Foot & ankle international
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A neuroma of a calcaneal nerve has never been reported. A series of 15 patients with heel pain due to a neuroma of a calcaneal nerve are reviewed. These patients previously had either a plantar fasciotomy (n = 4), calcaneal spur removal (n = 2), ankle fusion (n = 2), or tarsal tunnel decompression (n = 7). ⋯ Excellent relief of pain occurred in 60%, and good relief in 33%. One patient (17%) had no improvement and required resection of the lateral plantar nerve. Awareness that the heel may be innervated by multiple calcaneal branches suggests that surgery for heel pain of neural origin employ a surgical approach that permits identification of all possible calcaneal branches.
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Comparative Study
The development and validation of a multi-dimensional measure of chronic foot pain: the ROwan Foot Pain Assessment Questionnaire (ROFPAQ).
The development and validation of the ROwan Foot Pain Assessment Questionnaire (ROFPAQ) is described. This is the first attempt to develop a multi-dimensional measure of chronic foot pain, and recognizes pain as having sensory, affective and cognitive dimensions. The ROFPAQ was developed from themes that emerged from running focus groups and semi-structured interviews with people with chronic foot pain. ⋯ The final scale demonstrates better than standard readability, has a short completion time and a simple scoring method. The scale allows clinicians to determine which dimension(s) of foot pain are the most relevant to the subject, thereby aiding decisions regarding appropriate treatment. Topics for further work on the ROFPAQ are highlighted.
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Comparative Study
Intramedullary screw fixation of proximal fifth metatarsal fractures: a biomechanical study.
Intramedullary screw fixation is a popular technique for treatment of proximal fifth metatarsal fractures. The purpose of this study was to compare the fixation rigidity of a 5.5 mm partially threaded cannulated titanium screw, with presumed superior endosteal purchase, to a similar 4.5 mm screw. ⋯ The initial failure loads for the metatarsals fixed with 4.5 mm and 5.5 mm screws were not significantly different (332.4 N vs. 335.2 N, respectively), nor were the ultimate failure loads (849.8 N vs. 702.2 N, respectively). Based upon our results, maximizing screw diameter does not appear to be critical for fixation rigidity and may increase the risk of intraoperative or postoperative fracture.
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We report a very rare case of anterior dislocation of the subtalar joint. Forceful supination of the foot and dorsiflexion of the ankle was considered the cause of the injury in this case. Closed reduction was successful for the talocalcaneal component of subtalar joint, although surgery was subsequently performed because of the residual subluxation of the midtarsal joint including the talonavicular component of subtalar joint and the associated fracture of the lateral process of the talus. Satisfactory results were shown at three-year follow-up.