The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Irreducible ankle fracture-dislocations are very rare entities. The present case report demonstrates an unusual finding of tibialis posterior and flexor digitorum longus tendons interposed in the tibiofibular joint impairing successful closed reduction of ankle fracture-dislocation. ⋯ Subsequent urgent open reduction and internal fixation surgical management revealed interposition of the tibialis posterior and flexor digitorum longus tendons in the tibiofibular joint. In irreducible fracture-dislocation of the ankle with severe lateral displacement of the talus, one should be aware of the possibility of soft tissue interposition of the tibialis posterior and flexor digitorum longus tendons in the tibiofibular joint.
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Case Reports
Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings.
A schwannoma or neurilemmoma is a benign, isolated, noninvasive, and encapsulated tumor originating from Schwann cells of the peripheral nerve sheath. The incidence of a schwannoma occurring in the foot and ankle is rare, with prevalence rate of 1% to 10%. Schwannomas have no sex predilection, and they commonly occur in patients in their fourth decade. ⋯ All 3 patients presented with varying clinical symptoms, including pain, paresthesia, weakness, and a palpable mass. A schwannoma was eventually diagnosed in all 3 patients. We discuss and review the known entities of peripheral nerve schwannoma and describe the clinical and imaging findings and therapeutic strategies for treating and diagnosing peripheral nerve schwannoma.
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Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or post-traumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated. ⋯ The 12-item short-form physical and mental scores at the last follow-up point were 52.5 and 56.4, respectively. One (5.3%) patient underwent open repeat fusion for nonunion, 2 (10.5%) patients required a second procedure for implant removal, and 1 (5.3%) experienced reversible neuropraxia. In conclusion, posterior arthroscopic subtalar arthrodesis is a safe technique with a good union rate and a small number of complications in patients with no or very little hindfoot deformity.
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Case Reports
Dislocation of the First Metatarsophalangeal Joint: A Case Report and Suggested Classification System.
Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. ⋯ The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested.
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This investigation presents a review of all of the clinical outcome measures used by authors and published in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery® from January 1, 2011, to December 31, 2015. Of 1,336 articles published during this time frame, 655 (49.0%) were classified as original research and included in this analysis. Of these 655 articles, 151 (23.1%) included at least one clinical outcome measure. ⋯ The most frequently reported scales in the 151 included articles were the American Orthopaedic Foot and Ankle Society scales (54.3%; n = 82), visual analog scale (35.8%; n = 54), Medical Outcomes Study Short Form Health Survey (any version) (10.6%; n = 16), Foot Function Index (5.3%; n = 8), Maryland Foot Score (4.0%; n = 6), and Olerud and Molander scoring system (4.0%; n = 6). Twenty-four (15.9%) articles used some form of original/subjective measure of patient satisfaction/expectation. The results of this investigation detail the considerable variety of clinical outcome measurement tools used by authors in the Journal of the American Podiatric Medical Association and the Journal of Foot and Ankle Surgery® and might support the need for a shift toward the consistent use of a smaller number of valid, reliable, and clinically useful scales in the podiatric medical literature.