Comparison of tunnel ligament release instrument assisted minimally open surgery and conventional open surgery in the treatment of tarsal tunnel syndrome.

Aim: This study compared the results of tarsal tunnel syndrome release surgeries using mini-open incisions and standard incisions.

Patients And Methods: From January 2012 until April 2018, 31 feet of 29 patients diagnosed with tarsal tunnel syndrome were treated surgically. 15 feet of 15 patients underwent surgeries utilizing minimally open technique and 16 feet of 14 patients underwent surgeries utilizing standard incisions.

The Use Of Suture Anchors In Akin Osteotomy : A New Surgical Technique.

To perform an Akin osteotomy using suture anchors to achieve stability of the osteotomy line and avoid the need for a further operation to remove an implant. Akin osteotomy using suture anchors was performed on 35 feet of 30 patients (21 female, 9 male ; mean age 45 years, range 18-60 yrs) diagnosed with hallux valgus. In bilateral cases, surgery was firstly carried out on the foot in the more serious condition, followed by the second foot 2 months later.

Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers.

: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers.

Achilles Tendon Open Repair Augmented With Distal Turndown Tendon Flap and Posterior Crural Fasciotomy.

The aim of the present study was to investigate the outcomes after open repair of Achilles tendon rupture augmented with a distal turndown gastrocnemius flap and deep posterior crural fasciotomy based on the modified Lindholm technique. Twenty-three patients with acute Achilles tendon injury underwent open end-to-end tendon repair augmented with a distal turndown gastrocnemius flap and deep posterior compartment fasciotomy. The concentric and eccentric muscle strength was measured using a functional squat system, and dynamic balance was assessed using the Y-balance test with anterior, posteromedial, and posterolateral reach distances.

Correction of Brachymetatarsia and Medial Angulation of the Great Toe of Apert Foot By Distraction Osteogenesis: A Review of 7 Years of Experience.

Background: Apert foot anomalies may cause severe problems such as pain and development of callus formation related to weight redistribution, problems with footwear, and gait disturbances that may limit their daily activities. The main purpose of this study was to review our experience with distraction osteogenesis for the correction of brachymetatarsia and the great toe angulation of the patients with Apert syndrome.

Methods: This study retrospectively reviewed 7 patients (14 extremities) followed up for Apert syndrome who underwent distraction for the correction of bilateral congenital brachymetatarsia and angulation of the great toe between 2004 and 2008.

Application of C-Shaped Osteotomy and Distraction Osteogenesis for Correction of Radial Angulation Deformities of the Hand in Children With Apert Syndrome: Review of 10 Years of Experience.

Apert syndrome is characterized by short, radially deviated thumbs, leading to difficulties in daily life such as holding a fork or a spoon and buttoning up. The main goal of surgery is to achieve thumb to index finger pinch to overcome these difficulties. Seven patients (14 extremities) followed up with Apert syndrome underwent distraction after a C-shaped osteotomy to simultaneously correct the brachydactyly and the angulation deformity of the bilateral thumbs.

Charcot foot in diabetes and an update on imaging.

Charcot neuroarthropathy (CN) is a serious complication of diabetes mellitus that can cause major morbidity including limb amputation. Since it was first described in 1883, and attributed to diabetes mellitus in 1936, the diagnosis of CN has been very challenging even for the experienced practitioners. Imaging plays a central role in the early and accurate diagnosis of CN, and in distinction of CN from osteomyelitis.

Current challenges in imaging of the diabetic foot.

Although a variety of diagnostic imaging modalities are available for the evaluation of diabetes-related foot complications, the distinction between neuroarthropathy and osteomyelitis is still challenging. The early and accurate diagnosis of diabetic foot complications can help reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emission tomography are the main procedures currently in use for the evaluation of diabetes-related foot complications.

Differential diagnosis in a professional basketball player with foot pain: is it an avulsion fracture or an os supranaviculare?

The os supranaviculare is an accessory bone located on the dorsal aspect of the talonavicular joint close to the midpoint. This rare incidental skeletal variant has an estimated prevalence of 1%. It may rarely become symptomatic and should not be confused with cortical avulsion fractures of navicular or talar head.

Minimum-incision ray resection.

Ray resection for localized necrosis, infection, and osteomyelitis is an accepted procedure allowing removal of the diseased toe and metatarsal. The traditional approach involves a rather lengthy incision and dissection that can compromise the vascular supply to the remaining forefoot. The use of minimum incision techniques to perform metatarsal ray resection as presented here represents a simple, reliable, and easily reproduced procedure that limits soft-tissue dissection and the associated wound healing-related complications inherent to the traditional approach.

Transarticular versus extraarticular ankle pin fixation: a biomechanical study.

Background: Transarticular pin fixation for ankle stabilization has drawbacks, including ankle joint arthrosis. An extraarticular technique could help avoid these problems. We compared stiffness under minimal dorsiflexion loading with transarticular versus extraarticular fixation.

Closure of major diabetic foot wounds and defects with external fixation.

Amputation may become unavoidable in certain cases of severe ischemia, infection, or lower extremity ulcerations. When limb salvage procedures are indicated and available in diabetic patients, they will strongly support patient quality of life and prevent further complications when patients are educated appropriately. The authors describe their technique for limb salvage procedures based on a combination of an MRI-guided debridement of necrotic tissues, application of an antibiotic-impregnated bone cement, and closure of the soft tissue and bone defects with the use of an external fixation device.

A new perspective on management of open calcaneus fractures.

The treatment protocol of closed calcaneal fractures has been described in the literature extensively. However, treatment of open calcaneal fractures has not been discussed in detail. Various treatment alternatives have been suggested including external fixator, primary subtalar distraction arthrodesis, and partial calcanectomy according to the type of fracture.

[Osteometry of the femora in Turkish individuals: a morphometric study in 114 cadaveric femora as an anatomic basis of femoral component design].

Objectives: Clinical and experimental studies of total hip arthroplasty have demonstrated that a close geometric fit between the femoral component and supporting bone is essential for durable implant fixation. Long-term success of total hip prostheses depends on appreciation of the proximal femur anatomy and identification of mean reference values of critical landmarks. Current data on dimensions of prostheses and implantation are based on osteometric measurements of the femora in Western populations.

[Antibiotic resistance in Streptococcus pneumoniae strains isolated from sterile body sites].

Antibiotic resistance in Streptococcus pneumoniae has become an important issue in the last years. Penicillin resistance rates vary among countries and among different regions in countries. It is important to know penicillin resistance rates among isolates, in planning empirical antimicrobial therapy in pneumococcal infections.

Change in the amputation profile in diabetic foot in a tertiary reference center: efficacy of team working.

Diabetic foot is a serious complication of diabetes mellitus and the risk of lower extremity amputation is very high in this population when compared with people without diabetes. We have previously reported the lower-extremity amputation rate and significant factors in determining the risks for patients who had been admitted to Hacettepe University Hospital, a tertiary reference center for Turkey, between the years 1992 and 1996. In January 2000, a diabetic foot care team including an infectious diseases specialist, orthopaedic surgeons, endocrinologists, a plastic and reconstructive surgeon, a radiologist, and a diabetic foot nurse was assembled.

A new technical approach for sternal closure with suture anchors (Dogan technique).

Objectives: Various methods for sternal approximation have been described previously. Some patients undergoing these procedures are at risk for sternal dehiscence and mediastinitis. We used a different method, with a suture anchor system, for median sternotomy closure as an alternate technique in patients with a high risk of postoperative sternal dehiscence and sternal nonunion.

Closure of central defects of the forefoot with external fixation: a case report.

Excision of 1 or more central rays of the foot may complicate soft tissue coverage because large defects may result. The authors presents a technique in which an Ilizarov external fixator was used to narrow the forefoot after resection of the central rays in a patient with diabetes. After external fixator application for 8 weeks, the central defect healed uneventfully and has not shown any recurrence of ulceration after 4 years of follow-up.

Management of large soft-tissue defects in a diabetic patient.

Amputation as the only option for treatment of large ulcers in a patient with diabetes is well known. This is a case presentation of a patient with large ulcers and osteomyelitis related to diabetes. He was treated with extensive debridement, segmental shortening, and wound closure.