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[PMID]:28449701
[Au] Autor:Kuyucu E; Mutlu H; Mutlu S; Gülenç B; Erdil M
[Ad] Endereço:Orthopedics and Traumatology, Istanbul Medipol University, Istanbul, Turkey. ersinkuyucu@yahoo.com.tr.
[Ti] Título:Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint.
[So] Source:J Orthop Surg Res;12(1):68, 2017 Apr 27.
[Is] ISSN:1749-799X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. METHODS: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. RESULTS: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70. Both VPS and AOFAS-Hallux scores changed significantly. DISCUSSION: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. CONCLUSIONS: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.
[Mh] Termos MeSH primário: Artroscopia/métodos
Hallux Rigidus/diagnóstico por imagem
Hallux Rigidus/cirurgia
Articulação Metatarsofalângica/diagnóstico por imagem
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13018-017-0562-7


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[PMID]:28449699
[Au] Autor:Munteanu SE; Landorf KB; McClelland JA; Roddy E; Cicuttini FM; Shiell A; Auhl M; Allan JJ; Buldt AK; Menz HB
[Ad] Endereço:Discipline of Podiatry, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, 3086, Australia. s.munteanu@latrobe.edu.au.
[Ti] Título:Shoe-stiffening inserts for first metatarsophalangeal joint osteoarthritis (the SIMPLE trial): study protocol for a randomised controlled trial.
[So] Source:Trials;18(1):198, 2017 Apr 27.
[Is] ISSN:1745-6215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This article describes the design of a parallel-group, participant- and assessor-blinded randomised controlled trial comparing the effectiveness of shoe-stiffening inserts versus sham shoe insert(s) for reducing pain associated with first metatarsophalangeal joint (MTPJ) osteoarthritis (OA). METHODS: Ninety participants with first MTPJ OA will be randomised to receive full-length shoe-stiffening insert(s) (Carbon Fibre Spring Plate, Paris Orthotics, Vancouver, BC, Canada) plus rehabilitation therapy or sham shoe insert(s) plus rehabilitation therapy. Outcome measures will be obtained at baseline, 4, 12, 24 and 52 weeks; the primary endpoint for assessing effectiveness being 12 weeks. The primary outcome measure will be the foot pain domain of the Foot Health Status Questionnaire (FHSQ). Secondary outcome measures will include the function domain of the FHSQ, severity of first MTPJ pain (using a 100-mm Visual Analogue Scale), global change in symptoms (using a 15-point Likert scale), health status (using the Short-Form-12® Version 2.0 and EuroQol (EQ-5D-5L™) questionnaires), use of rescue medication and co-interventions, self-reported adverse events and physical activity levels (using the Incidental and Planned Activity Questionnaire). Data will be analysed using the intention-to-treat principle. Economic analysis (cost-effectiveness and cost-utility) will also be performed. In addition, the kinematic effects of the interventions will be examined at 1 week using a three-dimensional motion analysis system and multisegment foot model. DISCUSSION: This study will determine whether shoe-stiffening inserts are a cost-effective intervention for relieving pain associated with first MTPJ OA. The biomechanical analysis will provide useful insights into the mechanism of action of the shoe-stiffening inserts. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000552482 . Registered on 28 April 2016.
[Mh] Termos MeSH primário: Protocolos Clínicos
Órtoses do Pé
Articulação Metatarsofalângica/fisiopatologia
Osteoartrite/terapia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Análise Custo-Benefício
Seres Humanos
Osteoartrite/reabilitação
Avaliação de Resultados (Cuidados de Saúde)
Cooperação do Paciente
Sapatos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13063-017-1936-1


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[PMID]:29308853
[Au] Autor:Bobrov DS; Slinjakov LJ; Rigin NV
[Ti] Título:The Primary Metatarsalgia: Pathogenesis, Biomechanics and Surgical Treatment.
[So] Source:Vestn Ross Akad Med Nauk;72(1):53-8, 2017.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:This paper presents a comprehensive review on the current concept of the diagnosis and treatment of central metatarsalgia on the basis of medical literature analyses. Metatarsalgia is the term for pain in the forefoot. This is a set of symptoms corresponding to a wide range of diseases. Central metatarsalgia is a kind of metatarsalgia which arises from structural-functional changes that lead to excessive pressure in the area of metatarsal heads. The data analysis demonstrated that presently various types of osteotomies of metatarsal bones are the main surgical treatment options with the chance of complication ranging from 6 to 50%. Weil-osteotomy is known to be the most popular type of osteotomy for treatment of central metatarsalgia. The most common complication of Weil-osteotomy is floating toe, the one that doesn't contact with the supporting surface. In case Weil-osteotomy and intraphalangeal arthrodesis with trans acticular fixation are both performed, the complication of floating toe increases up to 50%. When Weil osteotomy, plantar plate repair, extensor digitorum longum tendon lengthening and triple Weil-osteotomy are performed simultaneously, the complication rate is 15% approximately which is much lower. Using combined osteotomy techniques as well as taking into account structural-functional pathologic changes of the forefoot and ligaments repair of metatarsalphalangeal joint will ensure the most successful development of surgical treatment techniques for central metatarsalgia.
[Mh] Termos MeSH primário: Artrodese/métodos
Metatarsalgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Ossos do Metatarso/diagnóstico por imagem
Ossos do Metatarso/cirurgia
Metatarsalgia/diagnóstico
Metatarsalgia/cirurgia
Articulação Metatarsofalângica/diagnóstico por imagem
Articulação Metatarsofalângica/cirurgia
Radiografia/métodos
Articulações Tarsianas/diagnóstico por imagem
Articulações Tarsianas/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.15690/vramn756


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[PMID]:29069047
[Au] Autor:Zhou C; Xue C; Yang B; Wang W; Xu Y; Huang F; Wang Y
[Ad] Endereço:aDepartment of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine bDepartment of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China.
[Ti] Título:Amputation of the first metatarsophalangeal joint due to a giant gouty tophi: A case report.
[So] Source:Medicine (Baltimore);96(43):e8441, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The first metatarsophalangeal joint (MTP1) is the most frequent site of gouty tophi. We report an unusual case with a giant skin-perforating tophi. This is the first case of gouty tophi at MTP1 which accepts surgical debulking and amputation. PATIENT CONCERNS: A 42-year-old man presented with a seven-year history of gout and a giant tophi at MTP1. The patient was referred to hospital due to persistent pain and ulcerations on the surface of the left MTP1. This rounded, giant, swelling, tophaceous tophi severely interfered with his normal walking. DIAGNOSES: The patient was diagnosed with gouty arthritis seven years ago, and did not receive regular anti-gout treatments. OUTCOMES: Biochemical examination showed he had raised serum uric acid (SUA, 11.92 mg/dl) and creatinine (258 µmol/l). There was a severe joint destruction of MTP1 by X-ray examination. We controlled the skin infection by sulbenicillin. He was given febuxostat to reduce SUA. After 3 months of treatment, SUA fell to 6.8 mg/dl. Then we performed surgical debulking of MTP1 and amputation of hallux. Surgical operations obviously relieved the pain, and improved the function of his left foot. The visual closure after amputation was good. CONCLUSION: Surgical amputation of the gout lesion at MTP1 maximized the function, and reduced the pain of this patient. In the case of giant tophi with severe gouty arthritis or skin infections, surgical decisions need to weigh gains and losses carefully.
[Mh] Termos MeSH primário: Amputação/métodos
Artrite Gotosa/cirurgia
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Adulto
Artrite Gotosa/sangue
Artrite Gotosa/patologia
Creatinina/sangue
Seres Humanos
Masculino
Articulação Metatarsofalângica/patologia
Ácido Úrico/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
268B43MJ25 (Uric Acid); AYI8EX34EU (Creatinine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171123
[Lr] Data última revisão:
171123
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008441


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[PMID]:28957551
[Au] Autor:Boer AC; Burgers LE; Mangnus L; Ten Brinck RM; Nieuwenhuis WP; van Steenbergen HW; Reijnierse M; Huizinga TWJ; van der Helm van Mil AHM
[Ad] Endereço:Department of Rheumatology.
[Ti] Título:Using a reference when defining an abnormal MRI reduces false-positive MRI results-a longitudinal study in two cohorts at risk for rheumatoid arthritis.
[So] Source:Rheumatology (Oxford);56(10):1700-1706, 2017 Oct 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: The use of hand and foot MRI in the diagnostic process of RA has been advocated. Recent studies showed that MRI is helpful in predicting progression from clinically suspect arthralgia (CSA) to clinical arthritis, and from undifferentiated arthritis (UA) to RA. Symptom-free persons can also show inflammation on MRI. This study aimed to evaluate if MRI findings in symptom-free volunteers are relevant when defining a positive MRI. Methods: Two hundred and twenty-five CSA patients and two hundred and one UA patients underwent MRI of MCP, wrist and MTP joints at baseline and were followed for 1 year on progression to arthritis and RA, respectively, as reported previously. MRI was considered positive if ⩾ 1 joint showed inflammation (called uncorrected definition), or if ⩾ 1 joint had inflammation that was present in < 5% of persons of the same age category at the same location (called 5% corrected definition). Test characteristics were compared for both definitions. Results: By using MRI data of symptom-free volunteers as reference, specificity of MRI-detected inflammation increased from 22 to 56% in CSA patients, and from 10 to 36% in UA patients. The sensitivity was not affected; it was 88 and 85% in CSA patients and 93 and 93% in UA patients. The accuracy also increased, from 32 to 60% in CSA patients and 22 to 44% in UA patients. Conclusion: The use of a reference population resulted in a substantial reduction of false-positive results, without influencing the sensitivity. Although common for other tests in medicine, this phenomenon is novel for MRI in the early detection of RA.
[Mh] Termos MeSH primário: Artrite Reumatoide/diagnóstico por imagem
Imagem por Ressonância Magnética/estatística & dados numéricos
Avaliação de Sintomas/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Artralgia/diagnóstico por imagem
Artrite/diagnóstico por imagem
Diagnóstico Precoce
Reações Falso-Positivas
Feminino
/diagnóstico por imagem
Mãos/diagnóstico por imagem
Seres Humanos
Estudos Longitudinais
Imagem por Ressonância Magnética/métodos
Masculino
Articulação Metacarpofalângica/diagnóstico por imagem
Articulação Metatarsofalângica/diagnóstico por imagem
Meia-Idade
Valor Preditivo dos Testes
Valores de Referência
Sensibilidade e Especificidade
Avaliação de Sintomas/métodos
Articulação do Punho/diagnóstico por imagem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex235


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[PMID]:28953644
[Au] Autor:Valero J; Moreno M; Gallart J; González D; Salcini JL; Gordillo L; Deus J; Lahoz M
[Ad] Endereço:aDepartment of Human Anatomy and Histology, School of Medicine, University of Zaragoza, Zaragoza bDepartment of Podiatry, University of Sevilla, Sevilla cDepartment of Surgery, Obstetrics and Gynecology, School of Medicine, University of Zaragoza, Zaragoza, Spain.
[Ti] Título:A new surgical procedure for hallux limitus treatment: Double-V osteotomy on the base of the proximal phalanx of the hallux.
[So] Source:Medicine (Baltimore);96(39):e8127, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to evaluate the effectiveness of the new Double-V osteotomy of the first metatarsophalangeal joint (1MPJ) in patients with hallux limitus (HL).A study of 66 patients was performed, 33 patients were treated Cheilectomy and 33 were treated Double-V. All patients underwent an assessment of the passive mobility of the 1MPJ before the procedure, reevaluated 12 months later evaluating dorsiflexion, plantarflexion, and patients status using both the American Orthopaedic Foot and Ankle Society (AOFAS) for Hallux Metatarsophalangeal-Interphalangeal Scale.In comparing the improvement achieved regarding the increase of mobility obtained with surgical treatment, the feet operated with procedure Double-V gained significant degrees of movement increased in all analyzed parameters (P < .05). We achieved 13.33° more than average in dorsiflexion motion and 2.12° more than average in plantarflexion with regard to the feet that were operated with Cheilectomy procedure. Double-V scores on the AOFAS scale improved significantly (P = .000) 91.48 points postoperative, while with the following Cheilectomy only 79.30 points.This new surgical technique, easy to perform and with low complexity in surgical execution and a minimum of complications, produces better clinical and functional results that Cheilectomy alone.
[Mh] Termos MeSH primário: Hallux Limitus/cirurgia
Hálux/cirurgia
Osteotomia/métodos
Falanges dos Dedos do Pé/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Articulação Metatarsofalângica/cirurgia
Meia-Idade
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008127


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[PMID]:28570126
[Au] Autor:Yamada AF; Crema MD; Nery C; Baumfeld D; Mann TS; Skaf AY; Fernandes ADRC
[Ad] Endereço:1 Department of Diagnostic Imaging, Federal University of São Paulo, Rua Napoleão de Barros, 800, São Paulo, SP 04024-002, Brazil.
[Ti] Título:Second and Third Metatarsophalangeal Plantar Plate Tears: Diagnostic Performance of Direct and Indirect MRI Features Using Surgical Findings as the Reference Standard.
[So] Source:AJR Am J Roentgenol;209(2):W100-W108, 2017 Aug.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The objective of our study was to assess the diagnostic performance and associations of the direct and indirect MRI features of the metatarsophalangeal (MTP) joint that are thought to be related to tears of the plantar plate (PP) using surgical findings as the reference standard. MATERIALS AND METHODS: We retrospectively included 23 patients with symptomatic instability of lesser MTP joints who had undergone preoperative 1.5-T MRI and surgical assessment. The MRI examinations were independently assessed by two musculoskeletal radiologists. Using the surgical data as the reference standard, we calculated the sensitivity, specificity, and accuracy of each MRI feature in the detection of PP tears. Multivariate logistic regression analysis was performed to identify which MRI features were independently associated with PP tears. Interobserver reliability was assessed using kappa statistics. RESULTS: Forty-five lesser MTP joints were included. The presence of pericapsular fibrosis was highly sensitive (91.2%), specific (90.9%), and accurate (91.1%) for the diagnosis of PP tears. With a cutoff value of 0.275 cm, the PP-proximal phalanx distance had a sensitivity of 64.7%, specificity of 90.9%, and accuracy of 71.1% in diagnosing PP tears. CONCLUSION: In patients with clinical features indicating lesser MTP joint instability, some direct and indirect MRI features exhibited good to excellent diagnostic performance in detecting the presence of PP tears.
[Mh] Termos MeSH primário: Artropatias/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Metatarsalgia/diagnóstico por imagem
Articulação Metatarsofalângica/diagnóstico por imagem
Articulação Metatarsofalângica/lesões
Placa Plantar/diagnóstico por imagem
Placa Plantar/lesões
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Aumento da Imagem/métodos
Artropatias/cirurgia
Masculino
Metatarsalgia/cirurgia
Articulação Metatarsofalângica/cirurgia
Meia-Idade
Variações Dependentes do Observador
Placa Plantar/cirurgia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.16.17276


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[PMID]:28399657
[Au] Autor:Phisitkul P; Hosuru Siddappa V; Sittapairoj T; Goetz JE; Den Hartog BD; Femino JE
[Ad] Endereço:1 Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
[Ti] Título:Cadaveric Evaluation of Dorsal Intermetatarsal Approach for Plantar Plate and Lateral Collateral Ligament Repair of the Lesser Metatarsophalangeal Joints.
[So] Source:Foot Ankle Int;38(7):791-796, 2017 Jul.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Access to the plantar plate has been described using either a plantar approach or an extensive dorsal approach that required complete joint destabilization and often a metatarsal osteotomy. Clinical scenarios related to plantar plate tear vary and the pathologies in early stages are frequently limited to unilateral soft tissue structures; a less invasive operative approach may be possible. A novel approach requiring a release of only the lateral collateral ligament and the lateral half of the plantar plate is presented in this cadaver model; the extent of joint exposure possible is described. The ability to place a secure suture through the lateral collateral ligament and the plantar plate was analyzed. METHODS: Nine fresh-frozen cadaveric specimens were dissected in a randomized fashion across the second to fourth metatarsophalangeal joints through the intermetatarsal space dorsally. Under distraction, soft tissue was sequentially released, including dorsal capsule, lateral collateral ligament, and the lateral half of the plantar plate. Integrity of the extensor tendons, deep transverse intermetatarsal ligament, proximal attachment of the plantar plate, and osseous structures was carefully preserved. The joint exposure was quantified after each step with sizing rods. Using a suture passer, 2-0 nonabsorbable braided sutures were passed into the lateral collateral ligament and the plantar plate, and the construct strength was measured using a tensiometer. RESULTS: Progressive increase in mean joint exposure was noted after each step of soft tissue release with the final exposure of 6 mm after release of the lateral half of the plantar plate. Joint exposures after a capsulotomy and a lateral collateral release were 3 mm and 4 mm, respectively. Under distraction, the unilateral release of soft tissue created a lateral opening of the joint while the proximal phalangeal base adducted and medially deviated. Successful suture passage was noted in all specimens that could sustain a minimum tension of 25 N without a catastrophic failure. There was no statistically significant correlation with age, sex, foot length, and rays of the specimens when joint exposure was considered. CONCLUSION: The dorsal intermetatarsal approach appeared to be feasible for access to the lateral collateral ligament and the lateral half of the plantar plate. The average joint exposure of 6 mm allowed a quality suture passage by a suture passer in both structures in all specimens without the need of a metatarsal osteotomy. CLINICAL RELEVANCE: This operative approach may be appropriate for early stages plantar plate tear when only lateral soft tissue repair is needed. This technique should not preclude conversion to a more extensile operative approach or an additional metatarsal osteotomy if needed. Applicability of this operative approach in cases with more advanced pathologies or involving only medial soft tissue structures requires further studies.
[Mh] Termos MeSH primário: Ligamentos Laterais do Tornozelo/fisiopatologia
Articulação Metatarsofalângica/cirurgia
Osteotomia/métodos
Placa Plantar/lesões
Placa Plantar/cirurgia
Cicatrização/fisiologia
[Mh] Termos MeSH secundário: Cadáver
Seres Humanos
Ligamentos Articulares
Suturas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170413
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717702460


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[PMID]:28391704
[Au] Autor:Park YH; Jeong CD; Choi GW; Kim HJ
[Ad] Endereço:1 Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.
[Ti] Título:Effect of Bipartite Hallucal Sesamoid on Hallux Valgus Surgery.
[So] Source:Foot Ankle Int;38(6):634-640, 2017 Jun.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bipartite hallucal sesamoids are often found in patients with hallux valgus. However, it is unknown whether bipartite hallucal sesamoids affect the results of hallux valgus surgery or not. The purpose of the present study was to evaluate the outcomes of chevron osteotomy for hallux valgus with and without bipartite hallucal sesamoid. METHODS: A total of 152 patients (168 feet) treated with distal or proximal chevron osteotomy for hallux valgus constituted the study cohort. The 168 feet were divided into 2 groups: bipartite hallucal sesamoid (31 feet) and without bipartite hallucal sesamoid (137 feet). Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), tibial sesamoid position, and first metatarsal length were measured for radiographic outcomes and the American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal (MTP-IP) score was measured for clinical outcomes. RESULTS: All radiographic measurements and the AOFAS score showed significant ( P < .05) improvement at the time of final follow-up compared with preoperative measurements in both groups. No significant differences ( P > .05) were found between the 2 groups in terms of HVA, IMA, DMAA, tibial sesamoid position, metatarsal shortening, and AOFAS score on final follow-up. CONCLUSIONS: This study suggests that bipartite hallucal sesamoids do not affect the results of hallux valgus surgery. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
[Mh] Termos MeSH primário: Hallux Valgus/cirurgia
Hálux/fisiologia
Ossos do Metatarso/cirurgia
Articulação Metatarsofalângica/fisiopatologia
Osteotomia/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Radiografia
Estudos Retrospectivos
Tíbia/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1177/1071100717700454


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[PMID]:28367694
[Au] Autor:Stone OD; Ray R; Thomson CE; Gibson JN
[Ad] Endereço:1 Edinburgh Royal Infirmary, Edinburgh, United Kingdom.
[Ti] Título:Long-Term Follow-up of Arthrodesis vs Total Joint Arthroplasty for Hallux Rigidus.
[So] Source:Foot Ankle Int;38(4):375-380, 2017 Apr.
[Is] ISSN:1944-7876
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The optimal operative management of hallux rigidus is still a matter for debate among surgeons. Despite arthrodesis widely considered to be the gold standard treatment, many surgeons advocate arthroplasty as a suitable alternative. There are, however, few long-term or high-quality studies evaluating these modalities. We present the 15-year follow-up of a randomized controlled trial. METHODS: This data is the follow-up to the original study published in 2005. In the original study, 63 patients (77 toes) were recruited to and randomized to have either metatarsophalangeal joint (MTPJ) arthrodesis or arthroplasty. The primary outcome measure was a decrease in pain on a visual analog scale (VAS) at 24 months. In the present study, data were available for all surviving patients (52 patients, 66 toes). Data were collected in the form of satisfaction scores, VAS for pain, the VAS foot and ankle and survivorship data. RESULTS: The results of the original study demonstrated that pain relief was greater following arthrodesis at 2 years. At 15 years, patients with an arthrodesis experienced less pain and were more satisfied compared to those with an arthroplasty. No functional differences were seen between these 2 groups. There were more revisions in the arthroplasty group. CONCLUSION: Despite the hope of better function, less pain, and greater satisfaction from MTPJ replacement, this was not found in our patient population. The long-term results of our study showed that arthrodesis outperformed arthroplasty. If an arthroplasty failed, then salvage was likely to be technically difficult, with significant potential for complications. LEVEL OF EVIDENCE: Level I, randomized controlled trial.
[Mh] Termos MeSH primário: Artrodese/métodos
Artroplastia de Substituição/métodos
Hallux Rigidus/cirurgia
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Seguimentos
Hallux Rigidus/diagnóstico
Seres Humanos
Estudos Longitudinais
Medição da Dor
Estudos Retrospectivos
Terapia de Salvação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1177/1071100716682994



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