scholarly journals Intra and interobserver analysis of the Sanders classification for calcaneal fractures

2019 ◽  
Vol 13 (2) ◽  
pp. 140-146
Author(s):  
Luís Henrique Grassi Marques da Costa ◽  
Thiago Alexandre Alves Silva ◽  
Wilel De Almeida Benevides ◽  
Daniel Soares Baumfeld
Keyword(s):  
Interobserver Reliability ◽  
Quality Criteria ◽  
Foot And Ankle ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
X Ray ◽  
A Value ◽  
American Orthopaedic

Objective: To evaluate the intra and interobserver variation in the Sanders classification of calcaneal fractures and the clinical-radiological correlation of postoperative X-ray images and computed tomography (CT) scans. Methods: We sent pre- and postoperative images in the form of a questionnaire to 18 foot and ankle surgeons with varying experience and examined evaluations of the postoperative reduction and Sanders classification quality criteria of 12 calcaneal fractures. The kappa (Ƙ) values were calculated and compared to those in the literature, and the quality of the reduction was compared to the patient's American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) score. Results: The mean intraobserver Ƙ of the Sanders classification was 0.49. Disregarding the subclasses, the intraobserver Ƙ was 0.55, and when type III and IV fractures were grouped, the intraobserver Ƙ was 0.57. The interobserver Ƙ values in these same three conditions were 0.22, 0.20, and 0.21, respectively. We also observed that the group of less experienced surgeons showed better intraobserver Ƙ values than the more experienced surgeons. In the analysis of the reduction quality based on X-ray images and the AOFAS-AHS score of the patient, we found a value of p=0.043. Conclusion: The Ƙ values were consistent with previous studies, confirming moderate intraobserver reproducibility and acceptable interobserver reliability. We also confirmed the presence of a significant relationship between the reduction quality based on X-ray images and the AOFAS-AHS score of the patient. Level of Evidence III; Diagnostic Studies; Nonconsecutive patients, no uniformly applied reference gold standard.

scholarly journals An evaluation of the efficacy of the locked plate with bone grafting in Sanders type III and IV intra-articular calcaneus fractures

2021 ◽  
Vol 9 ◽  
pp. 205031212110409
Author(s):  
Ali Varol ◽  
Yunus Oc ◽  
Bekir Eray Kilinc
Keyword(s):  
Bone Grafting ◽  
Plate Osteosynthesis ◽  
Locking Plates ◽  
Foot And Ankle ◽  
Calcaneal Fractures ◽  
Type Iii ◽  
Heel Height ◽  
The Mean ◽  
American Orthopaedic

Objective: To demonstrate the efficacy of locking plate osteosynthesis performed by an L-shaped lateral approach in patients with Sanders type III and IV intra-articular calcaneal fractures with posterior facet displacement. Methods: Fifty-three patients with Sanders type III or IV unilateral calcaneal fractures treated with locking plates and additional bone grafting were included in the study. Böhler and Gissane angles, and heel height values were measured on the radiological examinations. Clinical results of the patients were evaluated using the American Orthopaedic Foot and Ankle Society and Maryland evaluation criteria. The presence of arthrosis was investigated with Broden’s view. Preoperative and postoperative values were evaluated. Results: The mean Gissane angle was 119.32°, the mean Böhler angle was 9.47° and the mean heel height was 40.82 mm on radiographs at initial presentation of the patients. The mean Gissane angle was 114.63°, the mean Böhler angle was 23.33° and the mean heel height was 47.84 mm on the early postoperative radiographs of the patients. In patients, a mean 4.69° recovery was achieved in the Gissane angle, 13.86° in Böhler angle and 7.02 mm in heel height. On the most recent follow-up, Böhler angle was 21.49°, Gissane was 114.88° and the mean heel height was 46.95 mm. The mean American Orthopaedic Foot and Ankle Society score and Maryland score were 86.91 and 86.53, respectively, on the last follow-up. Conclusion: Internal fixation and grephonage using low-profile locking plates provides good functional results to patients since it facilitates anatomic restoration of the subtalar joint and correction of calcaneal height, width and varus/valgus heel.

Treatment Recommendations for Suspected Scapholunate Ligament Pathology

2021 ◽  
Author(s):  
Daniel Bakker ◽  
Joost T.P. Kortlever ◽  
Gerald A. Kraan ◽  
Nina Mathijssen ◽  
Joost W. Colaris ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Treatment Recommendations ◽  
Wrist Pain ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
Interosseous Ligament ◽  
Recent Onset ◽  
Diagnostic Arthroscopy ◽  
Reconstructive Option

Abstract Background The diagnosis and treatment of scapholunate interosseous ligament (SLIL) pathology is debated and notably variable. This study assessed the influence of diagnostic arthroscopy on treatment recommendations and the interobserver reliability of the arthroscopic classification of SLIL pathology. Methods The influence of diagnostic arthroscopy on treatment recommendations and the reliability of the arthroscopic classification of SLIL pathology were tested in a survey-based experiment. Seventy-seven surgeons evaluated 16 scenarios of people with wrist pain with variation in symptoms, scaphoid shift, time of symptom onset, and MRI appearance of the SLIL. Participants were randomized to view or not to view diagnostic wrist arthroscopy. Factors associated with recommendation for repair, capsulodesis, or tenodesis were analyzed. Results Viewing arthroscopic videos was associated with both offering surgery and a more reconstructive option. Other factors independently associated with recommendation for surgery included greater pain intensity and activity intolerance, women surgeons, an asymmetric scaphoid shift, and a recent onset of symptoms. The interobserver reliability of SLIL classification was slight. Conclusions Diagnostic arthroscopy leads to more surgery, and more invasive surgery, in spite of unreliable assessment of pathology. Clinical Relevance This points to the need to measure the potential benefits and harms of diagnostic wrist arthroscopy among people with wrist pain and no clear diagnosis on interview, examination, and radiographs. Level of Evidence Not applicable.

scholarly journals Trends of Foot and Ankle Publishing in JBJS[A] over a 15 Year Period From 2004-2018

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Bradley Alexander ◽  
James Hicks ◽  
Abhinav Agarwal ◽  
Aaradhana J. Jha ◽  
Spaulding F. Solar ◽  
...  
Keyword(s):  
Geographic Origin ◽  
Median Number ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Quality Research ◽  
Level Ii ◽  
Ankle Surgery ◽  
Ankle Research ◽  
Quality Of Research

Category: Other Introduction/Purpose: As the field of foot and ankle surgery grows and new innovations continue to be made it is important that the quality of research improves. This will help to lay a strong foundation for current and future surgeons in the field. Leading journals need to set the tone for all orthopedic journals by publishing quality literature. This current study will look at all foot and ankle articles published by JBJS[A] over a 15-year period and analyze authorship, article type, geographic origin of articles, and level of evidence trends. This study will give a representative view of where foot and ankle research is currently and where it can go as we enter the new decade. Methods: A foot and ankle research fellow reviewed all of the articles published in JBJS[A] from January 2004 to December of 2018. Articles that related to foot and ankle topics were then selected to analyzed. Editorials, letters to the editor, announcements, technical notes, retraction notes, events, errata, retracted manuscripts, historical papers and pediatric foot and ankle articles were excluded. After exclusions were applied 321 and information pertaining to each article was analyzed. Additionally, a Google Scholar search was conducted for each article to determine the number of times an article had been cited. For calculations relating to median number of citations for each article we excluded articles that were published less than three years ago (2017 and 2018). For level of evidence a kappa value (0.82) was calculated to measure interobserver reliability between two reviewers. Results: We found the following results to be significant. Clinical therapeutic studies were the predominant study design over 15 years. The amount of literature over ankle arthroplasty has increased more than any other article topic. The amount of level IV and V evidence has decreased and the amount of level II and III evidence has increased. The median number of authors has been increasing. This includes female authorship. There has been in an increase in MD, PhDs as last authors. There is more foot and ankle research being produced by Asian countries. A majority of high level of evidence articles (level I and II) comes from North America and Europe. Level of evidence doesn’t correlate with the amount of times an article is cited. Conclusion: As the field of foot and ankle surgery continues to grow it is important that there is a high quality of research being conducted and published to guide surgical and clinical decisions. Our study shows that research is being produced more globally and the number of individuals involved in the research process is increasing and diversifying. This has led to higher quality research being produced (more level II and III) and a decrease in lower quality research (IV and V). Overall, the standard of research has increased in JBJS[A] which benefits the foot and ankle surgery community. [Table: see text]

Quality of Research and Level of Evidence in Foot and Ankle Publications

2012 ◽  
Vol 33 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Heather L. Barske ◽  
Judith Baumhauer
Keyword(s):  
Clinical Research ◽  
Medical Profession ◽  
Research Articles ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
Ankle Research ◽  
Level I ◽  
Quality Of Research

Background: The quality of research and evidence to support medical treatments is under scrutiny from the medical profession and the public. This study examined the current quality of research and level of evidence (LOE) of foot and ankle surgery papers published in orthopedic and podiatric medical journals. Methods: Two independent evaluators performed a blinded assessment of all foot and ankle clinical research articles (January 2010 to June 2010) from seven North American orthopedic and podiatric journals. JBJS-A grading system was used for LOE. Articles were assessed for indicators of study quality. The data was stratified by journal and medical credentials. Results: A total of 245 articles were published, 128 were excluded based on study design, leaving 117 clinical research articles. Seven (6%) were Level I, 14 (12%) Level II, 18 (15%) Level III, and 78 (67%) Level IV. The orthopedic journals published 78 studies on foot and ankle topics. Of the podiatric journals, the Journal of the American Podiatric Medical Association (JAPMA) published 12 clinical studies and the Journal of Foot and Ankle Surgery (JFAS) published 27, 21 (78%) of which were Level IV studies. When the quality of research was examined, few therapeutic studies used validated outcome measures and only 38 of 96 (40%) gathered data prospectively. Thirty (31%) studies used a comparison group. Eighty-seven articles (74%) were authored by a MD and 22 (19%) by a DPM. Conclusion: Foot & Ankle International (FAI) published higher quality studies with a higher LOE as compared to podiatry journals. Regardless of the journal, MDs produced the majority of published clinical foot and ankle research. Although improvements have been made in the quality of some clinical research, this study highlights the need for continued improvement in methodology within foot and ankle literature.

Subtalar Arthroeresis in Posterior Tibial Tendon Dysfunction

2011 ◽  
Vol 18 (1) ◽  
pp. 55-59
Author(s):  
Sargon Konstantinovich Tamoev ◽  
N V Zagorodniy ◽  
V G Protsko ◽  
E M Sultanov ◽  
Z Kh Khamokov ◽  
...  
Keyword(s):  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
X Ray ◽  
Posterior Tibial ◽  
Study Results ◽  
Foot Function ◽  
American Orthopaedic ◽  
Foot Position

The purpose of the study was to evaluate the efficacy of subtalar arthroeresis for II stage tibial tendon dysfunction by Johnson and Storm classification. From November 2007 to August 2009, 18 patients with that pathology were operated on. After implantation of Kalix® II endorthesis the plasty of posterior tibial tendon was performed. The results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) scores system. After treatment average estimate by AOFAS increased from 47.2 before operation to 79.0 after surgery, pain index from 16.3 to 30.0, foot function from 28.7 to 41.6, foot position from 2.6 to 8.4. According to X-ray data the longitudinal arch angle decreased by 14.3° at an average and talar-calcaneal angle by 8°. Study results showed that technique of subtalar arthrodesis was effective enough for correction of flat foot resulted from II stage posterior tibial tendon dysfunction. Combination of that technique with tendon plasty ensured the full-value reconstruction of the foot.

Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality

2016 ◽  
Vol 10 (4) ◽  
pp. 302-307 ◽  
Author(s):  
Richard M. Hinds ◽  
Natalie R. Danna ◽  
John T. Capo ◽  
Kenneth J. Mroczek
Keyword(s):  
Foot And Ankle ◽  
Educational Content ◽  
Quality Of Information ◽  
Content Quality ◽  
Fellowship Programs ◽  
American Orthopaedic ◽  
Program Description ◽  
Informational Resource ◽  
Google Search

Background. The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. Methods. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Results. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. Conclusions. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Clinical Relevance. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Levels of Evidence: Level IV

scholarly journals Classification of Lexile Level Reading Load Using the K-Means Clustering and Random Forest Method

2020 ◽  
pp. 139-146
Author(s):  
Harits Ar Rosyid ◽  
Utomo Pujianto ◽  
Moch Rajendra Yudhistira
Keyword(s):  
Random Forest ◽  
Reading Ability ◽  
Random Forest Algorithm ◽  
Reading Material ◽  
A Value ◽  
Random Forest Method ◽  
Comprehension Ability ◽  
Lexile Levels

There are various ways to improve the quality of someone's education, one of them is reading. By reading, insight and knowledge of various kinds of things can increase. But, the ability and someone's understanding of reading is different. This can be a problem for readers if the reading material exceeds his comprehension ability. Therefore, it is necessary to determine the load of reading material using Lexile Levels. Lexile Levels are a value that gives a size the complexity of reading material and someone's reading ability. Thus, the reading material will be classified based a value on the Lexile Levels. Lexile Levels will cluster the reading material into 2 clusters which is easy, and difficult. The clustering process will use the k-means method. After the clustering process, reading material will be classified using the reading load Random Forest method. The k-means method was chosen because of the method has a simple computing process and fast also. Random Forest algorithm is a method that can build decision tree and it’s able to build several decision trees then choose the best tree. The results of this experiment indicate that the experiment scenario uses 2 cluster and SMOTE and GIFS preprocessing are carried out shows good results with an accuracy of 76.03%, precision of 81.85% and recall of 76.05%.

scholarly journals Ankle Hindfoot Scale vs Comprehensive SRMC Scoring System in Acute Achilles Tendon Rupture

2015 ◽  
Vol 2 (2) ◽  
pp. 77-79 ◽  
Author(s):  
Jambu Nageswaran ◽  
Samuel Chittaranjan Bedford ◽  
Ganesan Ganesan Ram
Keyword(s):  
Achilles Tendon ◽  
Scoring System ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
Asia Pacific ◽  
Foot And Ankle ◽  
Medical College ◽  
American Orthopaedic

ABSTRACT The existing scoring system like American Orthopaedic Foot and Ankle Society (AOFAS)-ankle hindfoot scale, Leppilahti et al scoring system, Achilles tendon total rupture score, foot and ankle outcome score, the physical activity scale (PAS) questionnaire and Tegner activity score were not designed to evaluate all the parameters following surgical treatment of Achilles tendon rupture. Hence, we developed a comprehensive score called the comprehensive Sri Ramachandra Medical College (SRMC) scoring system. We compared the results of 60 patients who were surgically treated for acute Achilles tendon rupture using our comprehensive SRMC scoring system with the most commonly used AOFAS-ankle hindfoot scale. Results We found that there was 6.7% poor results using our scoring system, whereas no poor results using AOFAS scoring system mainly because our scoring system also assesses quality of life, patient satisfaction and tendon strength. Similarly, there was 10% fair results in our scoring system compared to 3.3% in AOFAS scale indicating that our scoring system is more sensitive. Comprehensive SRMC scoring system was found to be reliable statistically as per alpha method (α = 0.7787) and was statistically significant at p < 0.001. Conclusion Comprehensive SRMC scoring system was found to be superior to AOFAS scale specifically for analyzing Achilles tendon repair. Poor results are likely to be picked up by our scoring system which has been shown in our results. How to cite this article Nageswaran J, Ram GG, Bedford SC. Ankle Hindfoot Scale vs Comprehensive Srmc Scoring System in Acute Achilles Tendon Rupture. J Foot Ankle Surg (Asia- Pacific) 2015;2(2):77-79.

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 Linear Attenuation as an Indicator for Safe Water

2019 ◽  
pp. 235-247
Author(s):  
M. U. Mgbukwu ◽  
L. D. Christopher ◽  
A. J. Iseh
Keyword(s):  
Attenuation Coefficient ◽  
Water Samples ◽  
Total Hardness ◽  
Linear Attenuation Coefficient ◽  
X Ray ◽  
Safe Water ◽  
A Value ◽  
Quality Of Water ◽  
Plateau State

This study analyses the linear attenuation coefficient as an indicator for safe water, the study was carried out using various water samples from borehole, well and pond in two Local Government Areas namely, Jos North and Jos East areas of Plateau State, Nigeria. The samples were collected in a Perspex of volume 7cmX7cmX7cm and filled to a height of 3cm. Energy of 70kVp of X-ray was passed through the samples with an X-ray detector under the Perspex of water to get the different final X-ray doses. From the study the linear attenuation coefficient ranges from 0.2878cm-1-0.4270cm-1, 0.3074cm-1-0.4743cm-1, 0.3074cm-1-0.4743cm-1 for borehole, well and pond in that order. The study showed a strong correlation between the linear attenuation coefficient and turbidity, total hardness and density which follows a trend for different samples. The highest value of linear attenuation ranges from borehole, well, pond in that order. This study was able to get a value of linear attenuation coefficient for safe water which ranges from 0.40203cm-1-0.02414cm-1 which can be used to ascertain the quality of water.

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