Kearnsrobb6166

Although many surgeons believe that shortening osteotomies are appropriate in patients with metatarsalgia and long second metatarsals, there remains ambiguity regarding when to repair the injured plantar plate and when to leave it alone. We prospectively assessed consecutive adult subjects who underwent an isolated second Weil metatarsal osteotomy (WMO) or a WMO plus plantar plate repair (WMO + PPR) for sub-second metatarsophalangeal joint pain during a 3.5-year period at our practice. Eighty-six patients (86 feet 21 WMO only and 65 WMO + PPR) with a mean age of 61 ± 11 years were followed for 1 year. Patients were assessed via use of the Foot and Ankle Outcome Score and radiographic parabola/alignment of the operative digit preoperatively and postoperatively. Patients in the WMO + PPR group demonstrated significant improvements preoperatively to postoperatively in 4 of the 5 FAOS subscales (Pain, Other Symptoms, Sport and Recreation Function, and Ankle- and Foot-Related Quality of Life [QoL], all p less then .05) and had higher QoL and Pain subscale scores at 1 year compared with those in the WMO-only group (QoL 68.6 ± 26.7 versus 49.7 ± 28.5, respectively [p = .01]; Pain 83.2 ± 14.5 versus 73.6 ± 19.9, respectively [p = .04]). The WMO + PPR group tended to have higher-grade tears on intraoperative inspection (median 3, range 0 to 4) compared with those in the WMO group (median 1, range 0 to 3). There were otherwise no group differences in preoperative or postoperative radiographic parabola, alignment of the second toe, or complication rates. Our findings suggest that when a shortening osteotomy is performed, imbricating/repairing and advancing the plantar plate may be valuable regardless of injury grade in the plate. Arch structure and arch function play an important role in maintaining balance, bearing body weight, and absorbing ground reaction forces. However, arch structure and arch function are known to vary extensively and may be affected by factors such as gender, age, and obesity. Therefore, the purpose of this study was to examine the influence of gender, age, and body mass index (BMI) on arch height and arch stiffness. A total of 173 participants (aged 57.60 ± 11.19 years, mean BMI 25.12 ± 3.93 kg/m2) participated in this cross-sectional study. A 3-dimensional laser scanner was used to measure foot structure information in each subject, from which arch height and arch stiffness were calculated. The results showed that women had low-arched feet compared with men (p = .001), and no arch stiffness difference was found. Older individuals tended to have a stiffer arch than middle-aged and younger individuals (p less then .05), and no arch height difference was found. BMI had an impact on arch height (p less then .05) but not arch stiffness. Finally, a weak positive relationship existed between arch height and arch stiffness (r = 0.32, p less then .01). The findings suggest that gender, age, and obesity have a certain impact on arch structure and arch stiffness. Figuring out the relationship between these factors and arch structure may be helpful in understanding the bases of foot deformity and foot dysfunction. We present a comparison of preoperative and final postoperative first ray measurements in 109 feet after triplane tarsometatarsal arthrodesis at a mean follow-up time of 17.4 months. Preoperative and final postoperative first ray variables including intermetatarsal angle (IMA), hallux valgus angle (HVA), tibial sesamoid position (TSP), distal metatarsal articular angle (DMAA), Seiberg index, metatarsal rotation angle (MRA), sesamoid subluxation, osseous union, and hardware failure were evaluated. Measurements were made by consistently using the mid-diaphyseal line of the bone segments for both preoperative and postoperative assessments. The mean preoperative HVA, IMA, and TSP were 22.9°, 13.3°, and 4.6. The mean differences (95% confidence interval) in preoperative and postoperative values were -14.9° (-16.3° to -13.4°) for HVA, -7.7° (-8.2° to -7.2°) for IMA, and -2.6 (-2.8 to -2.3) for TSP. Among bunions with MRA measurements, the mean difference was -12.3° (-14.5° to -10.0°). The preoperative to postoperative DMAA decreased by a mean of -14.2° (-15.9° to -12.6°). The results of this study suggest that triplane tarsometatarsal arthrodesis produces appropriate correction of hallux valgus radiographic parameters. Acalabrutinib ic50 The Ottawa ankle rules (OAR) indicate that any patient with the inability to ambulate up to four steps or with tenderness at either malleoli should receive diagnostic imaging for an acute ankle injury. Current trends indicate that health care providers tend to order more images in practice than necessary according to OAR. The purpose of this study is to analyze OAR in geriatric versus nongeriatric patients. Secondarily, we hope to refine these guidelines for ankle imaging in the hopes that health care providers will be comfortable in adhering to these guidelines more strictly. A retrospective chart review was conducted of 491 adult patients with an average (± standard deviation) age of 54.4 ± 21.6 years (range 18 to 96). Applying the current OAR resulted in a sensitivity of 98.2% and a specificity of 58.6% in this entire cohort. The calculated sensitivities were comparable between the nongeriatric and geriatric cohorts, at 98.60% and 97.99%, respectively. The specificities varied between the nongeriatric and geriatric cohorts, at 60.13% and 33.33%. We propose new guidelines that would mandate imaging studies for any patient ≥65 years of age presenting to the emergency department with ankle pain. When applying these proposed guidelines, the sensitivity of the entire study population was found to be improved to 99.0%, whereas the specificity dropped to 56.7%. The slight decrease in specificity was deemed acceptable because these guidelines are meant to be used as a screening tool and because the risk of OAR not correctly identifying ankle fracture (2% of geriatric fractures) was completely mitigated in the geriatric population. In this randomized retrospective study, 2 different endoscopic approaches were used to treat intractable plantar fasciitis with the aim to reduce complications and improve therapeutic effects. The lateral double incisions group included 23 feet in 22 patients, and the medial and lateral incisions group included 21 feet in 19 patients. Both groups were treated with endoscopy through the suprafascial approach. Patients were evaluated using the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS-AHS) and visual analog scale (VAS) preoperatively and 3, 6, 12, and 24 months postoperatively. At the final follow-up, the Roles-Maudsley (R-M) score was used to determine patient satisfaction. The AOFAS-AHS scores of the lateral double incisions group were 54.54 ± 7.02 preoperatively and 97.71 ± 3.67 postoperatively. Similarly, AOFAS-AHS scores in the medial and lateral incisions group were 55.52 ± 6.41 preoperatively and 96.64 ± 3.18 postoperatively. There was no significant difference in AOFAS-AHS scores between groups before and after surgery.