The Foot
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Psychological variables, including catastrophic thoughts and kinesiophobia, are common in people with chronic musculoskeletal pain and are associated with pain and function. However, the role of each factor has not been evaluated in people with plantar heel pain (plantar fasciitis). ⋯ After controlling for age, sex and BMI, kinesiophobia and catastrophising were significantly associated with foot function, while catastrophising was associated with first step pain in people with plantar heel pain. In addition to addressing biological factors in the management of plantar heel pain, clinicians should consider the potential role of pain catastrophising and kinesiophobia in this population.
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Review Case Reports
Schwannoma and neurofibroma of the posterior tibial nerve presenting as tarsal tunnel syndrome: review of the literature with two case reports.
We present two case reports of peripheral nerve tumors (schwannoma and neurofibroma) that presented as tarsal tunnel syndrome for many years. There has never been a report of multiple neurofibroma of the posterior tibial nerve presenting as a tarsal tunnel syndrome. Both patients were treated surgically with good outcomes.
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Comparative Study
Unstable fragility fractures of the ankle in the elderly: Transarticular Steinmann pin or external fixation.
Because of poor skin conditions and comorbidity, open reduction and internal fixation in ankle fractures is frequently contra-indicated in the elderly. This study reports the results of two temporary fixation types in fragility fractures in the older patient: transarticular Steinmann pin fixation and external fixation. ⋯ Both techniques show few complications, but have, as expected, poor results in fracture reduction and functional outcome. External fixation and subsequent internal fixation could result in better functional outcome.
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Randomized Controlled Trial Comparative Study
Outcome evaluation of minimally invasive surgery versus extensile lateral approach in management of displaced intra-articular calcaneal fractures: A randomised control trial.
Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic. ⋯ MIS methods minimized soft tissue complications and achieved comparable radiological reductions but clinical outcomes were poorer, with percutaneous methods having the worst outcomes.
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Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. ⋯ Good communication is needed between the surgical team and the local Rheumatology department managing the patient's disease in order to optimise perioperative care. Local pathways may vary from the BSR recommendations to determine the most suitable course of action with regards to continuing or stopping biologic therapy prior to foot and ankle surgery.