首页 > 最新文献

Journal of the American Podiatric Medical Association最新文献

英文 中文
Senior Podiatrists in Solo Practice are High Performers of Nail Excisions. 个人执业的资深足病医生是指甲切除术的高绩效者。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/22-063
Gabrielle M Rivin, Tracey C Vlahovic, Rachel C Hill, Alan B Fleischer, Shari R Lipner

Background: Nail excisions are indicated for onychocryptosis and nail spicules. They are technically demanding and require a refined skill set. We aimed to characterize practice patterns of US providers performing nail excisions.

Methods: We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.

Results: Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.

Conclusions: Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.

背景:指甲切除术适用于甲沟炎和甲沟炎。这些手术对技术要求很高,需要精湛的技能。我们的目的是了解美国医疗机构实施甲切除术的实践模式:我们对联邦医疗保险(Medicare)D 部分医疗机构的使用和支付数据进行了回顾性分析,这些数据涉及部分或全部指甲/甲基质切除术,同时/不包括甲板切除/破坏(当前程序术语代码 11750)。高绩效者的定义是每年进行的指甲切除术高于平均值 2 个标准差的医疗服务提供者。我们分析了甲切除术高绩效者的人口统计学风险因素,包括执业地点、从业年限、家庭收入中位数、执业类型和提供者性别。统计分析在 SAS v9.4 中进行,P < .05 为具有统计学意义:医疗服务提供者(n = 32,279 人)和高绩效者(n = 942 人)每年平均进行 34.7 次和 173 次指甲切除术。不出所料,足科医生占所有甲切除术实施者的 99.7%。与中西部和东北部相比,南部地区的医生更常进行指甲切除术(几率比 [OR],1.95;P < .0001;OR,1.46;P < .0001)。个人执业医师和团体执业医师分别更有可能成为指甲切除术的高绩效者(OR,2.15;P < .0001)。通过线性回归分析,医疗服务提供者的从业年限每增加 10 年,每位医疗服务提供者每年的指甲切除手术量就会增加 1.2 例(P < .0001)。执业地点的家庭收入中位数每增加 100,000 美元,每位医疗人员每年的指甲切除数量就会减少 9.9 例:结论:南方足科医生、经验丰富的足科医生、个体开业者以及家庭收入中位数较低地区的开业者更有可能实施较多的指甲切除术。确定足科医生的业绩趋势有助于足科医生了解他们的指甲切除业绩与全国其他足科医生相比如何。
{"title":"Senior Podiatrists in Solo Practice are High Performers of Nail Excisions.","authors":"Gabrielle M Rivin, Tracey C Vlahovic, Rachel C Hill, Alan B Fleischer, Shari R Lipner","doi":"10.7547/22-063","DOIUrl":"10.7547/22-063","url":null,"abstract":"<p><strong>Background: </strong>Nail excisions are indicated for onychocryptosis and nail spicules. They are technically demanding and require a refined skill set. We aimed to characterize practice patterns of US providers performing nail excisions.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.</p><p><strong>Results: </strong>Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.</p><p><strong>Conclusions: </strong>Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766447","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
Short-Term Outcomes of Arthroscopic Treatment of Freiberg Disease. 关节镜治疗弗赖贝格病的短期疗效。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/22-025
Jong-Kil Kim, Do-Yeon Kim, Jong-Sung Oh, Dong-Ill Ko, Kwang-Bok Lee

Background: Surgical treatment for Freiberg disease (also known as avascular necrosis of the metatarsal head) has not been completely defined. This retrospective study evaluated short-term outcomes after arthroscopic treatment of Freiberg disease.

Methods: From 2015 to 2019, 13 patients (15 feet) diagnosed as having Freiberg disease were enrolled for arthroscopic surgery. Feet were divided based on the Smillie classification system (two with stage I, eight with stage II, three with stage III, one with stage IV, and one with stage V). Arthroscopic interventions, including synovectomy, debridement, chondroplasty, microfracture, and loose body removal, were performed without considering the Smillie classification stage. Radiologic outcomes were evaluated by radiography (preoperatively and 3, 6, and 12 months postoperatively) and magnetic resonance imaging (preoperatively and 12 months postoperatively). Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal (MTP)-interphalangeal score and the visual analog scale (VAS) score. The MTP joint range of motion was measured using a goniometer preoperatively and postoperatively.

Results: Radiologic studies showed no evidence of osteonecrosis progression in postoperative 12-month radiographs of any patients. Postoperative 12-month magnetic resonance images showed reduction of bone marrow edema, irregularity of subchondral bone, and cartilage defects in all patients. Significant improvements in AOFAS and VAS scores occurred at all postoperative time points compared with preoperative scores (P = .001). The MTP joint range of motion also showed improvement at last follow-up (P = .001).

Conclusions: Arthroscopic surgery for Freiberg disease showed excellent clinical outcomes, MTP joint range of motion, and short-term outcomes regardless of stage (Smillie classification) in radiologic evaluation.

背景:弗赖贝格病(又称跖骨头血管性坏死)的手术治疗方法尚未完全确定。这项回顾性研究评估了关节镜治疗弗赖贝格病后的短期疗效:2015年至2019年,13名被诊断为弗莱贝格病的患者(15只脚)接受了关节镜手术。根据Smillie分类系统对足部进行了划分(2例I期,8例II期,3例III期,1例IV期,1例V期)。关节镜手术包括滑膜切除术、清创术、软骨成形术、微骨折术和松动体切除术,均在不考虑斯米利分类分期的情况下进行。放射学结果通过放射摄影(术前、术后 3、6 和 12 个月)和磁共振成像(术前和术后 12 个月)进行评估。临床效果采用美国骨科足踝协会(AOFAS)跖趾关节(MTP)-指间关节评分和视觉模拟量表(VAS)评分进行评估。术前和术后使用动态关节角度计测量 MTP 关节的活动范围:结果:放射学研究显示,所有患者术后12个月的X光片均未显示骨坏死进展。术后12个月的磁共振图像显示,所有患者的骨髓水肿、软骨下骨不规则和软骨缺损均有所减轻。与术前相比,术后所有时间点的 AOFAS 和 VAS 评分均有显著改善(P = .001)。最后一次随访时,MTP关节活动范围也有所改善(P = .001):结论:无论放射学评估分期(Smillie分类)如何,关节镜手术治疗弗赖贝格氏病在临床疗效、MTP关节活动范围和短期疗效方面均表现出色。
{"title":"Short-Term Outcomes of Arthroscopic Treatment of Freiberg Disease.","authors":"Jong-Kil Kim, Do-Yeon Kim, Jong-Sung Oh, Dong-Ill Ko, Kwang-Bok Lee","doi":"10.7547/22-025","DOIUrl":"10.7547/22-025","url":null,"abstract":"<p><strong>Background: </strong>Surgical treatment for Freiberg disease (also known as avascular necrosis of the metatarsal head) has not been completely defined. This retrospective study evaluated short-term outcomes after arthroscopic treatment of Freiberg disease.</p><p><strong>Methods: </strong>From 2015 to 2019, 13 patients (15 feet) diagnosed as having Freiberg disease were enrolled for arthroscopic surgery. Feet were divided based on the Smillie classification system (two with stage I, eight with stage II, three with stage III, one with stage IV, and one with stage V). Arthroscopic interventions, including synovectomy, debridement, chondroplasty, microfracture, and loose body removal, were performed without considering the Smillie classification stage. Radiologic outcomes were evaluated by radiography (preoperatively and 3, 6, and 12 months postoperatively) and magnetic resonance imaging (preoperatively and 12 months postoperatively). Clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal (MTP)-interphalangeal score and the visual analog scale (VAS) score. The MTP joint range of motion was measured using a goniometer preoperatively and postoperatively.</p><p><strong>Results: </strong>Radiologic studies showed no evidence of osteonecrosis progression in postoperative 12-month radiographs of any patients. Postoperative 12-month magnetic resonance images showed reduction of bone marrow edema, irregularity of subchondral bone, and cartilage defects in all patients. Significant improvements in AOFAS and VAS scores occurred at all postoperative time points compared with preoperative scores (P = .001). The MTP joint range of motion also showed improvement at last follow-up (P = .001).</p><p><strong>Conclusions: </strong>Arthroscopic surgery for Freiberg disease showed excellent clinical outcomes, MTP joint range of motion, and short-term outcomes regardless of stage (Smillie classification) in radiologic evaluation.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766448","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
Two-Point Discrimination in Feet with Ankle Sprains. 踝关节扭伤患足的两点辨别能力
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/22-192
Hacı Ali Olcar, Ökkeş H Miniksar, Berna Güngör, Tolgahan Kuru, Enes E Kapukaya, Davut Aydın, Murat Korkmaz

Background: This study aimed to compare two-point discrimination in feet with ankle sprains and feet without ankle problems, and to determine whether there was a change in the two-point discrimination values in ankle sprains.

Methods: A total of 108 people were included in the study. These subjects were aged between 18 and 40 years and visited the Medical Faculty of Yozgat Bozok University for various reasons in July and September of 2022. These people were divided into two groups: subjects with an ankle sprain and subjects with no ankle problems. Two-point discrimination values measured in millimeters were recorded for both groups using a caliper (esthesiometer) used in six regions of 216 feet. The two-point discrimination threshold values of the feet were compared statistically according to feet with ankle sprains and feet without ankle problems, and in right and left feet.

Results: The study determined that the two-point discrimination threshold values measured at the first toe tip, heel, third plantar metatarsal head, medial malleolus, and lateral malleolus in subjects with an ankle sprain was higher than in subjects with no ankle problems. When comparing both feet of the subjects with an ankle sprain, the two-point discrimination threshold value in the heel of the foot with an ankle sprain was higher than in the heel of the foot without ankle problems.

Conclusions: The two-point discrimination threshold value was higher in subjects with an ankle sprain than in subjects with no ankle problems. The data suggest that the two-point discrimination threshold may be higher in people with an ankle sprain. Further studies are needed to better understand the two-point discrimination threshold in ankle sprains.

研究背景本研究旨在比较踝关节扭伤者和无踝关节问题者的两点辨别力,并确定踝关节扭伤者的两点辨别力值是否有变化:研究共纳入 108 人。这些受试者年龄在 18 岁至 40 岁之间,于 2022 年 7 月至 9 月间因各种原因前往约兹加特博佐克大学医学院就诊。这些人被分为两组:踝关节扭伤的受试者和没有踝关节问题的受试者。在 216 只脚的六个区域使用卡尺(ESTHESI计)记录两组受试者的两点辨别值(以毫米为单位)。根据踝关节扭伤的脚和没有踝关节问题的脚,以及右脚和左脚,对脚部的两点辨别阈值进行了统计比较:研究结果表明,踝关节扭伤受试者在第一趾尖、足跟、第三跖骨头、内侧踝骨和外侧踝骨处测量的两点辨别阈值高于没有踝关节问题的受试者。在比较踝关节扭伤受试者的双脚时,踝关节扭伤受试者脚跟的两点辨别阈值高于无踝关节问题受试者的脚跟:结论:有踝关节扭伤的受试者的两点辨别阈值高于没有踝关节问题的受试者。这些数据表明,踝关节扭伤患者的两点辨别阈值可能更高。要更好地了解踝关节扭伤患者的两点辨别阈值,还需要进一步的研究。
{"title":"Two-Point Discrimination in Feet with Ankle Sprains.","authors":"Hacı Ali Olcar, Ökkeş H Miniksar, Berna Güngör, Tolgahan Kuru, Enes E Kapukaya, Davut Aydın, Murat Korkmaz","doi":"10.7547/22-192","DOIUrl":"10.7547/22-192","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare two-point discrimination in feet with ankle sprains and feet without ankle problems, and to determine whether there was a change in the two-point discrimination values in ankle sprains.</p><p><strong>Methods: </strong>A total of 108 people were included in the study. These subjects were aged between 18 and 40 years and visited the Medical Faculty of Yozgat Bozok University for various reasons in July and September of 2022. These people were divided into two groups: subjects with an ankle sprain and subjects with no ankle problems. Two-point discrimination values measured in millimeters were recorded for both groups using a caliper (esthesiometer) used in six regions of 216 feet. The two-point discrimination threshold values of the feet were compared statistically according to feet with ankle sprains and feet without ankle problems, and in right and left feet.</p><p><strong>Results: </strong>The study determined that the two-point discrimination threshold values measured at the first toe tip, heel, third plantar metatarsal head, medial malleolus, and lateral malleolus in subjects with an ankle sprain was higher than in subjects with no ankle problems. When comparing both feet of the subjects with an ankle sprain, the two-point discrimination threshold value in the heel of the foot with an ankle sprain was higher than in the heel of the foot without ankle problems.</p><p><strong>Conclusions: </strong>The two-point discrimination threshold value was higher in subjects with an ankle sprain than in subjects with no ankle problems. The data suggest that the two-point discrimination threshold may be higher in people with an ankle sprain. Further studies are needed to better understand the two-point discrimination threshold in ankle sprains.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112043","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
The Influence of Bilateral and Unilateral Flatfoot on Coronal Spinopelvic Alignment in Asymptomatic Young Healthy Males. 无症状年轻健康男性双侧和单侧扁平足对冠状脊柱对齐的影响
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/21-165
Pinar Kisacik, Erman Ceyhan

Background: This cross-sectional retrospective study aimed to present the influence of unilateral and bilateral flatfoot on coronal spinopelvic alignment in asymptomatic young healthy males.

Methods: This study was performed by examining the medical reports of individuals who applied to the National Health Board to work in positions requiring physical fitness between January 1, 2018, and January 1, 2019. Plain radiographs of the feet, pelvis, and spine were analyzed. The calcaneal pitch angle for flatfoot, pelvic obliquity, and the Cobb angle for spinal asymmetry were measured. After all of the analyses were completed, participants were divided into two groups-unilateral or bilateral flatfoot, depending on the calcaneal pitch angle measurements-and compared.

Results: There was no significant difference in age between groups (P = .609). The unilateral flatfoot group showed higher values in terms of body mass index, with a significant difference (P = .01). The curve patterns were identified as single thoracic, lumbar, and double. Post-hoc analyses suggest that young males without spinal asymmetry were more likely to have unilateral flatfoot (P < .008). There were significant differences between groups in pelvic obliquity and Cobb angle (P < .05). The effect size was found to be small to medium for pelvic obliquity and medium to large for Cobb angle.

Conclusions: Young males with bilaterally increased foot pronation demonstrate more increased pelvic obliquity and spinal curvature.

背景:这是一项横断面回顾性研究:这项横断面回顾性研究旨在介绍单侧和双侧扁平足对无症状年轻健康男性冠状脊柱排列的影响:本研究通过检查2018年1月1日至2019年1月1日期间向国家卫生委员会申请从事需要体能岗位工作的个人的体检报告来进行。对足部、骨盆和脊柱的平片进行了分析。测量了扁平足的小腿骨俯角、骨盆倾斜度和脊柱不对称的 Cobb 角。在完成所有分析后,根据小脚骨俯仰角的测量结果,将参与者分为单侧或双侧扁平足两组,并进行比较:结果:组间年龄无明显差异(P = .609)。单侧扁平足组的体重指数值较高,差异显著(P = .01)。曲线模式被确定为单侧胸椎、腰椎和双侧。事后分析表明,没有脊柱不对称的年轻男性更有可能患有单侧扁平足(P < .008)。在骨盆倾斜度和 Cobb 角方面,各组之间存在明显差异(P < .05)。骨盆倾斜度的影响大小为小至中,Cobb角的影响大小为中至大:结论:双侧足外翻增加的年轻男性骨盆倾斜度和脊柱弯曲度会增加。
{"title":"The Influence of Bilateral and Unilateral Flatfoot on Coronal Spinopelvic Alignment in Asymptomatic Young Healthy Males.","authors":"Pinar Kisacik, Erman Ceyhan","doi":"10.7547/21-165","DOIUrl":"10.7547/21-165","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional retrospective study aimed to present the influence of unilateral and bilateral flatfoot on coronal spinopelvic alignment in asymptomatic young healthy males.</p><p><strong>Methods: </strong>This study was performed by examining the medical reports of individuals who applied to the National Health Board to work in positions requiring physical fitness between January 1, 2018, and January 1, 2019. Plain radiographs of the feet, pelvis, and spine were analyzed. The calcaneal pitch angle for flatfoot, pelvic obliquity, and the Cobb angle for spinal asymmetry were measured. After all of the analyses were completed, participants were divided into two groups-unilateral or bilateral flatfoot, depending on the calcaneal pitch angle measurements-and compared.</p><p><strong>Results: </strong>There was no significant difference in age between groups (P = .609). The unilateral flatfoot group showed higher values in terms of body mass index, with a significant difference (P = .01). The curve patterns were identified as single thoracic, lumbar, and double. Post-hoc analyses suggest that young males without spinal asymmetry were more likely to have unilateral flatfoot (P < .008). There were significant differences between groups in pelvic obliquity and Cobb angle (P < .05). The effect size was found to be small to medium for pelvic obliquity and medium to large for Cobb angle.</p><p><strong>Conclusions: </strong>Young males with bilaterally increased foot pronation demonstrate more increased pelvic obliquity and spinal curvature.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878693","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
Progressive Pain Response in Idiopathic Clubfoot Children Undergoing Ponseti Casting: A Prospective Evaluation in 34 Feet. 接受 Ponseti 脚型固定的特发性马蹄内翻足患儿的渐进性疼痛反应:对 34 只足的前瞻性评估。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/23-056
Sitanshu Barik, Anil Agarwal, Ankur Upadhyay, Yogesh Patel

Background: Investigations of pain and physiologic responses response during Ponseti casting are in the preliminary stage. This short-term study aims to quantify pain responses and to note the variations, if any, during subsequent casting sessions.

Methods: In this prospective study, the pain parameters were evaluated in 34 clubfeet. Video recording of each casting session was performed 1 minute before casting, during casting, and after 1 minute of casting. The videos were scored objectively using Neonatal Infant Pain Score (NIPS). Heart rate (HR) and oxygen saturation were recorded by using a pulse oximeter.

Results: There was progressive increase in pain response until, at the last casting session, it was recorded as NIPS 4 (interquartile range, 1) (P = .02479). Before, during, and after casting, HR rose significantly in succeeding sessions. The mean HR during the first cast session was 175.5 ± 27.2/min, which increased to a mean of 197.3 ± 18.9/min (P = .000282). For the third parameter (oxygen saturation), no differences were observed between the first and last casting sessions.

Conclusions: There was moderate pain response during Ponseti casting sessions as demonstrated by the NIPS. It rose significantly toward the last cast. The clubfoot child showed an exaggerated heart rate in succeeding casting sessions. No variations were noticed for oxygen saturation.

背景:对庞塞蒂石膏固定过程中疼痛和生理反应的研究尚处于初步阶段。这项短期研究的目的是量化疼痛反应,并注意在随后的铸造过程中的变化(如果有的话):在这项前瞻性研究中,对 34 例足癣患者的疼痛参数进行了评估。方法:在这项前瞻性研究中,对 34 名足癣患者的疼痛参数进行了评估。在每次石膏注射前 1 分钟、注射过程中和注射 1 分钟后,分别进行视频记录。使用新生儿婴儿疼痛评分法(NIPS)对视频进行客观评分。使用脉搏血氧仪记录心率(HR)和血氧饱和度:结果:疼痛反应逐渐增加,直至最后一次石膏固定时,NIPS 记录为 4(四分位数间距,1)(P = .02479)。在铸造之前、铸造过程中和铸造之后,心率在随后的铸造过程中均显著上升。第一次铸造过程中的平均心率为 175.5 ± 27.2/分钟,随后增至平均 197.3 ± 18.9/分钟(P = .000282)。在第三个参数(血氧饱和度)方面,第一次和最后一次铸造过程之间没有观察到差异:结论:NIPS 显示,在庞塞蒂石膏固定过程中存在中等程度的疼痛反应。结论:通过 NIPS 可以看出,在庞塞蒂石膏固定过程中疼痛反应适中,在最后一次固定时疼痛反应明显加剧。马蹄内翻足患儿在随后的石膏固定过程中心率加快。血氧饱和度没有变化。
{"title":"Progressive Pain Response in Idiopathic Clubfoot Children Undergoing Ponseti Casting: A Prospective Evaluation in 34 Feet.","authors":"Sitanshu Barik, Anil Agarwal, Ankur Upadhyay, Yogesh Patel","doi":"10.7547/23-056","DOIUrl":"10.7547/23-056","url":null,"abstract":"<p><strong>Background: </strong>Investigations of pain and physiologic responses response during Ponseti casting are in the preliminary stage. This short-term study aims to quantify pain responses and to note the variations, if any, during subsequent casting sessions.</p><p><strong>Methods: </strong>In this prospective study, the pain parameters were evaluated in 34 clubfeet. Video recording of each casting session was performed 1 minute before casting, during casting, and after 1 minute of casting. The videos were scored objectively using Neonatal Infant Pain Score (NIPS). Heart rate (HR) and oxygen saturation were recorded by using a pulse oximeter.</p><p><strong>Results: </strong>There was progressive increase in pain response until, at the last casting session, it was recorded as NIPS 4 (interquartile range, 1) (P = .02479). Before, during, and after casting, HR rose significantly in succeeding sessions. The mean HR during the first cast session was 175.5 ± 27.2/min, which increased to a mean of 197.3 ± 18.9/min (P = .000282). For the third parameter (oxygen saturation), no differences were observed between the first and last casting sessions.</p><p><strong>Conclusions: </strong>There was moderate pain response during Ponseti casting sessions as demonstrated by the NIPS. It rose significantly toward the last cast. The clubfoot child showed an exaggerated heart rate in succeeding casting sessions. No variations were noticed for oxygen saturation.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766446","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
Effects of Balance and Strength Training for Ankle Proprioception in People with Chronic Ankle Instability: A Randomized Controlled Study. 平衡和力量训练对慢性踝关节不稳患者踝关节知觉的影响:随机对照研究
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-05-01 DOI: 10.7547/23-008
Asena Yekdaneh, Çiğdem Yazıcı Mutlu

Background: After an ankle sprain, the ligament and joint capsule are damaged, and as a result, proprioceptive sense is damaged, causing a feeling of giving away in the ankle and resulting in recurrent sprains. Given the relevant studies, it has been seen that people with chronic ankle instability (CAI) commonly have deficits in joint position sense and reinjury risks. Joint position sense plays an important role in ankle control, thereby reducing the risk of injury. Therefore, this study aims to compare the effects of balance and strength training on ankle proprioception in people with CAI.

Methods: This single-blind randomized controlled study included 29 volunteer participants (21 women and eight men) aged 18 to 30 years. Participants with a Cumberland ankle instability scale score less than or equal to 24 were randomly divided into two treatment groups: strength training (n = 14) and balance training (n = 15). Y balance test, joint position, and vibration sense were evaluated at the beginning and end of the treatment. "Hop to stabilization" exercises were applied to the balance group and resistive bands exercises to the strength group, which were performed for 6 weeks, 35 minutes per day, two times per week.

Results: There was no significant difference between the two groups in the anterior, posterolateral, and posteromedial directions of the Y balance test (P = .89, P = .50, and P = .34, respectively), but the strength training group showed significant improvement in ankle proprioception (140°) and vibration sense (fifth finger) (P < .001), and the post hoc Cohen's d effect size values were medium (.52) and small (.25), respectively.

Conclusions: The findings of this study show that strengthening and balance exercises have similar effects on dynamic balance, but strengthening exercises are more effective in improving joint position and vibration sense. Given the positive effects of both exercise programs, it is recommended to implement the two interventions separately or together for CAI rehabilitation.

背景:踝关节扭伤后,韧带和关节囊受损,本体感觉受损,导致踝关节有错位感,从而导致反复扭伤。根据相关研究,慢性踝关节不稳定(CAI)患者普遍存在关节位置感缺陷和再损伤风险。关节位置感在踝关节控制中发挥着重要作用,从而降低了受伤风险。因此,本研究旨在比较平衡训练和力量训练对 CAI 患者踝关节本体感觉的影响:这项单盲随机对照研究包括 29 名志愿者(21 名女性和 8 名男性),年龄在 18 至 30 岁之间。坎伯兰踝关节不稳定性量表评分小于或等于 24 分的参与者被随机分为两个治疗组:力量训练组(14 人)和平衡训练组(15 人)。在治疗开始和结束时对 Y 平衡测试、关节位置和振动感进行评估。平衡训练组进行 "跳到稳定 "练习,力量训练组进行阻力带练习,为期6周,每天35分钟,每周2次:两组在 Y 平衡测试的前方、后外侧和后内侧方向上无明显差异(分别为 P = .89、P = .50 和 P = .34),但力量训练组在踝关节本体感觉(140°)和振动觉(五指)上有明显改善(P < .001),且事后 Cohen's d效应大小值分别为中等(.52)和较小(.25):本研究结果表明,加强型锻炼和平衡型锻炼对动态平衡的影响相似,但加强型锻炼在改善关节位置和振动感方面更为有效。鉴于两种运动项目的积极效果,建议在 CAI 康复中分别或同时实施这两种干预措施。
{"title":"Effects of Balance and Strength Training for Ankle Proprioception in People with Chronic Ankle Instability: A Randomized Controlled Study.","authors":"Asena Yekdaneh, Çiğdem Yazıcı Mutlu","doi":"10.7547/23-008","DOIUrl":"10.7547/23-008","url":null,"abstract":"<p><strong>Background: </strong>After an ankle sprain, the ligament and joint capsule are damaged, and as a result, proprioceptive sense is damaged, causing a feeling of giving away in the ankle and resulting in recurrent sprains. Given the relevant studies, it has been seen that people with chronic ankle instability (CAI) commonly have deficits in joint position sense and reinjury risks. Joint position sense plays an important role in ankle control, thereby reducing the risk of injury. Therefore, this study aims to compare the effects of balance and strength training on ankle proprioception in people with CAI.</p><p><strong>Methods: </strong>This single-blind randomized controlled study included 29 volunteer participants (21 women and eight men) aged 18 to 30 years. Participants with a Cumberland ankle instability scale score less than or equal to 24 were randomly divided into two treatment groups: strength training (n = 14) and balance training (n = 15). Y balance test, joint position, and vibration sense were evaluated at the beginning and end of the treatment. \"Hop to stabilization\" exercises were applied to the balance group and resistive bands exercises to the strength group, which were performed for 6 weeks, 35 minutes per day, two times per week.</p><p><strong>Results: </strong>There was no significant difference between the two groups in the anterior, posterolateral, and posteromedial directions of the Y balance test (P = .89, P = .50, and P = .34, respectively), but the strength training group showed significant improvement in ankle proprioception (140°) and vibration sense (fifth finger) (P < .001), and the post hoc Cohen's d effect size values were medium (.52) and small (.25), respectively.</p><p><strong>Conclusions: </strong>The findings of this study show that strengthening and balance exercises have similar effects on dynamic balance, but strengthening exercises are more effective in improving joint position and vibration sense. Given the positive effects of both exercise programs, it is recommended to implement the two interventions separately or together for CAI rehabilitation.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766441","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
Osteoid Osteoma of the Talus Mimicking Pigmented Villonodular Synovitis in a 15-Year-Old Male: A Case Report. 一名 15 岁男性模仿色素性绒毛结节性滑膜炎的距骨骨样骨瘤:病例报告。
IF 0.7 4区 医学 Q3 Medicine Pub Date : 2024-04-04 DOI: 10.7547/23-006
Oğuzhan Gökalp, C. Ermutlu, Mehmet Bartu Sarısözen, K. Durak, U. Yalçınkaya, Adnan Çakar
Osteoid osteoma is a benign tumor of the bone which tends to occur in diaphysis or metaphysis of the long bones. The lesion is generally intraosseous with vague clinical symptoms, hence given the name "great mimicker". When located subperiosteally and juxtaarticulary, atypical clinical presentation and radiological may lead to a delayed or missed diagnosis. Performing surgery with a misdiagnosis carries the risk of incomplete resection of the lesion and recurrence. We report the case of a 15-year-old male with a subperiosteal osteoid osteoma of the talus, who was misdiagnosed with pigmented villonodular synovitis and operated through anterior ankle arthrotomy. A nodular lesion 1 cm in diameter with hard rubber consistency was removed from the dorsal aspect of the talar neck. The pathological specimens were consistent with subperiosteal osteoid osteoma. The patient's symptoms resolved rapidly in the early postoperative period. The patient remained asymptomatic at the 20th-month follow-up and the control MRI revealed no signs of recurrence. Atypical radiological and clinical presentation of juxtaarticular subperiosteal osteoid osteomas cause misdiagnosis, delay in diagnosis, incomplete resection and recurrence. It is important to keep in mind "juxtaarticular subperiosteal osteoid osteoma" in the differential diagnosis of cases with suspected Pigmented Villonodular Synovitis.
骨样骨瘤是一种良性骨肿瘤,好发于长骨的干骺端或干骺端。病变一般位于骨内,临床症状模糊,因此被称为 "大模仿者"。当病变位于骨膜下和关节下时,不典型的临床表现和影像学表现可能会导致诊断延迟或漏诊。在误诊的情况下进行手术,有可能导致病灶切除不彻底和复发。我们报告了一例患有距骨骨膜下类骨瘤的 15 岁男性患者,他被误诊为色素性绒毛结节性滑膜炎,并通过前踝关节切开术进行了手术。从距骨颈背侧切除了一个直径 1 厘米、呈硬橡胶状的结节性病变。病理标本与骨膜下类骨瘤一致。患者的症状在术后早期迅速缓解。随访20个月时,患者仍无症状,对照核磁共振检查也未发现复发迹象。骨膜下类骨瘤的非典型放射学和临床表现会导致误诊、诊断延误、切除不彻底和复发。在对疑似色素性绒毛膜滑膜炎病例进行鉴别诊断时,必须牢记 "并关节骨膜下类骨瘤"。
{"title":"Osteoid Osteoma of the Talus Mimicking Pigmented Villonodular Synovitis in a 15-Year-Old Male: A Case Report.","authors":"Oğuzhan Gökalp, C. Ermutlu, Mehmet Bartu Sarısözen, K. Durak, U. Yalçınkaya, Adnan Çakar","doi":"10.7547/23-006","DOIUrl":"https://doi.org/10.7547/23-006","url":null,"abstract":"Osteoid osteoma is a benign tumor of the bone which tends to occur in diaphysis or metaphysis of the long bones. The lesion is generally intraosseous with vague clinical symptoms, hence given the name \"great mimicker\". When located subperiosteally and juxtaarticulary, atypical clinical presentation and radiological may lead to a delayed or missed diagnosis. Performing surgery with a misdiagnosis carries the risk of incomplete resection of the lesion and recurrence. We report the case of a 15-year-old male with a subperiosteal osteoid osteoma of the talus, who was misdiagnosed with pigmented villonodular synovitis and operated through anterior ankle arthrotomy. A nodular lesion 1 cm in diameter with hard rubber consistency was removed from the dorsal aspect of the talar neck. The pathological specimens were consistent with subperiosteal osteoid osteoma. The patient's symptoms resolved rapidly in the early postoperative period. The patient remained asymptomatic at the 20th-month follow-up and the control MRI revealed no signs of recurrence. Atypical radiological and clinical presentation of juxtaarticular subperiosteal osteoid osteomas cause misdiagnosis, delay in diagnosis, incomplete resection and recurrence. It is important to keep in mind \"juxtaarticular subperiosteal osteoid osteoma\" in the differential diagnosis of cases with suspected Pigmented Villonodular Synovitis.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744913","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
The Utility of Sulfur Colloid Imaging to Differentiate Charcot's Neuroarthropathy from Osteomyelitis: A Case Study. 硫胶体成像在区分夏科神经性关节病和骨髓炎方面的实用性:病例研究。
IF 0.5 4区 医学 Q4 ORTHOPEDICS Pub Date : 2024-03-01 DOI: 10.7547/21-235
Christopher M Gill, Mark J Bullock, Andrew H Cohen

Charcot's neuroarthropathy and osteomyelitis can have similar initial presentations. The ability to differentiate between the two pathologic conditions is essential, as each requires different treatment. We present a case of a 53-year-old woman with pain, swelling, and warmth in her left first metatarsophalangeal joint and first tarsometatarsal joint. Radiographs showed comminuted fractures at the base of the first metatarsal. Osteomyelitis was suspected by the primary team based on physical findings and a history of previous first metatarsophalangeal joint arthrodesis. A triphasic bone scan and an indium white blood cell scan were positive for osteomyelitis. The podiatric medical team was suspicious for possible Charcot's neuroarthropathy based on physical findings and uncontrolled blood glucose levels at the time of her previous arthrodesis. A sulfur colloid scan was performed and compared with an indium scan, which showed no evidence of osteomyelitis. This case demonstrates the usefulness of sulfur colloid imaging compared with an indium white blood cell scan to differentiate osteomyelitis from Charcot's neuroarthropathy. This case also highlights the importance of using clinical judgment to make the correct diagnosis.

夏科神经性关节病和骨髓炎的初期表现可能相似。区分这两种病理状态的能力至关重要,因为每种病理状态需要不同的治疗方法。我们介绍了一例 53 岁女性的病例,她的左侧第一跖趾关节和第一跗跖关节疼痛、肿胀和发热。X 光片显示第一跖骨基部有粉碎性骨折。根据体格检查结果和既往第一跖趾关节关节置换术史,主治团队怀疑她患有骨髓炎。三相骨扫描和铟白细胞扫描显示骨髓炎阳性。足科医疗团队根据患者的体格检查结果和之前关节置换术时未控制的血糖水平,怀疑她可能患有 Charcot 神经关节病。他们进行了胶体硫扫描,并与铟扫描进行了比较,结果显示没有骨髓炎的迹象。该病例表明,与铟白细胞扫描相比,硫胶体成像有助于区分骨髓炎和夏科神经性关节病。本病例还强调了利用临床判断做出正确诊断的重要性。
{"title":"The Utility of Sulfur Colloid Imaging to Differentiate Charcot's Neuroarthropathy from Osteomyelitis: A Case Study.","authors":"Christopher M Gill, Mark J Bullock, Andrew H Cohen","doi":"10.7547/21-235","DOIUrl":"10.7547/21-235","url":null,"abstract":"<p><p>Charcot's neuroarthropathy and osteomyelitis can have similar initial presentations. The ability to differentiate between the two pathologic conditions is essential, as each requires different treatment. We present a case of a 53-year-old woman with pain, swelling, and warmth in her left first metatarsophalangeal joint and first tarsometatarsal joint. Radiographs showed comminuted fractures at the base of the first metatarsal. Osteomyelitis was suspected by the primary team based on physical findings and a history of previous first metatarsophalangeal joint arthrodesis. A triphasic bone scan and an indium white blood cell scan were positive for osteomyelitis. The podiatric medical team was suspicious for possible Charcot's neuroarthropathy based on physical findings and uncontrolled blood glucose levels at the time of her previous arthrodesis. A sulfur colloid scan was performed and compared with an indium scan, which showed no evidence of osteomyelitis. This case demonstrates the usefulness of sulfur colloid imaging compared with an indium white blood cell scan to differentiate osteomyelitis from Charcot's neuroarthropathy. This case also highlights the importance of using clinical judgment to make the correct diagnosis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957920","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
Comparison of Suture Types and Techniques in Achilles Tendon Repair: An Ex Vivo Biomechanical Animal Experiment. 跟腱修复中缝合类型和技术的比较:体内生物力学动物实验
IF 0.7 4区 医学 Q3 Medicine Pub Date : 2024-03-01 DOI: 10.7547/21-136
Fatih Dogar, Kaan Gurbuz, Duran Topak, Mustafa Abdullah Ozdemir, Burak Kuşçu, Yakup Ekinci, Sabri Batin, Hakan Yaykasli, Okkes Bilal

Background: The ideal suture technique and type in tendon repair remain unclear. This biomechanical study aimed to assess the biomechanical characteristics of three techniques-modified Kessler (mKE), modified Krackow (mKR), and modified tension Bunnell (mtBU)-in sheep Achilles tendon tear repair using three suture types-polypropylene, polyester, and ultra-high-molecular-weight polyethylene (UHMWPE)-which are also compared.

Methods: Sixty-three Achilles tendons harvested from sheep were transversely hacked as a replacement for rupture in a standardized measure and repaired using mKE, mKR, and mtBU techniques with No. 2 polypropylene, polyester, and UHMWPE sutures. Biomechanical parameters, such as Young's modulus, ultimate strength, and strength to the 5-mm gap, were recorded for statistical analysis.

Results: The mtBU technique with UHMWPE use resulted in increased ultimate strength, strength to 5-mm gap, Young's modulus, and quantity of specimens with low clinical failure modes compared with the other techniques with other suture materials. Furthermore, mtBU has the lowest thickness at the repair side of the tendons. This approach showed tendon failure during maximal traction testing, whereas the mKE and mKR techniques had polyethylene and polyester suture failures.

Conclusions: The UHMWPE suture was significantly superior to the other sutures in each technique in terms of strength and durability. The mtBU technique using UHMWPE suture showed better biomechanical results, implying that this repair might be more appropriate to obtain early mobilization after tendon ruptures.

背景:肌腱修复的理想缝合技术和类型仍不明确。这项生物力学研究旨在评估改良 Kessler(mKE)、改良 Krackow(mKR)和改良张力 Bunnell(mtBU)三种技术在绵羊跟腱撕裂修复中的生物力学特性,并对聚丙烯、聚酯和超高分子量聚乙烯(UHMWPE)三种缝合线进行比较:方法:对从绵羊身上采集的 63 条跟腱进行横向切割,以标准化方法替代断裂,并使用 2 号聚丙烯、聚酯和超高分子量聚乙烯缝合线,采用 mKE、mKR 和 mtBU 技术进行修复。记录生物力学参数,如杨氏模量、极限强度和 5 毫米间隙强度,以便进行统计分析:结果:与使用其他缝合材料的其他技术相比,使用超高分子量聚乙烯的 mtBU 技术提高了极限强度、5 毫米间隙强度、杨氏模量和低临床失效模式标本的数量。此外,mtBU 在肌腱修复侧的厚度最小。这种方法在最大牵引力测试中显示肌腱失效,而 mKE 和 mKR 的聚乙烯和聚酯缝合线失效:结论:在每种缝合技术中,超高分子量聚乙烯缝合线在强度和耐久性方面都明显优于其他缝合线。使用超高分子量聚乙烯缝线的 mtBU 技术显示出更好的生物力学效果,这意味着这种修复方法可能更适合肌腱断裂后的早期活动。
{"title":"Comparison of Suture Types and Techniques in Achilles Tendon Repair: An Ex Vivo Biomechanical Animal Experiment.","authors":"Fatih Dogar, Kaan Gurbuz, Duran Topak, Mustafa Abdullah Ozdemir, Burak Kuşçu, Yakup Ekinci, Sabri Batin, Hakan Yaykasli, Okkes Bilal","doi":"10.7547/21-136","DOIUrl":"10.7547/21-136","url":null,"abstract":"<p><strong>Background: </strong>The ideal suture technique and type in tendon repair remain unclear. This biomechanical study aimed to assess the biomechanical characteristics of three techniques-modified Kessler (mKE), modified Krackow (mKR), and modified tension Bunnell (mtBU)-in sheep Achilles tendon tear repair using three suture types-polypropylene, polyester, and ultra-high-molecular-weight polyethylene (UHMWPE)-which are also compared.</p><p><strong>Methods: </strong>Sixty-three Achilles tendons harvested from sheep were transversely hacked as a replacement for rupture in a standardized measure and repaired using mKE, mKR, and mtBU techniques with No. 2 polypropylene, polyester, and UHMWPE sutures. Biomechanical parameters, such as Young's modulus, ultimate strength, and strength to the 5-mm gap, were recorded for statistical analysis.</p><p><strong>Results: </strong>The mtBU technique with UHMWPE use resulted in increased ultimate strength, strength to 5-mm gap, Young's modulus, and quantity of specimens with low clinical failure modes compared with the other techniques with other suture materials. Furthermore, mtBU has the lowest thickness at the repair side of the tendons. This approach showed tendon failure during maximal traction testing, whereas the mKE and mKR techniques had polyethylene and polyester suture failures.</p><p><strong>Conclusions: </strong>The UHMWPE suture was significantly superior to the other sutures in each technique in terms of strength and durability. The mtBU technique using UHMWPE suture showed better biomechanical results, implying that this repair might be more appropriate to obtain early mobilization after tendon ruptures.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40338701","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
Association of Preulcerative Foot Care and Outcomes of Diabetic Foot Ulceration. 溃疡前足部护理与糖尿病足溃疡预后的关系
IF 0.7 4区 医学 Q3 Medicine Pub Date : 2024-03-01 DOI: 10.7547/22-071
Tze-Woei Tan, Jeffrey P Tolson, Juan C Arias Aristizabal, Diego J Urbina, Sarah A Fermawi, Craig Weinkauf, David G Marrero, David G Armstrong

Background: The purpose of this study was to determine the association of preulcerative foot care and outcomes of diabetic foot ulcerations (DFUs).

Methods: This retrospective cohort study using the Mariner all-payers claims data set included participants with a new DFU from 2010 to 2019. Patients were stratified into two cohorts (foot care and control) based on whether they had received any outpatient foot care within 12 months before DFU. Adjusted comparison was performed by propensity matching for age, sex, and the Charlson Comorbidity Index (1:2 ratio). Kaplan-Meier estimates and logistic regression examined the association between foot care and outcomes of DFUs.

Results: Of the 307,131 patients in the study cohort, 4.7% (n = 14,477) received outpatient preulcerative foot care within the 12-month period before DFU. The rate of major amputation was 1.8% (foot care, 1.2%), and 9.0% of patients had hospitalizations for foot infection within 12 months after DFU (foot care, 7.8%). In the study cohort, patients who received pre-DFU foot care had greater major amputation-free survival (P < .001) on Kaplan-Meier estimate. In both the study and matched cohorts, multivariable analysis demonstrated that foot care was associated with lower odds of major amputation for both study (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.48-0.66) and matched (OR, 0.61; 95% CI, 0.51-0.72) cohorts, and lower odds of hospitalizations for a foot infection in both study (OR, 0.91; 95% CI, 0.86-0.96) and matched (OR, 0.88, 95% CI, 0.82-0.94) cohorts.

Conclusions: Among patients with a new DFU, those who received outpatient preulcerative foot care within 12 months of diagnosis had lower risks of major amputation and hospitalizations for foot infection.

背景:本研究旨在确定溃疡前足部护理与糖尿病足溃疡(DFUs)预后的关系:本研究旨在确定溃疡前足部护理与糖尿病足溃疡(DFU)预后之间的关系:这项回顾性队列研究使用了 Mariner 所有支付者的索赔数据集,包括 2010 年至 2019 年期间新发 DFU 的参与者。根据患者在DFU发生前12个月内是否接受过任何足部门诊护理,将患者分为两个队列(足部护理队列和对照队列)。根据年龄、性别和夏尔森综合症指数(1:2 比例)进行倾向匹配,进行调整比较。卡普兰-梅耶估计值和逻辑回归检验了足部护理与 DFUs 结果之间的关联:在研究队列的 307,131 名患者中,4.7%(n = 14,477)的患者在 DFU 发生前的 12 个月内接受了溃疡前足部门诊治疗。重大截肢率为 1.8%(足部护理,1.2%),9.0% 的患者在 DFU 后 12 个月内因足部感染住院(足部护理,7.8%)。在研究队列中,根据 Kaplan-Meier 估计,接受 DFU 前足部护理的患者无重大截肢的存活率更高(P < .001)。在研究队列和匹配队列中,多变量分析表明,足部护理与较低的大截肢几率相关,无论是研究队列(几率比 [OR],0.56;95% 置信区间 [CI],0.48-0.66)还是匹配队列(OR,0.56;95% 置信区间 [CI],0.48-0.66)。在研究队列(OR,0.91;95% CI,0.86-0.96)和匹配队列(OR,0.88,95% CI,0.82-0.94)中,足部护理与较低的大截肢几率相关,与较低的足部感染住院几率相关:结论:在新发 DFU 患者中,确诊后 12 个月内接受足部溃疡前门诊治疗的患者截肢和因足部感染住院的风险较低。
{"title":"Association of Preulcerative Foot Care and Outcomes of Diabetic Foot Ulceration.","authors":"Tze-Woei Tan, Jeffrey P Tolson, Juan C Arias Aristizabal, Diego J Urbina, Sarah A Fermawi, Craig Weinkauf, David G Marrero, David G Armstrong","doi":"10.7547/22-071","DOIUrl":"https://doi.org/10.7547/22-071","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine the association of preulcerative foot care and outcomes of diabetic foot ulcerations (DFUs).</p><p><strong>Methods: </strong>This retrospective cohort study using the Mariner all-payers claims data set included participants with a new DFU from 2010 to 2019. Patients were stratified into two cohorts (foot care and control) based on whether they had received any outpatient foot care within 12 months before DFU. Adjusted comparison was performed by propensity matching for age, sex, and the Charlson Comorbidity Index (1:2 ratio). Kaplan-Meier estimates and logistic regression examined the association between foot care and outcomes of DFUs.</p><p><strong>Results: </strong>Of the 307,131 patients in the study cohort, 4.7% (n = 14,477) received outpatient preulcerative foot care within the 12-month period before DFU. The rate of major amputation was 1.8% (foot care, 1.2%), and 9.0% of patients had hospitalizations for foot infection within 12 months after DFU (foot care, 7.8%). In the study cohort, patients who received pre-DFU foot care had greater major amputation-free survival (P < .001) on Kaplan-Meier estimate. In both the study and matched cohorts, multivariable analysis demonstrated that foot care was associated with lower odds of major amputation for both study (odds ratio [OR], 0.56; 95% confidence interval [CI], 0.48-0.66) and matched (OR, 0.61; 95% CI, 0.51-0.72) cohorts, and lower odds of hospitalizations for a foot infection in both study (OR, 0.91; 95% CI, 0.86-0.96) and matched (OR, 0.88, 95% CI, 0.82-0.94) cohorts.</p><p><strong>Conclusions: </strong>Among patients with a new DFU, those who received outpatient preulcerative foot care within 12 months of diagnosis had lower risks of major amputation and hospitalizations for foot infection.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140957786","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
期刊
Journal of the American Podiatric Medical Association
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1