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- Author or Editor: Min Liu x
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Background:
We sought to compare clinical efficacy among endoscopy-assisted radio-frequency ablation under local anesthesia, extracorporeal shockwaves (ESWs), and eccentric exercises in treating insertional Achilles tendinosis.
Methods:
In this retrospective study, 78 patients diagnosed as having unilateral insertional Achilles tendinosis were enrolled. These participants underwent endoscopy-assisted radio-frequency ablation, ESWs, and eccentric calf muscle exercises between March 1, 2006, and February 28, 2011. Clinical efficacy was evaluated by the visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot scale, and the Victorian Institute of Sport Assessment–Achilles (VISA-A) scale before and after treatment.
Results:
Before treatment, there were no statistically significant differences in VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores among the different groups (all P > .05). For the endoscopy and ESW groups, VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores were significantly improved after 18 months of treatment (all P < .05). The VAS, AOFAS ankle/hindfoot scale, and VISA-A scale scores in the endoscopy group were significantly higher than those in the ESW and eccentric exercise groups after 18 months of therapy (all P < .05).
Conclusions:
Combined with synovectomy and tendon debridement, endoscopy-assisted radio-frequency ablation yields better clinical efficacy compared with ESWs in treating insertional Achilles tendinosis.
Abstract
Objectives: To examine the effects of foot dominance and body mass on foot plantar pressures in older women of regular, overweight, and obese weights.
Methods: 96 female adults were divided into regular-weight group (68.30 ± 4.19 yr), overweight group (69.88 ± 3.76 yr), and obesity group (68.47 ± 3.67 yr) based on their body mass index scores. Footscan® plantar pressure test system was used to assess the dynamic plantar pressures, and parameters were collected from risk analysis, foot axis analysis, single foot timing analysis, and pressure analysis.
Results: (1) The local risks of lateral forefoot and midfoot, the minimum and maximum subtalar joint angles, the flexibility of subtalar joint, foot flat phase, as well as the average pressures on toes, metatarsals,, midfoot, and lateral heel, with the peak pressures on toe 2–5, metatarsal 2, metatarsal 5, midfoot, and lateral heel had significant within-subject differences. (2) The phases of initial contact and foot flat, the average pressures on toe 2–5, metatarsals, midfoot, and heels, with the peak pressures on metatarsal 1–4, midfoot, and heels exhibited significant between-subjects differences. (3) There was an interaction effect of foot dominance and body mass index on the flexibility of subtalar joint.
Conclusions: The non-dominant foot works better for stability, especially when touching on and off the ground. The dominant foot works better for propulsion but is more susceptible to pain, injury, and falls. For obese older women, the forefoot and midfoot are primarily responsible for maintaining stability, but the lateral midfoot and hindfoot are more prone to pain and discomfort.
Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint was reduced successfully through the closed method, but multiple attempts at closed reduction under local anesthesia failed to reduce the dislocated second and third metatarsophalangeal joints. We performed a dorsal incision between the second and third metatarsals, and the metatarsal heads were found to be entrapped under the plantar plate. Dislocation reduction was performed without damage to the plantar plate, and one Kirschner wire was used to fix the fourth metatarsal head fracture. The pin was removed 8 weeks after surgery, and the patient regained normal gait and returned to work and his previous physical activity level without recurrent dislocation. (J Am Podiatr Med Assoc 103(3): 236–240, 2013)
