scholarly journals Clinical and Functional Outcomes in Patients with Distal Tibial Fracture Treated by Circular External Fixation: A Retrospective Cohort Study

2021 ◽  
Vol 16 (2) ◽  
pp. 86-95
Author(s):  
Paul Harwood ◽  
Patrick Foster ◽  
Vasileios P Giannoudis ◽  
Emma Ewins ◽  
D Martin Taylor
Keyword(s):  
Cohort Study ◽  
External Fixation ◽  
Retrospective Cohort Study ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Tibial Fracture ◽  
Distal Tibial Fracture

Functional Outcomes of Talectomy in Pediatric Feet

2021 ◽  
pp. 107110072098377
Author(s):  
Omar A. Al-Mohrej ◽  
Abdullah Y. Almarshad ◽  
Thamer S. Alhussainan
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Pediatric Patients ◽  
Medical Condition ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Talipes Equinovarus ◽  
The Mean

Background: Historically, talectomy has been predominantly performed to operatively treat severely rigid equinovarus feet. A limited number of investigators have studied functional outcomes in pediatric patients posttalectomy. We aimed to assess the outcomes of pediatric patients undergoing talectomy using the American Orthopaedic Foot & Ankle Society (AOFAS) score and a subjective survey of patients’ and their caregivers’ satisfaction. Methods: We performed a retrospective cohort study that included 31 patients with nonidiopathic severely rigid talipes equinovarus, in a single center, using consecutive sampling. All medical records of those patients were reviewed, and relative data were extracted. The AOFAS score was used to measure the outcomes during the last visit (April 2020). Satisfaction was evaluated in a binary manner by questioning the patients and their caregivers if they would undergo the same surgery again for the same result. Results: Thirty-one patients were included. Myelomeningocele was the primary diagnosis in 13 patients (41.9%), and arthrogryposis was diagnosed in 11 patients (35.5%). Twenty-two patients had bilateral procedures. The mean age at the time of surgery was 6.0 ± 3.0 years, and the mean follow-up was 6.0 ± 1.0 years. Plantigrade feet following the primary surgery were achieved in 88.5% of cases. Postoperatively, braces were well tolerated in 86.5% of patients. Deformity recurrence was observed in 21.2% of patients, and 17.3% of patients required subsequent surgeries. Patients with arthrogryposis had significantly higher AOFAS scores than those with myelomeningocele and other diagnoses ( P = .017). Further, patients who tolerated braces had higher AOFAS scores than those who did not tolerate braces ( P = .006). However, patients who developed hindfoot varus and dorsal bunion postoperatively had lower AOFAS scores ( P = .054 and P = .006, respectively). Patients who had recurrent deformities or required further surgeries also had lower AOFAS scores ( P = .025 and P = .015, respectively). Although 17.3% of patients were not able to comment about their satisfaction due to their general medical condition, 63.5% of patients reported that they were satisfied. Furthermore, 75.0% of caregivers were satisfied with the outcomes and their children’s functional status posttalectomy. Conclusion: The observed outcomes of primary and salvage talectomies demonstrate the general overall effectiveness of this operative intervention as an end-stage treatment for pediatric patients with severely rigid talipes equinovarus. Level of Evidence: Level III; retrospective cohort study.

scholarly journals Sagittal Tibiotalar Alignment May Not Affect Functional Outcomes in Fixed-Bearing Total Ankle Replacement: A Retrospective Cohort Study

2019 ◽  
Vol 16 (S2) ◽  
pp. 300-304
Author(s):  
Natalie M. Nielsen ◽  
Guilherme H. Saito ◽  
Austin E. Sanders ◽  
Scott J. Ellis ◽  
Carolyn M. Sofka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Total Ankle Replacement ◽  
Fixed Bearing ◽  
Ankle Replacement

scholarly journals Influence of Comorbidities on Functional Outcomes in Patients With Surgically Treated Fragility Hip Fractures: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Soo Hoon Yoon ◽  
Bo Ryun Kim ◽  
Sang Yoon Lee ◽  
Jaewon Beom ◽  
Jun Hwan Choi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Cerebrovascular Accident ◽  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Negative Impact ◽  
Korean Version ◽  
Significant Negative Impact

Abstract Background: The incidence and number of fragility hip fractures are gradually increasing, resulting in a wide consumption of medical resources. Various factors affecting functional recovery in patients with fragility hip fractures are known, and comorbid diseases are one of them. The purpose of this study is to determine the effect of comorbidities on functional outcomes in patients surgically treated for fragility hip fractures, thereby contributing to the efficient distribution of medical resources.Methods: This was a retrospective cohort study performed in the three tertiary rehabilitation facilities. A total of 211 patients (50 men and 161 women; average age 81.6±6.7 years) who had undergone surgery for fragility hip fractures were followed up from immediately after transfer to the Department of Rehabilitation Medicine to 6 months postoperatively. Comorbidities referred to a summary of the following conditions: hypertension, diabetes mellitus, chronic liver disease, dementia, cerebrovascular accident, and osteoporosis. Functional outcomes included Koval’s grade, functional ambulatory category (FAC), functional independence measure (FIM)-locomotion, modified Rivermead mobility index, Berg balance scale (BBS), 4-meter walking speed test, the Korean version of the Mini-Mental State Examination, Geriatric Depression Scale (GDS), EuroQol five-dimension (EQ-5D) questionnaire, the Korean version of the Modified Barthel Index, the Korean version of the instrumental activities of daily living (K-IADL), and Korean version of fatigue, resistance, ambulation, illnesses, and loss of weight scale (K-FRAIL). For all tests, each patient was assessed immediately after transfer and 6 months post-surgery.Results: Multivariate linear regression analyses adjusted for age, sex, the initial variable of the functional outcomes, and comorbidities revealed that dementia had a significant negative impact on Koval’s grade and K-FRAIL 6 months postoperatively. Diabetes mellitus had a significant negative impact on the FAC, GDS, EQ-5D, K-IADL, and K-FRAIL 6 months postoperatively. Patients with osteoporosis showed a significant negative outcome of FIM-locomotion 6 months postoperatively. A cerebrovascular accident revealed a significant negative impact on the BBS 6 months postoperatively. In addition, hypertension led to significantly less favorable outcomes of the K-FRAIL 6 months postoperatively. Conclusions: This study confirmed that comorbidities, particularly dementia and diabetes mellitus, significantly influence functional outcomes 6 months after fragility hip fracture surgeries.

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