Background: Calcaneal apophysitis is an overuse injury in pediatric patients that causes heel pain and reduction in function. The aim of this study is to explore this condition and offer medical insight into its presentation and symptomatology, along with current treatment options.
Methods: We explored PubMed/Medline for studies involving calcaneal apophysitis in pediatric patients. The search included all articles published from database inception until June 1, 2021. We only included articles published in English. Clinical information and demographics extracted from the reported studies were analyzed and assessed.
Results: Only 28 studies met our criteria, with a total of 1,362 cases. Of the cases reported, 973 affected boys (71.4%). Presentation was bilateral in 589 cases (43.2%) and unilateral in 433 cases (31.8%). Radiographic imaging was used for the diagnosis of 358 cases (26.3%). All reported treatment modalities were conservative, and these included physical therapy and rest, kinesiotherapy and taping, and orthotic devices. A total of 733 cases (53.7%) reported improved outcomes,32 cases (2.3%) reported no improvement, and the remainder of cases did not report prognostic outcomes (44%).
Conclusions: Calcaneal apophysitis is an overuse disease commonly found in the pediatric population. Educating parents and coaches with regard to its symptomatology, etiology, and treatment is essential to diagnose the condition earlier and provide better outcomes.
Background: We compared two different techniques used in medial malleolus fracture. It has been hypothesized that the hook plate technique, which has become widespread in recent years, may have an advantage over cannulated screws.
Methods: Preoperative and postoperative data for medial malleolus fractures operated on between 2010 and 2020 were analyzed retrospectively. Patients were divided into those operated on with a hook plate (n = 20) and those operated on with compression screws (n = 20) and were compared in terms of complications, pain, functional recovery, union success, and ankle joint range of motion. Fracture union times were recorded.
Results: Between groups, there were no significant differences in time to fracture union, pain, range of motion, and American Orthopaedic Foot and Ankle Society score (P = .420). Handling of the implant in a very weak patient in the hook plate group and revision in the cannulated screw group were the differences in complications between groups. The use of hook plates in a patient with medial malleolus fracture with metaphyseal fracture provided significant convenience in osteosynthesis.
Conclusions: Use of hook plates provides serious advantages to the surgeon in medial malleolus fractures with small or fragmented fragments and combined with malleolus metaphyseal fractures. Having a larger implant versus a cannulated screw is seen as a disadvantage, but screwing the implant close to the cortex increases its strength. Therefore, its use should be given priority in patients who are mentally unable to weightbear after surgery. Although hook plate is advantageous compared with cannulated screw in appropriate indications, it can be used safely in all malleolus fractures where cannulated screws are used.
A talar body fracture is typically associated with talar body dislocation, resulting in ankle and subtalar joint subluxation and/or dislocation. A talar body fracture with talar head dislocation is a very rare injury. In this report, we describe the case of a 23-year-old man who suffered a coronal shearing fracture of the talar body with talar head dislocation related to a navicular compression fracture. The patient sought orthopedic consultation 6 weeks after injury. The injury was managed with open reduction, talar head relocation, internal fixation of the talar body fracture with Kirschner wires and cancellous screws and talonavicular fusion with an iliac bone autograft. Follow-up 4 years after operative treatment showed that the patient had satisfactory treatment results, including good bone healing with minimal changes in the anterior talotibial compartment and excellent function of the hindfoot and ankle.
Plantar fasciitis is a common cause of heel pain. The aim of this study was to review the current literature and attempt to clarify whether endoscopic plantar fasciotomy (EPF) is an effective and reliable treatment for plantar fasciitis in comparison with other invasive or noninvasive treatments. We performed an electronic search of the medical literature in PubMed database using combinations of the following keywords: plantar fasciitis, endoscopic treatment, and plantar aponeurosis. Overall, we had shown that patients had better scores following EPF/endoscopic plantar fascia release. The clinical scores were improved postoperatively and most of the patients were satisfied. Furthermore, the clinical trials showed that time to return to work or to previous activities was shorter compared with other treatments. These studies suggest that EPF/endoscopic plantar fascia release is probably an effective treatment of chronic plantar fasciitis. EPF is an efficient, safe treatment with good early postoperative results in patients with recalcitrant plantar fasciitis. There is evidence that other methods are equivalently effective for EPF, and some authors support that they should be considered as a second-line treatment because of their minimal invasive character and very low risk of complications; thus, more research is required.
Charcot neuroarthropathy is a devastating condition that places patients at risk for poor outcomes. Although the condition was first described in 1703, knowledge of the causative agent(s) has yet to be fully understood. Recent advances in genetic research have helped to identify potential mechanisms and pathways for the enigmatic destruction and deformities that are often associated with the condition; however, alternative pathways have been proposed. For the purpose of this discussion, we will discuss the human leukocyte antigen, which is one of the most researched contributors to autoimmune pathology and, more recently, has been linked to diabetic complications.
Background: Using high-heeled shoes in daily life affects the stability of walking, body posture, and functionality. We aimed to determine the immediate effect of kinesiology taping (KT) on functionality, static and dynamic balance, exercise capacity, and posture in young women using high-heeled shoes.
Methods: Thirty-seven women who wore high-heeled shoes (mean ± SD age, 20.32 ± 1.37 years) were divided into control (n = 20) and study (n = 17) groups. Both limbs of study group participants were taped medially, laterally, and dorsally with KT; no application was made to the control group. Balance (TecnoBody postural line), functionality (vertical jump and functional reach tests), exercise capacity (6-Minute Walk Test), and human body posture (New York Posture Rating Chart) were assessed.
Results: Median use of high-heeled shoes was 8 hours daily, 5 days weekly, and 3 years in the study group versus 6 hours daily, 4 days weekly, and 4 years in the control group. Significance in functional reach distance was found within the control (P = .010) and study (P = .005) groups but not between the groups. Stabilometric monopedal right foot ellipse area (P = .016) and perimeter (P = .009); left foot ellipse area (P = .016), perimeter (P = .023), and front/back standard deviation (P = .018); and dynamic balance area gap percentage (P = .030) were significant within the study group. Posture, vertical jump distance, exercise capacity, stabilometric test results, and bipedal closed-eye and opened-eye results were similar within and between groups (P > .05).
Conclusions: Kinesiology taping has no immediate effect on exercise capacity, vertical jump function, posture, and bipedal static balance but can modulate functional reach function, static monopedal leg balance, and dynamic equilibrium. Further studies are recommended to investigate the additive effect of KT with high-heeled shoes and after 45 min, 24 hours, and 72 hours.
Background: Clinical thermography is a relatively novel technique in wide use in different medical fields because of its versatility and ease of application. It inflicts no pain and entails no contact with the pediatric patient, which assuages anxiety and fear in patients when undergoing diagnostic exploration. The use of infrared clinical thermography being suggested herein is to establish normality patterns, which have not been described in the relevant literature. These patterns may be extrapolated to pathologic study by means of future research lines.
Methods: An observational, cross-sectional study (descriptive in nature) was performed with a sample population of 328 children divided into two age groups: 6 to 7 years and 13 to 16 years, all of them schooled in the province of Cáceres in Spain. The variables analyzed herein were age, sex, and temperature. A thermographic camera was used to study foot temperature.
Results: Results show that the temperature varies among the different study areas established for the foot, although they remain constant bilaterally. In addition, the highest temperature was found in the area of the first metatarsal head (29.8°C), and the lowest at the heel (28.8°C).
Conclusions: It can be concluded that both feet have the same thermal behavior despite the variation in temperature among the different areas that were established in the foot for the purposes of this study.
Background: Three main computed tomography (CT)–based classification systems have been defined and used for posterior malleolar fractures. The intraobserver and interobserver reliability of two of these systems has never been investigated. The aim of this study was to investigate the intraobserver and interobserver reliability of the Haraguchi (HC) and Bartoníček-Rammelt (BRC) classifications.
Methods: Axial and sagittal CT sections and three-dimensional reconstruction images of 60 fractures were evaluated twice by six observers at a 6-week interval. Cohen κ values for intraobserver reliability and Fleiss κ values for interobserver reliability were calculated.
Results: The interobserver reliability of the HC was fair in both assessments (Fleiss κ: 0.263 and 0.249 for the first and second evaluations, respectively). The interobserver reliability of the BRC was moderate in both evaluations (Fleiss κ: 0.535 and 0.447, respectively). The intraobserver reliability values (Cohen κ) of the HC were determined to be between 0.532 and 0.927 for the six observers. These values indicated moderate agreement for one observer, substantial for four, and very good for one. Intraobserver reliability values for the BRC were determined to be between Cohen κ of 0.626 and 0.884. Based on these values, the BRC's intraobserver reliability indicated substantial agreement for two observers and very good for four observers.
Conclusions: Intraobserver and interobserver reliability values of the BRC were higher than those of the HC.
Background: Body awareness is an expression of the extent of sensitivity and attentiveness to internal bodily signals and sensations. The foot has a critical function in providing interoceptive and exteroceptive information. The purposes of this study were to 1) compare body awareness in individuals with and without hallux valgus (HV) deformity, and 2) investigate the relationship between body awareness and HV-related parameters.
Methods: A total of 129 participants completed the assessments. The severity of the HV was evaluated using the Manchester Scale; pain severity was evaluated using the numeric pain rating scale; and the functional status was evaluated using the Manchester-Oxford Foot Questionnaire. The patients were divided into two groups according to the Manchester Scale scores as the presence or absence of HV. The body awareness of the individuals with HV was assessed using the Body Awareness Questionnaire.
Results: Included in this study were 69 participants with HV and 60 healthy participants. There was no difference between groups in terms of demographic properties. Two groups were found different only in pain severity (P < .01). The correlation analysis showed that there was a low correlation between the body awareness score and pain severity in both feet (right foot, r = 0.306, P = .011; left foot, r = 0.320, P = .007) in individuals with HV.
Conclusions: Participants with HV had higher pain severity and the pain severity was associated with the body awareness. The level of body awareness should be assessed and taken into consideration in the management of pain in patients with HV.
