Tibiotalocalcaneal Arthrodesis: A Retrospective Comparison Between Nails and Lateral Locking Plate Complications.

Background: Tibiotalocalcaneal arthrodesis is a well-established procedure to treat some hindfoot diseases. Currently, the most used implants are retrograde intramedullary nails and locking plates combined with lag screws, but there are few articles comparing differences regarding the complications.

Methods: We have retrospectively analyzed the medical records and the radiographs of patients older than 18 years who underwent this procedure in our service between 2005 and 2019 through retrograde intramedullary nails or lateral locking plates and compression screws with at least 12 months of follow-up and with no history of osteomyelitis in these bones.

Congenital Clubfoot - Is the Ponseti Method the Definitive Solution?

Congenital clubfoot is one of the most common deformities at birth. The inadequacy or absence of treatment causes serious limitations for people with this condition. The initial treatment using the Ponseti method ensures functional results superior to other treatment modalities previously proposed.

Biomechanical evaluation in runners with Achilles tendinopathy.

Objectives: To evaluate the clinical characteristics, ground reaction force (GRF), and function of the plantar muscles and dorsiflexors of the ankle in runners with and without Achilles tendinopathy (AT) and in non-runners.

Methods: Seventy-two participants (42 men, 30 women; mean age: 37.3±9.

Common late complications of longitudinal forefoot amputations in neuropathic foot treatment.

Objective: To describe and quantify the complications arising in consecutive neuropathic patients undergoing partial longitudinal amputations of the foot.

Method: A retrospective study was conducted with data collected from the medical records of patients monitored at the Insensitive Foot Clinic of the Foot and Ankle Group of our institution who underwent partial amputation of foot rays from 2000 to 2016.

Results: A total of 28 patients met the inclusion criteria, with a total of 31 amputated/partially amputated feet.

HALLUX PROXIMAL PHALANX FRACTURE IN ADULTS: AN OVERLOOKED DIAGNOSIS.

Objectives: To describe the surgical treatment of fractures that involves the hallux interphalangeal joint, current indications and management options.

Methods: we performed a literature review of relevant clinical studies in multiple databases, including PubMed, MedLine and Scopus, from January 1989 to October 2020.

Results: There is consensus for surgical treatment of intra-articular fractures with a deviation greater than 2 mm, metadiaphyseal fractures with malrotation and/or malangulation, open fractures and unstable fractures.

Weightbearing Forefoot Axial Radiography - Technical Description and Reproducibility Evaluation.

 The present study aims to describe a new weightbearing radiographic method to visualize the heads of the five metatarsals on the coronal plane, evaluating their accuracy through intraclass correlation coefficients.  The subjects were evaluated, with weightbearing, with the ankle at 20 degrees of plantar flexion and the metatarsophalangeal joints at 10 degrees of extension, positioned on a wooden device. Two independent foot and ankle surgeons evaluated the radiography, with one of them doing it twice, at different moments, achieving an inter and intraobserver correlation, with intraclass correlation coefficients.

Epidemiological study on calcaneus fractures in a tertiary hospital.

Objective: To analyze the epidemiology and characteristics of patients with calcaneus fractures.

Methods: This is a retrospective revision of patients with calcaneus fractures hospitalized in the Institute of Orthopedics and Traumatology of this institution between 2006 and 2010. Data such as age, gender, laterality, trauma mechanism, type of fracture, associated injuries, compound fractures, and time from injury to surgery were analyzed.

Talar Body Reconstruction for Nonunions and Malunions.

Background: Talar body and neck nonunions and malunions may undergo a reconstructive surgery when joint cartilage is still viable, and no talar collapse or infection has occurred. This is a rare condition and the studies supporting the procedure have small number of cases. The objective of the present study is to report a case series of six patients who underwent talar reconstructions.

Matrix metalloproteinase-1 (MMP-1) and (MMP-8) gene polymorphisms promote increase and remodeling of the collagen III and V in posterior tibial tendinopathy.

Posterior tibial tendinopathy (PTT) can lead to acquired flatfoot in adults. Many patients develop PTT without any identifiable risk factors. Molecular changes in extracellular matrix (ECM) and matrix metalloproteinase (MMP) polymorphism may influence the risk of developing PTT.

Novel animal model for Achilles tendinopathy: Controlled experimental study of serial injections of collagenase in rabbits.

Our goal was to develop a novel technique for inducing Achilles tendinopathy in animal models which more accurately represents the progressive histological and biomechanical characteristic of chronic Achilles tendinopathy in humans. In this animal research study, forty-five rabbits were randomly assigned to three groups and given bilateral Achilles injections. Low dose (LD group) (n = 18) underwent a novel technique with three low-dose (0.

Increased cytokine levels and histological changes in cartilage, synovial cells and synovial fluid after malleolar fractures.

Background: Malleolar fractures are among the most common fractures in the human skeleton with a high risk of later development of post-traumatic osteoarthritis (OA). The acute ankle injury initiates a sequence of events potentially leading to progressive articular surface damage resulting from inflammatory changes in cartilage, synovial tissue and synovial fluid. We hypothesised that in the acute phase of ankle fracture, these changes occur at the same time in the different tissues.

EPIDEMIOLOGICAL STUDY ON LISFRANC INJURIES.

Objective: To analyze the characteristics of patients with Lisfranc injuries and their associated fractures

Methods: This is a retrospective analysis on 42 patients with Lisfranc injuries hospitalized at Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, between 2006 and 2010. Parameters on patient profile, risk factors, fracture characteristics, data on treatment and acute complications were analyzed

Results: Analysis of 42 cases showed that in our sample, men were more affected than women, with a ratio of 4.25:1.

Posterior tibial tendinopathy associated with matrix metalloproteinase 13 promoter genotype and haplotype.

Background: Posterior tibial tendon (PTT) is particularly vulnerable and its insufficiency is recognized as the main cause of adult acquired flat foot. Some patients have a predisposition without a clinically recognized cause, suggesting that individual characteristics play an important role in tendinopathy. The present study investigated whether genetic variants in matrix metalloproteinases (MMPs) are associated with PTT dysfunction.

Baseline characteristics and risk factors for ulcer, amputation and severe neuropathy in diabetic foot at risk: the BRAZUPA study.

Background: Studies on diabetic foot and its complications involving a significant and representative sample of patients in South American countries are scarce. The main objective of this study was to acquire clinical and epidemiological data on a large cohort of diabetic patients from 19 centers from Brazil and focus on factors that could be associated with the risk of ulcer and amputation.

Methods: This study presents cross sectional, baseline results of the BRAZUPA Study.

Cartilage lesions and ankle osteoarthrosis: review of the literature and treatment algorithm.

The main etiology of ankle osteoarthrosis is post-traumatic and its prevalence is highest among young individuals. Thus, this disease has a great socioeconomic impact and gives rise to significant losses of patients' quality of life. The objective of its treatment is to eliminate pain and keep patients active.

Charcot neuroarthropathy: realignment of diabetic foot by means of osteosynthesis using intramedullary screws - case report.

Diabetes mellitus is a serious disease that affects a large portion of the population. Charcot neuroarthropathy is one of its major complications and can lead to osteoarticular deformities, functional incapacity, ulcers and ankle and foot infections. Realignment of the foot by means of arthrodesis presents a high rate of implant failure due to weight-bearing on an insensitive foot.

Epidemiological study on talus fractures.

Objective: to analyze the characteristics of patients with talus fractures and the injuries that they present.

Methods: retrospective analysis on patients hospitalized in the Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine of the University of São Paulo, between 2006 and 2011, with talus fractures. Patient profile parameters, risk factors, fracture characteristics, treatment data and acute complications were analyzed.

Flexor hallux tendon transfer: comparative study through double or single approach.

Objective: To quantify the FHL length difference obtained through a single approach and by a double combined approach.

Methods: 16 fresh cadavers, a total of 32 feet, were used to measure the FHL graft length. With the cadaver positioned in ventral decubitus, a posteromedial incision in the ankle and a second incision in the plantar cavus were performed.

Kager's fat pad inflammation associated with HIV infection and AIDS: MRI findings.

Objective: To describe magnetic resonance imaging (MRI) features of Kager's fat pad inflammation in HIV-positive patients with lipodystrophy due to protease inhibitor treatment and posterior ankle pain.

Methods: A case-control, cross-sectional study; group 1 included 14 HIV-positive patients using protease inhibitors, presenting lipodystrophy syndrome and having posterior ankle pain; group 2 (CGHIV-) included 112 HIV-negative patients without lipodystrophy syndrome who were being evaluated for posterior ankle pain; group 3 (CGHIV + 1) included 23 HIV-positive patients not using a protease inhibitor, without lipodystrophy syndrome and with posterior ankle pain; group 4 (CGHIV + 2) comprised 18 HIV-positive patients who were being treated with a protease inhibitor and had lipodystrophy syndrome but did not have posterior ankle pain. Images were evaluated for the presence of edema by two radiologists who were blinded to clinical features.

MMP-1 promoter genotype and haplotype association with posterior tibial tendinopathy.

Purpose: Posterior tibial tendon (PTT) is particularly vulnerable and its insufficiency is recognized as the main cause of adult acquired flatfoot. Some patients have a predisposition without clinically recognized cause, suggesting that individual characteristics play an important role in tendinopathy. The objective of the present study is to investigate the association of -519 (rs1144393) matrix metalloproteinase-1 (MMP-1) polymorphism and the -1607 (rs1799750) and -519 MMP-1 haplotypes and risk of PTT dysfunction.

Epidemiologic study of ankle fractures in a tertiary hospital.

Objectives: To evaluate the epidemiology of ankle fractures surgically treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo.

Methods: Medical records of patients admitted with foot and ankle fractures between 2006 and 2011 were revised. Seventy three ankle fractures that underwent surgical treatment were identified.

Extensor digitorum brevis flap on the treatment of lower limb injuries.

Objective: To describe our pioneer national experience with 11 patients with soft tissue defects in the distal 1/3 of the leg, ankle and forefoot treated with extensor digitorum brevis muscle flap (EDB).

Methods: Between November 2009 and July 2012 11 patients were operated with the flap technique. We operated nine men and two women aged between 10 and 66 years.

Effectiveness of the dorsal thermoplastic locking orthosis to prevent floating toes in postoperative follow-up of Weil osteotomies: pilot study.

Background: The Weil oblique distal metatarsal osteotomy is regularly used in the treatment of primary metatarsalgia. The most frequent complication is the floating toe, which occurs in up to 36% of postoperative follow-up. The theory of reducing the plantar flexor mechanism tension associated with the retraction of the dorsal structures during the healing process of the surgical procedure may explain this negative evolution.

Hállux Rígidus: prospective study of joint replacement with hemiarthroplasty.

Objective: To report the results of medium-term follow-up after deploying Arthrosurface-HemiCap((r)) in patients with diagnosis of Hállux Rigidus (HR).

Method: Eleven patients underwent partial Arthroplasty of the first metatarsal-phalangeal joint. Six women and five men with an average age 51.

A comparative, prospective, and randomized study of two conservative treatment protocols for first-episode lateral ankle ligament injuries.

Background: The objective of this study was to investigate functional results, the amount of time that patients missed from regular working activities, and the incidence of residual mechanical ankle instability following conservative treatment of a first episode of severe lateral ankle ligament sprain (with articular instability).

Methods: This prospective and randomized study included 186 patients with severe lateral ankle ligament injuries, who were randomly assigned into 2 conservative treatment groups. In group A, participants were treated with a walking boot with weight-bearing allowed, pain management, ice, and elevation with restricted joint mobilization for 3 weeks.