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  • 1
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    Online Resource
    Syntethic Neoligamentplasty with FiberTape has the Same Rigididy than Transarticular Screws in Lisfranc Subtle Lesions
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0010-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0010-
    Abstract: Midfoot/Forefoot, Sports Introduction/Purpose: Lisfranc joint injuries occur due to direct or indirect trauma, where a twisting or axial force is transmitted to the foot. Recently, new treatment options are being sought in order to use methods that allow a more physiologic fixation of this joint. The purpose of this study was to analyze the stability of a cadaveric Lisfranc injury model fixed with a synthetic neoligamentplasty in comparison to the traditional trans-articular screw fixation. Methods: 24 fresh frozen lower leg cadaveric specimens were utilized. The medial (C1) and intermediate (C2) cuneiforms, first (M1) and second (M2) metatarsal bones were marked. A complete ligament injury was performed between C1-C2 and C1-M2 in 12 specimens (Group 1), and between C1-C2, C1-M2, C1-M1 and C2-M2 in 12 matched specimens (Group 2). The groups were further divided in fixation with screws (G1 Screws and G2 Screws) and with Tape (G1 Tape and G2 Tape). The tape fixation group used a fixation technique described by this group, using FiberTape (Arthrex, Inc.). After ligament lesion and fixation, the construct rigidity was measured with the help of a 3D Digitizer arm, comparing the distances between the marked bones over a stress condition (pronation and supination of the forefoot). Results: Distance C1-C2 increased 3 mm after ligament injury (23% increase) with supination motion. C1-M2 increased 4 mm after ligament injury (21% increase) with pronation motion. Distances between C1-M1 and C2-M2 only changed in Group 2, increasing 3 mm (14%) and 2 mm (16%) respectively. Rigidity between C1-C2, C1-M1 and C2-M2 did not differ between the fixation with screws and with tape. The fixation with screws presented more rigidity in C1-M2 distance (p=0,03), but only in pronation stress. Conclusion: Pronation and supination motion of the forefoot relative to the hindfoot produces measurable joint displacements. Tape and Screws can produce the same rigidity after repairing Lisfrac Ligament injuries, except for distance C1-M2 in pronation stress.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00101
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 2
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    Online Resource
    Biomechanical Evaluation With a Novel Cadaveric Model Using Supination and Pronation Testing of a Lisfranc Ligament Injury
    SAGE Publications ; 2020
    In:  Foot & Ankle Orthopaedics Vol. 5, No. 1 ( 2020-01-01), p. 247301141989826-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 5, No. 1 ( 2020-01-01), p. 247301141989826-
    Abstract: Lisfranc joint injuries can be due to direct or indirect trauma and while the precise mechanisms are unknown, twisting or axial force through the foot is a suspected contributor. Cadaveric models are a useful way to evaluate injury patterns and models of fixation, but a frequent limitation is the amount of joint displacement after injury. The purpose of this study was to test a cadaveric model that includes axial load, foot plantarflexion and pronation-supination motion, which could re-create bone diastasis similar to what is seen in subtle Lisfranc injuries. Our hypothesis was that applying pronation and supination motion to a cadaveric model would produce reliable and measurable bone displacements. Methods: Twenty-four fresh-frozen lower leg cadaveric specimens were used. The medial (C1) and intermediate (C2) cuneiforms and the first (M1) and second (M2) metatarsal bones were marked. A complete ligament injury was performed between C1-C2 and C1-M2 in 12 specimens (group 1), and between C1-C2, C1-M2, C1-M1, and C2-M2 in 12 matched specimens (group 2). Foot pronation and supination in addition to an axial load of 400 N was applied to the specimens. A 3D digitizer was used to measure bone distances. Results: After ligament injury, distances changed as follows: C1-C2 increased 3 mm (23%) with supination; C1-M2 increased 4 mm (21%) with pronation (no differences between groups). As expected, distances between C1-M1 and C2-M2 only changed in group 2, increasing 3 mm (14%) and 2 mm (16%), respectively (no differences between pronation and supination). M1-M2 and C2-M1 distances did not reach significant difference for any condition. Conclusions: Pronation or supination in addition to axial load produced measurable bone displacements in a cadaveric model of Lisfranc injury using sectioned ligaments. Distances M1-M2 and C2-M1 were not reliable to detect injury in this model. Clinical Relevance: This new cadaveric Lisfranc model included foot pronation-supination in addition to axial load delivering measurable bone diastasis. It was a reliable Lisfranc cadaveric model that could be used to test different Lisfranc reconstructions.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419898265
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2874570-X
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  • 3
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    Online Resource
    Evaluation of Ankle Mobility Loss in Patients Undergoing Subtalar Arthrodesis
    SAGE Publications ; 2020
    In:  Foot & Ankle Orthopaedics Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0011-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0011-
    Abstract: Hindfoot Introduction/Purpose: Objective: To evaluate and quantify the loss of ankle mobility in patients undergoing subtalar arthrodesis compared to the contralateral side, through physical examination. Methods: A total of 12 patients who had only the subtalar arthrodesis procedure from various causes in one foot were selected. The same foot and ankle surgeon performed all measurements of bilateral tibiotarsal range of motion, with loaded closed-chain and unloaded open-chain tests. Then, to assess whether there was a difference between the operated and the non-operated side, statistical analysis was performed with the Mann-Whitney test (Hollander and Wolfe 1999). Results: On the loaded closed-chain test, the operated side had a significantly lower range of motion than the contralateral side, with a mean difference of 5.4 degrees for dorsal flexion and 7.6 degrees for plantar flexion. The open-chain tests showed non- significant differences of 3 degrees for dorsal flexion and 5.3 degrees for plantar flexion. Conclusion: Subtalar joint arthrodesis was shown to cause a loss of mobility in the ipsilateral ankle, which is greater in plantar flexion movement.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011420S00118
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2874570-X
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  • 4
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    Online Resource
    All-arthroscopic AMIC® (AT-AMIC) for the treatment of talar osteochondral defects : case series
    SAGE Publications ; 2018
    In:  Foot & Ankle Orthopaedics Vol. 3, No. 3 ( 2018-07-01), p. 2473011418S0015-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 3, No. 3 ( 2018-07-01), p. 2473011418S0015-
    Abstract: Arthroscopy Introduction/Purpose: Various operative procedures have been used to treat osteochondral lesions of the talus. Among the new alternatives to treat these lesions, Autologous Matrix-Induced Chondrogenesis (AMIC®) has proven to provide satisfactory results through medium-term follow-up. The aim of this study is to report early post-operative clinical results of patients submitted to the AT-AMIC® technique and autologous bone graft, when necessary, for OLT’s at a six-month minimum follow-up. Methods: This is case series of 17 consecutive patients that were submitted to AT-AMIC®, between january of 2016 and april of 2017. 9 men and 8 women, between 15 and 67 years were diagnosed with OLTs with the typical history of deep ankle pain and corresponding magnetic resonance imaging injury. Surgery was proposed only after failure of conservative treatment of at least 3 months. Surgeries were performed by three different surgeons, with high arthroscopic experience. Patients answered the AOFAS score preoperatively and at the last follow-up, ranging from 6 to 18 months Results: Average size of OLTs were 1,12 cm2, with Raikin 4 location being the most common (70,5%). Calcaneal osteotomy was the most common associated procedure, with 17,6%. Average follow-up was 10,76 months. Average AOFAS before surgery was 46,35, increasing to 89,53 at the last follow-up. This difference was statistically significant with a p-value of 〈 0,001. No complications were observed and no changes in the post-operative protocol were needed. Conclusion: AT-AMIC® is a reliable and reproducible method of treatment for OLTs, reaching high clinical postoperative scores, with a very low rate of complications. Further comparative study is needed to prove its efficacy.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011418S00153
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2874570-X
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  • 5
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    Online Resource
    “Double-Row” Suture for Achilles’ Tendon Insercional Tendinopathy Reattachment and Two Types of Rehabilitation Protocol: A Retrospective Comparative Study
    SAGE Publications ; 2022
    In:  Foot & Ankle Orthopaedics Vol. 7, No. 4 ( 2022-10), p. 2473011421S0084-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 7, No. 4 ( 2022-10), p. 2473011421S0084-
    Abstract: Hindfoot Introduction/Purpose: The purpose of this Study is to evaluate the results of knotless double-row sutures for Achilles insercional tendinopathy reattachment and compare two types of post-operative rehabilitation protocols. Methods: This is a retrospective comparative study of collected data from patients who were treated in two different hospital by two different surgeons. Sixty-three (63) patients (66 feet) were included and separated in two different groups. All of them were submitted to the same technique for knotless double-row suture for Achilles insercional tendinopathy reattachment. Group 1 was treated with a functional rehabilitation at the end of a 4 weeks NWB period and group 2 with early and aggressive functional post- operative management. Results: We found that both types of post-operative regimen generate significant improvement in pain and functional scores. Regarding pain, both rehabilitation protocols generated similar results, with no statistically significant differences. However, the FAAM-AVD score, on average, of patients in Group 1 was slightly higher than that of patients in the Group 2. This means that more than 50% of patients in the group 1 had a higher FAAM-AVD than all patients in the group 2. Regarding the comparison of the postoperative rehabilitation of the groups, a more accentuated improvement was observed in the group where functional rehabilitation was postponed to the 5th post-operative week, and the patients having remained immobilized for 4 (four) weeks in a NWB suropodalic orthosis on the operated limb. Conclusion: The double-row suture system for Achilles' reattachment is an excellent option for the surgical treatment of insertional Achilles' tendinopathy. The functional outcome of patients who were submitted to a 4-week delayed functional rehabilitation program is slightly better than those submitted to an early and aggressive functional rehabilitation program.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011421S00843
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 6
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    Online Resource
    Minimally Invasive Chevron Akin: Locking The Metatarsal-Cuneiform Joint
    SAGE Publications ; 2022
    In:  Foot & Ankle Specialist
    Details
    In: Foot & Ankle Specialist, SAGE Publications
    Abstract: Minimally Invasive Chevron Akin (MICA) can be used to treat hallux valgus (HV) associated with a hypermobility of the first metatarsal-cuneiform joint (1MTCJ). The aim of this study was to perform a radiographic analysis of the MICA, focused on evaluating the 1MTCJ. Methods Forty patients (50 feet) with moderate to severe HV underwent a MICA procedure. Radiographic analysis included hallux valgus angle (HVA), intermetatarsal angles between the first and second rays (IMA), the intermetatarsal angle between the proximal fragment of the osteotomy and the second ray (IAPF) and the distance between a point 3 cm distal from the base of the second metatarsal and a point located at the same height for the first metatarsal base (Dist 1-2). The IAPF was compared with the preoperative IMA, and the other parameters were compared preoperatively and postoperatively. The radiographic complications were also recorded. Results Most patients were female (92%). The mean age was 50.4 years (SD = 16.1) and the mean follow-up was 16.1 months (SD = 3.5). The average HVA improved from 32.5° to 7.3°, and the average IMA from 14.2° to 4.2°. The IAPF and Dist1-2 values showed an increase of 4.8° and 4.0 mm respectively. There were no radiographic complications. Conclusion. Minimally invasive Chevron Akin promotes a great correction of the moderate to severe HV conventional parameters and increase the transversal stability of the 1MTCJ fixing this joint as medial as possible. Level of Evidence Level IV, case series
    Type of Medium: Online Resource
    ISSN: 1938-6400 , 1938-7636
    URL: Article
    DOI: 10.1177/19386400221079155
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2411886-2
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  • 7
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    Online Resource
    Anterograde Percutaneous Treatment for Lesser Metatarsal Fractures : Technique Description and Clinical Results
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Techniques in Foot & Ankle Surgery Vol. 13, No. 2 ( 2014-06), p. 94-97
    Details
    In: Techniques in Foot & Ankle Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 2 ( 2014-06), p. 94-97
    Type of Medium: Online Resource
    ISSN: 1536-0644
    URL: Article
    DOI: 10.1097/BTF.0000000000000031
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 8
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    Online Resource
    Flexor to Extensor Tendon Transfer and Weil Osteotomy to Treat Grade IV Plantar Plate Tears
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Techniques in Foot & Ankle Surgery Vol. 19, No. 2 ( 2018-09-14), p. 84-88
    Details
    In: Techniques in Foot & Ankle Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 19, No. 2 ( 2018-09-14), p. 84-88
    Abstract: The plantar plate (PP) plays an important role in the stabilization of the lesser metatarsophalangeal (MTP) joints. Lesser toes’ gross deformities are associated with high-grade PP tears, according to the anatomic classification. The aim of this study was to describe the outcomes of 11 patients with PP tears grade IV, treated with the Girdlestone-Taylor-Parrish (GTP) technique, associated with a Weil osteotomy. Materials and Methods: Seventeen MTP joints with instability were treated with the GTP technique associated with a Weil osteotomy. All individuals had forefoot pain and some degree of crossover of the second (or second and third) toe(s) with clinical signs of complete rupture of the PP. Patients were evaluated preoperatively and postoperatively (12-month follow-up) with the American Orthopaedic Foot and Ankle Score, visual analog pain scale, toe purchase, toe elevation, joint stability, and joint congruency. Eight patients (8/11) declared that they were satisfied or very satisfied at the final follow-up. Results: The second MTP joint was the most commonly affected (14/17), followed by the third MTP joint (3/17). Our results reached high positive findings with 15/17 congruent joints at the postoperative radiograph, 8/17 joints presenting no elevation in the postoperative observation, and 17 joints with stability improvements and no major complications. Conclusions: The GTP technique associated with the Weil osteotomy is a reliable option for treating grade IV PP tears. The limitations of our study were the small number of patients analyzed, the absence of a control group, and the minimum follow-up period of 12 months. Level of Evidence: Diagnostic Level 4. See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 1536-0644
    URL: Article
    DOI: 10.1097/BTF.0000000000000217
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 9
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    Online Resource
    Corin ankle arthroplasty: Case-series
    Elsevier BV ; 2022
    In:  Foot and Ankle Surgery Vol. 28, No. 6 ( 2022-08), p. 745-749
    Details
    In: Foot and Ankle Surgery, Elsevier BV, Vol. 28, No. 6 ( 2022-08), p. 745-749
    Type of Medium: Online Resource
    ISSN: 1268-7731
    URL: Article
    DOI: 10.1016/j.fas.2021.09.004
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2006229-1
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  • 10
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    Shoe heel abrasion and its possible biomechanical cause: a transversal study with infantry recruits
    Springer Science and Business Media LLC ; 2015
    In:  Journal of Orthopaedic Surgery and Research Vol. 10, No. 1 ( 2015-12)
    Details
    In: Journal of Orthopaedic Surgery and Research, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2015-12)
    Type of Medium: Online Resource
    ISSN: 1749-799X
    URL: Article
    DOI: 10.1186/s13018-015-0319-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2252548-8
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