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  • 1
    Online Resource
    Online Resource
    Talocalcaneal coalition resection and bone block subtalar joint arthrodesis : a techinical tip
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2020
    In:  Journal of the Foot & Ankle Vol. 14, No. 2 ( 2020-08-30), p. 211-218
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 14, No. 2 ( 2020-08-30), p. 211-218
    Abstract: In this technical tip, we present the case of an obese 17-year-old female diagnosed with a severe, rigid, and symptomatic flatfoot on a background of exuberant talocalcaneal and residual calcaneonavicular coalition. Through a technical modification of the fusion resection, both coalitions were quickly and safely removed with two single cuts of an oscillating saw, resecting a medial wedge through a medial approach, without the need for “peel-off” tarsal coalition resection. To protect and guide the resection osteotomy, one Freer elevator ws inserted under direct visualization on the patent posterolateral aspect of the subtalar joint posterior facet and a second elevator was positioned underneath the talar neck. Under fluoroscopic guidance, an osteotomy was performed connecting these two points. The patient also received a bone-block subtalar joint arthrodesis and a Cotton osteotomy. Good short-term alignment correction and functional outcome were achieved. Level of Evidence V; Therapeutic Studies; Expert Opinion.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2020.v14.1190
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2020
    detail.hit.zdb_id: 3040308-X
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  • 2
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    Online Resource
    Distal fibular periosteal flap for superior peroneal retinaculum reconstruction
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2021
    In:  Journal of the Foot & Ankle Vol. 15, No. 2 ( 2021-08-31), p. 183-187
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 15, No. 2 ( 2021-08-31), p. 183-187
    Abstract: Peroneal tendon instability is a common injury that occurs in physically active individuals, often as a result of trauma and in the context of an anatomically shallow distal fibular groove. Subluxation of these tendons over the lateral malleolus is accompanied by superior peroneal retinaculum injury. Several techniques have been described in the literature, including fibular groove deepening and retinaculum repair, but few reconstruction techniques are available for cases with insufficient residual retinaculum. We report the case of a 53-year-old man, without a history of trauma, who presented with chronic peroneal instability with a completely obliterated, unsalvageable retinaculum which we treated with a combination of fibular groove deepening and fibular periosteal flap to reconstruct the superior peroneal retinaculum. Level of Evidence V; Case Report; Expert Opinion. 
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2021.v15.1558
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2021
    detail.hit.zdb_id: 3040308-X
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  • 3
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    Online Resource
    Evaluation of foot and ankle injuries in professional soccer : prospective analyses of the Paulista Soccer Championship 2016
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2020
    In:  Journal of the Foot & Ankle Vol. 14, No. 2 ( 2020-08-30), p. 158-162
    Details
    In: Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 14, No. 2 ( 2020-08-30), p. 158-162
    Abstract: Objective: To evaluate the profile of foot and ankle injuries in professional soccer. Methods: Data were collected prospectively during the 2016 São Paulo Soccer Championship using two electronic forms: an initial form (10 variables) and a follow-up form (6 variables). The results were standardized and evaluated in SPSS 23.0. Results: A total of 259 injuries were reported: 106 to the thigh (40.9%), 42 to the foot and ankle (16.2%), 39 to the knee (15.1%), 39 to the head or face (15.1%) and 33 in other locations (12.7%). Of the 42 foot and ankle injuries, 20 were lateral ankle sprains (47.6%), 5 were medial ankle sprains (11.9%), 3 were to the triceps surae (7.1%), 3 were leg contusions (7.1%), 3 were foot contusions (7.1%), 2 were myalgias (4.8%), in addition to 5 other types (11.9%). There was physical contact in 73.8% of the injuries (p 〈 0.001), and six injuries (14.3%) were considered severe, i.e., involving a time loss of at least one month. Of the severe injuries, four were treated surgically (three by osteosynthesis and one by tenorrhaphy). The mean time loss due to injury was 19.7 days, and the overall incidence rate was 3.5 injuries per 1000 hours of exposure, with 2.1 ligament injuries per 1000 hours. X-rays and magnetic resonance imaging were the most requested tests in the follow-up of these patients. Conclusion: Foot and ankle injuries were the second most frequent injury in Brazilian professional soccer, 73.8% of which resulted from physical contact (p 〈 0.001). Lateral ankle sprains accounted for 47.6% of these injuries, which reaffirms their high prevalence and importance for sports medicine. Level of Evidence III; Prognostic Studies; Prospective Study.
    Type of Medium: Online Resource
    ISSN: 2675-2980
    URL: Article
    DOI: 10.30795/jfootankle.2020.v14.1140
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2020
    detail.hit.zdb_id: 3040308-X
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  • 4
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    Online Resource
    Flexor tenodesis procedure in the treatment of lesser toe deformities
    Springer Science and Business Media LLC ; 2021
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 142, No. 11 ( 2021-05-11), p. 3125-3137
    Details
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 142, No. 11 ( 2021-05-11), p. 3125-3137
    Abstract: In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. Level of evidence V – Technical Report/Case Report/Expert Opinion.
    Type of Medium: Online Resource
    ISSN: 1434-3916
    URL: Article
    DOI: 10.1007/s00402-021-03942-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1458452-9
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  • 5
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    Online Resource
    Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 143, No. 5 ( 2022-03-21), p. 2283-2295
    Details
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 143, No. 5 ( 2022-03-21), p. 2283-2295
    Abstract: Instability/collapse of the medial column has been associated with many conditions, particularly progressive collapsing foot deformity (PCFD), hallux valgus (HV), and midfoot arthritis (MA). Restoration of first ray length and sagittal plane alignment to restore the foot tripod is essential when treating these deformities. This study aimed to assess early results, healing, and complication rate of a distraction dorsal opening plantarflexion wedge allograft first tarsometatarsal joint fusion (LapiCotton Procedure) in patients with collapse/instability of the medial column. Methods In this prospective cohort study, we included PCFD, HV, and MA patients that underwent a LapiCotton procedure. Fusion site healing was defined by  〉  50% bone bridging in both interfaces between allograft wedge and host bone using weight-bearing computed tomography (WBCT) after 3 months. First ray collapse radiographic correction and minor and major complications (deep dehiscence, deep infection, and reoperation) were assessed. Results A total of 22 patients (22 feet) were included (11 PCFD, 6 MA, and 5 of HV patients). Mean follow-up was 5.9 months (range 3–12) and median allograft size was 8 mm (range 5–19 mm). Bone healing was observed in 91% of cases. Two minor complications (9%, both superficial dehiscence) and one major complication (4.5%, deep infection) were observed. Statistically significant improvement of the sagittal plane talus-first metatarsal angle was observed, with mean improvement of 9.4° (95% CI 6.7–12.1°; p   〈  0.0001). Conclusion In this prospective cohort study of 22 patients treated with the LapiCotton procedure for medial longitudinal arch collapse/instability, we observed a low complication rate (9% minor, 4.5% major), high healing rate after 3 months (91%), one clinically stable radiographic non-union (4.5%) and one unstable non-union (4.5%) needing reoperation. Our results demonstrate promising initial results for LapiCotton technique in treating collapse of the medial longitudinal arch in patients with PCFD, MA and HV deformities. Long-term results are needed to confirm these promising results. Level of evidence Level II, prospective cohort study.
    Type of Medium: Online Resource
    ISSN: 1434-3916
    URL: Article
    DOI: 10.1007/s00402-022-04399-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1458452-9
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  • 6
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    Online Resource
    Comparing Symptomatic and Asymptomatic Flatfeet Using Known Markers of Progressive Collapsing Foot Deformity (PCFD): A Case Control Study
    SAGE Publications ; 2023
    In:  Foot & Ankle Orthopaedics Vol. 8, No. 4 ( 2023-10)
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 8, No. 4 ( 2023-10)
    Abstract: Midfoot/Forefoot; Hindfoot Introduction/Purpose: Flattening of the longitudinal arch of the foot (Flatfoot) can represent a normal spectrum of foot morphology and alignment. The issue comes when the foot is collapsing progressively, what is now termed Progressive Collapsing Foot Deformity (PCFD). Literature on asymptomatic flatfoot is scarce since asymptomatic patients do not seek medical attention. Alignment differences between asymptomatic flatfoot and PCFD have not been established and might represent a key-step in understanding predictors of PCFD. The objective of this prospective study was to compare established PCFD measures in a cohort of asymptomatic flatfoot, PCFD patients and healthy controls. We hypothesized that asymptomatic flatfeet alignment would differ from both symptomatic PCFD patients and healthy controls. Methods: In this prospective comparative study, patients with asymptomatic flatfeet were recruited to undergo a weight-bearing CT (WBCT) scan. This cohort (22 feet, 10 males, 12 females) was compared to two other prospective cohorts (22 symptomatic PCFD and 22 healthy controls). Along with demographic data, PCFD measurements performed include Foot and Ankle Offset (FAO), Forefoot Arch Angle (FAA), Middle Facet Uncoverage, and the Transverse Arch Plantar (TAP) angle. Normality of variables was assessed using the Shapiro-Wilk test. Chi-squared or analysis of variance (ANOVA) test was performed to compare each parameter between the three groups. A post-hoc Bonferroni test was then performed to assess significance between each group pairing. P-values of 〉 0.05 were considered significant. Results: All three groups were comparable on BMI (p=0.10), Age (p=0.75) and Gender (p=0.78). All measurements taken differed significantly between the symptomatic PCFD and healthy controls (Table 1). FAO was significantly different between controls vs asymptomatic (p 〈 0.001) and asymptomatic vs symptomatic (p 〈 0.001). FAA was also significantly different between asymptomatic and both symptomatic (p=0.001) and control groups (p=0.001). Middle facet uncoverage differed between the asymptomatic and control group (p=0.001) but the asymptomatic and symptomatic group were similar (p=0.106). While the TAP angle was significantly different between asymptotic and symptomatic groups (p=0.013), the asymptomatic and control groups failed to reach significance (p=0.061) (Table 1). On average, deformity measurements for asymptomatic flatfeet were in between the values for healthy controls and symptomatic PCFD (Figures 1-3). Conclusion: To our knowledge this is the first prospective study to compare healthy controls, asymptomatic flatfoot and symptomatic PCFD patients. We observed that asymptomatic flatfoot patients usually had measurements of PCFD that would fall in between normal alignment asymptomatic controls and symptomatic PCFD patients. Further, the asymptomatic group differed significantly from both other groups on every measure but two. Our data supports the idea that asymptomatic flatfoot should be considered a risk factor for Progressive Collapsing Foot Deformity. Our data can hopefully shine light in finding predictive markers for the development of PCFD.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011423S00136
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2874570-X
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  • 7
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    Online Resource
    Deformities Influencing Different Classes in Progressive Collapsing Foot
    SAGE Publications ; 2023
    In:  Foot & Ankle Orthopaedics Vol. 8, No. 4 ( 2023-10)
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 8, No. 4 ( 2023-10)
    Abstract: Midfoot/Forefoot; Hindfoot Introduction/Purpose: The current classification system of progressive collapsing foot deformity (PCFD) is comprised of 5 possible classes. PCFD is understood to be a complex, three-dimensional deformity occurring in many regions along the foot and ankle. The question remains whether a deformity in one area impacts other areas. The objective of this study is to assess how each one of the classes is influenced by other classes by evaluating each associated angular measurement. We hypothesized that positive and linear correlations would occur for each class with at least one other class and that this influence would be high. Methods: We retrospectively assessed weight-bearing computed tomography (WBCT) measurements of 32 feet with PCFD diagnosis. The classes and their associated radiographic measurements were defined as follows: class A (hindfoot valgus) measured by the hindfoot moment arm (HMA), class B (midfoot abduction) measured by the talonavicular coverage angle (TNCA), class C (medial column instability) measured by Meary’s angle, class D (peritalar subluxation) measured by the medial facet uncoverage (MFU), and class E (ankle valgus) measured using the talar tilt angle (TTA). Multivariate analyses were completed comparing each class measurement to the other classes. A p-value 〈 0.05 was considered significant. Results: Class A showed a substantial positive correlation with class C (ρ=0.71; R2=0.576; p 0.001). Class B was substantially correlated with class D (ρ=0.74; R2=0.613; p 0.001). Class C showed a substantial positive correlation with class A (ρ=0.71; R2=0.576; p 0.001) and class D (ρ=0.75; R2=0.559; p 0.001). Class D showed a substantial positive correlation with class B and class C (ρ=0.74; R2=0.613; p 0.001), (ρ=0.75; R2=0.559; p 0.001) respectively. Class E did not show correlation with class B, C, or D (ρ=0.24; R2=0.074; p=0.059), (ρ=0.17; R2=0.071; p=0.179), and (ρ=0.22; R2=0.022; p=0.082) respectively. The average values of each class radiographic markers are listed in Figure 1. Conclusion: This study was able to find relations between components of PCFD deformity with exception of ankle valgus deformity (Class E). Measurements associated with each class were influenced by others, and in some instances, with pronounced strength such as between class A and C as well as between Class B and D. Surgical procedures to address certain class deformities could indirectly address other classes as well, which ultimately decreases surgical procedures numbers or complexity. The presented data may support the notion that PCFD is a three-dimensional complex deformity and suggests a possible relation among its ostensibly independent features.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011423S00141
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2874570-X
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  • 8
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    Online Resource
    Decreased Peritalar Subluxation in Progressive Collapsing Foot Deformity with Ankle Valgus Tilting
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  JBJS Open Access Vol. 8, No. 4 ( 2023-10-27)
    Details
    In: JBJS Open Access, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 4 ( 2023-10-27)
    Abstract: Middle facet subluxation (MFS) has been established as an early indicator of peritalar subluxation. However, when progressive collapsing foot deformity (PCFD) affects the ankle leading to a valgus talar tilt (Class E), structures and anatomic relationships distal to the ankle joint may be affected. Therefore, this study aimed to assess radiographic parameters of peritalar subluxation in patients with PCFD who either did or did not have a valgus ankle. Our hypothesis was that these parameters would differ in Class E patients, upsetting their capability to quantify deformity. Methods: We performed a prospective comparative study utilizing weight-bearing computed tomography (WBCT) images of 21 feet with PCFD and with valgus of the ankle and 64 with flexible PCFD without ankle involvement. Parameters including MFS, the medial cuneiform-to-floor distance, the forefoot arch angle, the talonavicular coverage angle, the hindfoot moment arm (HMA), the foot-ankle offset (FAO), and the talar tilt angle (TTA) were measured and compared. Variables that influence the presence of ankle valgus and overall alignment were assessed by multivariable regression models. Results: Patients with PCFD and ankle valgus demonstrated a higher mean HMA (20.79 mm [95% confidence interval (CI), 17.56 to 24.02 mm] versus 8.94 mm [95% CI, 7.09 to 10.79 mm] ), FAO (14.89% [95% CI, 12.51% to 17.26%] versus 6.32% [95% CI, 4.96% to 7.68%] ) and TTA (95% CI, 17.10° [14.75° to 19.46°] versus 2.30° [95% CI, 0.94° to 3.65°] ) and lower mean MFS (21.84% [95% CI, 15.04% to 28.63%] versus 38.45% [95% CI, 34.55% to 42.34%] ) compared with the group without ankle valgus (p 〈 0.0001 for all). The FAO was influenced by MFS in the group without ankle valgus (p 〈 0.0001) but not in the group with ankle valgus (p = 0.9161). FAO values of ≥12.14% were a strong predictor (79.2%) of ankle valgus deformity. Conclusions: Subluxation of the middle facet was not as severe and did not influence the overall alignment in patients with PCFD who had valgus of the ankle (Class E). These findings suggest a distal peritalar reduction in the presence of a proximal deformity, making MFS an imprecise disease parameter in this scenario. An FAO value of ≥12.14% was a strong indicator of ankle deformity in patients with PCFD. Level of Evidence: Diagnostic Level II . See Instructions for Authors for a complete description of levels of evidence.
    Type of Medium: Online Resource
    ISSN: 2472-7245
    URL: Article
    DOI: 10.2106/JBJS.OA.23.00025
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2873843-3
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  • 9
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    Online Resource
    Severe complications of posterior ankle arthroscopy
    Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe) ; 2019
    In:  Scientific Journal of the Foot & Ankle Vol. 13, No. 3 ( 2019-09-30), p. 223-7
    Details
    In: Scientific Journal of the Foot & Ankle, Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe), Vol. 13, No. 3 ( 2019-09-30), p. 223-7
    Abstract: Posterior ankle and hindfoot arthroscopic procedures are associated with a series of possible complications that must be taken into consideration by physicians when performing surgery. This article intends to assess the severe complications, such as subtalar ankle arthrodesis, occurring in patients undergoing ankle arthroscopy procedures in which at least one posterior portal is used. A series of five consecutive patients undergoing posterior ankle arthroscopy-related procedures were assessed. All the complications described in this article were considered severe by the group. We suggest that extreme care is necessary for the training and indications of this very useful but underestimated and complex tool. Level of Evidence V; Therapeutic Studies; Expert Opinion.
    Type of Medium: Online Resource
    ISSN: 2595-1459 , 2595-1467
    URL: Article
    DOI: 10.30795/scijfootankle.2019.v13.961
    Language: Unknown
    Publisher: Associacao Brasileira de Medicina e Cirurgia do Tornozelo e Pe (ABTPe)
    Publication Date: 2019
    detail.hit.zdb_id: 3040310-8
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  • 10
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    Online Resource
    Multiplanar instability of the first tarsometatarsal joint in hallux valgus and hallux rigidus patients: a case–control study
    Springer Science and Business Media LLC ; 2022
    In:  International Orthopaedics Vol. 46, No. 2 ( 2022-02), p. 255-263
    Details
    In: International Orthopaedics, Springer Science and Business Media LLC, Vol. 46, No. 2 ( 2022-02), p. 255-263
    Type of Medium: Online Resource
    ISSN: 0341-2695 , 1432-5195
    URL: Article
    DOI: 10.1007/s00264-021-05198-9
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1459230-7
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