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Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review. 矫形器对拇指内收外翻放射学测量的影响:系统回顾
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/23-171
Patrick A DeHeer, Niral A Patel, William Wolfe, Bethany Badell, Mallory Kirkland, Blake Wallace

Background: Hallux abducto valgus (HAV), commonly referred to as a bunion, is a prevalent foot deformity with multifactorial etiology, including genetic predisposition, biomechanical abnormalities, and footwear choices. HAV is often managed conservatively with orthotic devices aimed at reducing deformity progression and alleviating associated pain. However, the effectiveness of orthotics in altering radiographic measurements of HAV remains debated. This systematic review aims to evaluate the impact of orthotic interventions on radiographic parameters.

Methods: A comprehensive search of five electronic databases-PubMed, Cochrane Library, CINAHL, Medline, and EMBASE-was conducted, covering the period from inception to March 2021. The search included terms related to HAV and orthotic interventions. Studies were included if they provided pre- and post-treatment radiographic measurements of halux abductus angle (HAA), hallux valgus angle (HVA), or intermetatarsal angle (IMA) and involved the use of orthotics. A total of 523 references were initially identified, with five studies meeting the inclusion criteria for review. Data extraction focused on study characteristics, orthotic type, radiographic measurements, and follow-up duration.

Results: The systematic review found insufficient high-quality evidence to support the effectiveness of orthotics in slowing the progression of HAV deformity. Of the five studies included, results were mixed: two studies reported changes in radiographic measurements following orthotic use, though one of these involved toe spacers rather than traditional orthotics. The remaining studies found no significant impact of orthotics on HAA, HVA, or IMA. The heterogeneity in study design, population, and orthotic types limited the ability to draw robust conclusions.

Conclusions: Current evidence does not conclusively support the use of orthotics for altering the radiographic progression of HAV. The reviewed studies highlight significant variability in outcomes and suggest that while orthotics may provide symptomatic relief, their role in deformity correction remains unclear. Whether and to what extent orthotics affect common radiographic measures of HAV deformity should be proven with further studies and investigation.

背景:拇外翻(HAV)通常被称为拇囊炎,是一种常见的足部畸形,其病因是多因素的,包括遗传倾向、生物力学异常和鞋袜选择。拇外翻通常采用保守疗法,使用矫形器来减少畸形发展和减轻相关疼痛。然而,矫形器在改变 HAV 影像学测量结果方面的有效性仍存在争议。本系统综述旨在评估矫形器干预对放射学参数的影响:方法:对五个电子数据库(PubMed、Cochrane Library、CINAHL、Medline 和 EMBASE)进行了全面检索,检索期从开始到 2021 年 3 月。检索包括与 HAV 和矫形干预相关的术语。如果研究提供了治疗前后半外翻角 (HAA)、半外翻角 (HVA) 或跖间角 (IMA) 的影像学测量结果,并涉及矫形器的使用,则被纳入研究范围。最初共确定了 523 篇参考文献,其中有 5 项研究符合纳入审查的标准。数据提取的重点是研究特点、矫形器类型、放射学测量和随访时间:系统性综述发现,没有足够的高质量证据支持矫形器在延缓HAV畸形进展方面的有效性。在纳入的五项研究中,结果参差不齐:两项研究报告了使用矫形器后放射学测量结果的变化,但其中一项研究涉及的是脚趾垫片而非传统矫形器。其余研究发现矫形器对 HAA、HVA 或 IMA 没有明显影响。研究设计、研究人群和矫形器类型的异质性限制了得出可靠结论的能力:结论:目前的证据并不完全支持使用矫形器来改变 HAV 的放射学进展。所回顾的研究强调了结果的显著差异性,并表明尽管矫形器可缓解症状,但其在畸形矫正中的作用仍不明确。矫形器是否以及在多大程度上影响了常见的 HAV 畸形放射学测量,还需要进一步的研究和调查来证明。
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引用次数: 0
Walking Bike as an Effective Tool to Reduce Plantar Peak Pressure in Diabetes Mellitus. 步行自行车是降低糖尿病患者足底峰压的有效工具
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/22-127
Ulrich Illgner, Alexander Mehlhorn, Nani Osada, Veit Krenn, Franz Landauer

Background: Foot ulcers and infections are a major and costly problem in patients with diabetes and a major cause of amputations. Plantar peak pressure plays an essential role in plantar ulceration. Off-loading is a common tool to reduce plantar peak pressure and risk of ulceration. The goal of this study was to determine whether reduction of plantar peak pressure can be achieved using a walking bike (a bike without pedals) compared with walking.

Methods: The study starts with a PubMed literature review. In a blinded prospective protocol, 14 healthy individuals (seven men, seven women; mean ± SD age, 39.5 ± 11.3 years) are included. In-shoe pedobarography sensors were attached between the skin and the standardized shoes, then participants walked 10 m three times and then moved over the same distance using a walking bike without removal of the sensor (three times) in a gait laboratory (84 measurements).

Results: In this single-blinded prospective study, mean ± SD plantar peak pressure was significantly reduced from 49.4 ± 12.9 N/cm2 with walking to 35.2 ± 14.6 N/cm2 using a walking bike (P = .003). Mean ± SD step length increased significantly from 0.68 ± 0.13 m to 0.91 ± 0.19 m (P < .001) due to a significantly reduced number of steps (from 7.7 ± 1.4 steps per 10 m of walking to 5.7 ± 1.1 steps per 10 m of using a walking bike; P < .001).

Conclusions: Plantar peak pressure is a risk factor for ulceration in diabetes. Herein, a significant reduction of plantar peak pressure was seen using a walking bike compared with walking (P = .003). Walking bikes may be a tool for off-loading for diabetic patients, especially if both feet are ulcerated. Additional studies to validate these findings in patient care are planned.

背景:足部溃疡和感染是糖尿病患者的主要问题,代价高昂,也是截肢的主要原因。足底峰值压力在足底溃疡中起着至关重要的作用。负重是降低足底峰值压力和溃疡风险的常用工具。本研究的目的是确定与步行相比,步行自行车(无踏板的自行车)能否降低足底峰值压力:研究首先对 PubMed 上的文献进行了回顾。在盲法前瞻性方案中,14 名健康人(7 名男性,7 名女性;平均 ± SD 年龄,39.5 ± 11.3 岁)参与了研究。在皮肤和标准鞋之间安装了鞋内足底照相传感器,然后参与者步行 10 米三次,然后在步态实验室使用步行自行车移动相同距离(三次),不移除传感器(84 次测量):在这项单盲前瞻性研究中,平均±标准值足底峰值压力从步行时的 49.4 ± 12.9 牛顿/平方厘米显著降低到使用步行自行车时的 35.2 ± 14.6 牛顿/平方厘米(P = .003)。平均±标准步长从 0.68 ± 0.13 米显著增加到 0.91 ± 0.19 米(P < .001),原因是步数显著减少(从步行每 10 米 7.7 ± 1.4 步减少到使用步行自行车每 10 米 5.7 ± 1.1 步;P < .001):结论:足底峰值压力是糖尿病患者溃疡的风险因素。结论:足底峰值压力是糖尿病患者溃疡的危险因素。在这里,与步行相比,使用步行自行车可明显降低足底峰值压力(P = .003)。健步自行车可能是糖尿病患者减轻负重的一种工具,尤其是在双脚溃疡的情况下。我们还计划进行更多的研究,以在患者护理中验证这些发现。
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引用次数: 0
Atypical Presentation of Tenosynovial Giant Cell Tumor on the Hallucal Flexor Tendon Sheath: A Case Report. 非典型表现的腱鞘巨细胞瘤位于舌侧屈肌腱鞘上:病例报告。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/23-073
Khurram H Khan, Laine Angstadt, WooYoung Chun, Aileen Grace P Arriola

Tenosynovial giant cell tumor (TGCT) is a rare type of neoplasm that may be locally aggressive but is most often benign and can be divided into two subtypes: localized and diffuse. It tends to develop in the joints, bursae, and tendon sheaths primarily in the digits of the hand and less commonly in the forefoot. This soft-tissue mass has many possible differential diagnoses, including lipoma, ganglion cyst, plantar fibroma, and various sarcomas; surgical excision is usually indicated to reach a definitive diagnosis and rule out malignancy. We report a rare case of a 30-year-old woman with atypical plantar hallucal pain and a palpable mass on the plantar lateral aspect of the left hallux. Surgical excision and histopathologic evaluation confirmed a TGCT of the left hallucal flexor tendon sheath. Although it bears clinical resemblance to several other soft-tissue masses, TGCT has numerous pathognomonic features evident with advanced imaging and histologic analysis that help the physician obtain an accurate diagnosis and proceed with appropriate treatment.

腱鞘巨细胞瘤(TGCT)是一种罕见的肿瘤,可能具有局部侵袭性,但多为良性,可分为两种亚型:局部型和弥漫型。它往往发生在关节、滑囊和腱鞘中,主要发生在手的指端,前足较少见。这种软组织肿块有许多可能的鉴别诊断,包括脂肪瘤、神经节囊肿、足底纤维瘤和各种肉瘤;通常需要进行手术切除以明确诊断并排除恶性肿瘤。我们报告了一例罕见病例,患者是一名 30 岁女性,患有非典型足底幻觉痛,左脚脚掌外侧可触及肿块。手术切除和组织病理学评估证实了左侧拇指屈肌腱鞘的 TGCT。虽然 TGCT 在临床上与其他几种软组织肿块相似,但通过先进的影像学和组织学分析,TGCT 有许多明显的病理特征,有助于医生获得准确的诊断并进行适当的治疗。
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引用次数: 0
Investigation of Spatiotemporal Gait Characteristics, Balance, and Pain in Forefoot and Rearfoot Problems: Preliminary Results. 前足和后足问题的时空步态特征、平衡和疼痛调查:初步结果
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/22-139
Sulenur Yıldız, Elif Kirdi, Semra Topuz, Nilgun Bek

Background: Foot problems are common in the general adult population. Whereas older people experience foot problems because of multiple chronic diseases, younger people often have musculoskeletal foot problems related to overuse. Symptoms and severity may differ depending on the anatomical location of the problem, such as forefoot and rearfoot problems. We aimed to compare the differences in spatiotemporal gait characteristics, balance, and pain in musculoskeletal forefoot and rearfoot problems.

Methods: Twenty-six patients with forefoot (14 participants) and rearfoot (12 participants) problems participated in this prospective study. Spatiotemporal gait characteristics (velocity, cadence, step time, step length, step-extremity ratio, stride length, base support, percentage of swing phase, percentage of stance phase, swing time, and stance time) were evaluated using an electronic walkway, and balance assessment was made using a balance check screener and trainer. The visual analog scale foot and ankle was used to determine patient pain levels. The Mann-Whitney U test was used to determine differences between groups.

Results: There were no significant differences between groups regarding spatiotemporal gait characteristics (P > .05). The eyes closed normal stability and eyes open perturbed stability scores were lower in patients with rearfoot problems (P < .05). Pain intensity evaluated with the visual analog scale foot and ankle was higher in patients with rearfoot problems (P < .05).

Conclusions: Pain levels and balance deficits in this study were higher in patients with rearfoot problems. The balance evaluation and possible effects of pain management on balance should be considered, especially in patients with rearfoot problems, in aspects of treatment.

背景:足部问题在普通成年人中很常见。老年人的足部问题是由于多种慢性疾病引起的,而年轻人的足部肌肉骨骼问题则往往与过度使用有关。症状和严重程度可能因问题的解剖位置(如前足和后足问题)而异。我们旨在比较前足和后足肌肉骨骼问题在时空步态特征、平衡和疼痛方面的差异:26名患有前足(14人)和后足(12人)问题的患者参加了这项前瞻性研究。使用电子步道对时空步态特征(速度、步频、步幅、步长、步肢比、步长、基础支撑、摆动阶段百分比、站立阶段百分比、摆动时间和站立时间)进行评估,并使用平衡检查筛选器和训练器进行平衡评估。脚踝视觉模拟量表用于确定患者的疼痛程度。采用 Mann-Whitney U 检验确定组间差异:结果:各组在时空步态特征方面无明显差异(P > .05)。后足问题患者的闭眼正常稳定性和睁眼扰动稳定性得分较低(P < .05)。用视觉模拟量表评估足踝疼痛强度时,后足问题患者的疼痛强度更高(P < .05):结论:在本研究中,后足病患者的疼痛程度和平衡障碍程度更高。在治疗过程中应考虑平衡评估和疼痛治疗对平衡可能产生的影响,尤其是对有后足问题的患者。
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引用次数: 0
Evaluation of Ankle Joint Position Sense in Patients with Type 2 Diabetes Mellitus with Peripheral Neuropathy by Isokinetic Dynamometer. 用等速测力计评估伴有周围神经病变的 2 型糖尿病患者的踝关节位置感。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/22-035
Özlem Kılıç, Elem İnal, Hüseyin Demirci, Gülümser Aydın

Background: Proprioceptive disorders may occur when thick fibers are affected in diabetic neuropathy. This can lead to impaired joint stabilization and increased risk of falls and fractures. We evaluated joint position sense (JPS) in diabetic patients to detect those at risk for neuropathy earlier.

Methods: Sixty diabetic patients and 30 healthy individuals aged 30 to 60 years were included in the study and divided into three groups: 30 diabetic patients with peripheral neuropathy, 30 diabetic patients without peripheral neuropathy, and 30 nondiabetic control patients. Presence of neuropathy was determined electrophysiologically. Passive ankle JPS was evaluated by an isokinetic system in all three groups. Both 10° and 30° plantarflexion and 10° dorsiflexion were determined as target angles. The mean absolute angular error (MAAE) values for three trials with each angle were assessed by Kruskal-Wallis and Mann-Whitney U tests.

Results: The MAAEs with all of the angles were significantly higher in diabetic patients with peripheral neuropathy compared with diabetic patients without peripheral neuropathy and the control group (P < .001 for all of the comparisons). The MAAEs with right ankle 10° plantarflexion (P = .004) and 10° dorsiflexion (P = .007) and left ankle 10° plantarflexion (P = .008) were significantly higher in diabetic patients without peripheral neuropathy than in the control group.

Conclusions: According to these results, ankle JPS may be deteriorated before determination of neuropathy electrophysiologically.Therefore, we believe that prophylactic programs in terms of the risk of falls and fractures by evaluating JPS need to be developed in the early stages of diabetes.

背景:当糖尿病神经病变中的粗纤维受到影响时,可能会出现肢体感觉障碍。这会导致关节稳定性受损,增加跌倒和骨折的风险。我们对糖尿病患者的关节位置感(JPS)进行了评估,以便及早发现有神经病变风险的患者:研究纳入了 60 名糖尿病患者和 30 名 30 至 60 岁的健康人,并将他们分为三组:30 名有周围神经病变的糖尿病患者、30 名无周围神经病变的糖尿病患者和 30 名非糖尿病对照组患者。是否存在神经病变通过电生理学方法确定。所有三组患者的被动踝关节JPS均通过等速系统进行评估。10°和30°跖屈和10°背屈均被确定为目标角度。通过 Kruskal-Wallis 和 Mann-Whitney U 检验评估了每个角度三次试验的平均绝对角度误差(MAAE)值:结果:与无周围神经病变的糖尿病患者和对照组相比,患有周围神经病变的糖尿病患者所有角度的平均绝对角度误差都明显增大(所有比较中的 P < .001)。无周围神经病变的糖尿病患者右踝10°跖屈(P = .004)和10°背屈(P = .007)以及左踝10°跖屈(P = .008)的MAAEs明显高于对照组:因此,我们认为需要在糖尿病的早期阶段就通过评估 JPS 来制定预防跌倒和骨折风险的方案。
{"title":"Evaluation of Ankle Joint Position Sense in Patients with Type 2 Diabetes Mellitus with Peripheral Neuropathy by Isokinetic Dynamometer.","authors":"Özlem Kılıç, Elem İnal, Hüseyin Demirci, Gülümser Aydın","doi":"10.7547/22-035","DOIUrl":"https://doi.org/10.7547/22-035","url":null,"abstract":"<p><strong>Background: </strong>Proprioceptive disorders may occur when thick fibers are affected in diabetic neuropathy. This can lead to impaired joint stabilization and increased risk of falls and fractures. We evaluated joint position sense (JPS) in diabetic patients to detect those at risk for neuropathy earlier.</p><p><strong>Methods: </strong>Sixty diabetic patients and 30 healthy individuals aged 30 to 60 years were included in the study and divided into three groups: 30 diabetic patients with peripheral neuropathy, 30 diabetic patients without peripheral neuropathy, and 30 nondiabetic control patients. Presence of neuropathy was determined electrophysiologically. Passive ankle JPS was evaluated by an isokinetic system in all three groups. Both 10° and 30° plantarflexion and 10° dorsiflexion were determined as target angles. The mean absolute angular error (MAAE) values for three trials with each angle were assessed by Kruskal-Wallis and Mann-Whitney U tests.</p><p><strong>Results: </strong>The MAAEs with all of the angles were significantly higher in diabetic patients with peripheral neuropathy compared with diabetic patients without peripheral neuropathy and the control group (P < .001 for all of the comparisons). The MAAEs with right ankle 10° plantarflexion (P = .004) and 10° dorsiflexion (P = .007) and left ankle 10° plantarflexion (P = .008) were significantly higher in diabetic patients without peripheral neuropathy than in the control group.</p><p><strong>Conclusions: </strong>According to these results, ankle JPS may be deteriorated before determination of neuropathy electrophysiologically.Therefore, we believe that prophylactic programs in terms of the risk of falls and fractures by evaluating JPS need to be developed in the early stages of diabetes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment Optimization with Ultrasound for Chronic Heel Pain. 利用超声波优化慢性足跟痛的治疗。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/22-160
Ayşe Merve Ata, Bihter Semiha Altunay

Plantar fasciitis is the most common cause of chronic heel pain. It is characterized by localized inflammation and degeneration of the proximal part of the plantar aponeurosis. Treatment is mainly conservative. Herein, a 54-year-old woman with chronic heel pain was diagnosed as having plantar fascia rupture by ultrasound, probably after extracorporeal shock wave therapy. Corticosteroid injection was avoided after ultrasound imaging. Plantar fascia rupture after extracorporeal shock wave therapy is an unexpected complication. This case report highlights the importance of ultrasound imaging for both diagnosis and injection guidance in patients with plantar fasciitis.

足底筋膜炎是慢性足跟痛最常见的原因。其特点是足底肌腱近端局部发炎和退化。治疗以保守疗法为主。本文中,一名 54 岁的女性因慢性足跟痛而被超声波诊断为足底筋膜断裂,很可能是在体外冲击波治疗后造成的。超声波成像后,避免了皮质类固醇注射。体外冲击波治疗后足底筋膜断裂是一种意想不到的并发症。本病例报告强调了超声成像在足底筋膜炎患者诊断和注射指导方面的重要性。
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引用次数: 0
Tibiofibular Relationships of the Normal Syndesmosis on Axial Computed Tomography in the Turkish Population. 土耳其人正常胫腓联合的轴向计算机断层扫描关系。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/23-145
Uğur Yüzügüldü, Lachin Ramazanlı, Harun Yasin Tüzün, Uğur Bozlar, Sönmez Sağlam, Ömer Erşen, Mustafa Taşar

Objective: Computed tomography (CT) is superior to plain radiography for evaluating ankle syndesmosis, but anatomical variations can affect the measurements. This study aimed to assess the radiologic parameters of the incisura fibularis and the factors that could affect these parameters.

Materials and methods: Lower-extremity CT angiography images were used to evaluate the morphology of the incisura fibularis, anterior and posterior tibiofibular distance, longitudinal and transverse length of the distal fibula, length and depth of the incisura fibularis notch, tibiofibular clear space, tibiofibular overlap, and fibular rotation. Each measured parameter was compared based on sex and body side. Also, the effect of age, height, weight, and body mass index (BMI) on parameters was evaluated.

Results: A total of 123 patients (83 men and 40 women) were included, and 246 ankles were measured. The CT measurements demonstrated excellent intraobserver and interobserver reliability. No statistically significant sex or side differences were found in tibiofibular overlap (TFO) and tibiofibular clear space, the most-used parameters in radiographs. Age, weight, and BMI were found to be correlated with TFO.

Conclusions: The present study provides CT measurements of the normal tibiofibular syndesmosis in the Turkish population. Also, the correlations of the parameters with age, height, weight, and BMI are presented. Therefore, TFO and tibiofibular clear space of the uninjured side can be used to plan the treatment of ankle injuries.

目的:计算机断层扫描(CT)在评估踝关节巩膜时优于普通X线摄影,但解剖学上的变化会影响测量结果。本研究旨在评估腓骨切迹的放射学参数以及可能影响这些参数的因素:下肢 CT 血管造影图像用于评估腓骨切迹的形态、胫腓骨前后距离、腓骨远端纵向/横向长度、腓骨切迹凹槽的长度/深度、胫腓骨间隙、胫腓骨重叠和腓骨旋转。每个测量参数都根据性别和体侧进行了比较。此外,还评估了年龄、身高、体重和体重指数(BMI)对参数的影响:共纳入 123 名患者(83 名男性,40 名女性),测量了 246 个脚踝。CT 测量结果表明,观察者内部和观察者之间的可靠性极佳。在胫腓骨重叠度(TFO)和胫腓骨间隙(TFCS)这两个在X光片中最常用的参数上,没有发现明显的性别或侧位差异。研究发现,年龄、体重和体重指数与胫腓骨重叠度(TFO)相关:本研究提供了土耳其人正常胫腓联合的 CT 测量结果。结论:本研究提供了土耳其人群中正常胫腓联合的 CT 测量值,并给出了这些参数与年龄、身高、体重和体重指数的相关性。因此,未受伤一侧的 TFO 和 TFCS 可用于规划踝关节损伤的治疗。
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引用次数: 0
Leg Ulceration with Infected Calcinosis Cutis Mimicking Osteomyelitis: A Case Report. 腿部溃疡伴感染性角化钙化症模仿骨髓炎:病例报告
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/22-065
Fahad Hussain, Uzma Zafar, Robin C Lenz

Calcified tissue exposed in a leg ulcer can become infected and develop into a nidus of infection leading to sepsis. This case details a patient with a leg wound secondary to skin biopsy. This leg ulceration did not heal due to an underlying calcified mass and led to five hospital admissions for sepsis. She was diagnosed as having calcinosis cutis, which was suspected to be the source of her infections. The calcified mass was resected, and she healed uneventfully without further infections. Calcified soft-tissue masses should be considered in nonhealing leg ulcers and ulcers with multiple recurrent infections. Radiographs can be used to diagnose this condition, and surgical excision can be considered in cases of infection.

暴露在腿部溃疡中的钙化组织可能会受到感染,并发展成为导致败血症的感染巢。本病例详细描述了一名因皮肤活检而继发腿部伤口的患者。该腿部溃疡由于潜在的钙化肿块而无法愈合,导致五次因败血症入院。她被诊断出患有皮肤钙化症,并被怀疑是感染的根源。钙化肿块被切除后,她顺利痊愈,没有再受到感染。对于不愈合的腿部溃疡和多次反复感染的溃疡,应考虑软组织钙化肿块。可使用 X 光片来诊断这种情况,感染时可考虑手术切除。
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引用次数: 0
Comparison of the Effects of Low-Dye and Kinesiology Taping in Plantar Fasciitis on Pain and Function: A Randomized Double-Blind Study. 足底筋膜炎患者使用低染料绑带和肌力绑带对疼痛和功能的影响比较:随机双盲研究。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/23-157
Bayram Sonmez Unuvar, Bahar Anaforoglu Kulunkoglu, Hasan Gercek, Osman Tufekci, Sinan Bagcaci, Onur Erbas

Background: Plantar fasciitis (PF) is becoming an increasingly common source of limitation in people's daily activities. As such, this study sought to investigate the effects of kinesiology taping (KT) and low-Dye taping treatments, used in conjunction with extracorporeal shockwave therapy (ESWT), on pain and function in patients with PF.

Methods: To conduct this randomized controlled study, 45 individuals with PF aged 18 to 65 years were included, with 15 individuals assigned to each group: the KT, low-Dye, and control groups. Pain intensity was evaluated using the visual analog scale, and functionality was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scale before and after the study. Each group received three sessions of ESWT.

Results: When pretreatment and post-treatment differences were analyzed, first-step pain in the morning, pain with palpation, and pain after prolonged standing were reduced in the KT, low-Dye, and control groups (P < .05 for all). There were differences in the AOFAS total score in the KT (P <.001; r = 2.03), low-Dye (P < .001; r = 1.49), and control (P = .003; r = 0.92) groups. Low-Dye taping was more effective than the control in reducing pain with standing and improving AOFAS function scores (P < .05). Low-Dye taping and KT were effective in improving AOFAS total scores (P < .05) but were not superior to each other (P > .05).

Conclusions: Based on these findings, taping techniques such as KT and low-Dye, combined with conventional treatments such as ESWT, may be beneficial for improving pain and function in individuals with PF. Further randomized controlled trials with longer follow-up are needed to confirm this hypothesis.

背景:足底筋膜炎(PF足底筋膜炎(PF)正日益成为限制人们日常活动的常见原因。因此,本研究试图探讨肌力绑带(KT)和低染料绑带疗法与体外冲击波疗法(ESWT)结合使用对足底筋膜炎患者疼痛和功能的影响:为了进行这项随机对照研究,共纳入了 45 名年龄在 18 岁至 65 岁之间的 PF 患者,每组 15 人:KT 组、低染料组和对照组。研究前后使用视觉模拟量表评估疼痛强度,使用美国骨科足踝协会(AOFAS)量表评估功能。每组接受三次 ESWT 治疗:结果:在分析治疗前和治疗后的差异时,KT 组、低染料组和对照组的晨起第一步疼痛、触诊疼痛和长时间站立后疼痛均有所减轻(P < .05)。KT 组的 AOFAS 总分与对照组存在差异(P .05):基于这些研究结果,KT 和低染料等绑带技术与 ESWT 等传统疗法相结合,可能有助于改善 PF 患者的疼痛和功能。要证实这一假设,还需要进行更多的随机对照试验和更长时间的随访。
{"title":"Comparison of the Effects of Low-Dye and Kinesiology Taping in Plantar Fasciitis on Pain and Function: A Randomized Double-Blind Study.","authors":"Bayram Sonmez Unuvar, Bahar Anaforoglu Kulunkoglu, Hasan Gercek, Osman Tufekci, Sinan Bagcaci, Onur Erbas","doi":"10.7547/23-157","DOIUrl":"https://doi.org/10.7547/23-157","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis (PF) is becoming an increasingly common source of limitation in people's daily activities. As such, this study sought to investigate the effects of kinesiology taping (KT) and low-Dye taping treatments, used in conjunction with extracorporeal shockwave therapy (ESWT), on pain and function in patients with PF.</p><p><strong>Methods: </strong>To conduct this randomized controlled study, 45 individuals with PF aged 18 to 65 years were included, with 15 individuals assigned to each group: the KT, low-Dye, and control groups. Pain intensity was evaluated using the visual analog scale, and functionality was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) scale before and after the study. Each group received three sessions of ESWT.</p><p><strong>Results: </strong>When pretreatment and post-treatment differences were analyzed, first-step pain in the morning, pain with palpation, and pain after prolonged standing were reduced in the KT, low-Dye, and control groups (P < .05 for all). There were differences in the AOFAS total score in the KT (P <.001; r = 2.03), low-Dye (P < .001; r = 1.49), and control (P = .003; r = 0.92) groups. Low-Dye taping was more effective than the control in reducing pain with standing and improving AOFAS function scores (P < .05). Low-Dye taping and KT were effective in improving AOFAS total scores (P < .05) but were not superior to each other (P > .05).</p><p><strong>Conclusions: </strong>Based on these findings, taping techniques such as KT and low-Dye, combined with conventional treatments such as ESWT, may be beneficial for improving pain and function in individuals with PF. Further randomized controlled trials with longer follow-up are needed to confirm this hypothesis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vacuum-Assisted Eggshell-Type Bone Debridement with Implantation of Antibiotic-Impregnated Bone Substitute for Treatment of Calcaneal Osteomyelitis with Subsequent Charcot's Reconstruction: A Case Report. 真空辅助蛋壳型骨清除术与抗生素浸渍骨替代物植入术治疗钙骨骨髓炎及随后的夏科氏重建术:病例报告
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-07-01 DOI: 10.7547/23-092
Grant Yonemoto, Timothy P Cheung, Steven D Vyce, Michael I Gazes

Charcot's neuroarthropathy complicated by calcaneal osteomyelitis can be difficult to treat. Various surgical techniques describe how to manage these conditions. Eggshell-type debridement with application of antibiotic-impregnated bone substitute is a viable option that eliminates infected bone and allows staged reconstructive surgery. A 50-year-old woman with right midfoot Charcot's neuroarthropathy presented with osteomyelitis of the cuboid and fourth and fifth metatarsal bases after resection and failed antibiotic therapy. The patient eventually developed adductovarus, septic shock, and hematogenous osteomyelitis of the calcaneus, navicular, and lateral cuneiform. Vacuum-assisted eggshell-type debridement was performed, and the calcaneal defect was filled with antibiotic-impregnated calcium sulfate and calcium phosphate. Eight weeks after the initial surgery, the infection resolved; however, the patient had trouble walking. She underwent staged Charcot's reconstructive surgery with application of a dynamic multiplanar external fixator with gradual deformity and split-thickness skin graft to cover the residual plantar lateral foot wound. The second stage included septic fusion of the midfoot and subtalar joint from the frame. Twelve weeks postoperatively, radiographic union was achieved, the external fixator was removed, and the patient demonstrated a plantigrade foot. She was transitioned to a total-contact cast and allowed to bear weight as tolerated. Eighteen months after the initial procedure, the patient is wound-free and weightbearing in a CROW boot. This innovative eggshell-type debridement technique aspirates osteomyelitic cancellous bone while preserving cortical bone. It can be particularly useful in hematogenous osteomyelitis, where cortical integrity is not breached, or in situations where there is minimal cortical involvement. Specifically preserving the calcaneus, a major weightbearing bone, permits subsequent reconstructive surgical planning. At 18 months, there were no signs of osteomyelitis recurrence.

夏科氏神经性关节病并发小关节骨髓炎可能很难治疗。各种外科技术都描述了如何处理这些病症。应用抗生素浸渍骨替代物的蛋壳型清创术是一种可行的选择,它能清除受感染的骨骼,并可进行分期重建手术。一名 50 岁的女性患者患有右中足夏科氏神经关节病,在接受切除手术和抗生素治疗失败后,出现了立方体、第四和第五跖骨基底骨髓炎。患者最终出现内收、脓毒性休克以及小方块、舟骨和外侧楔骨的血源性骨髓炎。患者接受了真空辅助蛋壳式清创术,并用抗生素浸渍的硫酸钙和磷酸钙填充了小腿骨缺损处。初次手术八周后,感染缓解,但患者行走困难。她接受了分阶段的沙尔科重建手术,使用动态多平面外固定器进行渐进式畸形矫正,并进行分层厚皮移植以覆盖残留的足底外侧伤口。第二阶段包括从框架上对中足和距下关节进行化脓性融合。术后 12 周,患者实现了放射学结合,外固定器被移除,足部可以跖屈。她被转移到全接触式石膏上,并在可以承受的情况下负重。初次手术后 18 个月,患者伤口愈合,穿上 CROW 靴子可以负重。这种创新的蛋壳型清创技术可以吸出骨髓性松质骨,同时保留皮质骨。对于皮质完整性未被破坏的血源性骨髓炎,或皮质受累极少的情况,这种方法尤其有用。由于保留了主要的负重骨--小腿骨,因此可以进行后续的重建手术规划。18 个月后,骨髓炎没有复发迹象。
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Journal of the American Podiatric Medical Association
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