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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]:29437061
[Au] Autor:Chraim M; Krenn S; Alrabai HM; Trnka HJ; Bock P
[Ad] Endereço:Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.
[Ti] Título:Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot.
[So] Source:Bone Joint J;100-B(2):190-196, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70). RESULTS: The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) - Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS). CONCLUSION: The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: 2018;100-B:190-6.
[Mh] Termos MeSH primário: Artrodese/métodos
Artropatia Neurogênica/cirurgia
Doenças do Pé/cirurgia
Fixação Intramedular de Fraturas
[Mh] Termos MeSH secundário: Adulto
Idoso
Amputação
Desbridamento
Feminino
Seguimentos
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Complicações Pós-Operatórias
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0374.R2


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[PMID]:29252632
[Au] Autor:Wanderman N; Thurn J; Wyffels M; Sembrano JN
[Ad] Endereço:Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Successful Treatment of Mycobacterium gordonae Sacroiliitis Using a Novel Minimally Invasive Sacroiliac Joint Arthrodesis: A Case Report.
[So] Source:JBJS Case Connect;6(3):e55, 2016 Jul-Sep.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: A 43-year-old man with a history of well-controlled HIV (human immunodeficiency virus) infection presented with sacroiliac joint destruction from a Mycobacterium gordonae infection. A sacroiliac joint arthrodesis was performed using a minimally invasive technique utilizing both biologic fusion (allograft bone with rhBMP-2 [recombinant human bone morphogenetic protein-2]) and fixation with titanium ingrowth rods. CONCLUSION: To our knowledge, this is the first reported case of infectious sacroiliitis from a nontubercular mycobacterium (M. gordonae) treated with a combination of joint debridement, biologic fusion with bone graft, and nonbiologic functional fusion using titanium ingrowth rods, all performed in a minimally invasive fashion. This strategy effectively alleviated pain and preserved function at 2 years of follow-up.
[Mh] Termos MeSH primário: Artrodese/métodos
Infecções por Micobactéria não Tuberculosa/cirurgia
Micobactérias não Tuberculosas/isolamento & purificação
Articulação Sacroilíaca/cirurgia
Sacroileíte/cirurgia
[Mh] Termos MeSH secundário: Adulto
Infecções por HIV/complicações
Seres Humanos
Masculino
Infecções por Micobactéria não Tuberculosa/microbiologia
Sacroileíte/microbiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.14.00190


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[PMID]:28458187
[Au] Autor:Riedl M; Glisson RR; Matsumoto T; Hofstaetter SG; Easley ME
[Ad] Endereço:Wilhelminen Hospital, Department of Trauma Surgery, Montleartstraße 37, 1160 Wien, Austria. Electronic address: markus.riedl@wienkav.at.
[Ti] Título:Torsional stiffness after subtalar arthrodesis using second generation headless compression screws: Biomechanical comparison of 2-screw and 3-screw fixation.
[So] Source:Clin Biomech (Bristol, Avon);45:32-37, 2017 Jun.
[Is] ISSN:1879-1271
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Subtalar joint arthrodesis is a common operative treatment for symptomatic subtalar arthrosis. Because excessive relative motion between the talus and calcaneus can delay or prohibit fusion, fixation should be optimized, particularly in patients at risk for subtalar arthrodesis nonunion. Tapered, fully-threaded, variable pitch screws are gaining popularity for this application, but the mechanical properties of joints fixed with these screws have not been characterized completely. We quantified the torsion resistance of 2-screw and 3-screw subtalar joint fixation using this type of screw. METHODS: Ten pairs of cadaveric subtalar joints were prepared for arthrodesis and fixed using Acutrak 2-7.5 screws. One specimen from each pair was fixed with two diverging posterior screws, and the contralateral joint was fixed using two posterior screws and a third screw directed through the anterior calcaneus into the talar neck. Internal and external torsional loads were applied and joint rotation and torsional stiffness were measured at two torque levels. FINDINGS: Internal rotation was significantly less in specimens fixed with three screws. No difference was detectable between 2-screw and 3-screw fixation in external rotation or torsional stiffness in either rotation direction. Both 2-screw and 3-screw fixation exhibited torsion resistance surpassing that reported previously for subtalar joints fixed with two diverging conventional lag screws. INTERPRETATION: Performance of the tapered, fully threaded, variable pitch screws exceeded that of conventional lag screws regardless of whether two or three screws were used. Additional resistance to internal rotation afforded by a third screw placed anteriorly may offer some advantage in patients at risk for nonunion.
[Mh] Termos MeSH primário: Artrodese
Parafusos Ósseos
Articulação Talocalcânea
[Mh] Termos MeSH secundário: Adulto
Idoso
Fenômenos Biomecânicos
Cadáver
Calcâneo/cirurgia
Desenho de Equipamento
Feminino
Seres Humanos
Masculino
Meia-Idade
Rotação
Tálus
Torque
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29182127
[Au] Autor:Niedzielski K; Flont P; Domzalski M; Lipczyk Z; Malecki K
[Ti] Título:Lower limb equalization with percutaneus epiphysiodesis of the knee joint area.
[So] Source:Acta Orthop Belg;82(4):843-849, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Epiphysiodesis has become one of the most popular methods in the treatment of leg length discrepancy (LLD) due to its surgical simplicity, short hospitalization time, and a low risk of complications. PATIENTS AND METHODS: A retrospective analysis was performed on 34 patients treated for LDD with percutaneus epiphisiodesis of the distal femur and/or the proximal tibia. The mean discrepancy was 2.8 cm. The outcome evaluation method was based on Kemnitz et al. RESULTS: Based on the Kemnitz criteria, 23 (67.6%) patients experienced good results, while 2 (5.9%) satisfactory and 9 (26.5%) poor results. In 47% of patients, swellings of the knee joint were observed in the postoperative period. One serious complication - varus deformity of 10 degrees in femur occurred in the follow-up period. CONCLUSIONS: Percutaneous epiphysiodesis is a simple method of the LLD correction, with a low rate of complications and applicable in cases of late LDD diagnosis.
[Mh] Termos MeSH primário: Artrodese/métodos
Alongamento Ósseo/métodos
Epífises/cirurgia
Fêmur/cirurgia
Articulação do Joelho/cirurgia
Desigualdade de Membros Inferiores/cirurgia
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:28455729
[Au] Autor:Haskell A
[Ad] Endereço:Department of Orthopaedic Surgery, Palo Alto Medical Foundation, 301 Industrial Road, San Carlos, CA, 94070, USA. haskela@pamf.org.
[Ti] Título:CORR Insights : Can a Three-component Prosthesis be Used for Conversion of Painful Ankle Arthrodesis to Total Ankle Replacement?
[So] Source:Clin Orthop Relat Res;475(9):2295-2297, 2017 09.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Tornozelo/cirurgia
Artroplastia de Substituição do Tornozelo
[Mh] Termos MeSH secundário: Articulação do Tornozelo/cirurgia
Artrodese
Artroplastia de Substituição
Seres Humanos
Prótese Articular
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5372-z


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[PMID]:28872529
[Au] Autor:Odum SM; Van Doren BA; Anderson RB; Davis WH
[Ad] Endereço:1OrthoCarolina Research Institute, Charlotte, North Carolina 2Health Services Research Program, College of Health & Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina 3OrthoCarolina Foot and Ankle Institute, Charlotte, North Carolina.
[Ti] Título:In-Hospital Complications Following Ankle Arthrodesis Versus Ankle Arthroplasty: A Matched Cohort Study.
[So] Source:J Bone Joint Surg Am;99(17):1469-1475, 2017 Sep 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ankle arthrodesis has been the traditional surgical treatment for end-stage hindfoot arthritis. However, utilization of total ankle arthroplasty (TAA) is increasing as surgical techniques and implants have substantially improved. The purpose of this study was to compare the U.S. national rates of perioperative (in-hospital) complications between a statistically matched cohort of patients who underwent either an ankle arthrodesis or a TAA. METHODS: Data from the 2002 to 2013 Nationwide Inpatient Sample releases were analyzed. The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure codes were used to identify 4,192 patients treated with TAA (ICD 81.56) and 16,278 treated with ankle arthrodesis (ICD 81.11). ICD-9-CM diagnosis codes were utilized to identify major and minor in-hospital complications, and mortality was determined using the Uniform Bill patient disposition. The arthrodesis and TAA groups were matched with regard to age, sex, race, surgery year, hospital type, comorbidities, adjunctive procedures, and surgical indication. Unadjusted and adjusted in-hospital complication risks were compared between groups using the Fisher exact test and multiple logistic regression analysis. RESULTS: We were able to statistically match 1,574 patients who underwent a TAA (37.5%) with a patient who underwent arthrodesis. A major in-hospital complication occurred in 8.5% (134) of the 1,574 patients in the ankle arthrodesis group compared with 5.3% (84) of the 1,574 in the TAA group (p < 0.001) whereas a minor complication was found in 4.7% (74) in the ankle arthrodesis group compared with 5.9% (93) in the TAA group (p = 0.14). There were no deaths in either group. After adjusting for case mix, we found that ankle arthrodesis was 1.8 times more likely to be followed by a major complication (odds ratio [OR] = 1.78, 95% confidence interval [CI] = 1.32 to 2.39) whereas the minor complication rate was 29% lower in that group (OR = 0.71, 95% CI = 0.45 to 1.13). CONCLUSIONS: In a matched cohort of 3,148 patients treated with either TAA or ankle arthrodesis, ankle arthrodesis was associated with a 1.8 times higher risk of a major complication but a 29% lower risk of a minor complication. Our findings are consistent with other studies that have shown TAA to be a safe procedure in the inpatient environment. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Articulação do Tornozelo
Artrite/cirurgia
Artrodese/efeitos adversos
Artroplastia de Substituição do Tornozelo/efeitos adversos
Complicações Intraoperatórias/epidemiologia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00944


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[PMID]:28763410
[Au] Autor:Schoenfeld AJ; Nwosu K; Jiang W; Yau AL; Chaudhary MA; Scully RE; Koehlmoos T; Kang JD; Haider AH
[Ad] Endereço:1Department of Orthopaedic Surgery (A.J.S., K.N., and J.D.K.), Department of Surgery (W.J., M.A.C., R.E.S., and A.H.H.), and Center for Surgery and Public Health (A.J.S., W.J., M.A.C., R.E.S., and A.H.H.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 2Tufts University School of Medicine, Boston, Massachusetts 3Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
[Ti] Título:Risk Factors for Prolonged Opioid Use Following Spine Surgery, and the Association with Surgical Intensity, Among Opioid-Naive Patients.
[So] Source:J Bone Joint Surg Am;99(15):1247-1252, 2017 Aug 02.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is a growing concern that the use of prescription opioids following surgical interventions, including spine surgery, may predispose patients to chronic opioid use and abuse. We sought to estimate the proportion of patients using opioids up to 1 year after discharge following common spinal surgical procedures and to identify factors associated with sustained opioid use. METHODS: This study utilized 2006 to 2014 data from TRICARE insurance claims obtained from the Military Health System Data Repository. Adults who underwent 1 of 4 common spinal surgical procedures (discectomy, decompression, lumbar posterolateral arthrodesis, or lumbar interbody arthrodesis) were identified. Patients with a history of opioid use in the 6 months preceding surgery were excluded. Posterolateral arthrodesis and interbody arthrodesis were considered procedures of high intensity, and discectomy and decompression, low intensity. Covariates included demographic factors, preoperative diagnoses, comorbidities, postoperative complications, and mental health disorders. Risk-adjusted Cox proportional hazard models were used to evaluate the time to opioid discontinuation. RESULTS: This study included 9,991 patients. Eighty-four percent filled at least 1 opioid prescription on discharge. At 30 days following discharge, 8% continued opioid use; at 3 months, 1% continued use; and at 6 months, 0.1%. In the adjusted analysis, the low-intensity surgical procedures were associated with a higher likelihood of discontinuing opioid use (discectomy: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.36 to 1.50; and decompression: HR = 1.34, 95% CI = 1.25 to 1.43). Depression (HR = 0.84, 95% CI = 0.77 to 0.90) was significantly associated with a decreased likelihood of discontinuing opioid use (p < 0.001). CONCLUSIONS: By 6 months following discharge, nearly all patients had discontinued opioid use after spine surgery. As only 0.1% of the patients continued opioid use at 6 months following surgery, these results indicate that spine surgery among opioid-naive patients is not a major driver of long-term prescription opioid use. Socioeconomic status and pre-existing mental health disorders may be factors associated with sustained opioid use following spine surgery. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Analgésicos Opioides
Artrodese
Discotomia
Transtornos Relacionados ao Uso de Opioides
Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Descompressão Cirúrgica
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01075


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[PMID]:28638013
[Au] Autor:Bensman VM; Savchenko YP; Gumenyuk SE; Triandafilov KG; Vasil'chenko PP; Pyatakov SN; Khoritonenko VV
[Ad] Endereço:Kuban State Medical University.
[Ti] Título:[Surgical treatment of diabetic neuroosteoarthropathy (DNOAP) and its long-term results].
[Ti] Título:Khirurgicheskoe lechenie diabeticheskoi neiroosteoartropatii i ego otdalennye rezul'taty..
[So] Source:Khirurgiia (Mosk);(6):41-50, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To develop pathogenetically justified surgical treatment of diabetic neuroosteoarthropathy (DNOAP). MATERIAL AND METHODS: 52 patients were operated and long-term results were studied in 36 of them. 2 groups were assessed depending on completeness of surgical treatment including changed synovial structures removal. Tarso-metatarsal arthrodesis was created after synovectomy in median foot to restore longitudinal arch. Cruro-calcaneal neoarthrosis was performed after elimination of posterior focus of DNOAP. Excision of large, deep plantar ulcer (or osteomyelitic fistula) was completed by tissues tension with needles for primary wound healing. RESULTS: DNOAP patients are tolerant against surgical infection that is decreased in patients with neuropathic form of diabetic foot syndrome. Skin plasty is followed by rejection in DNOAP that was cured with prednisolone. Deep suppurations complicating foot skeleton fragmentation have subacute course and do not lead to sepsis. Infected wounds heal by primary intention in 98% after closure with primary suture. It was empirically found that synovectomy and osteochondral detritus removal discontinue DNOAP course. Reconstructive surgical stage is aimed to restoring the shape and function of the foot. Analysis of long-term outcomes showed absence of DNOAP signs in 76.2±9.2% of cases after radical surgery and positive results of treatment in 97.2±2.7% of patients. CONCLUSION: Our data conceptually assume the possibility of autoimmune mechanism in DNOAP pathogenesis. On this basis pathogenetically reasonable surgical procedures are established to interrupt pathological process. These interventions differ by technological aspects only depending on middle or rear foot destruction.
[Mh] Termos MeSH primário: Artrodese/métodos
Pé Diabético
Dissecação/métodos
Efeitos Adversos de Longa Duração
Infecção da Ferida Cirúrgica
[Mh] Termos MeSH secundário: Adulto
Pé Diabético/diagnóstico por imagem
Pé Diabético/cirurgia
Feminino
Seguimentos
Seres Humanos
Efeitos Adversos de Longa Duração/diagnóstico
Efeitos Adversos de Longa Duração/etiologia
Masculino
Meia-Idade
Avaliação de Processos e Resultados (Cuidados de Saúde)
Radiografia/métodos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Federação Russa
Infecção da Ferida Cirúrgica/diagnóstico
Infecção da Ferida Cirúrgica/prevenção & controle
Técnicas de Fechamento de Ferimentos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017641-50


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[PMID]:28562561
[Au] Autor:Wen J; Liu H; Xiao S; Li X; Fang K; Zeng M; Tang Z; Cao S; Li F
[Ad] Endereço:Department of Pediatric Orthopedics, Hunan Provincial People's Hospital, Changsha,Hunan, China.
[Ti] Título:Comparison of mid-term efficacy of spastic flatfoot in ambulant children with cerebral palsy by 2 different methods.
[So] Source:Medicine (Baltimore);96(22):e7044, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson-Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior-talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded.Among 12 children in the SJS group, the AOFAS-AH scores were median preoperative score of 61 (58-64) versus median postoperative score of 83 (75-92), with significant difference (P < .05). Of the 20 feet treated, only 1 foot developed occasional pain. Postoperative ATA was decreased from preoperative 35° (20°-50°) to 19° (12°-25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 20° (15°-40°) to postoperative 0° (0°-3°). The differences in both findings were statistically significant (P < .05). Fourteen children (22 treated feet) formed the D-FSA group; all demonstrated fusion of the talocalcaneal joint; AOFAS-AH scores were median preoperative score of 61 (58-64) versus median postoperative score of 83 (75-92), with significant difference (P < .05). Only 1 foot had occasional pain. Postoperative ATA was decreased from preoperative 35° (20°-45°) to 16° (12°-25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 19° (10°-40°) to postoperative 2° (0°-5°); the differences in both findings were statistically significant (P < .05).Both nonfusion subtalar arthroereisis using SJS and D-FSA were effective for the surgical treatment of spastic flatfoot, with similar clinical outcomes.
[Mh] Termos MeSH primário: Artrodese
Paralisia Cerebral/complicações
Pé Chato/cirurgia
Espasticidade Muscular/cirurgia
[Mh] Termos MeSH secundário: Paralisia Cerebral/diagnóstico por imagem
Paralisia Cerebral/fisiopatologia
Paralisia Cerebral/cirurgia
Criança
Pré-Escolar
Feminino
Pé Chato/complicações
Pé Chato/diagnóstico por imagem
Pé Chato/fisiopatologia
Seguimentos
/patologia
/cirurgia
Seres Humanos
Masculino
Espasticidade Muscular/complicações
Espasticidade Muscular/diagnóstico por imagem
Espasticidade Muscular/fisiopatologia
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007044



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