Pub Date : 2021-12-23DOI: 10.30795/jfootankle.2021.v15.1584
Diego Javier Yearson, Ignacio Melendez, Federico Anain, Santiago Siniscalchi, Juan Drago
Introducción: el hallux valgus es la deformidad musculoesquelética más frecuente. La laxitud y la hipermovilidad tarso metatarsiana favorecen su desarrollo. El objetivo de este trabajo es plantear una patología tridimensional, y elaborar un algoritmo quirúrgico para cada patrón de deformidad, incorporando el componente rotacional del metatarsiano. Materiales y métodos: evaluamos prospectivamente una serie de 89 casos entre febrero de 2020 y febrero 2021, 80 mujeres y 9 hombres. Nivel de evidencia IV. La edad promedio fue 39 años y el seguimiento 11.3 meses. Utilizamos la clasificación de Hardy-Clapham y separamos 2 grupos, los hallux sin componente rotacional (tipo 1 a 3), y aquellos con componente rotacional (tipo 4 a 7). Resultados: el 59% entraron en el primer grupo, a los cuales se realizó osteotomía distal en chevron acorde a la deformidad en el plano frontal. El 41 % restante tuvo componente rotacional, y se realizó una osteotomía distal en chevron rotacional, crecientica en la base, o artrodesis de Lapidus modificada, según la deformidad en plano frontal o inestabilidad asociada. Consolidaron todos pacientes. AOFAS 94.5%, VAS 0.71 y 100% de satisfacción. Discusión: el componente rotacional es fundamental en la interpretación del hallux valgus, pero no es el único para tener en cuenta. El mismo puede no estar presente o no ser trascendente, y se alcanzan excelentes resultados como los publicados por décadas. Es fundamental diferenciar los pacientes con componente rotacional para realizar el tratamiento adecuado. Conclusión: considerando el hallux valgus una patología tridimensional, proponemos un protocolo de tratamiento acorde para cada paciente.
本研究的目的是评估和比较两种不同类型的肌肉骨骼畸形。松动和跗骨跖骨过度活动有利于其发育。本文的目的是提出一个三维病理，并为每个畸形模式开发一个手术算法，包括跖骨的旋转成分。材料和方法:我们前瞻性地评估了2020年2月至2021年2月期间的89例病例，80名女性和9名男性。证据水平IV.平均年龄39岁，随访11.3个月。使用Hardy-Clapham分类和分手2组、无组件hallux轮流(1 - 3)型,和那些与轮流组件(4 - 7型)。结果:59%进入第一组共进行了截distal在雪佛龙(chevron)符合一级畸形步伐。根据前额平面畸形或相关不稳定性，其余41%的患者有旋转成分，并根据前额平面畸形或相关不稳定性进行远端旋转chevron、基底生长或改良Lapidus关节融合术。他们合并了所有的病人。AOFAS 94.5%， VAS 0.71, 100%满意度。讨论:旋转成分是解释拇外翻的基础，但不是唯一需要考虑的成分。它可能不存在，也可能不超然，并取得了几十年发表的优秀成果。为了进行适当的治疗，区分使用旋转成分的患者是至关重要的。结论:考虑到拇外翻是一种三维病理，我们对每个患者提出了相应的治疗方案。
{"title":"Hallux valgus: Patología tridimensional. Nuevo enfoque terapéutico","authors":"Diego Javier Yearson, Ignacio Melendez, Federico Anain, Santiago Siniscalchi, Juan Drago","doi":"10.30795/jfootankle.2021.v15.1584","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1584","url":null,"abstract":"Introducción: el hallux valgus es la deformidad musculoesquelética más frecuente. La laxitud y la hipermovilidad tarso metatarsiana favorecen su desarrollo. El objetivo de este trabajo es plantear una patología tridimensional, y elaborar un algoritmo quirúrgico para cada patrón de deformidad, incorporando el componente rotacional del metatarsiano. \u0000Materiales y métodos: evaluamos prospectivamente una serie de 89 casos entre febrero de 2020 y febrero 2021, 80 mujeres y 9 hombres. Nivel de evidencia IV. La edad promedio fue 39 años y el seguimiento 11.3 meses. Utilizamos la clasificación de Hardy-Clapham y separamos 2 grupos, los hallux sin componente rotacional (tipo 1 a 3), y aquellos con componente rotacional (tipo 4 a 7). \u0000Resultados: el 59% entraron en el primer grupo, a los cuales se realizó osteotomía distal en chevron acorde a la deformidad en el plano frontal. El 41 % restante tuvo componente rotacional, y se realizó una osteotomía distal en chevron rotacional, crecientica en la base, o artrodesis de Lapidus modificada, según la deformidad en plano frontal o inestabilidad asociada. Consolidaron todos pacientes. AOFAS 94.5%, VAS 0.71 y 100% de satisfacción. \u0000Discusión: el componente rotacional es fundamental en la interpretación del hallux valgus, pero no es el único para tener en cuenta. El mismo puede no estar presente o no ser trascendente, y se alcanzan excelentes resultados como los publicados por décadas. Es fundamental diferenciar los pacientes con componente rotacional para realizar el tratamiento adecuado. \u0000Conclusión: considerando el hallux valgus una patología tridimensional, proponemos un protocolo de tratamiento acorde para cada paciente.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80395705","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}
Background: The osteochondral grafting has become a popular procedure for treating challenging talar dome lesions. However, the vast majority are treated through medial malleolus osteotomy. The aim of this study was to determine the posteromedial area of the talus that can be reached without malleolar osteotomy through the posteromedial approach. Study Design: Descriptive laboratory study. Evidence Level 4 Methods: Fifteen human cadaveric ankles were dissected in a standard fashion to expose the posteromedial talar dome. Seven approaches were used on the cadaver's left limb (46.7%). We did not observe any significant difference between the evaluated sides (chi-square test, p = 0.715). Results: On average, 2,09 cm2 (range, 1,72-2,69) of the posteromedial talus dome or 15,27 % (range 12-20) of total talus dome can be accessed without osteotomy. Conclusion: If the osteochondral lesion is within the area accessible through PM approach (mean 2 cm2), as seen on magnetic resonance imaging, it is possible that it can be treated without a medial malleolus osteotomy. Keywords: talus; osteochondral lesions; osteotomy; arthrotomy; surgery
{"title":"Access to the talar dome through the medial posterolateral approach: an anatomical study.","authors":"Wellington Farias Molina, Lourenço Galizia Heitzmann, Guilherme Bottino Martins, Luiz Sérgio Martins Pimenta, Giezy Rasfasky Fiorot, Ian Almeida Fragalli","doi":"10.30795/jfootankle.2021.v15.1596","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1596","url":null,"abstract":"Background: The osteochondral grafting has become a popular procedure for treating challenging talar dome lesions. However, the vast majority are treated through medial malleolus osteotomy. The aim of this study was to determine the posteromedial area of the talus that can be reached without malleolar osteotomy through the posteromedial approach. \u0000Study Design: Descriptive laboratory study. Evidence Level 4 \u0000Methods: Fifteen human cadaveric ankles were dissected in a standard fashion to expose the posteromedial talar dome. Seven approaches were used on the cadaver's left limb (46.7%). We did not observe any significant difference between the evaluated sides (chi-square test, p = 0.715). \u0000 Results: On average, 2,09 cm2 (range, 1,72-2,69) of the posteromedial talus dome or 15,27 % (range 12-20) of total talus dome can be accessed without osteotomy. \u0000Conclusion: If the osteochondral lesion is within the area accessible through PM approach (mean 2 cm2), as seen on magnetic resonance imaging, it is possible that it can be treated without a medial malleolus osteotomy. \u0000Keywords: talus; osteochondral lesions; osteotomy; arthrotomy; surgery","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78881304","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1578
M. Herrera-Pérez, D. González-Martín, R. Viladot-Pericé
This study performs a literature review on the treatment of hallux rigidus and proposes a treatment algorithm.This literature systematic review expanded a similar study conducted in 2014 by the authors and analyzed the levels of recommendation according to scientific evidence.Most articles found in the search present scarce evidence (level IV or case series), we only found 8 articles with an at least moderate level of recommendation (B); of these, only one article had a level of evidence I.Conservative treatment is effective with the implementation of footwear modifications, use of insoles, and infiltrations with hyaluronic acid. Cheilectomy, either isolated or combined with Moberg osteotomy, shows good outcomes in stage III, or moderate, although its outcomes worsen after 5 years. Metatarsophalangeal joint (MTPJ) arthrodesis is still the gold standard in stage IV, or advanced. In recent years, the technique of interposition arthroplasty has re-emerged, especially with the use of a synthetic cartilage implant (Cartiva®), with outcomes at least similar to those of MTPJ arthrodesis in comparative studies. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.
{"title":"Proposed treatment algorithm for hallux rigidus","authors":"M. Herrera-Pérez, D. González-Martín, R. Viladot-Pericé","doi":"10.30795/jfootankle.2021.v15.1578","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1578","url":null,"abstract":"This study performs a literature review on the treatment of hallux rigidus and proposes a treatment algorithm.This literature systematic review expanded a similar study conducted in 2014 by the authors and analyzed the levels of recommendation according to scientific evidence.Most articles found in the search present scarce evidence (level IV or case series), we only found 8 articles with an at least moderate level of recommendation (B); of these, only one article had a level of evidence I.Conservative treatment is effective with the implementation of footwear modifications, use of insoles, and infiltrations with hyaluronic acid. Cheilectomy, either isolated or combined with Moberg osteotomy, shows good outcomes in stage III, or moderate, although its outcomes worsen after 5 years. Metatarsophalangeal joint (MTPJ) arthrodesis is still the gold standard in stage IV, or advanced. In recent years, the technique of interposition arthroplasty has re-emerged, especially with the use of a synthetic cartilage implant (Cartiva®), with outcomes at least similar to those of MTPJ arthrodesis in comparative studies. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86724651","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1565
L. Lara, Lúcio Torres Filho, G. Cervone, J. Grajales, Glaucia Bordignon, L. Lancia, D. Santos, Igor Marijusckin, D. Russo
Objective: To evaluate the outcomes of the metatarsophalangeal arthrodesis (MTPA) of the hallux using a percutaneous technique. Methods: The MTPA of the hallux was performed in a total of 27 feet: 20 patients diagnosed with hallux rigidus and 7 with rheumatoid arthritis. The mean postoperative follow-up time was 30.7 months. The results were evaluated using the visual analogue scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot score, and regards to union rate. Results: All 27 patients were operated percutaneously and noticed relief of the pain, with a mean increase of 50.9 points in AOFAS scores and a mean decrease of 7.4 points in the VAS. The mean union time was 10 weeks. There were no cases of nonunion. Conclusion: Percutaneous first MTP arthrodesis proved effective for treating hallux rigidus and degenerative rheumatic pathologies. Level of Evidence IV; Therapeutic Studies; Cases Series.
{"title":"Metatarsophalangeal arthrodesis of the hallux using a minimally invasive technique","authors":"L. Lara, Lúcio Torres Filho, G. Cervone, J. Grajales, Glaucia Bordignon, L. Lancia, D. Santos, Igor Marijusckin, D. Russo","doi":"10.30795/jfootankle.2021.v15.1565","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1565","url":null,"abstract":"Objective: To evaluate the outcomes of the metatarsophalangeal arthrodesis (MTPA) of the hallux using a percutaneous technique. Methods: The MTPA of the hallux was performed in a total of 27 feet: 20 patients diagnosed with hallux rigidus and 7 with rheumatoid arthritis. The mean postoperative follow-up time was 30.7 months. The results were evaluated using the visual analogue scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot score, and regards to union rate. Results: All 27 patients were operated percutaneously and noticed relief of the pain, with a mean increase of 50.9 points in AOFAS scores and a mean decrease of 7.4 points in the VAS. The mean union time was 10 weeks. There were no cases of nonunion. Conclusion: Percutaneous first MTP arthrodesis proved effective for treating hallux rigidus and degenerative rheumatic pathologies. Level of Evidence IV; Therapeutic Studies; Cases Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91222870","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1599
Ricardo Rodríguez Ciodaro, Carlos Eduardo Pardo Laverde, Álvaro Santiago Guerrero Forero, María Helena Solano Trujillo, Claudia Caicedo Donoso, Nicolás Hernández Arango
Los Pseudotumores Hemofílicos, son lesiones de baja prevalencia, associadas a el déficit de factor de la coagulación XIII o IX, característicos de la Hemofilia. La localización es más frecuente en zonas como la cadera o el iliopsoas, mientras que en articulaciones distales son exóticos. Nosotros mostramos en este caso el desarrollo de un Pseudotumor Hemofílico en relación al abordaje anterolateral convencional de artroscopia de tobillo, en un paciente con Hemofilia tipo A leve, quien requierió manejo quirúrgico por artropatía hemofílica.
{"title":"Pseudotumor hemofílico de tobillo - A propósito de un caso","authors":"Ricardo Rodríguez Ciodaro, Carlos Eduardo Pardo Laverde, Álvaro Santiago Guerrero Forero, María Helena Solano Trujillo, Claudia Caicedo Donoso, Nicolás Hernández Arango","doi":"10.30795/jfootankle.2021.v15.1599","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1599","url":null,"abstract":"Los Pseudotumores Hemofílicos, son lesiones de baja prevalencia, associadas a el déficit de factor de la coagulación XIII o IX, característicos de la Hemofilia. La localización es más frecuente en zonas como la cadera o el iliopsoas, mientras que en articulaciones distales son exóticos. Nosotros mostramos en este caso el desarrollo de un Pseudotumor Hemofílico en relación al abordaje anterolateral convencional de artroscopia de tobillo, en un paciente con Hemofilia tipo A leve, quien requierió manejo quirúrgico por artropatía hemofílica.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88388273","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1600
Samuel Braza, Nacime Salomão Barbachan Mansur, Vineel Mallavarapu, Kepler Alencar Mendes de Carvalho, K. Dibbern, Caio Augusto de Souza Nery, M. Lalevée, C. de César Netto
Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round. Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.
目的:评价传统x线摄影(CR)所获得的拇外翻(HV)测量值与负重计算机断层摄影(WBCT)测量值是否一致。方法:采用回顾性病例对照研究，对26只HV足和20只对照足进行CR和WBCT分析。测量拇外翻角(HVA)、跖间角(IMA)、指间角(IPA)、远端跖关节角(DMAA)、籽骨站(SS)和第一跖骨头形。用卡方检验比较外翻患者与对照组。采用t检验比较CR和WBCT。p值小于0.05被认为是显著的。结果:WBCT能够区分HV患者和对照组，HVA(35.29和9.02,p < 0.001)、IMA(16.01和10.01,p < 0.001)和DMAA(18.90和4.10,p < 0.001)的平均值高于对照组。比较两种方法时，CR和WBCT测量的HVA (-0.84, p = 0.79)、IMA (-0.93, p = 0.39)、IPA (1.53, p = 0.09)和SS (p = 0.40)差异无统计学意义，但DMAA (13.43, p < 0.0001)差异有统计学意义。CR分析得出不同的跖骨头形状，而所有的WBCT形状分类都是圆形的。结论:WBCT与CR的单维HV测量结果相似，而更多的三维结果则不同。CR可用于评估HV的轴向方面，但x线平片可能无法准确评估畸形的多维方面。证据等级III;治疗研究;回顾性病例对照研究。
{"title":"Hallux valgus measurements using weight-bearing computed tomography: what changes?","authors":"Samuel Braza, Nacime Salomão Barbachan Mansur, Vineel Mallavarapu, Kepler Alencar Mendes de Carvalho, K. Dibbern, Caio Augusto de Souza Nery, M. Lalevée, C. de César Netto","doi":"10.30795/jfootankle.2021.v15.1600","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1600","url":null,"abstract":"Objective: To assess whether traditional hallux valgus (HV) measurements obtained with conventional radiography (CR) correspond to those obtained with weight-bearing computed tomography (WBCT). Methods: In this retrospective case-control study, 26 HV feet and 20 control feet were analyzed with CR and WBCT. Hallux valgus angle (HVA), intermetatarsal angle (IMA), interphalangeal angle (IPA), distal metatarsal articular angle (DMAA), sesamoid station (SS), and first metatarsal head shape were measured. Chi-square tests were used to compare hallux valgus and control patients. T-tests were used to compare CR and WBCT. P-values less than 0.05 were considered significant. Results: WBCT was capable of discriminating patients with HV from controls, showing higher mean values for HV patients than controls in HVA (35.29 and 9.02, p < 0.001), IMA (16.01 and 10.01, p < 0.001), and DMAA (18.90 and 4.10, p < 0.001). When comparing the two methods, differences were not significant between CR and WBCT measurements in HVA (-0.84, p = 0.79), IMA (-0.93, p = 0.39), IPA (1.53, p = 0.09), or SS (p = 0.40), but were significant for DMAA (13.43, p < .0001). CR analysis yielded varied metatarsal head shapes, while all WBCT shape classifications were round. Conclusion: Unidimensional HV measurements were similar between WBCT and CR, while more three-dimensional findings were not. CR may be used to assess the axial aspects of HV, but multidimensional aspects of the deformity may not be accurately assessed with plain radiographs. Level of Evidence III; Therapeutic Studies; Retrospective Case-Control Study.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80455113","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1579
M. Herrera-Pérez, D. González-Martín, J. Ruiz-Escobar, R. Viladot-Pericé
This study proposes an update on conservative treatment of hallux rigidus based on scientific evidence. This is a narrative review of 19 articles that analyzed conservative treatment of hallux rigidus in its different modalities. Conservative treatment is effective in approximately half of the patients with hallux rigidus, and footwear modifications, use of insoles, and hyaluronic acid injections are the most effective treatments, according to evidence-based medicine. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.
{"title":"Conservative treatment of hallux rigidus: narrative review of scientific evidence","authors":"M. Herrera-Pérez, D. González-Martín, J. Ruiz-Escobar, R. Viladot-Pericé","doi":"10.30795/jfootankle.2021.v15.1579","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1579","url":null,"abstract":"This study proposes an update on conservative treatment of hallux rigidus based on scientific evidence. This is a narrative review of 19 articles that analyzed conservative treatment of hallux rigidus in its different modalities. Conservative treatment is effective in approximately half of the patients with hallux rigidus, and footwear modifications, use of insoles, and hyaluronic acid injections are the most effective treatments, according to evidence-based medicine. Level of Evidence III; Therapeutic Studies; Systematic Review of Level III Studies.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"2010 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74052616","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1582
Kefilwe Boineelo Benjamin, N. Saragas, P. Ferrao
Objective: We aimed to evaluate patient satisfaction after surgery for both single and two adjacent neuromas. Methods: We reviewed the data of patients treated operatively for interdigital neuromas between 2003 and 2016. We interviewed them and administered the Self-Reported Foot and Ankle Score questionnaire. Patient scores were then analyzed categorically, and variation between groups was assessed. Results: Sixty-two patients were available for review. Thirty-one patients had a single interdigital neuroma excised and 31 had two adjacente interdigital neuromas excised. Twenty-eight of the 31 (90%) patients with a single neuroma had good or excellent results while 23 (74.2%) of those with adjacent neuromas had similar outcomes. One patient with a single neuroma had a poor result while four patients with adjacent neuromas had poor results. The mean score was 41 (excellent) for patients with a single interdigital neuroma and 37 (good) for those with adjacent neuromas (p=0.473). The majority of patients in both groups would undergo surgery again. Conclusion: We found no statistically significant difference in outcomes of patients who undergo surgery for either single or two adjacent interdigital neuromas. General patient satisfaction is good and/or excellent post excision. Level of Evidence II; Prognostic Studies; Retrospective Study.
{"title":"One versus two adjacent interdigital neuroma excision: a patient outcome study","authors":"Kefilwe Boineelo Benjamin, N. Saragas, P. Ferrao","doi":"10.30795/jfootankle.2021.v15.1582","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1582","url":null,"abstract":"Objective: We aimed to evaluate patient satisfaction after surgery for both single and two adjacent neuromas. Methods: We reviewed the data of patients treated operatively for interdigital neuromas between 2003 and 2016. We interviewed them and administered the Self-Reported Foot and Ankle Score questionnaire. Patient scores were then analyzed categorically, and variation between groups was assessed. Results: Sixty-two patients were available for review. Thirty-one patients had a single interdigital neuroma excised and 31 had two adjacente interdigital neuromas excised. Twenty-eight of the 31 (90%) patients with a single neuroma had good or excellent results while 23 (74.2%) of those with adjacent neuromas had similar outcomes. One patient with a single neuroma had a poor result while four patients with adjacent neuromas had poor results. The mean score was 41 (excellent) for patients with a single interdigital neuroma and 37 (good) for those with adjacent neuromas (p=0.473). The majority of patients in both groups would undergo surgery again. Conclusion: We found no statistically significant difference in outcomes of patients who undergo surgery for either single or two adjacent interdigital neuromas. General patient satisfaction is good and/or excellent post excision. Level of Evidence II; Prognostic Studies; Retrospective Study.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86428037","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1580
G. Arrondo, L. Casola
The severity of hallux rigidus depends on the degree of joint involvement, from local pain to stress fractures of other bones of the foot due to hyper-support. Radiology is mandatory to have an accurate diagnosis and gives us a parameter of joint injury. We use the Coughlin and Shurnas classification as the gold standard for treatment. Level of Evidence IV.
{"title":"Hallux rigidus: clinical examination, radiology, and classification","authors":"G. Arrondo, L. Casola","doi":"10.30795/jfootankle.2021.v15.1580","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1580","url":null,"abstract":"The severity of hallux rigidus depends on the degree of joint involvement, from local pain to stress fractures of other bones of the foot due to hyper-support. Radiology is mandatory to have an accurate diagnosis and gives us a parameter of joint injury. We use the Coughlin and Shurnas classification as the gold standard for treatment. Level of Evidence IV.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76264556","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 : 2021-12-20DOI: 10.30795/jfootankle.2021.v15.1570
D. Saraiva, M. Knupp, A. Rodrigues, T. Gomes, X. Oliva
We present a case of a rheumatoid patient presenting with acute signs of posterior tibial tendon dysfunction (PTTD). Magnetic resonance imaging (MRI) results were inconclusive regarding the grade of posterior tibial tendon (PTT) tear. We performed posterior tibial tendoscopy, releasing all tendon adherences, and accomplished complete synovectomy. By the end of the procedure, we observed PTT integrity, normal excursion, and mild tendinosis. At 24-month follow-up, the Visual Analog Scale for pain (VAS-Pain) decreased from 9 (preoperatively) to 1. The Foot and Ankle Outcome Score (FAOS) increased from 16% (preoperatively) to 94%. Clinically, the patient had a symmetric bilateral heel rise test and no pain over the course of the PTT. A standard radiographic assessment demonstrated a normal foot arch and hindfoot alignment. This report illustrates how posterior tibial tendoscopy can simultaneously provide accurate diagnosis and surgically address acute PTTD on a rheumatoid patient, relieving symptoms and improving midterm clinical scores. Level of Evidence V; Therapeutic Studies; Expert Opinion.
{"title":"Tendoscopic treatment of acute posterior tibial tendon dysfunction: case report","authors":"D. Saraiva, M. Knupp, A. Rodrigues, T. Gomes, X. Oliva","doi":"10.30795/jfootankle.2021.v15.1570","DOIUrl":"https://doi.org/10.30795/jfootankle.2021.v15.1570","url":null,"abstract":"We present a case of a rheumatoid patient presenting with acute signs of posterior tibial tendon dysfunction (PTTD). Magnetic resonance imaging (MRI) results were inconclusive regarding the grade of posterior tibial tendon (PTT) tear. We performed posterior tibial tendoscopy, releasing all tendon adherences, and accomplished complete synovectomy. By the end of the procedure, we observed PTT integrity, normal excursion, and mild tendinosis. At 24-month follow-up, the Visual Analog Scale for pain (VAS-Pain) decreased from 9 (preoperatively) to 1. The Foot and Ankle Outcome Score (FAOS) increased from 16% (preoperatively) to 94%. Clinically, the patient had a symmetric bilateral heel rise test and no pain over the course of the PTT. A standard radiographic assessment demonstrated a normal foot arch and hindfoot alignment. This report illustrates how posterior tibial tendoscopy can simultaneously provide accurate diagnosis and surgically address acute PTTD on a rheumatoid patient, relieving symptoms and improving midterm clinical scores. Level of Evidence V; Therapeutic Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90648002","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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