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Showing 601 - 800 of 3562 Journals sorted alphabetically
Extreme Physiology & Medicine     Open Access   (Followers: 1)
F&S Reports     Open Access  
F&S Science : Official journal of the American Society for Reproductive Medicine     Open Access  
Facial Plastic Surgery & Aesthetic Medicine     Full-text available via subscription   (Followers: 7)
Facta Universitatis, Series : Medicine and Biology     Open Access  
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Practice     Hybrid Journal   (Followers: 17)
Family Practice & Palliative Care     Open Access   (Followers: 5)
Family Practice Management     Full-text available via subscription   (Followers: 4)
Faridpur Medical College Journal     Open Access  
FEM : Revista de la Fundación Educación Médica     Open Access  
Finlay : Revista de Enfermedades no Transmisibles     Open Access  
Fisioterapia     Full-text available via subscription   (Followers: 2)
Fisioterapia & Saúde Funcional     Open Access  
Flugmedizin · Tropenmedizin · Reisemedizin - FTR     Hybrid Journal  
FMC - Formación Médica Continuada en Atención Primaria     Full-text available via subscription  
Folia Medica     Open Access  
Folia Medica Indonesiana     Open Access  
Folia Morphologica     Full-text available via subscription  
Folia Phoniatrica et Logopaedica     Full-text available via subscription   (Followers: 1)
Fontanus     Open Access   (Followers: 1)
Food Hydrocolloids for Health     Open Access  
Foodborne Pathogens and Disease     Hybrid Journal   (Followers: 11)
Foot & Ankle Specialist     Hybrid Journal   (Followers: 4)
Foot and Ankle Clinics     Full-text available via subscription   (Followers: 12)
Foot and Ankle Online Journal     Full-text available via subscription   (Followers: 6)
Forensic Science International : Mind and Law     Open Access   (Followers: 4)
Forum Medycyny Rodzinnej     Hybrid Journal  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontières     Full-text available via subscription   (Followers: 3)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Medical Technology     Open Access  
Frontiers in Medicine     Open Access   (Followers: 2)
Frontiers in Network Physiology     Open Access   (Followers: 2)
Frontiers in Neuroprosthetics     Open Access   (Followers: 6)
Frontiers in Synaptic Neuroscience     Open Access   (Followers: 2)
Frontiers in Tropical Diseases     Open Access  
Frontiers of Medical and Biological Engineering     Hybrid Journal  
Frontiers of Medicine     Hybrid Journal   (Followers: 2)
Fuss & Sprunggelenk     Hybrid Journal  
Future Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Future Prescriber     Hybrid Journal  
Future Science OA     Open Access  
Gaceta Médica Boliviana     Open Access  
Gaceta Médica Espirituana     Open Access  
Galen Medical Journal     Open Access  
Galician Medical Journal     Open Access   (Followers: 1)
Galle Medical Journal     Open Access  
Gefäßmedizin Scan     Hybrid Journal  
Gender and the Genome     Open Access   (Followers: 1)
Gene Expression     Full-text available via subscription   (Followers: 1)
General Reanimatology     Open Access  
Genes     Open Access   (Followers: 2)
Genome Instability & Disease     Hybrid Journal  
Geoforum     Hybrid Journal   (Followers: 25)
Gestão e Desenvolvimento     Open Access  
Ghana Medical Journal     Open Access   (Followers: 1)
GigaScience     Open Access   (Followers: 4)
Gimbernat : Revista d’Història de la Medicina i de les Ciències de la Salut     Open Access  
Glia     Hybrid Journal   (Followers: 5)
Global Advances in Health and Medicine     Open Access  
Global Bioethics     Open Access   (Followers: 5)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access  
Global Journal of Cancer Therapy     Open Access  
Global Journal of Fertility and Research     Open Access  
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Infectious Diseases and Clinical Research     Open Access   (Followers: 1)
Global Journal of Medical and Clinical Case Reports     Open Access  
Global Journal of Obesity, Diabetes and Metabolic Syndrome     Open Access   (Followers: 2)
Global Journal of Perioperative Medicine     Open Access  
Global Journal of Rare Diseases     Open Access  
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Reproductive Health     Open Access  
Grande Medical Journal     Open Access  
Growth Factors     Hybrid Journal   (Followers: 2)
GSTF Journal of Advances in Medical Research     Open Access  
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi     Open Access  
Hamdan Medical Journal     Open Access  
Hämostaseologie     Hybrid Journal   (Followers: 4)
Hämostaseologie     Open Access  
Hand     Hybrid Journal   (Followers: 4)
Hand Clinics     Full-text available via subscription   (Followers: 6)
Hand Therapy     Hybrid Journal   (Followers: 11)
Hard Tissue     Open Access  
Head & Face Medicine     Open Access   (Followers: 1)
Head and Neck Cancer Research     Open Access  
Head and Neck Tumors     Open Access  
Health Information : Jurnal Penelitian     Open Access  
Health Matrix : The Journal of Law-Medicine     Open Access  
Health Notions     Open Access  
Health Science Journal of Indonesia     Open Access  
Health Science Reports     Open Access   (Followers: 1)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Sciences Review     Open Access  
Health Security     Hybrid Journal   (Followers: 1)
Healthcare Technology Letters     Open Access  
Hearing, Balance and Communication     Hybrid Journal   (Followers: 6)
Hearts     Open Access   (Followers: 1)
HEC Forum     Hybrid Journal   (Followers: 1)
Heighpubs Otolaryngology and Rhinology     Open Access  
Heilberufe     Hybrid Journal  
HeilberufeSCIENCE     Hybrid Journal  
Heilpflanzen     Hybrid Journal   (Followers: 8)
Helicobacter     Hybrid Journal  
HemaSphere     Open Access   (Followers: 2)
Hemoglobin     Hybrid Journal  
Hepatology, Medicine and Policy     Open Access  
HERALD of North-Western State Medical University named after I.I. Mechnikov     Open Access  
Herald of the Russian Academy of Sciences     Full-text available via subscription  
Herzschrittmachertherapie + Elektrophysiologie     Hybrid Journal  
Highland Medical Research Journal     Full-text available via subscription  
Hipertensión y Riesgo Vascular     Full-text available via subscription  
HIV Australia     Full-text available via subscription   (Followers: 3)
Homeopathy     Hybrid Journal   (Followers: 1)
Homoeopathic Links     Hybrid Journal  
Hong Kong Physiotherapy Journal     Open Access   (Followers: 14)
Horizonte Medico     Open Access  
Hormones : International Journal of Endocrinology and Metabolism     Hybrid Journal  
Hospital a Domicilio     Open Access  
Hospital Practices and Research     Open Access  
Hospital Topics     Hybrid Journal   (Followers: 1)
Hua Hin Sook Jai Klai Kangwon Journal     Open Access  
Huisarts en wetenschap     Hybrid Journal   (Followers: 4)
Human & Veterinary Medicine - International Journal of the Bioflux Society     Open Access   (Followers: 4)
Human Factors in Healthcare     Open Access   (Followers: 2)
Human Fertility     Hybrid Journal   (Followers: 4)
Humanidades Médicas     Open Access  
I.P. Pavlov Russian Medical Biological Herald     Open Access  
Iatreia     Open Access  
Ibnosina Journal of Medicine and Biomedical Sciences     Open Access  
IDCases     Open Access  
IEEE Journal of Biomedical and Health Informatics     Hybrid Journal   (Followers: 14)
IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology     Hybrid Journal  
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 5)
IEEE Open Journal of Engineering in Medicine and Biology     Open Access   (Followers: 1)
IEEE Transactions on Medical Robotics and Bionics     Hybrid Journal   (Followers: 3)
IEEE/ACM Transactions on Computational Biology and Bioinformatics     Hybrid Journal   (Followers: 18)
IJID Regions     Open Access   (Followers: 1)
IJS Global Health     Open Access  
IJU Case Reports     Open Access  
iLiver     Open Access   (Followers: 6)
Im OP     Hybrid Journal  
Image Analysis & Stereology     Open Access   (Followers: 1)
IMAGING     Full-text available via subscription   (Followers: 1)
Imaging in Medicine     Open Access  
Imaging Journal of Clinical and Medical Sciences     Open Access   (Followers: 1)
Imam Journal of Applied Sciences     Open Access  
Indian Journal of Ayurveda and lntegrative Medicine Klue     Open Access   (Followers: 4)
Indian Journal of Burns     Open Access   (Followers: 2)
Indian Journal of Clinical Medicine     Open Access  
Indian Journal of Community and Family Medicine     Open Access   (Followers: 3)
Indian Journal of Community Medicine     Open Access   (Followers: 1)
Indian Journal of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian Journal of Medical Microbiology     Open Access   (Followers: 1)
Indian Journal of Medical Research     Open Access   (Followers: 3)
Indian Journal of Medical Sciences     Open Access   (Followers: 2)
Indian Journal of Medical Specialities     Hybrid Journal  
Indian Journal of Otology     Open Access   (Followers: 1)
Indian Journal of Public Health     Open Access   (Followers: 1)
Indian Journal of Transplantation     Open Access  
Indian Spine Journal     Open Access  
Indo-Pacific Journal of Phenomenology     Open Access   (Followers: 1)
Indonesia Journal of Biomedical Science     Open Access   (Followers: 1)
Indonesian Biomedical Journal     Open Access  
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Medicine     Open Access  
Indonesian Journal of Tropical and Infectious Disease     Open Access  
Infant Observation: International Journal of Infant Observation and Its Applications     Hybrid Journal   (Followers: 1)
Inflammation     Hybrid Journal   (Followers: 3)
Inflammation Research     Hybrid Journal   (Followers: 4)
Info Diabetologie     Full-text available via subscription   (Followers: 1)
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
Informatics in Medicine Unlocked     Open Access  
Injury Prevention     Hybrid Journal   (Followers: 6)
InnovAiT     Hybrid Journal   (Followers: 1)
Innovare Journal of Health Science     Open Access  
Innovare Journal of Medical Science     Open Access  
Innovation in Aging     Open Access   (Followers: 1)
Inside Precision Medicine     Full-text available via subscription   (Followers: 6)
Insights in Biology and Medicine     Open Access  
Integrative and Complementary Therapies     Full-text available via subscription   (Followers: 6)
Integrative Medicine Insights     Open Access   (Followers: 1)
Integrative Medicine International     Open Access   (Followers: 1)
Integrative Medicine Research     Open Access   (Followers: 3)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 12)
Intelligence-Based Medicine     Open Access  
Intelligent Medicine     Open Access   (Followers: 1)
intensiv     Hybrid Journal   (Followers: 1)
interactive Journal of Medical Research     Open Access  
Interdisciplinary Perspectives on Infectious Diseases     Open Access   (Followers: 1)
Interdisciplinary Sciences : Computational Life Sciences     Hybrid Journal   (Followers: 2)
Internal Medicine     Open Access   (Followers: 1)
International Biomechanics     Open Access   (Followers: 1)
International Health     Hybrid Journal   (Followers: 5)
International Health Trends and Perspectives     Open Access  
International Journal for Numerical Methods in Biomedical Engineering     Hybrid Journal   (Followers: 2)
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 10)
International Journal of Academic Medicine     Open Access   (Followers: 1)

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Foot & Ankle Specialist
Journal Prestige (SJR): 0.503
Citation Impact (citeScore): 1
Number of Followers: 4  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1938-6400 - ISSN (Online) 1938-7636
Published by Sage Publications Homepage  [1174 journals]
  • Calendar for June 2022

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      Pages: 293 - 295
      Abstract: Foot & Ankle Specialist, Volume 15, Issue 3, Page 293-295, June 2022.

      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-17T11:46:47Z
      DOI: 10.1177/19386400221105555
      Issue No: Vol. 15, No. 3 (2022)
       
  • Anemia Severity and the Risks of Postoperative Complications Following
           Total Ankle Arthroplasty

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      Authors: Adam M. Gordon, Azeem Tariq Malik
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:Although studies have demonstrated the effect of anemia severity on postoperative complications after arthroplasties of the shoulder, hip, and knee, no studies have investigated the effect on total ankle arthroplasty (TAA). The objective was to determine the influence of preoperative anemia severity on complications following TAA.Methods:The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was queried from 2006 to 2019 for patients undergoing TAA. Utilizing the World Health Organization (WHO) definitions of anemia, patients were stratified into 3 cohorts: nonanemia (hematocrit>36% for women,>39% for men), mild anemia (hematocrit 33%-36% for women, 33%-39% for men), and moderate to severe anemia (hematocrit
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-30T04:41:51Z
      DOI: 10.1177/19386400221106650
       
  • Radiographic and Cadaveric Analysis of Minimally Invasive Bunionectomy
           Osteotomy Position—“MIS Bunion Sweet Spot”

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      Authors: Rikhil Patel, Noman Siddiqui, Mark A. Dreyer, Kevin Lam, Vineela Ayyagari, Alexandru Onica
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Minimally invasive surgery (MIS) is a growing technique that favors faster recovery and cosmetic results. We propose a recommended osteotomy position or “MIS Sweet Spot” to make the procedure more reproducible and lessen the learning curve to improve outcomes. A total of 211 patients from 3 surgeons between 2 different study centers were included in a retrospective radiograph measurement analysis and a cadaveric dissection to confirm the safety of nearby anatomical structures. An average distance of 2.2 cm proximal from the first metatarsophalangeal joint was found as the “Sweet Spot” to perform the transverse osteotomy. At this distance, neurovascular and tendinous structures were unharmed and the osteotomy remained extracapsular. Furthermore, an average of 10.7° of intermetatarsal angle reduction and a reduction of tibial sesamoid position of 3 points were achieved. A predictable and measurable distance for osteotomy placement will help to provide more confidence in producing the bunionectomy osteotomy with the specialized tools used in MIS and can help to reduce operative time and improve results.Level of Clinical Evidence (LOCE): 3
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-22T09:40:19Z
      DOI: 10.1177/19386400221101950
       
  • Sleep Apnea and Postoperative Medical Complications and Health Care
           Expenditures Following Open Reduction and Internal Fixation of Bimalleolar
           Ankle Fractures

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      Authors: Semran B. Thamer, Aaron W. Lam, Ivan J. Golub, Matthew L. Magruder, Rushabh M. Vakharia, Amiethab A. Aiyer, Amr A. Abdelgawad
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      IntroductionSleep Apnea (SA) is a common sleep disorder that increases postoperative morbidity. There is limited research on how SA influences outcomes following operative fixation of ankle fractures. Therefore, the aim of this study was to determine whether patients who undergo surgical fixation for bimalleolar ankle fractures have higher rates of medical complications and health care expenditures.MethodsA retrospective review from January 1, 2005 to March 31, 2014 was conducted using the parts A and B Medicare Data from PearlDiver database. Patients with and without SA on the day of the primary open reduction and internal fixation (ORIF) of their bimalleolar ankle fractures were queried using the International Classification of Diseases, Ninth Revision codes. Welch’st-tests were used to compare costs of care. A multivariate binomial logistic regression model was used to calculate the odds ratio (OR) of adverse events. A P-value
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-13T12:52:24Z
      DOI: 10.1177/19386400221098629
       
  • Rates of Operative Management for Achilles Tendon Rupture Over the Last
           Decade and the Influence of Gender and Age

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      Authors: J. Heath Wilder, Sione A. Ofa, Olivia C. Lee, Naomi E. Gadinsky, Ramon F. Rodriguez, William F. Sherman
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundWith emerging evidence supporting functional rehabilitation for Achilles tendon ruptures (ATRs), this study sought to evaluate the treatment trends for patients sustaining an acute ATR and whether gender and age may influence the rates of operative repair.MethodsA retrospective database review identified ATRs from 2010 through 2019. Patients were then stratified into three cohorts based on age (18-30, 30-45, and 46 and older), separated by gender, and then assessed whether patients were treated operatively or not. Cochran-Armitage Trend test was performed to analyze the trends of operative management. Chi-square analyses were performed to assess whether the proportion of patients who received operative management in each age cohort differed from 2010 to 2019. Logistic regression analyses were performed to assess whether gender influenced treatment.ResultsOver the previous decade, the total rates of operative treatment for ATR significantly decreased (18.3%-12.3%, P < .0001). Each individual age cohort experienced a proportional decrease in operative management when comparing 2010 with 2019 (all P < .0001). Within all age cohorts, males were significantly more likely to receive operative treatment for an ATR over the previous decade (odds ratios: 2.63-3.22). Conclusion. Overall rates of operative management for ATR decreased across all cohorts likely due to previous studies providing evidence of similar results between operative and nonoperative managements. Over the previous decade, males were demonstrated to be far more likely than females to undergo operative management. Why females are less likely to receive an operation for ATR is likely multi-factorial and requires further exploration.Level of Evidence:Level III: Retrospective comparative study
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-13T12:50:25Z
      DOI: 10.1177/19386400221102745
       
  • YouTube as a Source of Patient Information for Ankle Arthroplasty:
           Quantitative Analysis of Video Reliability, Quality, and Content

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      Authors: Davis A. Hartnett, Daniel S. Yang, Christopher J. Lama, Christopher L. McDonald, Alan H. Daniels, Brad D. Blankenhorn
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background. There are limited data on the quality and content of videos discussing total ankle arthroplasty (TAA) on the YouTube video platform. Methods. The first 60 unique YouTube videos resulting from the keyword query “ankle arthroplasty” and “ankle replacement” were analyzed for comprehensiveness and quality. Content was assessed using the Journal of American Medical Association (JAMA) benchmark criteria, DISCERN, Global Quality Scale (GQS), and an arthroplasty-specific score. Results. Videos demonstrated low mean DISCERN (49.2/80), GQS (3.2/5), and arthroplasty-specific scores (4.3/12) with substantial variability between videos. Most of the content was produced by nonacademic physicians (46.7%) and academic sources (21.7%). Academic videos saw significantly higher mean JAMA scores (P = .013) but were otherwise comparable to non-academic physicians. Commercial content demonstrated significantly low-quality scores compared to academic (P = .012) and physician (P = .008) sources despite the highest mean viewership. Conclusions. Information on TAA on the YouTube platform is highly variable based on video source, with generally poor quality and content.Level of Evidence: Level V, systemic review of non-peer reviewed resources
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-13T12:43:43Z
      DOI: 10.1177/19386400221097567
       
  • Infinity Ankle Arthroplasty Early Latin-America Experience and Patient
           Outcomes

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      Authors: Daniel Baumfeld, Tiago Baumfeld, Ricardo Fernandes Rezende, Caio Nery, Santiago Guerreiro
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      IntroductionThe promising data from Ankle Arthroplasty are consequence of the evolution of instruments and implants. Recent studies have shown good results in the short and intermediate follow-up, in addition to high patient satisfaction. The aim of this study is to present the results obtained with 49 cases treated with the Infinity total ankle prosthesis in 2 South America countries.MethodsThis is a case series of 48 patients (27 women and 22 men), treated with 49 Infinity prostheses in Brazil and Colombia. They underwent surgical treatment between April 1, 2016, and January 18, 2020. We used the visual-analogue pain scale (VAS), the AOFAS score for ankle and hindfoot and the measurement of range of motion (ROM) in the pre- and post-surgical period. The radiological evaluation was performed on ankle radiographs in anteroposterior and lateral views, obtained in orthostasis, measuring the parameters suggested by Hintermann. Average follow-up was 4 years.ResultsVAS reduced from an average of 7.94 to 1.98; AOFAS increased from 28.02 to 83.16 and ROM increased from 11.45 to 28.08. Distal Tibial Slope is higher for higher improvements in VAS and lower for higher improvements in AOFAS and ROM. We observed 4 wound infections, 1 intra-op medial malleolus fracture. No bone cysts, tibial or talar components subsidence, polyethylene component wear or failure were observed. No salvation procedures were required in this series.DiscussionThis study results corroborates literature data showing great improvements in pain, functional pattern, and movement.ConclusionInfinity Ankle Arthroplasty is a safe and reproducible procedure with good outcomes at a short-term follow-up.Level of evidences:4 - Case series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-03T09:05:42Z
      DOI: 10.1177/19386400221097565
       
  • An Operational Definition of First Ray Hypermobility

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      Authors: Ward M. Glasoe
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:The first ray (metatarsocuneiform) behaves as a load-bearing strut in supporting weight. Due to its functional importance, stress-testing techniques are used to assess the stability of the first ray and objectify evidence of hypermobility. The test and measurement of first ray hypermobility (FRH) is of interest to clinicians and researchers. The condition itself, however, has proven elusive to diagnose. This article defines FRH for the purpose of improving the consistency by which the diagnosis is made. Currently, the lack of a consensus definition prevents research from determining the incidence rates and prevalence of FRH, a commonly reported medical condition.The Definition:Symptomatic FRH presents as dorsal displacement that measures greater than 8 mm, accompanied with signs and symptoms consistent with loading insufficiency of the first ray. The operational definition is objective and if adopted across health care professions, the criterion could become the standard for identifying FRH in patients and research participants.Level of Evidence:Level V, expert opinion
      Citation: Foot & Ankle Specialist
      PubDate: 2022-06-03T08:31:12Z
      DOI: 10.1177/19386400221093864
       
  • Utilization of the Modified Lapidus Procedure for Correction of Moderate
           to Severe Hallux Valgus Deformity With Increased Distal Metatarsal
           Articular Angle

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      Authors: Milaan Shah, Brianna Stirling, J. Benjamin Jackson, Tyler Gonzalez
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:Hallux valgus, a common deformity treated by orthopaedic foot and ankle surgeons, can frequently present with an increased distal metatarsal articular angle (DMAA), which may require correction in addition to the hallux valgus deformity. Thus, we investigated the efficacy of the modified Lapidus procedure, a triplanar correction, in correcting the DMAA in hallux valgus surgery.Methods:A retrospective chart review was performed on patients who underwent the hallux valgus reconstruction with a modified Lapidus procedure between April 26, 2018, and November 19, 2020. Exclusion criteria included patients with inadequate follow-up. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and DMAA were measured on preoperative weight-bearing, 2-week postoperative non-weight-bearing, and at final follow-up weight-bearing radiographs.Results:The study included a total of 99 cases of modified Lapidus procedure for hallux valgus on 85 subjects. On radiologic assessment, the average DMAA decreased from 17.72 ± 6.18 degrees preoperatively to 9.19 ± 5.19 degrees 2 weeks postoperatively (P < .0001) and 9.79 ± 4.62 degrees at the final follow-up (P < .0001). The average HVA decreased from 31.34 ± 10.39 degrees preoperatively to 13.34 ± 6.16 degrees 2 weeks postoperatively (P < .0001) and 15.05 ± 7.43 degrees at final follow-up (P < .0001). Last, the IMA decreased from 14.99 ± 3.82 degrees preoperatively (P < .0001) to 4.66 ± 2.59 degrees 2 weeks postoperatively and 6.62 ± 3.46 degrees at final follow-up (P < .0001). The recurrence rate was 3.03%.Conclusion:The modified Lapidus procedure is an effective procedure in correcting the HVA, IMA, and DMAA in hallux valgus surgery without the need for additional distal or proximal metatarsal osteotomies. Surgeons should consider this technique in patients with moderate to severe hallux valgus deformity who may require correction of their DMAA.Level of Evidence:Level IV-Retrospective comparative study.
      Citation: Foot & Ankle Specialist
      PubDate: 2022-05-24T11:39:46Z
      DOI: 10.1177/19386400221093859
       
  • High Pain Catastrophizing Scale Predicts Lower Patient-Reported Outcome
           Measures in the Foot and Ankle Patient

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      Authors: Andrea Veljkovic, Oliver Gagne, Monther Abuhantash, Alastair S. E. Younger, Michael Symes, Murray J. Penner, Kevin J. Wing, Khalid A. Syed, Johnny Lau
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:Postoperative outcomes may be affected by the patient’s preoperative morbidity. It is hypothesized that patient’s pain catastrophization prior to foot and ankle surgery may affect their patient-reported outcomes. Methods: This study prospectively assessed a consecutive cohort of 46 patients undergoing foot and ankle reconstruction to describe the relationship between Pain Catastrophizing Scale (PCS) and patient-reported outcomes measured by 12-item Short Form Health Survey and Foot and Ankle Outcome Score (FAOS).Results:The 1-year postoperative FAOS pain, activities of daily living, and quality of life scores correlated significantly with all baseline PCS subcategories. We found that the mental domain of the SF-12 had a statistically significant correlation with the rumination and helplessness PCS subcategories.Conclusion:This study showed a significant association between a high preoperative PCS and a worse 1-year FAOS. As such, catastrophization could be screened for and potentially treated preoperatively to improve patient-reported outcomes in elective foot and ankle surgery.Level of Evidence:Therapeutic, Level III Evidence
      Citation: Foot & Ankle Specialist
      PubDate: 2022-05-24T06:54:25Z
      DOI: 10.1177/19386400221093865
       
  • Are SER-II Ankle Fractures Anatomic' Computed Tomography Demonstrates
           Mortise Malalignment in the Setting of Apparently Normal Radiographs

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      Authors: Bonnie Y. Chien, Eitan M. Ingall, Steven Staffa, Caroline Williams, Christopher P. Miller, John Y. Kwon
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:Ankle fracture treatment is predicated on minimal displacement, leading to abnormal joint contact area. The purpose of this investigation is to determine whether computed tomography (CT) detects subtle mortise malalignment undetectable by x-ray in supination-external rotation–II (SER-II) injuries.Methods:A total of 24 patients with SER-II injuries, as demonstrated by negative gravity stress radiography, were included. Medial clear space (MCS) measurements were performed on bilateral ankle x-rays (injured and contralateral, uninjured side) at several time points as well as bilateral non-weight-bearing CT performed once clinical and radiographic healing was demonstrated (mean = 66 days post injury, range = 61-105 days). Statistical analyses examined differences in measurements between both sides.Results:Final x-rays demonstrated no differences between normal and injured ankle MCS (P = .441). However, CT coronal/axial MCS measurements were different (P < .05). CT coronal MCS measured wider by a mean difference of 0.67 mm (P < .001).Conclusion:There is a high incidence of subtle mortise malalignment in SER-II ankle fractures, as demonstrated by CT, which is undetectable when assessed by plain radiographs. Although clinical outcomes are yet unknown, there are important implications of the finding of confirmed, subtle mortise malalignment in SER-II injuries and the limitations of x-ray to detect it.Level of Evidence:Level III
      Citation: Foot & Ankle Specialist
      PubDate: 2022-05-19T11:01:08Z
      DOI: 10.1177/19386400221093861
       
  • Risk Factors for Failure of Conservative Management of Insertional
           Achilles Tendinosis

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      Authors: Bryce F. Kunkle, Nicholas A. Baxter, Alexander M. Caughman, John A. Barcel, Daniel J. Scott, Christopher E. Gross
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Introduction:While many patients benefit from nonoperative treatment of insertional Achilles tendinopathy (IAT), some elect for surgical debridement and reconstruction. The purpose of this study is to determine the relationship of patient demographic characteristics, comorbidity profiles, and radiological parameters with failure of conservative management of IAT.Methods:A retrospective chart review was performed to identify patients who received either surgical or nonsurgical treatment of IAT at an academic institution from September 2015 to June 2019 (N = 226). Demographic and comorbidity data, and the presence and magnitude of relevant radiological parameters were collected and compared between the surgically (n = 48) and nonsurgically (n = 178) treated groups.Results:No significant differences could be detected between groups regarding demographic factors or previous procedures. The surgery group was significantly more likely to have evidence of Haglund’s deformity on clinical exam (83% vs 69%, P = .005), lower SF-12 physical scores (25.5 vs 35.5, P < .001), higher VAS pain scores (6.3 vs 5.3, P = .033), any mental illness (33% vs 20%, P = .044), and depression (27% vs 12%, P = .012).Discussion:Patients who received surgery for IAT were significantly more likely to have evidence of Haglund’s deformity on clinical exam, depression, higher VAS pain scores, and lower SF-12 physical scores. Both patients and surgeons should be aware of the higher rates of failure of conservative treatment in these patients.Level of Evidence:Level III
      Citation: Foot & Ankle Specialist
      PubDate: 2022-05-18T10:18:11Z
      DOI: 10.1177/19386400221090358
       
  • Increased Arthrodesis Rates in Charcot Neuroarthropathy Utilizing Distal
           Tibial Distraction Osteogenesis Principles

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      Authors: Noman A. Siddiqui, Kelsey J. Millonig, Brittany E. Mayer, Jessica N. Fink, Philip K. McClure, Christopher Bibbo
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Charcot neuroarthropathy of the hindfoot and ankle poses substantial challenges due to deformity, segmental bone loss, chronic infection, and difficulty with bracing. Hindfoot or ankle arthrodesis is often employed at high rates of complications and nonunion. This study reports 15 consecutive patients with Charcot neuroarthropathy who underwent tibiotalocalcaneal or tibiocalcaneal fusion with simultaneous distal tibial distraction osteogenesis with a mean follow-up period of 20.2 ± 5.66 months. Arthrodesis rate was 93.3% (14 patients) with mean time to fusion of 4.75 ± 3.4 months. One hypertrophic nonunion occurred at the arthrodesis site. Complete consolidation of 4 cortices was achieved at the distraction site in 93.3% of patients (14 patients) with a mean duration to consolidation of 9.8 ± 3.3 months. One patient experienced hypertrophic nonunion at the regeneration site. The authors report a technique to enhance arthrodesis rates in Charcot neuroarthropathy by combining distal tibial distraction osteogenesis with simultaneous tibiotalocalcaneal or tibiocalcaneal arthrodesis for hindfoot fusion and salvage. Distraction osteogenesis supports enhanced vascularity to the arthrodesis site.Level of Clinical Evidence: Level 4
      Citation: Foot & Ankle Specialist
      PubDate: 2022-05-04T06:56:43Z
      DOI: 10.1177/19386400221087822
       
  • Three-Dimensional-Printed Lesser Metatarsal Replacement: The First Case
           Report

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      Authors: Naji S. Madi, Aman Chopra, Selene G. Parekh
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Different procedures have been reported for severe and recurrent lesser toes deformity. These included DuVries metatarsophalangeal joint arthroplasty, resection arthroplasty, partial proximal phalangectomy, syndactylization, or lesser toe amputation. In the presence of a failed metatarsal head resection, the surgeon is faced with limited salvage options including Hoffman procedure or lesser toe amputation. The 3D printing technology has allowed orthopaedic surgeons to expand the therapeutic arsenal to address challenging situations. We herein present the first case of 3D-printed second lesser metatarsal replacement performed after a failed second metatarsal head resection.Level of Evidence: V
      Citation: Foot & Ankle Specialist
      PubDate: 2022-04-20T06:15:37Z
      DOI: 10.1177/19386400221088455
       
  • Regional Anesthesia Decreases Inpatient But Not Outpatient Opioid Demand
           in Ankle and Distal Tibia Fracture Surgery

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      Authors: Daniel J. Cunningham, Ariana Paniagua, Isabel DeLaura, Gloria Zhang, Billy Kim, Jonathan Kim, Terry Lee, Micaela LaRose, Samuel Adams, Mark J. Gage
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Introduction:Regional anesthesia (RA) is commonly used in ankle and distal tibia fracture surgery. However, the pragmatic effects of this treatment on inpatient and outpatient opioid demand are unclear. The hypothesis was that RA would decrease inpatient opioid consumption and have little effect on outpatient demand in patients undergoing ankle and distal tibia fracture surgery compared with patients not receiving RA.Methods:All patients aged 18 years and older undergoing ankle and distal tibia fracture surgery at a single institution between July 2013 and July 2018 were included in this study (n = 1310). Inpatient opioid consumption (0-72 hours postoperatively) and outpatient opioid prescribing (1 month preoperatively to 90 days postoperatively) were recorded in oxycodone 5-mg equivalents (OEs). Adjusted models were used to evaluate the impact of RA versus no RA on inpatient and outpatient opioid demand.Results:Patients without RA had higher rates of high-energy mechanism of injury, additional injuries, open fractures, and additional surgery compared with patients with RA. Adjusted models demonstrated decreased inpatient opioid consumption in patients with RA (12.1 estimated OEs without RA vs 8.8 OEs with RA from 0 to 24 hours postoperatively, P < .001) but no significant difference after that time (9.7 vs 10.4 from 24 to 48 hours postoperatively, and 9.5 vs 8.5 from 48 to 72 hours postoperatively). Estimated cumulative outpatient opioid demand was significantly increased in patients receiving RA at all time points (112.5 OEs without RA vs 137.3 with RA from 1 month preoperatively to 2 weeks, 125.6 vs 155.5 OEs to 6 weeks, and 134.6 vs 163.3 OEs to 90 days, all P values for RA
      Citation: Foot & Ankle Specialist
      PubDate: 2022-04-20T06:13:46Z
      DOI: 10.1177/19386400221088453
       
  • Anterior Capsule Reconstruction in the Setting of PVNS

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      Authors: Eric Lukosius, Aman Chopra, Selene Parekh
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Background:Pigmented villonodular synovitis (PVNS) is a benign proliferative disease affecting tendon sheaths and synovial tissue. Pigmented villonodular synovitis in the foot and ankle has a high rate of recurrence, which can be destructive if incompletely removed. This case series analyzes functional outcomes after PVNS operative resection with an anterior ankle capsular reconstruction, using a novel technique.Methods:Three patients with PVNS underwent surgery between 2010 and 2020. The operative technique involved a posterior, midline approach for PVNS resection of the affected ankle joint, followed by a standard anterior approach for capsular excision. Subsequent anterior capsular reconstruction was performed with a regenerative tissue matrix and a bioresorbable anchoring system. Preoperative and postoperative range of motion for the ankle and subtalar joints, visual analog scale (VAS) for pain, and return to daily activities was assessed along with appropriate radiographs and magnetic resonance imaging (MRI) imaging.Results:All 3 surgeries had a mean follow-up period of 52.3 (range, 4-123) months and resulted in successful recovery as assessed by the VAS and self-reported activity. Preoperative ankle dorsiflexion and plantarflexion along with subtalar inversion and eversion range of motion were all normal. Postoperative ankle motion and subtalar motion were not statistically different. No complications or recurrence of PVNS was observed.Conclusion:Further investigation is warranted to better understand the clinical outcomes of this technique designed to successfully eliminate PVNS recurrence.Level of Evidence:IV- Retrospective case series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-04-13T09:52:21Z
      DOI: 10.1177/19386400221088456
       
  • Outcomes Following Repeat Ankle Arthroscopy and Microfracture for
           Osteochondral Lesions of the Talus

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      Authors: Kevin A. Schafer, Brian M. Cusworth, Gregory S. Kazarian, Jonathon D. Backus, Sandra E. Klein, Jeffrey E. Johnson, Jeremy J. McCormick
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundThe management of symptomatic osteochondral lesions of the talus (OLTs) previously treated with arthroscopy is controversial. Minimal data exist on the role for repeat arthroscopy. Here, we describe our experience with repeat arthroscopy and microfracture for symptomatic OLTs.MethodsOur database was queried over an 8-year period to identify patients undergoing repeat arthroscopy and microfracture as treatment for symptomatic OLTs. Phone surveys were conducted to assess residual pain, patient satisfaction, and need for subsequent surgery. We compared patient outcomes based on the size of their OLT (small lesions ≤150 mm2, large >150 mm2) and the presence or absence of subchondral cysts.ResultsWe identified 14 patients who underwent repeat arthroscopy and microfracture for symptomatic OLTs. Patients reported reasonable satisfaction (7.6 ± 3.5 out of 10) but moderate residual pain (4.7 ± 3.4 out of 10) at midterm follow-up (5.1 ± 2.9 years). In total, 21% (3/14) of patients had undergone subsequent surgery. Patients with small (n = 5) and large OLTs (n = 9) had similar postoperative pain scores (4.2 ± 4.1 vs 4.9 ± 3.2) and postoperative satisfaction levels (6.4 ± 4.9 vs 8.3 ± 2.5).ConclusionAt midterm follow-up, repeat arthroscopy for symptomatic OLTs demonstrated reasonable satisfaction but moderate residual pain. Lesion size or presence of subchondral cysts did not affect outcome, but our sample size was likely too small to detect statistically significant differences. These data show that repeat ankle arthroscopy can be performed safely with modest outcomes, and we hope that this report aids in managing patient expectations.Level of Evidence: Level IV Case Series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-03-07T05:30:12Z
      DOI: 10.1177/19386400221079203
       
  • Mini-Open Achilles Tendon Repair: Improving Outcomes While Decreasing
           Complications

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      Authors: Tyler Hoskins, Jay Patel, Joseph H. Choi, Brendan Fitzpatrick, Brian Begley, Chris J. Mazzei, Colin J. Harrington, Justin M. Miller, James C. Wittig, David Epstein
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      An acute rupture of the Achilles tendon is a traumatic injury that can cause considerable morbidity and reduced function. Nonoperative intervention may put patients at higher risk of rerupture, whereas surgical intervention carries risk of infection, wound complications, and iatrogenic nerve injury. The mini-open Achilles tendon repair technique has been popularized in helping decrease complications. The goal of this study was to examine and compare the functional outcomes and rate of complications in patients treated with a mini-open repair technique versus a traditional open repair for acute Achilles tendon ruptures. A retrospective review was performed of all patients with a complete Achilles tendon rupture that were treated by a single foot and ankle fellowship-trained surgeon. Functional outcome scores were assessed using the American Orthopaedic Foot and Ankle scoring system (AOFAS) and the Achilles Tendon Rupture Score (ATRS). Eighty-one patients with a complete Achilles tendon rupture underwent mini-open repair and 22 patients underwent traditional open repair surgery between 2013 and 2020. The mean follow-up was 38.40 months (range, 12-71). Mean preoperative AOFAS and ATRS improved in the mini-open group from 45.60 and 47.18 respectively, to 90.29 and 87.97 after surgery (p < .05). Mean preoperative AOFAS and ATRS scores for the traditional open repair (n = 22) cohort were 44.02 and 42.27, respectively. Postoperatively, the AOFAS and ATRS scores improved to 85.27 and 86.64 (P value < .05), respectively. There was no statistically significant difference in postoperative ATRS scores. However, the mini-open repair group showed a statistically higher postoperative AOFAS score (90.30) than the traditional open-repair group (85.27) (P value < .05). The overall complication rate for our study was 2.9% (2 mini-open repair and 1 traditional open repair). The complication rate in the mini-open repair group and traditional open repair cohort were 2.4% and 4.5%, respectively (P value > .05). One patient in the mini-open repair cohort (1.2%) reruptured his Achilles tendon 4 months postoperatively. A second patient in the mini-open repair group (1.2%) developed a superficial skin infection and suture irritation. One patient (4.5%) in the traditional open repair group developed a superficial skin infection. There were no sural nerve injuries in our series. The mini-open approach to repair a ruptured Achilles tendon is a viable treatment option to decrease the incidence rate of postoperative complications and rerupture rates while also producing a superior cosmetic result.Level of Evidence: 3 (retrospective cohort study N ≥ 30).
      Citation: Foot & Ankle Specialist
      PubDate: 2022-03-07T05:28:03Z
      DOI: 10.1177/19386400221078671
       
  • Modified Bösch Osteotomy Combined With a Percutaneous Adductor Tendon
           Release for the Treatment of Hallux Valgus Deformity: Learning Curve

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      Authors: Mauricio Esteban Ghioldi, Lucas Nicolás Chemes, Eric Daniel Dealbera, Mariano De Prado, Jorge Javier Del Vecchio
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      PurposeThe expression “learning curve” indicates the relation between the time needed to learn a new technique and the technique-related outcome. Percutaneous surgery (also called “minimally invasive surgery”) has experienced sustained and respectable growth, especially in forefoot deformities. The main purpose was to assess the number of feet necessary to become skilled in a specific minimally invasive surgery (MIS) procedure.MethodsFrom January 2015 to June 2018, 46 consecutive patients were evaluated and included in the study. Patients were divided into 2 groups according to the surgery period: first 30 feet (Group 1), and subsequent 30 feet (Group 2) from the whole population evaluated. Age, body mass index, and operative time were evaluated. Hallux valgus angle and the 1 to 2 intermetatarsal angle were also measured. Patients were assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scale, the Foot and Ankle Ability Measure activities of daily living (FAAM ADL) subscale and the visual analog scale (VAS).ResultsThe comparison of the 2 groups showed statistically significant differences in hallux valgus angle (HVA) but not in intermetatarsal angle (IMA). The mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS score in Group 1 were 12.83, 3.93, and 24.77 points, respectively. In Group 2, the mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS scores were 15.19, 4.3, and 24.5 points, respectively. The differences between groups in FAAM ADL score was statistically significant (P = 0.0364). Group 1 showed a global complication rate of 16.67% (n = 5) while group 2 showed 3,3% (n = 1).ConclusionAfter the first 30 cases, radiographic, clinical, and functional outcomes substantially improved, and the level of the perioperative complications decreased. The results suggest that the learning curve plateau for performing a percutaneous subcapital osteotomy can be reached after 30 surgeries.Levels of EvidenceLevel III
      Citation: Foot & Ankle Specialist
      PubDate: 2022-03-03T08:52:54Z
      DOI: 10.1177/19386400221079198
       
  • Management of Giant Cell Tumor of Talus With Extended Intralesional
           Curettage and Reconstruction Using Polymethylmethacrylate Cement

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      Authors: Muhammad Saad Ilyas, Rizwan Akram, Uruj Zehra, Amer Aziz
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      An 18-year-old man presented with complaints of pain and swelling around the left ankle region. Local examination revealed diffuse, hard, mildly tender swelling with ill-defined margins over the medial aspect of the left ankle joint just below the medial malleolus. Radiographic and computed tomographic assessment revealed osteolytic lesion with moderately defined margins. Provisional diagnosis of Campanacci grade 2 giant cell tumor was made, which was later confirmed on histopathology. Extended intralesional curettage and reconstruction with polymethylmethacrylate cement was done under spinal anesthesia. Full weight bearing was allowed at 4 weeks when the below knee back slab was removed. Radiographic assessment was done every 3 months during the first year of follow-up and then every 6 months. No evidence of recurrence of tumor, collapse of talus, or avascular necrosis was found during follow-up. Managing such rare form of bone tumors with extended intralesional curettage and bone cement is an appropriate treatment and gives good functional results.Level of Evidence: Level V
      Citation: Foot & Ankle Specialist
      PubDate: 2022-03-01T10:10:31Z
      DOI: 10.1177/19386400221079487
       
  • Comparison of Posterior and Lateral Surface Plating for Type B Weber
           Lateral Malleoli Fractures

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      Authors: Atmananda Hegde, Chethan Shetty, Nitin Joseph, Prajwal Mane
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      PurposeThe purpose of this study is to compare the functional outcomes, radiological outcomes, complication rates, and hardware removal between lateral and posterior surface plating in isolated type B Weber lateral malleolus fractures.MethodsIt was a retrospective study that compared the outcomes of type B Weber lateral malleoli fractures treated by either lateral surface or posterior surface plating. Radiological and functional outcomes were assessed at regular intervals. The follow-up details and the complications and need for implant removal were collected from the hospital records.ResultsOur study included 60 patients (male-35 and female-25). The mean age was 41.7 ± 10.5 years. In all, 28 (46.7%) patients received lateral surface plating and 32 (53.3%) patients received posterior surface plating. The mean time gap between the injury and the surgery was significantly more among patients who underwent lateral plate insertion (P < .001). The mean operative time required for both the procedures was comparable, hence nonsignificant (P = .576). The mean American Orthopaedic Foot and Ankle Society score (AOFAS) after 2 years of operation was significantly higher for posterior plate insertion (P = .014). The complication rates as well as the implant removal rates were higher in patients with lateral plating (P < .05).ConclusionPosterior surface plating can be considered as the procedure of choice for isolated type B Weber lateral malleolus fractures with respect to better functional outcome, lesser complications rates, and need for implant removal.Level of Evidence:Level III: Economic/decision
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-23T06:23:35Z
      DOI: 10.1177/19386400221079197
       
  • Minimally Invasive Chevron Akin: Locking The Metatarsal-Cuneiform Joint

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      Authors: Gustavo Araujo Nunes, Gabriel Ferraz Ferreira, Tiago Baumfeld, Miguel Viana Pereira Filho, Daniel Baumfeld, Peter Lam
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      IntroductionMinimally Invasive Chevron Akin (MICA) can be used to treat hallux valgus (HV) associated with a hypermobility of the first metatarsal-cuneiform joint (1MTCJ). The aim of this study was to perform a radiographic analysis of the MICA, focused on evaluating the 1MTCJ.MethodsForty patients (50 feet) with moderate to severe HV underwent a MICA procedure. Radiographic analysis included hallux valgus angle (HVA), intermetatarsal angles between the first and second rays (IMA), the intermetatarsal angle between the proximal fragment of the osteotomy and the second ray (IAPF) and the distance between a point 3 cm distal from the base of the second metatarsal and a point located at the same height for the first metatarsal base (Dist 1-2). The IAPF was compared with the preoperative IMA, and the other parameters were compared preoperatively and postoperatively. The radiographic complications were also recorded.ResultsMost patients were female (92%). The mean age was 50.4 years (SD = 16.1) and the mean follow-up was 16.1 months (SD = 3.5). The average HVA improved from 32.5° to 7.3°, and the average IMA from 14.2° to 4.2°. The IAPF and Dist1-2 values showed an increase of 4.8° and 4.0 mm respectively. There were no radiographic complications. Conclusion. Minimally invasive Chevron Akin promotes a great correction of the moderate to severe HV conventional parameters and increase the transversal stability of the 1MTCJ fixing this joint as medial as possible.Level of EvidenceLevel IV, case series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-23T06:21:03Z
      DOI: 10.1177/19386400221079155
       
  • Outcomes and Complications of the INFINITY Total Ankle: A Systematic
           Review

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      Authors: Matthew D. Doyle, Megan A. Ishibashi, Ryan M. Sherick, Logan H. Mitchell, Francesca M. Castellucci-Garza, Nilin M. Rao
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Ankle arthroplasty is a viable treatment option for end-stage ankle arthritis and has shown improvements in pain relief, motion, as well as function and gait. Newer generation total ankle prostheses have improved instrumentation and surgical techniques, as well as minimal bone resection on both the tibia and talus. The purpose of this systematic review was to determine the short-term clinical success of the INFINITY total ankle, including the common complications and rate of revision with this prosthesis. We performed a systematic review of electronic databases that included reported complications and revisions using this prosthesis. Complications were recorded according to the Glazebrook classification. Six total published studies with clinical outcomes and complications and 432 prostheses were included. The weighted mean follow-up was 24.5 months and weighted mean patient age was 62.3 years. There were 43 (10.0%) total complications—9 low grade, 16 medium grade, and 18 high grade. There were 26 total revision procedures (6.0%). Revisions were mostly performed for deep infection, aseptic loosening, and subsidence. When including deep infections, the overall implant survivorship was 94%. When excluding the 8 deep infections requiring revision, implant survivorship was 96%. The INFINITY has acceptable short-term complication and revision rates. This fourth-generation prosthesis compares to prior reported studies with earlier generation ankle implants in the short term.Level of Evidence:IV
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-22T08:29:56Z
      DOI: 10.1177/19386400221079491
       
  • Validity and Reliability of the American Orthopaedic Foot and Ankle
           Society Score for the English-Literate Singapore Population With Hallux
           Valgus

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      Authors: Chin Chuen Tan, Andrew Arjun Sayampanathan, Yu Heng Kwan, William Yeo, Inderjeet Singh Rikhraj, Nicholas Eng Meng Yeo
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundThis study aimed to evaluate the reliability and validity of the American Orthopaedic Foot and Ankle Society Metatarsophalangeal-Interphalangeal (AOFAS MTP-IP) score in patients with hallux valgus in Singapore.MethodA total of 121 English-literate patients with hallux valgus identified between October 2017 and May 2020 were analyzed. Reliability was assessed via Cronbach α. Construct validity was evaluated through 20 a priori hypotheses by correlating the AOFAS MTP-IP score for hallux and lesser toes with other patient-reported outcome measures (PROMs). Standardized response means (SRMs) were calculated to evaluate responsiveness at 6 months postoperative. Structural validity was evaluated via confirmatory factor analysis (CFA) whereby a good fit was indicated when comparative fit index (CFI) is>0.95, Tucker-Lewis index (TLI) is>0.95 and standardized root mean residual (SRMR) is
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-22T07:25:26Z
      DOI: 10.1177/19386400221079490
       
  • Radiographic Comparison of Heterotopic Ossification After Primary Total
           Ankle Arthroplasty in Fourth-Generation Implants

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      Authors: Matthew D. Doyle, Logan H. Mitchell, Megan A. Ishibashi, Francesca M. Castellucci-Garza, Ryan M. Sherick, Nilin M. Rao
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Heterotopic ossification (HO) is a known sequela in total ankle arthroplasty. The purpose of this study was to determine the radiographic incidence of HO in fourth-generation total ankle implants including the INFINITY, CADENCE, and VANTAGE. Radiographs were assessed for the incidence and location of HO in each implant using the modified Brooker classification. Seventy-one patients were included. There were 41 INFINITY, 16 CADENCE, and 14 VANTAGE implants. The average radiographic follow-up was 19.7 months. The incidence of HO was 69.0%. Overall, the HO was Class I in 31 cases (63.3%); Class II in 7 cases (14.3%); Class III in 10 cases (20.4%); and Class IV in 1 case (2.0%). For INFINITY; n = 33 patients (80.5%), CADENCE; n = 8 patients (50%); VANTAGE n = 8 patients (57.1%). When comparing INFINITY with CADENCE/VANTAGE, there was a statistically significant difference in presence of HO (P = 0.01). When comparing INFINITY with CADENCE, there was a statistically significant difference in presence of HO (P = 0.04). In the 33 cases of INFINITY with HO, 30 had neutral or posterior coverage, and in 4 cases, the prosthesis did not extend to the posterior tibial cortex (P = 0.005). This study demonstrates a continued high rate of HO with 3 fourth-generation ankle implants in the short term, although many were Class 1 and posterior. The INFINITY had a higher overall incidence of HO. Adequate posterior cortical coverage did not play a role in radiographic presence of HO. Further research is warranted with longer-term follow-up to determine the clinical and radiographic significance of HO.Level of Evidence:Level III: Retrospective comparative
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-16T09:05:24Z
      DOI: 10.1177/19386400221079199
       
  • Hallux Valgus Interphalangeus Measurement: Comparison of the 2
           Radiographic Methods

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      Authors: Nimesh Nebhani, Mihir Yatin Trivedy, Gavin Heyes, Andrew Molloy, Lyndon Mason
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundTo determine the reliability of Delta PP (difference in medial and lateral proximal phalanx wall length) compared with HIA (hallux interphalangeal angle) in the assessment of HVI (hallux valgus interphalangeus) in both preoperative and postoperative radiographs.MethodsThis was a retrospective observational study of 186 feet with hallux valgus. The number of cases required to adequately power the study was 128. Preoperative and postoperative hallux alignment were evaluated by 2 different radiological parameters, Delta PP and HIA. Interobserver variability was assessed independently by 2 authors and compared using a intraclass correlation coefficient.ResultsThe intraclass correlation coefficient was more than 0.8 for all parameters, thus both HIA and Delta PP measurement provide reliable and reproducible data. Mean HIA significantly increased following surgical correction of hallux valgus. In comparison, the mean Delta PP decreased after correction. This postoperative increase in HIA indicates that preoperative HIA underestimates the magnitude of HVI and therefore is an inaccurate tool for measuring HVI’s contribution to the TVDH (total valgus deformity of the hallux) and to preoperative planning. However, the Delta PP was a greater determinant of the phalanx deformity’s contribution to the TVDH.ConclusionThe outcome of our study shows that both HIA and Delta PP are reproducible when assessing the HVI deformity; however, Delta PP quantifies the amount of correction obtained more precisely. The additional benefit of measuring the Delta PP is that it allows for accurate planning in determining the dimensions of the medial-based wedge of the Akin osteotomy that needs to be resected.Levels of Evidence:Level 4
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-16T08:59:29Z
      DOI: 10.1177/19386400221078677
       
  • Minimally Invasive Repair of Subacute Achilles Tendon Ruptures: A Report
           of 2 Cases

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      Authors: Natalie R. Black, Jie Chen, Karl M. Schweitzer
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Minimally invasive repair techniques are typically reserved for the surgical treatment of acute Achilles tendon ruptures, with surgery performed within 2 weeks of injury. We present 2 successful cases of percutaneous Achilles tendon repair performed in the subacute setting. At final follow-up (15 and 18 months, respectively), both patients had American Orthopaedic Foot and Ankle Society hindfoot scale scores of 100 and had returned to their normal and recreational activities. Percutaneous Achilles tendon repair techniques may have expanded use in the subacute setting, which may mitigate wound issues and infection rates associated with more open approaches, while still providing a quality repair to allow for the most optimal functional outcome.Level of Evidence:Level IV: Case report
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-12T10:46:58Z
      DOI: 10.1177/19386400221076944
       
  • May the Symptomatic Subtalar Joint Be Conservatively Treated With
           Intra-Articular Hyaluronic Acid Injections After a Calcaneus Fracture'
           

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      Authors: Henrique Mansur, Daniel Augusto Maranho, Isnar Moreira de Castro Junior, Fernanda Ferreira Gomes
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundSubtalar pain following intra-articular calcaneus fractures may be associated with disability, pain, and a negative impact on the quality of life. Salvage procedures as subtalar fusion are associated with further consequences as stiffness, altered ankle biomechanics, and adjacent articular overloading with degenerative changes. The objective of the present study is to evaluate the short-term effects of viscosupplementation with intra-articular hyaluronic acid (HA) on function and pain, in patients with painful subtalar joint after calcaneus fracture.MethodsWe searched for patients who underwent osteosynthesis of intra-articular calcaneus fracture between January 2011 and July 2015 and were diagnosed during the follow-up with pain and subtalar osteoarthritis. Between January and December of 2018, 13 patients (50 ± 10 years) accepted to participate in this study and received intra-articular HA injections. Three consecutive doses of 20 mg of HA were administered within a week interval, through anterolateral injections into the subtalar joint. We prospectively evaluated the function using the ankle/hindfoot American Orthopaedic Foot & Ankle Society score (AOFAS) and level of pain using the visual analog scale (VAS) before the intervention and 4, 12, and 24 weeks after the first injection.ResultsHindfoot function improved with an increase of AOFAS from 55 ± 19 before the intervention to 88 ± 20 at the 24th week (P = .001). Similarly, we observed relief of pain during the 24 weeks following intra-articular hyaluronic acid injection, with a decrease in VAS from 8.3 ± 1.3 before treatment to 2.2 ± 3.0 at the 24th week (P = .001).ConclusionFor patients experiencing pain and dysfunction with subtalar osteoarthritis after intra-articular calcaneus fracture, viscosupplementation with intra-articular HA may be associated with improvement in function and pain in the short term. Furthermore, patients with higher grades of osteoarthritis may have limited benefit in pain relief and function improvement.Level of evidence:IV, Case series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-05T09:37:42Z
      DOI: 10.1177/19386400211068256
       
  • Short-Term Complications Following Total Ankle Arthroplasty and Associated
           Risk Factors: A NSQIP Database Analysis

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      Authors: Nicholas F. Kwon, Richard M. Danilkowicz, Jaewhan Kim, Nathan L. Grimm, Samuel B. Adams
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      IntroductionTotal ankle arthroplasty (TAA) has become increasingly utilized over the past 20 years to treat osteoarthritis of the ankle. The efficacy and safety of this procedure has been previously reported, but relatively few studies have documented the risk of postoperative complications associated with TAA over the past 10 years. Thus, the aim of this study is to provide a current report on the safety of TAA, particularly in association with a number of preoperative risk factors.MethodsA retrospective review of all patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent TAA between 2012 and 2018 was performed. A total of 1333 patients were included in this analysis. Penalized logistic regression to consider small numbers of the postoperative complications was used to identify factors associated with incidence of the complications.ResultsThe rate of readmission and superficial wound infection were found to be 1.4% and 0.6%, respectively. Risk factors associated with a prolonged hospital stay were black race, Hispanic race, and smoking. Diabetes was associated with a significantly increased risk of readmission. Age, sex, body mass index, and steroid use were not associated with increased risk of postoperative complications.ConclusionIn this study, the rate of surgical site infection and readmission in TAA was found to be relatively low, compared to published data on total knee arthroplasty and total hip arthroplasty. Both race and smoking increase the risk of prolonged hospital stay, while diabetes increases the risk of readmission.Levels of Evidence:Level III, retrospective comparative trial.
      Citation: Foot & Ankle Specialist
      PubDate: 2022-02-01T08:12:08Z
      DOI: 10.1177/19386400211072379
       
  • Syndesmosis Injury Contributes a Large Negative Effect on Clinical
           Outcomes: A Systematic Review

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      Authors: John J. Heifner, Jack E. Kilgore, Jennifer A. Nichols, Christopher W. Reb
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Introduction:The literature largely addresses questions of diagnostic accuracy and therapeutic accuracy. However, the magnitude of the clinical impact of syndesmosis injury is commonly described in intuitive yet qualitative terms. This systematic review aimed to quantify the impact of syndesmosis injury.Methods:Published clinical outcomes data were used to compute an effect size reflecting the impact of syndesmosis injury. This was done within the clinical contexts of isolated syndesmosis injury and syndesmosis injury with concomitant ankle fracture. Clinical outcomes data included Olerud-Molander (OM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale for pain, and days missed from sport competition. Parametric data were compared with Student t tests. Effect size was computed using Cohen’s d.Results:In ankle fracture patients, syndesmosis injury demonstrated a large effect size for OM (d = 0.96) and AOFAS (d = 0.83) scores. In athletic populations without concomitant ankle fracture, syndesmosis injury demonstrated a large effect size on days missed from competition (d = 2.32).Discussion:These findings confirm the magnitude of the negative impact of syndesmosis injury in athletic populations with isolated injury and in ankle fracture patients. In ankle fracture patients, this large negative effect remains despite surgery. Thus, syndesmosis repair may not fully mitigate the impact of the injury.Levels of Evidence:Level III: Systematic review
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-20T11:39:11Z
      DOI: 10.1177/19386400211067865
       
  • A Novel Plating System for First Metatarsophalangeal Joint Arthrodesis: A
           Retrospective Comparison of Hybrid and Traditional Locking Plate
           Constructs

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      Authors: Osama Elattar, Nicholas A. Andrews, Jared Halstrom, Whitt M. Harrelson, Pallavi Nair, Ashish Shah
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundDorsal plate fixation is commonly used for first metatarsophalangeal joint (1st MTPJ) arthrodesis and plate design continues to evolve. A new staple compression plate (SCP) design attempts to utilize the continuous compression of a nitinol staple across the fusion site while simultaneously providing the stability of a dorsal locked plate. Herein, we compare the radiographic, clinical, and patient-reported outcomes of 1st MTPJ joint arthrodesis using 2 dorsal locking plate constructs including a novel SCP construct.MethodsForty-four patients who underwent 1st MTPJ arthrodesis between 2016 and 2020 were retrospectively evaluated. There were 2 group cohorts. Group 1 cohort included 23 patients who received a CrossRoads Extremity SCP, and Group 2 cohort included 21 patients who received a Stryker dorsal locking precontoured titanium plate (LPP). All patients were evaluated with radiographs, Patient-Reported Outcomes Measures Information System (PROMIS) outcome scores, and Foot Function Index (FFI).ResultsThe complication and union rates did not vary between groups with a fusion rate of 95.7% in the SCP group and 90.5 % in the LPP group. Similarly, we found no significant differences in PROMIS or FFI scores between the SCP and LPP plates.ConclusionUse of either dorsal locking plate construct for 1st MTPJ arthrodesis was associated with high union rates and comparable functional outcomes. As locked plate technology continues to evolve for 1st MTPJ arthrodesis, it is important that clinical outcomes are reported.Levels of Evidence:Level IV
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-20T11:37:37Z
      DOI: 10.1177/19386400211067860
       
  • Naviculectomy With Limited Soft-Tissue Releases as a Third Way Beyond
           Manipulative Treatment and Extensive Soft-Tissue Releases for Ambulatory
           Children With Complex Congenital Vertical Talus: A Technical Note

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      Authors: Ahmad S. Aly, Shady Samir, Shady Mahmoud, Tamer A. El-Sobky
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      We investigated the radioclinical outcomes of naviculectomy and limited/tailored soft-tissue releases in a short series of ambulatory children with complex/intractable congenital vertical talus subsets namely neglected, multiple operated, and recurrent patients. We postulated that this technique will yield satisfactory radioclinical outcomes and minimal complications because it avoids extensive surgical release/trauma that is otherwise classically recommended for complex congenital vertical talus. The cohort consisted of 5—4 boys and 1 girl—complex congenital vertical talus children with neglected, multiple operated, and/or recurrent subsets. Patients were included if manipulative casting techniques were deemed unlikely to produce a plantigrade foot. Patients underwent naviculectomy with variable on-demand limited soft-tissue releases. Two patients had bilateral affection and 2 had a nonidiopathic cause. The mean age was 5.2 years (4-6.25) and mean follow-up was 2.3 years (1-3). We reported satisfactory outcomes as per foot posture, function, overall parent satisfaction including pain and radiography per lateral views of talar-axis-first metatarsal base angle on the short/intermediate term. Whereas manipulative casting is unlikely to yield lasting outcomes in ambulatory children with complex subsets of congenital vertical talus, extensive surgical soft-tissue releases have unfavorable long-term complications. As a substitute, naviculectomy as a form of resection arthroplasty created a practical and affordable third way between manipulative casting with or without minimally invasive surgery and the extensive surgical soft-tissue releases on the short-to-intermediate term.Level of Evidence:Level IV case series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-19T11:10:53Z
      DOI: 10.1177/19386400211068265
       
  • Periprosthetic Fracture After Hindfoot Fusion Nail Treated With Spanning
           Antegrade Tibial Nail

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      Authors: Justin Haghverdian, Christopher E. Gross, Andrew R. Hsu
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Periprosthetic fracture after hindfoot fusion nailing is a complex, uncommon complication. There is no consensus in the literature regarding optimal treatment of these injures, with proposed solutions, including cast immobilization, retrograde femoral and humeral nails, circular external fixation, and amputation. The goal of revision surgery is to adequately bypass and stabilize the fracture, protect the hindfoot fusion site from increased stress, and promote early weight bearing in a load-sharing fashion. In this report, we present the case of an unstable periprosthetic tibia fracture involving the proximal aspect of a hindfoot fusion nail 10 weeks after surgery in the setting of an incompletely fused hindfoot. The patient was successfully treated using a spanning antegrade suprapatellar tibia nail extending from the proximal aspect of the tibia to the plantar aspect of the calcaneus to bypass the tibia fracture as well as protect and maintain fixation across the hindfoot fusion. At final follow-up, the patient had union across her tibia fracture as well as her hindfoot fusion and was able to return to her activities of daily living and ambulate in normal shoe wear.Level of Evidence:Level V
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-19T11:06:20Z
      DOI: 10.1177/19386400211064384
       
  • Preoperative Depression is Associated With Increased Complications
           Following Ankle Fracture Surgery

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      Authors: Matthew S. Broggi, Syed Tahmid, John Hurt, Rishin J. Kadakia, Jason T. Bariteau, Michelle M. Coleman
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundThe effects of preoperative depression following ankle fracture surgery remains unknown. The purpose of this study is to investigate the relationship between preoperative depression and outcomes following ankle fracture surgery.MethodsThis retrospective study used the Truven MarketScan database to identify patients who underwent ankle fracture surgery from January 2009 to December 2018. Patients with and without a diagnosis of preoperative depression were identified based on International Classification of Diseases (ICD) codes. Chi-squared and multivariate analyses were performed to determine the association between preoperative depression and postoperative complications following ankle fracture surgery.ResultsIn total, 107,897 patients were identified for analysis, 13,981 of whom were diagnosed with depression (13%). Preoperative depression was associated with the increased odds for postoperative infection (odds ratio [OR]: 1.33, confidence interval [CI]: 1.20-1.46), wound complications (OR: 1.13, CI: 1.00-1.28), pain-related postoperative emergency department visits (OR: 1.58, CI: 1.30-19.1), 30-day and 90-day readmissions (OR: 1.08, CI: 1.03-1.21 and OR: 1.13, CI: 1.07-1.18), sepsis (OR: 1.39, CI: 1.12-1.72), and postoperative development of complex regional pain syndrome (OR: 1.46, CI: 1.18-1.81).ConclusionPreoperative depression is associated with increased complications following ankle fracture surgery. Further studies are warranted to investigate the degree to which depression is a modifiable risk factor.Level of Evidence:3
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-15T11:37:58Z
      DOI: 10.1177/19386400211065967
       
  • Squamous Cell Carcinoma of the Foot Occurring in a Wart

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      Authors: Oluwatosin Ogunlana, Vinod K. Panchbhavi, William B. Norbury, Mukaila Raji
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Verrucous carcinoma is a rare form squamous cell carcinoma which appears similar to a wart. When it occurs in the feet, it can be easily misdiagnosed. It rarely metastasizes or recurs posttreatment. We report a case of a septuagenarian with recurrence of verrucous carcinoma diagnosed within 6 months at the site of previous treatment. Unique features in our patient’s clinical presentation include his advanced age, being nondiabetic, and the rapid recurrence of carcinoma.Level of Evidence: Level IV: Case report
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-12T08:45:09Z
      DOI: 10.1177/19386400211070431
       
  • Peroneal Stabilization Via Tightening of the Peroneal Tendon Sheath

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      Authors: Nicole K. Cates, Nicholas D. Salerno, Amber M. Kavanagh, John M. Schuberth, Laurence G. Rubin
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      Peroneal subluxation is a rare but debilitating pathology that can be the result of a superior peroneal retinaculum tear or intrasheath laxity. On clinical examination of both cases, the pathology is observed when the ankle is circumducted in eversion and dorsiflexion. With a superior peroneal retinaculum tear, the tendons dislocate from the peroneal groove, whereas with intrasheath laxity the tendons remain in the groove. In the present case series, peroneal stabilization was performed for both superior peroneal retinaculum tear and intrasheath laxity. With our technique, the fibro-osseous connections of the peroneal tendon sheath are detached from the distal one third of the fibula. Drill holes are made through the fibula for suture to be passed through and the peroneal tendon sheath is reattached to the fibula through horizontal mattress sutures via pants over vest technique to restore tension to the sheath. A total of 5 patients underwent peroneal stabilization, 100% (5/5) of which had preoperative pain with palpation along the peroneal tendons and a palpable click with range of motion of the ankle joint. Postoperatively, 100% (5/5) of the patients were fully weight-bearing, compared to 60% (3/5) preoperatively. No patients had residual subluxation of the peroneal tendons postoperatively or a need for revisional surgery. Residual peroneal tendonitis was present in 20% (1/5) of patients and sural neuritis occurred in 20% (1/5) of patients. The peroneal tendons are physiologically tightened within the peroneal tendon sheath to mitigate the pathologic subluxation, without sacrificing tendons for transfer or using allograft material.Clinical Level of Evidence: Therapeutic, Case Series, Level 4
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-12T08:44:17Z
      DOI: 10.1177/19386400211068240
       
  • Accuracy of CT-Derived Patient-Specific Instrumentation for Total Ankle
           Arthroplasty: The Impact of the Severity of Preoperative Varus Ankle
           Deformity

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      Authors: Benjamin D. Umbel, Taylor Hockman, Devon Myers, B. Dale Sharpe, Gregory C. Berlet
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundSignificant preoperative varus tibiotalar deformity was once believed to be a contraindication for total ankle arthroplasty (TAA). Our primary goal was to evaluate the influence of increasing preoperative varus tibiotalar deformity on the accuracy of final implant positioning using computed tomography (CT)-derived patient-specific guides for TAA.MethodsThirty-two patients with varus ankle arthritis underwent TAA using CT-derived patient-specific guides. Patients were subcategorized into varying degrees of deformity based on preoperative tibiotalar angles (0°-5° neutral, 6°-10° mild, 11°-15° moderate, and>15° severe). Postoperative weightbearing radiographs were used to measure coronal plane alignment of the tibial implant relative to the target axis determined by the preoperative CT template. Average follow-up at the time of data collection was 36.8 months.ResultsAverage preoperative varus deformity was 6.06° (range: 0.66°-16.3°). Postoperatively, 96.9% (30/31) of patients demonstrated neutral implant alignment. Average postoperative tibial implant deviation was 1.54° (range: 0.17°-5.7°). Average coronal deviation relative to the target axis was 1.61° for the neutral group, 1.78° for the mild group, 0.94° for the moderate group, and 1.41° for the severe group (P = .256). Preoperative plans predicted 100% of tibial and talar implant sizes correctly within 1 size of actual implant size. Conclusion. Our study supports the claim that neutral postoperative TAA alignment can be obtained using CT-derived patient-specific instrumentation (PSI). Furthermore, final implant alignment accuracy with PSI does not appear to be impacted by worsening preoperative varus deformity. All but one patient (96.9%) achieved neutral postoperative alignment relative to the predicted target axis.Level of Evidence:Level IV, Clinical Case Series
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-07T08:50:12Z
      DOI: 10.1177/19386400211068262
       
  • Evaluating the Validity and Reliability of the Persian Version of American
           Orthopedic Foot and Ankle Society Midfoot Scale

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      Authors: Amir Reza Vosoughi, Amin Kordi Yoosefinejad, Yasaman Safaei Dehbarez, Zeinab Kargarshouraki, Hamideh Mahdaviazad
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundThe use of a valid and reliable outcome scoring system is crucial for evaluating the result of different treatment interventions. The aims of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system into the Persian language and assess its validity and reliability.MethodIn total, 57 patients with midfoot injuries were enrolled. Forward-backward translation and cultural adaptation methods were used to develop the Persian version of AOFAS midfoot scoring system. Reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach’s alpha. The discriminant and convergent validities of the scoring system were assessed using the total score of the mental and physical component of SF-36.ResultsThe mean age of the participants was 46.2 ± 16.3 years. The intra-observer reliability of the totals core of the Persian version of AOFAS midfoot scoring system was 0.96 (confidence interval [CI]: 0.92-0.97) and the inter-observer reliability of the scoring system was 0.90 (CI: 0.86-0.95). The Persian version of AOFAS midfoot scoring system had acceptable convergence with physical component scoring system of SF-36 and its subscales (0.57); moreover, it had acceptable discriminant validity with the mental component of SF-36 and its subscales (0.36).ConclusionThe Persian version of AOFAS midfoot is a reliable and valid instrument and could be used by Persian language clinicians and researchers.Level of Clinical Evidence:3
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-07T08:47:04Z
      DOI: 10.1177/19386400211068242
       
  • Treatment of Chronic Ankle Instability in the Military Population: A
           Systematic Review

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      Authors: Ezra Goodrich, Bryan Vopat, Ashley Herda
      Abstract: Foot & Ankle Specialist, Ahead of Print.
      BackgroundThe high incidence of ankle sprain within the military sets the stage for prevalent chronic ankle instability. The purpose of this review was to compare and evaluate chronic ankle instability treatment strategies in the military population.MethodsElectronic databases were systematically searched in accordance with the Preferred Reporting Items for Systematic Reviews guidelines for English-language, human studies with a military patient population that had been diagnosed with and treated for chronic ankle instability. Exclusion criteria were animal, cadaver, and review studies and case reports.ResultsEight studies met the inclusion criteria, representing 695 military service members—625 males (89.9%) and 70 females (10.1%)—and 4 treatment strategies: Broström-related procedures, modified Watson-Jones procedure, Colville’s technique, and anatomic lateral ligament reconstruction using semitendinosus tendon allograft. The percentage of satisfactory outcomes was 100% for Colville’s technique, and ranged from 73.2% to 94.7% for Broström-related procedures and 72% to 80% for the modified Watson-Jones procedure. Mean American Orthopaedic Foot and Ankle Society scores, anterior drawer displacement, talar tilt, and visual analogue scale scores were also reported.ConclusionThis review demonstrates that the Bröstrom procedure has consistently satisfactory outcomes within the military population, and Colville’s technique is another promising option for this patient population but would require additional studies to support this claim.Levels of Evidence:Level IV
      Citation: Foot & Ankle Specialist
      PubDate: 2022-01-07T08:44:40Z
      DOI: 10.1177/19386400211068239
       
 
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