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- Author or Editor: Abdulhamit Misir x
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Background: In professional athletes, Achilles tendon ruptures are devastating injuries, often resulting in season loss or decreased return to sports level. We aimed to perform a comprehensive video analysis to describe the mechanisms of Achilles tendon rupture as well as body posture in professional athletes. We hypothesized that Achilles tendon ruptures in professional athletes develop with a specific injury mechanism and that body posture at the time of injury varies by sport.
Methods: Of 114 identified Achilles tendon ruptures that occurred in professional athletes between 1970 and 2020, 42 with adequate video data were analyzed for injury mechanism, body posture, and player and sport characteristics by three independent reviewers.
Results: Mean ± SD age of the 42 athletes (41 men and 1 woman) was 28.4 ± 4.26 years. Eighteen athletes played basketball (42.9%), 14 football (33.3%), five soccer (11.9%), three baseball (7.1%), and two rugby (4.8%). Thirty-five patients (83.3%) had noncontact injuries. The most frequent months of injury were January (16.7%) and October (14.3%). During Achilles tendon rupture, the ankle was in dorsiflexion, the body was bent forward, the knee and hip were in extension, and the foot was in a neutral position. Most injuries occurred during take-off/acceleration (40.5%) or stop and turn (38.5%) maneuvers.
Conclusions: In professional athletes, the Achilles tendon most often ruptures during take-off/acceleration. The most common position during rupture is the trunk in flexion, the knee and hip in extension, and the ankle in dorsiflexion. This information can guide professional athletes in terms of physical therapy techniques, including neuromuscular training, proprioception, and balance training specific to preventing Achilles tendon rupture.
Background: Patients frequently use YouTube to learn about their illness. For this reason, the educational and quality of YouTube videos about various diseases has been investigated. In this study, we aimed to evaluate the accuracy and quality of YouTube videos.
Methods: A standard query was performed on the YouTube database using the following search terms: Plantar fasciitis, heel spur, and calcaneal spur. For each search term, the top 50 videos determined by YouTube’s “relevance” according to its algorithm were evaluated (150 videos in total). After exclusion, 140 videos were included in the study. These videos were watched by 2 observers and the videos were evaluated and scored according to the Global Quality Score (GQS), DISCERN, Journal of the American Medical Association (JAMA), and Plantar Fasciitis and Calcaneal Spurs Specific Score (PFSS) scoring systems.
Results: According to the JAMA criteria, 76.42% of the videos and 43.57% of the videos according to the GQS scored 2 points or less. According to DISCERN criteria, 67.15% of the videos were evaluated as very poor/poor. According to the PFSS, 83.5% of the videos were rated as poor or very poor.
Conclusions: These findings can be interpreted as the general information content of the videos about plantar fasciitis is insufficient and their reliability and quality are low. As a result, it can be concluded that the quality and reliability of YouTube videos regarding plantar fasciitis are insufficient for patients. Universities/associations prepare videos that provide information about plantar fasciitis to patients, and that these videos are presented on certain platforms can be a solution.
Background
No detailed comparative studies have been performed regarding plantar pressure changes between proximal dome and distal chevron osteotomies. This study aimed to compare radiographic and plantar pressure changes after distal chevron and proximal dome osteotomies and to investigate the effect of radiographic and plantar pressure changes on clinical outcomes.
Methods
This study included 26 and 22 patients who underwent distal chevron and proximal dome osteotomies, respectively. Visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scores were used to evaluate pain and functional outcomes. Hallux valgus angle, intermetatarsal angle, talar–first metatarsal angle, and calcaneal inclination angle were measured in the evaluation of radiographic outcomes. Preoperative and postoperative plantar pressure changes were evaluated.
Results
There were no statistically significant differences between the two groups in age, body mass index, or AOFAS forefoot and VAS scores. In the proximal dome group, the pressure measurement showed significant lateralization of the maximal anterior pressure point in the forefoot (P < .001). In addition, the postoperative calcaneal inclination angle was significantly lower (P = .004) and the talar–first metatarsal angle was significantly higher (P < .001) in the proximal dome group. Postoperative transfer metatarsalgia was observed in one patient (3.8%) in the distal chevron group and five (22.7%) in the proximal dome group (P < .05).
Conclusions
Proximal dome osteotomy led to more lateralization of the maximum anterior pressure point, decreased calcaneal inclination angle and first metatarsal elevation, and related higher transfer metatarsalgia.
Background: The fact that lateral malleolar fracture is accompanied by posterior malleolar fracture may adversely affect syndesmosis malreduction rates. We aimed to compare syndesmosis malreduction rates determined on postoperative radiographs between isolated lateral malleolar fractures and lateral malleolar fractures accompanied by posterior malleolar fractures.
Methods: We retrospectively examined 128 operative patients: 73 with isolated lateral malleolar fractures (group L) and 55 with lateral + posterior malleolar fractures (group LP). In group LP, no patients received posterior fragment fixation. In both groups, indirect syndesmosis fixation was performed with a single screw after open reduction and internal fixation of the lateral malleolus. Patient age, sex, fracture side, fracture type (Lauge-Hansen and Danis-Weber classifications), Kellgren-Lawrence osteoarthritis classification, syndesmotic incongruency on postoperative radiographs, syndesmotic malreduction of postoperative fibula fracture, fracture union time, complication rates, accompanying injuries, and preoperative and postoperative radiographic syndesmotic measurements (tibiofibular overlap, tibiofibular clear space, medial clear space) were recorded, and the groups were compared.
Results: Mean ± SD age was 44.32 ± 15.66 years in group L and 48.93 ± 14.03 years in group LP (P = .087). There were no significant differences in preoperative and postoperative tibiofibular distance, tibiofibular overlap, and medial clear space values between groups (P > .05). The prevalence of grade 2 fractures according to the Kellgren-Lawrence classification was significantly higher in group LP (P = .047). Postoperative syndesmosis malreduction was detected in 12 patients in group L and in nine in group LP (P = .991).
Conclusions: In lateral malleolar fractures accompanied by small-fragment posterolateral or avulsion-type posterior malleolar fractures, closed syndesmotic screw fixation does not cause syndesmosis malreduction.
