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The association of ASA score and outcomes following total ankle arthroplasty ASA 评分与全踝关节置换术后疗效的关系
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.011

Background

This study seeks to evaluate the relationship between American Society of Anesthesiologist (ASA) score and postoperative outcomes following TAA.

Methods

The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried from 2007 to 2020 to identify 2210 TAA patients. Patients were stratified into low (n = 1328; healthy/mild systemic disease) or high (n = 881; severe/life-threatening systemic disease) ASA score cohorts.

Results

There was no statistically significant difference in complications, readmission, or reoperation rate based on ASA score. Increased ASA score was significantly associated with longer length of stay (low = 1.69 days, high = 1.98 days; p < .001) and higher rate of adverse discharge (low = 95.3 %, high = 87.4 %; p < .001).

Conclusion

Higher ASA scores (3 and 4) were statically significantly associated with increased length of stay and non-home discharge disposition. These findings are valuable for physicians and patients to consider prior to TAA given the increased utilization of resources and cost associated with higher ASA scores.

Level of Evidence

Level III, Retrospective cohort study

背景本研究旨在评估美国麻醉医师协会(ASA)评分与TAA术后预后之间的关系。方法查询了美国外科学院(ACS)国家外科质量改进计划(NSQIP)数据库2007年至2020年的数据,确定了2210名TAA患者。将患者分为ASA评分低(n = 1328;健康/轻度全身性疾病)或高(n = 881;严重/危及生命的全身性疾病)两组。结果根据ASA评分,并发症、再入院或再手术率没有显著统计学差异。ASA评分越高,住院时间越长(低分 = 1.69 天,高分 = 1.98 天;p < .001),不良出院率越高(低分 = 95.3 %,高分 = 87.4 %;p < .001)。鉴于较高的 ASA 评分会增加资源利用率和成本,这些研究结果对医生和患者在进行 TAA 之前的考虑很有价值。
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引用次数: 0
Defining the patient acceptable symptom state using PROMIS following reconstruction of the progressive collapsing foot deformity 使用 PROMIS 界定患者在进行性塌足畸形重建后可接受的症状状态
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.002

Background

The patient acceptable symptom state (PASS) represents the threshold beyond which patients are satisfied with their outcome. This study aimed to define PASS thresholds for progressive collapsing foot deformity (PCFD) reconstruction using Patient-Reported Outcomes Measurement Information System (PROMIS) scores and anchor question responses.

Methods

This retrospective study consisted of 109 patients who underwent flexible PCFD reconstruction, had preoperative and 2-year postoperative PROMIS scores, and 2-year postoperative anchor question responses. ROC curve analyses were performed to quantify PASS thresholds.

Results

PASS thresholds for the PROMIS Physical Function (PF) and Pain Interference (PI) domains were found to be lower and higher, respectively, than population norms. Furthermore, patients with higher preoperative PROMIS PF scores or lower preoperative PROMIS PI scores had a significantly higher likelihood of achieving the PASS thresholds.

Conclusion

In addition to guiding future outcomes research, these results may help surgeons optimize treatment for PCFD and better manage patient expectations.

Level of evidence

III, retrospective cohort study

患者可接受的症状状态(PASS)代表患者对治疗结果满意的阈值。本研究旨在利用患者报告结果测量信息系统(PROMIS)的评分和锚点问题的回答来确定进行性塌足畸形(PCFD)重建的 PASS 临界值。这项回顾性研究包括109名接受了柔性PCFD重建术的患者,他们术前和术后两年的PROMIS评分以及术后两年的锚定问题回答。研究人员进行了 ROC 曲线分析,以量化 PASS 临界值。结果发现,PROMIS 身体功能(PF)和疼痛干扰(PI)领域的 PASS 临界值分别低于和高于人群标准。此外,术前 PROMIS PF 评分较高或术前 PROMIS PI 评分较低的患者达到 PASS 临界值的可能性明显更高。除了指导未来的结果研究外,这些结果还可以帮助外科医生优化 PCFD 的治疗并更好地管理患者的期望值。三、回顾性队列研究
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引用次数: 0
Response to letter to editor: “Effect of chronic heavy tobacco smoking on ankle fracture healing” 解决长期大量吸烟对踝关节骨折愈合的多方面影响。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.06.006
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引用次数: 0
A modified lateral column lengthening for the treatment of flexible flatfoot: From clinical applications to finite element analysis 治疗柔性扁平足的改良侧柱延长术:从临床应用到有限元分析
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.008

Background

Finite element (FE) analysis and clinical follow-up were used to evaluate the efficacy of a modified lateral column lengthening (H-LCL) for treating flexible flatfoot.

Methods

By applying inclusion and exclusion criteria, we selected patients who underwent H-LCL surgery at our institution from January 2019 to January 2023. We compared the Visual Analog Scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, Pain Interference (PI), and Physical Function (PF) scores in Patient-Reported Outcomes Measurement Information System (PROMIS) between preoperative and final follow-up assessments of patients, as well as FE submodels. Furthermore, evaluate the H-LCL’s biomechanical characteristics and clinical outcome before and after surgery.

Results

A total of 66 patients met the criteria. The average surgery time was 69.47 ± 13.22 min, and the follow-up duration was 15.18 ± 6.40 months. In the last follow-up, VAS and PI decreased compared to before surgery, while AOFAS and PF increased compared to before surgery. Meary’s angle (dorsoplantar image and lateral image), calcaneal valgus angle, and talonavicular coverage angle decreased compared to before surgery, while the pitch angle increased compared to before surgery. In FE analysis, postoperative tension on the plantar fascia (PF), spring ligament (SL), and posterior tibial tendon (PTT) decreased compared to before surgery, pressure on the talonavicular joint and subtalar joints also decreased compared to before surgery, and there was no significant change in pressure on the calcaneocuboid joint.

Conclusion

H-LCL in correcting flexible flatfoot resulted in a significant improvement of clinical outcome scores and led to good radiological correction of flatfoot deformities. It can reduce the soft tissue and interosseous pressure in maintaining the foot arch.

我们利用有限元(FE)分析和临床随访评估了改良侧柱延长术(H-LCL)治疗柔性扁平足的疗效。通过纳入和排除标准,我们选择了2019年1月至2023年1月期间在我院接受H-LCL手术的患者。我们比较了患者术前评估和最终随访评估之间的视觉模拟量表(VAS)评分、美国骨科足踝协会(AOFAS)评分、患者报告结果测量信息系统(PROMIS)中的疼痛干扰(PI)和身体功能(PF)评分,以及 FE 子模型。此外,还要评估 H-LCL 的生物力学特征和手术前后的临床效果。共有 66 名患者符合标准。平均手术时间为(69.47±13.22)分钟,随访时间为(15.18±6.40)个月。在最后一次随访中,VAS和PI与手术前相比有所下降,而AOFAS和PF与手术前相比有所上升。与手术前相比,Meary角(背跖影和侧影)、小腿外翻角和距骨覆盖角均有所下降,而俯仰角则有所上升。在FE分析中,术后足底筋膜(PF)、弹簧韧带(SL)和胫后肌腱(PTT)的张力与术前相比有所下降,距关节和跗关节的压力与术前相比也有所下降,而小方块关节的压力没有明显变化。H-LCL 在矫正柔性扁平足方面的临床疗效评分明显改善,扁平足畸形的放射学矫正效果良好。它可以减少软组织和骨间压力,维持足弓。
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引用次数: 0
Dorsal calcaneal wedge removal in zadek osteotomy: A cadaveric study Zadek 截骨术中的钙楔背侧切除:尸体研究
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.004

Background

Insertional Achilles tendinopathy (IAT) is a common pathology with multiple surgical interventions available for treatment. The Zadek, dorsal closing wedge calcaneal osteotomy (ZO) has been demonstrated to be effective treatment of IAT. There have been various recommendations in the literature as to what measurement of wedge removal should be considered ideal to produce greatest postoperative range of motion (ROM), thus postoperative biomechanical potential. Accordingly, the purpose of this cadaveric study was to assess the range of motion achieved after various measurements of wedge removal by ZO.

Methods

The ZO was performed on six cadaveric specimens. A 7.5 mm and 15 mm wedge osteotomy was marked and sequentially completed on each specimen. Lateral fluoroscopic imaging was utilized to take preoperative and postoperative ROM measurements for each osteotomy. Dorsiflexion (DF) and plantarflexion (PF) ROM arcs were measured for each wedge size and compared by t-test. Effect sizes were calculated by Cohen’s d analysis.

Results

Maximal DF was 110.87 ± 12.97 deg in the pre-osteotomy state. Removal of a 7.5 mm wedge improved DF by 8 deg to a mean 102.93 ± 13.81 deg (p = 0.08). Removal of a 15 mm wedge improved DF by 16 deg to a mean 95.96 ± 11.41 deg (p = 0.003). Cohen’s d and effect size calculation demonstrated a 7.5 mm wedge to have a small effect on DF, while a 15 mm wedge had a medium effect (0.29, 0.52 respectively). Maximal PF did not change significantly amongst the pre-osteotomy, 7.5 mm wedge, or 15 mm wedge positions. ICC was 0.96.

Conclusion

Based on the results presented in this study, removal of a 15 mm wedge with ZO yields significant and greater improvement in ROM than a 7.5 mm wedge. We hope the current study will better inform preoperative planning for ZO.

Study type

Prospective Cadaver Study.

Level of evidence

V.

背景插入性跟腱病(IAT)是一种常见病症,有多种手术治疗方法可供选择。Zadek背侧闭合楔形小腿截骨术(ZO)已被证明是治疗IAT的有效方法。关于楔形切除的理想测量方法,文献中有各种建议,以产生最大的术后活动范围(ROM),从而实现术后生物力学潜力。因此,这项尸体研究的目的是评估通过 ZO 去除楔形物的各种测量方法后达到的活动范围。在每个标本上标记并依次完成 7.5 毫米和 15 毫米的楔形截骨。利用侧透视成像对每个截骨部位进行术前和术后 ROM 测量。对每种楔形大小的背屈(DF)和跖屈(PF)ROM弧度进行测量,并通过t检验进行比较。结果截骨前的最大 DF 为 110.87 ± 12.97 度。去除 7.5 mm 的楔块后,DF 平均为 102.93 ± 13.81 度,提高了 8 度(p = 0.08)。移除 15 毫米楔形块可将 DF 改善 16 度,达到平均 95.96 ± 11.41 度(p = 0.003)。Cohen's d 和效应大小计算显示,7.5 毫米楔形对 DF 的影响较小,而 15 毫米楔形的影响中等(分别为 0.29 和 0.52)。最大 PF 在截骨前、7.5 毫米楔块或 15 毫米楔块位置之间没有明显变化。结论根据本研究的结果,与 7.5 毫米楔形体相比,使用 ZO 移除 15 毫米楔形体可显著且更大程度地改善 ROM。我们希望本研究能为 ZO 的术前规划提供更好的参考。
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引用次数: 0
Role of insole material in treatment of plantar fasciitis: A randomized clinical trial 鞋垫材料在治疗足底筋膜炎中的作用:随机临床试验
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.04.006

Background

In this randomized clinical trial, we compared the early effects of polyethylene (PE), polyurethane (PU), and Carbon Fiber insoles in the treatment of PF using a set of patient-reported outcomes.

Methods

Patients were randomly allocated one of the three prefabricated insoles – Carbon Fiber (n = 14), PU (n = 14), or PE (n = 17) for regular use. Their response was recorded using PROMIS 3a (for pain intensity), PROMIS 4a (for pain interference), FAOS (Foot and Ankle Outcome Score), and VAS for pain at baseline, two, six, and twelve weeks.

Results

The PROMIS pain intensity scores improved in both the Carbon Fiber and the PE groups starting at the 6th week (p = 0.04) and 2nd week (p = 0.002), respectively. PROMIS pain interference scores also showed positive trends in these two groups (p = 0.02, p = 0.004, respectively).

Conclusion

Prefabricated Carbon Fiber and PE insoles showed significant pain-reducing effects in patients with PF.

Levels of evidence

Level I, Randomized controlled trial.

背景在这项随机临床试验中,我们使用一组患者报告的结果,比较了聚乙烯(PE)、聚氨酯(PU)和碳纤维鞋垫治疗足外翻的早期效果。方法患者被随机分配到三种预制鞋垫中的一种--碳纤维(n = 14)、聚氨酯(n = 14)或聚乙烯(n = 17),定期使用。使用 PROMIS 3a(疼痛强度)、PROMIS 4a(疼痛干扰)、FAOS(足踝结果评分)和 VAS 对基线、2 周、6 周和 12 周的疼痛进行记录。结果碳纤维组和 PE 组的 PROMIS 疼痛强度评分分别从第 6 周(p = 0.04)和第 2 周(p = 0.002)开始有所改善。PROMIS疼痛干扰评分在这两组中也呈现出积极趋势(分别为p = 0.02和p = 0.004)。结论预制碳纤维鞋垫和PE鞋垫对PF患者有显著的止痛效果。
{"title":"Role of insole material in treatment of plantar fasciitis: A randomized clinical trial","authors":"","doi":"10.1016/j.fas.2024.04.006","DOIUrl":"10.1016/j.fas.2024.04.006","url":null,"abstract":"<div><h3>Background</h3><p><span>In this randomized clinical trial, we compared the early effects of polyethylene (PE), </span>polyurethane<span> (PU), and Carbon Fiber insoles in the treatment of PF using a set of patient-reported outcomes.</span></p></div><div><h3>Methods</h3><p>Patients were randomly allocated one of the three prefabricated insoles – Carbon Fiber (n = 14), PU (n = 14), or PE (n = 17) for regular use. Their response was recorded using PROMIS 3a (for pain intensity), PROMIS 4a (for pain interference), FAOS (Foot and Ankle Outcome Score), and VAS for pain at baseline, two, six, and twelve weeks.</p></div><div><h3>Results</h3><p>The PROMIS pain intensity scores improved in both the Carbon Fiber and the PE groups starting at the 6th week (p = 0.04) and 2nd week (p = 0.002), respectively. PROMIS pain interference scores also showed positive trends in these two groups (p = 0.02, p = 0.004, respectively).</p></div><div><h3>Conclusion</h3><p>Prefabricated Carbon Fiber and PE insoles showed significant pain-reducing effects in patients with PF.</p></div><div><h3>Levels of evidence</h3><p>Level I, Randomized controlled trial.</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"30 6","pages":"Pages 524-528"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees 使用分类和回归树预测住院糖尿病足患者下肢截肢的模型
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-01 DOI: 10.1016/j.fas.2024.03.007

Background

The decision to perform amputation of a limb in a patient with diabetic foot ulcer (DFU) is not an easy task. Prediction models aim to help the surgeon in decision making scenarios. Currently there are no prediction model to determine lower limb amputation during the first 30 days of hospitalization for patients with DFU.

Methods

Classification And Regression Tree analysis was applied on data from a retrospective cohort of patients hospitalized for the management of diabetic foot ulcer, using an existing database from two Orthopaedics and Traumatology departments. The secondary analysis identified independent variables that can predict lower limb amputation (mayor or minor) during the first 30 days of hospitalization.

Results

Of the 573 patients in the database, 290 feet underwent a lower limb amputation during the first 30 days of hospitalization. Six different models were developed using a loss matrix to evaluate the error of not detecting false negatives. The selected tree produced 13 terminal nodes and after the pruning process, only one division remained in the optimal tree (Sensitivity: 69%, Specificity: 75%, Area Under the Curve: 0.76, Complexity Parameter: 0.01, Error: 0.85). Among the studied variables, the Wagner classification with a cut-off grade of 3 exceeded others in its predicting capacity.

Conclusions

Wagner classification was the variable with the best capacity for predicting amputation within 30 days. Infectious state and vascular occlusion described indirectly by this classification reflects the importance of taking quick decisions in those patients with a higher compromise of these two conditions. Finally, an external validation of the model is still required.

Level of evidence

III

背景决定对糖尿病足溃疡(DFU)患者实施截肢手术并非易事。预测模型旨在帮助外科医生做出决策。方法利用两个骨科和创伤科现有的数据库,对住院治疗糖尿病足溃疡患者的回顾性队列数据进行分类和回归树分析。结果 在数据库中的 573 名患者中,有 290 名患者在住院的前 30 天内进行了下肢截肢。利用损失矩阵建立了六个不同的模型,以评估未检测到假阴性的误差。选定的树产生了 13 个末端节点,经过修剪后,最优树中只剩下一个分部(灵敏度:69%,特异度:75%,曲线下面积:0.76,复杂度参数:0.75):0.76,复杂度参数:0.01,误差:0.85):0.85).结论瓦格纳分级是预测 30 天内截肢的最佳变量。该分级间接描述了感染状态和血管闭塞情况,反映了对这两种情况较严重的患者迅速做出决定的重要性。最后,还需要对模型进行外部验证。
{"title":"Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees","authors":"","doi":"10.1016/j.fas.2024.03.007","DOIUrl":"10.1016/j.fas.2024.03.007","url":null,"abstract":"<div><h3>Background</h3><p>The decision to perform amputation of a limb in a patient with diabetic foot ulcer (DFU) is not an easy task. Prediction models aim to help the surgeon in decision making scenarios. Currently there are no prediction model to determine lower limb amputation during the first 30 days of hospitalization for patients with DFU.</p></div><div><h3>Methods</h3><p>Classification And Regression Tree analysis was applied on data from a retrospective cohort of patients hospitalized for the management of diabetic foot ulcer, using an existing database from two Orthopaedics and Traumatology departments. The secondary analysis identified independent variables that can predict lower limb amputation (mayor or minor) during the first 30 days of hospitalization.</p></div><div><h3>Results</h3><p>Of the 573 patients in the database, 290 feet underwent a lower limb amputation during the first 30 days of hospitalization. Six different models were developed using a loss matrix to evaluate the error of not detecting false negatives. The selected tree produced 13 terminal nodes and after the pruning process, only one division remained in the optimal tree (Sensitivity: 69%, Specificity: 75%, Area Under the Curve: 0.76, Complexity Parameter: 0.01, Error: 0.85). Among the studied variables, the <em>Wagner classification</em> with a cut-off grade of 3 exceeded others in its predicting capacity<em>.</em></p></div><div><h3>Conclusions</h3><p>Wagner classification was the variable with the best capacity for predicting amputation within 30 days. Infectious state and vascular occlusion described indirectly by this classification reflects the importance of taking quick decisions in those patients with a higher compromise of these two conditions. Finally, an external validation of the model is still required.</p></div><div><h3>Level of evidence</h3><p>III</p></div>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":"30 6","pages":"Pages 471-479"},"PeriodicalIF":1.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1268773124000687/pdfft?md5=f3c5f52e3d9789958c7965a27a9f57bf&pid=1-s2.0-S1268773124000687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses. 慢性踝关节不稳的治疗和预防:荟萃分析综述。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-30 DOI: 10.1016/j.fas.2024.07.010
Dahai Hu, Hongyan Sun, Shengli Wang, Huajun Wang, Xiaofei Zheng, Hui Tang, Huige Hou

Background: Chronic ankle instability (CAI) is a common and highly disabling condition. Although several studies have evaluated and analyzed prevention and treatment strategies for CAI, an unbiased and systematic synthesis of evidence is required to provide the most powerful and comprehensive evidence-based measures for the its prevention and treatment of CAI. This study aimed to synthesize evidence from the existing literature addressing the treatment and prevention of CAI.

Methods: The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant studies from inception to December 12, 2023. Data on effect sizes and corresponding 95 % confidence intervals for selected intervention measures were extracted. Systematic reviews were assessed for quality of included studies using a measurement tool (i.e., "AMSTAR 2").

Results: In total, 37 studies were included, among which 21 (57 %) were of high or moderate quality. Strong evidence suggested that lower weight (P < 0.001), lower body mass index (P = 0.002), and non-stability defects (P = 0.04) significantly reduced the risk of developing CAI. Strong evidence supported exercise and moderate evidence supported manual therapy, acupuncture, and surgery for improving CAI. Additionally, external support plays an active role in the treatment process of CAI.

Conclusion: This is the first study synthesizing evidence supporting interventions for the treatment and prevention of CAI. Low body weight and body mass index were effective preventive measures against CAI. Exercise, manual therapy, acupuncture, and surgery can improve ankle function in patients with CAI. Plantar sensory treatment and neuromuscular training may be good therapeutic options for patients with CAI.

Level of evidence: Level I.

背景:慢性踝关节不稳定(CAI)是一种常见的高致残性疾病。尽管已有多项研究对 CAI 的预防和治疗策略进行了评估和分析,但仍需要对证据进行公正、系统的综合,以便为 CAI 的预防和治疗提供最有力、最全面的循证措施。本研究旨在综合现有文献中有关 CAI 治疗和预防的证据:方法:系统检索了 PubMed、Embase、Cochrane 和 Web of Science 数据库中从开始到 2023 年 12 月 12 日的相关研究。提取了选定干预措施的效应大小和相应的 95 % 置信区间数据。使用测量工具(即 "AMSTAR 2")对纳入研究的质量进行系统性回顾评估:共纳入 37 项研究,其中 21 项(57%)为高质量或中等质量。强有力的证据表明,较低的体重(P 结论:这是第一项综合了 "AMSTAR 2 "的研究:这是第一份综合了支持治疗和预防 CAI 干预措施的证据的研究。低体重和体重指数是预防 CAI 的有效措施。运动、手法治疗、针灸和手术可改善 CAI 患者的踝关节功能。足底感觉治疗和神经肌肉训练可能是CAI患者的良好治疗选择:证据等级:一级。
{"title":"Treatment and prevention of chronic ankle instability: An umbrella review of meta-analyses.","authors":"Dahai Hu, Hongyan Sun, Shengli Wang, Huajun Wang, Xiaofei Zheng, Hui Tang, Huige Hou","doi":"10.1016/j.fas.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.fas.2024.07.010","url":null,"abstract":"<p><strong>Background: </strong>Chronic ankle instability (CAI) is a common and highly disabling condition. Although several studies have evaluated and analyzed prevention and treatment strategies for CAI, an unbiased and systematic synthesis of evidence is required to provide the most powerful and comprehensive evidence-based measures for the its prevention and treatment of CAI. This study aimed to synthesize evidence from the existing literature addressing the treatment and prevention of CAI.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane, and Web of Science databases were systematically searched for relevant studies from inception to December 12, 2023. Data on effect sizes and corresponding 95 % confidence intervals for selected intervention measures were extracted. Systematic reviews were assessed for quality of included studies using a measurement tool (i.e., \"AMSTAR 2\").</p><p><strong>Results: </strong>In total, 37 studies were included, among which 21 (57 %) were of high or moderate quality. Strong evidence suggested that lower weight (P < 0.001), lower body mass index (P = 0.002), and non-stability defects (P = 0.04) significantly reduced the risk of developing CAI. Strong evidence supported exercise and moderate evidence supported manual therapy, acupuncture, and surgery for improving CAI. Additionally, external support plays an active role in the treatment process of CAI.</p><p><strong>Conclusion: </strong>This is the first study synthesizing evidence supporting interventions for the treatment and prevention of CAI. Low body weight and body mass index were effective preventive measures against CAI. Exercise, manual therapy, acupuncture, and surgery can improve ankle function in patients with CAI. Plantar sensory treatment and neuromuscular training may be good therapeutic options for patients with CAI.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Soleful solutions: Advancements in treatment strategies for ledderhose disease. 独一无二的解决方案:ledderhose疾病治疗策略的进展。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-25 DOI: 10.1016/j.fas.2024.07.008
Jamie Tersago, Alina Constantin

Introduction: Ledderhose disease (plantar fibromatosis) is a benign and progressive proliferative disorder of the plantar fascia that forms fixed and painful nodules within the fascia, causing functional disability and decreased quality of life.

Methods: we conducted a narrative review using Pubmed (https://pubmed.ncbi.nlm.nih.gov/) and searched for the terms "Ledderhose disease" "plantar fibromatosis" "Ledderhose disease treatment" "plantar fibromatosis treatment" with further focused searches in Pubmed to supplement information regarding each intervention.

Results: many non-surgical therapeutic strategies are used in managing symptoms. These include pharmacological and non-pharmacological treatment options. Surgical treatment is employed when these therapies are not able to control the symptoms.

Conclusion: understanding and exploring effective treatment modalities for Ledderhose disease (LD) is important in improving the functional disability and quality of life. This review aims to showcase a general outline of the condition and illustrate the present treatments used to manage the disease.

Levels of evidence: Therapeutic study, Level V.

简介Ledderhose病(足底纤维瘤病)是足底筋膜的一种良性、进行性增生性疾病,会在筋膜内形成固定、疼痛的结节,导致功能障碍和生活质量下降。方法:我们使用Pubmed(https://pubmed.ncbi.nlm.nih.gov/)进行了叙述性综述,搜索了 "Ledderhose病""足底纤维瘤病""Ledderhose病治疗""足底纤维瘤病治疗 "等词,并在Pubmed上进行了进一步的重点搜索,以补充有关各项干预措施的信息。结果:许多非手术治疗策略被用于控制症状。结果:许多非手术治疗策略被用于控制症状,其中包括药物和非药物治疗方案。结论:了解和探索莱德霍斯病(LD)的有效治疗方法对于改善功能障碍和生活质量非常重要。本综述旨在展示该疾病的概况,并说明目前用于控制该疾病的治疗方法:治疗研究,V级。
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引用次数: 0
Ultrasound assessment of talar cartilage thickness measurements in asymptomatic subjects with pes planus and its relationship with anthropometric parameters. 用超声波评估无症状扁平足患者的距骨软骨厚度及其与人体测量参数的关系。
IF 1.9 3区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-19 DOI: 10.1016/j.fas.2024.07.006
Orhan Güvener, Serkan Taş, Ümit Yüzbaşıoğlu, Figen Dağ

Introduction: Individuals with pes planus may have alterations in talar cartilage thickness due to changes in lower extremity alignment. The aim of this study was to measure the talar cartilage thickness of subjects with pes planus and compare the results with those of healthy controls. Another aim of the present study was to evaluate its relationship with anthropometric foot parameters.

Methods: This cross-sectional study included 48 individuals (16 males and 32 females) in the pes planus group and 48 individuals in the healthy control group (14 males and 34 females) based on the Navicular Drop (ND) test and the Foot Posture Index (FPI). Talar cartilage thickness (TCT) was measured with ultrasound. Anthropometric foot parameters of the individuals, such as foot length and foot width, were evaluated using a podoscope.

Results: TCT was higher in participants with pes planus compared to the control group (dominant side, p = 0.006; non-dominant side, p = 0.002). Foot width and length were similar in both groups for the dominant and non-dominant feet (p > 0.05). TCT on the dominant foot was positively correlated with the FPI score (r = 0.205, p = 0.045), ND score (r = 0.297, p = 0.003), foot width (r = 0.244, p = 0.017) and foot length (r = 0.253, p = 0.013). On the other hand, TCT on the non-dominant side was positively correlated with the FPI score (r = 0.235, p = 0.021), ND score (r = 0.363, p < 0.001), foot width (r = 0.270, p = 0.008) and length (r = 0.303, p = 0.003).

Conclusion: The talar cartilage of patients with pes planus seems to be thicker, and this is generally related to body weight, body mass index, foot anthropometrics, and posture characteristics.

Level of evidence: Level III, diagnostic comparative study.

导言:扁平足患者可能会因下肢排列的改变而导致距骨软骨厚度的改变。本研究旨在测量扁平足患者的距骨软骨厚度,并将结果与健康对照组进行比较。本研究的另一个目的是评估其与足部人体测量参数的关系:这项横断面研究包括 48 名扁平足患者(16 名男性和 32 名女性)和 48 名健康对照组患者(14 名男性和 34 名女性)。用超声波测量了足距软骨厚度(TCT)。使用足镜评估了个人的足部人体测量参数,如足长和足宽:结果:与对照组相比,扁平足患者的趾骨软骨厚度更高(优势侧,p = 0.006;非优势侧,p = 0.002)。两组患者的优势足和非优势足的宽度和长度相似(p > 0.05)。优势足的 TCT 与 FPI 评分(r = 0.205,p = 0.045)、ND 评分(r = 0.297,p = 0.003)、足宽(r = 0.244,p = 0.017)和足长(r = 0.253,p = 0.013)呈正相关。另一方面,非优势侧的 TCT 与 FPI 评分(r = 0.235,p = 0.021)、ND 评分(r = 0.363,p 结论)呈正相关:扁平足患者的距骨软骨似乎更厚,这通常与体重、体重指数、足部人体测量学和姿势特征有关:证据等级:三级,诊断性比较研究。
{"title":"Ultrasound assessment of talar cartilage thickness measurements in asymptomatic subjects with pes planus and its relationship with anthropometric parameters.","authors":"Orhan Güvener, Serkan Taş, Ümit Yüzbaşıoğlu, Figen Dağ","doi":"10.1016/j.fas.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.fas.2024.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with pes planus may have alterations in talar cartilage thickness due to changes in lower extremity alignment. The aim of this study was to measure the talar cartilage thickness of subjects with pes planus and compare the results with those of healthy controls. Another aim of the present study was to evaluate its relationship with anthropometric foot parameters.</p><p><strong>Methods: </strong>This cross-sectional study included 48 individuals (16 males and 32 females) in the pes planus group and 48 individuals in the healthy control group (14 males and 34 females) based on the Navicular Drop (ND) test and the Foot Posture Index (FPI). Talar cartilage thickness (TCT) was measured with ultrasound. Anthropometric foot parameters of the individuals, such as foot length and foot width, were evaluated using a podoscope.</p><p><strong>Results: </strong>TCT was higher in participants with pes planus compared to the control group (dominant side, p = 0.006; non-dominant side, p = 0.002). Foot width and length were similar in both groups for the dominant and non-dominant feet (p > 0.05). TCT on the dominant foot was positively correlated with the FPI score (r = 0.205, p = 0.045), ND score (r = 0.297, p = 0.003), foot width (r = 0.244, p = 0.017) and foot length (r = 0.253, p = 0.013). On the other hand, TCT on the non-dominant side was positively correlated with the FPI score (r = 0.235, p = 0.021), ND score (r = 0.363, p < 0.001), foot width (r = 0.270, p = 0.008) and length (r = 0.303, p = 0.003).</p><p><strong>Conclusion: </strong>The talar cartilage of patients with pes planus seems to be thicker, and this is generally related to body weight, body mass index, foot anthropometrics, and posture characteristics.</p><p><strong>Level of evidence: </strong>Level III, diagnostic comparative study.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Foot and Ankle Surgery
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