[Foot and ankle pathologies: how to prescribe the right imaging].

Musculoskeletal diseases of the foot and ankle are common reasons for primary care consultations. The purpose of this article, which focuses on the seven most common foot and ankle pathologies seen in general practice, is to help general practitioners perform an initial radiological assessment that allows for a correct diagnosis and can then be used by the specialist without the need for repeat imaging. This approach optimizes collaboration between the general practitioner and the specialist, reduces costs, and avoids unnecessary patient radiation.

[Foot injuries in the emergency room : three lesions that should not be missed].

Urgent consultations for foot injuries are common. Trauma injuries are often obvious, such as displaced or open fractures, dislocations, or tissue breakdown. However, they can also have a subtle presentation and still hide severe structural damage.

Automatic Body Segment and Side Recognition of an Inertial Measurement Unit Sensor during Gait.

Inertial measurement unit (IMU) sensors are widely used for motion analysis in sports and rehabilitation. The attachment of IMU sensors to predefined body segments and sides (left/right) is complex, time-consuming, and error-prone. Methods for solving the IMU-2-segment (I2S) pairing work properly only for a limited range of gait speeds or require a similar sensor configuration.

Knee adduction moment decomposition: Toward better clinical decision-making.

Knee adduction moment (KAM) is correlated with the progression of medial knee osteoarthritis (OA). Although a generic gait modification can reduce the KAM in some patients, it may have a reverse effect on other patients. We proposed the "decomposed ground reaction vector" (dGRV) model to 1) distinguish between the components of the KAM and their contribution to the first and second peaks and KAM impulse and 2) examine how medial knee OA, gait speed, and a brace influence these components.

Posterior to anterior malleolar extended lateral approach to the ankle (PAMELA): early results of a novel approach.

Introduction: In a previous cadaveric study, we described the Posterior to Anterior Malleolar Extended Lateral Approach (PAMELA) to address complex ankle fractures. It was demonstrated to provide optimal exposure of the posterior and lateral malleoli, and of the anterolateral portion of the ankle through a single incision. The aim of this study is to report the clinical results of this novel approach.

[Six pitfalls around the ankle sprains].

Ankle sprains are frequently encountered. They result most of the time in lesions of the lateral ligament complex. Nevertheless, in the context of an ankle sprains, more severe injuries including fracture of the lateral process of the talus, fracture of the base of the 5th metatarsal, tear of the medial ligament complex, lesion of the syndesmosis, sprain of the Chopart joint, and peroneal tendons luxation are potentially overlooked and, if treated inadequately, may be associated with poor functional outcome.

Three-Year Rates of Reoperation and Revision Following Mobile Versus Fixed-Bearing Total Ankle Arthroplasty: A Cohort of 302 Patients with 2 Implants of Similar Design.

Background: Currently, the implants utilized in total ankle arthroplasty (TAA) are divided between mobile-bearing 3-component and fixed-bearing 2-component designs. The literature evaluating the influence of this mobility difference on implant survival is sparse. The purpose of the present study was therefore to compare the short-term survival of 2 implants of similar design from the same manufacturer, surgically implanted by the same surgeons, in fixed-bearing or mobile-bearing versions.

Impact of foot modeling on the quantification of the effect of total ankle replacement: A pilot study.

Background: Kinematic and kinetic foot models showed that computing ankle joint angles, moments and power with a one-segment foot modeling approach alters kinematics and tends to overestimate ankle joint power. Nevertheless, gait studies continue to implement one-segment foot models to assess the effect of total ankle replacement.

Research Question: The objective of this pilot study was to investigate the effect of the foot modeling approach (one-segment versus multi-segment) on how total ankle replacement is estimated to benefit or degrade the patient's biomechanical performance.

Bilateral gait asymmetry associated with tibiotalocalcaneal arthrodesis versus ankle arthrodesis.

Background: Gait asymmetries have been reported following ankle arthrodesis. However, similar reports do not exist for tibiotalocalaneal arthrodesis (TTCA), which involves further articular fusion. This study aimed to assess the extent of gait asymmetry following TTCA when compared to ankle arthrodesis.

Calcaneocuboid and Naviculocuneiform Dislocation: An Unusual Injury of the Midfoot.

. Midfoot dislocations are rare traumatic injuries. The best known patterns involve the Lisfranc and Chopart joints, although some other types have been described.

Long-term evaluation of the distal transverse plantar approach for Morton's neuroma excision.

Background: There is currently no consensus on the ideal approach for the operative treatment of Morton’s neuroma. The distal transverse plantar approach aims at optimal exposure without the scar complications associated with the longitudinal plantar approach. Long-term evaluation based on validated outcome instruments is lacking.

Posterior to anterior malleolar extended lateral approach to the ankle (PAMELA): a cadaveric anatomic study.

Introduction: The posterolateral approach is used in most cases of surgical treatment of ankle fractures involving the posterior and lateral malleoli. However, this approach does not allow access to the anterolateral structures of the ankle, which represent important landmarks to allow an anatomical reduction in case of complex ankle fracture. Our objective is to propose a novel surgical approach for optimal management of injuries including both a fracture of the posterior malleolus and a complex lesion of the lateral and/or anterolateral portions of the ankle.

Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma.

Introduction: A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture.

Case Report: We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation.

Outcome of the modified Lapidus procedure for hallux valgus deformity during the first year following surgery: A prospective clinical and gait analysis study.

Background: The modified Lapidus procedure is a surgical option to treat moderate to severe hallux valgus deformity with good radio-clinical outcome. However, comprehensive biomechanical outcome evaluation of this surgery at mid-term follow-up is missing. This study assesses and compares the radio-clinical and gait outcome at 6 and 12 months following modified Lapidus procedure.

Preoperative gait asymmetry in end-stage unilateral ankle osteoarthrosis patients.

Background: Gait asymmetries following unilateral ankle surgeries have been reported in published literature. Preoperative compensatory gait patterns are usually assumed to be the cause; however, this hypothesis is not backed by objective data. This study aims to assess gait symmetry in patients with unilateral ankle osteoarthrosis (AOA).

Comparison of peripheral nerve blockade characteristics between non-diabetic patients and patients suffering from diabetic neuropathy: a prospective cohort study.

Animal data have demonstrated increased block duration after local anaesthetic injections in diabetic rat models. Whether the same is true in humans is currently undefined. We, therefore, undertook this prospective cohort study to test the hypothesis that type-2 diabetic patients suffering from diabetic peripheral neuropathy would have increased block duration after ultrasound-guided popliteal sciatic nerve block when compared with patients without neuropathy.

[Evidence based treatment of hallux valgus].

Hallux valgus is a frequent disorder of the foot and decision-making about the best treatment provokes many questions among patients and specialists. These include the need for surgery, which surgical technique is the best choice, and is minimally invasive surgery going to replace open techniques? While the modern media provides patients with easy access to details concerning surgical techniques, they rarely include means for the patient to distinguish between objective information and publicity. The general practitioner is a person of trust for the patient and should help him or her consider treatment proposals.

Fixed and mobile-bearing total ankle prostheses: Effect on tibial bone strain.

Background: Total ankle replacement is associated to a high revision rate. To improve implant survival, the potential advantage of prostheses with fixed bearing compared to mobile bearing is unclear. The objective of this study was to test the hypothesis that fixed and mobile bearing prostheses are associated with different biomechanical quantities typically associated to implant failure.

Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments.

The pathogenesis of hallux valgus deformity is multifactorial. Conservative treatment can alleviate pain but is unable to correct the deformity. Surgical treatment must be adapted to the type and severity of the deformity.

Qualitative analysis of foot intersegment coordination in the sagittal plane following surgery for end-stage ankle osteoarthrosis.

Today, ankle joint kinematic assessment gives important information regarding the intersegment range of motion. It does not, however, provide information regarding coordination between the segments. This study aimed to determine whether or not intersegment coordination can provide valuable, otherwise missed information in relation to kinematic alterations of the ankle joint.

Subjective versus objective assessment in early clinical outcome of modified Lapidus procedure for hallux valgus deformity.

Background: Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity.

Characterization of gait in female patients with moderate to severe hallux valgus deformity.

Background: Hallux valgus is one of the most common forefoot problems in females. Studies have looked at gait alterations due to hallux valgus deformity, assessing temporal, kinematic or plantar pressure parameters individually. The present study, however, aims to assess all listed parameters at once and to isolate the most clinically relevant gait parameters for moderate to severe hallux valgus deformity with the intent of improving post-operative patient prognosis and rehabilitation.

[Ankle fractures in the elderly patient].

Ankle fractures in adults are usually managed by open reduction internal fixation. In elderly patients the surgical dilemma relates to bone quality. Osteoporosis is the enemy of internal fixation, and secure purchase of screws in osteopenic bone may be difficult to achieve.