Should We Use Intermetatarsal Angle as Primary Determinant to Define the Limits of Distal Chevron Osteotomy?

Classic treatment algorithms limit the use of distal chevron osteotomy (DCO) to cases with an intermetatarsal angle (IMA) <14°. As the IMA increases, it is accepted that the contact between the metatarsal head and shaft will be insufficient. We have investigated the reliability of IMA to predict contact area percentage after DCO.

The effect of dehydration and irrigation on tendon adhesion formation after tendon exposure.

Objective: The aim of this study was to evaluate the effects of dehydration due to tendon exposure on adhesion formation on the tendon surface.

Methods: Achilles tendons of 60 New Zealand white rabbits were surgically exposed and evaluated. In the control group (Group 1), the wound was closed immediately; and in the remaining two groups, Achilles tendons were exposed to air for 60 minutes without (Group 2) or with (Group 3) regular saline irrigation.

Comparison of early results of vascularized and non-vascularized fibular grafting in the treatment of osteonecrosis of the femoral head.

Objective: Osteonecrosis of the femoral head, a disease primarily affecting young adults, is often associated with the collapse of the articular surface and subsequent arthrosis. Some authors have reported good results with the use of vascularized and non-vascularized fibular grafts to treat osteonecrotic lesions of the femoral head. The aim of this study was to compare the results of vascularized fibular grafting with that of non-vascularized fibular grafting in the treatment of femoral head osteonecrosis.

[Partial removal of nail matrix in the treatment of ingrowing toe nail].

Objectives: Ingrowing toe nail is a frequent disorder of the foot. In this study, we evaluated the results of surgical treatment of ingrowing toe nail.

Methods: Sixty-two patients (31 males, 31 females; mean age 38 years; range 11 to 72 years) with ingrowing toe nail underwent partial removal of the nail matrix according to the Winograd technique.

The effect of dehydration and irrigation on the healing of Achilles tendon: an experimental study.

Background: Air exposure is a factor that inhibits in vitro cellular proliferation and matrix synthesis in tendons. Aim of this experimental study was to evaluate effect of dehydration and irrigation on healing of Achilles tendon.

Methods: Achilles tenotomy was done in forty-five Sprague-Dawley rats.

Spiral-shaped metallic implant in the treatment of Achilles tendon ruptures: an experimental study on the Achilles tendon of sheep.

There are 2 main factors contributing to the strength of tendon repair: the tensile strength of the material used in repair and the tendon-holding capacity of the suture configuration. In the current study, we aimed to find a technique with high repair strength by increasing both the tensile strength of the material and the tendon-holding capacity of the configuration. We developed metal implants (models 1 and 2) made from stainless-steel wire with 2 different spiral-shaped configurations.

[Tendon holding capacities of the suture materials used in repairing Achilles tendon rupture].

Objectives: We evaluated tendon holding capacities of suture materials that are commonly used in repair of Achilles tendon ruptures.

Methods: Achilles tendons of 60 sheep were removed by incisions 2-cm proximal to the calcaneal insertion and 1-cm distal to the musculotendinous junction. The tendons were randomly divided into six groups and sutures were placed with the Kessler technique at the distal end of the tendons using one of the following suture materials: 2 polydioxanone (PDS), 1 PDS, 2 Vicryl, 1 Vicryl, 2 Ethibond, and 1 Prolene.

The effect of proteolytic enzyme serratiopeptidase in the treatment of experimental implant-related infection.

Background: Infection around an implanted orthopaedic device is a devastating complication, and the treatment of infections involving slime-forming bacteria is especially difficult. The purpose of the present study was to evaluate the effectiveness of a proteolytic enzyme, serratiopeptidase, in the eradication of a periprosthetic infection in an in vivo animal model.

Methods: In sixty Sprague-Dawley rats, the medullary canal of the right femur was drilled through the intercondylar notch and was inoculated with a Staphylococcus epidermidis strain (ATCC 35984) with a high slime-producing capacity.

Suture holding capacity of the Achilles tendon during the healing period: an in vivo experimental study in rabbits.

Background: Early motion and weightbearing is known to promote the healing of Achilles tendon repair. It is important to be informed about the repair strength for a secure rehabilitation. There are reports about the initial repair strength of Achilles tendons; however, they are mainly in vitro studies that represent the time zero strength of the repair.

Morton neuroma: comparative results of two conservative methods.

Background: The initial treatment of Morton neuromas consists of conservative methods that include shoe modifications and steroid injections. The purpose of this prospective study was to compare the efficacy of these two methods to determine which is more effective as the initial treatment method.

Methods: Eighty-two patients with Morton neuromas were randomly assigned to receive either footwear modification with orthoses or steroid injections as initial treatment.

Effect of metatarsophalangeal joint position on the reliability of the tangential sesamoid view in determining sesamoid position.

Background: Lateral displacement of the sesamoids of the first toe relative to the metatarsal head is a common finding in hallux valgus deformity. Several methods have been described for quantifying the amount of subluxation from anteroposterior radiographs but a tangential sesamoid radiograph has been determined to be the best view to evaluate sesamoid displacement.

Method: We evaluated the sesamoid position at different angles of the first metatarsophalangeal (MTP) joint to determine the effect of first MTP joint dorsiflexion on sesamoid position when tangential sesamoid view radiographs are made.

[Foot and ankle injuries in child and adolescent athletes].

Foot and ankle injuries are most commonly encountered in athletes. Of these, pediatric and adolescent injuries have unique characteristics because of the distinct growth potentials and their consequences specific to this age group. In this article, foot and ankle injuries in child and adolescent athletes are reviewed in the light of the literature.

Lateral shifting of the first metatarsal head in hallux valgus surgery: effect on sesamoid reduction.

Thirty feet with hallux valgus (HV) having grade 2 and 3 sesamoid stations on AP radiographs were examined after Lindgren-Turan oblique distal metatarsal osteotomy with a minimum follow-up of 12 months. Adductor tendon release from the lateral sesamoid was not performed to determine the isolated effect of distal metatarsal osteotomy on metatarsosesamoidal reduction. Of the 30 feet, 20 (67%) had reduced and 10 (33%) unreduced sesamoids at the follow-up.

Initial pull-out strength of tendon sutures: an in vitro study in sheep Achilles tendon.

Forty-eight fresh frozen sheep Achilles tendons were used to compare the pull-out strengths of Kessler, Bunnell and locking loop techniques which are the standard configurations described for Achilles tendon repair. A simulated Achilles tendon rupture was done with a tenotomy made 2 cm proximal to the calcaneal insertion. One of the configurations was placed at the distal end of the proximal portion of the tendon specimens using No.

Transpedicular drainage of Pott's abscess. A report of two cases.

The treatment of Pott's disease remains controversial. The authors present two cases of spinal tuberculosis treated with posterior stabilization and supplementary abscess evacuation via the pedicular route with subsequent chemotherapy. The aim of this procedure was to increase the healing rate.

Transpedicular fixation in the treatment of various spinal disorders.

36 patients with 157 inserted pedicular screws are presented. The patients are evaluated in 5 different groups; group I: fractures, group II: spinal tuberculosis, group III: spinal tumours, group IV: spondylolisthesis and group V: scoliosis. The mean age and the mean follow-up of the groups are respectively 42 years and 10.

The "lazy-V" de-epithelialised turn-over fasciocutaneous flap in the reconstruction of skin defects after tendo Achilles repair.

Few methods of closure of skin defects lying over the tendo Achilles have been described. The de-epithelialised turn-over flap is one of them but it cannot be used in the presence of a scar proximal to the defect. We describe a modification ("The Lazy-V") of the de-epithelialised turn-over flap which gives it a rotation arc, thus enhancing the versatility of the procedure.