Foot & ankle international
-
Conventional treatment for tibiotalar joint arthritis relies on arthrodesis or prosthetic arthroplasty. Fresh osteochondral allografting is an alternative procedure to replace diseased articular cartilage. ⋯ Fresh osteochondral transplantation for tibiotalar joint arthritis is a promising alternative to arthrodesis and prosthetic replacement. Early results demonstrate successful outcomes and good pain relief in over half the patients in this series.
-
Comparative Study
Effects of a UCBL orthosis and a calcaneal osteotomy on tibiotalar contact characteristics in a cadaver flatfoot model.
A flatfoot deformity alters the contact characteristics of the ankle joint, shifting the location of articulation posterolaterally, increasing pressure, and decreasing the contact area within the ankle. These changes may explain the pattern of articular degeneration and subsequent angulation observed in a long-standing adult acquired flatfoot. Corrective orthoses and surgical reconstruction have been used to realign pes planovalgus feet, but the effects of these treatments on tibiotalar contact characteristics are unknown. We hypothesized that realignment of a flatfoot with either corrective orthosis or surgical reconstruction would restore the contact characteristics of the ankle to the intact state. ⋯ The changes observed in the magnitude and location of the mean and peak pressures indicate that the UCBL orthosis and calcaneal osteotomy altered hindfoot alignment to significantly influence tibiotalar contact characteristics. The results further suggest that the UCBL orthosis corrected ankle malalignment better than the calcaneal osteotomy in an adult acquired flatfoot. This study provides biomechanical data to support the clinical impression that realignment of the hindfoot corrects the pathologic tibiotalar contact characteristics associated with an adult acquired flatfoot. The results support the conclusion that the clinical management of a pes planovalgus foot with a UCBL orthosis or a medial translational osteotomy of the calcaneus may avert the onset of pantalar disease seen with late-stage posterior tibial tendon dysfunction.
-
Comparative Study
Combination of hook plate and tibial pro-fibular screw fixation of osteoporotic fractures: a clinical evaluation of operative strategy.
Internal fixation of osteoporotic ankle fractures is technically difficult and may fail because of unreliable purchase. This study was undertaken to determine if a combination of a hook plate and tibial pro-fibular screws can provide secure fixation until fracture union. ⋯ The combination of hook plate and tibial pro-fibular screws in osteoporotic ankle fractures in a series of patients has not been reported before. This novel technique provides stable fixation for osteoporotic ankle fractures in elderly patients until union is achieved with good clinical scores.
-
The purpose of this study was to evaluate the results of operative treatment of recurrent peroneal tendon dislocations followed by accelerated rehabilitation incorporating early range of motion and intermittent immobilization. ⋯ This procedure was reliable for preventing recurrent peroneal tendon instability. Range of motion was nearly normal, immobilization time was minimal, and all patients returned to daily activities and sports within 3 months of surgery.
-
Comparative Study
Ligamentous Lisfranc joint injuries: a biomechanical comparison of dorsal plate and transarticular screw fixation.
The current treatment of displaced ligamentous injuries of the tarsometatarsal (TMT) joints is open reduction and rigid fixation using transarticular screws. This technique causes further articular surface damage that theoretically may increase the risk of arthritis. Should the screws break, hardware removal is difficult. An alternative method that avoids these potential complications is rigid fixation using dorsal plates. ⋯ Dorsal plating may be an alternative to transarticular screws in the treatment of displaced Lisfranc injuries.