Republication of "Minimally Invasive Surgery Using the Circular External Fixator to Correct Neglected Severe Stiff Equinocavus Foot Deformities".

Background: Stiff equinocavus deformities of the foot are challenging to treat, often requiring extensive soft tissue dissection and bone removal. These procedures frequently yield suboptimal results and not infrequently amputation. Minimally invasive surgery using a circular external fixator potentially avoids the trauma to the soft tissue and may lead to improvement in outcomes and a lower amputation rate.

Anterior tibial tendon transfer in idiopathic clubfoot: does the outcome differ with the initial treatment? Proposed classification to surgical indication.

Purpose: To establish parameters and propose a radiographic classification for foot adduction/supination deformities to assist the indication of Garceau procedure. Secondly, to investigate whether the outcome of Garceau surgery depends on the initial treatment used, peritalar release, or the Ponseti method, and verify the maintenance of correction until skeletal maturity.

Methods: Prospective cohort study, with follow-up evaluations in 2009 and 2019.

Diabetic Foot. Part 1: Ulcers and Infections.

Diabetes is a systemic disease that has achieved epidemic proportions in modern society. Ulcers and infections are common complications in the feet of patients with advanced stages of the disease, and are the main cause of amputation of the lower limb. Peripheral neuropathy is the primary cause of loss of the protective sensation of the feet and frequently leads to plantar pressure ulcers and osteoarticular disruption, which in turn develops into Charcot neuropathy (CN).

Diabetic Foot. Part 2: Charcot Neuroarthropathy.

Charcot neuroarthropathy (CN) is an unfortunate and common complication of patients with diabetes, most likely resulting from a lack of proper understanding of the disease, which leads to late diagnosis. It is commonly misdiagnosed as infection and treated with antibiotics and a frustrated attempt of surgical drainage, which will reveal only debris of the osteoarticular destruction. Proper education of diabetic patients and of the health care professionals involved in their treatment is essential for the recognition of the initial signs of CN.

What is the Prognosis of Triple Arthrodesis in the Treatment of Adult Acquired Flatfoot Deformity (AAFD)?

 The present study aims to evaluate the ability of triple arthrodesis in eliminating the main complaints presented by patients with adult acquired flatfoot deformity (AAFD): 1) disabling hindfoot pain; 2) major deformities, such as medial arch collapse, valgus, abduction, and supination.  A total of 17 patients (20 feet) with advanced AAFD who underwent surgical correction by triple arthrodesis were evaluated after a mean follow-up period of 43 months (range: 18-84 months). The average age of the patients at surgery was 62 years old (range: 38-79 years old).

Talalgia: plantar fasciitis.

Plantar fasciitis is a very common painful syndrome, but its exact etiology still remains obscure. The diagnosis is essentially clinical, based on history-taking and physical examination. Complementary laboratory tests and imaging examinations may be useful for differential diagnoses.

Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis.

Objective: to evaluate the long-term results from reconstruction of the forefoot in patients with rheumatoid arthritis who underwent arthrodesis of the metatarsophalangeal joint of the hallux, resection arthroplasty of the heads of the lateral metatarsals and correction of the deformities of the smaller toes through arthrodesis of the proximal interphalangeal joint or closed manipulation.

Methods: seventeen patients (27 feet) who underwent forefoot reconstruction surgery by means of arthrodesis of the first metatarsophalangeal joint, resection of the heads of the lateral metatarsals and correction of the deformities of the smaller toes, were studied retrospectively. The mean follow-up was 68 months (12-148 months); the mean age was 52 years (range: 20-75 months); and four patients were male and 13 were female.

MIDFOOT CHARCOT ARTHROPATHY IN DIABETIC PATIENTS: COMPLICATION OF AN EPIDEMIC DISEASE.

Objectives: To outline the epidemiological profile of diabetic patients with Charcot arthropathy affecting the midfoot alone or extending from the midfoot to the hindfoot; To assess the results from the treatment that these patients undergo, according to a preestablished protocol, over the medium term.

Methods: We retrospectively evaluated 88 patients (110 extremities) with Charcot arthropathy of the midfoot. The minimum follow-up period was 12 months.

EVALUATION OF THE INTERMETATARSAL ANGLE AFTER THE ARTHRODESIS OF THE FIRST METATARSOPHALANGEAL JOINT FOR TREATMENT OF THE HALLUX VALGUS.

Objective: To evaluate the correction of the intermetatarsal angle after arthrodesis of the metatarsophalangeal joint of the hallux. We believe that varus deformity of the first metatarsal can be corrected after arthrodesis of the first metatarsophalangeal joint, without the need for proximal osteotomy.

Methods: Forty-three feet of patients who had undergone arthrodesis of the first metatarsophalangeal joint between May 1997 and October 2009 were retrospectively analyzed by means of radiographs.

ANALYSIS OF CLINICAL AND FUNCTIONAL OUTCOME AND COMPLICATIONS OF TALAR NECK FRACTURES.

Objective: To evaluate the clinical, functional and radiographic results from talar neck fractures in patients treated at the Foot and Ankle Surgery Group of Santa Casa de Sao Paulo.

Method: We evaluated 20 patients. The mean follow-up time was 71 months.

OSTEOTOMY OF THE FIRST METATARSAL BASE ON THE TREATMENT OF MODERATE TO SEVERE HALLUX VALGUS RESULTS AFTER MEAN FOLLOW-UP TIME OF EIGHT YEARS.

Objective: To assess the result of the treatment of moderate to severe hallux valgus with osteotomy of the first metatarsal base associated to distal release of soft parts and medial capsuloplasty.

Methods: 13 patients were assessed (15 feet) submitted to surgical treatment of hallux valgus moderate to severe. The mean follow-up time was 102 months; there were 12 female and 1 male patients, with mean age at the time of surgery of 49 years.

Correction of severe recurrent clubfoot using a simplified setting of the Ilizarov device.

Background: Severe recurrent clubfoot deformities are challenging to treat. The Ilizarov method offers a safer alternative; however, the management of the device is complex.

Methods: A simplified standard setting of the Ilizarov device was used to treat 29 patients (35 feet) with a mean age of 14 years with severely stiff recurrent clubfoot deformities and large scars caused by one or more previous surgeries.

Correction of neglected clubfoot using the Ilizarov external fixator.

Background: This study was conducted to evaluate the corrective capability of the Ilizarov external fixator in the treatment of neglected clubfoot.

Methods: Thirty patients (38 feet) with a mean age of 19 (5 to 39) years with severe deformities and stiff feet associated with neglected clubfoot were studied. A limited soft-tissue dissection, Achilles tenotomy, and plantar fasciotomy were done.