AAFD correction surgery. Preoperative talonavicular coverage angle <21.6 degrees was a risk factor associated with HV increase immediately after the surgery. Conclusion: In this case series, using plain radiographs to measure standard parameters of foot alignment, we found the association between AAFD correction and HV deformity measures somewhat paradoxical. Correction of overpronation of the hindfoot and midfoot appears to improve the first metatarsal rotational deformity but may also increase HVA. A lower preoperative talonavicular coverage angle was associated with an increase of the HVA after surgery. Level of Evidence: Level IV, case series study.

scholarly journals Lateral open wedge calcaneus osteotomy with bony allograft augmentation in adult acquired flatfoot deformity. Clinical and radiological results

2021 ◽  
Author(s):  
Gabriele Colo’ ◽  
Mattia Alessio Mazzola ◽  
Giulio Pilone ◽  
Giacomo Dagnino ◽  
Lamberto Felli
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Deformity Correction ◽  
Tibialis Posterior ◽  
Open Wedge ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Adult Acquired Flatfoot Deformity

Abstract The aim of this study is to evaluate the results of patients underwent lateral open wedge calcaneus osteotomy with bony allograft augmentation combined with tibialis posterior and tibialis anterior tenodesis. Twenty-two patients underwent adult-acquired flatfoot deformity were retrospectively evaluated with a minimum 2-year follow-up. Radiographic preoperative and final comparison of tibio-calcaneal angle, talo–first metatarsal and calcaneal pitch angles have been performed. The Visual Analog Scale, American Orthopedic Foot and Ankle Score, the Foot and Ankle Disability Index and the Foot and Ankle Ability Measure were used for subjective and functional assessment. The instrumental range of motion has been also assessed at latest follow-up evaluation and compared with preoperative value. There was a significant improvement of final mean values of clinical scores (p < 0.001). Nineteen out of 22 (86.4%) patients resulted very satisfied or satisfied for the clinical result. There was a significant improvement of the radiographic parameters (p < 0.001). There were no differences between preoperative and final values of range of motion. One failure occurred 7 years after surgery. Adult-acquired flatfoot deformity correction demonstrated good mid-term results and low recurrence and complications rate. Level of evidence Level 4, retrospective case series.

Pengaruh Ukuran Perusahaan, Leverage, Kebijakan Dividen dan Profitabilitas terhadap Nilai Perusahaan Studi pada Perusahaan Manufaktur Sektor Food And Beverages

2021 ◽  
Vol 4 (3) ◽  
pp. 626-640
Author(s):  
Nur Anisa ◽  
Sri Hermuningsih ◽  
Alfiatul Maulida
Keyword(s):  
Firm Size ◽  
Firm Value ◽  
Quantitative Research ◽  
Sampling Method ◽  
Dividend Policy ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Manufacturing Companies ◽  
Food And Beverages ◽  
Selection Of

This study aims to examine the effect of firm size, leverage, dividend policy and profitability on firm value in the study of manufacturing companies in the food and beverages sector. This research uses quantitative research. The technique used in sampling is the purposive sampling method, namely the selection of samples is carried out with predetermined criteria. So that as many as 35 data were obtained from 7 food and beverages companies listed on the IDX during the 2016-2020 period. The data analysis method used is multiple linear regression analysis using the SPSS version 23 program. Based on the results of the study, it shows that: (1) firm size has no effect on firm value, (2) leverage has a negative and significant effect on firm value, (3) dividend policy has no effect on firm value, (4) profitability has a positive and significant effect on firm value. Keywords: firm size, leverage, dividend policy and profitability.

Predictors of outcome after primary flexor tendon repair in zone 1, 2 and 3

2016 ◽  
Vol 41 (8) ◽  
pp. 793-801 ◽  
Author(s):  
I. Z. Rigo ◽  
M. Røkkum
Keyword(s):  
Flexor Tendon ◽  
Linear Regression Analysis ◽  
Tendon Repair ◽  
Tendon Sheath ◽  
Multiple Linear Regression Analysis ◽  
Level Of Evidence ◽  
Pulley System ◽  
Skeletal Injury ◽  
Active Mobilization

We retrospectively reviewed the outcomes of flexor tendon repairs in zones 1, 2 and 3 in 356 fingers in 291 patients between 2005 and 2010. The mean (standard deviation) active ranges of motion of two interphalangeal joints of the fingers were 98° (40) and 114° (45) at 8 weeks postoperatively and at the last follow-up (mean 7 months, range 3–98), respectively. Using the Strickland criteria, ‘excellent’ or ‘good’ function was obtained in 95 (30%) out of 322 fingers at 8 weeks and 107 (48%) out of 225 fingers at the last follow-up. A total of 48 (13%) fingers required reoperation because of rupture, adhesion, contracture or other complications. The prevalence of rupture was 4%. We carried out multiple linear regression analysis to identify the predictors of the active digital motion. The following variables were found as negative predictors: age; smoking; injury localization between subzones 1C and 2C; injury to the little finger; the extent of soft tissue damage; concomitant skeletal injury; delay to surgery; use of a 2-strand Kessler repair technique; attempted suture or preservation of the tendon sheath–pulley system; and resecting or leaving the concomitant superficial flexor tendon cuts untreated. Analysing the 8 weeks results of tendon repairs in zones 1 and 2, early active mobilization was found to be superior to Kleinert’s regime. Level of evidence: III

scholarly journals THE EFFECT OF SOCIAL ECONOMIC FACTORS ON FARMER BEHAVIOR IN RICE FARMING IN SUMBER KULON VILLAGE, JATITUJUH DISTRICT, MAJALENGKA REGENCY

2020 ◽  
Vol 4 (2) ◽  
pp. 312-320
Author(s):  
Muhammad Nasirudin ◽  
Wulan Sumekar ◽  
Tutik Dalmiyatun
Keyword(s):  
Descriptive Analysis ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Economic Factors ◽  
Rice Farming ◽  
Land Preparation ◽  
Analysis Techniques ◽  
Farmer Behavior ◽  
Selection Of ◽  
Socio Economic Factors

Farmers' behavior indicates someone already knows good knowledge, attitude and skills in rice farming activities. the purpose of this study is the influence of socio-economic factors on the behavior of farmers in rice farming. This research was conducted on 21 September - 10 November 2019 in Sumber Kulon Village, Jatitujuh District, Majalengka Regency, West Java. The method used in this study is a survey with 240 respondents. Data collection techniques using questionnaires and interviews, while data analysis techniques using descriptive analysis and multiple linear regression analysis. Patani activities in rice farming are started from land preparation, selection of rice seeds, rice seedbed, planting, maintenance, food and post-harvest. The results showed that the influence of socio-economic factors on farmer's behavior in the level of siginification was 0.05 with 0.006, Educational variable was 0.094, experience variable was 0.552, motivation variable was 0.034, acceptance variable was 0.096, media information variable was 0,000 and agricultural extension variables were of 0.010. This can be seen from the contribution of farmers in social factors by 27% of the behavior of farmers because farmers only depend on rice farming activities. The reasons for choosing to keep doing this activity are, among other things, a family business. 

scholarly journals Radiographic assessment of the percutaneous Bianchi system technique for treatment of hallux valgus

2021 ◽  
Vol 15 (2) ◽  
pp. 140-145
Author(s):  
Tércio Manoel de Vasconcelos Silva ◽  
Marcus Vinicius Mota Garcia Moreno ◽  
Janice de Souza Guimarães ◽  
Túlio Eduardo Vieira Marçal ◽  
Thiago Batista Faleiro ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Statistical Significance ◽  
Case Series ◽  
Deformity Correction ◽  
Level Of Evidence ◽  
Paired Samples ◽  
Valgus Angle ◽  
Assessment Period ◽  
System Technique ◽  
Student’S T

Objective: To present initial radiographic results of surgical correction of the hallux valgus angle (HVA) and the intermetatarsal angle (IMA) using the percutaneous Bianchi system (PBS) technique. Methods: Seventeen patients with moderate to severe hallux valgus (HV) were exclusively treated with the PBS technique and assessed radiographically preoperatively and during the postoperative period, from January 2019 to January 2020. The degree of deformity correction was recorded, based on the HVA and the IMA. Stata (v. 14.0) software was used for statistical analyses. Pre-surgical and post-surgical mean HVA and IMA were compared using Student’s t test for paired samples and the McNemar test was used to compare HVA and IMA categories. Statistical significance was set at 5% and 95% confidence intervals were estimated. Results: Both HVA and IMA were reduced significantly during the assessment period. Mean radiographic correction of the HVA was 15.1° and mean radiographic correction of the IMA was 7.3. Conclusions: According to the results presented, use of the PBS technique achieved adequate correction of the radiographic parameters of the patients who underwent the treatment as proposed, although it is necessary to conduct additional studies with longer follow-up to achieve a higher recommendation level. Level of Evidence IV; Therapeutic Studies; Case Series.

Derotation of the Talus and Arthrodesis Treatment of Stages II-V Müller-Weiss Disease: Midterm Results of 36 Cases

2019 ◽  
Vol 40 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Chengjie Yuan ◽  
Chen Wang ◽  
Chao Zhang ◽  
Jiazhang Huang ◽  
Xu Wang ◽  
...  
Keyword(s):  
Case Series ◽  
Deformity Correction ◽  
Stage Iv ◽  
Staging System ◽  
Functional Improvement ◽  
Midterm Results ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Metatarsal Angle

Background: Various operative procedures have been reported for the treatment of Müller-Weiss disease (MWD). This study reports the midterm operative treatment results for stages II to V MWD with derotation of the talus and arthrodesis. Methods: Thirty-four patients (36 feet) with MWD were treated by talonavicular (TN) or talonavicular-cuneiform (TNC) arthrodesis in our center from 2008 to 2015. The affected feet were staged according to the Maceira staging system (stage II: 9; stage III: 10; stage IV: 9; stage V: 8). The American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scale, the visual analog scale (VAS), and relative radiologic parameters were evaluated preoperatively and also during follow-up. The mean follow-up duration was 38.2 (range, 25-113 months). Results: The final follow-up showed satisfactory outcomes. Overall, the AOFAS scores improved from 41.5 (range, 20-56) to 85.3 (range, 68-100) points ( P <.001), and the VAS score decreased from 5.7 (range, 3-8) to 0.9 (range, 0-4) points ( P <.001). The Tomeno-Méary angle decreased from −6.7 (range, −26.4 to 17.7) to 0.7 (range, −5.3 to 7) degrees ( P=.001). The calcaneal pitch angle increased from 13.7 (range, 4.1-26.2) to 22.0 (range, 13.3-28.9) degrees ( P < .001). The anteroposterior (AP) talar–first metatarsal angle decreased from −15.8 (range, −30.1 to −13.7) to −7.0 (range, −25.9 to −8.9) degrees ( P < .001), and the AP talocalcaneal angle increased from 14.7 (range, 4.7-22.3) to 22.1 (range, 13.4-29.5) degrees ( P=.005). The AP talonavicular coverage angle decreased from −27.0 (range, −40.4 to −13.3) to −7.8 degrees (range, −20.7 to −1.8) degrees ( P < .001). Conclusion: The midterm results found that the TN or TNC joint fusion could achieve a favorable clinical and radiologic outcome for patients with MWD. Even for the patients with severe deformities (stages IV-V), this treatment strategy could also achieve satisfactory deformity correction and functional improvement. Intraoperative restoration of talus rotation was the key to normal alignment of the subtalar joint/TN joint. Level of Evidence: Level IV, retrospective case series.

scholarly journals Posteromedial bowing of the tibia: a benign condition or a case for limb reconstruction?

2018 ◽  
Vol 12 (2) ◽  
pp. 187-196 ◽  
Author(s):  
J. Wright ◽  
R. A. Hill ◽  
D. M. Eastwood ◽  
A. Hashemi-Nejad ◽  
P. Calder ◽  
...  
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Deformity Correction ◽  
First Year ◽  
Leg Length ◽  
Level Of Evidence ◽  
Benign Condition ◽  
Limb Reconstruction ◽  
Correction Surgery ◽  
First Year Of Life

Purpose To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures. Results The greatest correction of deformity occurred in the first year of life, but after the age of four years, remodelling was limited. The absolute leg-length discrepancy (LLD) increased throughout growth with a mean 14.3% discrepancy in tibial length. In the lengthening group, mean length gained per episode was 45 mm (35 to 60). Mean duration in frame was 192 days, with a mean healing index of 42.4 days/cm. Significantly higher rates of recurrence in LLD were seen in those undergoing lengthening under the age of ten years (p = 0.046). Four contralateral epiphysiodeses were also performed. Conclusion Posteromedial bowing of the tibia improves spontaneously during the first years of life, but in 20/38 (53%) patients, limb reconstruction was indicated for significant residual deformity and/or worsening LLD. For larger discrepancies and persistent deformity, limb reconstruction with a hexapod external fixator should be considered as part of the treatment options. Level of evidence Level IV (Case series)

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