Effects of Parallax and Distortion in Total Ankle Arthroplasty.

Background: Surgeons rely on intraoperative fluoroscopy to assist in placement of implant components during total ankle arthroplasty (TAA). Parallax alters the direction of an object when viewed from two different points, resulting in image distortion. The purpose of this study was to evaluate parallax/distortion in intraoperative fluoroscopic images during TAA.

Parallax and Distortion in Fluoroscopy Units.

Background: Parallax is an imaging phenomenon where an object appears to be at different positions when viewed from different angles. Distortion can occur secondary to internal fluoroscopic, or external environmental, factors. Fluoroscopy is a vital tool to assist surgeons intraoperatively.

Anatomic Description of the Calcaneocuboid Joint: Implications for Staple Fixation.

Understanding the anatomy of the calcaneocuboid (CCJ) remains essential when selecting staple fixation to optimize osseous purchase during rearfoot procedures. This anatomic study quantitatively describes the CCJ in relation to staple fixation sites. The calcaneus and cuboid from 10 cadavers were dissected.

Correlation of Lisfranc Injuries With Regional Bone Density.

Lisfranc injuries present a challenge due to their ubiquity though frequent missed diagnoses. A paucity of data exists associating the contribution of bone density to injury type. This investigation compares the regional bone density between Lisfranc injury types using computed-tomography (CT)-derived Hounsfield units.

Self-Reported Conflicts of Interests and Financial Disclosures in The Journal of Foot & Ankle Surgery: A Systematic Review.

Industry, academia, and professional societies provide financial and in-kind support for physician-lead research; however, the prevalence and role remain unreported. From consultancies to leadership positions, foot and ankle surgeons receive a spectrum of support. To provide transparency between these relationships and published outcomes, journals report conflicts of interest (COI) and financial disclosures (FD).

Triple arthrodesis for adult acquired flatfoot.

The primary goal of triple arthrodesis for stage III and IV adult acquired flatfoot is to obtain a well-aligned plantigrade foot that will support the ankle in optimal alignment. Ancillary procedures including posterior muscle group lengthening, medial displacement calcaneal osteotomy, medial column stabilization, peroneus brevis tenotomy, or transfer and harvest of regional bone graft are often necessary to achieve adequate realignment. Image intensification is helpful in confirming optimal realignment before fixation.

Is advanced imaging necessary before surgical repair.

Posterior tibial tendon dysfunction (tendinitis, tendinosis, or rupture) and adult acquired flatfoot deformity can manifest with a wide array of bony and soft tissue abnormalities visible on plain radiographs, ultrasound, and magnetic resonance imaging. Imaging abnormalities include various combinations of malalignment, anatomic variants, and enthesopathic and tendinopathic changes. A thorough understanding of differences between anatomic and pathologic presentations of structures in various imaging modalities is an essential tool for clinical and surgical planning.

Surgical considerations for the neglected or chronic Achilles tendon rupture: a combined technique for reconstruction.

The Achilles tendon is among the most commonly injured tendons in the human body. The most common reason for delayed treatment is a missed diagnosis or a deficiency in presentation. The neglected or chronically ruptured Achilles tendon presents a unique treatment challenge.

Surgical approach for combined ankle and subtalar joint chronic mechanical instability.

Combined ankle and subtalar joint instability can lead to severe disability of the lower extremity. Multiple procedures have been described for hindfoot and ankle instability, including anatomic and non-anatomic reconstructions. The authors present their technique consisting of a free autogenous split peroneus longus tendon graft combined with a modified Brostrom-Gould repair.

Technical considerations for surgical intervention of Jones fractures.

Jones fractures are a common injury treated by foot and ankle surgeons. Surgical intervention is recommended because of the high rate of delayed union, nonunion, and repeat fracture, when treated conservatively. Percutaneous intramedullary screw fixation is commonly used in the treatment of these fractures.

Role of body mass index in acute charcot neuroarthropathy.

Obesity has been posited as a predictor for the development of Charcot neuroarthropathy, a severe form of degenerative joint disease associated with peripheral neuropathy and diabetes mellitus. The present case-control study investigated the relationship between elevated (overweight and obese) body mass index and acute Charcot neuroarthropathy in a diabetic population. The final data set consisted of 49 patients, 20 (40.

Factors affecting healing of ankle fractures.

Ankle fractures have been widely described in orthopedic and podiatric studies. These injuries have been associated with significant patient morbidity, infection, malunion, nonunion, and arthritis. Avoiding complications and optimizing outcomes demands an awareness of the factors affecting the healing of ankle fractures.

Venous thromboembolism and foot and ankle surgery: current updates 2012.

Significant patient morbidity and mortality is associated with the development of venous thromboembolism (VTE) following orthopedic surgery. The majority of the literature supports proper prophylaxis following major orthopedic surgery involving hip and knee procedures. Foot and ankle surgery, however, is starkly contrasted because of the lack of recommendations.

An anatomic safe zone for posterior ankle arthroscopy: a cadaver study.

Posterior ankle arthroscopy has traditionally been associated with concern for injury to the posterior tibial nerve and vessels, and this concern is greatest when the patient is positioned supine. Positioning the patient prone could be a safer method for posterior ankle arthroscopy. The purpose of this cadaver study was to determine the anatomic safe zone devoid of vital structures relative to the posteromedial and posterolateral arthroscopic portals created.

Incidence of talar dome lesions with concomitant peroneal tendon pathologic features: a magnetic resonance imaging evaluation.

Few studies have evaluated the incidence of talar dome lesions and injuries to the peroneal tendons occurring concomitantly. The purpose of our research was to evaluate the incidence of osteochondral lesions of the talus (OLT) with peroneal tendon pathologic features according to the magnetic resonance imaging (MRI) findings. A database search was conducted in the Department of Radiology at the Western Pennsylvania Hospital and Forbes Regional Campus for all MRI examinations ordered by attending physicians of the Department of Foot and Ankle Surgery from 2008 to 2010.

Deep vein thrombosis after bunionectomy: a case report of two genetic mutations.

Deep venous thrombosis after foot and ankle surgery is a serious complication that can have potentially life-threatening complications, such as pulmonary embolus. Genetic mutations have been reported in the published data to cause an increased risk of developing deep vein thrombosis. Two such genetic mutations are the methylenetetrahydrofolate reductase gene variant C677T and the 4G/5G polymorphism of the plasminogen activator inhibitor gene.

The hematoma block: a simple, effective technique for closed reduction of ankle fracture dislocations.

Management of a dislocated ankle fracture can be challenging because of instability of the ankle mortise, a compromised soft tissue envelope, and the potential neurovascular compromise. Every effort should be made to quickly and efficiently relocate the disrupted ankle joint. Within the emergency department setting, narcotics and benzodiazepines can be used to sedate the patient before attempting closed reduction.

Ankle joint sepsis with subsequent osteomyelitis in an adult patient without identifiable etiologies: a case report.

Ankle sepsis can lead to rapid joint destruction with long-term articular degeneration and dysfunction. Timely diagnosis by means of joint aspiration can be helpful. In this article, we describe the case of an otherwise healthy adult male with isolated ankle sepsis.

Nonoperative care for the treatment of adult-acquired flatfoot deformity.

Nonoperative therapy for adult-acquired flatfoot is a reasonable treatment option that is likely to be beneficial for most patients. In this article, we describe the results of a retrospective cohort study that focused on nonoperative measures, including bracing, physical therapy, and anti-inflammatory medications, used to treat adult-acquired flatfoot in 64 consecutive patients. The results revealed the incidence of successful nonsurgical treatment to be 87.

Incidence of plantar fascia ruptures following corticosteroid injection.

Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection.

The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010.

Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an array of diverse pathologies including neurologic, arthritic, traumatic, neoplastic, infectious, or vascular etiologies must be considered. This clinical practice guideline (CPG) is a revision of the original 2001 document developed by the American College of Foot and Ankle Surgeons (ACFAS) heel pain committee.

A retrospective analysis of anterior calcaneal osteotomy with allogenic bone graft.

Anterior calcaneal osteotomy (ACO) with extension bone graft is commonly employed in the treatment of symptomatic supple, hypermobile flatfoot in adolescent as well as adult (>or= 18 years of age) patients. Although autogenous bone graft has been considered the gold standard, allogenic bone is widely used for this procedure because it is readily available, requires no additional procedure for procurement and has incorporation rates similar to autogenous bone graft. There is increasing agreement among surgeons that the union rates with allograft bone are comparable with that observed with autograft bone when used in the ACO.