Pub Date : 2018-11-09DOI: 10.4172/2329-910X.1000280
Graham Me, L. Kolodziej, Kimmel Hm
Objective: Subtalar joint instability creates misalignment of talus on the calcaneus. The loss of talar alignment and stability leads to a prolonged period of foot pronation during the stance phase of the gait cycle. Over or hyperpronation is known as a contributing factor to the progression of hallux valgus (HV) and hallux limitus/rigidus (HL/R). The purpose of this retrospective radiographic study is to evaluate the number of adult patients (feet) diagnosed with HV and HL/R who underwent surgical correction within a one year period.Methods: Pre-operative weightbearing radiographs for one-hundred five feet, that met the inclusion criteria, were retrospectively analyzed. Both transverse (talar second metatarsal (T2M)) and sagittal (talar declination (TD)) plane angular measurements were independently calculated and compared to normal values based on literature.Results: In this study, 97 (92.38%) of 105 feet with HV and HL/R had values above normal for at least one of the T2M and/or TD angle indicating an abnormal talar alignment. The mean T2M was 21.88 ± 7.95 (range 1.13 to 50.58 degrees) and the mean TD was 23.45 ± 3.94 (range 14.75 to 34.24 degrees). Forty (38.1%) feet exhibited a single plane deformity and 57 (54.28%) comprised of a both transverse and sagittal plane deformities.Conclusion: This supports the hypothesis that a correlation between subtalar joint instability and HV or HL/R exists. This hind foot deformity should be considered as a contributing factor in the progression of 1st MPJ pathology.
{"title":"The Frequency of Subtalar Joint Instability in Adult Patients Who Underwent Surgical Correction of First Metatarsophalangeal Joint Surgery-A Retrospective Radiographic Evaluation","authors":"Graham Me, L. Kolodziej, Kimmel Hm","doi":"10.4172/2329-910X.1000280","DOIUrl":"https://doi.org/10.4172/2329-910X.1000280","url":null,"abstract":"Objective: Subtalar joint instability creates misalignment of talus on the calcaneus. The loss of talar alignment and stability leads to a prolonged period of foot pronation during the stance phase of the gait cycle. Over or hyperpronation is known as a contributing factor to the progression of hallux valgus (HV) and hallux limitus/rigidus (HL/R). The purpose of this retrospective radiographic study is to evaluate the number of adult patients (feet) diagnosed with HV and HL/R who underwent surgical correction within a one year period.Methods: Pre-operative weightbearing radiographs for one-hundred five feet, that met the inclusion criteria, were retrospectively analyzed. Both transverse (talar second metatarsal (T2M)) and sagittal (talar declination (TD)) plane angular measurements were independently calculated and compared to normal values based on literature.Results: In this study, 97 (92.38%) of 105 feet with HV and HL/R had values above normal for at least one of the T2M and/or TD angle indicating an abnormal talar alignment. The mean T2M was 21.88 ± 7.95 (range 1.13 to 50.58 degrees) and the mean TD was 23.45 ± 3.94 (range 14.75 to 34.24 degrees). Forty (38.1%) feet exhibited a single plane deformity and 57 (54.28%) comprised of a both transverse and sagittal plane deformities.Conclusion: This supports the hypothesis that a correlation between subtalar joint instability and HV or HL/R exists. This hind foot deformity should be considered as a contributing factor in the progression of 1st MPJ pathology.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45292204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-01DOI: 10.4172/2329-910X.1000281
P. D’Hooghe, C. Joyce, K. Hunt, J. Kaux
Chronic ankle instability is associated with a number of coincident injuries about the ankle joint. Improvements in ankle arthroscopy and preoperative imaging modalities have aided in the identification and treatment of these lesions. Although their clinical significance may be variable, the presence of concomitant lesions in chronic ankle instability predisposes patients to chronic pain and osteoarthritis. A comprehensive review of the literature reveals that a multitude of studies have described associated lesions in patients with chronic ankle instability. These lesions include peroneal tendon injuries, chondral and osteochondral lesions of the tibial plafond and talar dome, intraarticular loose bodies, anterior/anterolateral ankle soft tissue impingement, lateral malleolus ossicles, tibiofibular syndesmosis injuries, and peroneal nerve injuries. This review serves as a comprehensive analysis of the literature, focusing on identification, treatment, and long-term outcomes of concomitant injuries in chronic ankle instability.
{"title":"Concomitant injuries in chronic ankle instability","authors":"P. D’Hooghe, C. Joyce, K. Hunt, J. Kaux","doi":"10.4172/2329-910X.1000281","DOIUrl":"https://doi.org/10.4172/2329-910X.1000281","url":null,"abstract":"Chronic ankle instability is associated with a number of coincident injuries about the ankle joint. Improvements in ankle arthroscopy and preoperative imaging modalities have aided in the identification and treatment of these lesions. Although their clinical significance may be variable, the presence of concomitant lesions in chronic ankle instability predisposes patients to chronic pain and osteoarthritis. A comprehensive review of the literature reveals that a multitude of studies have described associated lesions in patients with chronic ankle instability. These lesions include peroneal tendon injuries, chondral and osteochondral lesions of the tibial plafond and talar dome, intraarticular loose bodies, anterior/anterolateral ankle soft tissue impingement, lateral malleolus ossicles, tibiofibular syndesmosis injuries, and peroneal nerve injuries. This review serves as a comprehensive analysis of the literature, focusing on identification, treatment, and long-term outcomes of concomitant injuries in chronic ankle instability.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45793245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-15DOI: 10.4172/2329-910X.1000268
I. Frangež, H. Klar, T. Nizič-Kos
Background: Charcot neuroarthropathy is potentially a limb-threatening disease, most commonly associated with diabetes mellitus. Early diagnosis is a key factor in the management and plays a central role in the prevention of severe deformity. Conservative treatment remains the gold standard for most patients with acute stage of the Charcot neuroarthropathy. Surgery is usually reserved for patients with severe or unstable deformities that are refractory to conservative treatment. The aim of this article is to provide a brief overview of the Charcot neuroarthropathy and to present our experience in surgical treatment of patients with this condition.Methods: 14 patients with Charcot neuroarthropathy and clinically unstable foot with a major dislocation in Lisfranc joint, stadius Eichenholz II, treated from January 2016 to September 2017 at University Medical Centre Ljubljana, were included in the study. Primary they were treated conservatively, until the acute edema, increased local temperature and redness were gone. All patients underwent an open reduction and internal fixation with plates or with intramedullary nails and plates.Results: Successful recovery was obtained in all 14 cases, achieving stable foot. No postoperative complications were observed during the follow-ups.Conclusion: Successful surgical treatment with internal fixation with plates or with intramedullary nail or plate, improved our patients quality of life. Based on our experience delayed open reduction and internal fixation of acute unstable Charcot foot is good and appropriate technique especially for patients without coexisting infections or macroangiopathy.
{"title":"Our Experience with Internal Fixation of Unstable Charcot Foot with Intramedullary Nail and Plate","authors":"I. Frangež, H. Klar, T. Nizič-Kos","doi":"10.4172/2329-910X.1000268","DOIUrl":"https://doi.org/10.4172/2329-910X.1000268","url":null,"abstract":"Background: Charcot neuroarthropathy is potentially a limb-threatening disease, most commonly associated with diabetes mellitus. Early diagnosis is a key factor in the management and plays a central role in the prevention of severe deformity. Conservative treatment remains the gold standard for most patients with acute stage of the Charcot neuroarthropathy. Surgery is usually reserved for patients with severe or unstable deformities that are refractory to conservative treatment. The aim of this article is to provide a brief overview of the Charcot neuroarthropathy and to present our experience in surgical treatment of patients with this condition.Methods: 14 patients with Charcot neuroarthropathy and clinically unstable foot with a major dislocation in Lisfranc joint, stadius Eichenholz II, treated from January 2016 to September 2017 at University Medical Centre Ljubljana, were included in the study. Primary they were treated conservatively, until the acute edema, increased local temperature and redness were gone. All patients underwent an open reduction and internal fixation with plates or with intramedullary nails and plates.Results: Successful recovery was obtained in all 14 cases, achieving stable foot. No postoperative complications were observed during the follow-ups.Conclusion: Successful surgical treatment with internal fixation with plates or with intramedullary nail or plate, improved our patients quality of life. Based on our experience delayed open reduction and internal fixation of acute unstable Charcot foot is good and appropriate technique especially for patients without coexisting infections or macroangiopathy.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46729508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-04DOI: 10.4172/2329-910X.1000265
P. D’Hooghe, Axibal Dp, Fuld Rs, Sutphin Bs, K. Hunt
Background: Ankle sprains are very common injuries among athletic populations. Sparse data exists regarding return to play (RTP) following common lateral ligament repairs. Our purpose is to compare RTP timelines and outcomes between open and arthroscopic treatment of lateral ankle instability in athletes.Methods: In this systematic review, MEDLINE and EMBASE searches were performed to identify available literature through November 2017 describing open and/or arthroscopic treatment of lateral ankle instability in athletes, their outcomes, and a RTP timeline.Results: A total of ten studies met criteria. 174 athletes were treated with open ankle instability procedures (9 studies) and 19 athletes were treated with arthroscopic procedures (1 study). 167/174 patients with open treatment returned to sport (96% RTP rate, weighted mean RTP timeline of 2.85 months). In comparison, all 19 patients in the arthroscopic group returned to sport (100% RTP rate, weighted mean RTP timeline of 3.794 months).Conclusion: Very few articles describing outcomes of lateral ligament repair in athletes include return to play metrics. Considering the data available, athletes treated with open ankle ligament repair procedures (nine studies with 167 athletes) returned to play almost 1 month earlier than athletes treated with arthroscopic procedures (1 study with 19 athletes). As timing of return to activities is a valuable metric to compare surgical and rehabilitative techniques, more studies that detail return to sport are needed as part of a description of ankle ligament repairs.
{"title":"Return to Play Following Arthroscopic vs. Open Treatment of Lateral Ankle Instability in Recreational/Athletic","authors":"P. D’Hooghe, Axibal Dp, Fuld Rs, Sutphin Bs, K. Hunt","doi":"10.4172/2329-910X.1000265","DOIUrl":"https://doi.org/10.4172/2329-910X.1000265","url":null,"abstract":"Background: Ankle sprains are very common injuries among athletic populations. Sparse data exists regarding return to play (RTP) following common lateral ligament repairs. Our purpose is to compare RTP timelines and outcomes between open and arthroscopic treatment of lateral ankle instability in athletes.Methods: In this systematic review, MEDLINE and EMBASE searches were performed to identify available literature through November 2017 describing open and/or arthroscopic treatment of lateral ankle instability in athletes, their outcomes, and a RTP timeline.Results: A total of ten studies met criteria. 174 athletes were treated with open ankle instability procedures (9 studies) and 19 athletes were treated with arthroscopic procedures (1 study). 167/174 patients with open treatment returned to sport (96% RTP rate, weighted mean RTP timeline of 2.85 months). In comparison, all 19 patients in the arthroscopic group returned to sport (100% RTP rate, weighted mean RTP timeline of 3.794 months).Conclusion: Very few articles describing outcomes of lateral ligament repair in athletes include return to play metrics. Considering the data available, athletes treated with open ankle ligament repair procedures (nine studies with 167 athletes) returned to play almost 1 month earlier than athletes treated with arthroscopic procedures (1 study with 19 athletes). As timing of return to activities is a valuable metric to compare surgical and rehabilitative techniques, more studies that detail return to sport are needed as part of a description of ankle ligament repairs.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47321829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-04-03DOI: 10.4172/2329-910X.1000264
C. Roll, B. Kinner
Background: Peripheral talar fractures are rare injuries. They comprise fractures of the lateral process, the lateral and medial tubercle of the posterior process, the medio-caudal ridge, and traumatic osteochondral fractures of the lateral talar dome. The objective of this observational case series was to report the clinical and radiological outcome after surgical treatment.Methods: 16 peripheral talar fractures could be included in this retrospective case series. All patients were treated operatively and followed for a minimum of 12 months. Clinical and radiological outcome were recorded.Results: Mean follow-up was 16 months. 13 subjects presented with concomitant injuries. 2 patients suffered an additional spine fractures, and 4 patients were polytraumatized. No non-union or mal-union were observed. One patient needed subtalar and calcaneo-cuboidal fusion during follow up due to a concomitant calcaneal fracture. Other secondary procedures like implant removal were necessary in 5/16 subjects. During the last follow-up the recorded AOFAS score (mean ± SD) was 87.3 ± 6.6 and the EQ5-D (mean ± SD) 0.91 ± 0.06.Conclusion: With early diagnosis and timely surgical treatment good results can be expected after peripheral fractures of the talus. Less favourable outcomes are usually associated with concomitant injuries.
{"title":"Peripheral Talus Fractures-A Clinical Observational Study of 16 Cases","authors":"C. Roll, B. Kinner","doi":"10.4172/2329-910X.1000264","DOIUrl":"https://doi.org/10.4172/2329-910X.1000264","url":null,"abstract":"Background: Peripheral talar fractures are rare injuries. They comprise fractures of the lateral process, the lateral and medial tubercle of the posterior process, the medio-caudal ridge, and traumatic osteochondral fractures of the lateral talar dome. The objective of this observational case series was to report the clinical and radiological outcome after surgical treatment.Methods: 16 peripheral talar fractures could be included in this retrospective case series. All patients were treated operatively and followed for a minimum of 12 months. Clinical and radiological outcome were recorded.Results: Mean follow-up was 16 months. 13 subjects presented with concomitant injuries. 2 patients suffered an additional spine fractures, and 4 patients were polytraumatized. No non-union or mal-union were observed. One patient needed subtalar and calcaneo-cuboidal fusion during follow up due to a concomitant calcaneal fracture. Other secondary procedures like implant removal were necessary in 5/16 subjects. During the last follow-up the recorded AOFAS score (mean ± SD) was 87.3 ± 6.6 and the EQ5-D (mean ± SD) 0.91 ± 0.06.Conclusion: With early diagnosis and timely surgical treatment good results can be expected after peripheral fractures of the talus. Less favourable outcomes are usually associated with concomitant injuries.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44108129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-03-15DOI: 10.4172/2329-910X.1000263
Ashish Batra, J. O’Sullivan, D. Nicholson, P. Rao
Background: The Achilles tendon is the most frequently ruptured tendon in the body and its incidence is increasing, more so among athletes. Various surgical techniques exist for treating it and one of these is as discussed in this study, Achilles tendon injury treated with Knotless PARS (Arthrex) that allows for earlier weight bearing and mobilization and, therefore, faster rehabilitation and an improved functional outcome. Aim: The post-operative progress of patients, specifically athletes subset with Achilles tendon injury treated with Knotless PARS is discussed in this article using Newcastle Orthopaedic Foot and Ankle Score (NOFAS). Methods: We retrospectively evaluated the patients operated on between March 2015 and January, 2017, 19 feet of 19 patients diagnosed with acute Achilles tendon rupture were treated. All clinical outcomes were examined using the Newcastle Orthopaedic Foot and Ankle Score (NOFAS) in patients operated in the last 28 months after the operation. We measured their progress in 3 categories as follows: (1) Improvement in pain and symptoms. (2) Recovery and lifestyle improvement and (3) Motion and activity. Conclusion: The study suggests that the post-operative progress of patients with Achilles tendon injury treated with Knotless PARS (Arthrex) is strong, but the best results only appear in patients post 12 months of their surgery. We suggest, prospective and comparative studies will help for further research of this subject.
{"title":"Post-Operative Outcome of Achilles Tendon Injury Treated with Knotless Percutaneous Achilles Repair System","authors":"Ashish Batra, J. O’Sullivan, D. Nicholson, P. Rao","doi":"10.4172/2329-910X.1000263","DOIUrl":"https://doi.org/10.4172/2329-910X.1000263","url":null,"abstract":"Background: The Achilles tendon is the most frequently ruptured tendon in the body and its incidence is increasing, more so among athletes. Various surgical techniques exist for treating it and one of these is as discussed in this study, Achilles tendon injury treated with Knotless PARS (Arthrex) that allows for earlier weight bearing and mobilization and, therefore, faster rehabilitation and an improved functional outcome. \u0000Aim: The post-operative progress of patients, specifically athletes subset with Achilles tendon injury treated with Knotless PARS is discussed in this article using Newcastle Orthopaedic Foot and Ankle Score (NOFAS). \u0000Methods: We retrospectively evaluated the patients operated on between March 2015 and January, 2017, 19 feet of 19 patients diagnosed with acute Achilles tendon rupture were treated. All clinical outcomes were examined using the Newcastle Orthopaedic Foot and Ankle Score (NOFAS) in patients operated in the last 28 months after the operation. We measured their progress in 3 categories as follows: (1) Improvement in pain and symptoms. (2) Recovery and lifestyle improvement and (3) Motion and activity. \u0000Conclusion: The study suggests that the post-operative progress of patients with Achilles tendon injury treated with Knotless PARS (Arthrex) is strong, but the best results only appear in patients post 12 months of their surgery. We suggest, prospective and comparative studies will help for further research of this subject.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46899752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-06DOI: 10.4172/2329-910X.1000260
Shankhdhar Lk, K. Shankhdhar, U. Shankhdhar, S. Shankhdhar
Barefoot walking is relatively common in developing countries including India, due to many social, religious and cultural factors. Such a behavior exposes them for injury and wounds in feet. Poverty and illiteracy induced negligence add fuel to fire, leading to delayed and insufficient/inadequate medical attention and fury of the lesions further aggravated by associated diabetic peripheral neuropathy, infection and peripheral vascular disease, terminating unfortunately even into amputations.
{"title":"Lesser Talked of Factors Influencing Diabetic Foot Care in India","authors":"Shankhdhar Lk, K. Shankhdhar, U. Shankhdhar, S. Shankhdhar","doi":"10.4172/2329-910X.1000260","DOIUrl":"https://doi.org/10.4172/2329-910X.1000260","url":null,"abstract":"Barefoot walking is relatively common in developing countries including India, due to many social, religious and cultural factors. Such a behavior exposes them for injury and wounds in feet. Poverty and illiteracy induced negligence add fuel to fire, leading to delayed and insufficient/inadequate medical attention and fury of the lesions further aggravated by associated diabetic peripheral neuropathy, infection and peripheral vascular disease, terminating unfortunately even into amputations.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47232388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-02-05DOI: 10.4172/2329-910X.1000258
Xi Pan, Jiao-Jiao Bai, Jiao Sun, Ran Wu, Yue Ming, Li-Rong Chen, Z. Wang
Objective: The aim of the present study was to explore the walking strategy by monitoring the characteristics of plantar pressure in elderly patients with diabetic peripheral neuropathy. Methods: This descriptive study was conducted at the endocrine ward at Huadong Hospital, Fudan University, shanghai, China, from April 2016 to December 2016. Elderly patients with diabetic peripheral neuropathy were enrolled from Huadong Hospital, Fudan University. Non-diabetes elderly were enrolled from Changning District Xianxia Street Community Service Center, Shanghai, China. A total of 229 participants were recruited. Non-diabetic elderly were grouped for DC, and elderly with type 2 diabetes, according to the Toronto clinical neuropathy score (TCSS) into no significant peripheral neuropathy group (DM group), mild peripheral neuropathy group (DN1 group), moderate peripheral nerve lesion group (DN2 group) and severe peripheral neuropathy group (DN3 group), a total of five groups. Outcome measures included the center of pressure (COP)A¯Â¼ÂŒthe plantar force time curve, the Foot balance curve and loading time. Results: COP trajectories: The COP trajectories in elderly with DPN were abnormal significantly with abnormal foldback, beginning point shifted forward and terminal point lateral shifted; The COP excursions along the medio-lateral axes reduced in elderly with DPN and increased in elderly without PN; The COP excursions and maximum excursions along the longitudinal reduced in elderly with DPN; The COP minimum excursions along the longitudinal axis increased in elderly with DPN, with the most severe PN significantly (p<0.05). The plantar force time curve: The plantar force time curve were abnormal significantly in mild and severe PN with single more force peak; Among the morphologically normal curves, the first and second peak force reduced in elderly DM with PN and without PN. The time to peak and valley in elderly DM with PN and without PN delayed (p<0.05). Foot balance: The Foot balance curve were abnormal significantly, with no positive wave or negative wave, with the most severe PN significantly. Among the morphologically normal curves, the positive and negative peak values reduced in elderly with DPN (p<0.05). Loading time: Loading time was significantly longer in the severe PN; In the stance phase of gait cycle, the time of midstance phase were longer, and the time of heel contact phase and propulsion phase were shorter in elderly with DPN and without DPN, with moderate and severe PN more significant (p<0.05); The loading time of the whole foot were prolonged and advanced, The loading time of midfoot and heel were shorten (p<0.05). Conclusions: The gait strategies in elderly with DPN were abnormal including shifted forward of the first loading site, lateral shifted of the final site, poor lateral stability and abnormal reentry, shortage driving force, plantar pressure loading offset, the prolonged loading time, prolonged stance phases and the fo
{"title":"Walking Strategy Abnormalities in Elderly with Diabetic Neuropathy: A Biomechanical Investigation through three Curves Analysis","authors":"Xi Pan, Jiao-Jiao Bai, Jiao Sun, Ran Wu, Yue Ming, Li-Rong Chen, Z. Wang","doi":"10.4172/2329-910X.1000258","DOIUrl":"https://doi.org/10.4172/2329-910X.1000258","url":null,"abstract":"Objective: The aim of the present study was to explore the walking strategy by monitoring the characteristics of plantar pressure in elderly patients with diabetic peripheral neuropathy. \u0000Methods: This descriptive study was conducted at the endocrine ward at Huadong Hospital, Fudan University, shanghai, China, from April 2016 to December 2016. Elderly patients with diabetic peripheral neuropathy were enrolled from Huadong Hospital, Fudan University. Non-diabetes elderly were enrolled from Changning District Xianxia Street Community Service Center, Shanghai, China. A total of 229 participants were recruited. Non-diabetic elderly were grouped for DC, and elderly with type 2 diabetes, according to the Toronto clinical neuropathy score (TCSS) into no significant peripheral neuropathy group (DM group), mild peripheral neuropathy group (DN1 group), moderate peripheral nerve lesion group (DN2 group) and severe peripheral neuropathy group (DN3 group), a total of five groups. Outcome measures included the center of pressure (COP)A¯Â¼ÂŒthe plantar force time curve, the Foot balance curve and loading time. \u0000Results: \u0000COP trajectories: The COP trajectories in elderly with DPN were abnormal significantly with abnormal foldback, beginning point shifted forward and terminal point lateral shifted; The COP excursions along the medio-lateral axes reduced in elderly with DPN and increased in elderly without PN; The COP excursions and maximum excursions along the longitudinal reduced in elderly with DPN; The COP minimum excursions along the longitudinal axis increased in elderly with DPN, with the most severe PN significantly (p<0.05). \u0000The plantar force time curve: The plantar force time curve were abnormal significantly in mild and severe PN with single more force peak; Among the morphologically normal curves, the first and second peak force reduced in elderly DM with PN and without PN. The time to peak and valley in elderly DM with PN and without PN delayed (p<0.05). \u0000Foot balance: The Foot balance curve were abnormal significantly, with no positive wave or negative wave, with the most severe PN significantly. Among the morphologically normal curves, the positive and negative peak values reduced in elderly with DPN (p<0.05). \u0000Loading time: Loading time was significantly longer in the severe PN; In the stance phase of gait cycle, the time of midstance phase were longer, and the time of heel contact phase and propulsion phase were shorter in elderly with DPN and without DPN, with moderate and severe PN more significant (p<0.05); The loading time of the whole foot were prolonged and advanced, The loading time of midfoot and heel were shorten (p<0.05). \u0000Conclusions: The gait strategies in elderly with DPN were abnormal including shifted forward of the first loading site, lateral shifted of the final site, poor lateral stability and abnormal reentry, shortage driving force, plantar pressure loading offset, the prolonged loading time, prolonged stance phases and the fo","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41766509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-26DOI: 10.4172/2329-910X.1000257
Pena Fernandez Mp, Quijada Rodriguez Jl
Calcaneal fractures in children are uncommon injuries. Most of such injuries are due to low impact traumas, and are usually slightly displaced and extra-articular. However, in the case of high impact trauma (a fall from a high place or a traffic accident), displaced intra-articular injuries can occur. Currently, there is no consensus about the most appropriate treatment for such injuries. We present the case of an 11-year-old patient who suffered a fall from 2 m high, having pain and functional impotence in the left foot. After a radiological study by simple radiography and CT, he is diagnosed of intra-articular fracture of displaced calcaneus. It was decided to apply a conservative treatment by immobilization and discharge during 8 weeks, obtaining satisfactory clinical and functional results after more than one year of follow-up.
{"title":"Intra-Articular Calcaneal Fracture in Patient of 11 Years, What Treatment is the Most Adequate?","authors":"Pena Fernandez Mp, Quijada Rodriguez Jl","doi":"10.4172/2329-910X.1000257","DOIUrl":"https://doi.org/10.4172/2329-910X.1000257","url":null,"abstract":"Calcaneal fractures in children are uncommon injuries. Most of such injuries are due to low impact traumas, and are usually slightly displaced and extra-articular. However, in the case of high impact trauma (a fall from a high place or a traffic accident), displaced intra-articular injuries can occur. Currently, there is no consensus about the most appropriate treatment for such injuries. We present the case of an 11-year-old patient who suffered a fall from 2 m high, having pain and functional impotence in the left foot. After a radiological study by simple radiography and CT, he is diagnosed of intra-articular fracture of displaced calcaneus. It was decided to apply a conservative treatment by immobilization and discharge during 8 weeks, obtaining satisfactory clinical and functional results after more than one year of follow-up.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41536024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-22DOI: 10.4172/2329-910X.1000256
Maaty Mt, Khalek Ma
Background: Plantar fasciitis is a common cause of plantar heel pain that may cause significant discomfort and disability. Many surgical techniques were involved in treatment like open plantar fasciotomy, endoscopic techniques, and percutaneous fasciotomy. This study was conducted to evaluate the results of surgical treatment of resistant plantar fasciitis by a new minimal invasive technique of combined percutaneous partial plantar fasciotomy, drilling of the calcaneus and resection of the calcaneal spur. Methods: Between June 2013 and July 2015, twenty-five patients presented by resistant plantar fasciitis had undergone a minimal invasive surgery by percutaneuos partial plantar fasciotomy, drilling of the calcaneus and resection of the calcaneal spur. Results: Heel pain was relieved within an average of 4 weeks (range: 3-8 weeks). Postoperatively twenty two 88% patients were rated as having excellent results, three patients 12% were rated as having good results and no patients 0% were rated as having a poor result without any improvement. Conclusion: This technique compares favorably with other reported open surgical procedures and other minimal invasive and high-cost techniques. It is a relatively safe, short procedure, with a rapid learning curve and it is not associated with serious complications.
{"title":"A New Minimal Invasive Technique in the Treatment of Resistant Plantar Fasciitis by Percutaneous Partial Plantar Fasciotomy, Drilling of the Calcaneus and Resection of Calcaneal Spur","authors":"Maaty Mt, Khalek Ma","doi":"10.4172/2329-910X.1000256","DOIUrl":"https://doi.org/10.4172/2329-910X.1000256","url":null,"abstract":"Background: Plantar fasciitis is a common cause of plantar heel pain that may cause significant discomfort and disability. Many surgical techniques were involved in treatment like open plantar fasciotomy, endoscopic techniques, and percutaneous fasciotomy. This study was conducted to evaluate the results of surgical treatment of resistant plantar fasciitis by a new minimal invasive technique of combined percutaneous partial plantar fasciotomy, drilling of the calcaneus and resection of the calcaneal spur. \u0000Methods: Between June 2013 and July 2015, twenty-five patients presented by resistant plantar fasciitis had undergone a minimal invasive surgery by percutaneuos partial plantar fasciotomy, drilling of the calcaneus and resection of the calcaneal spur. \u0000Results: Heel pain was relieved within an average of 4 weeks (range: 3-8 weeks). Postoperatively twenty two 88% patients were rated as having excellent results, three patients 12% were rated as having good results and no patients 0% were rated as having a poor result without any improvement. \u0000Conclusion: This technique compares favorably with other reported open surgical procedures and other minimal invasive and high-cost techniques. It is a relatively safe, short procedure, with a rapid learning curve and it is not associated with serious complications.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47166141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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