Thermal-assisted capsular modification for functional ankle instability.

Chronic symptoms following lateral ankle sprain occasionally requires surgical intervention. Many options are available including thermal assisted capsular modification. The authors review the history of thermal modification of tissues, the indication for use in the ankle and report their experience with a consecutive case series over a one year period.

A prospective trial of night splinting in the treatment of recalcitrant plantar fasciitis: the Ankle Dorsiflexion Dynasplint.

Twelve patients were treated with the Ankle Dorsiflexion Dynasplint (Dynasplint Systems Inc, Severna, Md) for recalcitrant plantar fasciittis. Using a modified plantar fasciitis functional assessment scale and a visual analog pain assessment scale for evaluation, 75% of patients reported improvement ofsymptoms at 1-month follow-up. The average percentage of weekly sleeping hours spent in the splint was 95%.

Preliminary results on the safety and efficacy of the OssaTron for treatment of plantar fasciitis.

The OssaTron may be another alternative for management of plantar fasciitis (heel pain syndrome) after failure of non-operative management and prior to surgical management. This study evaluated primarily the safety and early preliminary efficacy of the OssaTron in treatment of patients with plantar fasciitis unresponsive to non-operative management. Twenty heels of 20 patients were treated with 1000 extracorporeal shockwaves from the OssaTron to the affected heel after administration of a heel block.

Outcomes in hallux rigidus patients treated nonoperatively: a long-term follow-up study.

The purpose of this study was to analyze radiographic outcome and patient satisfaction in non-operative care of hallux rigidus. Twenty-two patients representing 24 feet were surveyed and radiographed. Average follow-up was 14.

Foot health and shoewear for women.

Females are different from males in structure and biomechanics. The foot in the female tends to have a narrower heel in relationship to the forefoot and overall is narrower than a man's foot relative to length. Females tend to pronate their feet more and have smaller Achilles tendons than males, both factors having implications for shoe fit.

Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis.

Fifteen centers for orthopaedic treatment of the foot and ankle participated in a prospective randomized trial to compare several nonoperative treatments for proximal plantar fasciitis (heel pain syndrome). Included were 236 patients (160 women and 76 men) who were 16 years of age or older. Most reported duration of symptoms of 6 months or less.

Arthroscopic evaluation of the subtalar joint: does sinus tarsi syndrome exist?

This is a retrospective review of 49 subtalar arthroscopies performed between 1989 and 1996. Patients were evaluated in the following areas: (1) preoperative diagnosis, (2) preoperative tests and clinical evaluation, (3) intraoperative findings, (4) postoperative diagnosis,(5) complications, and (6) clinical outcome. Particular attention was paid to the accuracy of the preoperative diagnosis, subtalar instability, intraoperative findings in sinus tarsi syndrome, and clinical outcome.

Arthroscopy of the great toe.

The few available reports of arthroscopic treatment of the first MTP joint in the literature indicate favorable outcome. However, arthroscopy of the great toe is an advanced technique and should only be undertaken by experienced surgeons.

Proximal phalanx osteotomy for the surgical treatment of hallux rigidus.

This study reviewed 17 patients (24 great toes) treated by a single surgeon for hallux rigidus with a dorsal-closing wedge osteotomy of the proximal phalanx in conjunction with a moderate cheilectomy. The average age of patients was 47 years (range, 20-69 years). The minimum follow-up was 1 year (range, 1-16 years; median follow-up, 30 months), and all but five patients were studied for 2 years or more.

A new operative approach for flatfoot secondary to posterior tibial tendon insufficiency: a preliminary report.

The treatment of Johnson stage 2 posterior tibial tendon insufficiency remains controversial. Because the deformities remain flexible in stage 2, bony osteotomies are preferable over fusion operations. It is our contention that operative intervention should address all of the components of the pes planovalgus deformity that exists in stage 2 disease.

Trochanteric bone grafts in foot and ankle surgery.

Eighty-five patients who underwent trochanteric bone graft harvest in association with foot and ankle surgery were studied retrospectively by patient questionnaire. The average follow-up was 49 months (range, 14-101 months). Ninety-five percent of the patients expressed satisfaction with the procedure, in that they would choose to accept the trochanteric bone graft again if required to make the choice.

Arthroscopy of the subtalar joint.

The purpose of this study was to determine the position and relative safety of the anterior, posterior, and newly defined middle portals by measuring their distance from the neurovascular structures and tendons on the lateral side of the foot and ankle. Furthermore, this study demonstrates specific components of the posterior subtalar joint and arthroscopic access to each utilizing a technique that allows direct anatomic correlation. The 15 specimens were divided into three groups of five feet each, with one arthroscopic portal site and one instrumentation portal site per group.

Tibiocalcaneal arthrodesis for nonbraceable neuropathic ankle deformity.

Seven patients with nonbraceable, neuropathic ankle joints have been successfully treated by tibiocalcaneal arthrodesis utilizing an adolescent condylar blade plate, large cannulated AO screws, and a special cancellous allograft mixture. All patients had fragmentation and partial resorption of the talus. This procedure was considered as an alternative to below-knee amputation.