Pub Date : 2021-07-30DOI: 10.26420/footanklestud.2021.1024
Bagirathan S, Ibrahim N, Patel Ng
Soft tissue defects in the posterior ankle region with underlying Achilles tendon loss pose a reconstructive challenge to both Orthopaedic and Plastic surgeons. Such injuries can result in a severely debilitating sequelae for the patient, therefore reconstruction of the area must provide reliable function and durability with minimal complications and aesthetically pleasing results to enable normal foot wear. We describe the case of a twenty-seven year old male, who presented following a traumatic open rupture of the Achilles tendon and failed reverse sural artery flap. We performed a single stage composite soft tissue reconstruction with a free anterolateral thigh (ALT) flap and rolled vascularised Tensor Fascia Lata (TFL) for functional Achilles tendon reconstruction. The patient had no post-operative complications and was able to fully weight bear and dorsiflex his foot beyond ninety degrees at seven month follow-up. Whilst many options are available to reconstruct this area, we review the literature to illustrate the advantages of using this technique to achieve all of the above factors, and advocate for all foot and ankle surgeons to be aware of its use in their reconstructive repertoire.
{"title":"Single Stage Reconstruction of Posterior Soft Tissue Ankle Defects with a Free Anterolateral Thigh Flap and Rolled Tensor Fascia Lata for Functional Tendo-Achilles Reconstruction - A Case Report and Review of the Literature","authors":"Bagirathan S, Ibrahim N, Patel Ng","doi":"10.26420/footanklestud.2021.1024","DOIUrl":"https://doi.org/10.26420/footanklestud.2021.1024","url":null,"abstract":"Soft tissue defects in the posterior ankle region with underlying Achilles tendon loss pose a reconstructive challenge to both Orthopaedic and Plastic surgeons. Such injuries can result in a severely debilitating sequelae for the patient, therefore reconstruction of the area must provide reliable function and durability with minimal complications and aesthetically pleasing results to enable normal foot wear. We describe the case of a twenty-seven year old male, who presented following a traumatic open rupture of the Achilles tendon and failed reverse sural artery flap. We performed a single stage composite soft tissue reconstruction with a free anterolateral thigh (ALT) flap and rolled vascularised Tensor Fascia Lata (TFL) for functional Achilles tendon reconstruction. The patient had no post-operative complications and was able to fully weight bear and dorsiflex his foot beyond ninety degrees at seven month follow-up. Whilst many options are available to reconstruct this area, we review the literature to illustrate the advantages of using this technique to achieve all of the above factors, and advocate for all foot and ankle surgeons to be aware of its use in their reconstructive repertoire.","PeriodicalId":138116,"journal":{"name":"Foot & Ankle: Studies","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130270820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-07DOI: 10.26420/footanklestud.2021.1023
T. Hale, J. Bennett
In the study of Charcot foot, the lateral column has been largely neglected in previous research. The purpose of the current study is to radiographically characterize the lateral column in Charcot midfoot collapse.
{"title":"Radiographic Evaluation of Charcot Foot Involving the Lateral Column","authors":"T. Hale, J. Bennett","doi":"10.26420/footanklestud.2021.1023","DOIUrl":"https://doi.org/10.26420/footanklestud.2021.1023","url":null,"abstract":"In the study of Charcot foot, the lateral column has been largely neglected in previous research. The purpose of the current study is to radiographically characterize the lateral column in Charcot midfoot collapse.","PeriodicalId":138116,"journal":{"name":"Foot & Ankle: Studies","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128838895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-12DOI: 10.26420/footanklestud.2021.1022
E. Hession, J. Ryan
Introduction: Calcific tendinitis is an uncommon presentation in the forefoot with relatively few cases reported in the medical literature. It is commonly overlooked and should form part of a differential diagnosis when assessing patients presenting with acute pain of the forefoot localised to a single joint or tendon. We present two cases of young women involved in amateur running and martial arts respectively who presented with acute pain of their forefoot. Case Description: These 2 cases describe a 44 year old amateur female runner and 23 year old female martial arts athlete who presented with acute onset of pain affecting the dorsal aspect of their great toe interphalangeal joint and base of 1st metatarsal respectively. Both patients had tender erythematous swellings at the site of pain and difficulty weightbearing. Plain radiography revealed areas of calcification at the respective sites which was confirmed with ultrasound. Both patients underwent US guided corticosteroid injections with significant symptom improvement within 48 hours of injections and rapid return to sport. Discussion: These two cases demonstrate an atypical presentation of acute calcific tendinitis affecting the forefoot and add two more cases to the reported literature. Combining the characteristic clinical presentation of acute pain affecting a tendon or joint with a tender erythematous swelling on examination with the typical radiographic features of calcification can promptly diagnose this often misdiagnosed condition and avoid unnecessary investigations. Conservative treatment and intralesional injection with corticosteroids can lead to rapid resolution and favourable patient outcomes.
{"title":"Acute Calcific Tendinitis of the Forefoot in Young Women- A Presentation of Two Cases","authors":"E. Hession, J. Ryan","doi":"10.26420/footanklestud.2021.1022","DOIUrl":"https://doi.org/10.26420/footanklestud.2021.1022","url":null,"abstract":"Introduction: Calcific tendinitis is an uncommon presentation in the forefoot with relatively few cases reported in the medical literature. It is commonly overlooked and should form part of a differential diagnosis when assessing patients presenting with acute pain of the forefoot localised to a single joint or tendon. We present two cases of young women involved in amateur running and martial arts respectively who presented with acute pain of their forefoot. Case Description: These 2 cases describe a 44 year old amateur female runner and 23 year old female martial arts athlete who presented with acute onset of pain affecting the dorsal aspect of their great toe interphalangeal joint and base of 1st metatarsal respectively. Both patients had tender erythematous swellings at the site of pain and difficulty weightbearing. Plain radiography revealed areas of calcification at the respective sites which was confirmed with ultrasound. Both patients underwent US guided corticosteroid injections with significant symptom improvement within 48 hours of injections and rapid return to sport. Discussion: These two cases demonstrate an atypical presentation of acute calcific tendinitis affecting the forefoot and add two more cases to the reported literature. Combining the characteristic clinical presentation of acute pain affecting a tendon or joint with a tender erythematous swelling on examination with the typical radiographic features of calcification can promptly diagnose this often misdiagnosed condition and avoid unnecessary investigations. Conservative treatment and intralesional injection with corticosteroids can lead to rapid resolution and favourable patient outcomes.","PeriodicalId":138116,"journal":{"name":"Foot & Ankle: Studies","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127648808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-28DOI: 10.26420/footanklestud.2021.1019
R. L., V. Pr, Oskam J, Groenier Kh, G. Rob., Bilo Hjg, Landman Gwd
Background: Ingrown toenails (unguis incarnatus) are common in persons with Diabetes Mellitus (DM) and Peripheral Arterial Disease (PAD). Minimal invasive treatment of ingrown toenails with spiculectomy and/or orthonyxia might be a promising treatment option. Aim: The aim of this study was to evaluate the efficacy and safety of minimal invasive treatment spiculectomy and orthonyxia Design/Setting: Prospective observational cohort study in an outpatient podiatric clinic Method: Eighty-eight patients with unguis incarnatus were included. Primary outcomes were post-procedural complication rate (infection and hemorrhage), and duration of pain. Patient satisfaction during and after treatment procedure was evaluated. Results: Healing was achieved in 80/88 (90.9%) persons; non-DM group 28/32 (87.5%) vs DM group 51/56 (91.1%); median healing time (21 [14, 42] days) and median treatment time; (56 [30, 86] days) were comparable between the non-DM and the DM groups. (Sixty-four patients (72.7%) had a significant pain reduction within 0-2 days. Median reduction of the VAS score after the first treatment was 2.0 points [0.0, 6.0] (non-DM group 3.5[1.0, 6.0]; DM group 2.0[0.0, 5.0] (p=0.0117)). Forty-eight (94, 4%) patients, 31(96.9%) non-DM group vs 53(94.6%) DM group (p=0.534)) had no limitations in daily activities by the affected toe after 14 days. There were no treatment-related complications like bleeding or infection. Conclusion: Spiculectomy and orthonyxia resulted in a high patient satisfaction. Five of 88 patients needed referral for a partial nail resection. This treatment seems to be very suiTable for persons with a high risk for foot ulcerations.
{"title":"Spiculectomy and Orthonyxia for Ingrown Toenails in Patients at Risk; Prospective Observational Cohort Study","authors":"R. L., V. Pr, Oskam J, Groenier Kh, G. Rob., Bilo Hjg, Landman Gwd","doi":"10.26420/footanklestud.2021.1019","DOIUrl":"https://doi.org/10.26420/footanklestud.2021.1019","url":null,"abstract":"Background: Ingrown toenails (unguis incarnatus) are common in persons with Diabetes Mellitus (DM) and Peripheral Arterial Disease (PAD). Minimal invasive treatment of ingrown toenails with spiculectomy and/or orthonyxia might be a promising treatment option. Aim: The aim of this study was to evaluate the efficacy and safety of minimal invasive treatment spiculectomy and orthonyxia Design/Setting: Prospective observational cohort study in an outpatient podiatric clinic Method: Eighty-eight patients with unguis incarnatus were included. Primary outcomes were post-procedural complication rate (infection and hemorrhage), and duration of pain. Patient satisfaction during and after treatment procedure was evaluated. Results: Healing was achieved in 80/88 (90.9%) persons; non-DM group 28/32 (87.5%) vs DM group 51/56 (91.1%); median healing time (21 [14, 42] days) and median treatment time; (56 [30, 86] days) were comparable between the non-DM and the DM groups. (Sixty-four patients (72.7%) had a significant pain reduction within 0-2 days. Median reduction of the VAS score after the first treatment was 2.0 points [0.0, 6.0] (non-DM group 3.5[1.0, 6.0]; DM group 2.0[0.0, 5.0] (p=0.0117)). Forty-eight (94, 4%) patients, 31(96.9%) non-DM group vs 53(94.6%) DM group (p=0.534)) had no limitations in daily activities by the affected toe after 14 days. There were no treatment-related complications like bleeding or infection. Conclusion: Spiculectomy and orthonyxia resulted in a high patient satisfaction. Five of 88 patients needed referral for a partial nail resection. This treatment seems to be very suiTable for persons with a high risk for foot ulcerations.","PeriodicalId":138116,"journal":{"name":"Foot & Ankle: Studies","volume":"132 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130842997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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