Foot & Ankle Reconstruction Journal Scan

Multimodal Analgesia Therapy Reduces Length of Hospitalization in Patients Undergoing Fusions of the Ankle and Hindfoot.

Foot Ankle Int. 2013 Jul 8;

Authors: Michelson JD, Addante RA, Charlson MD

Abstract
BACKGROUND: Multimodal postoperative analgesia employs multiple medications given perioperatively to block the generation and perception of pain at different points in the nociceptive pathway. This retrospective study examines its effect on the length of stay for patients undergoing hindfoot and ankle fusions.
METHODS: All patients operated upon by the senior authors between 2007 and 2011, inclusive, underwent ankle fusion, subtalar fusion, pantalar arthrodesis, triple arthrodesis, or combined ankle/subtalar fusions. The perioperative pain management was either the "traditional" method (patient-controlled-analgesia-delivered parenteral narcotics beginning immediately postoperatively) or the multimodal pain protocol (pre- and postoperative oral administration of opioids, celecoxib, pregabalin, acetaminophen, and prednisone). The choice of pain protocol was up to the surgeons, without any exclusion criteria. Physical therapy protocols were not changed during the study. The study included 220 patients; 175 received the multimodal protocol and 45 received traditional management. Multimodal protocol patients were younger (53.9 vs 59.7 years; P < .003), but there were no other differences between the groups with respect to gender, obesity, body mass index, tobacco use, alcohol use, or comorbidities. Complex cases (revision surgeries, Charcot joint surgeries, multiple concurrent procedures, etc) were equally represented in both groups.

Creative cutting to contour and correct Hallux bone graft for three planes of correction.

Foot Ankle Surg. 2013 Sep;19(3):199-201

Authors: Ahluwalia RS, Blucher NC, Platt SR, Hennessy MS

PMID: 23830170 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23830170?dopt=Abstract

Pseudoaneurysms around the foot and ankle: Case report and literature review.

Foot Ankle Surg. 2013 Sep;19(3):194-8

Authors: Yu JL, Ho E, Wines AP

Abstract
Pseudoaneurysms developing around the foot and ankle are known to be an uncommon complication following surgery. We present a case of a pseudoaneurysm following ankle surgery for a tibial plafond fracture and comprehensively review the literature with emphasis on their anatomic location, aetiology and treatment options.

PMID: 23830169 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23830169?dopt=Abstract

Related Articles

The effect of rollover footwear on the rollover function of walking.

J Foot Ankle Res. 2013;6(1):24

Authors: Forghany S, Nester CJ, Richards B

Abstract
BACKGROUND: Rollover footwear is assumed to provide an enhanced surface over which the body can roll more easily. The aim of this study was to investigate the effects of rollover footwear on the rollover function of walking.
METHODS: Twenty subjects walked in three conditions: (i) a MBT shoe (Masai Barefoot Technology) characterized by a stiff sole rounded in the anterior-posterior direction; (ii) alternative rollover shoe (a prototype of Scholl STARLIT) characterized by a stiff sole rounded in the anterior-posterior direction; (iii) a flat control shoe. Data on the lower limb kinematics and ground reaction force were collected. The rollover function of walking was characterized using the radii of lower limb rollover shapes and duration of terminal double limb support. These data were compared between the three shoe conditions and the relationship between the radii of the curved shoe sole and the radii of the rollover shapes investigated.
RESULTS: The radii of the whole and middle part of foot-shoe, ankle-foot and knee-ankle-foot rollover shapes were significantly smaller

Radiographic Correction of Stage III Posterior Tibial Tendon Dysfunction With a Modified Triple Arthrodesis.

Foot Ankle Int. 2013 Jul 5;

Authors: Mehta SK, Kellum RB, Robertson GH, Moore AR, Wingerter SA, Tarquinio TA

Abstract
BACKGROUND: The literature supports fusion as the surgical treatment of choice for stage III posterior tibial tendon dysfunction (PTTD). The present study reports the radiographic correction following a modified triple arthrodesis (fusions of the subtalar, talonavicular, and first tarsometatarsal joints) in patients with stage III PTTD.
METHODS: An institutional review board-approved retrospective study was performed to assess the radiographic outcome of a modified triple arthrodesis in 21 patients (22 feet). Pre- and postoperative weight-bearing radiographs were reviewed in a blinded fashion by clinicians of varying levels of training. The talo-first metatarsal, talocalcaneal, and talonavicular coverage angles were measured on anteroposterior views. On lateral views, the talo-first metatarsal (Meary's), talocalcaneal, calcaneal pitch, and talar declination angles and the medial cuneiform to floor distance were measured. Statistical analysis was performed to compare pre- and postoperative measurements, assess the degree of correction, and determine interobserver reliability of the radiographic measurements.