International Journal of Environmental Research and Public Health

Research

9 pages, 4078 KiB

Open AccessArticle

Clinical Features and Treatment of Intra-Tendinous Suture Reaction Following Achilles Tendon Repair Using Nonabsorbable Suture Material: A Retrospective Case Series Study

by Jahyung Kim, Hwa-Jun Kang, Bom-Soo Kim, Yu-Mi Kim, Hyong-Nyun Kim, Jae-Yong Park, Young-Rak Choi, Altanzul Bat-Ulzii and Jaeho Cho

Int. J. Environ. Res. Public Health 2022, 19(19), 12897; https://doi.org/10.3390/ijerph191912897 - 8 Oct 2022

Cited by 1 | Viewed by 2469

Abstract

We aimed to investigate the clinical manifestations, radiological findings, and therapeutic outcome of treatment for patients with surgically confirmed foreign body reaction following an Achilles tendon repair using non-absorbable suture material. Eight consecutive patients who were confirmed as having an intra-tendinous suture foreign [...] Read more.

We aimed to investigate the clinical manifestations, radiological findings, and therapeutic outcome of treatment for patients with surgically confirmed foreign body reaction following an Achilles tendon repair using non-absorbable suture material. Eight consecutive patients who were confirmed as having an intra-tendinous suture foreign body reaction in the histopathological report were enrolled in this study. Medical records of all patients in terms of clinical and radiological features were retrieved. Also, the outcome of treatment was evaluated at a follow-up of at least 12 months. All the patients complained of pain and a palpable mass around a previous surgical site at mean 25.1 months (range, 4–72 months) after the initial surgery. Magnetic resonance imaging (MRI) or ultrasound were used to detect the lesion. All the patients underwent surgical excision of foreign body reaction tissue and primary repair using absorbable suture material. After the treatment, the wounds were healed completely in all, and the average FAOS (foot and ankle outcome score) was 91.32 at mean follow-up for 22.4 months. In conclusion, intra-tendinous suture reaction is a rare complication following an Achilles tendon repair using nonabsorbable suture material, but it can be treated adequately with only surgical excision of foreign body reaction tissue and primary repair using absorbable suture material. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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10 pages, 1144 KiB

Open AccessArticle

Anatomical Characteristics of Extensor Hallucis Longus Tendon Variations and Its Clinical Implications: A Korean Cadaveric Study

by Jeong-Hyun Park, Yu-Jin Choi, Mijeong Lee, Digud Kim, Hyung-Wook Kwon, Kwang-Rak Park, Sa-Beom Park and Jaeho Cho

Int. J. Environ. Res. Public Health 2022, 19(16), 9833; https://doi.org/10.3390/ijerph19169833 - 10 Aug 2022

Cited by 1 | Viewed by 3341

Abstract

The purpose of this study is to ascertain the morphological characteristics of the extensor hallucis longus (EHL) tendon variation using larger-scale dissection of Korean cadavers and to classify the types of variation along with incidence. A total of 158 feet from adult formalin-fixed [...] Read more.

The purpose of this study is to ascertain the morphological characteristics of the extensor hallucis longus (EHL) tendon variation using larger-scale dissection of Korean cadavers and to classify the types of variation along with incidence. A total of 158 feet from adult formalin-fixed cadavers (50 males, 29 females) were dissected. The morphological characteristics and measurements of the EHL tendon variants were evaluated. Three types of the EHL tendon variation were classified, wherein the most common type was Type 2 (106 feet, 67.1%), Type 3 (3 feet, 1.9%) was the rarest type, and Type 1 without accessory tendon was found in 49 feet (31.0%). Type 2K (11 feet, 7%) and Type 3K (1 foot, 0.6%) were described as new subtypes. The present study suggests morphological characteristics of the EHL tendon variation in Korean populations and high morphological variability of the EHL tendon along with the possibility of differences according to race or ethnicity and gender. Furthermore, a newly updated classification complemented by new subtypes of variation will help foot and ankle surgeons in diagnosis and surgical planning with hallux problems. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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9 pages, 1694 KiB

Open AccessArticle

Anatomical Classification for Plantaris Tendon Insertion and Its Clinical Implications: A Cadaveric Study

by Jeong-Hyun Park, Jaeho Cho, Digud Kim, Hyung-Wook Kwon, Mijeong Lee, Yu-Jin Choi, Kwan Hyun Yoon and Kwang-Rak Park

Int. J. Environ. Res. Public Health 2022, 19(10), 5795; https://doi.org/10.3390/ijerph19105795 - 10 May 2022

Cited by 3 | Viewed by 1667

Abstract

The purposes of this study were to ascertain the morphological characteristics of a plantaris tendon (PT) insertion using a larger-scale dissection of Korean cadavers and to classify the types of PT insertion related to the calcaneal tendon (CT). A total of 108 feet [...] Read more.

The purposes of this study were to ascertain the morphological characteristics of a plantaris tendon (PT) insertion using a larger-scale dissection of Korean cadavers and to classify the types of PT insertion related to the calcaneal tendon (CT). A total of 108 feet from adult formalin-fixed cadavers (34 males, 20 females) were dissected. The morphological characteristics and measurements of the PT insertion were evaluated. Five types of PT insertion were classified, wherein the most common type was Type 1 (39 feet, 63.1%). Type 2 and Type 3 were similar, with 16 feet (14.8%) and 15 feet (13.9%), respectively. Type 4 (6 feet, 5.6%) was the rarest type, and Type 5 had 25 feet (23.1%). The case of an absent PT was noted in 7 feet (6.5%). In the proximal portion, the tendon had a thick and narrow shape, became thin and wide in the middle portion, and then changed to thick and narrow again just before the insertion into the calcaneal tuberosity. This study confirmed the five types according to the location of the PT and the area of its insertion-related CT. The morphology of the PT insertion may be anatomically likely to influence the occurrence of tendinopathy in the CT. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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6 pages, 275 KiB

Open AccessCommunication

Incidence of Congenital Clubfoot: Preliminary Data from Italian CeDAP Registry

by Daniela Dibello, Lucio Torelli, Valentina Di Carlo, Adamo Pio d’Adamo, Flavio Faletra, Alessandro Mangogna and Giulia Colin

Int. J. Environ. Res. Public Health 2022, 19(9), 5406; https://doi.org/10.3390/ijerph19095406 - 29 Apr 2022

Cited by 3 | Viewed by 1765

Abstract

(1) Background: We find the incidence of clubfoot in Italy from “Certificate of Delivery Care Registry (CeDAP)”, a database of the Italian Ministry of Health, the most comprehensive public data available for this purpose. (2) Methods: The CeDAP registry is a web system [...] Read more.

(1) Background: We find the incidence of clubfoot in Italy from “Certificate of Delivery Care Registry (CeDAP)”, a database of the Italian Ministry of Health, the most comprehensive public data available for this purpose. (2) Methods: The CeDAP registry is a web system that provides epidemiological and sociodemographic information about newborns. It started on 1 January 2002, following the ministerial Decree no. 349 of 16 July 2001. The certificate is structured into six sections; each collects specific information referring to the birthplace, parents, pregnancy, childbirth, newborn, and the possible presence of congenital malformations or the causes of neonatal mortality. The midwife or the doctor draws up the certificate no later than ten days after birth. Each region transmits the data every six months to the Ministry of Health. The period between 2013 and 2017 has been selected for the study, with every Italian region’s data. We conducted a retrospective descriptive study. (3) Results: The overall rate in northern Italy is 1.09 (with some exceptions described), but we think it is essential to reevaluate this number again, given more accurate data collections by every Italian hospital. (4) Conclusions: This study intends to build a framework for future epidemiologic studies about clubfoot in Italy. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

11 pages, 1481 KiB

Open AccessArticle

Relationship between Kinesiophobia and Ankle Joint Position Sense and Postural Control in Individuals with Chronic Ankle Instability—A Cross-Sectional Study

by Mastour Saeed Alshahrani and Ravi Shankar Reddy

Int. J. Environ. Res. Public Health 2022, 19(5), 2792; https://doi.org/10.3390/ijerph19052792 - 27 Feb 2022

Cited by 25 | Viewed by 3663

Abstract

Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly influence physical factors, and understanding their relationship is crucial in assessing and managing individuals with FAI. The present study [...] Read more.

Functional ankle instability (FAI) is a condition that causes mechanical alterations to the ankle joint and leads to disability. Fear of movement can significantly influence physical factors, and understanding their relationship is crucial in assessing and managing individuals with FAI. The present study aimed to (1) assess the impact of kinesiophobia on ankle joint position sense (JPS) and postural control and (2) evaluate if kinesiophobia can predict JPS and postural control in FAI individuals. This cross-sectional study included 55 FAI individuals. The Tampa Scale of Kinesiophobia (TSK) score was used to measure kinesiophobia. The ankle JPS was evaluated using a digital inclinometer. The individuals were asked to actively reposition to the target position of 10° and 15° of dorsiflexion and plantarflexion. The reposition accuracy is measured in degrees. The static postural control was evaluated in unilateral stance using a stabilometric force platform, including assessments for the ellipse area, anterior to posterior sway, and medial to lateral sway in mm². Kinesiophobia showed a significant positive correlation (moderate) with the ankle JPS errors in dorsiflexion (10°: r = 0.51, p < 0.001; at 15°: = r = 0.52, p < 0.001) and plantarflexion (10°: r = 0.35, p = 0.009; at 15°: = r = 0.37, p = 0.005). Kinesiophobia also showed significant positive (moderate) correlation with postural control variables (ellipse area: r = 0.44, p = 0.001; Anterior–Posterior sway: r = 0.32, p = 0.015; Medial–Lateral sway: r = 0.60, p < 0.001). Kinesiophobia significantly predicted ankle JPS (p < 0.05) and postural control (p < 0.05). Increased fear of movement is associated with increased ankle JPS errors and postural sway in FAI individuals. Therefore, assessment of these factors is critical in FAI individuals. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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10 pages, 3145 KiB

Open AccessArticle

Clinical Manifestations, Diagnosis and Management of Synovial Fistula Associated Lateral Ankle Sprain or Instability: A Retrospective Study of 19 Surgically Confirmed Patients

by Jahyung Kim, Bum-Jin Shim, Jae-Shin Yang, Altanzul Bat-Ulzii and Jaeho Cho

Int. J. Environ. Res. Public Health 2022, 19(4), 2428; https://doi.org/10.3390/ijerph19042428 - 19 Feb 2022

Cited by 1 | Viewed by 3597

Abstract

We aimed to investigate the preoperative history, clinical manifestations, imaging findings, and postoperative clinical outcomes for patients with surgically confirmed synovial fistula around the ankle joint. 19 consecutive patients who were confirmed to have synovial fistula in the surgical field were enrolled in [...] Read more.

We aimed to investigate the preoperative history, clinical manifestations, imaging findings, and postoperative clinical outcomes for patients with surgically confirmed synovial fistula around the ankle joint. 19 consecutive patients who were confirmed to have synovial fistula in the surgical field were enrolled in this study. Medical records of all patients in terms of preoperative details, operative findings, and postoperative outcomes at 1 year after the surgery were retrieved. As a diagnostic modality, the normal saline test or MRI was used. Intraoperatively, the synovial fistula was repaired with the capsuloligamentous repair or additional periosteal augmentation. All patients had a history of ankle sprain prior to symptoms and showed positive results in the saline load test. One patient had recurred symptom after the surgery, so needed a revisional periosteal augmentation. At 1 year follow-up period, the average Foot ankle outcome score was 87.65 and no surgery-related complication was detected. Synovial fistula of the ankle joint needs to be taken into consideration as a possible complication in patients with ankle sprain history and recurrent joint swelling. The saline load test would be useful for its diagnosis, and treatment should be focused on the complete closure of capsular opening along with restoration of its surrounding pathologic conditions. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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7 pages, 8046 KiB

Open AccessArticle

A Simple Method to Locate the Master Knot of Henry Using the Correlation between the Flexor Tendon Length Parameter and the Foot Length

by Kwang Rak Park, Won-Jin Park, Si-Wook Lee, Hongtae Kim, Hyunsu Lee and Jae-Ho Lee

Int. J. Environ. Res. Public Health 2022, 19(4), 2281; https://doi.org/10.3390/ijerph19042281 - 17 Feb 2022

Cited by 1 | Viewed by 6777

Abstract

The precise location of the Master Knot of Henry (MKH) has important clinical significance, but its anatomical definition has not been agreed upon. The purpose of this study is to present a linear regression equation for predicting length variables based on foot length, [...] Read more.

The precise location of the Master Knot of Henry (MKH) has important clinical significance, but its anatomical definition has not been agreed upon. The purpose of this study is to present a linear regression equation for predicting length variables based on foot length, by evaluating the correlation of length variables related to flexor hallucis longus (FHL) and flexor digitorum longus (FDL), with respect to the location of the MKH. A total of 95 limbs were dissected from 48 adult cadavers, and were fixed in formalin. Measurements were made for the length parameter, with reference to the landmark. The relevance between length variables was analyzed through simple correlation analysis and linear regression analysis. The foot length was 213.69 ± 17.53 mm, MKH-great toe distal phalanx was 140.16 ± 14.69 mm, MKH-FHL insertion was 124.55 ± 13.46 mm, MKH-little toe distal phalanx was 121.79 ± 13.41 mm, MKH-FDL little toe insertion was 109.07 ± 14.16 mm, and the FHL-FDL angle was 33.15 ± 5.39. The correlation coefficient between all the length variables for foot length showed a high positive correlation. We derived a regression equation that can predict the length of each variable. This regression formula is considered to be highly useful because it can estimate the positional relationship of the MKH relatively simply. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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9 pages, 1409 KiB

Open AccessArticle

Efficacy of the Treatment of Plantar Warts Using 1064 nm Laser and Cooling

by Elena de Planell-Mas, Blanca Martínez-Garriga, Miguel Viñas and Antonio J. Zalacain-Vicuña

Int. J. Environ. Res. Public Health 2022, 19(2), 801; https://doi.org/10.3390/ijerph19020801 - 12 Jan 2022

Cited by 4 | Viewed by 3722

Abstract

Cutaneous plantar warts may be treated using several optional methods, with the use of laser surgery having increased in the last few years. This work examined the efficacy of laser treatment combined with simple cooling to reduce pain. The cure rate was approximately [...] Read more.

Cutaneous plantar warts may be treated using several optional methods, with the use of laser surgery having increased in the last few years. This work examined the efficacy of laser treatment combined with simple cooling to reduce pain. The cure rate was approximately 84%. There were no significant differences in the efficacy of treatment for different viral genotypes. The laser parameters were 500 msec pulses, 30 W of power, and a fluence of 212 J/cm² delivered in up to four sessions. Successful treatment was achieved after an average of 3.6 sessions. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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13 pages, 345 KiB

Open AccessArticle

Epidemiology, Clinical Characteristics, and Risk Factors for Running-Related Injuries among South African Trail Runners

by Carel T. Viljoen, Dina C. Janse van Rensburg, Evert Verhagen, Willem van Mechelen, Elzette Korkie and Tanita Botha

Int. J. Environ. Res. Public Health 2021, 18(23), 12620; https://doi.org/10.3390/ijerph182312620 - 30 Nov 2021

Cited by 10 | Viewed by 3106

Abstract

Trail running involves running on varying natural terrains, often including large elevation gains/losses. Trail running has a high risk of injury, and runners often participate in remote regions where medical support is challenging. The aim of this study was to determine the epidemiology, [...] Read more.

Trail running involves running on varying natural terrains, often including large elevation gains/losses. Trail running has a high risk of injury, and runners often participate in remote regions where medical support is challenging. The aim of this study was to determine the epidemiology, clinical characteristic, and associated injury risk factors among trail runners. A modified Oslo Sports Trauma Research Center Questionnaire for Health Problems (OSTRC-H) was used biweekly to collect running-related injury (RRI) and training history data prospectively, among 152 participants (males n = 120, females n = 32) over 30 weeks. We report an overall injury rate of 19.6 RRIs per 1000 h and an RRI mean prevalence of 12.3%. The leading anatomical site of RRIs was the lower limb (82.9%), affecting the knee (29.8%), shin/lower leg (18.0%), and the foot/toes (13.7%). A history of previous RRI in the past 12 months (p = 0.0032) and having a chronic disease (p = 0.0188) are independent risk factors for RRIs among trail runners. Two in three trail runners sustain an RRI mainly affecting the knee, shin/lower leg, and foot/toes. A history of previous RRI in the past 12 months and a having chronic disease is independently associated with RRI among trail runners. These results could be used to develop future RRI prevention strategies, combined with clinical knowledge and experience. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

10 pages, 1024 KiB

Open AccessArticle

Relationship of the Use of Short Footwear with the Development of Hallux Valgus in a Sample of Andalusian Schoolchildren

by María Luisa González-Elena, Aurora Castro-Méndez, Manuel Coheña-Jiménez and Antonio Córdoba-Fernández

Int. J. Environ. Res. Public Health 2021, 18(21), 11244; https://doi.org/10.3390/ijerph182111244 - 26 Oct 2021

Cited by 9 | Viewed by 2282

Abstract

Background: Several studies have shown the relationship between poor footwear fit and the risk of feet deformities. The available evidence seems to show that the development of hallux valgus deformity in the feet of schoolchildren may be related to the use of shoes [...] Read more.

Background: Several studies have shown the relationship between poor footwear fit and the risk of feet deformities. The available evidence seems to show that the development of hallux valgus deformity in the feet of schoolchildren may be related to the use of shoes that are poorly fitting in length. The objective of this cross-sectional study was to analyze the relationship between poor footwear fit in length and risk of developing hallux valgus. Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length was obtained and compared to the inner length of the shoe in 187 schoolchildren. Hallux valgus angle (HVA) was measured on weight-bearing podogram image obtained from the longest foot in 188 schoolchildren. Results: By default, the footwear was poorly fitting in length (too short or close-fitting) in 38.5% of the schoolchildren, with boys having the worst footwear fit; though no significant differences stood out. (p = 0.276). Regarding the HVA, no significant differences were recorded according to age or gender (p = 0.573). A strong correlation was observed between too-short footwear and the increase in HVA in 10-year-old boys (r = 0.817; p = 0.025) and in 9-year-old girls (r = 0.705; p = 0.005). Conclusions: Inadequate footwear fit in length may be a predisposing extrinsic risk factor for the development of hallux valgus in schoolchildren of both sexes. Results of the present study demonstrate the need to adapt the sizes of footwear to the rapid increase in foot-length that occur at puberty to avoid the risk of developing hallux valgus, especially at the ages of onset pubertal foot growth. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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13 pages, 4726 KiB

Open AccessArticle

Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture

by Jaeho Cho, Jahyung Kim, Eun Myeong Kang, Jeong Seok Lee, Tae-Hong Min, Sung Hun Won, Young Yi and Dong-il Chun

Int. J. Environ. Res. Public Health 2021, 18(19), 10400; https://doi.org/10.3390/ijerph181910400 - 2 Oct 2021

Cited by 5 | Viewed by 6258

Abstract

Although various outcomes of the sinus tarsi approach have been reported, these are limited to the Sanders type 2 displaced intraarticular calcaneal fractures (DIACF) because of the limited visibility of the posterior facet joint. In this study we aimed to (1) introduce a [...] Read more.

Although various outcomes of the sinus tarsi approach have been reported, these are limited to the Sanders type 2 displaced intraarticular calcaneal fractures (DIACF) because of the limited visibility of the posterior facet joint. In this study we aimed to (1) introduce a sinus tarsi approach combined with an anterolateral fragment open-door technique that enables adequate visibility of the innermost and middle portion of the posterior facet joint, and (2) evaluate the radiographic and clinical outcomes of the patients treated with that technique. This is a retrospective case-series study performed on medical records of 25 patients who presented with the Sanders type 3 or 4 DIACF and were treated with the sinus tarsi approach. The radiologic measurements showed significant corrections of the Bohler’s angle, calcaneal width, length, height, and articular step-off in both X-rays and CTs in the last follow-up period. The mean AOFAS score was 90.08 ± 6.44 at the last follow-up. Among all the follow-up patients, two cases (8%) had acute superficial infections, and no other wound complications occurred. Therefore, we suggest that the Sanders type 3 or 4 DIACF could be successfully treated with the proposed technique with low complications and bring out effective clinical and radiologic outcomes. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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11 pages, 3453 KiB

Open AccessArticle

Adult Stature Estimation from Radiographic Metatarsal Length in a Contemporary Korean Population

by Suyeon Park, Young Yi, Battur Tsengel, Jahyung Kim, Dong-Il Chun, Sung-Hun Won, Tae-Hong Min, Jeong-Hyun Park, Mijeong Lee and Jaeho Cho

Int. J. Environ. Res. Public Health 2021, 18(19), 10363; https://doi.org/10.3390/ijerph181910363 - 1 Oct 2021

Cited by 1 | Viewed by 2387

Abstract

The ability to estimate stature can be important in the identification of skeletal remains. This study aims to develop a Korean-specific equation predicting stature using radiographic measurements in the contemporary Korean population. 200 healthy Korean adults, including 102 males and 98 females, were [...] Read more.

The ability to estimate stature can be important in the identification of skeletal remains. This study aims to develop a Korean-specific equation predicting stature using radiographic measurements in the contemporary Korean population. 200 healthy Korean adults, including 102 males and 98 females, were randomly selected (age, range 20–86 years). The first and second metatarsals of the foot were measured by a standing X-ray using a digital medical image viewer. The result showed a statistically significant correlation between metatarsal length and stature in Korean populations (male, R = 0.46, p < 0.001; female, R = 0.454, p < 0.001). Values of correlation coefficients (R) of the equations were 0.431 to 0.477. Compared to equations derived from other races, the Korean-specific equation showed significantly lower error values for estimating the actual height of Koreans through cross-validation. In conclusion, this study is the first to propose a Korean-specific regression formula for estimating stature using metatarsal length and a verified formula for precise application to the Korean population. However, given the relatively low correlation coefficient, the stature estimation formula derived from this study can be utilized when other bones that allow more accurate stature estimation are not available. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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Review

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18 pages, 3108 KiB

Open AccessReview

Conservative and Surgical Treatment of Talar Fractures: A Systematic Review and Meta-Analysis on Clinical Outcomes and Complications

by Babak Saravi, Gernot Lang, Robert Ruff, Hagen Schmal, Norbert Südkamp, Sara Ülkümen and Jörn Zwingmann

Int. J. Environ. Res. Public Health 2021, 18(16), 8274; https://doi.org/10.3390/ijerph18168274 - 4 Aug 2021

Cited by 8 | Viewed by 3484

Abstract

The integrity of the talus is crucial for the physiologic function of the feet. The present study sought to summarize the available evidence on clinical outcomes and complications following conservative and surgical treatment of talar fractures. We systematically searched Medline via OVID to [...] Read more.

The integrity of the talus is crucial for the physiologic function of the feet. The present study sought to summarize the available evidence on clinical outcomes and complications following conservative and surgical treatment of talar fractures. We systematically searched Medline via OVID to find relevant studies with a follow-up of at least six months. Hereafter, the success and complication rates were extracted and analyzed in a random effects proportion meta-analysis. Complications were defined as avascular bone necrosis (AVN) and posttraumatic osteoarthritis (OA). Additionally, a subgroup analysis was performed for fracture localization (talar neck fractures (TN) and combined talar body/neck fractures (TN/TB)) and severity of the fracture. The quality of the included studies was assessed utilizing the Coleman Methodology Score (CMS). A total of 29 retrospective studies, including 987 fractures with a mean follow-up of 49.9 months, were examined. Success rates were 62%, 60%, and 50% for pooled fractures, TN, and TN/TB, respectively. The overall complication rate for AVN was 25%. The rate was higher for TN (43%) than TN/TB (25%). Talar fractures revealed a 43% posttraumatic osteoarthritis (OA) rate in our meta-analysis. Success rates showed an association with fracture severity, and were generally low in complex multi-fragmentary fractures. The mean CMS was 34.3 (range: 19–47), indicating a moderate methodological quality of the studies. The present systematic review on clinical outcomes of patients undergoing conservative or surgical treatment for talar fractures reveals a lack of reliable prospective evidence. Talar fractures are associated with relatively poor postoperative outcomes, high rates of AVN, and posttraumatic osteoarthritis. Poor outcomes revealed a positive association with fracture severity. Prospective studies investigating predictors for treatment success and/or failure are urgently needed to improve the overall quality of life and function of patients undergoing surgical treatment due to talar fractures. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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Other

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7 pages, 6820 KiB

Open AccessBrief Report

Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approach at the Achilles Tendon as a Potential Treatment for Achilles Tendinopathy: A Pilot Study

by Laura Calderón-Díez, José Luis Sánchez-Sánchez, Miguel Robles-García, Pedro Belón-Pérez and César Fernández-de-las-Peñas

Int. J. Environ. Res. Public Health 2022, 19(19), 11906; https://doi.org/10.3390/ijerph191911906 - 21 Sep 2022

Cited by 1 | Viewed by 2480

Abstract

Achilles tendon tendinopathy (AT) is a musculoskeletal condition characterized by pain in the Achilles tendon and impaired physical performance or sport activities. AT is difficult to treat, and the results are variable. Preliminary evidence suggests a positive effect for pain of percutaneous electrolysis [...] Read more.

Achilles tendon tendinopathy (AT) is a musculoskeletal condition characterized by pain in the Achilles tendon and impaired physical performance or sport activities. AT is difficult to treat, and the results are variable. Preliminary evidence suggests a positive effect for pain of percutaneous electrolysis in patients with tendinopathy. Our aim was to determine the validity and safety of a percutaneous electrolysis approach targeting the interphase between the Achilles tendon and the Kager’s fat with ultrasound imaging in both healthy individuals and on a fresh cadaver model (not ultrasound guiding). A needle was inserted from the medial to the lateral side under the body of the Achilles tendon, just between the tendon and the Kager’s triangle, about 5 cm from the insertion of tendon in the calcaneus in 10 healthy volunteers (ultrasound study) and 10 fresh cadaver legs. An accurate needle penetration of the interphase was observed in 100% of the approaches, in both human and cadaveric models. No neurovascular bundle of the sural nerve was pierced in any insertion. The distance from the tip of the needle to the sural nerve was 5.28 ± 0.7 mms in the cadavers and 4.95 ± 0.68 mms in the volunteer subjects, measured in both cases at a distance of 5 cm from the insertion of the Achilles tendon. The results of the current study support that percutaneous electrolysis can be safely performed at the Kager’s fat–Achilles tendon interphase if it is US guided. In fact, penetration of the sural nerve was not observed in any needle approach when percutaneous needling electrolysis was performed by an experienced clinician. Future studies investigating the clinical effectiveness of the proposed intervention are needed. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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7 pages, 1094 KiB

Open AccessCase Report

The Improved Proximal Phalanx Osteotomy for Reducing Sesamoid in Hallux Valgus Surgery—A Cadaver Study

by Dong-Oh Lee, Eunah Hong and Dai-Soon Kwak

Int. J. Environ. Res. Public Health 2022, 19(11), 6487; https://doi.org/10.3390/ijerph19116487 - 26 May 2022

Viewed by 3222

Abstract

A metatarsal osteotomy is known to have the effect of reduction of the sesamoid. However, the reduction of the sesamoid is not always completed by a metatarsal osteotomy alone. The purpose of this cadaver study was to show that the improved technique of [...] Read more.

A metatarsal osteotomy is known to have the effect of reduction of the sesamoid. However, the reduction of the sesamoid is not always completed by a metatarsal osteotomy alone. The purpose of this cadaver study was to show that the improved technique of a modified Akin proximal phalanx osteotomy (MPO) could be helpful for the reduction of the sesamoids in hallux valgus surgery. Ten feet of cadavers were used; the cadavers had hallux valgus on both feet. The first trial of two feet underwent only the MPO. The other eight feet underwent a proximal metatarsal chevron osteotomy and MPO simultaneously. The hallux valgus angle, intermetatarsal angle, Hardy’s grade, and Smith’s grade were measured. To predict possible complications, cadavers were dissected after surgery. In the feet that underwent an MPO only, the hallux valgus angle and sesamoid position were improved. In the feet that underwent an MPO and metatarsal osteotomy, the hallux valgus deformity was completely corrected, and the sesamoid position was improved. Overall, the hallux valgus angle and intermetatarsal angle improved from 30.6 to 8.4 degrees and from 11.2 to 4.1 degrees, respectively. The sesamoid position was reduced from 5.3 to 2.5 (Hardy) and from 1.7 to 0.7 (Smith). The MPO combined with the metatarsal osteotomy were helpful for reducing the sesamoids compared to the metatarsal osteotomy only. Full article

(This article belongs to the Special Issue Treatment of Foot and Ankle Injury and Public Health)

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