- Arthroereisis: What Have We Learned? [Review]
- FAFoot Ankle Clin 2018; 23(3):415-434
- One of the most common orthopedic problems in the authors' practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of consensus about the type of surgical t...
One of the most common orthopedic problems in the authors' practice is flatfoot and, although it is most commonly treated conservatively, there is still lack of consensus about the type of surgical treatment that is best recommended in a specific patient. Keeping in mind that medial soft tissue reconstruction alone has not proved enough as an isolated procedure and that osteotomies and arthrodesis are considered more invasive surgery, arthroereisis is a quick, easy, and reproducible technique that seems to have good results without major complications in the correct patient. Indications, biomechanical principles, and technique are described in this article.
- Subtalar Joint Biomechanics: From Normal to Pathologic. [Review]
- FAFoot Ankle Clin 2018; 23(3):341-352
- Subtalar joint biomechanics are primarily driven by the shape of the articulations with contributions from the surrounding soft tissues. The joint motion occurs about a single axis oriented medially ...
Subtalar joint biomechanics are primarily driven by the shape of the articulations with contributions from the surrounding soft tissues. The joint motion occurs about a single axis oriented medially and superiorly. Joint contact forces change during different stages of gait and are affected by hindfoot alignment and traumatic alterations to their normal anatomy. A valgus subtalar joint axis is likely a contributing, and perhaps primary, risk factor for progression to adult acquired flat foot. The subtalar joint axis also contributes to the clinical picture of a cavus foot and a special subset of patients with dynamic varus.
- Comparison of Anatomic Structures at Risk With 2 Lateral Lengthening Calcaneal Osteotomies. [Journal Article]
- FAFoot Ankle Int 2018 Aug 02; :1071100718789435
- CONCLUSIONS: Anatomic structures can be damaged after both osteotomies. With the Hintermann osteotomy, the calcaneal anterior and medial articular surface can be protected to a larger extent than with the Evans osteotomy.The Hintermann osteotomy seems to be superior, regarding damage of the articular surfaces of the subtalar joint. These findings have to be correlated with biomechanical and clinical studies before a final recommendation can be given, which osteotomy is superior.
- O 097 - Predictors of midfoot break in children with cerebral palsy and flatfeet. [Journal Article]
- GPGait Posture 2018 Jun 26
- Foot Arch Height and Quality of Life in Adults: A Strobe Observational Study. [Journal Article]
- IJInt J Environ Res Public Health 2018 Jul 23; 15(7)
- CONCLUSIONS: Specific foot and general health-related QoL did not seem to be influenced by the foot arch height between high, normal and low feet arches heights. Nevertheless, further studies with higher sample sizes and matched-paired groups should be carried out.
- Functional evaluation of bilateral subtalar arthroereisis for the correction of flexible flatfoot in children: 1-year follow-up. [Journal Article]
- GPGait Posture 2018 Jun 11; 64:152-158
- CONCLUSIONS: According to the present analysis, both implants appear effective in restoring physiological alignment of the rearfoot, however the endo-orthotic implant appeared more effective in restoring a more correct frontal-plane mobility of foot joints.
- Effect of the calcaneal medializing osteotomy on soft tissues supporting the plantar arch: A computational study. [Journal Article]
- RERev Esp Cir Ortop Traumatol 2018 Jun 12
- Medializing calcaneal osteotomy forms part of the treatment options for adult acquired flat foot. The structural correction that is achieved is widely known. However, the effect of this procedure on ...
Medializing calcaneal osteotomy forms part of the treatment options for adult acquired flat foot. The structural correction that is achieved is widely known. However, the effect of this procedure on the soft tissues that support the plantar arch has been little studied, since it is not possible to quantify experimentally the tension and deformation variations generated. Therefore, the objective of this study was to evaluate the effect of medializing calcaneal osteotomy on the soft tissue that supports the plantar arch, using a computational model of the human foot designed with a clinical approach. The proposed finite element model was reconstructed from computerized tomography images of a healthy patient. All the bones of the foot, the plantar fascia, cartilages, plantar ligaments and the calcaneus-navicular ligament were included, respecting their anatomical distribution and biomechanical properties. Simulations were performed emulating the monopodal support phase of the human walk of an adult. The effect on each tissue was evaluated according to clinical and biomechanical criteria. The results show that calcaneal osteotomy reduces the tension normally generated on the evaluated tissues, with the effect on the calcaneus-navicular ligament and the plantar fascia being the most notable. The deformation results obtained are consistent with experimental tests and clinical knowledge. The versatility of this model allows the objective assessment of different conditions and supports decision making for the treatment of adult acquired flat foot in middle and advanced stages.
- Long-Term Outcomes of Corrective Osteotomies Using Porous Titanium Wedges for Flexible Flatfoot Deformity Correction. [Journal Article]
- JFJ Foot Ankle Surg 2018 Jun 08
- Common corrective osteotomies used in flexible flatfoot deformity reconstruction include Cotton and Evans osteotomies, which require structural graft to maintain correction. Auto-, allo-, and xenogra...
Common corrective osteotomies used in flexible flatfoot deformity reconstruction include Cotton and Evans osteotomies, which require structural graft to maintain correction. Auto-, allo-, and xenografts are associated with a number of limitations, including disease transmission, rejection, donor site morbidity, technical challenges related to graft fashioning, and graft resorption. Porous titanium is a synthetic substance designed to address these flaws; however, few studies have been reported on the efficacy, safety, and long-term outcomes. A multicenter retrospective cohort of 63 consecutive preconfigured porous titanium wedges (PTWs) used in flexible flatfoot reconstructions from June 1, 2009 to June 30, 2015 was evaluated. The primary outcome measure was the pre- to postdeformity correction efficacy. The secondary outcomes included maintenance of correction at a minimum follow-up point of 12 months, complications, graft incorporation, and graft safety profile. Multivariate linear regression found a statistically significant improvement in all radiographic parameters from preoperatively to the final weightbearing radiographs (calcaneocuboid 18.850 ± 4.020 SE, p < .0001; Kite's, 7.810 ± 3.660 SE, p = .04; Meary's 13.910 ± 3.100 SE, p = .0001; calcaneal inclination, 5.550 ± 2.140 SE, p = .015). When restricted to patients with >4 years of follow-up data, maintenance of correction appeared robust in all 4 measurements, demonstrating a lack of bone or graft resorption. No patients were lost to follow-up, no major complications or implant explantation or migration occurred, and all implants were incorporated. Minor complications included hardware pain from plates over grafts (8%), 1 case of scar neuritis, and a 5% table incidence of transfer pain associated with the PTWs. These results support the use of PTWs for safety and degree and maintenance of correction in flatfoot reconstruction.
- Earliest Probable Case of Mueller-Weiss Disease From Ancient Egypt. [Journal Article]
- JFJ Foot Ankle Surg 2018 Jun 04
- Mueller-Weiss disease is an alteration of the tarsal navicular that is primarily due to anomalous ossification of the bone and lateral deviation of the talar head associated with screw-like movement ...
Mueller-Weiss disease is an alteration of the tarsal navicular that is primarily due to anomalous ossification of the bone and lateral deviation of the talar head associated with screw-like movement through the axis of the subtalar joint. This syndrome tends to be associated with various degrees of flatfoot and hindfoot valgus combined with subtalar joint varus. Ancient cases of Mueller-Weiss disease have not been described in specialized literature. We present the case of an adult male from the Hellenistic period (Ptolemaic dynasty; fourth to first century BC), the skeleton for which was found inside a sarcophagus in the archaeological site of Sharuna (middle Egypt) with Mueller-Weiss disease. The specimen is, in all likelihood, the earliest case of this type of foot pathology in the archaeological record.
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- [Musculoskeletal system functional disorders in pregnancy]. [Journal Article]
- CGCeska Gynekol 2018; 83(2):138-144
- CONCLUSIONS: The lack of movement activities within the framework of sedentary lifestyle correlates with the musculoskeletal system disorders, which may influence both the adaptation mechanisms in general, and the bodys ability to adapt to the changes in pregnancy. High prevalence of the musculoskeletal system functional disorders in pregnancy may only represent a reflection of the state of female musculoskeletal system at present, and pregnancy, being the period of increased burden placed on the musculoskeletal system, only reflects its dysfunction. Physiotherapy shows a way to resolve the musculoskeletal system functional disorders during pregnancy.