Pub Date : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1787
N. S. Barbachan Mansur, K. Dibbern, C. C. César Netto
The 2019 progressive collapsing foot deformity (PCFD) consensus did not only change the disease nomenclature and provided a new classification for the condition formerly known as flatfoot deformity. It was also the pinnacle of a revolution in the field in terms of knowledge and clinical perspectives. The use of advanced imaging, such as weight-bearing computed tomography, three-dimensional algorithms, and magnetic resonance, expanded the way we understand peritalar subluxation and how we can address it. However,much of these improvements felt short in terms of global reproducibility due to economic restraints. The objective of this review studyis to present PCFD new concepts through the lens and realities of developing countries, considering their potentially limited access tonovel technologies. Level of Evidence V; Expert opinion.
{"title":"Progressive collapsing foot deformity: how to use new knowledge in developing countries","authors":"N. S. Barbachan Mansur, K. Dibbern, C. C. César Netto","doi":"10.30795/jfootankle.2024.v18.1787","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1787","url":null,"abstract":"The 2019 progressive collapsing foot deformity (PCFD) consensus did not only change the disease nomenclature and provided a new classification for the condition formerly known as flatfoot deformity. It was also the pinnacle of a revolution in the field in terms of knowledge and clinical perspectives. The use of advanced imaging, such as weight-bearing computed tomography, three-dimensional algorithms, and magnetic resonance, expanded the way we understand peritalar subluxation and how we can address it. However,much of these improvements felt short in terms of global reproducibility due to economic restraints. The objective of this review studyis to present PCFD new concepts through the lens and realities of developing countries, considering their potentially limited access tonovel technologies. Level of Evidence V; Expert opinion.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"108 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978154","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1760
Alberto de Castro Carrasco, Patricia Domínguez Dorado, Laura Anta Martínez, Carmen Alvarez-Val
Objective: To describe a variation in the final osteosynthesis technique for total ankle replacement (TAR) implantation through lateralapproach. Methods: We retrospectively reviewed a series of cases dated between January 2022 and May 2023 in which intramedullary nailing was used as the osteosynthesis technique for the fibula during TAR implantation via lateral approach. Results: In all cases, skin scarring and soft tissue recovery to baseline were achieved in one and a half month to three months. Consolidation of the fibula occurred at an average of three months. No material was removed in any of the cases to date. Finally, patients were satisfied, resuming their previous activities. Conclusion: To our knowledge, this study is the first to investigate a modification of the osteosynthesis technique in the lateral approach to TAR. We believe the intramedullary nail for the fibula may be a useful tool to prevent soft tissue complications, requiring prospective and comparative studies to evaluate its efficacy. Level of Evidence IV; Therapeutic Studies; Case Series.
目的：描述通过外侧入路植入全踝关节置换术（TAR）的最终骨合成技术的变异。方法：我们回顾性分析了2022年1月至2023年5月间的一系列病例，这些病例在经外侧入路植入TAR时使用髓内钉作为腓骨的骨合成技术。结果：在所有病例中，皮肤瘢痕和软组织均在一个半月至三个月内恢复至基线。腓骨平均在三个月后愈合。迄今为止，所有病例均未去除任何材料。最后，患者感到满意，恢复了以往的活动。结论：据我们所知，这项研究是首次对 TAR 外侧入路骨合成技术的改良进行研究。我们认为腓骨髓内钉可能是预防软组织并发症的有效工具，需要进行前瞻性比较研究以评估其疗效。证据等级 IV；治疗研究；病例系列。
{"title":"Intramedullary nailing as osteosynthesis technique for the fibula in total ankle arthroplasty via lateral approach","authors":"Alberto de Castro Carrasco, Patricia Domínguez Dorado, Laura Anta Martínez, Carmen Alvarez-Val","doi":"10.30795/jfootankle.2024.v18.1760","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1760","url":null,"abstract":"Objective: To describe a variation in the final osteosynthesis technique for total ankle replacement (TAR) implantation through lateralapproach. Methods: We retrospectively reviewed a series of cases dated between January 2022 and May 2023 in which intramedullary nailing was used as the osteosynthesis technique for the fibula during TAR implantation via lateral approach. Results: In all cases, skin scarring and soft tissue recovery to baseline were achieved in one and a half month to three months. Consolidation of the fibula occurred at an average of three months. No material was removed in any of the cases to date. Finally, patients were satisfied, resuming their previous activities. Conclusion: To our knowledge, this study is the first to investigate a modification of the osteosynthesis technique in the lateral approach to TAR. We believe the intramedullary nail for the fibula may be a useful tool to prevent soft tissue complications, requiring prospective and comparative studies to evaluate its efficacy. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"11 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979991","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1783
Caio Augusto de Souza Nery
My first expression as Editor-in-Chief of the Journal of the Foot and Ankle is one of deep gratitude for the opportunity that is being given to me by the Editor Emeritus and now President of ABTPé, Prof. Dr. Alexandre Leme Godoy-Santos and our colleagues from the board of Associate Editors who elevated me to this position. My gratitude also extends to ABTPé, which, through successive directorships, has been providing support and encouragement to the maintenance and growth of our journal. The task we undertake is challenging and immense—it depends on everyone's participation, from the most renowned professional who allows himself to publish with us to the most novice student who aspires, one day, to have his name written on our pages so that his ideas can be known to everyone. It depends on the altruism and tenacity of authors, reviewers, translators, correctors, layout designers, and technical editors to achieve the desired indexing. We have already been much further from achieving this goal than we are now, but we still have a long way to go! Let's accomplish this together. In addition to a new system for submitting and evaluating articles, more in line with the major international scientific journals, we will include in each issue review articles whose main virtue will be to update professionals who are working daily and instruct young doctors who are still preparing to participate in this toil. I urge everyone to read, disseminate, discuss, criticize, and share the learning we bring to our pages with your colleagues, residents, and students. We will consolidate the position of the Journal of the Foot and Ankle as a viable and practical alternative for disseminating your research. Welcome...we need everyone's help!
{"title":"My deepest gratitude...","authors":"Caio Augusto de Souza Nery","doi":"10.30795/jfootankle.2024.v18.1783","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1783","url":null,"abstract":"My first expression as Editor-in-Chief of the Journal of the Foot and Ankle is one of deep gratitude for the opportunity that is being given to me by the Editor Emeritus and now President of ABTPé, Prof. Dr. Alexandre Leme Godoy-Santos and our colleagues from the board of Associate Editors who elevated me to this position. My gratitude also extends to ABTPé, which, through successive directorships, has been providing support and encouragement to the maintenance and growth of our journal.\u0000The task we undertake is challenging and immense—it depends on everyone's participation, from the most renowned professional who allows himself to publish with us to the most novice student who aspires, one day, to have his name written on our pages so that his ideas can be known to everyone. It depends on the altruism and tenacity of authors, reviewers, translators, correctors, layout designers, and technical editors to achieve the desired indexing. We have already been much further from achieving this goal than we are now, but we still have a long way to go! Let's accomplish this together.\u0000In addition to a new system for submitting and evaluating articles, more in line with the major international scientific journals, we will include in each issue review articles whose main virtue will be to update professionals who are working daily and instruct young doctors who are still preparing to participate in this toil.\u0000I urge everyone to read, disseminate, discuss, criticize, and share the learning we bring to our pages with your colleagues, residents, and students. We will consolidate the position of the Journal of the Foot and Ankle as a viable and practical alternative for disseminating your research.\u0000Welcome...we need everyone's help!","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982100","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1711
J. S. Martins, Lucas vaz Peixoto, Leonardo Pires Silva de Castro, Gabriella de Figueiredo Rodrigues, Leandro Oliveira Silva, Janaina Yacy Hess Ferreira, Isabela Oliveira Caldeira de Moura
Objective: To evaluate functional results of subtalar arthroereisis with non-conventional implants, as well as their clinical, radiographic, and functional results, comparing them with those of the conventional technique. Methods: Documentary research consisting of the analysis and review of medical records of six patients, with application of the Orthopaedic Foot and Ankle Score (AOFAS) and Short Form Health Survey 36 (SF-36) questionnaires and evaluation of pre-and postoperative radiographic results. Results: Patients achieved satisfactory clinical and functional results, indicated by an improvement in the pitch, kite, Giannestras, and Meary angles analyzed and by comparing the pre-and postoperative periods. There was also an improvement in the AOFAS and SF-36 questionnaire scores postoperatively, suggesting an evolution in the quality of life of patients studied. Conclusion: Subtalar arthroereisis is a non-invasive surgical procedure that contributes to the clinical improvement of patients. The use of interference screw showed good results, with the advantage of it being a low-cost implant when compared to the conventional ones, which makes the procedure more accessible. Level of Evidence III; Therapeutic Studies; Case control study.
{"title":"Arthroereisis with interference screw in flexible flatfoot, a comparison with the conventional surgical technique","authors":"J. S. Martins, Lucas vaz Peixoto, Leonardo Pires Silva de Castro, Gabriella de Figueiredo Rodrigues, Leandro Oliveira Silva, Janaina Yacy Hess Ferreira, Isabela Oliveira Caldeira de Moura","doi":"10.30795/jfootankle.2024.v18.1711","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1711","url":null,"abstract":"Objective: To evaluate functional results of subtalar arthroereisis with non-conventional implants, as well as their clinical, radiographic, and functional results, comparing them with those of the conventional technique. Methods: Documentary research consisting of the analysis and review of medical records of six patients, with application of the Orthopaedic Foot and Ankle Score (AOFAS) and Short Form Health Survey 36 (SF-36) questionnaires and evaluation of pre-and postoperative radiographic results. Results: Patients achieved satisfactory clinical and functional results, indicated by an improvement in the pitch, kite, Giannestras, and Meary angles analyzed and by comparing the pre-and postoperative periods. There was also an improvement in the AOFAS and SF-36 questionnaire scores postoperatively, suggesting an evolution in the quality of life of patients studied. Conclusion: Subtalar arthroereisis is a non-invasive surgical procedure that contributes to the clinical improvement of patients. The use of interference screw showed good results, with the advantage of it being a low-cost implant when compared to the conventional ones, which makes the procedure more accessible. Level of Evidence III; Therapeutic Studies; Case control study.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"33 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979340","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1747
Pedro Bragato Romanholi, Daiana Kerry Picanço Gobbo, Thaís Buchaim Said, Daniel Araújo Silva, D. Rosemberg, T. Mann, Cláudia Diniz Freitas, Felipe Daniel Plata Rosa, D. R. Nishikawa
Introdução: as medidas radiográficas são utilizadas para indicar e programar procedimentos ortopédicos no antepé, bem como para seguimento pós-operatório. Com isso, muitas vezes é necessário avaliar se houve alteração no alinhamento sagital do primeiro metatarso (1M). O objetivo desse estudo foi analisar a confiabilidade inter e intraobservador das medidas angulares utilizadas para avaliação do alinhamento sagital do 1M. Secundariamente, avaliar se o tipo anatômico do pé interfere na confiabilidade das medições. Métodos: as medidas angulares utilizadas foram todas aquelas encontradas na literatura, tais como: ângulo de declinação do 1M (AD1M), ângulo plantar distal do 1M (APD1M), ângulo dorsal proximal do 1M (ADP1M), ângulo intermetatarsal lateral (AIML), e o ângulo descrito por Day. Para avaliação da confiabilidade interobservador foi utilizado o Coeficiente de Correlação Intraclasse (CCI) e para avaliação da confiabilidade intraobservador, o Coeficiente de Correlação de Concordância de Lin (CCCL). Resultados: dentre todas as medidas obtidas, AD1M foi o que apresentou os maiores valores de CCI e CCCL nas 40 radiografias avaliadas, independentemente do tipo anatômico do pé. Conclusão: com os resultados observados, podemos estimar que o AD1M parece representar uma ferramenta radiográfica adequada para mensuração do alinhamento sagital do 1M, quando avaliada pelo CCI e CCCL.
导言：X 射线测量用于显示和规划前足矫形手术以及术后随访。因此，经常需要评估第一跖骨（1M）的矢状线是否发生了变化。本研究旨在分析用于评估第一跖骨矢状对齐度的角度测量值在观察者之间和观察者内部的可靠性。其次，评估足的解剖类型是否会影响测量的可靠性。方法： 所使用的角度测量值均为文献中的测量值，如：1M 下倾角（AD1M）、1M 远跖角（APD1M）、1M 近背角（ADP1M）、跖外侧角（AIML）和 Day 所描述的角度。采用类内相关系数（ICC）评估观察者之间的可靠性，采用林氏一致性相关系数（LCCC）评估观察者内部的可靠性。结果：在所获得的所有测量结果中，无论足的解剖类型如何，在所评估的 40 张 X 光片中，AD1M 的 ICC 和 LCC 值最高。结论：根据观察到的结果，我们可以估计 AD1M 似乎是测量 1M 的矢状对齐度的合适影像学工具，可通过 CCI 和 CCCL 进行评估。
{"title":"Inter- and intraobserver reliability of the first metatarsal sagittal alignment measurements","authors":"Pedro Bragato Romanholi, Daiana Kerry Picanço Gobbo, Thaís Buchaim Said, Daniel Araújo Silva, D. Rosemberg, T. Mann, Cláudia Diniz Freitas, Felipe Daniel Plata Rosa, D. R. Nishikawa","doi":"10.30795/jfootankle.2024.v18.1747","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1747","url":null,"abstract":"Introdução: as medidas radiográficas são utilizadas para indicar e programar procedimentos ortopédicos no antepé, bem como para seguimento pós-operatório. Com isso, muitas vezes é necessário avaliar se houve alteração no alinhamento sagital do primeiro metatarso (1M). O objetivo desse estudo foi analisar a confiabilidade inter e intraobservador das medidas angulares utilizadas para avaliação do alinhamento sagital do 1M. Secundariamente, avaliar se o tipo anatômico do pé interfere na confiabilidade das medições. \u0000Métodos: as medidas angulares utilizadas foram todas aquelas encontradas na literatura, tais como: ângulo de declinação do 1M (AD1M), ângulo plantar distal do 1M (APD1M), ângulo dorsal proximal do 1M (ADP1M), ângulo intermetatarsal lateral (AIML), e o ângulo descrito por Day. Para avaliação da confiabilidade interobservador foi utilizado o Coeficiente de Correlação Intraclasse (CCI) e para avaliação da confiabilidade intraobservador, o Coeficiente de Correlação de Concordância de Lin (CCCL). \u0000Resultados: dentre todas as medidas obtidas, AD1M foi o que apresentou os maiores valores de CCI e CCCL nas 40 radiografias avaliadas, independentemente do tipo anatômico do pé. \u0000Conclusão: com os resultados observados, podemos estimar que o AD1M parece representar uma ferramenta radiográfica adequada para mensuração do alinhamento sagital do 1M, quando avaliada pelo CCI e CCCL.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"14 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140981718","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1745
Eduardo de Oliveira Carrilho Padula, Lucas Pires, Marcio Babinski
Objective: Study the relationship between the region of interest (ROI) and Hounsfield units (HU) in the tibial bone callus. Methods: Twenty-one adult Wistar rats were submitted to tibial fracture. The fracture was radiographed after their euthanasia, and the bone calluses were analyzed histologically after being stained with hematoxylin and eosin. Euthanasia occurred between the 2nd and 6th weeks after fracture and fixation, thus obtaining various consolidation stages. Histologically, vessels, chondroblasts, connective tissue (collagen), maximum size of the chondrocyte, and the concentration of chondrocytes were quantified. Results: It was observed that the higher the HU, the more mature and closer to bone consolidation it is, proving that the use of ROI and bone callus measurement with HU is reliable for the histological process of maturation of the bone callus and can be safely used as proof of evolution of the bone healing process. Conclusion: The ROI was successfully used in digital radiography to observe HU in fractured bones. Level of Evidence IV; Therapeutic Studies; Case Series.
目的： 研究胫骨胼胝体中感兴趣区域（ROI）与 Hounsfield 单位（HU）之间的关系：研究胫骨胼胝体中感兴趣区（ROI）与 Hounsfield 单位（HU）之间的关系。方法：21 只成年 Wistar 大鼠接受胫骨骨折：21 只成年 Wistar 大鼠接受胫骨骨折治疗。安乐死后对骨折处进行射线照相，用苏木精和曙红染色后对骨胼胝体进行组织学分析。安乐死发生在骨折和固定后的第 2 至第 6 周，因此可获得不同的巩固阶段。在组织学上，对血管、软骨细胞、结缔组织（胶原蛋白）、软骨细胞的最大尺寸和软骨细胞的浓度进行了量化。结果观察发现，HU 值越高，骨愈合越成熟，越接近骨整合，证明使用 ROI 和 HU 值测量骨胼胝体对骨胼胝体成熟的组织学过程是可靠的，可以安全地用作骨愈合过程演变的证明。结论在数字射线摄影中成功使用 ROI 观察骨折骨的 HU 值。证据等级 IV；治疗研究；病例系列。
{"title":"Correlation between the region of interest in digital radiography, Hounsfield units, and histological maturation on Wistar rats submitted to tibial fracture","authors":"Eduardo de Oliveira Carrilho Padula, Lucas Pires, Marcio Babinski","doi":"10.30795/jfootankle.2024.v18.1745","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1745","url":null,"abstract":"Objective: Study the relationship between the region of interest (ROI) and Hounsfield units (HU) in the tibial bone callus. Methods: Twenty-one adult Wistar rats were submitted to tibial fracture. The fracture was radiographed after their euthanasia, and the bone calluses were analyzed histologically after being stained with hematoxylin and eosin. Euthanasia occurred between the 2nd and 6th weeks after fracture and fixation, thus obtaining various consolidation stages. Histologically, vessels, chondroblasts, connective tissue (collagen), maximum size of the chondrocyte, and the concentration of chondrocytes were quantified. Results: It was observed that the higher the HU, the more mature and closer to bone consolidation it is, proving that the use of ROI and bone callus measurement with HU is reliable for the histological process of maturation of the bone callus and can be safely used as proof of evolution of the bone healing process. Conclusion: The ROI was successfully used in digital radiography to observe HU in fractured bones. Level of Evidence IV; Therapeutic Studies; Case Series.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"100 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978202","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1762
T. Baumfeld, Tainne Gomes Lopes, Gustavo Henrique Dornela de Souza, Eduardo Frois Temponi, Lucas do Amaral Santos, Gustavo Araújo Nunes, C. F. Aquino, Túlio Campos
Introdução: A entorse de tornozelo é uma lesão comum na população geral e, principalmente, em atletas. O diagnóstico e tratamento adequados permitem o retorno precoce às atividades habituais, evitando recorrência, instabilidade crônica e artrose pós-traumática. O objetivo deste trabalho é avaliar a abordagem diagnóstica e terapêutica desta lesão por ortopedistas do estado de Minas Gerais. Métodos: Esse trabalho foi conduzido pela Comissão Científica da Sociedade Brasileira de Ortopedia e Traumatologia-SBOT/MG em 2023. Foi criado um questionário na plataforma Google Forms com perguntas sobre a abordagem não cirúrgica da entorse de tornozelo. Esse questionário foi distribuído por e-mail e WhatsApp aos membros titulares da SBOT de Minas Gerais. Resultados: 116 ortopedistas responderam ao questionário, sendo 27,6% especialistas em pé e tornozelo. A maioria trabalha em Belo Horizonte e realiza entre 10 e 30 atendimentos relacionados à entorse de tornozelo por mês. A maior parte dos profissionais solicita radiografias e prescreve anti-inflamatórios. A maior divergência de respostas ocorreu quanto ao uso de imobilização. O encaminhamento para tratamento fisioterapêutico variou com o grau da lesão. Discussão: Os dados coletados apontam que a abordagem inicial nas entorses de tornozelo é heterogênea, porém a maioria utiliza protocolos de reabilitação convencionais, apesar da abordagem funcional ser preconizada pela literatura científica. Conclusão: Em Minas Gerais, o protocolo convencional de imobilização e reabilitação é utilizado com maior frequência.
{"title":"Non-surgical treatment of ankle sprains: a survey of orthopedic surgeons in Minas Gerais","authors":"T. Baumfeld, Tainne Gomes Lopes, Gustavo Henrique Dornela de Souza, Eduardo Frois Temponi, Lucas do Amaral Santos, Gustavo Araújo Nunes, C. F. Aquino, Túlio Campos","doi":"10.30795/jfootankle.2024.v18.1762","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1762","url":null,"abstract":"Introdução: A entorse de tornozelo é uma lesão comum na população geral e, principalmente, em atletas. O diagnóstico e tratamento adequados permitem o retorno precoce às atividades habituais, evitando recorrência, instabilidade crônica e artrose pós-traumática. O objetivo deste trabalho é avaliar a abordagem diagnóstica e terapêutica desta lesão por ortopedistas do estado de Minas Gerais. Métodos: Esse trabalho foi conduzido pela Comissão Científica da Sociedade Brasileira de Ortopedia e Traumatologia-SBOT/MG em 2023. Foi criado um questionário na plataforma Google Forms com perguntas sobre a abordagem não cirúrgica da entorse de tornozelo. Esse questionário foi distribuído por e-mail e WhatsApp aos membros titulares da SBOT de Minas Gerais. Resultados: 116 ortopedistas responderam ao questionário, sendo 27,6% especialistas em pé e tornozelo. A maioria trabalha em Belo Horizonte e realiza entre 10 e 30 atendimentos relacionados à entorse de tornozelo por mês. A maior parte dos profissionais solicita radiografias e prescreve anti-inflamatórios. A maior divergência de respostas ocorreu quanto ao uso de imobilização. O encaminhamento para tratamento fisioterapêutico variou com o grau da lesão. Discussão: Os dados coletados apontam que a abordagem inicial nas entorses de tornozelo é heterogênea, porém a maioria utiliza protocolos de reabilitação convencionais, apesar da abordagem funcional ser preconizada pela literatura científica. Conclusão: Em Minas Gerais, o protocolo convencional de imobilização e reabilitação é utilizado com maior frequência.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"50 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140980641","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}
Resumo Objetivo: O objetivo do presente estudo é descrever a epidemiologia, o tratamento e os resultados clínicos e radiográficos dos casos de hálux valgo traumático associados a lesões dos raios laterais. Métodos: avaliação clínica e radiográfica (ângulo de valgismo do hálux) de sete pacientes que sofreram acidentes de transito e apresentaram hálux valgo pós traumático associado à lesões dos raios laterais. Resultados: todos os pacientes foram submetidos à reparo ligamentar medial para tratamento do hálux valgo pós traumático, e fixação das fraturas associadas. Em um seguimento mínimo de 12 meses os pacientes evoluíram bem, sem dor com correção média do ângulo de valgismo do hálux de 13,7 graus. Conclusão: Os casos de hálux valgo pós traumático associados à lesão dos raios laterais, tratados com reparo ligamentar e fixação das fraturas associadas apresentaram bons resultados clínico funcionais e radiográficos a curto e médio prazo. Palavras chave: hálux valgo, metatarso, trauma Nível de evidência IV
摘要 目的：本研究旨在描述外伤性外翻并伴有外侧脊柱损伤病例的流行病学、治疗、临床和影像学结果。方法：对七名因道路交通事故导致外伤后外侧腓肠肌外翻并伴有外侧腓肠肌损伤的患者进行临床和影像学评估（腓肠肌外翻角度）。结果：所有患者都接受了内侧韧带修复术，以治疗创伤后外翻并固定相关骨折。在至少12个月的随访中，患者进展良好，无疼痛，拇指外翻角度平均矫正13.7度。结论：外伤后外侧韧带损伤导致的拇指外翻病例，经过韧带修复和相关骨折固定治疗后，在中短期内显示出良好的临床、功能和影像学效果。关键词：外翻、跖骨、创伤 证据等级 IV
{"title":"Post-traumatic hallux valgus with lateral metatarsal injuries: management and short-term results","authors":"Marcos Hideyo Sakaki, Jordanna Maria Pereira Bergamasco, Eduardo Perusso Padovezi, Mateus Henrique Marangoni, Frederico Quagliato Tringali, Lais Nunes Salles Pinheiro","doi":"10.30795/jfootankle.2024.v18.1733","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1733","url":null,"abstract":"Resumo \u0000Objetivo: O objetivo do presente estudo é descrever a epidemiologia, o tratamento e os resultados clínicos e radiográficos dos casos de hálux valgo traumático associados a lesões dos raios laterais. Métodos: avaliação clínica e radiográfica (ângulo de valgismo do hálux) de sete pacientes que sofreram acidentes de transito e apresentaram hálux valgo pós traumático associado à lesões dos raios laterais. Resultados: todos os pacientes foram submetidos à reparo ligamentar medial para tratamento do hálux valgo pós traumático, e fixação das fraturas associadas. Em um seguimento mínimo de 12 meses os pacientes evoluíram bem, sem dor com correção média do ângulo de valgismo do hálux de 13,7 graus. Conclusão: Os casos de hálux valgo pós traumático associados à lesão dos raios laterais, tratados com reparo ligamentar e fixação das fraturas associadas apresentaram bons resultados clínico funcionais e radiográficos a curto e médio prazo. \u0000Palavras chave: hálux valgo, metatarso, trauma \u0000Nível de evidência IV","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"9 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140980553","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1757
Florencio Pablo Segura, Facundo Segura, J. Porta, Natalia Heredia, Ignacio Masquijo, Federico Anain, Leando Casola, Agustina Trevisson, V. Cafruni, Maria Paz Lucero Zudaire, I. Toledo, Florencio Vicente Segura
Objective: Determine if large language models (LLMs) provide better or similar information compared to an expert trained in foot and ankle pathology in various aspects of daily practice (definition and treatment of pathology, general questions). Methods: Three experts and two artificial intelligent (AI) models, ChatGPT (GPT-4) and Google Bard, answered 15 specialty-related questions, divided equally among definitions, treatments, and general queries. After coding, responses were redistributed and evaluated by five additional experts, assessing aspects like clarity, factual accuracy, and patient usefulness. The Likert scale was used to score each question, enabling experts to gauge their agreement with the provided information. Results: Using the Likert scale, each question could score between 5 and 25 points, totaling 375 or 75 points for evaluations. Expert 2 led with 69.86%, followed by Expert 1 at 68.53%, ChatGPT at 64.80%, Expert 3 at 58.40%, and Google Bard at 54.93%. Comparing experts, significant differences emerged, especially with Google Bard. The rankings varied in specific sections like definitions and treatments, highlighting GPT-4’s variability across sections. The results emphasize the differences in performance among experts and AI models. Conclusion: Our findings indicate that GPT-4 often performed comparably to or even better than experts, particularly in definition and general question sections. However, both LLMs lagged notably in the treatment section. These results underscore the potential of LLMs as valuable tools in orthopedics but highlight their limitations, emphasizing the irreplaceable role of expert expertise in intricate medical contexts. Evidence Level: III, observational, analytics.
{"title":"Inteligencia Artificial en patología de pierna y pie: ¿Pueden los los grandes modelos de lenguaje reemplazar nuestra práctica?","authors":"Florencio Pablo Segura, Facundo Segura, J. Porta, Natalia Heredia, Ignacio Masquijo, Federico Anain, Leando Casola, Agustina Trevisson, V. Cafruni, Maria Paz Lucero Zudaire, I. Toledo, Florencio Vicente Segura","doi":"10.30795/jfootankle.2024.v18.1757","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1757","url":null,"abstract":"Objective: Determine if large language models (LLMs) provide better or similar information compared to an expert trained in foot and ankle pathology in various aspects of daily practice (definition and treatment of pathology, general questions). Methods: Three experts and two artificial intelligent (AI) models, ChatGPT (GPT-4) and Google Bard, answered 15 specialty-related questions, divided equally among definitions, treatments, and general queries. After coding, responses were redistributed and evaluated by five additional experts, assessing aspects like clarity, factual accuracy, and patient usefulness. The Likert scale was used to score each question, enabling experts to gauge their agreement with the provided information. Results: Using the Likert scale, each question could score between 5 and 25 points, totaling 375 or 75 points for evaluations. Expert 2 led with 69.86%, followed by Expert 1 at 68.53%, ChatGPT at 64.80%, Expert 3 at 58.40%, and Google Bard at 54.93%. Comparing experts, significant differences emerged, especially with Google Bard. The rankings varied in specific sections like definitions and treatments, highlighting GPT-4’s variability across sections. The results emphasize the differences in performance among experts and AI models. Conclusion: Our findings indicate that GPT-4 often performed comparably to or even better than experts, particularly in definition and general question sections. However, both LLMs lagged notably in the treatment section. These results underscore the potential of LLMs as valuable tools in orthopedics but highlight their limitations, emphasizing the irreplaceable role of expert expertise in intricate medical contexts. Evidence Level: III, observational, analytics.","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"57 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978708","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 : 2024-05-14DOI: 10.30795/jfootankle.2024.v18.1725
Rogério de Andrade Gomes, A. H. Gomes, João Murilo Brandão Magalhães, Wagner da Fonseca Vieira, B. J. Pádua, Gustavo Heringer Cezar Fortes, Paulo Arthur Mendes Milhomem, Paulo Feliciano Sarquis Dias
Objetivo: Realizar uma avaliação clínica e imaginológica de pacientes com fraturas do tornozelo submetidos a osteossíntese com haste bloqueada, analisando o encurtamento da fíbula e redução tíbio-talar através de parâmetros de imagem bem estabelecidos na literatura. Métodos: Foram selecionados 25 pacientes operados pela técnica de haste intramedular bloqueada de fíbula, submetidos a cirurgia entre abril de 2018 e dezembro de 2022. Os pacientes tinham idade acima de 55 anos, com risco aumentado para complicações de cicatrização. Para avaliação clínica foram usados: escore AOFAS e escala visual analógica. Os parâmetros de imagem utilizados foram o ângulo talocrural, o espaço claro medial e a linha tibiofibular. Resultados: Foi avaliado escore AOFAS com média de 83,48 (± 15,34), com mínimo de 40 e máximo de 98 pontos. Na escala visual analógica de dor, a média foi 2,56 pontos (± 2,50), com mínimo de 0 e máximo de 8. Na linha anterior tibiofibular, a diferença entre a média e o valor de referência (2 mm) foi de 0,38 mm. Sobre o espaço claro medial, 100% apresentou valores dentro da referência (até 4 mm). Na análise do ângulo talocrural, a média das diferenças obtidas entre os valores de cada paciente e a referência se situaram dentro dos valores normais. Conclusão: A osteossíntese de fraturas do tornozelo com haste intramedular bloqueada é uma excelente alternativa nos pacientes idosos e com risco aumentado para complicações, conduzindo a bons resultados funcionais em seguimento de médio prazo, apesar de não mostrar uma redução satisfatória de redução da sindesmose na maioria dos casos
{"title":"Treatment of ankle fractures with fibular nail: clinical and imaging evaluation","authors":"Rogério de Andrade Gomes, A. H. Gomes, João Murilo Brandão Magalhães, Wagner da Fonseca Vieira, B. J. Pádua, Gustavo Heringer Cezar Fortes, Paulo Arthur Mendes Milhomem, Paulo Feliciano Sarquis Dias","doi":"10.30795/jfootankle.2024.v18.1725","DOIUrl":"https://doi.org/10.30795/jfootankle.2024.v18.1725","url":null,"abstract":"Objetivo: Realizar uma avaliação clínica e imaginológica de pacientes com fraturas do tornozelo submetidos a osteossíntese com haste bloqueada, analisando o encurtamento da fíbula e redução tíbio-talar através de parâmetros de imagem bem estabelecidos na literatura. \u0000Métodos: Foram selecionados 25 pacientes operados pela técnica de haste intramedular bloqueada de fíbula, submetidos a cirurgia entre abril de 2018 e dezembro de 2022. Os pacientes tinham idade acima de 55 anos, com risco aumentado para complicações de cicatrização. Para avaliação clínica foram usados: escore AOFAS e escala visual analógica. Os parâmetros de imagem utilizados foram o ângulo talocrural, o espaço claro medial e a linha tibiofibular. \u0000Resultados: Foi avaliado escore AOFAS com média de 83,48 (± 15,34), com mínimo de 40 e máximo de 98 pontos. Na escala visual analógica de dor, a média foi 2,56 pontos (± 2,50), com mínimo de 0 e máximo de 8. Na linha anterior tibiofibular, a diferença entre a média e o valor de referência (2 mm) foi de 0,38 mm. Sobre o espaço claro medial, 100% apresentou valores dentro da referência (até 4 mm). Na análise do ângulo talocrural, a média das diferenças obtidas entre os valores de cada paciente e a referência se situaram dentro dos valores normais. \u0000Conclusão: A osteossíntese de fraturas do tornozelo com haste intramedular bloqueada é uma excelente alternativa nos pacientes idosos e com risco aumentado para complicações, conduzindo a bons resultados funcionais em seguimento de médio prazo, apesar de não mostrar uma redução satisfatória de redução da sindesmose na maioria dos casos","PeriodicalId":436014,"journal":{"name":"Journal of the Foot & Ankle","volume":"37 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140979883","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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