Pub Date : 2017-01-01DOI: 10.4172/2329-910X.1000247
C. Pasapula, S. Cutts
Traditionally tibialis Posterior Insufficiency is still considered the commonest cause of acquired adult flat foot. This is still considered as the primary cause and has influenced both treatment and the diagnosis of the condition. Foot surgeons are now questioning the whole classification and the fundamental errors within this that have not been challenge for over 30 years. In this review article we examine the emerging evidence that suggests a new and alternative pathogenesis to this disease process centred on failure of the spring ligament.
{"title":"Modern Theory of the Development of Adult Acquired Flat Foot and an Updated Spring Ligament Classification System","authors":"C. Pasapula, S. Cutts","doi":"10.4172/2329-910X.1000247","DOIUrl":"https://doi.org/10.4172/2329-910X.1000247","url":null,"abstract":"Traditionally tibialis Posterior Insufficiency is still considered the commonest cause of acquired adult flat foot. This is still considered as the primary cause and has influenced both treatment and the diagnosis of the condition. Foot surgeons are now questioning the whole classification and the fundamental errors within this that have not been challenge for over 30 years. In this review article we examine the emerging evidence that suggests a new and alternative pathogenesis to this disease process centred on failure of the spring ligament.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281696","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 : 2016-11-30DOI: 10.4172/2329-910X.1000219
J. Vedel, J. K. Johansen
Aneurysmal bone cysts are a benign tumor of the bone, most commonly seen in the tibia, femur, spine and humerus. Cases of aneurysmal bone cysts in the foot, although rare, have been reported several times. To our knowledge, no case of aneurysmal bone cysts in the phalanx of a toe has been reported. We report a case of a primary benign bone tumor in the distal phalanx of the first toe in a 25-year-old male who presented with swelling and pain localized to the distal portion of his left first toe fourteen months ago. En bloc resection was performed, and subsequent microscopy revealed aneurysmal bone cyst.
{"title":"Aneurysmal Bone Cyst in a Phalanx of a Toe","authors":"J. Vedel, J. K. Johansen","doi":"10.4172/2329-910X.1000219","DOIUrl":"https://doi.org/10.4172/2329-910X.1000219","url":null,"abstract":"Aneurysmal bone cysts are a benign tumor of the bone, most commonly seen in the tibia, femur, spine and \u0000 humerus. Cases of aneurysmal bone cysts in the foot, although rare, have been reported several times. To our \u0000 knowledge, no case of aneurysmal bone cysts in the phalanx of a toe has been reported. We report a case of a \u0000 primary benign bone tumor in the distal phalanx of the first toe in a 25-year-old male who presented with swelling \u0000 and pain localized to the distal portion of his left first toe fourteen months ago. En bloc resection was performed, and \u0000 subsequent microscopy revealed aneurysmal bone cyst.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281097","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 : 2016-11-29DOI: 10.4172/2329-910X.1000217
Shankhdhar Lk, K. Shankhdhar, U. Shankhdhar, S. Shankhdhar
Podiatric care is often an ignored aspect of diabetic foot care. Foremost thing in podiatric care is a podiatric table which serves many purposes ranging for clinical examination to procedures but it is quite expansive and very few physicians, at least in developing countries, can afford it. So we designed a very economical and affordable Samadhan Foot Stand which serves effectively as substitute for a podiatric table. Word Samadhan is a Hindi word meaning solution. We offer this as solution to a hard pressed need for an affordable podiatric table, so we named it Samadhan Foot Stand.
{"title":"Innovation in Podiatry: The Samadhan Foot Stand","authors":"Shankhdhar Lk, K. Shankhdhar, U. Shankhdhar, S. Shankhdhar","doi":"10.4172/2329-910X.1000217","DOIUrl":"https://doi.org/10.4172/2329-910X.1000217","url":null,"abstract":"Podiatric care is often an ignored aspect of diabetic foot care. Foremost thing in podiatric care is a podiatric table which serves many purposes ranging for clinical examination to procedures but it is quite expansive and very few physicians, at least in developing countries, can afford it. So we designed a very economical and affordable Samadhan Foot Stand which serves effectively as substitute for a podiatric table. Word Samadhan is a Hindi word meaning solution. We offer this as solution to a hard pressed need for an affordable podiatric table, so we named it Samadhan Foot Stand.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281554","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 : 2016-11-28DOI: 10.4172/2329-910X.1000216
E. Wagner, Cristian Ortiz, A. Keller, D. Zanolli, Pablo Wagner, Pablo Mocoçain, X. Ahumada
Spontaneous rupture of the extensor retinaculum of the ankle is a rare condition, only reported a few times in the literature. We present a case report of a spontaneous rupture of the ankle extensor retinaculum, which was reconstructed with a fascia lata autograft, along with a discussion of the literature.
{"title":"Case Report: Spontaneous Rupture of the Ankle Extensor Retinaculum","authors":"E. Wagner, Cristian Ortiz, A. Keller, D. Zanolli, Pablo Wagner, Pablo Mocoçain, X. Ahumada","doi":"10.4172/2329-910X.1000216","DOIUrl":"https://doi.org/10.4172/2329-910X.1000216","url":null,"abstract":"Spontaneous rupture of the extensor retinaculum of the ankle is a rare condition, only reported a few times in the \u0000 literature. We present a case report of a spontaneous rupture of the ankle extensor retinaculum, which was \u0000 reconstructed with a fascia lata autograft, along with a discussion of the literature.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281535","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 : 2016-11-28DOI: 10.4172/2329-910X.1000215
Jay Emlen, L. Logan, M. Huchital, A. Siegel, Matthew J. Weintraub, J. Doucette, Peter Barbosa
Objective: Traditional thong style flips-flops are a popular form of footwear that is widely accepted in diverse cultures around the world. Several new products have emerged on the market with similar modifications, including padded toe separators in each of the four interdigital spaces and contoured foot beds containing medial arch support and deep heel seats. We examined one of these toe separating, contoured sandals (TSCS) to assess the user perception and biomechanical impact of this new trend of modifications. Twenty subjects participated in this study which examined step length differences and participant satisfaction comparing TSCS to generic thong style flip-flops. Methods: To access subject satisfaction, 20 volunteer female participants were asked to complete a 21-question user satisfaction survey. Step length was examined using the Pedigait motion capture and video gait analysis system. Step length differences between sandal types were compared using a paired T-test. Results: Evaluation of the data revealed that subjects reported positive perceptions with respect to stability (97%), support (75%), balance (65%), and flexibility (45%) afforded by the TSCS. The experimental TSCS were associated with a significantly greater average step length than that of the control flip-flop (3.6 vs. 3.2; p<0.0001). Conclusion: Through subjective (user perceptions) and objective (measured step length events) means it was determined that TSCS provide an improved means of ambulation as compared to traditional thong style flip-flops.
目的:传统的人字拖是一种流行的鞋类形式，在世界各地的不同文化中被广泛接受。市场上出现了几款经过类似修改的新产品，包括在四个趾间空间的每一个填充脚趾分离器，以及包含内侧弓支撑和深跟座椅的轮廓足床。我们检查了这些趾分离，轮廓凉鞋(TSCS)之一，以评估用户感知和这种新趋势的修改的生物力学影响。20名受试者参与了这项研究，比较了TSCS与普通丁字拖风格的人字拖的步长差异和参与者满意度。方法:为了获得受试者满意度，我们要求20名女性志愿者完成一份包含21个问题的用户满意度调查。使用Pedigait动作捕捉和视频步态分析系统检测步长。不同类型凉鞋的步长差异采用配对t检验进行比较。结果:对数据的评估显示，受试者对TSCS提供的稳定性(97%)、支持度(75%)、平衡性(65%)和灵活性(45%)有积极的看法。与对照触发器相比，实验TSCS与更大的平均步长相关(3.6 vs 3.2;p < 0.0001)。结论:通过主观(用户感知)和客观(测量步长事件)，确定TSCS与传统的丁字裤式人字拖相比提供了一种改进的行走方式。
{"title":"Comparative Analysis of User Perception and Step Length Using Toe Separating, Contoured Sandals versus Thong Style Flip-Flops","authors":"Jay Emlen, L. Logan, M. Huchital, A. Siegel, Matthew J. Weintraub, J. Doucette, Peter Barbosa","doi":"10.4172/2329-910X.1000215","DOIUrl":"https://doi.org/10.4172/2329-910X.1000215","url":null,"abstract":"Objective: Traditional thong style flips-flops are a popular form of footwear that is widely accepted in diverse cultures around the world. Several new products have emerged on the market with similar modifications, including padded toe separators in each of the four interdigital spaces and contoured foot beds containing medial arch support and deep heel seats. We examined one of these toe separating, contoured sandals (TSCS) to assess the user perception and biomechanical impact of this new trend of modifications. Twenty subjects participated in this study which examined step length differences and participant satisfaction comparing TSCS to generic thong style flip-flops. \u0000Methods: To access subject satisfaction, 20 volunteer female participants were asked to complete a 21-question user satisfaction survey. Step length was examined using the Pedigait motion capture and video gait analysis system. Step length differences between sandal types were compared using a paired T-test. \u0000Results: Evaluation of the data revealed that subjects reported positive perceptions with respect to stability (97%), support (75%), balance (65%), and flexibility (45%) afforded by the TSCS. The experimental TSCS were associated with a significantly greater average step length than that of the control flip-flop (3.6 vs. 3.2; p<0.0001). \u0000Conclusion: Through subjective (user perceptions) and objective (measured step length events) means it was determined that TSCS provide an improved means of ambulation as compared to traditional thong style flip-flops.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281480","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 : 2016-11-11DOI: 10.4172/2329-910X.1000E108
T. Roukis
Clinical Research on Foot and Ankle is an academic peer-reviewed international journal that publishes articles on a wide range of fields related to foot surgery, sports medicine, Achilles heels problem, different techniques of physical therapies, wound management and healing procedure, and other medical issues related to ankle care. The previous issue Volume 4, Issue 2 of the Journal published five research articles and two case reports.
{"title":"Advanced Procedures in Foot and Ankle Surgery","authors":"T. Roukis","doi":"10.4172/2329-910X.1000E108","DOIUrl":"https://doi.org/10.4172/2329-910X.1000E108","url":null,"abstract":"Clinical Research on Foot and Ankle is an academic peer-reviewed international journal that publishes articles on a wide range of fields related to foot surgery, sports medicine, Achilles heels problem, different techniques of physical therapies, wound management and healing procedure, and other medical issues related to ankle care. The previous issue Volume 4, Issue 2 of the Journal published five research articles and two case reports.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70282270","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 : 2016-11-11DOI: 10.4172/2329-910X.1000214
Loisel François, H. Kielwasser, G. Faivre, K. Bernadette, Obert Laurent
Introduction: Several human and animal studies have revealed a link between abnormal serum lipid levels and Achilles tendon rupture. However, clinicians have not detected macroscopic amounts of fatty tissue during the repair of ruptured tendons. Material and Methods: A lipid profile and evaluation of tendon lipomatosis were performed in a group of 65 patients with Achilles tendon rupture recruited over a two-year period at two French hospitals. Cardiovascular and tendon rupture risk factors were inventoried. Results: Ten patients had a history of hypercholesterolemia, seven of whom were undergoing statin treatment (15%). Two patients had known risk factors for tendon rupture (3%): one was taking inhaled corticosteroids and the other suffered from hyperuricemia. Total cholesterol was normal in 63% of cases; triglycerides were normal in 67% of cases and HDL cholesterol was normal in 54% of cases. If cardiovascular risk factors were taken into account, the portion of high-LDL cholesterol went from 17% to 23%, but this was not significant. Pathology analysis found four cases of tendon lipomatosis among the 36 collected samples (11%). Discussion: Since this study did not include a control group, we cannot make any conclusions about the lack of relationship between abnormal lipid profile and tendon rupture. The prevalence of hypercholesterolemia in our study population was similar to that of the general population. Although high cholesterol levels have been implicated by some authors, cholesterol accumulation within the tendon is probably not directly responsible for weakening it; however, an increase in atheromatous plaque in tendon blood vessels may lead to hypoxia.
{"title":"Achilles Tendon Rupture and Abnormal Lipid Profile: A Descriptive Clinical Laboratory and Histology Study","authors":"Loisel François, H. Kielwasser, G. Faivre, K. Bernadette, Obert Laurent","doi":"10.4172/2329-910X.1000214","DOIUrl":"https://doi.org/10.4172/2329-910X.1000214","url":null,"abstract":"Introduction: Several human and animal studies have revealed a link between abnormal serum lipid levels and Achilles tendon rupture. However, clinicians have not detected macroscopic amounts of fatty tissue during the repair of ruptured tendons. \u0000Material and Methods: A lipid profile and evaluation of tendon lipomatosis were performed in a group of 65 patients with Achilles tendon rupture recruited over a two-year period at two French hospitals. Cardiovascular and tendon rupture risk factors were inventoried. \u0000Results: Ten patients had a history of hypercholesterolemia, seven of whom were undergoing statin treatment (15%). Two patients had known risk factors for tendon rupture (3%): one was taking inhaled corticosteroids and the other suffered from hyperuricemia. Total cholesterol was normal in 63% of cases; triglycerides were normal in 67% of cases and HDL cholesterol was normal in 54% of cases. If cardiovascular risk factors were taken into account, the portion of high-LDL cholesterol went from 17% to 23%, but this was not significant. Pathology analysis found four cases of tendon lipomatosis among the 36 collected samples (11%). \u0000Discussion: Since this study did not include a control group, we cannot make any conclusions about the lack of relationship between abnormal lipid profile and tendon rupture. The prevalence of hypercholesterolemia in our study population was similar to that of the general population. Although high cholesterol levels have been implicated by some authors, cholesterol accumulation within the tendon is probably not directly responsible for weakening it; however, an increase in atheromatous plaque in tendon blood vessels may lead to hypoxia.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281422","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 : 2016-10-31DOI: 10.4172/2329-910X.1000213
I. Frangež, T. Kos, M. Mencinger, D. Smrke, M. Cimerman
Background: Bladder carcinoma with distal bone metastasis is rare. Treatment should be multidisciplinary, including pain relief, treatment of threatening (or) pathological fractures, and oncologic therapy for bladder cancer. Case report: A 52-year-old male patient with bladder cancer reported having pain in the right foot and ankle. Xray and CT revealed multiple bone metastases of bladder cancer to the right foot and ankle, causing pathological fractures. The patient refused proposed below-knee amputation, therefore, preservative surgery with metastasectomy of larger metastases in the foot and ankle, and distal fibulaectomy were performed. To fulfill the defects in the foot, bone guided regeneration with equine xenograft bone block and collagen membrane was performed and additionally stabilized with osteosynthetic material. Two months after surgery, the bone graft was incorporated into the bone and the patient was capable of weight bearing, pain-free, and able to continue with chemotherapy and radiation therapy. Despite the therapy, the patient died of embolism due to metastasis 6 months following the foot operation. Discussion: The aim of our case report is to show that amputation is not the only method of treatment for patients with multiple metastases of the foot and ankle. Alternatively, bone-guided regeneration with xenograft can be successfully performed also in such patients. Rehabilitation following bone-guided regeneration is shorter compared to amputation, and also enables a better quality of life.
{"title":"Xenograft Bone-Guided Regeneration of the Foot in Case of Metastatic Bladder Carcinoma causing Pathological Fracture","authors":"I. Frangež, T. Kos, M. Mencinger, D. Smrke, M. Cimerman","doi":"10.4172/2329-910X.1000213","DOIUrl":"https://doi.org/10.4172/2329-910X.1000213","url":null,"abstract":"Background: Bladder carcinoma with distal bone metastasis is rare. Treatment should be multidisciplinary, including pain relief, treatment of threatening (or) pathological fractures, and oncologic therapy for bladder cancer. Case report: A 52-year-old male patient with bladder cancer reported having pain in the right foot and ankle. Xray and CT revealed multiple bone metastases of bladder cancer to the right foot and ankle, causing pathological fractures. The patient refused proposed below-knee amputation, therefore, preservative surgery with metastasectomy of larger metastases in the foot and ankle, and distal fibulaectomy were performed. To fulfill the defects in the foot, bone guided regeneration with equine xenograft bone block and collagen membrane was performed and additionally stabilized with osteosynthetic material. Two months after surgery, the bone graft was incorporated into the bone and the patient was capable of weight bearing, pain-free, and able to continue with chemotherapy and radiation therapy. Despite the therapy, the patient died of embolism due to metastasis 6 months following the foot operation. Discussion: The aim of our case report is to show that amputation is not the only method of treatment for patients with multiple metastases of the foot and ankle. Alternatively, bone-guided regeneration with xenograft can be successfully performed also in such patients. Rehabilitation following bone-guided regeneration is shorter compared to amputation, and also enables a better quality of life.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281407","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 : 2016-10-28DOI: 10.4172/2329-910X.1000212
E. Kemler, M. Krist, Ingrid GL van de Port, A. Hoes, G. D. de Wit, F. Backx
Background: Ankle sprains are common injuries, associated with high healthcare and societal costs. After sustaining an acute ankle sprain, ankle taping is the standard treatment in the Netherlands. Ankle braces are sometimes used as an alternative. The aim of the present study was to assess the costs-effectiveness of soft ankle bracing compared to ankle tape treatment in patients with an acute lateral ankle ligamentous sprain (ALALS). Methods: We conducted an economic evaluation from a societal perspective alongside a controlled trial. In order of presentation, patients were alternately allocated to four week treatment with a soft ankle brace or four week treatment with ankle tape. Costs and clinical outcomes with respect to re-injuries were derived from online patient questionnaires at 5, 9, 13, 26, 39, and 52 weeks after inclusion. Univariate and probabilistic sensitivity analyses were performed. Cost-effectiveness was assessed using bootstrapping with 5000 replications. Results: In total 157 patients with an ALALS were included, of which 151 (tape n=76, brace n=75) were analyzed. After one-year of follow-up, no significant clinical differences were found between both treatments groups. Mean total costs were €1,634 (SD 261) per patient in the brace group and €1,846 (SD 296) per patient in the tape group; mean difference -€212 (95%CI -854 to 436). The use of an ankle brace was less expensive in 71% of the bootstrap replications. Conclusions: In patients with ALALS, soft ankle bracing compared to ankle taping had similar clinical effect. The costs of soft bracing were lower. However, this difference was not statistically significant.
{"title":"Economic Evaluation of a Soft Ankle Brace Compared to Tape in Acute Lateral Ankle Ligamentous Sprains","authors":"E. Kemler, M. Krist, Ingrid GL van de Port, A. Hoes, G. D. de Wit, F. Backx","doi":"10.4172/2329-910X.1000212","DOIUrl":"https://doi.org/10.4172/2329-910X.1000212","url":null,"abstract":"Background: Ankle sprains are common injuries, associated with high healthcare and societal costs. After sustaining an acute ankle sprain, ankle taping is the standard treatment in the Netherlands. Ankle braces are sometimes used as an alternative. The aim of the present study was to assess the costs-effectiveness of soft ankle bracing compared to ankle tape treatment in patients with an acute lateral ankle ligamentous sprain (ALALS). Methods: We conducted an economic evaluation from a societal perspective alongside a controlled trial. In order of presentation, patients were alternately allocated to four week treatment with a soft ankle brace or four week treatment with ankle tape. Costs and clinical outcomes with respect to re-injuries were derived from online patient questionnaires at 5, 9, 13, 26, 39, and 52 weeks after inclusion. Univariate and probabilistic sensitivity analyses were performed. Cost-effectiveness was assessed using bootstrapping with 5000 replications. Results: In total 157 patients with an ALALS were included, of which 151 (tape n=76, brace n=75) were analyzed. After one-year of follow-up, no significant clinical differences were found between both treatments groups. Mean total costs were €1,634 (SD 261) per patient in the brace group and €1,846 (SD 296) per patient in the tape group; mean difference -€212 (95%CI -854 to 436). The use of an ankle brace was less expensive in 71% of the bootstrap replications. Conclusions: In patients with ALALS, soft ankle bracing compared to ankle taping had similar clinical effect. The costs of soft bracing were lower. However, this difference was not statistically significant.","PeriodicalId":92013,"journal":{"name":"Clinical research on foot & ankle","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2329-910X.1000212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70281344","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 : 2016-10-24DOI: 10.4172/2329-910X.1000211
Nadia Dembskey, H. Abrahamse
Onychomycosis is a very common condition that accounts for 50% of all nail pathologies. Currently 2–5% of the world population suffers from this disorder. It is primarily caused by dermatophytes, but the infection can also be caused by yeasts and non-dermatophyte moulds. Onychomycosis is a therapeutic challenge and recently there has been an increase in resistance to oral and topical antifungal agents, leading to 20–25% relapse and/or reinfection rate. During the past 5 years, the emergence of laser therapy has been the topic of discussion as a newer, safer modality of treatment. Nail clippings and scrapings are the most common methods of sampling for suspected onychomycosis. The simplest method for detecting fungi is by way of 20% potassium hydroxide (KOH) preparations, but lately show insufficient sensitivity in onychomycosis – as much as 40–68%. Fungi can also be grown in culture form; however a 70% sensitivity detection failure rate is seen. Recently, histological fungal detection – in the form of Periodic Acid- Schiff (PAS) stain – has shown high sensitivity at 92% in the detection of fungal elements. The exact mechanism of action of laser is unknown but it is believed that heat disintegrates fungal structures. One of the most appealing characteristics of laser therapy is its ability to deliver energy to the target tissue and avoid systemic side effects at the same time. In 2009 the United Kingdom (UK) Podiatry magazine Podiatry Now published a letter suggesting laser treatment was “possibly the most radical development in the treatment of onychomycosis our profession has ever seen”, although concerns were raised over the unproven efficacy and investment costs involved. Papers have been published investigating the efficacy of lasers for the treatment of onychomycosis. Even though laser therapy provides an alternative option with rapid procedure duration, conflicting evidence is shown in a variety of papers and studies with longer follow-up periods suggest onychomycosis relapse in those treated with laser, which warrants further investigation.
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