Foot & ankle international
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Diabetic peripheral neuropathy is now well recognized as the most common cause of Charcot arthropathy of the foot and ankle, but it may be associated with other peripheral neuropathies. While not well known, it is well documented that rheumatoid arthritis is correlated with peripheral neuropathy. However, despite rheumatoid neuropathy, Charcot arthropathy has never been associated with rheumatoid arthritis. We report a series of Charcot arthropathy patients with concomitant rheumatoid arthritis. ⋯ Level IV, retrospective case series.
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Comparative Study
Biomechanical comparison of 4 different lateral plate constructs for distal fibula fractures.
Displaced lateral malleolar fractures are often treated with reduction and surgical stabilization. However, there has not been a comprehensive laboratory comparison to determine the most appropriate device for treating these patients. This study subjected a range of contemporary lateral fibular plates to a series of mechanical tests designed to reveal performance differences. ⋯ Identification of an optimal lateral fibular plating system has the potential to improve the clinical outcome of malleolar fracture fixation, particularly when patient conditions are unfavorable.
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In Chopart-level amputations the heel often deviates into equinus and varus when, due to the lack of healthy anterior soft tissue, rebalancing tendon transfers to the talar head are not possible. Consequently, anterior and lateral wound dehiscence and ulceration may occur requiring higher-level amputation to achieve wound closure, with considerable loss of function for the patients. ⋯ Level IV, retrospective case series.
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The flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon are routinely used in reconstructive foot and ankle surgery. The tendons cross in the chiasma plantare and show variable interconnections. This can complicate harvesting of the tendons. Previous anatomical studies were inconclusive and did not reference the connections to surgically relevant landmarks. The purpose of this study was to integrate these conflicting results, introduce a thorough classification system, and analyze the position of the interconnections relative to the surgically relevant bone landmarks. ⋯ The exact knowledge of the anatomy of the crossing of FDL and FHL in the plantar foot is essential to facilitate tendon harvesting, reduce morbidity and explain possible postoperative functional loss.
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Comparative Study
Multimodal analgesia therapy reduces length of hospitalization in patients undergoing fusions of the ankle and hindfoot.
Multimodal postoperative analgesia employs multiple medications given perioperatively to block the generation and perception of pain at different points in the nociceptive pathway. This retrospective study examines its effect on the length of stay for patients undergoing hindfoot and ankle fusions. ⋯ Level III, comparative series.