Foot & ankle specialist
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Foot & ankle specialist · Apr 2010
Randomized Controlled TrialEffects of topical alkane vapocoolant spray on pain intensity prior to digital nerve block for ingrown nail surgery.
Needle penetration and local anesthetic infiltration are 2 painful steps that cause considerable stress and anxiety during digital nerve block, which is the most frequently used regional anesthesia for ingrown nail surgery. The purpose of this study was to evaluate the effectiveness of topical alkane vapocoolant spray in decreasing pain during digital nerve block for ingrown nail surgery. The authors conducted a prospective, randomized clinical trial with 62 patients who underwent big toenail surgery. ⋯ VAS scores during needle penetration were significantly lower in the intervention group. However, VAS scores during infiltration were similar statistically. Alkane vapocoolant spray has no noticeable clinical benefit in decreasing pain intensity during digital nerve block in patients undergoing toenail surgery.
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Foot & ankle specialist · Apr 2010
Comparative StudyA prospective study comparing attempted weight bearing in fiberglass below-knee casts and prefabricated pneumatic braces.
Partial weight bearing is commonly advised after fracture of the lower extremity. Research has determined this to be inaccurate both in its instruction and its reproducibility. Many trauma departments are commonly using alternatives to plaster in the splintage of fractures, such as fiberglass and the prefabricated pneumatic braces. ⋯ There was a significant difference in percentage of weight placed through the splinted limb, with the pneumatic brace group placing much greater force than the fiberglass group. This may have been caused by altered proprioception from the walker. It is important to realize this when prescribing partial weight bearing in a particular splint as this may result in avoidable complications.
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Foot & ankle specialist · Apr 2010
Treatment of painful pediatric flatfoot with Maxwell-Brancheau subtalar arthroereisis implant a retrospective radiographic review.
The purposes of this study were to evaluate the outcome of pediatric patients who have undergone Maxwell-Brancheau arthroereisis (MBA) subtalar implants for the treatment of painful pediatric flatfoot deformities. In a retrospective study, 39 patients (68 feet) were evaluated clinically and radiographically. The mean age of the patients was 12 years (range, 6-16 years). ⋯ There were significant changes noted in pre- and postoperative measurements (P < .001). The MBA implant is effective for the correction of painful, flexible flatfoot deformity in children in short-term follow-up. However, this is a multiplanar deformity, and additional procedures may be needed in addition to the MBA.
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Foot & ankle specialist · Oct 2009
Positional effects of the knee and ankle on the ends of acute Achilles tendon ruptures.
Conservative management of acute Achilles tendon ruptures in a plantarflexed short leg cast or functional brace is a viable alternative to surgery. The ideal plantarflexion angle to allow the free ends of the tendon to oppose one another has not been clearly defined. The purpose of this cadaveric study was to define a plantarflexion angle where the free Achilles tendon ends reliably oppose one another. ⋯ With differing degrees of knee flexion (0, 45, and 90 degrees), the diastasis between the free ends of the Achilles tendon was measured as the ankle was moved from 20 degrees of dorsiflexion to 30 degrees of plantarflexion (-20, -10, neutral, 10, 20, and 30 degrees). Regardless of knee flexion angle, the ankle plantarflexion angle where the free ends of the Achilles tendon opposed one another was 28.0 (95% confidence interval: 25.0-33.6) degrees. The ideal ankle angle in which to immobilize patients appears tightly clustered around 28 degrees of plantarflexion.