The American College of Foot and Ankle Surgeons developed the Universal Evaluation Scoring System... more The American College of Foot and Ankle Surgeons developed the Universal Evaluation Scoring System to evaluate parameters related to foot and ankle surgery. The project was developed in four sections or modules. The second of these modules, Forefoot, is presented here.
Page 1. DIABETIC FOOT DISORDERS A Clinical Practice Guideline Robert G. Frykberg, DPM, MPH, David... more Page 1. DIABETIC FOOT DISORDERS A Clinical Practice Guideline Robert G. Frykberg, DPM, MPH, David G. Armstrong, DPM, John Giurini, DPM, Annemarie Edwards, DPM, Marc Kravette, DPM, Steven Kravitz, DPM, Charles Ross, DPM, James Stavosky, DPM, ...
The Salto-Talaris polyethylene articulating surface was designed to allow, but limit accessory mo... more The Salto-Talaris polyethylene articulating surface was designed to allow, but limit accessory motion. This investigation examines surface characteristics between the polyethylene bearing and anatomic talar component in various positions of function. A Salto Talaris talar prosthesis and matching polyethylene bearing were scanned to create digital solid body models and manipulated to assess surface contact during simulated gait. With computer micromanipulation of the component positions, the surface intersections were recorded for 15 different alignments. The Salto Talaris has limited contact congruity with four points of contact in dorsiflexion, neutral, and plantarflexion. Lateral and medial translations showed only 2-point contact. The radii of curvatures between the talar component and polyethylene surfaces do not match. There was no sulcus contact yet component separation distance was small, suggesting increased loads. Surface incongruency was measured based on computer model analysis which raises a concern of increased contact pressures.
Open reduction with internal fixation for unstable ankle fractures is relatively predictable with... more Open reduction with internal fixation for unstable ankle fractures is relatively predictable with excellent outcomes. However, the management of ankle fractures in the elderly remains less predictable secondary to the various co-morbidities associated with advanced age. We sought to determine the incidence of complications after ORIF of ankle fractures in an elderly population. Specifically, the aim of this study was
... Luke Cicchinelli, DPM Private Practice, East Valley Foot and Ankle Specialists, Mesa, Arizona... more ... Luke Cicchinelli, DPM Private Practice, East Valley Foot and Ankle Specialists, Mesa, Arizona, Faculty, The Podiatry Institute, Atlanta, Georgia Anish R. Kadakia, MD ChiefDivision of Foot and Ankle Surgery, Assistant Professor of Orthopedic Surgery, University of Michigan ...
The use of arthroscopy in the management of acute traumatic conditions of the foot and ankle has ... more The use of arthroscopy in the management of acute traumatic conditions of the foot and ankle has increased in recent years, primarily because of an appreciation of fracture morphology and the utility of reducing the surgical footprint. This article presents an overview of the use of this modality in foot and ankle trauma and presents an anatomical survey of the various fractures where arthroscopic assistance can be of benefit. In addition, a discussion of the seminal articles on this subject is included. Therapeutic Level IV: Review.
The present retrospective study assessed the complications and loss of reduction in 126 patients ... more The present retrospective study assessed the complications and loss of reduction in 126 patients aged 16 years or older who bore weight in a short leg cast within 15 days after surgical repair of acute unilateral closed ankle fractures from January 1997 to December 2003. Fracture reduction was assessed on immediate postoperative and weightbearing digital radiographs at least 6 weeks after surgery. The medical records were reviewed for postoperative complications. Complete radiographs were available for 81 patients. The mean follow-up period was 171 (range 42 to 1275) days. The mean patient age was 50 years. Patients began walking an average of 8 days after surgery. From the medical record review, no cases of malunion or nonunion occurred. A total of 14 complications developed in 12 (9.5%) of 126 patients, including a delay in wound healing in 6, nerve paresthesia in 5, and hardware migration in 1. The patients aged 60 years or older had a slightly greater overall complication rate (6 of 38, p = .18). Patients who walked on postoperative day 1 had slightly more wound problems (2 of 19, p = .36). Of the 81 ankle fracture radiographs, 80 (98.8%) showed no displacement in fracture reduction on the final follow-up examination. One patient had a 2-mm loss of fracture reduction and was allowed to walk on postoperative day 1 (p = .09). These results support early protected weightbearing after operative treatment of closed isolated lateral malleolar and bimalleolar ankle fractures without syndesmotic involvement in patients of all ages.
This multicenter study retrospectively reviewed the medical records and radiographs of 15 consecu... more This multicenter study retrospectively reviewed the medical records and radiographs of 15 consecutive patients (17 feet; mean patient age, 54.1 years), who underwent revision "bone-block" Lapidus arthrodesis for a symptomatic nonunion. In all cases but one, the procedure was performed with ipsilateral autogenous bone grafting. All cases used either screw fixation or a combination of screw and plate fixation. Patients were monitored for a minimum of 6 months postoperatively to assess clinical and radiographic union. Successful union was seen in 14 (82%) of the 17 feet that underwent revision. Nonunion was documented in 3 (18%) cases. These results support a favorable rate of union with the described surgical technique. Chi-square tests of association were used to determine whether gender, fixation, bone stimulation, and smoking were predictive of or associated with bone healing. Active smoking in the perioperative period was a predictor of nonunion (P = .05). Based on these findings, the authors recommend aggressive preoperative counseling, and smoking should be considered a relative contraindication to revision surgery.
A case of a concomitant rupture of the Achilles tendon and superior peroneal retinaculum is prese... more A case of a concomitant rupture of the Achilles tendon and superior peroneal retinaculum is presented. This combination of injuries has only been reported once in the available literature. The intraoperative findings revealed a mid-substance failure of the superficial peroneal retinaculum, which is also a rare finding. It is suggested that mid-substance failure of this structure be included within the existing classification scheme for superficial peroneal retinacular tears. The authors also discuss the probable pathoanatomical features of these combined injuries and a proposed mechanism of injury.
The American College of Foot and Ankle Surgeons developed the Universal Evaluation Scoring System... more The American College of Foot and Ankle Surgeons developed the Universal Evaluation Scoring System to evaluate parameters related to foot and ankle surgery. The project was developed in four sections or modules. The second of these modules, Forefoot, is presented here.
Page 1. DIABETIC FOOT DISORDERS A Clinical Practice Guideline Robert G. Frykberg, DPM, MPH, David... more Page 1. DIABETIC FOOT DISORDERS A Clinical Practice Guideline Robert G. Frykberg, DPM, MPH, David G. Armstrong, DPM, John Giurini, DPM, Annemarie Edwards, DPM, Marc Kravette, DPM, Steven Kravitz, DPM, Charles Ross, DPM, James Stavosky, DPM, ...
The Salto-Talaris polyethylene articulating surface was designed to allow, but limit accessory mo... more The Salto-Talaris polyethylene articulating surface was designed to allow, but limit accessory motion. This investigation examines surface characteristics between the polyethylene bearing and anatomic talar component in various positions of function. A Salto Talaris talar prosthesis and matching polyethylene bearing were scanned to create digital solid body models and manipulated to assess surface contact during simulated gait. With computer micromanipulation of the component positions, the surface intersections were recorded for 15 different alignments. The Salto Talaris has limited contact congruity with four points of contact in dorsiflexion, neutral, and plantarflexion. Lateral and medial translations showed only 2-point contact. The radii of curvatures between the talar component and polyethylene surfaces do not match. There was no sulcus contact yet component separation distance was small, suggesting increased loads. Surface incongruency was measured based on computer model analysis which raises a concern of increased contact pressures.
Open reduction with internal fixation for unstable ankle fractures is relatively predictable with... more Open reduction with internal fixation for unstable ankle fractures is relatively predictable with excellent outcomes. However, the management of ankle fractures in the elderly remains less predictable secondary to the various co-morbidities associated with advanced age. We sought to determine the incidence of complications after ORIF of ankle fractures in an elderly population. Specifically, the aim of this study was
... Luke Cicchinelli, DPM Private Practice, East Valley Foot and Ankle Specialists, Mesa, Arizona... more ... Luke Cicchinelli, DPM Private Practice, East Valley Foot and Ankle Specialists, Mesa, Arizona, Faculty, The Podiatry Institute, Atlanta, Georgia Anish R. Kadakia, MD ChiefDivision of Foot and Ankle Surgery, Assistant Professor of Orthopedic Surgery, University of Michigan ...
The use of arthroscopy in the management of acute traumatic conditions of the foot and ankle has ... more The use of arthroscopy in the management of acute traumatic conditions of the foot and ankle has increased in recent years, primarily because of an appreciation of fracture morphology and the utility of reducing the surgical footprint. This article presents an overview of the use of this modality in foot and ankle trauma and presents an anatomical survey of the various fractures where arthroscopic assistance can be of benefit. In addition, a discussion of the seminal articles on this subject is included. Therapeutic Level IV: Review.
The present retrospective study assessed the complications and loss of reduction in 126 patients ... more The present retrospective study assessed the complications and loss of reduction in 126 patients aged 16 years or older who bore weight in a short leg cast within 15 days after surgical repair of acute unilateral closed ankle fractures from January 1997 to December 2003. Fracture reduction was assessed on immediate postoperative and weightbearing digital radiographs at least 6 weeks after surgery. The medical records were reviewed for postoperative complications. Complete radiographs were available for 81 patients. The mean follow-up period was 171 (range 42 to 1275) days. The mean patient age was 50 years. Patients began walking an average of 8 days after surgery. From the medical record review, no cases of malunion or nonunion occurred. A total of 14 complications developed in 12 (9.5%) of 126 patients, including a delay in wound healing in 6, nerve paresthesia in 5, and hardware migration in 1. The patients aged 60 years or older had a slightly greater overall complication rate (6 of 38, p = .18). Patients who walked on postoperative day 1 had slightly more wound problems (2 of 19, p = .36). Of the 81 ankle fracture radiographs, 80 (98.8%) showed no displacement in fracture reduction on the final follow-up examination. One patient had a 2-mm loss of fracture reduction and was allowed to walk on postoperative day 1 (p = .09). These results support early protected weightbearing after operative treatment of closed isolated lateral malleolar and bimalleolar ankle fractures without syndesmotic involvement in patients of all ages.
This multicenter study retrospectively reviewed the medical records and radiographs of 15 consecu... more This multicenter study retrospectively reviewed the medical records and radiographs of 15 consecutive patients (17 feet; mean patient age, 54.1 years), who underwent revision "bone-block" Lapidus arthrodesis for a symptomatic nonunion. In all cases but one, the procedure was performed with ipsilateral autogenous bone grafting. All cases used either screw fixation or a combination of screw and plate fixation. Patients were monitored for a minimum of 6 months postoperatively to assess clinical and radiographic union. Successful union was seen in 14 (82%) of the 17 feet that underwent revision. Nonunion was documented in 3 (18%) cases. These results support a favorable rate of union with the described surgical technique. Chi-square tests of association were used to determine whether gender, fixation, bone stimulation, and smoking were predictive of or associated with bone healing. Active smoking in the perioperative period was a predictor of nonunion (P = .05). Based on these findings, the authors recommend aggressive preoperative counseling, and smoking should be considered a relative contraindication to revision surgery.
A case of a concomitant rupture of the Achilles tendon and superior peroneal retinaculum is prese... more A case of a concomitant rupture of the Achilles tendon and superior peroneal retinaculum is presented. This combination of injuries has only been reported once in the available literature. The intraoperative findings revealed a mid-substance failure of the superficial peroneal retinaculum, which is also a rare finding. It is suggested that mid-substance failure of this structure be included within the existing classification scheme for superficial peroneal retinacular tears. The authors also discuss the probable pathoanatomical features of these combined injuries and a proposed mechanism of injury.
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