Foot & ankle surgery (New York, N.Y.)最新文献

英文中文

Letter to the editor regarding “Periarticular open wedge osteotomy for severe valgus deformity and associated rearfoot talar coalitions”

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-26 DOI: 10.1016/j.fastrc.2024.100457

Balachandar Gopalan DNB Orth, ChM Tr & Orth (Consultant Orthopaedic Surgeon)

引用次数: 0

Conservative management of a 63-year-old athlete with a full-thickness tear of the second metatarsophalangeal plantar plate: A case report with 48 months follow-up

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-25 DOI: 10.1016/j.fastrc.2024.100461

Jacek Cholewicki PhD , Michael P Swords DO , John M Popovich Jr. PhD, DPT, ATC , Ryan S Fajardo MD

Plantar plate (PP) tears often necessitate surgical intervention to address concerns of progressive toe deformity and impaired function, particularly in the case of full-thickness PP tears or when conservative treatment fails. There is currently a lack of level 1 or 2 evidence regarding the efficacy of surgical versus non-surgical approaches to guide the management of plantar plate tears, especially for older individuals. This case presents a successful conservative management of a 63-year-old male recreational athlete/competitive skier with a full-thickness PP tear. The patient presented with a history of worsening pain around the left second metatarsophalangeal (MTP) joint, accompanied by a visible medial toe deviation and loss of toe purchase. Based on the history, physical exam, and MRI findings, the diagnosis of a subacute, full-thickness PP tear at the phalangeal attachment of the second MTP joint was made. During the surgical consultation, the patient was presented with both surgical and conservative treatment options and opted for conservative management. Conservative treatment consisted of avoiding activities requiring toe extension, carbon fiber insoles, a metatarsal pad, and sling taping of the toe for walking and other activities. He also performed daily toe plantarflexion stretches and used night splint taping with the second toe in 10-20 degrees of plantarflexion. At the 7-month follow-up, the patient was pain-free and had a notable reduction in toe deformity. The serial MRI findings revealed evolving scarring, with complete scar formation evident on the 19-month follow-up MRI. At the most recent follow-up, the patient remained physically active and pain-free 4 years after initiating treatment.

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引用次数: 0

A rare case of fibroma of a tendon-sheath of the fourth toe: A case report

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-24 DOI: 10.1016/j.fastrc.2024.100460

Thanh Thao Nguyen DPM, MPH , John M. Giurini DPM, FACFAS

Fibroma of the tendon sheath (FTS) arising from the extensor tendon of a toe is a rare event. A review of the literature reveals less than 10 such cases. The current case report describes such a very rare tumor arising from the extensor digitorum longus tendon in a 61-year old male patient. The patient presented with a 6-month history of a progressive localized swelling of his left fourth toe. The tumor was diagnosed based on clinical, radiographic, surgical and histopathologic findings. By presenting this case report, the authors hope to call attention to this rare condition as a possible differential diagnosis in patients presenting with a soft tissue mass involving the toes.

引用次数: 0

Pseudoaneurysm of the posterior tibial artery after posterior ankle arthroscopy

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-21 DOI: 10.1016/j.fastrc.2024.100458

Tobias Finck , Peter Savov , Sarah Ettinger , Matthias Lerch , Christina Stukenborg-Colsman , Jörn Tongers , Thomas Aper , Christian Plaass

The risk of vascular injury during arthroscopy of the upper ankle joint was known for the anterior approach. We present a case of a pseudoaneurysm of the posterior tibial artery after posterior ankle arthroscopy. Five weeks after posterior ankle arthroscopy a painful swelling developed posterior to the medial malleolus. Duplex ultrasonography was performed and confirmed the diagnosis of a pseudoaneurysm. Subsequently, the patient was presented to the vascular surgery department and underwent reconstruction. Nevertheless, even four years after the initial surgery, the patient is still not free of symptoms. Despite the greatest care during the treatment, vascular injuries can occur after posterior ankle arthroscopy with lasting pain for the patient.

引用次数: 0

Podiatry hospitalists shaping the future of podiatric hospital care

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-16 DOI: 10.1016/j.fastrc.2024.100456

Sara E. Lewis DPM, MHA

引用次数: 0

The management of non-union following minimally invasive bunion surgery

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-16 DOI: 10.1016/j.fastrc.2024.100455

Gil Genuth M.D. , Rachel Thompson B.A. , Amanda Zeng B.A. , Nick Cullen M.D. , Andrew Goldberg M.D. , A. Holly Johnson M.D.

As the use of minimally invasive surgery (MIS) becomes more prevalent for the correction of hallux valgus deformity, there is increased information on complications following the procedure, including non-union. However, there remains a gap in literature relating to the management of symptomatic non-union following MIS. This retrospective, multicenter study investigates the incidence, risk factors, and outcomes of symptomatic non-union following MIS bunion surgery. Among four orthopedic institutions, 17 cases of symptomatic non-union were identified after MIS bunion surgery between June 2018 and January 2024, representing an estimated prevalence rate of 0.3 %. Risk factors including smoking, Vitamin D deficiency, and comorbidities such as diabetes and Lyme disease were noted in some cases, although no obvious risk factors were found to contribute to the development of non-union after MIS bunion surgery performed using a distal metatarsal osteotomy and proximal phalanx osteotomy. Both open and MIS approaches were employed for revision surgeries, with 67 % performed as open surgeries. 14 of 17 (82 %) non-union cases achieved complete healing following revision surgery, with an average time to union of 11 weeks. This study highlights both open and MIS techniques as preliminary treatment protocols for symptomatic non-union following MIS bunion surgery, providing guidance for surgeons on how to manage this rare, but challenging, complication.

{"title":"The management of non-union following minimally invasive bunion surgery","authors":"Gil Genuth M.D. , Rachel Thompson B.A. , Amanda Zeng B.A. , Nick Cullen M.D. , Andrew Goldberg M.D. , A. Holly Johnson M.D.","doi":"10.1016/j.fastrc.2024.100455","DOIUrl":"10.1016/j.fastrc.2024.100455","url":null,"abstract":"<div><div>As the use of minimally invasive surgery (MIS) becomes more prevalent for the correction of hallux valgus deformity, there is increased information on complications following the procedure, including non-union. However, there remains a gap in literature relating to the management of symptomatic non-union following MIS. This retrospective, multicenter study investigates the incidence, risk factors, and outcomes of symptomatic non-union following MIS bunion surgery. Among four orthopedic institutions, 17 cases of symptomatic non-union were identified after MIS bunion surgery between June 2018 and January 2024, representing an estimated prevalence rate of 0.3 %. Risk factors including smoking, Vitamin D deficiency, and comorbidities such as diabetes and Lyme disease were noted in some cases, although no obvious risk factors were found to contribute to the development of non-union after MIS bunion surgery performed using a distal metatarsal osteotomy and proximal phalanx osteotomy. Both open and MIS approaches were employed for revision surgeries, with 67 % performed as open surgeries. 14 of 17 (82 %) non-union cases achieved complete healing following revision surgery, with an average time to union of 11 weeks. This study highlights both open and MIS techniques as preliminary treatment protocols for symptomatic non-union following MIS bunion surgery, providing guidance for surgeons on how to manage this rare, but challenging, complication.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100455"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isolated proximal dislocation of fibular sesamoid of the great toe: A rare and overlooked pathology

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-05 DOI: 10.1016/j.fastrc.2024.100454

Antigoni Gkoudina , Konstantinos Makiev , Kosmas Petras , Michael Iosifidis , Efthymios Iliopoulos

Isolated traumatic hallucal sesamoid dislocation represents a rare entity in the annals of orthopaedic foot trauma. Only a few publications limited to case reports exist hitherto in the literature. Herein we report the case of a male adolescent with proximal traumatic dislocation of the fibular sesamoid, managed surgically with open reduction and repair of ruptured first MTP joint capsule. At three months follow up, the patient was asyptomatic and had fully resumed his normal daily activities.

引用次数: 0

Minimally invasive treatment of Talar neck fractures using the calcaneal distractor - a technical note

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-03 DOI: 10.1016/j.fastrc.2024.100452

M. Katzensteiner , M. Bischofreiter , G. Schalamon , R. Ortmaier , Ch. Rodemund , G. Mattiassich

Talar neck fractures, though rare, pose significant challenges in treatment due to their complex nature and potential for severe complications. Despite the fact that most of talar fractures are treated operatively, there is scarcity of clear recommendations concerning appropriate surgical technique and care. Historically, conservative management was favored, but open reduction and internal fixation (ORIF) have become the standard of care. However, merely restoring rotation, axis, and length is insufficient; restoring the articulating surface in an anatomical manner is essential for long-term joint health. Surgical access to the fracture site via anteromedial and anterolateral approaches provides visualization, but risks compromising the sensitive, partly retrograde blood supply to the talar body. While being biomechanically superior, screws inserted from a posterior to anterior direction pose challenges in soft tissue preservation and accurate placement. Despite widespread usage of this technique, postoperative outcomes remain suboptimal with considerable rates of malunion, osteonecrosis and osteoarthritis. An overlooked technique in the literature is the use of a distractor, commonly employed in minimally-invasive surgical calcaneal fracture treatment in order to maintain length, alignment and joint reposition during fixation. With the potential to reduce soft tissue damage and preserve the blood supply minimally invasive techniques present a promising advancement in fracture management of talar neck fractures.

{"title":"Minimally invasive treatment of Talar neck fractures using the calcaneal distractor - a technical note","authors":"M. Katzensteiner , M. Bischofreiter , G. Schalamon , R. Ortmaier , Ch. Rodemund , G. Mattiassich","doi":"10.1016/j.fastrc.2024.100452","DOIUrl":"10.1016/j.fastrc.2024.100452","url":null,"abstract":"<div><div>Talar neck fractures, though rare, pose significant challenges in treatment due to their complex nature and potential for severe complications. Despite the fact that most of talar fractures are treated operatively, there is scarcity of clear recommendations concerning appropriate surgical technique and care. Historically, conservative management was favored, but open reduction and internal fixation (ORIF) have become the standard of care. However, merely restoring rotation, axis, and length is insufficient; restoring the articulating surface in an anatomical manner is essential for long-term joint health. Surgical access to the fracture site via anteromedial and anterolateral approaches provides visualization, but risks compromising the sensitive, partly retrograde blood supply to the talar body. While being biomechanically superior, screws inserted from a posterior to anterior direction pose challenges in soft tissue preservation and accurate placement. Despite widespread usage of this technique, postoperative outcomes remain suboptimal with considerable rates of malunion, osteonecrosis and osteoarthritis. An overlooked technique in the literature is the use of a distractor, commonly employed in minimally-invasive surgical calcaneal fracture treatment in order to maintain length, alignment and joint reposition during fixation. With the potential to reduce soft tissue damage and preserve the blood supply minimally invasive techniques present a promising advancement in fracture management of talar neck fractures.</div></div>","PeriodicalId":73047,"journal":{"name":"Foot & ankle surgery (New York, N.Y.)","volume":"5 1","pages":"Article 100452"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The complexities of self-harm in foot & ankle surgery

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-01 DOI: 10.1016/j.fastrc.2024.100453

Preeti Kumrah DPM, MS , Niral A. Patel DPM, MS , Kayli Hurst DPM, MS , Patrick A. Deheer DPM

This paper delves into the complexities of self-harm within the context of foot and ankle surgery, an aspect often overlooked in the surgical realm. Mental health's impact on surgical outcomes, particularly in podiatric surgery, is explored, emphasizing the need for routine pre-operative mental health assessments. The prevalence of mental health disorders in patients with musculoskeletal conditions, their influence on pain perception, and the interplay with immune system dysregulation are discussed. Recognizing the intricacies of self-harm, the paper provides guidelines for practitioners to navigate these conditions, including the importance of compassionate responses, motivational interviewing techniques, and specialized psychiatric referrals. Screening tools for anxiety are outlined, and considerations for wound management in cases of self-inflicted injuries are detailed. The paper highlights the effects of self-harm on surgical outcomes, including complications, prolonged recovery, and challenges in post-operative care adherence. Treatment recommendations encompass preoperative screening, patient education, anxiety-reduction techniques, medication management, and a multidisciplinary approach involving mental health professionals. The conclusion advocates for a collaborative care model between podiatric surgeons and mental health professionals, emphasizing the significance of preoperative psychological evaluations in optimizing surgical outcomes and providing holistic podiatric care. The paper also identifies areas for future research, including the direct impacts of self-harm on postoperative outcomes and wound healing, and the need for further assessment in podiatric procedures.

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引用次数: 0

About the Journal

Foot & ankle surgery (New York, N.Y.)

Pub Date : 2024-12-01 DOI: 10.1016/S2667-3967(24)00087-9

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