Foot & ankle international
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Comparative Study
Three-dimensional fluoroscopy for evaluation of articular reduction and screw placement in calcaneal fractures.
Anatomic reconstruction of the posterior calcaneal facet after intra-articular fracture is one of the critical factors in achieving a good functional result. Intraoperative evaluation of fracture reduction and implant placement relies on direct view by standard fluoroscopy. We hypothesized that three-dimensional (3D) fluoroscopy is more accurate than conventional fluoroscopy, and equivalent to CT for determining fracture reduction and screw position in calcaneal fractures. ⋯ This new technology may be particularly useful in assessing calcaneal fractures and may lead to improved fracture reduction, less implant misplacement, and improved patient outcomes.
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Randomized Controlled Trial Comparative Study
Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective, randomized, controlled trial.
The response of chronic plantar fasciitis to any treatment is unpredictable. Autologous blood might provide cellular and humoral mediators to induce healing in areas of degeneration, the underlying pathology in plantar fasciitis. This study compared the efficacy of intralesional autologous blood with corticosteroid injection for plantar fasciitis present for more than 6 weeks. ⋯ Intralesional autologous blood injection is efficacious in lowering pain and tenderness in chronic plantar fasciitis, but corticosteroid is more superior in terms of speed and probably extent of improvement.
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Fixed flexion deformity of the proximal interphalangeal joint with or without hyperextension of the metatarsophalangeal joint is one of the most common foot deformities. Many operative options have been recommended. Complaints after operative procedures include a too straight toe, floating toe, painful toe recurvatum, mallet toe, pin track infection, broken hardware, and the necessity of removing hardware. A proximal interphalangeal joint arthrodesis for hammertoe deformity using a 2-mm absorbable pin for internal fixation is described. ⋯ This procedure can be used for hammer toe deformities requiring surgery when the metatarsophalangeal joint is stable, the skin is not compromised, and the intramedullary canal of the proximal phalanx is 2.0 mm or less. It also has been useful in stabilizing hammertoe correction when there are severe pre-existing metal allergies.
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Since we have frequently noted osseous cyst-like lesions within the calcaneus on MRI studies, we sought to systematically evaluate this finding to determine the incidence and morphologic characteristics on MRI. ⋯ Calcaneal lesions are relatively common incidental findings on MRI. These lesions appear to represent intraosseous ganglion cysts that arise from the anterior margin of the posterior facet of the subtalar joint in the anatomical neighborhood where vessels penetrate the superior calcaneal cortex. The lesions can vary is size; however, there is no correlation between patient age and lesion size and no significant association between age and presence of these foci.