Abstract:
BACKGROUND:Nonunion risk factor identification and modification are subjective. We describe and validate a predictive nonunion risk factor model to identify foot and ankle operative patients at risk for nonunion. MATERIALS AND METHODS:One hundred international experts in foot and ankle surgery were surveyed. Nineteen nonunion risk factors were stratified into 3 categories: more significant than, as significant as, and less significant than smoking 1 pack per day. A nonunion risk assessment model was developed by assigning a weighted score to each risk factor, based on its mean score from the survey. A total nonunion risk (TNR) score was calculated for individual patients. It was retrospectively validated in 2 patient cohorts from a single center's prospectively collected end-stage ankle arthritis patient database: 22 cases of ankle and/or hindfoot fusion nonunion and 40 sex- and procedure-matched controls with bony fusion. Analyses included descriptive statistics, logistic regression, and univariate and multivariate linear regression models. RESULTS:The mean TNR score was 6.6 ± 5.6 in controls and 13.5 ± 8.2 in the nonunion group (P < .001). Data showed excellent intraobserver and interobserver correlation coefficients. In a logistic regression model, the risk of nonunion exceeded 9% with a TNR score greater than or equal to 10. Multivariate linear regression analysis, adjusted for age and sex, suggested that lack of fusion site stability and obesity (body mass index greater than 30) were significantly predictive of nonunion. CONCLUSION:The nonunion risk assessment model provides a reliable, sensitive, and specific method for predicting nonunion based on objective patient assessment. Orthopaedic patients at risk for nonunion could benefit from targeted intervention. LEVEL OF EVIDENCE:Level IV, retrospective observational study.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Thevendran G,Wang C,Pinney SJ,Penner MJ,Wing KJ,Younger ASdoi
10.1177/1071100715577789subject
Has Abstractpub_date
2015-08-01 00:00:00pages
901-7issue
8eissn
1071-1007issn
1944-7876pii
1071100715577789journal_volume
36pub_type
杂志文章abstract:BACKGROUND:A few studies report correlations between radiographic and anatomic measurements of the distal metatarsal articular angle (DMAA). However, little is known about how the DMAA correlates with the hallux valgus angle (HVA) and with anatomic and clinical radiographic measurements. METHODS:We dissected, measured...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100714522027
更新日期:2014-04-01 00:00:00
abstract::Foot and ankle operations are being performed with greater frequency as outpatient procedures. Although the surgical procedure remains the same whether the operation is done in an inpatient or an outpatient setting, the anesthesia and postoperative analgesia are greatly affected when patients must be discharged soon a...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002100107
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100717702688
更新日期:2017-07-01 00:00:00
abstract::Solitary calcaneal bone cysts are uncommon. Usually they measure 1/3 to 1/2 of the calcaneal length. Symptomatic calcaneal bone cysts are generally treated with open debridement and autologous bone grafting. We report a case of a patient with a displaced intra-articular calcaneal fracture who presents with a large ben...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070102200610
更新日期:2001-06-01 00:00:00
abstract::There are few reports in the literature documenting the efficacy of isolated arthrodesis for inflammatory arthritis of the talonavicular joint. Accordingly, we reviewed a single surgeon's experience with this procedure in twenty consecutive cases from this patient population. A technique using indirect joint distracti...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070002100406
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to review consecutive fifth metatarsal fractures in the author's (KFK) practice from August, 1999, to November, 2003. METHODS:During this period 64 patients (66 fractures; 35 tuberosity fractures, 10 Jones fractures, three stress fractures, two segmental shaft fractures and 16 ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600907
更新日期:2005-09-01 00:00:00
abstract::Twenty-nine feet in 28 patients who underwent subtalar distraction bone block fusion for the treatment of subtalar deformities associated with symptomatic arthrosis were evaluated. All patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score. Eighteen men and 10 wo...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079701801206
更新日期:1997-12-01 00:00:00
abstract::Twenty-two adult diabetic patients with clinical suspicion of foot and/or ankle infection were prospectively evaluated using radiography, technetium-99m methylene diphosphonate bone scanning (99mTc), indium-111-labeled leukocyte scanning (111In), and gallium-67 scanning (67Ga) to determine the presence of clinically s...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079601700103
更新日期:1996-01-01 00:00:00
abstract::Thirteen patients presenting with symptomatic pathologic variations or congenital deformities of the subtalar joint are presented. These variations included: four abnormal posterior talar processes, five patients with asymmetric subtalar joint development, and four congenital complete subtalar coalitions with a second...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079701800803
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively to minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy. METHODS:Forty cadaveric specimens were used. In 20 specimens, the sural, medial plantar (MP), and lateral plantar ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100715595696
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The timing and strategy for operative treatment of flatfoot are still controversial. The purpose of this study was to evaluate clinical outcomes and radiographic changes following calcaneal Z osteotomy combined with subtalar arthroereisis for severe adolescent flexible flatfoot. METHODS:Data were analyzed f...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100716658975
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Although a variety of surgical techniques are available for the treatment of ankle degenerative disease, arthrodesis is a common treatment especially for unilateral posttraumatic arthritis in young patients. A clear trend toward internal fixation for ankle arthrodesis is evident, but fusion site compression ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100713483097
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:In Charcot-Marie-Tooth (CMT) disease, selective weakness of the tibialis anterior muscle often leads to recruitment of the long toe extensors as secondary dorsiflexors, with subsequent clawing of the toes. Extensor hallucis longus (EHL) and extensor digitorum longus (EDL) tendon transfers offer the ability t...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719901119
更新日期:2020-04-01 00:00:00
abstract::The mobility and stability of the ankle joint have been extensively investigated, but many critical important issues still need to be elucidated. However, there seems to be a general agreement on several important observations. A more isometric pattern of rotation for the calcaneofibular and the tibiocalcaneal ligamen...
journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.1177/107110070002100715
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:We present the results of an alternative technique for decompression of a Morton intermetatarsal neuroma that is minimally invasive and does not require endoscopic instrumentation. METHODS:Seventeen nerve decompressions were performed in 14 patients using an instrument designed to release the transverse car...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2007.0263
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:To assess the efficacy of surgical correction of stage II tibial tendon deficiency with medial translational calcaneus osteotomy and flexor digitorum longus tendon transfer to the navicular, the authors retrospectively reviewed results of treatment of stage II posterior tibial tendon deficiency in 129 patien...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070402500701
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Liposomal bupivacaine is increasingly being utilized in attempts to provide prolonged local analgesia in the immediate postoperative period. The purpose of this study was to quantify the reduction in opioid consumption as well as postoperative pain scores in the postoperative period when liposomal bupivacain...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100714568664
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:More than 40 open procedures have been described for ankle arthrodesis, most with high complication rates. Since its description in 1983, arthroscopic ankle arthrodesis has become a viable option in selected patients. With one of the largest series in the literature, the purpose of the paper was to analyze t...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070502600402
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Insufficient or excessive bony constraint surrounding the talus might contribute to the occurrence of ligamentous injury or bone contusion, respectively, at the time of ankle inversion injuries. This study aimed to investigate the relationship between radiographic lateral ankle instability and osteochondral ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719868476
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Morton's neuroma is a common primary diagnosis for referral to foot and ankle surgeons. On presentation, many patients have had an ultrasound reporting the presence of Morton's neuroma, which may not correlate with the clinical examination findings. The prevalence of such sonographic findings in the general ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0543
更新日期:2012-07-01 00:00:00
abstract::Angioleiomyomas are relatively rare, benign, vascular soft tissue tumors with a predilection for the lower extremity. They may occur in either the cutaneous or subcutaneous tissue and are usually well encapsulated. Erosion of adjacent bone due to secondary compression phenomenon has rarely been reported in the literat...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070102200810
更新日期:2001-08-01 00:00:00
abstract::The purpose of this study was to analyze long-term costs for foot ulcers in diabetic patients. Patients were treated and followed prospectively by a foot care team. A retrospective economic analysis was performed of costs for 274 patients during 3 years from healing of an initial foot ulcer, with or without amputation...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079501600702
更新日期:1995-07-01 00:00:00
abstract::Thirteen patients who had undergone unilateral triple or double arthrodesis were studied an average of 5.2 years after surgery. Patients with a neuromuscular disorder; inflammatory arthritis; or any other focus of lower extremity arthritis, deformity, or joint dysfunction were excluded from the study. Clinical and rad...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079902000902
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The importance of isolated gastrocnemius contracture in disorders of the foot and ankle has been established in recent years. The aim of this study was to describe the proximal anatomical approach to the medial and lateral heads of gastrocnemius and to compare the sizes of the medial and lateral heads of the...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2009.1202
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Lateral column lengthening (LCL) has become an accepted procedure for the operative treatment of the flexible flatfoot deformity. Hindfoot arthrodesis via a calcaneocuboid distraction arthrodesis (CCDA) has been considered a less favourable surgical option than the anterior open wedge calcaneal distraction o...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0386
更新日期:2012-05-01 00:00:00
abstract::A method for measuring first metatarsal rotation on weightbearing tangential radiographs is described. Under controlled conditions using cadaver specimens, 5 degree changes in first metatarsal rotation were associated with a mean change in radiographically measured rotation of 5.4 degrees (SD = 1.7 degrees). A clinica...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079601700307
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:The tendo Achilles (TA) is a tendon very susceptible to injury. Biomechanical methodologies for exploring tendon strain are limited, however, as they are typically performed in vitro or by indirectly measuring the displacement of reference markers. By using panoramic ultrasound, this study reports a novel ap...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.0905
更新日期:2010-10-01 00:00:00
abstract:RECOMMENDATION:The optimal antibiotic treatment after foot/ankle fractures or fusion should be determined based on the result of culture. In the absence of culture results, administered antibiotics should include coverage against common pathogens such as Staphylococcus aureus. LEVEL OF EVIDENCE:Strong. DELEGATE VOTE:...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719861644
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Patients with diabetes who sustain an ankle fracture are at increased risk for complications including higher rates of in hospital mortality, in-hospital postoperative complications, length of stay and non-routine discharges. The purpose of this study was to retrospectively compare the complications associat...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0120
更新日期:2011-02-01 00:00:00
abstract::A prospective randomized controlled trial comparing open and percutaneous repair of closed ruptured Achilles tendons was performed over a period of 30 months. Sixty-six patients from seven district general hospitals were entered into the study with 33 patients randomized into each group. A modification of the techniqu...
journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/107110070102200705
更新日期:2001-07-01 00:00:00