Foot & ankle international
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Lisfranc injuries to the tarsometatarsal complex of the midfoot have become increasingly recognized in the athletic population. Regardless of mechanism, any injury that results in instability in the midfoot requires operative stabilization to preserve function and enable return to sport. In this manuscript, the anatomy, etiology, prevalence, current treatment modalities, and clinical outcomes of patients who suffer Lisfranc injuries are reviewed, with a special focus on the unique characteristics surrounding such an injury in an athlete.
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Comparative Study
Relationship Between Displacement and Degenerative Changes of the Sesamoids in Hallux Valgus.
Although the tangential sesamoid view is used to visualize the sesamoid position relative to the first metatarsal head, correctly evaluating patients with severe varus of the first metatarsal is difficult. Computed tomography (CT) can be helpful due to its cross-sectional images in any plane. The purposes of this study were to evaluate the alignment of the tibial sesamoid and investigate the relationship between malalignment and degenerative change in the sesamoid metatarsal joint (SMJ) using simulated weight-bearing CT imaging in patients with hallux valgus. ⋯ Level III, retrospective comparative study.
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Suture-button constructs are an alternative to screw fixation for syndesmotic injuries, and proponents advocate that suture-button constructs may allow physiological motion of the syndesmosis. Recent biomechanical data suggest that fibular instability with syndesmotic injuries is greatest in the sagittal plane, but the design of a suture-button construct, being a rope and 2 retention washers, is most effective along the axis of the rope (in the coronal plane). Some studies report that suture-button constructs are able to constrain fibular motion in the coronal plane, but the ability of a tightrope to constrain sagittal fibular motion is unknown. The purpose of this study was to assess fibular motion in response to an external rotation stress test in a syndesmotic injury model after fixation with a screw or suture-button constructs. ⋯ Fixation of a syndesmotic injury with a single suture-button construct did not restore physiological fibular motion, which may have implications for postoperative care and clinical outcomes.
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The objective of this study was to report the results of a new minimally invasive Achilles reconstruction technique and to assess the perioperative morbidity, medium- to long-term outcomes, and functional results. ⋯ Level III, retrospective comparative study.
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The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. ⋯ Level IV, retrospective case series.