Diagnostic accuracy of magnetic resonance imaging (MRI) versus dynamic ultrasound for plantar plate injuries: A systematic review and meta-analysis.

Background: Previous literature has suggested both MRI and ultrasound can accurately diagnose plantar plate tears. There is a significant cost difference between these two modalities, sparking interest for which should be the preferred method for diagnosis.

Purpose: The purpose of this study was to examine the diagnostic accuracy of MRI and dynamic, musculoskeletal ultrasound for lesser metatarsal plantar plate injuries using a systematic review and meta-analysis.

Do Patient Personality Traits and Self-Reported Physical and Psychosocial Symptoms Help to Predict Hallux Valgus Surgery Outcomes?

As many as 10% of patients remain unsatisfied after hallux valgus surgery. We explored the effects of patient personality traits and other preoperative patient characteristics on patient-reported outcomes following surgery. Eighty consecutive adult patients (mean age 45 ± 14 years, 91% female [73/80]) undergoing scarf bunionectomy at our practice were prospectively enrolled from January 2016 to January 2017 and followed for 12 months.

Correlation of Preoperative Radiographic Severity With Disability and Symptom Severity in Hallux Valgus.

Background: Some US insurance companies have recently started to require minimum angular measurements, for coverage decisions, in patients seeking operative correction for symptomatic hallux valgus. This logic naturally assumes that the magnitude of radiographic bunion deformity is related to the magnitude of patient's presenting symptoms and/or disability.

Methods: We conducted an analysis of existing data in our practice to determine whether patient-reported symptoms and disability prior to bunion surgery correlated with preoperative radiographic measurements commonly used to quantify hallux valgus severity.

Correlation of Radiographic Measurements With Patient-Centered Outcomes in Hallux Valgus Surgery.

Background:: Evaluation of patients undergoing hallux valgus surgery has historically emphasized radiographic angles and relationships. However, patient-reported outcomes are increasingly important as health care systems trend towards a "value-based" delivery approach.

Methods:: We conducted a retrospective analysis of pre-existing data in our practice to examine whether patient-reported outcomes after bunion surgery, determined via Foot and Ankle Outcome Scores (FAOS), correlated with radiographic parameters commonly measured in hallux valgus deformity.

Percutaneous Kirschner Wire Versus Commercial Implant for Hammertoe Repair: A Cost-Effectiveness Analysis.

Hammertoe deformities are one of the most common foot deformities, affecting up to one third of the general population. Fusion of the joint can be achieved with various devices, with the current focus on percutaneous Kirschner (K)-wire fixation or commercial intramedullary implant devices. The purpose of the present study was to determine whether surgical intervention with percutaneous K-wire fixation versus commercial intramedullary implant is more cost effective for proximal interphalangeal joint arthrodesis in hammertoe surgery.

Association Between Second Metatarsal Length and Forefoot Loading Under the Second Metatarsophalangeal Joint.

Background: Metatarsal length is believed to play a role in plantar plate dysfunction, although the mechanism through which progressive injury occurs is still uncertain. We aimed to clarify whether length of the second metatarsal was associated with increased plantar pressure measurements in the forefoot while walking.

Methods: Weightbearing radiographs and corresponding pedobarographic data from 100 patients in our practice walking without a limp were retrospectively reviewed.

Cost-Effectiveness Analysis of Primary Arthrodesis Versus Open Reduction Internal Fixation for Primarily Ligamentous Lisfranc Injuries.

The purpose of the present study was to determine whether surgical intervention with open reduction internal fixation (ORIF) or primary arthrodesis (PA) for Lisfranc injuries is more cost effective. We conducted a formal cost-effectiveness analysis using a Markov model and decision tree to explore the healthcare costs and health outcomes associated with a scenario of ORIF versus PA for 45 years postoperatively. The outcomes assessed included long-term costs, quality-adjusted life-years (QALYs), and incremental cost per QALY gained.

Forefoot Adduction Is a Risk Factor for Jones Fracture.

Jones fractures are among the most common fractures of the foot; however, much remains unknown about their etiology. The purpose of the present study was to further examine the risk factors of forefoot and hindfoot alignment on Jones fractures using an epidemiologic study design. We used a retrospective, matched, case-control study design.

Association of Abnormal Metatarsal Parabola With Second Metatarsophalangeal Joint Plantar Plate Pathology.

Background: Plantar plate pathology is common, yet it is unclear whether, and to what extent, the length of the second metatarsal contributes to this problem.

Methods: We conducted a retrospective case-control (1:2) study to examine radiographic risk factors for plantar plate tears. One hundred patients (age 55.

Joint Manipulation Under Anesthesia for Arthrofibrosis After Hallux Valgus Surgery.

Arthrofibrosis is a known complication of hallux valgus surgery. Joint manipulation under anesthesia has been studied for adhesive capsulitis of the shoulder; however, a paucity of published data exists on the use of this modality in the foot and ankle. The purpose of the present study was to investigate the outcomes of first metatarsophalangeal joint manipulation for arthrofibrosis that occurred as a complication of bunion surgery.

Positive drawer test combined with radiographic deviation of the third metatarsophalangeal joint suggests high grade tear of the second metatarsophalangeal joint plantar plate.

Unlabelled: There is uncertainty regarding the most accurate and cost-effective method for diagnosing plantar plate injuries within the foot. The purpose of this study was to examine the combined value of using clinical and radiographic findings to diagnose high grade tears (> 50% disruption) within the second metatarsophalangeal (MTP) joint. Ninety-eight consecutive patients (117 feet) who underwent corrective surgery for plantar forefoot pain at a single foot and ankle specialty clinic were included in this retrospective analysis.

The radiographic effects of the scarf bunionectomy on rearfoot alignment.

Statement Of Purpose: Excessive pronation of the rearfoot has been implicated as a destabilizing force in the progression of hallux abducto valgus. Although the scarf bunionectomy has been shown to effectively correct the intermetatarsal angle associated with hallux valgus deformity, its effect on the rearfoot has yet to be established. The purpose of this case series is to demonstrate the effect of the scarf bunionectomy on rearfoot alignment.

Static Versus Dynamic Musculoskeletal Ultrasound for Detection of Plantar Plate Pathology.

Unlabelled: Musculoskeletal ultrasound (US) is a common modality used to examine plantar plate pathology. Comparison of the diagnostic accuracy of static versus dynamic ultrasound has not been previously published. The objective of this study was to prospectively compare the value of using preoperative static and dynamic ultrasound findings to diagnose plantar plate pathology using intraoperative inspection as the standard of reference.

Retrospective comparative study of operative repair of hammertoe deformity.

Background: The purpose of this study was to compare the outcomes of patients with second hammertoe deformities who underwent correction using either joint resection arthroplasty, proximal interphalangeal joint (PIP) arthrodesis without osteotomy, or interpositional implant arthroplasty.

Methods: Medical records from patients who underwent second PIP correction from July 1999 to December 2008 were retrospectively reviewed. A total of 114 patients (136 second toes) were the basis for this retrospective comparative study.

Hallux valgus surgery may produce early improvements in balance control: results of a cross-sectional pilot study.

Background: Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.

Methods: Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants.

The calcaneal scarf osteotomy: surgical correction of the adult acquired flatfoot deformity and radiographic results.

Purpose: Surgical correction of the adult acquired flatfoot deformity (AAFD) is continually evolving. This technique article presents the technique of the calcaneal scarf osteotomy (CSO) and radiographic evidence supporting the ability of this procedure to correct an AAFD.

Method: The technique described here is a single osteotomy that corrects flatfoot deformity in all 3 planes.

Clinical examination of plantar plate abnormality: a diagnostic perspective.

Background: Plantar plate tears can cause pain and deformity in the forefoot but are frequently missed on initial examination. The purpose of this article was to evaluate the diagnostic statistics of common clinical examination parameters using observed intraoperative abnormality as the referenced standard.

Methods: Medical records of 90 patients (109 feet) who underwent a plantar plate repair were reviewed for the presence and onset of pain, plantar edema, instability of the second metatarsophalangeal (MTP) joint (drawer sign), pain with range of motion of the lesser MTP joint, first MTP joint range of motion, crossover toes, previous first ray surgery, and previous corticosteroid injections.

Body mass index and achilles tendonitis: a 10-year retrospective analysis.

Introduction: High body mass index (BMI) has been implicated as an etiologic agent in Achilles tendonitis (AT) and may contribute to poorer treatment outcomes. The purpose of this study was to better elucidate the role of BMI in both the development and treatment of AT.

Methods: A matched case-control (1:1) study design was used.

Musculoskeletal ultrasound for preoperative imaging of the plantar plate: a prospective analysis.

The purpose of this study was to prospectively compare preoperative findings on musculoskeletal ultrasound evaluation to observed intraoperative findings for patients undergoing surgical correction of plantar plate tears. Fifty consecutive patients with forefoot pain and a suspected unilateral plantar plate tear at the second metatarsophalangeal (MTP) joint were identified. The same examiner performed a 2-plane (longitudinal and transverse) musculoskeletal ultrasound on the painful second MTP joint.

Retrospective analysis of the survivability of absorbable versus nonabsorbable subtalar joint arthroereisis implants.

Subtalar joint arthroereisis is a surgical modality that has been shown to be an effective procedure for flexible flatfoot in both pediatric and adult populations. Despite advances in understanding its mechanics and function, complication and implant removal rates remain as high as 30% to 40%. Analysis was performed to determine the survivability of 2 subtalar joint arthroereisis implants, absorbable and nonabsorbable, used alone and in combination with other procedures in both the adult and pediatric populations.

The underlying osseous deformity in plantar plate tears: a radiographic analysis.

Purpose: Plantar plate tears can cause pain and deformity of the forefoot. The purpose of this study is to correlate common radiographic findings with observed intra-operative pathology in patients with plantar plate pathology.

Methods: Bilateral weight-bearing radiographs were reviewed for 88 patients (106 feet) who underwent surgical repair of suspected plantar plate pathology.

Magnetic resonance imaging versus musculoskeletal ultrasound for identification and localization of plantar plate tears.

Purpose: Plantar plate injuries have been identified as a cause of forefoot pain and deformity. Magnetic resonance imaging (MRI) and musculoskeletal ultrasound (US) have been suggested as appropriate imaging modalities for this pathology. A comparison of these two modalities utilizing intra-operatively pathology as the reference standard has not been published.

Retrospective analysis of mini-open repair versus open repair for acute Achilles tendon ruptures.

Purpose: Debate exists over optimal treatment for acute Achilles tendon ruptures. Recent literature suggests the mini-open technique may provide the reliability of the open repair with the decreased complication rate of non-operative treatment. This retrospective review compares acute tendon ruptures treated with one of two techniques: open repair (TO) or mini-open repair (MOA).