首页 > 最新文献

Foot & ankle specialist最新文献

英文 中文
Comparison of Anterior Ankle Translation With and Without Ankle Braces. 使用和不使用踝关节支架时踝关节前移的比较。
Pub Date : 2024-06-01 Epub Date: 2023-07-06 DOI: 10.1177/19386400231184125
Dawn T Gulick, Todd S Everett, Kerstin M Palombaro

Background: Lateral ankle sprains are a common musculoskeletal injury. Ankle braces are frequently used to prevent ankle injuries.

Aim: The purpose of this study was to examine the anterior translation of the talocrural joint of 2 ankle braces relative to a control.

Methods: Ankle mobility was assessed with the Mobil-Aider arthrometer in 3 conditions: TayCo ankle brace, Aircast ankle brace, and control. Three measures were recorded for each condition.

Results: Thirty participants (9 male and 21 female patients) participated. Friedman's analysis of variance found significant between-group differences for the trial with the largest translation. Wilcoxon signed-ranks post hoc testing found significant between-group differences between the control and TayCo (P < .001) and the control and Aircast conditions (P < .001). Post hoc power analysis revealed a Kendall's W of 0.804.

Clinical application: The TayCo brace is unique in that it is worn on the outside of the athletic shoe, whereas the Aircast is composed of lateral constraints worn inside the shoe. Both braces provided significant constraint over anterior talus translation when compared to control. The TayCo brace (51%-52% of control) was also significantly better than the Aircast (58%-59% of control) with less anterior translation permitted. This may be instrumental in preventing ankle injuries.

Level of evidence: 2b.

背景:踝关节外侧扭伤是一种常见的肌肉骨骼损伤:踝关节外侧扭伤是一种常见的肌肉骨骼损伤。目的:本研究的目的是检测 2 个踝关节支架相对于对照组的距骨关节前移情况:方法:使用 Mobil-Aider 关节测量仪评估 3 种情况下的踝关节活动度:方法:使用 Mobil-Aider 关节测量仪评估 3 种情况下的踝关节活动度:TayCo 护踝、Aircast 护踝和对照组。结果:30 名参与者(9 名男性和 21 名女性)的踝关节活动度进行了评估:30 名参与者(9 名男性和 21 名女性患者)参加了此次研究。弗里德曼方差分析发现,平移量最大的试验组间差异显著。Wilcoxon 符号秩和事后检验发现,对照组和 TayCo(P < .001)以及对照组和 Aircast 条件(P < .001)之间存在显著的组间差异。事后功率分析显示 Kendall's W 为 0.804:TayCo 支具的独特之处在于它是穿在运动鞋外面的,而 Aircast 是由穿在鞋内的侧向约束组成的。与对照组相比,两种支具都对距骨前移有明显的限制作用。TayCo 支架(51%-52% 的对照组)也明显优于 Aircast 支架(58%-59% 的对照组),允许的前移更少。这可能有助于预防踝关节损伤。
{"title":"Comparison of Anterior Ankle Translation With and Without Ankle Braces.","authors":"Dawn T Gulick, Todd S Everett, Kerstin M Palombaro","doi":"10.1177/19386400231184125","DOIUrl":"10.1177/19386400231184125","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprains are a common musculoskeletal injury. Ankle braces are frequently used to prevent ankle injuries.</p><p><strong>Aim: </strong>The purpose of this study was to examine the anterior translation of the talocrural joint of 2 ankle braces relative to a control.</p><p><strong>Methods: </strong>Ankle mobility was assessed with the Mobil-Aider arthrometer in 3 conditions: TayCo ankle brace, Aircast ankle brace, and control. Three measures were recorded for each condition.</p><p><strong>Results: </strong>Thirty participants (9 male and 21 female patients) participated. Friedman's analysis of variance found significant between-group differences for the trial with the largest translation. Wilcoxon signed-ranks post hoc testing found significant between-group differences between the control and TayCo (P < .001) and the control and Aircast conditions (P < .001). Post hoc power analysis revealed a Kendall's W of 0.804.</p><p><strong>Clinical application: </strong>The TayCo brace is unique in that it is worn on the outside of the athletic shoe, whereas the Aircast is composed of lateral constraints worn inside the shoe. Both braces provided significant constraint over anterior talus translation when compared to control. The TayCo brace (51%-52% of control) was also significantly better than the Aircast (58%-59% of control) with less anterior translation permitted. This may be instrumental in preventing ankle injuries.</p><p><strong>Level of evidence: </strong>2b.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"264-269"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758705","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}
引用次数: 0
Assessing Lateral Ankle Sprains With a New Arthrometer. 用新型关节测量仪评估外侧踝关节扭伤
Pub Date : 2024-06-01 Epub Date: 2022-11-26 DOI: 10.1177/19386400221125851
Nicholas R Taweel, Dawn T Gulick, Kerstin M Palombaro

Background: Lateral ankle sprains are a common musculoskeletal injury across a variety of activities. Researchers have sought to identify a method to objectively assess joint laxity with a device that is simple to use and affordable.

Aim: The purpose of this study was to assess the use of an ankle arthrometer on individuals with ankle sprains.

Methods: The participant was evaluated by the physician and the degree of ankle sprain was identified. In the prone position, the arthrometer was used to perform an anterior drawer test (uninjured before injured, 3 measures each). Both clinicians were blinded to the data of the other.

Results: There were 30 participants, 10 in each group (uninjured, grade 1 sprain, grade 2 sprain). Mann-Whitney U testing found significant differences between the control and grade I ankle sprain groups (P < .001), the control and grade II ankle sprain groups (P < .001), and the grade I and grade II ankle sprain groups (P = .004). There was ±0.31-mm difference in anterior translation between healthy ankles, whereas there was 1.11- and 2.16-mm difference between ankles in grade 1 and grade 2 sprains, respectively.

Clinical application: Despite the manual anterior drawer test being convenient, the subjectivity makes it unreliable. This study is consistent with prior literature about the difference in translation (millimeters) between the uninjured and injured ankles corresponding to the magnitude of ankle laxity. This study also contributes to the evolving evidence to support the relationship of a ratio of measures (injured/uninjured) as an objective measure of laxity. These comparisons to the individual's healthy ankle mitigate the variability of the normative values. The use of an arthrometer to assess ankle joint laxity enhances the objectivity of patient assessment throughout the recovery process.

Levels of evidence: Level III.

背景:踝关节外侧扭伤是各种活动中常见的肌肉骨骼损伤。研究人员一直在寻找一种方法来客观评估关节松弛程度,这种设备使用简单且价格适中。目的:本研究旨在评估踝关节测量仪在踝关节扭伤患者中的使用情况:方法:由医生对参与者进行评估,确定踝关节扭伤的程度。在俯卧位,使用关节计进行前抽屉测试(未受伤前和受伤前,各测量 3 次)。两名临床医生对另一方的数据均为盲人:共有 30 名参与者,每组 10 人(未受伤、1 级扭伤、2 级扭伤)。Mann-Whitney U 检验发现,对照组和 I 级踝关节扭伤组(P < .001)、对照组和 II 级踝关节扭伤组(P < .001)以及 I 级踝关节扭伤组和 II 级踝关节扭伤组(P = .004)之间存在显著差异。健康踝关节的前移量相差±0.31毫米,而一级和二级扭伤踝关节的前移量分别相差1.11毫米和2.16毫米:临床应用:尽管手动前抽屉测试很方便,但其主观性使其并不可靠。这项研究与之前关于未受伤和受伤踝关节之间的平移差异(毫米)与踝关节松弛程度相对应的文献一致。这项研究还为支持将测量比率(受伤/未受伤)作为踝关节松弛度的客观测量方法的不断发展的证据做出了贡献。这些与个人健康踝关节的比较减轻了标准值的可变性。使用关节测量仪来评估踝关节松弛程度可提高患者在整个康复过程中评估的客观性:证据等级:III 级。
{"title":"Assessing Lateral Ankle Sprains With a New Arthrometer.","authors":"Nicholas R Taweel, Dawn T Gulick, Kerstin M Palombaro","doi":"10.1177/19386400221125851","DOIUrl":"10.1177/19386400221125851","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprains are a common musculoskeletal injury across a variety of activities. Researchers have sought to identify a method to objectively assess joint laxity with a device that is simple to use and affordable.</p><p><strong>Aim: </strong>The purpose of this study was to assess the use of an ankle arthrometer on individuals with ankle sprains.</p><p><strong>Methods: </strong>The participant was evaluated by the physician and the degree of ankle sprain was identified. In the prone position, the arthrometer was used to perform an anterior drawer test (uninjured before injured, 3 measures each). Both clinicians were blinded to the data of the other.</p><p><strong>Results: </strong>There were 30 participants, 10 in each group (uninjured, grade 1 sprain, grade 2 sprain). Mann-Whitney U testing found significant differences between the control and grade I ankle sprain groups (P < .001), the control and grade II ankle sprain groups (P < .001), and the grade I and grade II ankle sprain groups (P = .004). There was ±0.31-mm difference in anterior translation between healthy ankles, whereas there was 1.11- and 2.16-mm difference between ankles in grade 1 and grade 2 sprains, respectively.</p><p><strong>Clinical application: </strong>Despite the manual anterior drawer test being convenient, the subjectivity makes it unreliable. This study is consistent with prior literature about the difference in translation (millimeters) between the uninjured and injured ankles corresponding to the magnitude of ankle laxity. This study also contributes to the evolving evidence to support the relationship of a ratio of measures (injured/uninjured) as an objective measure of laxity. These comparisons to the individual's healthy ankle mitigate the variability of the normative values. The use of an arthrometer to assess ankle joint laxity enhances the objectivity of patient assessment throughout the recovery process.</p><p><strong>Levels of evidence: </strong>Level III.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"235-239"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40485288","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}
引用次数: 0
Realignment Surgery for Failed Osteochondral Autologous Transplantation in Osteochondral Lesions of the Talus Associated With Malalignment. 距骨骨软骨损伤伴错位的骨软骨自体移植失败后的重新对位手术。
Pub Date : 2024-06-01 Epub Date: 2023-04-05 DOI: 10.1177/19386400231163030
Jaeyoung Kim, Lavan Rajan, Oliver Gagne, Ji-Beom Kim, Woo-Chun Lee

Background: While osteochondral autologous transplantation (OAT) offers favorable results in most patients with osteochondral lesions of the talus (OLT), some patients continue to experience persistent pain following the procedure. Information regarding the etiology of this pain and outcomes of revision surgery are limited. This study aimed to report results of revision surgery with realignment procedures in patients with failed OAT who demonstrated concomitant malalignment at the distal tibia or hindfoot.

Methods: Eight patients (8 ankles), who had been experiencing persistent pain for more than 1 year following OAT, underwent realignment procedures during revision surgery. All patients underwent primary OAT for the treatment of medial OLTs. Patients were divided into 2 groups based on the main location of deformity: the supramalleolar realignment group (SRG, 5 ankles) and the hindfoot realignment group (HRG, 3 ankles). No direct procedure was performed on the osteochondral lesion at the time of revision surgery. Ankle and hindfoot alignment were evaluated using 6 parameters in weightbearing radiographs. Computed tomography (CT) was used to assess for medial gutter narrowing, spur formation, and cyst volume around transplanted osteochondral plug preoperatively and postoperatively. Clinical outcomes were assessed using Foot Function Index and Visual Analogue Scale.

Results: All patients had medial gutter narrowing or spur formation, which are early signs of ankle arthritis. The SRG had varus distal tibial alignment with a median medial distal tibial angle of 85.7 degrees (interquartile range [IQR], 3.2). The HRG had valgus hindfoot alignment and a lower medial longitudinal arch with a median hindfoot moment arm of 8.4 mm (IQR, 6.1) and a median Meary's angle of 11.8 degrees (IQR, 1.4). Spontaneous restoration of the osteochondral lesion was observed after realignment surgery, with cyst volume decreasing from 0.2592 to 0.0873 cm3 (P < .05). Clinical scores improved in all patients.

Conclusion: The current study demonstrates the effectiveness of realignment surgery in a selected patient group who experienced persistent pain and showed radiographic evidence of malalignment after primary OAT. Our study provides evidence supporting the use of realignment procedures in these cases, with results indicating improved patient-reported outcomes and spontaneous restoration of osteochondral lesions.

Levels of evidence: Level IV: Case series.

背景:虽然骨软骨自体移植(OAT)对大多数距骨骨软骨损伤(OLT)患者都有良好的疗效,但一些患者在术后仍会出现持续性疼痛。有关这种疼痛的病因和翻修手术效果的信息十分有限。本研究旨在报告对胫骨远端或后足同时存在错位的OAT失败患者进行复位手术的结果:8名患者(8个脚踝)在接受OAT术后持续疼痛超过1年,在翻修手术中接受了重新对位手术。所有患者都接受了治疗内侧OLT的初次OAT手术。根据畸形的主要部位将患者分为两组:并踝上矫正组(SRG,5 个脚踝)和后足矫正组(HRG,3 个脚踝)。翻修手术时未对骨软骨病损进行直接手术。通过负重X光片上的6个参数来评估踝关节和后足的对位情况。术前和术后使用计算机断层扫描(CT)评估移植骨软骨塞周围的内侧沟狭窄、骨刺形成和囊肿体积。临床结果采用足部功能指数和视觉模拟量表进行评估:所有患者都有内侧沟狭窄或骨刺形成,这是踝关节炎的早期症状。SRG患者的胫骨远端呈曲折排列,胫骨远端内侧角度中位数为85.7度(四分位数间距[IQR],3.2)。HRG后足内翻,内侧纵弓较低,后足力矩臂中位数为8.4毫米(IQR,6.1),Meary角中位数为11.8度(IQR,1.4)。复位手术后观察到骨软骨病变自发恢复,囊肿体积从 0.2592 立方厘米降至 0.0873 立方厘米(P < .05)。所有患者的临床评分均有所改善:目前的研究表明,在原发性 OAT 术后出现持续疼痛并有影像学证据显示对位不良的特定患者群体中,重新对位手术是有效的。我们的研究提供了支持在这些病例中使用复位手术的证据,结果表明患者报告的结果有所改善,骨软骨病变也得到了自发恢复:四级:病例系列。
{"title":"Realignment Surgery for Failed Osteochondral Autologous Transplantation in Osteochondral Lesions of the Talus Associated With Malalignment.","authors":"Jaeyoung Kim, Lavan Rajan, Oliver Gagne, Ji-Beom Kim, Woo-Chun Lee","doi":"10.1177/19386400231163030","DOIUrl":"10.1177/19386400231163030","url":null,"abstract":"<p><strong>Background: </strong>While osteochondral autologous transplantation (OAT) offers favorable results in most patients with osteochondral lesions of the talus (OLT), some patients continue to experience persistent pain following the procedure. Information regarding the etiology of this pain and outcomes of revision surgery are limited. This study aimed to report results of revision surgery with realignment procedures in patients with failed OAT who demonstrated concomitant malalignment at the distal tibia or hindfoot.</p><p><strong>Methods: </strong>Eight patients (8 ankles), who had been experiencing persistent pain for more than 1 year following OAT, underwent realignment procedures during revision surgery. All patients underwent primary OAT for the treatment of medial OLTs. Patients were divided into 2 groups based on the main location of deformity: the supramalleolar realignment group (SRG, 5 ankles) and the hindfoot realignment group (HRG, 3 ankles). No direct procedure was performed on the osteochondral lesion at the time of revision surgery. Ankle and hindfoot alignment were evaluated using 6 parameters in weightbearing radiographs. Computed tomography (CT) was used to assess for medial gutter narrowing, spur formation, and cyst volume around transplanted osteochondral plug preoperatively and postoperatively. Clinical outcomes were assessed using Foot Function Index and Visual Analogue Scale.</p><p><strong>Results: </strong>All patients had medial gutter narrowing or spur formation, which are early signs of ankle arthritis. The SRG had varus distal tibial alignment with a median medial distal tibial angle of 85.7 degrees (interquartile range [IQR], 3.2). The HRG had valgus hindfoot alignment and a lower medial longitudinal arch with a median hindfoot moment arm of 8.4 mm (IQR, 6.1) and a median Meary's angle of 11.8 degrees (IQR, 1.4). Spontaneous restoration of the osteochondral lesion was observed after realignment surgery, with cyst volume decreasing from 0.2592 to 0.0873 cm<sup>3</sup> (P < .05). Clinical scores improved in all patients.</p><p><strong>Conclusion: </strong>The current study demonstrates the effectiveness of realignment surgery in a selected patient group who experienced persistent pain and showed radiographic evidence of malalignment after primary OAT. Our study provides evidence supporting the use of realignment procedures in these cases, with results indicating improved patient-reported outcomes and spontaneous restoration of osteochondral lesions.</p><p><strong>Levels of evidence: </strong>Level IV: Case series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"240-248"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245712","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}
引用次数: 0
Technique Variation in the Surgical Treatment of Lateral Ankle Instability. 踝关节外侧不稳定手术治疗中的技术变化。
Pub Date : 2024-06-01 Epub Date: 2023-10-12 DOI: 10.1177/19386400231202029
Aaron J Wilke, Robert Martin, Nathaniel A Bates, James R Jastifer, Kevin D Martin

Introduction: Lateral ankle sprains are the most common type of injury to the ankle and can lead to ankle instability. There are many described techniques for the surgical treatment of lateral ankle instability. The purpose of this study is to quantify the variation in surgeon technique for lateral ankle instability treatment.

Methods: Surveys were sent to 62 orthopaedic foot and ankle surgeons regarding surgical technique for the treatment of lateral ankle instability. Clinical agreement was defined as greater than 80% agreement to assess the cohesiveness of surgical methods as described by Marx et al. Results. Response rate was 49/62 (79%). There was clinical agreement for not using bone tunnels and not using metal anchors. All other factors lacked clinical agreement. A greater average number of throws and knots (4.2 for each, range 1-6 throws, range 2-12 knots) were used by surgeons that do not believe knots cause pain compared to an average of 3.9 (range, 1-6) throws and 4.0 (range, 2-15) knots by surgeons who do believe knots cause pain. The association that surgeon who believed knots do cause pain and thus used fewer knots and throws was not statistically significant (P > .05). The preferred material by surgeons in our study are as follows: nonabsorbable braided suture (26/49, 53%), suture tape (15/49, 31%), and fiber tape (4/49, 8%). Among surgeons who use absorbable suture (34/49, 69%), there was no significant difference (P > .05) between surgeons who believe knots cause pain (23/34, 68%) and those who do not (11/34, 32%).

Discussion and conclusion: Among this small sample of orthopaedic foot and ankle surgeons, there is wide variation in surgical technique for lateral ankle instability treatment and little agreement on the clinical standard of care. This disagreement highlights the need for comparative outcome studies in the treatment of ankle instability.

Level of evidence: Level III: Retrospective cohort study.

简介:脚踝外侧扭伤是最常见的脚踝损伤类型,可导致脚踝不稳定。有许多描述的手术治疗踝关节外侧不稳定的技术。本研究的目的是量化外科医生治疗踝关节外侧不稳定的技术变化。方法:对62名足部和踝关节整形外科医生进行调查,了解治疗踝关节外侧不稳定的手术技术。临床一致性被定义为超过80%的一致性,以评估Marx等人所描述的手术方法的内聚性。结果。有效率为49/62(79%)。不使用骨隧道和不使用金属锚固件在临床上是一致的。所有其他因素缺乏临床一致性。不相信结会引起疼痛的外科医生使用了更大的平均投掷次数和结数(每次4.2次,范围1-6次,范围2-12节),而相信结会导致疼痛的外科医生平均使用3.9次(范围1-6次)和4.0次(范围2-15次)。外科医生认为打结确实会引起疼痛,因此使用较少的打结和投掷物,这一关联在统计学上并不显著(P>0.05)。在我们的研究中,外科医生首选的材料如下:不可吸收编织缝合线(26/49,53%)、缝合带(15/49,31%)和纤维带(4/49,8%)。在使用可吸收缝线的外科医生中(34/49,69%),认为打结会引起疼痛的外科医生(23/34,68%)和不认为打结会导致疼痛的外科医生之间没有显著差异(P>0.05)(11/34,32%)。讨论和结论:在这一小部分足部和踝关节整形外科医生中,治疗踝关节外侧不稳定的手术技术差异很大,临床护理标准几乎没有一致性。这一分歧突出了在治疗踝关节不稳定方面进行比较结果研究的必要性。证据水平:第三级:回顾性队列研究。
{"title":"Technique Variation in the Surgical Treatment of Lateral Ankle Instability.","authors":"Aaron J Wilke, Robert Martin, Nathaniel A Bates, James R Jastifer, Kevin D Martin","doi":"10.1177/19386400231202029","DOIUrl":"10.1177/19386400231202029","url":null,"abstract":"<p><strong>Introduction: </strong>Lateral ankle sprains are the most common type of injury to the ankle and can lead to ankle instability. There are many described techniques for the surgical treatment of lateral ankle instability. The purpose of this study is to quantify the variation in surgeon technique for lateral ankle instability treatment.</p><p><strong>Methods: </strong>Surveys were sent to 62 orthopaedic foot and ankle surgeons regarding surgical technique for the treatment of lateral ankle instability. Clinical agreement was defined as greater than 80% agreement to assess the cohesiveness of surgical methods as described by Marx et al. Results. Response rate was 49/62 (79%). There was clinical agreement for not using bone tunnels and not using metal anchors. All other factors lacked clinical agreement. A greater average number of throws and knots (4.2 for each, range 1-6 throws, range 2-12 knots) were used by surgeons that do not believe knots cause pain compared to an average of 3.9 (range, 1-6) throws and 4.0 (range, 2-15) knots by surgeons who do believe knots cause pain. The association that surgeon who believed knots do cause pain and thus used fewer knots and throws was not statistically significant (P > .05). The preferred material by surgeons in our study are as follows: nonabsorbable braided suture (26/49, 53%), suture tape (15/49, 31%), and fiber tape (4/49, 8%). Among surgeons who use absorbable suture (34/49, 69%), there was no significant difference (P > .05) between surgeons who believe knots cause pain (23/34, 68%) and those who do not (11/34, 32%).</p><p><strong>Discussion and conclusion: </strong>Among this small sample of orthopaedic foot and ankle surgeons, there is wide variation in surgical technique for lateral ankle instability treatment and little agreement on the clinical standard of care. This disagreement highlights the need for comparative outcome studies in the treatment of ankle instability.</p><p><strong>Level of evidence: </strong><i>Level III: Retrospective cohort study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"259-263"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41222097","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}
引用次数: 0
Ankle Biomechanics During Multidirectional Landings in Athletes With Chronic Ankle Instability. 慢性踝关节不稳定运动员多向着地过程中的踝关节生物力学。
Pub Date : 2024-06-01 Epub Date: 2023-11-08 DOI: 10.1177/19386400231208522
Ainthira Sonsukong, Roongtiwa Vacshalathiti, Pongthanayos Kiratisin, Jim Richards, Daniel T P Fong, Komsak Sinsurin

Background: Assessing and understanding the control of the ankle during multidirectional jump landings in athletes with chronic ankle instability (CAI) would help health professionals develop interventions to reduce the risk of recurrent injuries. The aim of this study was to investigate the angle, angular velocity, and movements of the ankle joint, and the muscle activity of peroneus longus (PL), tibialis anterior (TA), and gastrocnemius (GAS) muscles during multidirectional landings in athletes with CAI.

Methods: Nineteen athletes with CAI (≤25 Cumberland Ankle Instability Tool-Thai Score) participated. A Vicon Nexus motion analysis system synchronously collected data with an AMTI force plate and surface electromyography (EMG) to capture kinematics, kinetics, and muscle activity, respectively. Participants were asked to perform single-leg jump-landing tests in forward (0°), 30° diagonal, 60° diagonal, and lateral (90°) directions. Ankle joint kinematics, kinetics, and muscle activity of PL, TA, and GAS were analyzed. Repeated measure ANOVA (analysis of variance) and Friedman tests were used to analyze the main effects of the jump-landing direction.

Results: Athletes with CAI exhibited significant differences in ankle angles, angular velocities, ankle movements, and average muscle activity of GAS between directions. Greatest average EMG of GAS muscle was observed during landing in the lateral direction compared with the forward and 30° diagonal directions.

Conclusion: Lateral and diagonal direction movements showed the greatest risks associated with recurrent ankle sprains. Impairments of neuromuscular control in both pre-landing and landing phases were observed in athletes with CAI when considered alongside previously published data.

Level of evidence: Laboratory-based observational study.

背景:评估和了解患有慢性踝关节不稳定(CAI)的运动员在多向跳跃着陆过程中对踝关节的控制将有助于卫生专业人员制定干预措施,以降低复发性损伤的风险。本研究旨在研究CAI运动员多向着地过程中踝关节的角度、角速度和运动,以及腓骨长肌(PL)、胫骨前肌(TA)和腓肠肌(GAS)的肌肉活动。Vicon Nexus运动分析系统与AMTI力板和表面肌电图(EMG)同步收集数据,以分别捕捉运动学、动力学和肌肉活动。参与者被要求在向前(0°)、对角线30°、对角线60°和横向(90°)方向进行单腿跳跃着陆测试。分析了PL、TA和GAS的踝关节运动学、动力学和肌肉活动。采用重复测量方差分析(ANOVA)和弗里德曼检验来分析跳跃着地方向的主要影响。结果:患有CAI的运动员在不同方向的踝关节角度、角速度、踝关节运动和GAS的平均肌肉活动方面表现出显著差异。与前向和30°对角线方向相比,GAS肌肉在侧向着陆时的平均肌电图最大。结论:外侧和斜向运动显示出与复发性踝关节扭伤相关的最大风险。当与先前公布的数据一起考虑时,在患有CAI的运动员中观察到落地前和落地阶段的神经肌肉控制受损。证据水平:基于实验室的观察性研究。
{"title":"Ankle Biomechanics During Multidirectional Landings in Athletes With Chronic Ankle Instability.","authors":"Ainthira Sonsukong, Roongtiwa Vacshalathiti, Pongthanayos Kiratisin, Jim Richards, Daniel T P Fong, Komsak Sinsurin","doi":"10.1177/19386400231208522","DOIUrl":"10.1177/19386400231208522","url":null,"abstract":"<p><strong>Background: </strong>Assessing and understanding the control of the ankle during multidirectional jump landings in athletes with chronic ankle instability (CAI) would help health professionals develop interventions to reduce the risk of recurrent injuries. The aim of this study was to investigate the angle, angular velocity, and movements of the ankle joint, and the muscle activity of peroneus longus (PL), tibialis anterior (TA), and gastrocnemius (GAS) muscles during multidirectional landings in athletes with CAI.</p><p><strong>Methods: </strong>Nineteen athletes with CAI (≤25 Cumberland Ankle Instability Tool-Thai Score) participated. A Vicon Nexus motion analysis system synchronously collected data with an AMTI force plate and surface electromyography (EMG) to capture kinematics, kinetics, and muscle activity, respectively. Participants were asked to perform single-leg jump-landing tests in forward (0°), 30° diagonal, 60° diagonal, and lateral (90°) directions. Ankle joint kinematics, kinetics, and muscle activity of PL, TA, and GAS were analyzed. Repeated measure ANOVA (analysis of variance) and Friedman tests were used to analyze the main effects of the jump-landing direction.</p><p><strong>Results: </strong>Athletes with CAI exhibited significant differences in ankle angles, angular velocities, ankle movements, and average muscle activity of GAS between directions. Greatest average EMG of GAS muscle was observed during landing in the lateral direction compared with the forward and 30° diagonal directions.</p><p><strong>Conclusion: </strong>Lateral and diagonal direction movements showed the greatest risks associated with recurrent ankle sprains. Impairments of neuromuscular control in both pre-landing and landing phases were observed in athletes with CAI when considered alongside previously published data.</p><p><strong>Level of evidence: </strong><i>Laboratory-based observational study</i>.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"249-258"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489584","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}
引用次数: 0
Outcomes Following Modified Broström for Chronic Lateral Ankle Instability With and Without Peroneal Tendon Exploration. 采用或不采用腓肠肌肌腱探查术治疗慢性外侧踝关节失稳的改良布罗斯特伦术后疗效。
Pub Date : 2024-06-01 Epub Date: 2021-11-02 DOI: 10.1177/19386400211055278
Bryan G Adams, Brian P Milam, Nicholas J Drayer, Ama Winland, Debra Hood, Paul M Ryan, Justin Robbins

Background: It is not known how peroneal tendon exploration influences results after modified Broström for lateral ankle instability. We propose peroneal exploration at the time of modified Broström will have similar outcomes as no peroneal exploration.

Methods: A retrospective analysis was performed of patients undergoing modified Broström with and without peroneal exploration. Foot and Ankle Outcome scores and data regarding military retention were gathered and compared.

Results: Seventeen patients were identified in the modified Broström only cohort and 24 in the peroneal exploration cohort. Patients had mean follow-up of 5 years in both cohorts. The mean FAOS in the modified Broström only cohort was 68 and 72 in the cohort with peroneal exploration (P = .541). When each FAOS subcategory was analyzed, no difference was identified in any subcategory. Eight of 17 patients (47%) in the modified Broström only cohort remained active duty compared with 8 of 24 patients (33%) in the modified Broström with peroneal exploration cohort (P = .518). One patient medically discharged in the modified Broström only cohort versus 6 in peroneal exploration cohort (P = .109). Overall satisfaction with the procedure was 12 of 17 (71%) in the modified Broström only cohort and 19 of 24 (79%) in the peroneal exploration cohort (P = .529).

Conclusions: No significant difference was identified between patients undergoing modified Broström alone or modified Broström with peroneal exploration. There was no significant difference in return to duty, medical discharge or patient satisfaction.

Levels of evidence: Level III: retrospective case-control study with prospectively collected data.

背景:目前尚不清楚腓骨肌腱探查如何影响改良Brostöm治疗外侧踝关节不稳的结果。我们认为在进行改良布氏手术时进行腓肠肌探查与不进行腓肠肌探查的结果相似:我们对接受改良布氏手术和未进行腓骨探查的患者进行了回顾性分析。方法:对接受改良布氏手术并进行腓肠肌探查和不进行腓肠肌探查的患者进行回顾性分析,收集并比较足踝结果评分和军方保留数据:结果:仅接受改良布氏手术的患者有 17 人,接受腓肠肌探查手术的患者有 24 人。两组患者的平均随访时间均为 5 年。改良布氏疗法组的平均 FAOS 为 68,腓肠肌探查组为 72(P = .541)。在对每个 FAOS 子类别进行分析时,没有发现任何子类别存在差异。在仅进行改良布氏手术的组群中,17 名患者中有 8 名(47%)仍在服役,而在进行改良布氏手术和腓骨探查的组群中,24 名患者中有 8 名(33%)仍在服役(P = .518)。仅使用改良布氏疗法的组别中有一名患者因病出院,而使用腓肠肌探查疗法的组别中有 6 名患者因病出院(P = .109)。对手术的总体满意度为:改良布氏手术组17人中有12人(71%)满意,腓肠肌探查组24人中有19人(79%)满意(P = .529):结论:单纯接受改良布氏手术和改良布氏手术加腓肠肌探查的患者之间没有明显差异。证据等级:III级:回顾性病例分析:III级:回顾性病例对照研究,前瞻性收集数据。
{"title":"Outcomes Following Modified Broström for Chronic Lateral Ankle Instability With and Without Peroneal Tendon Exploration.","authors":"Bryan G Adams, Brian P Milam, Nicholas J Drayer, Ama Winland, Debra Hood, Paul M Ryan, Justin Robbins","doi":"10.1177/19386400211055278","DOIUrl":"10.1177/19386400211055278","url":null,"abstract":"<p><strong>Background: </strong>It is not known how peroneal tendon exploration influences results after modified Broström for lateral ankle instability. We propose peroneal exploration at the time of modified Broström will have similar outcomes as no peroneal exploration.</p><p><strong>Methods: </strong>A retrospective analysis was performed of patients undergoing modified Broström with and without peroneal exploration. Foot and Ankle Outcome scores and data regarding military retention were gathered and compared.</p><p><strong>Results: </strong>Seventeen patients were identified in the modified Broström only cohort and 24 in the peroneal exploration cohort. Patients had mean follow-up of 5 years in both cohorts. The mean FAOS in the modified Broström only cohort was 68 and 72 in the cohort with peroneal exploration (P = .541). When each FAOS subcategory was analyzed, no difference was identified in any subcategory. Eight of 17 patients (47%) in the modified Broström only cohort remained active duty compared with 8 of 24 patients (33%) in the modified Broström with peroneal exploration cohort (P = .518). One patient medically discharged in the modified Broström only cohort versus 6 in peroneal exploration cohort (P = .109). Overall satisfaction with the procedure was 12 of 17 (71%) in the modified Broström only cohort and 19 of 24 (79%) in the peroneal exploration cohort (P = .529).</p><p><strong>Conclusions: </strong>No significant difference was identified between patients undergoing modified Broström alone or modified Broström with peroneal exploration. There was no significant difference in return to duty, medical discharge or patient satisfaction.</p><p><strong>Levels of evidence: </strong>Level III: retrospective case-control study with prospectively collected data.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39686512","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}
引用次数: 0
Syndesmotic Suture Button Fixation Results in Higher Tegner Activity Scale Scores When Compared to Screw Fixation: A Multicenter Investigation. 与螺钉固定术相比,缝合钮固定术可获得更高的泰格纳活动量表评分:一项多中心调查
Pub Date : 2024-06-01 Epub Date: 2023-05-26 DOI: 10.1177/19386400231174829
Mitchel R Obey, Kevin Schafer, Lauren M Matheny, Christopher M McAndrew, Michael J Gardner, William M Ricci, Thomas O Clanton, Jonathon D Backus

Background: Suture buttons and metal screws have been used and compared in biomechanical, radiographic, and clinical outcome studies for syndesmotic injuries, with neither implant demonstrating clear superiority. The aim of this study was to compare clinical outcomes of both implants.

Methods: Patients who underwent syndesmosis fixation at 2 separate academic centers from 2010 through 2017 were compared. Thirty-one patients treated with a suture button and 21 patients treated with screws were included. Patients in each group were matched by age, sex, and Orthopaedic Trauma Association fracture classification. Tegner Activity Scale (TAS), Foot and Ankle Ability Measure (FAAM), patient satisfaction score, surgical failure, and reoperation rates were compared.

Results: Patients who underwent suture button fixation had significantly higher TAS scores than those who underwent screw fixation (p < 0.001). There was no significant difference in FAAM ADL scores between cohorts (p = 0.08). Symptomatic hardware removal rates were similar (3.2% suture button cohort vs 9.0% in screw cohort). One patient (4.5%) underwent revision surgery secondary to syndesmotic malreduction after screw fixation, for a reoperation rate of 13.5%.

Conclusion: Patients with unstable syndesmotic injuries treated with suture button fixation had higher mean TAS scores compared to patients treated with screws. Foot and Ankle Ability Measure and ADL scores in these cohorts were similar.Level of Evidence: Level 3 Retrospective Matched Case-Cohort.

背景:在治疗巩膜损伤的生物力学、影像学和临床结果研究中,缝合钮扣和金属螺钉都曾被使用和比较过,但这两种植入物都没有显示出明显的优越性。本研究旨在比较两种植入物的临床效果:对 2010 年至 2017 年期间在两个独立的学术中心接受巩膜固定术的患者进行比较。31名患者接受了缝合扣治疗,21名患者接受了螺钉治疗。每组患者的年龄、性别和创伤骨科协会骨折分类相匹配。比较了泰格纳活动量表(TAS)、足踝能力测量(FAAM)、患者满意度评分、手术失败率和再手术率:接受缝合扣固定术的患者的 TAS 评分明显高于接受螺钉固定术的患者(P < 0.001)。两组患者的 FAAM ADL 评分无明显差异(p = 0.08)。无症状的硬件移除率相似(缝合扣组为3.2%,螺钉组为9.0%)。一名患者(4.5%)在螺钉固定后因巩膜错位而接受了翻修手术,再次手术率为13.5%:结论:与使用螺钉固定的患者相比,使用缝合扣固定治疗的不稳定巩膜损伤患者的平均TAS评分更高。这两组患者的足踝能力测量和ADL评分相似:3 级回顾性匹配病例队列。
{"title":"Syndesmotic Suture Button Fixation Results in Higher Tegner Activity Scale Scores When Compared to Screw Fixation: A Multicenter Investigation.","authors":"Mitchel R Obey, Kevin Schafer, Lauren M Matheny, Christopher M McAndrew, Michael J Gardner, William M Ricci, Thomas O Clanton, Jonathon D Backus","doi":"10.1177/19386400231174829","DOIUrl":"10.1177/19386400231174829","url":null,"abstract":"<p><strong>Background: </strong>Suture buttons and metal screws have been used and compared in biomechanical, radiographic, and clinical outcome studies for syndesmotic injuries, with neither implant demonstrating clear superiority. The aim of this study was to compare clinical outcomes of both implants.</p><p><strong>Methods: </strong>Patients who underwent syndesmosis fixation at 2 separate academic centers from 2010 through 2017 were compared. Thirty-one patients treated with a suture button and 21 patients treated with screws were included. Patients in each group were matched by age, sex, and Orthopaedic Trauma Association fracture classification. Tegner Activity Scale (TAS), Foot and Ankle Ability Measure (FAAM), patient satisfaction score, surgical failure, and reoperation rates were compared.</p><p><strong>Results: </strong>Patients who underwent suture button fixation had significantly higher TAS scores than those who underwent screw fixation (p < 0.001). There was no significant difference in FAAM ADL scores between cohorts (p = 0.08). Symptomatic hardware removal rates were similar (3.2% suture button cohort vs 9.0% in screw cohort). One patient (4.5%) underwent revision surgery secondary to syndesmotic malreduction after screw fixation, for a reoperation rate of 13.5%.</p><p><strong>Conclusion: </strong>Patients with unstable syndesmotic injuries treated with suture button fixation had higher mean TAS scores compared to patients treated with screws. Foot and Ankle Ability Measure and ADL scores in these cohorts were similar.<b>Level of Evidence:</b> Level 3 Retrospective Matched Case-Cohort.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"270-276"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9515131","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}
引用次数: 0
Syndesmosis Injury Contributes a Large Negative Effect on Clinical Outcomes: A Systematic Review. 鞘膜损伤对临床结果产生了巨大的负面影响:系统性综述。
Pub Date : 2024-06-01 Epub Date: 2022-01-20 DOI: 10.1177/19386400211067865
John J Heifner, Jack E Kilgore, Jennifer A Nichols, Christopher W Reb

Introduction: The literature largely addresses questions of diagnostic accuracy and therapeutic accuracy. However, the magnitude of the clinical impact of syndesmosis injury is commonly described in intuitive yet qualitative terms. This systematic review aimed to quantify the impact of syndesmosis injury.

Methods: Published clinical outcomes data were used to compute an effect size reflecting the impact of syndesmosis injury. This was done within the clinical contexts of isolated syndesmosis injury and syndesmosis injury with concomitant ankle fracture. Clinical outcomes data included Olerud-Molander (OM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale for pain, and days missed from sport competition. Parametric data were compared with Student t tests. Effect size was computed using Cohen's d.

Results: In ankle fracture patients, syndesmosis injury demonstrated a large effect size for OM (d = 0.96) and AOFAS (d = 0.83) scores. In athletic populations without concomitant ankle fracture, syndesmosis injury demonstrated a large effect size on days missed from competition (d = 2.32).

Discussion: These findings confirm the magnitude of the negative impact of syndesmosis injury in athletic populations with isolated injury and in ankle fracture patients. In ankle fracture patients, this large negative effect remains despite surgery. Thus, syndesmosis repair may not fully mitigate the impact of the injury.

Levels of evidence: Level III: Systematic review.

导言:文献主要讨论诊断准确性和治疗准确性的问题。然而,对于腓骨联合损伤的临床影响程度,通常采用直观但定性的方式进行描述。本系统性综述旨在量化巩膜损伤的影响:方法:使用已发表的临床结果数据来计算反映巩膜损伤影响的效应大小。这是在孤立的腓骨联合损伤和腓骨联合损伤伴有踝关节骨折的临床背景下进行的。临床结果数据包括奥勒鲁德-莫兰德(OM)和美国骨科足踝协会(AOFAS)评分、疼痛视觉模拟量表和运动比赛缺席天数。参数数据采用学生 t 检验进行比较。效应大小用 Cohen's d 计算:结果:在踝关节骨折患者中,巩膜损伤对 OM(d = 0.96)和 AOFAS(d = 0.83)评分的影响较大。在没有并发踝关节骨折的运动员中,踝关节联合损伤对比赛缺席天数(d = 2.32)的影响较大:讨论:这些研究结果证实了踝关节联合损伤对运动员和踝关节骨折患者的负面影响。在踝关节骨折患者中,尽管进行了手术,这种巨大的负面影响依然存在。因此,巩膜修复可能无法完全缓解损伤的影响:三级:系统综述。
{"title":"Syndesmosis Injury Contributes a Large Negative Effect on Clinical Outcomes: A Systematic Review.","authors":"John J Heifner, Jack E Kilgore, Jennifer A Nichols, Christopher W Reb","doi":"10.1177/19386400211067865","DOIUrl":"10.1177/19386400211067865","url":null,"abstract":"<p><strong>Introduction: </strong>The literature largely addresses questions of diagnostic accuracy and therapeutic accuracy. However, the magnitude of the clinical impact of syndesmosis injury is commonly described in intuitive yet qualitative terms. This systematic review aimed to quantify the impact of syndesmosis injury.</p><p><strong>Methods: </strong>Published clinical outcomes data were used to compute an effect size reflecting the impact of syndesmosis injury. This was done within the clinical contexts of isolated syndesmosis injury and syndesmosis injury with concomitant ankle fracture. Clinical outcomes data included Olerud-Molander (OM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale for pain, and days missed from sport competition. Parametric data were compared with Student t tests. Effect size was computed using Cohen's d.</p><p><strong>Results: </strong>In ankle fracture patients, syndesmosis injury demonstrated a large effect size for OM (d = 0.96) and AOFAS (d = 0.83) scores. In athletic populations without concomitant ankle fracture, syndesmosis injury demonstrated a large effect size on days missed from competition (d = 2.32).</p><p><strong>Discussion: </strong>These findings confirm the magnitude of the negative impact of syndesmosis injury in athletic populations with isolated injury and in ankle fracture patients. In ankle fracture patients, this large negative effect remains despite surgery. Thus, syndesmosis repair may not fully mitigate the impact of the injury.</p><p><strong>Levels of evidence: </strong>Level III: Systematic review.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"284-294"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697216","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}
引用次数: 0
Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery. 合成弹性可降解基质用于足踝外科软组织重建的安全性简介
Pub Date : 2024-06-01 Epub Date: 2021-12-30 DOI: 10.1177/19386400211067627
Michael J Kelly, Daniel M Dean, Syed H Hussaini, Steven K Neufeld, Daniel J Cuttica

Background: Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle.

Methods: A retrospective chart review of consecutive patients who underwent surgery using FlexBand to augment a soft tissue repair was performed to evaluate for major and minor complications related to the PUUR matrix. Results. A total of 105 patients with an average >6 months follow-up were included. The most common procedures were spring ligament repair, Achilles tendon repair, and Brostrom. There were 12 complications. Four major complications occurred with only 1 requiring PUUR matrix removal. Patients with wound complications had a higher body mass index (BMI) and rate of smoking.

Conclusion: Complication rates involving PUUR matrix in soft tissue foot and ankle reconstruction procedures are low and comparable with historical complication rates. The PUUR matrix is safe for use in a variety of soft tissue procedures about the foot and ankle.Level of Evidence: Level 4, Retrospective case-series.

背景:增强软组织修复有助于在愈合过程中保护手术修复的组织。FlexBand(Artelon,马里埃塔,佐治亚州)是一种合成的、可降解的、基于聚己内酯的聚氨酯脲(PUUR)基质,已被研究并用于多种情况下的软组织修复。本研究的目的是评估PUUR基质在一大批接受足踝软组织修复的患者中的安全性:方法:对使用 FlexBand 进行手术以增强软组织修复的连续患者进行回顾性病历审查,以评估与 PUUR 基质相关的主要和次要并发症。结果。共纳入 105 名患者,平均随访时间超过 6 个月。最常见的手术是弹簧韧带修复、跟腱修复和 Brostrom。共有 12 例并发症。主要并发症有4例,只有1例需要移除PUUR基质。伤口并发症患者的体重指数(BMI)和吸烟率都较高:结论:PUUR基质在足踝软组织重建手术中的并发症发生率较低,与历史并发症发生率相当。PUUR基质可安全用于各种足踝软组织手术:4级,回顾性病例系列。
{"title":"Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery.","authors":"Michael J Kelly, Daniel M Dean, Syed H Hussaini, Steven K Neufeld, Daniel J Cuttica","doi":"10.1177/19386400211067627","DOIUrl":"10.1177/19386400211067627","url":null,"abstract":"<p><strong>Background: </strong>Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle.</p><p><strong>Methods: </strong>A retrospective chart review of consecutive patients who underwent surgery using FlexBand to augment a soft tissue repair was performed to evaluate for major and minor complications related to the PUUR matrix. <i>Results</i>. A total of 105 patients with an average >6 months follow-up were included. The most common procedures were spring ligament repair, Achilles tendon repair, and Brostrom. There were 12 complications. Four major complications occurred with only 1 requiring PUUR matrix removal. Patients with wound complications had a higher body mass index (BMI) and rate of smoking.</p><p><strong>Conclusion: </strong>Complication rates involving PUUR matrix in soft tissue foot and ankle reconstruction procedures are low and comparable with historical complication rates. The PUUR matrix is safe for use in a variety of soft tissue procedures about the foot and ankle.<b>Level of Evidence:</b> Level 4, Retrospective case-series.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"201-207"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39633745","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}
引用次数: 0
The Fifth Metatarsal Shaft Fracture Is Well Treated With Benign Neglect. 第五跖骨轴骨折可通过良性忽视得到很好的治疗。
Pub Date : 2024-06-01 Epub Date: 2021-11-10 DOI: 10.1177/19386400211056810
Leah J Gonzalez, Joseph R Johnson, Sanjit R Konda, Kenneth A Egol

Background. Spiral fifth metatarsal fractures have been studied previously in professional dancers. However, little has been reported about outcomes of these injuries in the general population. The objective of this study was to examine patient demographics of those who sustain this injury and their functional outcomes, as stratified by treatment type. Methods. A total of 186 "nonprofessional dancer" patients with a fifth metatarsal fracture who were treated by one orthopaedic surgeon at our academic medical center were identified through chart review. All patients were allowed to weight bearing as tolerated (WBAT). Time to healing, persistence of pain, range of motion, and complications were recorded. Independent samples t tests, 1-way analysis of variance, and Fisher exact tests were used for analysis. Results. Thirty-seven of the 186 patients with fifth metatarsal fractures reviewed were identified as having a spiral fifth metatarsal fracture with appropriate follow-up. The cohort was 78.4% female with a mean age of 50.3 years. Twenty-two were initially treated in a controlled ankle motion (CAM) boot, 14 in a postoperative shoe, and 1 continued in their own shoes. All patients were allowed to WBAT. All fractures healed by a mean of 3.1 months. By the end of the follow-up period, 67.6% of patients had full range of ankle motion, with 5.4% reporting feeling stiff, 27.0% reporting mild persistent pain, and 2.7% reporting significant persistent pain. Conclusion. Fifth metatarsal shaft ("Dancer's") fractures occur within the general population, not only among professional dancers. Without operative fixation and regardless of nonoperative treatment selected, these fractures heal reliably and do so without clinically relevant complication.Level of Evidence: Level III: Retrospective comparative study.

背景。以前曾对专业舞蹈演员的第五跖骨螺旋形骨折进行过研究。然而,关于此类损伤在普通人群中的治疗效果却鲜有报道。本研究的目的是根据治疗类型的不同,研究此类损伤患者的人口统计学特征及其功能性结果。研究方法通过病历审查,共确定了 186 名第五跖骨骨折的 "非职业舞蹈演员 "患者,这些患者均在本学术医疗中心接受过一名骨科医生的治疗。所有患者均可在耐受情况下负重(WBAT)。记录痊愈时间、持续疼痛、活动范围和并发症。采用独立样本 t 检验、单因素方差分析和费雪精确检验进行分析。结果在接受复查的 186 例第五跖骨骨折患者中,有 37 例被确定为螺旋形第五跖骨骨折,并进行了适当的随访。其中 78.4% 为女性,平均年龄为 50.3 岁。22名患者最初穿着受控踝关节运动(CAM)靴接受治疗,14名患者穿着术后鞋,1名患者继续穿着自己的鞋。所有患者均可进行 WBAT。所有骨折的平均愈合时间为 3.1 个月。在随访期结束时,67.6%的患者踝关节可以完全活动,5.4%的患者感觉僵硬,27.0%的患者有轻微持续性疼痛,2.7%的患者有明显持续性疼痛。结论第五跖骨轴("舞者")骨折发生在普通人群中,而不仅限于专业舞蹈演员。无论选择哪种非手术治疗方法,这些骨折在不进行手术固定的情况下都能可靠愈合,并且不会出现临床相关的并发症:证据等级:三级:回顾性比较研究。
{"title":"The Fifth Metatarsal Shaft Fracture Is Well Treated With Benign Neglect.","authors":"Leah J Gonzalez, Joseph R Johnson, Sanjit R Konda, Kenneth A Egol","doi":"10.1177/19386400211056810","DOIUrl":"10.1177/19386400211056810","url":null,"abstract":"<p><p><i>Background.</i> Spiral fifth metatarsal fractures have been studied previously in professional dancers. However, little has been reported about outcomes of these injuries in the general population. The objective of this study was to examine patient demographics of those who sustain this injury and their functional outcomes, as stratified by treatment type. <i>Methods.</i> A total of 186 \"nonprofessional dancer\" patients with a fifth metatarsal fracture who were treated by one orthopaedic surgeon at our academic medical center were identified through chart review. All patients were allowed to weight bearing as tolerated (WBAT). Time to healing, persistence of pain, range of motion, and complications were recorded. Independent samples <i>t</i> tests, 1-way analysis of variance, and Fisher exact tests were used for analysis. <i>Results.</i> Thirty-seven of the 186 patients with fifth metatarsal fractures reviewed were identified as having a spiral fifth metatarsal fracture with appropriate follow-up. The cohort was 78.4% female with a mean age of 50.3 years. Twenty-two were initially treated in a controlled ankle motion (CAM) boot, 14 in a postoperative shoe, and 1 continued in their own shoes. All patients were allowed to WBAT. All fractures healed by a mean of 3.1 months. By the end of the follow-up period, 67.6% of patients had full range of ankle motion, with 5.4% reporting feeling stiff, 27.0% reporting mild persistent pain, and 2.7% reporting significant persistent pain. <i>Conclusion</i>. Fifth metatarsal shaft (\"Dancer's\") fractures occur within the general population, not only among professional dancers. Without operative fixation and regardless of nonoperative treatment selected, these fractures heal reliably and do so without clinically relevant complication.<b>Level of Evidence:</b> Level III: Retrospective comparative study.</p>","PeriodicalId":73046,"journal":{"name":"Foot & ankle specialist","volume":" ","pages":"189-193"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39857455","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}
引用次数: 0
期刊
Foot & ankle specialist
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1