Foot & ankle specialist
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Foot & ankle specialist · Aug 2015
ReviewPictorial Review and Basic Principles of Foot and Ankle Hardware Extraction.
This pictorial review presents basic principles of the types of hardware extraction commonly encountered in foot and ankle surgical practice. We review the indications, contraindications and complications of hardware removal including pain, intra-articular fixation, and carcinogenesis, as well as special considerations in pediatric patients and in the setting of infection. Figures are then used to describe the appropriate techniques for use of the screwdriver shafts, conical extraction screws, extraction bolts, hollow reamers, and other instruments found in most hardware extraction sets. ⋯ Therapeutic, Level V: Expert opinion.
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Foot & ankle specialist · Aug 2015
United States National Trends in Ankle Arthroscopy: Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.
. Ankle arthroscopy is increasingly being utilized for disorders previously limited to management with open surgery. Despite uniformly good results and few complications, little is known regarding national trends in ankle arthroscopy. This study sought to investigate changes in the use of inpatient and ambulatory ankle arthroscopy in the United States. ⋯ N/A (descriptive epidemiology study).
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Regional anesthesia has increasingly expanded its role in the perioperative care of patients undergoing foot and ankle surgery. In addition to avoiding side effects associated with both general anesthesia and neuraxial anesthetic techniques, especially those related to cardiovascular and pulmonary systems, regional nerve blocks have been shown to improve postoperative pain and reduce hospital stay and associated expenses. The techniques utilized to achieve analgesia of the foot and ankle are diverse, multifaceted, and often incorporate ultrasound guidance. Given the aging of patient populations, and especially the growing incidence of cardiovascular-, pulmonary-, and obesity-related morbidity, the use of regional blocks is likely to expand in these surgical procedures. This review highlights some of the most current developments in the expanding role of regional anesthesia in foot and ankle surgery. ⋯ Therapeutic, Level II.
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Foot & ankle specialist · Jun 2015
Treatment of Stage II Adult Acquired Flatfoot Deformity With Subtalar Arthroereises.
The role of arthroereises in the treatment of adult acquired flatfoot deformity (AAFD) has been controversial. This study aims to evaluate the outcome of subtalar arthroereisis in treating stage II AAFD. A total of 24 feet with stage II AAFD were treated surgically between 2009 and 2011 using subtalar arthroereisis. The average follow-up was 29.7 months (range = 24 to 35 months). The average postoperative AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot Scale score was 85.6 (compared with 51.7 preoperatively). Average preoperative talar-first metatarsal angle and talonavicular coverage angle were -13.9° and 38.3°, respectively. The average postoperative angles were 1.6° and 11.2°, respectively (P < .01). No deformity recurrences were found at the time of last follow-up, with the exception of 1 case. Subtalar arthroereisis appears to be a reasonable treatment option for stage IIA and IIC AAFD. It can be used alone to correct mild hindfoot valgus, and it can also be performed with a calcaneal osteotomy to gain more correction in severe stage II AAFD. ⋯ Therapeutic, Level IV: Retrospective Case Series.