4,262 results match your criteria Lower Extremity Reconstruction Foot


[Clinical effectiveness of simultaneous reconstructions of multiple joint scar contracture deformity of limb].

Zhonghua Shao Shang Za Zhi 2020 Apr;36(4):308-312

Department of Burn Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.

To explore the clinical effects of simultaneous reconstruction of multiple joint scar contracture deformity of limb. From January 2010 to June 2018, 24 patients with multiple joint scar contracture deformity of the same limb were reconstructed in simultaneous operations in Xiangya Hospital of Central South University, including 16 males and 8 females, aged 3-42 years, with 15 patients having deformities in the upper limbs and 9 patients having deformities in the lower limbs. One operation was performed to repair contracture deformity of axillary fossa and elbow in 3 patients, cubital fossa and palmar of wrist in 4 patients, cubital fossa and hand in 5 patients, palmar of wrist, palm, and palmar of finger in 3 patients, groin and medial knee in 2 patients, popliteal fossa and posterior ankle in 1 patient, and anterior ankle and dorsum of foot in 6 patients. Read More

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http://dx.doi.org/10.3760/cma.j.cn501120-20190124-00016DOI Listing

Cone-beam imaging with tilted rotation axis: Method and performance evaluation.

Med Phys 2020 Apr 27. Epub 2020 Apr 27.

Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA.

Purpose: The recently introduced robotic x-ray systems provide the flexibility to acquire cone-beam computed tomography (CBCT) data using customized, application-specific source-detector trajectories. We exploit this capability to mitigate the effects of x-ray scatter and noise in CBCT imaging of weight-bearing foot and cervical spine (C-spine) using scan orbits with a tilted rotation axis.

Methods: We used an advanced CBCT simulator implementing accurate models of x-ray scatter, primary attenuation, and noise to investigate the effects of the orbital tilt angle in upright foot and C-spine imaging. Read More

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http://dx.doi.org/10.1002/mp.14209DOI Listing

Foot Salvage with Selective Arterialization of Pedal Venosomes.

Plast Reconstr Surg Glob Open 2020 Feb 20;8(2):e2612. Epub 2020 Feb 20.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis, St. Louis, Mo.

Background: Lower extremity salvage using microvascular flaps can be considered in high-functioning patients, but indications for salvage are often restricted by distal microvascular disease that may threaten the foot as a whole. Selective arterialization of specific pedal venosomes is a novel potential solution to this problem.

Methods: A 48-year-old man with a chronic left plantar forefoot wound, osteomyelitis of the second and third metatarsal heads, and critical limb ischemia was evaluated for foot salvage. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159967PMC
February 2020

Esterified Hyaluronic Acid Matrix in Lower Extremity Reconstruction With Exposed Tendon and Bone: A Retrospective Review.

J Burn Care Res 2020 Apr 18. Epub 2020 Apr 18.

University of Tennessee Health Science Center, Memphis; Firefighters' Regional Burn Center, Memphis, Tennessee.

Lower extremity wounds with exposed bone and tendon often need coverage to allow the underlying tissue to regenerate prior to skin graft. The surgeon is limited in his or her choices to augment tissue regeneration in these types of complicated cases; for instance, autologous skin should not be placed on exposed bone or tendon and is at risk for contracture when placed over the joints. Therefore, novel technologies are necessary to provide a scaffolding for tissue to regenerate and allow for a successful graft. Read More

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http://dx.doi.org/10.1093/jbcr/iraa044DOI Listing

The medial sural artery perforator (MSAP) flap: A versatile flap for lower extremity reconstruction.

Injury 2020 Apr 12;51(4):1077-1085. Epub 2020 Feb 12.

Southmead Hospital, North Bristol NHS Trust Westbury-on-Trym, Bristol, BS10 5NB, United Kingdom. Electronic address:

Background: The medial sural artery perforator (MSAP) flap provides a thin, pliable and durable soft tissue reconstruction with adequate pedicle length and low donor morbidity. It is an ideal choice for small-to-moderate defects of the lower extremity, although it does have limitations. We report our experience of the flap in a three-pronged anatomical, clinical and patient reported outcome-based study. Read More

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http://dx.doi.org/10.1016/j.injury.2020.02.060DOI Listing

[Clinical application of digital technology in repairing of heel wound with peroneal artery perforator propeller flap].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Mar;34(3):367-372

Department of Orthopedics, the 920th Hospital of Joint Logistic Support Force of Chinese PLA, Kunming Yunnan, 650032, P.R.China.

Objective: To study the effectiveness of digital technique in repairing of heel wound with peroneal artery perforator propeller flap.

Methods: Between March 2016 and March 2019, the heel wounds of 31 patients were repaired with the peroneal artery perforator propeller flaps. There were 21 males and 10 females, with an average age of 36 years (range, 12-53 years). Read More

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http://dx.doi.org/10.7507/1002-1892.201908079DOI Listing

Computer-Assisted Gradual Correction of Charcot Foot Deformities: An In-Depth Evaluation of Stage One of a Planned Two-Stage Approach to Charcot Reconstruction.

J Foot Ankle Surg 2020 Mar 4. Epub 2020 Mar 4.

Student, University of California, San Diego, La Jolla, CA.

The surgical treatment of Charcot foot is a widely debated topic, with issues ranging from when to operate to how to properly correct a deformity. Historically, correction of a severe deformity was attempted in 1 acute surgical procedure that frequently required open reduction and internal fixation through large incisions. This 1-time procedure would often result in complications including under- or overcorrection of the deformity, neurovascular injury, or incision dehiscence leading to possible soft-tissue infection or osteomyelitis. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.06.008DOI Listing

Successful Lower Limb Replantation of Knee-Level Amputation in a Child: A Case Report.

J Foot Ankle Surg 2020 Mar - Apr;59(2):427-430

Surgeon, Orthopedics Department, Ningxia Armed Police General Hospital, Yinchuan, Ningxia Hui Autonomous Region, China.

Replantation of a lower extremity amputated at the knee joint level in a child is rare. We present a case of a 3-year-old child with his right leg totally severed from the knee joint in a traumatic accident. After 5 hours of cold ischemia time, together with antishock therapies, the child underwent leg replantation under stable conditions. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.08.024DOI Listing
July 2018
0.979 Impact Factor

Revascularization of post-traumatic leg amputation: a case report.

Ghana Med J 2019 Dec;53(4):308-311

Departement of Internal Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana.

There are few reports on lower extremity revascularization because of its high risks of general and local complications as well as poor functional prognosis. However, revascularization of the traumatically amputated lower extremity is a technically feasible surgical undertaking if there can be effective collaboration between the orthopaedic surgeon and the vascular surgeon. Successful outcome is usually judged by functional achievements of the patient toward returning to the preinjury level. Read More

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http://dx.doi.org/10.4314/gmj.v53i4.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036437PMC
December 2019

One-Year Outcomes of Peripheral Endovascular Device Intervention in Critical Limb Ischemia Patients: Sub-Analysis of the LIBERTY 360 Study.

Vasc Health Risk Manag 2020 10;16:57-66. Epub 2020 Feb 10.

North Carolina Heart and Vascular, Rex Hospital, UNC School of Medicine, Raleigh, NC, USA.

Background: High-risk patients with advanced peripheral artery disease (PAD), including critical limb ischemia (CLI), are often excluded from peripheral endovascular device intervention clinical trials, leading to difficulty in translating trial results into real-world practice. There is a need for prospectively assessed studies to evaluate peripheral endovascular device intervention outcomes in CLI patients.

Methods: LIBERTY 360 is a prospective, observational, multi-center study designed to evaluate the procedural and long-term clinical outcomes of peripheral endovascular device intervention in real-world patients with symptomatic lower-extremity PAD. Read More

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http://dx.doi.org/10.2147/VHRM.S230934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020930PMC

Indications and Limitations of Bilayer Wound Matrix-Based Lower Extremity Reconstruction: A Multidisciplinary Case-Control Study of 191 Wounds.

Plast Reconstr Surg 2020 Mar;145(3):813-822

Philadelphia, Pa. From the Division of Plastic Surgery, Department of Surgery, and the Department of Orthopedic Surgery, University of Pennsylvania.

Background: Little is known about the efficacy of newer skin substitute scaffolds to reconstruct complex lower extremity wounds. The investigators present a multihospital experience of reconstructive surgeons utilizing collagen-GAG bilayer wound matrix in lower extremity soft-tissue reconstruction with the goals to (1) characterize a suitable patient population, (2) categorize failures to optimize patient selection, and (3) determine wound factors affecting success.

Methods: Subjects underwent collagen-GAG-based lower extremity wound reconstruction from May of 2010 to June of 2017. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043722PMC

Commentary: What Matters on the New Horizon of Below-the-Ankle Intervention: Don't Judge a Foot by Its Image.

Authors:
Osami Kawarada

J Endovasc Ther 2020 04 25;27(2):194-197. Epub 2020 Feb 25.

Department of Cardiovascular Medicine, Hanwa Memorial Hospital, Osaka, Japan.

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http://dx.doi.org/10.1177/1526602820906523DOI Listing

Satisfactory functional and MRI outcomes at the foot and ankle following harvesting of full thickness peroneus longus tendon graft.

Bone Joint J 2020 Feb;102-B(2):205-211

Department of Orthopaedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Aims: To evaluate the donor site morbidity and tendon morphology after harvesting whole length, full-thickness peroneus longus tendon (PLT) proximal to the lateral malleolus for ligament reconstructions or tendon transfer.

Methods: A total of 21 eligible patients (mean age 34.0 years (standard deviation (SD) 11. Read More

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http://dx.doi.org/10.1302/0301-620X.102B2.BJJ-2019-0949.R1DOI Listing
February 2020

[Anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap for foot and ankle defect].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jan;34(1):87-91

Depantment of Microsurgical and Reconstruction, the First Affiliated Hospital of Xinjiang Medical University, Urumchi Xinjiang, 830054,

Objective: To investigate the clinical application of the anterior tibial artery perforator propeller flap relay peroneal artery terminal perforator propeller flap in repair of foot and ankle defects.

Methods: Between October 2014 and October 2018, 18 cases with foot and ankle defects were treated. There were 12 males and 6 females with an average age of 32. Read More

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http://dx.doi.org/10.7507/1002-1892.201904095DOI Listing
January 2020

Response to the commentary on "Comparison of adductor canal block with local infiltration analgesia in primary total knee arthroplasty: A meta-analysis of randomized controlled trials" (Int J Surg 2019; Epub ahead of print).

Authors:
Qin Xu Xuefang Zhao

Int J Surg 2020 02 9;74:120-122. Epub 2020 Jan 9.

Department of Anesthesiology, Weifang People's Hospital, No. 151 Guangwen Street, 261000, Weifang, China. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.01.001DOI Listing
February 2020

Functional Reconstruction of Hindfoot With Total Calcaneus and Talus Loss by Ilizarov Technique: A Case Report.

J Foot Ankle Surg 2020 Jan - Feb;59(1):142-148

Professor, Department of Traumatic Orthopedics, the First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China. Electronic address:

Total calcaneus and talus loss in the hindfoot is an unusual but severe condition encountered in clinical settings. This condition affects lower-extremity function and poses a significant challenge to limb salvage. We present a case of a 43-year-old man with total calcaneus and talus loss in the right foot treated by Ilizarov technique. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.03.022DOI Listing

Impact of first metatarsal shortening on forefoot loading pattern: a finite element model study.

BMC Musculoskelet Disord 2019 Dec 27;20(1):625. Epub 2019 Dec 27.

Department of Orthopedics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Rd., Jing'an District, Shanghai, China.

Backgrounds: There has long been a consensus that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. However, appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. This study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed. Read More

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http://dx.doi.org/10.1186/s12891-019-2973-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933751PMC
December 2019
1.898 Impact Factor

[Application of infrared thermal imaging technology in the design of free anterolateral thigh perforator flap transplantation].

Zhongguo Gu Shang 2019 Nov;32(11):1053-1057

Department of Hand and Foot Surgery, Jinhua Central Hospital, Jinhua 321000, Zhejiang, China.

Objective: To explore clinical effect of infrared thermal imaging technology for the treatment of free anterolateral thigh perforator flap transplantation.

Methods: From June 2014 to June 2018, 31 patients with skin defect at various degrees treated by free anterolateral thigh perforator flap transplantation, including 21 males and 10 females aged from 16 to 59 years old with an average age of(35.3±1. Read More

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http://dx.doi.org/10.3969/j.issn.1003-0034.2019.11.015DOI Listing
November 2019

[Lower limb postoperative analgesia evolution : Time for sensitive blocks].

Authors:
P Laurent J C Cres

Rev Med Liege 2019 Dec;74(12):662-666

Service d'Anesthésie, Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgique.

For about twenty years, peripheral nervous blocks have become the gold standard in postoperative analgesia for knee and foot surgery. The development of echography adapted to anesthesia gave anesthesiologists the opportunity to perform distal, mostly sensitive nerve blocks. Proximal nervous blocks associated analgesia used to be better than general (intravenous or oral) analgesia. Read More

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December 2019

The long-term arterial assist intermittent pneumatic compression generating venous flow obstruction is responsible for improvement of arterial flow in ischemic legs.

PLoS One 2019 11;14(12):e0225950. Epub 2019 Dec 11.

Lehigh University, Philadelphia, PA, United States of America.

Background: There is a large group of patients with ischemia of lower limbs not suitable for surgical reconstruction of arteries treated with the help of external assist by intermittent pneumatic compression devices (IPC). Until recently the generally accepted notion was that by compressing tissues below the knee, veins become emptied, venous pressure drops to zero and the increased arterial-venous pressure gradient enables greater arterial flow. We used a pump that, in contradiction to the "empty veins" devices, limited the limb venous outflow by venous obstructions and in a long period therapy expanded the perfusion vessels and brought about persistent reactive hyperemia. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225950PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6905612PMC

[Application of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Dec;33(12):1552-1555

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P.R.China.

Objective: To investigate effectiveness of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs.

Methods: Between January 2015 and October 2018, 7 patients with soft tissue defects of the lower limbs were repaired with the anteromedial thigh perforator flaps. The patients were males, aged 8-30 years (median, 23 years). Read More

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http://dx.doi.org/10.7507/1002-1892.201905019DOI Listing
December 2019

Reverse sural flap - A feasible option for oncological defects of the lower extremity, ankle, and foot: Our experience from Northeast India.

South Asian J Cancer 2019 Oct-Dec;8(4):255-257

Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.

Background: Soft-tissue management around the lower third of the leg and foot presents a challenge to the surgeon. To achieve local control of tumor, additional surgical margins are required, thus creating large soft-tissue defects. The reverse sural artery flap (RSAF) is a popular option for many of these defects. Read More

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http://dx.doi.org/10.4103/sajc.sajc_11_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852637PMC
December 2019

Comparison between distally based peroneal and posterior tibial artery perforator-plus fasciocutaneous flap for reconstruction of the lower extremity.

Burns 2020 02 29;46(1):225-233. Epub 2019 Nov 29.

Department of Orthopaedics Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China. Electronic address:

Background: Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps and distally based posterior tibial artery perforator-plus fasciocutaneous (DPTAPF) flaps are widely used to reconstruct soft-tissue defects of the distal lower leg, ankle, and foot. However, a comparative study of both flaps in a considerable sample size is lacking. This retrospective study aimed to compare the efficacy of the flaps and provide referential evidence for selection of flaps. Read More

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http://dx.doi.org/10.1016/j.burns.2019.06.002DOI Listing
February 2020

Acral melanoma: considerations about the surgical management of this tumor.

An Bras Dermatol 2019 Sep - Oct;94(5):632-633. Epub 2019 Sep 30.

Clinic of Dermatology, Department of Medicine, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

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http://dx.doi.org/10.1016/j.abd.2019.09.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857676PMC
December 2019

Successful Treatment of Chronic Lower Extremity Ulcers with Allogeneic Platelet-Rich Plasma and Artificial Dermis: A Case Report.

Adv Skin Wound Care 2019 Dec;32(12):550-552

At the Huaihe Hospital of Henan University, Kaifeng, China, Qiannan Zhao, MA, is a graduate student, Department of Reconstructive and Plastic Surgery; Yuanyuan Ma, MD, is a plastic surgeon, Department of Reconstructive and Plastic Surgery; Yuquan Lu, PhD, is a professor, International Joint Research Laboratory for Cell Medical Engineering; Yuan Chai, MD, is a plastic surgeon, Department of Reconstructive and Plastic Surgery; and Yuemin Zhou, PhD, MD, is a professor, Department of Reconstructive and Plastic Surgery. Acknowledgments: This work was supported by the Medical Science and Technology Research Project of Henan Province (1721102410005). The authors have disclosed no financial relationships related to this article. Submitted April 12, 2019; accepted in revised form July 9, 2019.

Hydroxyurea is an oral medication associated with painful, nonhealing ulcers, for which there is no effective treatment but permanent discontinuation of hydroxyurea. The authors present a case of leg ulcers that likely occurred as a result of hydroxyurea use in a patient with essential thrombocythemia. Topical treatment with allogeneic platelet-rich plasma and artificial dermis completely healed the leg ulcers without hydroxyurea cessation. Read More

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http://dx.doi.org/10.1097/01.ASW.0000604176.47082.60DOI Listing
December 2019

[Reconstruction of Lower Extremity Palsy after Pelvic Fractures with the Muscle Transfers].

Acta Chir Orthop Traumatol Cech 2019 ;86(5):348-352

Traumatologická klinika Lékařské fakulty Univerzity Palackého v Olomouci a Fakultní nemocnice Olomouc.

PURPOSE OF THE STUDY The prevalence of nerve structure injuries accompanying pelvic and acetabular fractures is stated to be 5-25 %, with most frequent injuries to motor nerve structures associated with fractures of the posterior wall of the acetabulum. Prognostically worse outcomes of regeneration are documented mainly in iatrogenic, intraoperative injuries to nerve structures. This study aims to document the functional effect of muscle transfers restoring the movement of lower extremities with irreversible nerve lesion caused by the pelvic and acetabular fracture. Read More

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December 2019

Peroneal Tendon Pathology: Treatment and Reconstruction of Peroneal Tears and Instability.

Orthop Clin North Am 2020 Jan;51(1):121-130

Foot and Ankle Surgery Division; The Orthopedic Institute of North Texas, PA, Baylor Frisco - Professional Building #1, 5575 Warren Parkway, #115, Frisco, TX 75034, USA; Orthopaedics, Texas A&M University HSC, College of Medicine. Electronic address:

Peroneal tendon pathology is becoming an increasingly recognized source of lateral-sided ankle pain. High clinical suspicion, along with judicious physical examination coupled with confirmatory advanced imaging modalities, are necessary to make an accurate diagnosis and aid in guiding treatment. Peroneal pathology encompasses several distinct conditions. Read More

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http://dx.doi.org/10.1016/j.ocl.2019.09.001DOI Listing
January 2020

Outcomes of Reconstruction of the Flexible Adult-acquired Flatfoot Deformity.

Orthop Clin North Am 2020 Jan 17;51(1):109-120. Epub 2019 Oct 17.

Department of Orthopaedic Foot and Ankle Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA. Electronic address:

Reconstruction of the flexible adult-acquired flatfoot deformity (AAFD) is controversial, and numerous procedures are frequently used in combination, including flexor digitorum longus transfer, medializing calcaneal osteotomy (MCO), heel cord lengthening/gastrocnemius recession, lateral column lengthening (LCL), Cotton osteotomy or first tarsometatarsal fusion, and spring ligament reconstruction. This article summarizes recent studies demonstrating that patients have significant improvements after operative treatment of flexible AAFD. It reviews current literature on clinical and radiographic outcomes of the MCO, LCL, and Cotton osteotomies. Read More

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http://dx.doi.org/10.1016/j.ocl.2019.08.005DOI Listing
January 2020

Update on Investigation Methods for Lower Extremity Biomechanics.

Clin Podiatr Med Surg 2020 Jan 22;37(1):23-37. Epub 2019 Oct 22.

PMSR/RRA Podiatric Residency, Western University College of Podiatric Medicine, Chino Valley Medical Center, 309 East Second Street, Pomona, CA 91766, USA.

Imaging with biomechanical analysis augments the clinical examination and improves outcomes by correlating imaging findings with the examination. Plain film radiographs are the gold standard to assess osseous alignment. The biomechanical examination provides information to formulate an accurate assessment. Read More

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http://dx.doi.org/10.1016/j.cpm.2019.08.003DOI Listing
January 2020

The Biomechanics of Diabetes Mellitus and Limb Preservation.

Clin Podiatr Med Surg 2020 Jan 21;37(1):151-169. Epub 2019 Oct 21.

College of Podiatric Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA; Chino Valley Medical Center, Chino, CA 91710, USA.

Biomechanical changes to the lower extremity in patients with diabetes mellitus are typically greatest with peripheral neuropathy, although peripheral arterial disease also impacts limb function. Changes to anatomic structures can impact daily function. These static changes, coupled with kinetic and kinematic changes of gait, lead to increased vertical and shear ground reactive forces, resulting in ulcerations. Read More

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http://dx.doi.org/10.1016/j.cpm.2019.08.011DOI Listing
January 2020

Surgical Biomechanics: Principles of Procedure Choice.

Authors:
Jarrod Shapiro

Clin Podiatr Med Surg 2020 Jan;37(1):101-116

Western University of Health Sciences, College of Podiatric Medicine, Department of Podiatric Medicine, Surgery and Biomechanics, Chino Valley Medical Center Podiatric Medicine and Surgery Residency with Rearfoot Reconstruction and Ankle Certificate, 795 East 2nd Street, Suite 7, Pomona, CA 91766, USA. Electronic address:

Surgical treatment of foot and ankle ailments is common, but in the past the choice of procedures was often dictated principally by positional considerations. This article reviews the use of the 2 primary biomechanical approaches, the kinematic and kinetic methods, and presents a novel unified method to guide surgical procedure choice, the kineticokinematic approach. Decision-making methods and resources are discussed and 2 case studies are presented to elucidate how this method may be used when choosing surgical procedures. Read More

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http://dx.doi.org/10.1016/j.cpm.2019.08.009DOI Listing
January 2020

Acellular Fish Skin Graft Use for Diabetic Lower Extremity Wound Healing: A Retrospective Study of 58 Ulcerations and a Literature Review.

Wounds 2019 Oct 21;31(10):262-268. Epub 2019 Aug 21.

St. Vincent Hospital, Indianapolis, IN.

Objective: This retrospective study evaluates the efficacy of acellular fish skin graft for the treatment of full-thickness diabetic foot ulcers (DFUs). The primary objective is to calculate the total wound surface area (cm2) healed over a 16-week period. The secondary objective is to provide a systematic review on acellular fish skin grafts. Read More

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October 2019

Selecting a free flap for soft tissue coverage in lower extremity reconstruction.

Injury 2019 Dec 21;50 Suppl 5:S32-S39. Epub 2019 Oct 21.

Department of Plastic Surgery, University of Tennessee Health Science Center Memphis, TN, 38163, USA. Electronic address:

Background: Goals of lower extremity microvascular reconstruction (LEMR) include the restoration of function, prevention of infection, and optimal cosmesis. Indications for LEMR include large defects that are not amenable to pedicled options, a large zone of injury, and large complex defects. The novice microsurgeon should first master a handful of free flaps to develop an armamentarium of options for addressing such defects. Read More

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http://dx.doi.org/10.1016/j.injury.2019.10.045DOI Listing
December 2019

Rectus abdominis free tissue transfer in lower extremity reconstruction: Long term follow up in 58 cases.

Injury 2019 Dec 19;50 Suppl 5:S25-S28. Epub 2019 Oct 19.

Department of Orthopedic Surgery and Traumatology, Clemenceau Medical Center affiliated with Johns Hopkins International, Clemenceau Beirut, Lebanon.

This study evaluates the long-term results of rectus abdominis free-tissue transfer performed for lower extremity reconstruction.

Methods: Over a period of 8 years 58 were available for long term follow-up. Indications for reconstruction included acute wounds with soft tissue defects, diabetic foot ulcers, and chronic osteomyelitis. Read More

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http://dx.doi.org/10.1016/j.injury.2019.10.042DOI Listing
December 2019

Immediate vs. delayed toe-to-thumb transfer: Is the infection rate greater?

Handchir Mikrochir Plast Chir 2019 Dec 7;51(6):434-439. Epub 2019 Nov 7.

Azienda Ospedaliera San Camillo Forlanini, Unit of Reconstructive Surgery of the Limbs.

Background: After loss of a thumb, the big toe is a possible donor site for reconstruction with wrap-around free flap and trimmed-toe transfer techniques. Early reconstructions seem to reduce the risk of post-operative infections, despite several studies that show different infection rates of the recipient site in immediate toe-to-hand transfer. The authors carried out a retrospective analysis of their experience in thumb reconstruction with big toe transfer and evaluated the results achieved with both immediate and delayed reconstructions in terms of infection occurrence. Read More

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http://dx.doi.org/10.1055/a-0874-2253DOI Listing
December 2019

Replantation and Lengthening of a Lower Leg in a 7-Year-Old Child: A Case Report.

J Foot Ankle Surg 2019 Nov;58(6):1273-1275

Surgeon, Department of Hand Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. Electronic address:

Replantation of the lower leg has controversial indications, but it may be considered in carefully selected patients. Although the function of prosthetic lower legs has been improved in recent decades, leg salvage remains a laudable goal. We present the case of a 7-year-old child who sustained a traumatic amputation at the level of the middle tibia with loss of the middle portion of the lower leg. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.03.018DOI Listing
November 2019

Peripheral Vascular Disease Diagnostic Related Outcomes in Diabetic Charcot Reconstruction.

J Foot Ankle Surg 2019 Nov;58(6):1058-1063

Professor and Program Director, Center for Wound Healing and Hyperbaric Medicine, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC.

Postreconstructive outcomes were compared in diabetic patients with Charcot neuroarthropathy (CN) who had peripheral arterial disease (PAD) diagnosed with angiography versus patients who were diagnosed clinically. A retrospective review was performed of patients with diabetic CN requiring reconstruction secondary to ulceration and/or acute infection. Of the 284 patients in the CN osseous reconstruction cohort, after accounting for exclusion criteria, 59 (20. Read More

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http://dx.doi.org/10.1053/j.jfas.2019.06.002DOI Listing
November 2019
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Functional and oncological outcomes of limb-salvage surgery for foot and ankle tumors.

Foot (Edinb) 2019 Dec 27;41:34-38. Epub 2019 Jun 27.

Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt; Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address:

Background: Limb-salvage surgery has become the backbone treatment for musculoskeletal tumors in the last decades. However, limb-salvage with safe margins for tumors of the foot and ankle is challenging, due to the complex anatomy of this region. This study aimed to evaluate functional and oncological outcomes, complications, and local recurrence of limb-salvage procedures for tumors of the foot and ankle. Read More

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http://dx.doi.org/10.1016/j.foot.2019.06.007DOI Listing
December 2019

Septicemia secondary to (non-O1/non-O139) in wound.

BMJ Case Rep 2019 Oct 30;12(10). Epub 2019 Oct 30.

Internal Medicine, Long Island Jewish at Forest Hills, Forest Hills, New York, USA.

A 63-year-old woman with a prior history of chronic lower extremity lymphedema came to the hospital for evaluation of new-onset left leg pain and swelling associated with haemorrhagic blisters and foul-smelling discharge. Relevant history included a recent trip to a Hudson River Valley beach in New York 1 week prior to hospitalisation. Laboratory evaluation revealed significant leukocytosis and lactic acidosis. Read More

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http://dx.doi.org/10.1136/bcr-2019-231901DOI Listing
October 2019
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[Transplantation of compound tissue flap of toe to reconstruct the thumb with necrosis caused by electric burns in four patients].

Zhonghua Shao Shang Za Zhi 2019 Oct;35(10):761-763

Department of Burns, the Third Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Institute of Burn Research, Baotou 014010, China.

From January 2010 to December 2017, 4 patients of thumb with necrosis caused by electric burns (all male, aged from 31 to 58 years) were admitted to our hospital, with 1 patient of second degree injury of right thumb, 2 patients of third degree injury of right thumb, and 1 patient of third degree injury of left thumb. Routine debridement under general anesthesia was performed within 7 days after injury. The compound tissue flap of contralateral second toe was transplanted to reconstruct the thumb with third degree defect, and compound tissue flap of ipsilateral distal hallex was transplanted to reconstruct the thumb with second degree defect. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2019.10.011DOI Listing
October 2019
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Editor's Choice - Impact of Endovascular Pedal Artery Revascularisation on Wound Healing in Patients With Critical Limb Ischaemia.

Eur J Vasc Endovasc Surg 2019 Dec 22;58(6):854-863. Epub 2019 Oct 22.

Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

Objective: The present study investigated the impact of endovascular pedal artery revascularisation (PAR) on the clinical outcomes of patients with critical limb ischaemia (CLI).

Methods: This retrospective analysis of a single centre cohort included 239 patients who underwent endovascular revascularisation of infrapopliteal arteries for a chronic ischaemic wound. PAR was attempted in 141 patients during the procedure. Read More

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http://dx.doi.org/10.1016/j.ejvs.2019.07.034DOI Listing
December 2019

Resection Arthroplasty: Current Indications and Tips.

Foot Ankle Clin 2019 Dec 17;24(4):689-693. Epub 2019 Sep 17.

Mount Sinai West, NYC, 425 West 59th Street 5th Floor, New York, NY 10019, USA; Leni & Peter W. May Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Resection arthroplasty for metatarsalgia is a selective procedure primarily indicated for patients with rheumatoid arthritis. These patients present with significant forefoot deformities, poor bone quality, and loss of soft tissue integrity. Resection of the metatarsal heads and correction of lesser toe deformities improve pain and decrease transfer metatarsalgia. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.005DOI Listing
December 2019
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Freiberg's Infraction: Surgical Options.

Foot Ankle Clin 2019 Dec 8;24(4):669-676. Epub 2019 Oct 8.

Trauma and Orthopaedic Department, Hospital de Rengo, 331, Callejón El Rodeo 97, Rengo, Región del Libertador Gral. Bernardo O'Higgins, Chile.

Freiberg's infraction is an uncommon condition of the lesser metatarsophalangeal joints. Onset is usually between the 11th and 17th year of age. It is the only osteochondrosis that dominantly affects females with a reported female-to-male ratio of 5. Read More

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http://dx.doi.org/10.1016/j.fcl.2019.08.004DOI Listing
December 2019
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[Outcome of corrective osteotomy of shortened medial foot column after old talar neck fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Nov;33(11):1345-1350

Department of Orthopedics, Shanghai Ruijin Hospital, Medicine School of Shanghai Jiaotong University, Shanghai, 200025,

Objective: To investigate the effectiveness of corrective osteotomy for shortened medial foot column after old talar neck fracture.

Methods: The clinical data of 10 patients with shortened medial foot column after old talar neck fracture between June 2012 and May 2017 was retrospectively analyzed. There were 7 males and 3 females with an average age of 45. Read More

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http://dx.doi.org/10.7507/1002-1892.201903091DOI Listing
November 2019
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Preliminary Study on Functional and Aesthetic Reconstruction by Using a Small Artery-only Free Medial Flap of the Second Toe for Fingertip Injuries.

Clinics (Sao Paulo) 2019 21;74:e1226. Epub 2019 Oct 21.

Department of Microsurgery and Orthopedic Trauma, the First Affiliated Hospital of Sun Yat-sen University, Guang zhou, 510080, China.

Objectives: This study was designed to introduce the feasibility of fingertip reconstruction by using a free medial flap of the second toe without vein anastomosis.

Methods: In total, 8 patients with fingertip injuries were treated successfully with this method. Patients who underwent reconstruction from September 2016 to October 2017 in our hospital with an artery-only free medial flap transfer of the second toe for fingertip injuries were included, and patients who underwent additional procedures that may impact the postoperative results and were followed up for less than 6 months were excluded. Read More

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http://dx.doi.org/10.6061/clinics/2019/e1226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6792235PMC

Robust Stride Detector from Ankle-Mounted Inertial Sensors for Pedestrian Navigation and Activity Recognition with Machine Learning Approaches.

Sensors (Basel) 2019 Oct 16;19(20). Epub 2019 Oct 16.

Inria Saclay, team DataShape, 1 Rue Honoré d'Estienne d'Orves, 91120 Palaiseau, France.

In this paper, a stride detector algorithm combined with a technique inspired by zero velocity update (ZUPT) is proposed to reconstruct the trajectory of a pedestrian from an ankle-mounted inertial device. This innovative approach is based on sensor alignment and machine learning. It is able to detect 100% of both normal walking strides and more than 97% of atypical strides such as small steps, side steps, and backward walking that existing methods can hardly detect. Read More

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http://dx.doi.org/10.3390/s19204491DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833053PMC
October 2019

Minimally invasive reconstruction technique for chronic Achilles tendon tears allows rapid return to walking and leads to good functional recovery.

Knee Surg Sports Traumatol Arthrosc 2020 Jan 13;28(1):305-311. Epub 2019 Oct 13.

Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland.

Purpose: Chronic Achilles tendon tears, including chronic ruptures with end gap over 6 cm making end-to-end suturing impossible, can be treated with autologous hamstring graft reconstruction. The primary goal of this study was to present the biomechanical and long-term clinical results of recently developed minimally invasive Achilles tendon reconstruction technique.

Methods: Minimally invasive Achilles tendon reconstruction was applied to 8 foot and ankle cadaveric specimens as well as 18 patients with chronic Achilles tendon tears. Read More

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http://dx.doi.org/10.1007/s00167-019-05723-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970963PMC
January 2020
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Grade 2 Chondrosarcoma of the Great Toe: An Unusual Location.

J Am Podiatr Med Assoc 2019 Sep;109(5):393-396

Enchondroma is the most common benign cartilage bone tumor of the toes. In contrast, the foot is a rare region for chondrosarcoma, and the involvement of phalanges is extremely rare. In this article, we report an unusual case of intermediate chondrosarcoma involving the proximal phalanx of the great toe of a 52-year-old woman who was previously treated with curettage and bone grafting because of misinterpretation of enchondroma at a local hospital. Read More

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http://dx.doi.org/10.7547/18-097DOI Listing
September 2019
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THE USE OF MICROSOFT KINECT ™ FOR ASSESSING READINESS OF RETURN TO SPORT AND INJURY RISK EXERCISES: A VALIDATION STUDY.

Int J Sports Phys Ther 2019 Sep;14(5):724-730

University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, WA.

Introduction: Assessing readiness of return to sport after procedures such as anterior cruciate ligament (ACL) reconstruction is a complex process, complicated by the pressures that athletes face in returning to sport as quickly as possible. Advances in motion analysis have been able to demonstrate movements that are risk factors for initial ACL injury and subsequent reinjury after reconstruction. An inexpensive, objective measure is needed to determine when athletes are ready to return to sport after ACL reconstruction. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769275PMC
September 2019
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Reconstruction of the distal lower leg and foot sole with medial plantar flap: a retrospective study in one center.

J Plast Surg Hand Surg 2020 Feb 3;54(1):40-46. Epub 2019 Oct 3.

Department of Plastic Surgery, Jinling Hospital, Nanjing Medical University, Nanjing, China.

Soft tissue reconstruction of the distal lower leg and foot sole is a challenge for surgeons. In this article, we describe our experience and outcomes with distal lower leg and foot sole reconstruction using the medial plantar flap. From January 2007 to December 2017, 29 consecutive patients from our department underwent reconstruction of soft tissue defects over the distal lower leg, heel and plantar forefoot using medial plantar flaps. Read More

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http://dx.doi.org/10.1080/2000656X.2019.1673169DOI Listing
February 2020
3 Reads