Foot and Ankle
Sayyed-Hadi Sayyed-Hosseinian; Farshid Bagheri; Reza pourali; Ehsan Vahedi; Ali Birjandinejad; Mohammad Hosein Ebrahimzadeh
Abstract
Background: Ankle arthrodesis is one of the major surgeries for the treatment of advanced osteoarthritis of the ankle joint. There are various techniques available for ankle arthrodesis and each technique has unique advantages and disadvantages. The aim of the present study was to evaluate the results ...
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Background: Ankle arthrodesis is one of the major surgeries for the treatment of advanced osteoarthritis of the ankle joint. There are various techniques available for ankle arthrodesis and each technique has unique advantages and disadvantages. The aim of the present study was to evaluate the results of ankle arthrodesis with two this different approaches.Methods: The medical records of the patients who were admitted for ankle arthrodesis and treated by a single surgeon from January 2015 to January 2020 were reviewed. The patients were recalled for re-evaluation after a mean follow-up of 19 months. Functional outcomes were assessed using validated AOFAS Ankle-Hind foot score, Manchester-Oxford Foot Questionnaire (MOXFQ) and visual analog scale (VAS) score for pain. The collected data were recorded in a pre-designed checklist and then analyzed using SPSS software.Results: A total of 32 patients, 18 men and 14 women with a mean age of 46.7 years were included in the study. 67.6% had history of ankle fractures. Anterior approach was used in 24 patients, 75%, and the rest of the patients had surgery with lateral approach (25%). The most common instrument for arthrodesis was concomitant use of plate and screws in 18 patients (56%). Union occurred in 28 patients (87.5%) within 11.1 weeks after the surgery. The AOFAS score increased significantly and MOXFQ and VAS scores decreased significantly following the surgery (p<0.001 for each). Advanced age and intramedullary nail were related to prolonged time to union (p<0.05). Surgical approaches (either anterior or lateral) had no association with AOFAS, MOXFQ, and VAS scores. Non-union was seen in 4 patients (12.5%) and deep infection in 3 patients (9.3%) after ankle arthrodesis.Conclusion: The study results showed that, this surgery could improve patients’ pain and function with relatively low post-operative complications.
Foot and Ankle
shahab Ilka,; Alireza baghyari; Afshin Ahmadzadeh Heshmati
Abstract
Background: The aim of this study was to compare corticosteroid injection and corticosteroid injection with needle release (Pie-crusting) method in the treatment of plantar fasciitis in patients with heel pain.Methods: The present study is a randomized clinical trial. The study population included patients ...
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Background: The aim of this study was to compare corticosteroid injection and corticosteroid injection with needle release (Pie-crusting) method in the treatment of plantar fasciitis in patients with heel pain.Methods: The present study is a randomized clinical trial. The study population included patients with heel pain who had referred to a teaching center with plantar fasciitis for treatment during the years 2020-2019. The patients were randomly divided into two groups: corticosteroid injection and corticosteroid injection plus Pie-crusting method. The patients were visited again in the third (T1), sixth (T2), twelfth (T3) and twenty-fourth (T4) weeks post treatment, and the severity of pain and ankle and foot score (AOFAS) were determined at each visit. The data of this study were analyzed with SPSSv.24 software.Results: 89 patients (46 in steroid injection group and 43 in "pie-crusting" group) were examined. Patients in the two groups were similar in terms of age, sex and body mass index. The two groups showed a significant difference in terms of VAS of pain only in the T4. The AOFAS in the T2 (p=0.039), in the T3 (p>0.001), in the T4 (p>0.001) statistically significant differences were reported. Comparing the angle of inclination of the calcaneus, there was no statistically significant difference between the two groups in the T4.Conclusion: The results of this research showed good results in use of combination of corticosteroid therapy and "pie-crusting surgery" for plantar fasciitis.
Foot and Ankle
Mohammad Nouri; kavous vaziri; Morteza Jaannesari Ladani
Abstract
Background: The purpose of this study is to investigate the results of surgical treatment for hallux rigidus using the Weil osteotomy method in grade III patients with this disease.Methods: This quasi-experimental study involved a single-group intervention "before and after" the surgery. The research ...
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Background: The purpose of this study is to investigate the results of surgical treatment for hallux rigidus using the Weil osteotomy method in grade III patients with this disease.Methods: This quasi-experimental study involved a single-group intervention "before and after" the surgery. The research population consisted of patients with grade 3 hallux rigidus. The data collection tool used in this study was a checklist based on clinical examinations that evaluated joint movement in both plantar and lateral directions, as well as the Visual Analog Scale (VAS) to measure pain. The range of motion and pain level of the metatarsophalangeal (MTP) join were investigated and recorded before the operation and 1, 3, and 6 months after the operation. All this information was entered into SPSS software version 26.Results: The study groups included 8 (22.9%) male and 27 (77.1%) female patients, with an average age of 77.1 ± 12.17 years. The amount of pain decreased significantly (P=0.00) at the one-month and three-month follow-ups after the intervention, and the amount of passive movement of the joint in the plantar directions significantly increased from one month to three months after the intervention (P=0.00). 17 patients (48.6%) took up to two weeks after surgery, 10 patients (28.6%) between two to four weeks, and 8 patients (22.9%) more than one month to recover the mobility. The average joint space of the patients after the operation in plain radiography was 3.6 ± 0.46.Conclusion: : The Weil osteotomy surgery in hallux rigidus patients showed a significant decrease in pain level, and also a significant increase in joint motion and improvement in the average joint space in short term.
Foot and Ankle
Saam Hajialilo Sami; Mohammadhasan Nozaeim; Nima Naderi; Amir Mohammad Arefpour
Abstract
Background: Malignant soft tissue Tumours of the foot represent a unique subset of all soft tissue tumours, showing variance in type, location, age, prognosis, and treatment from tumours in the rest of the musculoskeletal system. The main objective was to describe the prevalence, demography and anatomical ...
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Background: Malignant soft tissue Tumours of the foot represent a unique subset of all soft tissue tumours, showing variance in type, location, age, prognosis, and treatment from tumours in the rest of the musculoskeletal system. The main objective was to describe the prevalence, demography and anatomical distribution of the malignant soft tissue tumours of the foot and subsequently, analyze the significance of operation, chemotherapy, and radiotherapy for local control and survival rate in patients with foot malignant tumours.Methods: The malignant soft-tissue foot tumours surgically treated by the author during a 6-years period (2010-2016) were retrospectively studied for their presenting symptomatology, treatment modalities and outcomes. The follow-up was considered for at least 5 years survival benchmark.Results: Only three of our patients under went amputation as a primary surgical plan. Others went under limb-salvage surgeries. Operation type had no significant effect on overall survival in our case series. The results of this study support the use of wide surgical excision and limb salvage surgery if obtainable, which is similar to previous reports.Conclusion: Our study focused exclusively on the presentation, treatments and outcomes of malignant soft-tissue tumours of the foot. By focusing solely on malignant soft-tissue tumours of the foot we hoped to better characterize the presentation, treatment and outcomes of this rare clinical entity.
Pediatrics
Marina R. Makarov, MD; Connor M. Smith, MD; Taylor J. Jackson, MD; Chan Hee Jo, Ph.D; John G JBirch, MD, FRCS(C)
Abstract
Introduction: Pediatric patients with Blount disease frequently demonstrate secondary adaptive deformities in the adjacent distal femur. This study evaluates adaptation of longitudinal and angular proportions of the ipsilateral healthy femur to progressive leg length discrepancy in unilateral cases.Methods: ...
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Introduction: Pediatric patients with Blount disease frequently demonstrate secondary adaptive deformities in the adjacent distal femur. This study evaluates adaptation of longitudinal and angular proportions of the ipsilateral healthy femur to progressive leg length discrepancy in unilateral cases.Methods: The study included 55 children with unilateral Blount disease. Preoperative radiographs were analyzed to characterize the condition as infantile or adolescent and measure femoral/tibial lengths and mechanical lateral distal femoral angles (mLDFA). Results: There were 26 patients with infantile and 29 with adolescent Blount disease. Adolescent patients were significantly older (14.4 ± 2.0 vs. 9.2 ±2.4; p<0.01). Black race was prevalent in both groups (69-79%). The adolescent group was predominantly male (25/29; 86%), while the infantile group was predominantly female (15/26; 58%, p<0.01). Leg length inequality in adolescent patients was significantly greater than in the infantile group (2.8 ± 2.0 vs.1.5 ± 1.1cm; p<0.01) with ipsilateral femoral shortening (1.8 ± 1.8 cm) accentuating tibial shortening (1.0 ± 1.1cm). Patients with infantile Blount disease had more pronounced tibial discrepancy (2.0 ± 1.1 cm; p<0.01) but modest overgrowth of the ipsilateral femur (0.5 ± 0.7; p<0.01) partially compensating ipsilateral tibial shortening. There was a significant difference in tibial:femoral ratios between the groups (p<0.01). The infantile group had on average normal mLDFA (88°), most adolescent patients had accentuating distal femoral varus deformity (96° ± 5°; p<0.01).Conclusions: Patients with unilateral infantile and adolescent Blount disease demonstrated distinctly different adaptation of the ipsilateral femur. Concomitant ipsilateral femoral changes aggravate angular deformity and leg length discrepancy in adolescent Blount disease.
Foot and Ankle
mohamad taghi peivandi; Farshid Bagheri; Ali Birjandi nezhad; Sara Amel Farzad; Lida Jarahi; Milad Esmail zade; Amin Razi; Reza Habibzadeh shojaie
Abstract
Introduction The use of parathyroid hormone in the management of fracture disorders is poorly documented. Aim of study was evaluation of parathyroid hormone efficacy on :union: of tibia/fibula diaphysis fractures. Materials and methods: It was a hospital-based study who conducted on patient with non-:union: ...
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Introduction The use of parathyroid hormone in the management of fracture disorders is poorly documented. Aim of study was evaluation of parathyroid hormone efficacy on :union: of tibia/fibula diaphysis fractures. Materials and methods: It was a hospital-based study who conducted on patient with non-:union: or delayed-:union: fracture of tibia/fibula. At Shahid Kamyab hospital, patients with inclusion criteria, entered the study after completing the conscious consent form in both case and control groups. CBC, ESR, Ca, P, Mg, ALK-P, Cr, BUN tests were performed as baseline, then in the case group prescribe oral D-Calcium and monthly injection of parathyroid hormone for 3 months at a daily dose of 8 units and in the control group, prescribe oral D-Calcium and the expected treatment method, and those who had a specific risk factor such as digoxin tablets or kidney failure were excluded from the study. After entering the study and receiving the hormone once the month, patients evaluate with radiographic parameter. Results: Of evaluated cases, mean and standard deviation of age in the intervention group was 16.9 ± 37.7 years and in the control group was 13.8 ± 39.1 years (P = 0.73). In terms of gender in the two groups, 24 cases were male and 6 cases were female (P = 1.0). In addition in clinical findings, fracture type (P = 1.0), fracture shape (P = 0.18), fixation method (P = 0.26), radiographical result (P = 0.06) did not have a statistically significant difference between the two groups. Conclusion: We not find any positive effect of this hormon on fracture status, as clinical or para clinical evaluation.
Foot and Ankle
Seyed Alireza Aminjavaheri; Seyed Hossein Shafiei; Mohammad Ali Ghasemi; Alireza Moharrami; Mir Mansour Moazen Jamshidi; Seyed Mohammad Javad Mortazavi
Abstract
Introduction: The risk of femoral neck fracture increases in the End Stage Renal Disease (ESRD) patients who underge hemodialysis. The aim of this study was to describe our experience with the treatment of femoral neck fracture in this particular group of patients. Method: In a retrospective study, between ...
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Introduction: The risk of femoral neck fracture increases in the End Stage Renal Disease (ESRD) patients who underge hemodialysis. The aim of this study was to describe our experience with the treatment of femoral neck fracture in this particular group of patients. Method: In a retrospective study, between January 2010 to December 2015, there were 16 displaced femoral neck fracture in 12 haemodialytic ESRD patient. All patients underwent total hip arthroplasty via direct anterior approach (three cementless and 9 cemented). No closed suction drain was used. Follow up regime was at 3,6 and 12 month and annually thereafter. Result: All patients were satisfied with the results of total hip arthroplasty. At the time of the final follow-up of 22 months (2-47) months, all the hips in the 12 haemodialytic patients functioned well without any loosening, and with a Harris hip score (HHS) of 90(82–100). Of those patients who received cementless components: one patient showed loosening of femoral component on the right and then left hip one year after surgery. He underwent revision of femoral component to a cemented one. The other complications include one greater trochanteric fracture, one intraoperative distal femoral fracture, one postoperative hematoma formation and one superficial surgical site infection. Conclusion: In this small series, relatively high complication rate is observable in cases of ESRD with femoral neck fracture treated by hip Arthroplasty. The use of cemented femoral sterns is preferred and extra caution is advised to avoid fracture in such osteoporotic bones.
