Abstract:
BACKGROUND:Open metatarsophalangeal (MTP) arthrodesis using locked plates produces good clinical outcomes. However, arthroscopic fusion with new-generation fully threaded compression screws is emerging as an alternative. The purpose of this study was to compare low-profile contoured locked plates with fully threaded compression screws for first MTP fusion, in a biomechanical cadaveric model. METHODS:The first rays of 8 matched pairs of fresh frozen cadaveric feet underwent dissection and dual-energy x-ray absorptiometry (DEXA) scanning to measure bone mineral density (BMD). The "plate" group was prepared with cup-and-cone reamers, and fixation of the MTP joint with 1 compression screw and low-profile dorsal locked plate. The matched-pair "screws" group was prepared through a simulated arthroscopic technique, achieving fixation with 2 new-generation fully threaded compression screws. The plantar MTP gap was recorded with an extensometer during 250 000 90-N cyclic loads followed by a single load to failure. RESULTS:The screw group demonstrated significantly greater stiffness, 31.6 N/mm (plates) and 51.7 N/mm (screws) (P = .0045). There was no significant difference in plantar gapping or load to failure, 198.6 N (plates) and 290.1 N (screws) (P = .2226). Stiffness and load to failure were highly correlated to BMD for the screw group, r =0.79 and r = 0.94, respectively, but less so for the plate group, r = 0.36 and r = 0.62, respectively. The maximum metatarsal head height measured on the lateral view was strongly correlated with load to failure for both the plate- and screw-only groups (r > 0.9). CONCLUSION:These data demonstrate that hallux MTP arthrodesis utilizing fully threaded compression screws had similar plantar gapping and load to failure when compared with the low-profile locking plate, but with significantly more stiffness. These results support an increased role of fully threaded screws for MTP arthrodesis using either the arthroscopic or open technique. However, with decreased BMD plate fixation may remain the better fixation choice. CLINICAL RELEVANCE:Our data suggest that with regard to construct stability, fully threaded headless compression screws may be just as effective as low-profile locking plates, but BMD and MTP joint fluoroscopic measurements should be considered in the decision-making process for fixation.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Fuld RS 3rd,Kumparatana P,Kelley J,Anderson N,Baldini T,Younger ASE,Hunt KJdoi
10.1177/1071100719837524subject
Has Abstractpub_date
2019-07-01 00:00:00pages
836-844issue
7eissn
1071-1007issn
1944-7876journal_volume
40pub_type
杂志文章abstract:BACKGROUND:The calcaneal osteotomy is a common procedure to correct hindfoot malalignment. Reported union rates are high, utilizing fixation methods including staples, plates, and most commonly cannulated screws. We began our practice using 6.5 mm and 7.3 mm cannulated screws, but complaints of postoperative posterior ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100714549191
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:A recent clinical study suggested that restrictive tenosynovitis of the flexor hallucis longus (FHL) may play an important causative role in hallux rigidus. The goals of this research were to assess normal function of the FHL and the effect of restricted FHL gliding on the loading of the hallux metatarsophal...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.0367
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The modified Broström (MB) procedure has long been the mainstay for the treatment of chronic lateral ankle instability (CLAI). Recently, suture tape (ST) has emerged as augmentation for this repair. The clinical benefit of such augmentation has yet to be fully established. The purpose of this study was to de...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720976071
更新日期:2021-01-23 00:00:00
abstract:BACKGROUND:Lateral release (LR) for the treatment of hallux valgus is a routinely performed technique, either by means of open or minimally invasive (MI) surgery. Despite this, there is no available evidence of the efficacy and safety of MI lateral release. Our aim was to study 2 popular techniques for MI LR in cadaver...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720920863
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:This prospective study evaluated the results of arthroscopic subtalar arthrodesis for painful hindfoot osteoarthritis. METHODS:The hypotheses were that (1) the arthroscopic technique results in a reliable fusion rate, (2) the clinical outcome is better than the open procedure and (3) complication rates are ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2007.0001
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND::The effect of bone mineral density (BMD) on outcomes from total ankle arthroplasty (TAA) has not been studied. BMD can be estimated by measuring Hounsfield units (HU) on standard computed tomography (CT), which is frequently performed prior to TAA. We aimed to identify whether tibial and talar HU measured f...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100718799102
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The moment, a force applied at a distance, is responsible for movement and balance. A key component of the moment is the moment arm. The moment arms of nine muscles surrounding the ankle complex during motion in three planes, were studied. MATERIALS AND METHODS:Five cadaveric feet were mounted in a testing ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0300
更新日期:2011-03-01 00:00:00
abstract::Periprosthetic osteolysis is a common occurrence after total ankle arthroplasty (TAA) and poses many challenges for the foot and ankle surgeon. Osteolysis may be asymptomatic and remain benign, or it may lead to component instability and require revision or arthrodesis. In this article, we present a current and compre...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720978426
更新日期:2020-12-21 00:00:00
abstract:BACKGROUND:The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radi...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100720947030
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Recently, peripheral nerve blocks have increasingly been used in orthopedic surgery. The foot block is an alternative for anesthesia in cases of forefoot and midfoot operations. We propose a modification of the block technique due to potential difficulties concerning the tibial nerve. MATERIALS AND METHODS:...
journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章
doi:10.3113/FAI.2010.0619
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Posterior tibial tendon dysfunction (PTTD) is a common malady leading to acquired flatfoot, which frequently causes foot and ankle pain and swelling. We hypothesized that patients with PTTD and pitting edema along the course of the posterior tibial tendon (PTT) would have evidence of fluid within the tendon ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2011.0189
更新日期:2011-02-01 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:The Krackow locking loop technique has been used for Achilles tendon repair with documented success in allowing early range of motion with stable fixation. Previous studies documented failure at the rupture site by knot failure. We propose a modification of the traditional Krackow technique where the knots o...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI-2009-0410
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND::Operative management of chronic Achilles tendon ruptures is challenging, and numerous techniques have been described. Risk of infection and wound breakdown have been described after open techniques, and minimally invasive methods have been proposed to avoid them. The aim of this study was to describe the cl...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100718793172
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Little information is available on the American Orthopaedic Foot and Ankle Society (AOFAS) outcome tool and its capacity to show changes and improvement in function of patients without a floor or ceiling effect. The purpose of the study was to compare results from the Musculoskeletal Functional Assessment (M...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2006.0788
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:One of the goals of the AOFAS website is to provide easily understandable information about orthopaedic foot and ankle conditions to the public. However, validation of this goal has not been conducted. Evaluation of text reading level is frequently performed using the Flesch-Kincaid formula (FKF). This study...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2009.0287
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:The presence of metatarsus adductus can complicate hallux valgus surgery. It reduces the gap between the first and second metatarsal and can restrict the transposition of the first metatarsal head. It also confounds the measurement of the first second intermetatarsal angle. MATERIALS AND METHODS:Twenty-seve...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2010.0220
更新日期:2010-03-01 00:00:00
abstract::The OssaTron may be another alternative for management of plantar fasciitis (heel pain syndrome) after failure of non-operative management and prior to surgical management. This study evaluated primarily the safety and early preliminary efficacy of the OssaTron in treatment of patients with plantar fasciitis unrespons...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070202300302
更新日期:2002-03-01 00:00:00
abstract::Tibiotalar arthrodesis remains the gold standard reconstructive procedure for the treatment of disabling ankle arthritis. The purpose of this study was to review the clinical results of tibiotalar arthrodesis utilizing the chevron fusion technique. The results of 46 consecutive patients who underwent ankle arthrodesis...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070402500406
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Coronal plane deformity is common in patients who undergo total ankle arthroplasty. The correction of this deformity is paramount to the long-term survival of the implant. Coronal plane correction is achieved with soft tissue balancing and, in some part, is maintained through articular geometry constraint. T...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100719862744
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The surgical management of brachymetatarsia remains controversial, and choice is based on potential complications. We report a classification of complications based on severity, and we hypothesized that use of a semicircular external fixator would minimize severe complications in lateral metatarsal lengtheni...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100715593373
更新日期:2015-11-01 00:00:00
abstract::Ruptures of tibialis anterior tendon can be caused by open, closed, direct, or indirect trauma, as well as spontaneously. Sixty-three cases of tibialis anterior tendon ruptures have been reported in the international literature. The treatment of choice is the surgical end-to-end or side-to-side anastomosis after previ...
journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.1177/107110079501600712
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Metastatic disease of the skeleton occurs in at least 20% to 30% of patients with malignancy, but metastasis to the foot and hand (acrometastasis) is extremely rare (0.007% to 0.3%). Metastases to the feet are even rarer and have been reported in half to one-third the rate for hand metastases. Failure to rec...
journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.3113/FAI.2008.0699
更新日期:2008-07-01 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::The free vascularized fibula graft has been an increasingly useful tool in orthopaedic surgery. In addition to its many applications, the reported low donor site morbidity has helped make this a popular treatment modality. Isolated flexor hallucis longus flexion contracture has been reported in the literature; however...
journal_title:Foot & ankle international
pub_type: 杂志文章,评审
doi:10.1177/107110079501601004
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:The fibula is commonly used for bone grafts. Previous clinical and biomechanical studies have suggested that the length of the residual portion of the distal part of the fibula has an important effect on the long-term stability of the ankle joint. However, we cannot find clear-cut guidelines for the amount o...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070602700306
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Fixed equinovarus deformities can be challenging to treat especially in medically debilitated patients. The purpose of this study was to evaluate Achilles lengthening with posterior tibial tenotomy and immediate weightbearing in this difficult group of patients. MATERIALS AND METHODS:Thirteen extremities in...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2008.0325
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to perform a histological comparative analysis of tibiotalar joint samples taken from areas of osteolysis adjacent to total ankle arthroplasties vs control synovial specimens to determine the reaction to and presence of polyethylene (PE) particles. METHODS:A total of 57 patholo...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/1071100716682333
更新日期:2017-04-01 00:00:00
abstract::Sixty patients (68 feet) underwent tarsal tunnel release for the tarsal tunnel syndrome and were re-examined objectively and clinically after they had reached maximum medical benefits and returned to their usual and customary lifestyle and employment. All of the patients demonstrated both a positive tinel sign and an ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Failed total ankle arthroplasty (TAA) often results in significant bone loss and requires salvage arthrodesis. This study quantified the bone loss following failed TAA and reports the outcome of seven arthrodesis reconstructions using the Ilizarov method. METHODS:A retrospective review of ankle fusions was ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.3113/FAI.2012.0947
更新日期:2012-11-01 00:00:00