Pub Date : 2020-08-30DOI: 10.30795/jfootankle.2020.v14.1147
T. Ferreira, M. Marcatti, F. Bertolini, Otaviano de Oliveira Júnior, G. Nunes
Objective: To present the clinical and functional results of surgical treatment of patients with chronic instability of the ankle using the arthroscopic Brostrom technique. Methods: This is a case series of patients who underwent surgical treatment for chronic instability of the lateral ligament of the ankle using the arthroscopic Brostrom technique. Clinical assessments of ankle stability were performed preoperatively and at the last follow-up using the American Orthopedic Foot and Ankle Score (AOFAS), a visual analog scale (VAS) for pain, and the anterior drawer and talar inversion tilt tests. Surgical complications and patient satisfaction ratings were also analyzed. Results: A total of 16 patients were analyzed, with a mean follow-up of 14 months. There was a statistically significant (p<0.001) improvement in mean AOFAS, which increased from 67.2 to 90.8 points and the mean VAS for pain score reduced from 6.5 to 1.5 points. All ankles were stable and had normal results for the anterior drawer test and the talar inversion tilt test. Three patients (19%) reported that resumption of sporting activities provoked subjective pain in the ankle, which improved progressively during follow-up. Two patients (12.5%) exhibited neurapraxia of the superficial peroneal nerve. A majority of the patients (81%) rated treatment as good or excellent. Conclusion: Treatment of chronic instability of the ankle ligament using the arthroscopic Brostrom technique restored ankle stability and achieved good clinical results. There was a high rate of early complications, but the majority were transitory and underwent complete remission during follow-up. Level of Evidence IV; Therapeutic Studies; Case Series.
{"title":"Arthroscopic Brostrom technique","authors":"T. Ferreira, M. Marcatti, F. Bertolini, Otaviano de Oliveira Júnior, G. Nunes","doi":"10.30795/jfootankle.2020.v14.1147","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1147","url":null,"abstract":"Objective: To present the clinical and functional results of surgical treatment of patients with chronic instability of the ankle using the arthroscopic Brostrom technique. Methods: This is a case series of patients who underwent surgical treatment for chronic instability of the lateral ligament of the ankle using the arthroscopic Brostrom technique. Clinical assessments of ankle stability were performed preoperatively and at the last follow-up using the American Orthopedic Foot and Ankle Score (AOFAS), a visual analog scale (VAS) for pain, and the anterior drawer and talar inversion tilt tests. Surgical complications and patient satisfaction ratings were also analyzed. Results: A total of 16 patients were analyzed, with a mean follow-up of 14 months. There was a statistically significant (p<0.001) improvement in mean AOFAS, which increased from 67.2 to 90.8 points and the mean VAS for pain score reduced from 6.5 to 1.5 points. All ankles were stable and had normal results for the anterior drawer test and the talar inversion tilt test. Three patients (19%) reported that resumption of sporting activities provoked subjective pain in the ankle, which improved progressively during follow-up. Two patients (12.5%) exhibited neurapraxia of the superficial peroneal nerve. A majority of the patients (81%) rated treatment as good or excellent. Conclusion: Treatment of chronic instability of the ankle ligament using the arthroscopic Brostrom technique restored ankle stability and achieved good clinical results. There was a high rate of early complications, but the majority were transitory and underwent complete remission during follow-up. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83222772","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 : 2020-08-30DOI: 10.30795/jfootankle.2020.v14.1188
Cristian Ortiz
Any forecast of the pandemic dynamics has proven to be far away from what has really happened, particularly in South America. In most of our countries, we are still struggling with what has been called the first wave. The virus has impacted not only our health status but also every aspect of our lives, including our daily work. Spending less time in the operating room has a positive side that each one has experienced differently. It has provided the opportunity for more quality time with the family and an understanding of how vulnerable we all are, how complicated politics and economic decisions are, and how important the way we all communicate and share experiences is.Most of us have seen our workplaces becoming busy with an increasing number of patients, which has led us to cancel any elective surgery and stay home in isolation. This difficult time we are going through has allowed us to think about our purpose in life, especially as physicians. We have been forced to develop new ways of teaching medicine, researching, and even practicing medicine. Most importantly, difficult times require that we learn a new way of living.This has led us to reflect on the importance of research and on how important it is that all of us give our best for our patients. Treating patients well impels us to be informed, to be updated about new knowledge, and to practice our skills while continuously looking for answers. The virtuous circle to be a good doctor should always include clinical practice, medical education, and research.When I was asked to write this editorial, one thought immediately came to my mind: how easily some journalists and public figures get into trouble after making a comment, writing an editorial, or even after publishing a post on social media. A recent example is what happened to J. K. Rowling, the famous author of the Harry Potter series. Last December, she tweeted her support for Maya Forstater, who was fired for what were deemed “transphobic” tweets. Rowling has received accusations and threats from trans activists and many worldwide famous people. A single ‘like’ was deemed evidence of ‘wrongthink’, and a persistent level of harassment began. The world has definitely changed, and everyone’s comments and behaviors are completely public. We should not be afraid to speak up and express our opinion, we should not be stopped by the fear of having people against us. As physicians, we are all exposed by expressing our medical opinion every day in the office, in a meeting, or even in a remote setting. Every decision and opinion should be based on evidence, but they will inevitably include our personal background-which is a mix of knowledge and personal life experience. Hopefully, these opinions will always express our genuine interest in the patients and their families as our main focus.As I get older, I pay more attention to the basis of my daily practice, which begins with proper information provided by good sources of medical education such a
{"title":"Changing time","authors":"Cristian Ortiz","doi":"10.30795/jfootankle.2020.v14.1188","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1188","url":null,"abstract":"Any forecast of the pandemic dynamics has proven to be far away from what has really happened, particularly in South America. In most of our countries, we are still struggling with what has been called the first wave. The virus has impacted not only our health status but also every aspect of our lives, including our daily work. Spending less time in the operating room has a positive side that each one has experienced differently. It has provided the opportunity for more quality time with the family and an understanding of how vulnerable we all are, how complicated politics and economic decisions are, and how important the way we all communicate and share experiences is.Most of us have seen our workplaces becoming busy with an increasing number of patients, which has led us to cancel any elective surgery and stay home in isolation. This difficult time we are going through has allowed us to think about our purpose in life, especially as physicians. We have been forced to develop new ways of teaching medicine, researching, and even practicing medicine. Most importantly, difficult times require that we learn a new way of living.This has led us to reflect on the importance of research and on how important it is that all of us give our best for our patients. Treating patients well impels us to be informed, to be updated about new knowledge, and to practice our skills while continuously looking for answers. The virtuous circle to be a good doctor should always include clinical practice, medical education, and research.When I was asked to write this editorial, one thought immediately came to my mind: how easily some journalists and public figures get into trouble after making a comment, writing an editorial, or even after publishing a post on social media. A recent example is what happened to J. K. Rowling, the famous author of the Harry Potter series. Last December, she tweeted her support for Maya Forstater, who was fired for what were deemed “transphobic” tweets. Rowling has received accusations and threats from trans activists and many worldwide famous people. A single ‘like’ was deemed evidence of ‘wrongthink’, and a persistent level of harassment began. The world has definitely changed, and everyone’s comments and behaviors are completely public. We should not be afraid to speak up and express our opinion, we should not be stopped by the fear of having people against us. As physicians, we are all exposed by expressing our medical opinion every day in the office, in a meeting, or even in a remote setting. Every decision and opinion should be based on evidence, but they will inevitably include our personal background-which is a mix of knowledge and personal life experience. Hopefully, these opinions will always express our genuine interest in the patients and their families as our main focus.As I get older, I pay more attention to the basis of my daily practice, which begins with proper information provided by good sources of medical education such a","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"164 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80352519","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 : 2020-08-30DOI: 10.30795/jfootankle.2020.v14.1179
M. Workman, N. Saragas, P. Ferrao
Glomus tumors are rare, benign neoplasms arising from components of the glomus apparatus. They are uncommon in the foot, often leading to misdiagnosis or a delay in diagnosis. This can have a significant impact on a patient’s quality of life and may result in incorrect surgical procedures being performed. Correct recognition leads to timeous diagnosis and marginal excision, which is curative. A glomus tumor should be considered in patients with no obvious cause for localized, severe foot pain. We report two different presentations of a glomus tumor in the foot. Level of Evidence V; Therapeutic Studies; Expert Opinion.
{"title":"Glomus tumors in the foot","authors":"M. Workman, N. Saragas, P. Ferrao","doi":"10.30795/jfootankle.2020.v14.1179","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1179","url":null,"abstract":"Glomus tumors are rare, benign neoplasms arising from components of the glomus apparatus. They are uncommon in the foot, often leading to misdiagnosis or a delay in diagnosis. This can have a significant impact on a patient’s quality of life and may result in incorrect surgical procedures being performed. Correct recognition leads to timeous diagnosis and marginal excision, which is curative. A glomus tumor should be considered in patients with no obvious cause for localized, severe foot pain. We report two different presentations of a glomus tumor in the foot. Level of Evidence V; Therapeutic Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81288602","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 : 2020-08-30DOI: 10.30795/jfootankle.2020.v14.1175
Enzo Sperone, M. Iglesias, A. Bigatti, Ivan Torterola, Yanser Atilmis, Alberto macklin Vadell
Objective: To report our experience with intramedullary fixation and osteosynthesis of the tibia with suprapatellar approach and semiextended positioning. Methods: This study retrospectively assessed 6 patients with tibial fracture treated with suprapatellar intramedullary nail fixation and osteosynthesis from September 2015 to September 2018. Results: There was acceptable bone fixation. Mean healing time was 6 months (range: 4-10 months). Postoperative pain was assessed using a visual analog scale, and the knee was divided into 9 quadrants to help locate the specific site of pain; all participants reported that pain was located at distal quadrants. Knee function was completely restored. Conclusion: Suprapatellar approach with the knee in the semiextended position is a good surgical technique for extra-articular proximal tibial fractures or those associated with soft tissue involvement at the conventional infrapatellar entry site. Thus, this analysis led us to believe that the technique should also be applicable to middle diaphyseal fractures or fractures in general, regardless of their location. Level of Evidence IV, Therapeutic Studies; Case Series.
{"title":"Suprapatellar intramedullary nailing of the tibia","authors":"Enzo Sperone, M. Iglesias, A. Bigatti, Ivan Torterola, Yanser Atilmis, Alberto macklin Vadell","doi":"10.30795/jfootankle.2020.v14.1175","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1175","url":null,"abstract":"Objective: To report our experience with intramedullary fixation and osteosynthesis of the tibia with suprapatellar approach and semiextended positioning. Methods: This study retrospectively assessed 6 patients with tibial fracture treated with suprapatellar intramedullary nail fixation and osteosynthesis from September 2015 to September 2018. Results: There was acceptable bone fixation. Mean healing time was 6 months (range: 4-10 months). Postoperative pain was assessed using a visual analog scale, and the knee was divided into 9 quadrants to help locate the specific site of pain; all participants reported that pain was located at distal quadrants. Knee function was completely restored. Conclusion: Suprapatellar approach with the knee in the semiextended position is a good surgical technique for extra-articular proximal tibial fractures or those associated with soft tissue involvement at the conventional infrapatellar entry site. Thus, this analysis led us to believe that the technique should also be applicable to middle diaphyseal fractures or fractures in general, regardless of their location. Level of Evidence IV, Therapeutic Studies; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83024710","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 : 2020-08-30DOI: 10.30795/jfootankle.2020.v14.1159
M. Herrera-Pérez, P. Martín-Vélez, Diego Rendón-Díaz, J. Pais-Brito
Objective: This study aimed to report the short-term results of retrograde tibiotalocalcaneal (TTC) nailing in a selected series of patients with fragility ankle fractures. Methods: This study included 17 patients who underwent primary retrograde TTC nailing from January 2016 to April 2019. The Olerud-Molander ankle score (OMAS) was recorded preoperatively and at the final follow-up. Results: Mean patient age was 81.5 years (range, 67-91 years), and mean follow-up duration was 20.9 months (range, 8-50 months). No patient was lost to follow-up. Eleven patients had diabetes. Thirteen patients were able to walk with an assistive device, and 4 with help from another person. Two patients died at 8 and 9 months after treatment. Radiographic healing was observed in 100% of the fractures. No deep infection or scarring problems were recorded. Two patients were wheelchair bound after treatment, whereas 15 recovered their previous autonomy. The mean OMAS score changed from 64.1 (range, 55-75) preoperatively to 55.3 (range, 45-65) postoperatively. Conclusion: Our results suggest that primary retrograde TTC nailing is a valid option in selected patients with fragility ankle fractures, multiple comorbidities, poor soft tissue condition, and difficulty in walking before the fracture. Level of Evidence IV; Therapeutic Studies, Case Series.
{"title":"Acute retrograde tibiotalocalcaneal nailing in osteoporotic periarticular ankle fractures","authors":"M. Herrera-Pérez, P. Martín-Vélez, Diego Rendón-Díaz, J. Pais-Brito","doi":"10.30795/jfootankle.2020.v14.1159","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1159","url":null,"abstract":"Objective: This study aimed to report the short-term results of retrograde tibiotalocalcaneal (TTC) nailing in a selected series of patients with fragility ankle fractures. Methods: This study included 17 patients who underwent primary retrograde TTC nailing from January 2016 to April 2019. The Olerud-Molander ankle score (OMAS) was recorded preoperatively and at the final follow-up. Results: Mean patient age was 81.5 years (range, 67-91 years), and mean follow-up duration was 20.9 months (range, 8-50 months). No patient was lost to follow-up. Eleven patients had diabetes. Thirteen patients were able to walk with an assistive device, and 4 with help from another person. Two patients died at 8 and 9 months after treatment. Radiographic healing was observed in 100% of the fractures. No deep infection or scarring problems were recorded. Two patients were wheelchair bound after treatment, whereas 15 recovered their previous autonomy. The mean OMAS score changed from 64.1 (range, 55-75) preoperatively to 55.3 (range, 45-65) postoperatively. Conclusion: Our results suggest that primary retrograde TTC nailing is a valid option in selected patients with fragility ankle fractures, multiple comorbidities, poor soft tissue condition, and difficulty in walking before the fracture. Level of Evidence IV; Therapeutic Studies, Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84623479","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 : 2020-04-30DOI: 10.30795/jfootankle.2020.v14.1163
Lucas Candido Honório, M. D. Azeredo, Joaquim Maluf Neto
Objective: Retrospectively analyze surgical procedures performed on patients with insertional Achilles (calcaneal tendon) tendinopathy, focusing on outcomes and the impact on the patients’ functional quality. Methods: A descriptive, retrospective, case series study drawn up by collecting data directly from the patients’ medical records. For the functional analysis of patients, we used the questionnaire of the adapted American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS). An assessment was carried out on each of the patients who underwent surgery at our hospital from 2010 to 2019, using the surgical technique described in this article, i.e., resection of the affected portion of the tendon with its subsequent reinsertion. Results: All surgical patients achieved an improvement in their AOFAS score and in pain levels, with good functional performance only three months into the postoperative period, from 50.1 to 83.75 (p<0.001). Conclusion: The use of the technique proved very effective, particularly in terms of the maintenance of foot function and important improvement in pain levels, thus producing a relevant increase in function among patients. Level of Evidence IV; Therapeutic Study; Case Series.
{"title":"Insertional Achilles tendinopathy","authors":"Lucas Candido Honório, M. D. Azeredo, Joaquim Maluf Neto","doi":"10.30795/jfootankle.2020.v14.1163","DOIUrl":"https://doi.org/10.30795/jfootankle.2020.v14.1163","url":null,"abstract":"Objective: Retrospectively analyze surgical procedures performed on patients with insertional Achilles (calcaneal tendon) tendinopathy, focusing on outcomes and the impact on the patients’ functional quality. Methods: A descriptive, retrospective, case series study drawn up by collecting data directly from the patients’ medical records. For the functional analysis of patients, we used the questionnaire of the adapted American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS). An assessment was carried out on each of the patients who underwent surgery at our hospital from 2010 to 2019, using the surgical technique described in this article, i.e., resection of the affected portion of the tendon with its subsequent reinsertion. Results: All surgical patients achieved an improvement in their AOFAS score and in pain levels, with good functional performance only three months into the postoperative period, from 50.1 to 83.75 (p<0.001). Conclusion: The use of the technique proved very effective, particularly in terms of the maintenance of foot function and important improvement in pain levels, thus producing a relevant increase in function among patients. Level of Evidence IV; Therapeutic Study; Case Series.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"1639 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86513501","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 : 2019-12-23DOI: 10.30795/scijfootankle.2019.v13.1097
Ignacio Arzac Ulla
Macrodactyly is an uncommon congenital foot condition that can be difficult to treat and that can have a profound negative impact on patients and their families. Although many treatments have been described, results tend to be inconsistent. The author reports a case in which a combination of parcial bone and finger resection, resulted in a foot with acceptable function and cosmesis. Level of Evidence V; Therapeutics Studies; Expert Opinion.
{"title":"Macrodactyly of the foot","authors":"Ignacio Arzac Ulla","doi":"10.30795/scijfootankle.2019.v13.1097","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1097","url":null,"abstract":"Macrodactyly is an uncommon congenital foot condition that can be difficult to treat and that can have a profound negative impact on patients and their families. Although many treatments have been described, results tend to be inconsistent. The author reports a case in which a combination of parcial bone and finger resection, resulted in a foot with acceptable function and cosmesis. Level of Evidence V; Therapeutics Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"36 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72591608","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 : 2019-12-23DOI: 10.30795/scijfootankle.2019.v13.1107
Larissa Barbosa Oliveira, D. Maranho, Karen Voltan Garofo, M. C. Mattos e Dinato
Calcifying aponeurotic fibroma (CAF) is a rare lesion that can affect the feet and should be considered as a differential diagnosis of plantar tumors. The treatment is given by surgical resection, and the definitive diagnosis is confirmed by histopathological analysis. This case report shows the presentation and treatment of a 17-year-old patient with CAF and emphasizes the importance of proper imaging planning to reduce risks and recurrence. Level of Evidence V; Therapeutic Studies; Expert Opinion.
{"title":"Calcifying aponeurotic fibroma","authors":"Larissa Barbosa Oliveira, D. Maranho, Karen Voltan Garofo, M. C. Mattos e Dinato","doi":"10.30795/scijfootankle.2019.v13.1107","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1107","url":null,"abstract":"Calcifying aponeurotic fibroma (CAF) is a rare lesion that can affect the feet and should be considered as a differential diagnosis of plantar tumors. The treatment is given by surgical resection, and the definitive diagnosis is confirmed by histopathological analysis. This case report shows the presentation and treatment of a 17-year-old patient with CAF and emphasizes the importance of proper imaging planning to reduce risks and recurrence. Level of Evidence V; Therapeutic Studies; Expert Opinion.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78567262","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 : 2019-11-11DOI: 10.30795/scijfootankle.2019.v13.1069
K. Stéfani, Leonardo V. Moraes, Vinícius Quadros Borges, G. Ferreira
Introduction: The objective of this study was to evaluate the difference in muscle strength between flexion and ankle extension to test the hypothesis that this predisposes to a dynamic equine and, thus, to evaluate this correlation with pain in the forefoot (metatarsalgias) and hindfoot (plantar fasciitis, tendinopathy of the tendon insertional and non-insertional calcaneus). Methods: In this prospective cohort study, 50 patients were consecutively diagnosed with forefoot pain (metatarsalgias) or pain in the hindfoot (plantar fasciitis, tendonopathy of the insertional and non-insertional calcaneal tendon), and 50 patients had no foot diseases. The body mass index (BMI) was evaluated, and IGT was evaluated through the Silfverskiöld test. The parameter of gastrocnemius contracture was considered in cases of limitation of ankle extension <10. The intervention was to measure flexion strength and ankle extension with a manual dynamometer, evaluating isometric contraction based on the method suggested by Kahn et al. Results: One hundred patients participated in the study, with 50 patients in the study group and 50 in the control group. The mean age was 63.42 years, and the mean BMI was 28.53 in the study group and 62.26 and 28.84 in the control group, with no difference in distribution between age groups (p = 0.634) and for BMI (p = 0.709). The difference was significant between the groups in relation to the Silfverskiöld test (p = 0.019), the ankle force variation in dynamometry (p <0.001) and normalized variation (p <0.001). In addition, a significant difference between groups was observed in the dynamometry of plantar flexion (p <0.001). Conclusion: The hypothesis of causes for sural triceps shortening considered as idiopathic are as follows. The difference in strength between the dorsiflexion musculature and the one that performs the plantar flexion, the delay in neuromuscular activation of the dorsiflexors, or even a combination of these two factors. We demonstrated the possibility of the evaluation of the force through a manual dynamometer that can be used in routine outpatient visits, which proved to be effective and reproducible.
{"title":"TL 18141 - Isolated gastrocnemius tightness","authors":"K. Stéfani, Leonardo V. Moraes, Vinícius Quadros Borges, G. Ferreira","doi":"10.30795/scijfootankle.2019.v13.1069","DOIUrl":"https://doi.org/10.30795/scijfootankle.2019.v13.1069","url":null,"abstract":"Introduction: The objective of this study was to evaluate the difference in muscle strength between flexion and ankle extension to test the hypothesis that this predisposes to a dynamic equine and, thus, to evaluate this correlation with pain in the forefoot (metatarsalgias) and hindfoot (plantar fasciitis, tendinopathy of the tendon insertional and non-insertional calcaneus). Methods: In this prospective cohort study, 50 patients were consecutively diagnosed with forefoot pain (metatarsalgias) or pain in the hindfoot (plantar fasciitis, tendonopathy of the insertional and non-insertional calcaneal tendon), and 50 patients had no foot diseases. The body mass index (BMI) was evaluated, and IGT was evaluated through the Silfverskiöld test. The parameter of gastrocnemius contracture was considered in cases of limitation of ankle extension <10. The intervention was to measure flexion strength and ankle extension with a manual dynamometer, evaluating isometric contraction based on the method suggested by Kahn et al. Results: One hundred patients participated in the study, with 50 patients in the study group and 50 in the control group. The mean age was 63.42 years, and the mean BMI was 28.53 in the study group and 62.26 and 28.84 in the control group, with no difference in distribution between age groups (p = 0.634) and for BMI (p = 0.709). The difference was significant between the groups in relation to the Silfverskiöld test (p = 0.019), the ankle force variation in dynamometry (p <0.001) and normalized variation (p <0.001). In addition, a significant difference between groups was observed in the dynamometry of plantar flexion (p <0.001). Conclusion: The hypothesis of causes for sural triceps shortening considered as idiopathic are as follows. The difference in strength between the dorsiflexion musculature and the one that performs the plantar flexion, the delay in neuromuscular activation of the dorsiflexors, or even a combination of these two factors. We demonstrated the possibility of the evaluation of the force through a manual dynamometer that can be used in routine outpatient visits, which proved to be effective and reproducible.","PeriodicalId":21602,"journal":{"name":"Scientific Journal of the Foot & Ankle","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74004341","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 : 2019-11-11DOI: 10.30795/scijfootankle.2019.v13.983
R. Silva, A. Baptista, K. Carvalho
Introduction: Hallux valgus is a multifactorial disease, and heredity is the main associated factor. Pain and discomfort when using closed-toed shoes occur in many cases, adversely affecting quality of life. Surgical treatment is indicated when pain and disability persist after conservative treatment. Currently, more than 150 surgical techniques are described for hallux valgus correction, with no consensus regarding the best treatment. With the advent of minimally invasive techniques for hallux valgus correction, Vernois developed the percutaneous chevron osteotomy. This technique allows up to 100% lateral translation of the contact area of the osteotomy. Objective: the objective of the present study was to assess the correction of radiographic parameters, clinical improvement and potential complications of the first 30 cases of moderate and severe hallux valgus operated on at our hospital using the percutaneous chevron technique. Methods: A total of 26 patients (30 feet) underwent surgery. The following parameters were measured in the pre- and postoperative periods: the first metatarsophalangeal (MTP) angle, the intermetatarsal angle between the 1st and 2nd metatarsals (IMA), the distal metatarsal articular angle (DMAA) and the pre- and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores, with a minimum follow-up period of 6 months. Results: The mean age of the patients was 52.3 years. During the preoperative period, the mean AOFAS score was 45.6; it increased to 90.3 after the procedure, indicating a statistically significant improvement. The mean MTP angle, IMA and DMAA were 29.7°, 14.2° and 14.2° before surgery and 12.8°, 8.2° and 11.1° after surgery, respectively. The improvements in the MTP angle and the IMA were also significant. There was no decrease in angles or worsening of AOFAS scores during follow-up. Conclusion: The percutaneous chevron technique was safe and effective for correcting cases of moderate and severe hallux valgus, with significant improvements in clinical and radiological parameters and a low rate of postoperative complications.
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