Search Results
Trephine Arthrodesis of the Foot and Ankle
Indications, Operative Technique, and Long-term Follow-up
We conducted a retrospective analysis of trephine arthrodesis in a total of 22 joints in 15 feet to determine the efficacy of this procedure in the foot and ankle. Twelve of the 22 joints that were fused involved the tarsometatarsal articulations, 3 the naviculocuneiform joint, 6 the subtalar joint, and 1 the ankle. A successful fusion rate of 95% (21/22) was achieved. These results lend evidence that the trephine arthrodesis technique can be used with satisfactory results and confidence in the foot and ankle. (J Am Podiatr Med Assoc 96(3): 198–204, 2006)
Abstract
Osteonecrosis is acknowledged as a relatively uncommon disorder caused by various factors, including autoimmune diseases, drug-induced diseases, inherited metabolic disorders, coagulation disorders, and underlying malignancies. To our knowledge, no previous research has investigated osteonecrosis stemming from extracorporeal membrane oxygenation. Herein, we report a rare case of postperipheral venoarterial extracorporeal membrane oxygenation–induced multifocal osteonecrosis in the foot and ankle that demonstrated a low serpiginous peripheral signal on T1-weighted images and a double-line sign on fat-suppressed or T2-weighted magnetic resonance images. Conservative treatment was applied, and the patient was mostly recuperated after 6 months.
Master Techniques in Orthopaedic Surgery: The Foot and Ankle. 3rd Ed. Edited by Harold B. Kitaoka, MD. 803 pages. Lippincott Williams & Wilkins, Philadelphia, PA, 2013. $237.79.
Background: Article citations are a well-accepted method of evaluating the influence or impact of a particular article. Other medical specialties have published the top cited articles in their specialty. To date, an analysis of the foot and ankle podiatric medicine–related article citation method has not been published.
Methods: Three citation indices were used on October 10, 2014, February 20, 2015, and May 1, 2015, to determine the top 100 cited foot and ankle–related articles.
Results: Most of the top 100 cited foot and ankle podiatric medicine–related articles were published in The Journal of Bone and Joint Surgery by medical doctors in the United States in the past two decades, with most of the article topics being the diabetic foot or trauma. The predominant level of evidence for the articles is evenly distributed among levels III, IV, and V.
Conclusions: Podiatric medical research and publication has made great strides during the past two decades, particularly in the diabetic foot, but continued research and peer-reviewed journal publication in additional areas regarding the foot and ankle must become a priority in the podiatric medical community.
Surgical Management of Gout in the Foot and Ankle
A Systematic Review
Background: The surgical management of tophaceous gout has been well documented in the literature, including its effect on foot pain and disability. To date, there have been no systematic reviews assessing the quality of the literature relating to the operative management of tophaceous gout and the outcomes in the foot and ankle.
Methods: The following electronic databases were searched (1980–2014): Allied and Complementary Medicine, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Scopus, and the Cochrane Library. The articles identified were published in English and included adult participants (age ≥18 years) with diagnosed gout and surgical intervention to the foot and ankle. The Downs and Black Quality Index was modified to assess the quality of the articles being reviewed.
Results: Six articles were reviewed and were of moderate quality (mean quality score of 71%). Surgical management was conducted on men (88%) with a mean age of 52 years. There was wide variation in the types of surgical procedures performed, with 28% of studies reporting surgery to the first metatarsophalangeal joint. Most studies were retrospective. A wide range of outcome measures were reported: foot pain, function, preoperative and postoperative activity levels, monitoring of uric acid levels, and patient satisfaction after surgery.
Conclusions: The review demonstrated a limited number of good-quality studies. Several surgical procedures for the foot and ankle in people with chronic tophaceous gout were reported. Future studies should include prospective observational studies using validated and reliable patient-reported outcome measures.
Background: This retrospective study of a case series analyzed the results from the application of a distally based adipofascial sural flap for nonweightbearing defects of the foot and ankle.
Methods: Twenty-eight patients with post-traumatic ankle and foot defects (ten women and 18 men; age range, 17–63 years) underwent surgery between November 1, 2003, and November 30, 2008. Distally based adipofascial sural flaps were used in ten open fractures, 14 soft-tissue post-traumatic defects, and four deep burns. Defects were on the dorsal side of the foot (eight cases), the lateral malleolus (four cases), the medial malleolus and inframalleolar region (four cases), the Achilles tendon region (eight cases), and the anterior surface of the ankle (four cases). Surgical procedures were performed by a single surgeon (A.M.).
Results: All of the flaps healed uneventfully. There was no partial or total flap loss. All 28 patients walked normally at the time of follow-up. Three delayed healings occurred at the donor site.
Conclusions: This is a homogeneous series of lower-limb reconstructions with the distally based adipofascial sural flap, which permits better analysis of the results. This flap has a constant and reliable blood supply. It can be used for the reconstruction of nonweightbearing foot and ankle regions to avoid the bulky volume of the fasciocutaneous flap in this area and to minimize the donor site scar. (J Am Podiatr Med Assoc 101(1): 41–48, 2011)
Radiographic Anatomy of the Foot and Ankle—Part 1
The Distal Leg
The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone (“front” and “back” perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline (“normal”) and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The findings from the original project, owing to its broad scope, have been divided into five parts: the lower leg (the focus of this paper), the greater tarsus, the lesser tarsus, the metatarsals, and the phalanges.
Radiographic Anatomy of the Foot and Ankle—Part 2
The Greater Tarsus
Background
Normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional).
Methods
Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation.
Results
Images of each foot and distal leg bone (“front” and “back” perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique.
Conclusions
Foundational knowledge is provided that future researchers can use as a baseline (“normal”) and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus (the focus of this article), the lesser tarsus, the metatarsals, and the phalanges.
Radiographic Anatomy of the Foot and Ankle—Part 3
The Lesser Tarsus
Background
The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional).
Methods
Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation.
Results
Images of each foot and distal leg bone ("front” and “back” perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique.
Conclusions
Foundational knowledge is provided that future researchers can use as a baseline (“normal”) and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus (the focus of this article), the metatarsals, and the phalanges.
Radiographic Anatomy of the Foot and Ankle—Part 4
The Metatarsals
Background
The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional).
Methods
Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation.
Results
Images of each foot and distal leg bone (“front” and “back” perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique.
Conclusions
Foundational knowledge is provided that future researchers can use as a baseline (“normal”) and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals (the focus of this article), and the phalanges.
