| 1. |
- Akermark, C, et al.
(författare)
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A prospective randomized controlled trial of plantar versus dorsal incisions for operative treatment of primary Morton's neuroma
- 2013
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 34:9, s. 1198-1204
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Tidskriftsartikel (refereegranskat)abstract
- There are a great number of studies on the outcome of surgery for Morton’s neuroma. However, there is a lack of controlled trials to determine the outcome in general and for the 2 most used surgical approaches. This prospective and randomized trial studied the outcome and adverse events of resected primary Morton’s neuromas, comparing plantar and dorsal incisions. Methods: Seventy-six patients were randomized to treatment with either a plantar or a dorsal incision by 2 senior surgeons. Questionnaires were evaluated and physical examinations performed at baseline and at 3 and 12 months postoperatively by the treating surgeon and at a mean of 34 months (range, 28-42 months) by an independent surgeon. The follow-up rate was 93%. Results: Histological examination of specimens verified resection of nerves in all cases except 1, which was in the dorsal group (artery). The main outcome variable, pain at daily activities, was significantly reduced by 96% (plantar) and 97% (dorsal) and restrictions in daily activities were reduced by 77% (plantar) and 67% (dorsal) at the final follow-up. Scar tenderness was noted by 3% (plantar) and 0% (dorsal) at the final evaluation. Clinically good results with surgery were noted in 87% (plantar) and 83% (dorsal) of cases. There were 5 complications in the plantar group and 6 in the dorsal group, with a difference in type of complications. Conclusions: This study demonstrated 87% (plantar) and 83% (dorsal) clinically good outcomes and no significant differences between the procedures in regard to pain, restrictions in daily activities, and scar tenderness. However, there was a difference between the groups in the type of complications. Level of Evidence: Level I, prospective randomized trial.
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| 2. |
- Arndt, A, et al.
(författare)
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Ankle and subtalar kinematics measured with intracortical pins during the stance phase of walking
- 2004
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 25:5, s. 357-364
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Tidskriftsartikel (refereegranskat)abstract
- The absence of external landmarks on the talus has rendered the description of ankle and subtalar joint kinematics difficult. Abnormal motion at these joints has, however, been implied in the etiology of an array of lower extremity overuse injuries. Methods: Intracortical pins were inserted under local anesthesia in the tibia, talus, and calcaneus with external marker clusters traced by a video motion analysis system. Kinematic data were collected during walking trials on a flat surface for three subjects. Gait pattern was monitored by comparison of ground reaction force curves during stance phase with and without the pins inserted. Results: Results were presented in terms of helical axis orientation for both joints and the component rotations about these axes. Large intersubject differences were seen in both ankle and subtalar joint helical axis orientation. Maximum rotations over the complete stance phase for the ankle and subtalar joints respectively were: eversion/inversion, 6.3° and 8.3°; dorsiflexion/plantarflexion, 18.7° and 3.7°; and abduction/adduction, 5.0° and 6.1°. Conclusions: The majority of ankle eversion/inversion occurred at the subtalar joint; however, the ankle component cannot be ignored. Abduction/adduction range of motion at the subtalar joint was surprisingly high, indicating that this component motion during walking is not purely attributable to the ankle joint. Future research should include greater subject numbers in order to present more universally applicable results. Clinical Relevance: The in vivo kinematics of the talus during weightbearing activity are poorly understood. The description of this motion may assist in the structuring of clinical rehabilitation and in the design and insertion of ankle joint prostheses.
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| 3. |
- Arndt, A, et al.
(författare)
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Asymmetrical loading of the human triceps surae: I. Mediolateral force differences in the Achilles tendon
- 1999
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 20:7, s. 444-449
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Tidskriftsartikel (refereegranskat)abstract
- An in vitro experiment was designed to identify whether tensile force on different triceps surae components would result in nonhomogenous force distribution across the human Achilles tendon. Medial tendon forces were significantly higher than lateral (23.2 ± 6.6%; P ≤ 0.05) when only the gastrocnemius medialis was subjected to force. Lateral forces were significantly higher when both gastrocnemii (30.6 ± 16.5%) or all three muscles (20.7 ± 10.9%) were loaded. Experimental identification of force concentrations in the human Achilles tendon contributes to the understanding of the origin of its injury.
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| 4. |
- Arndt, A, et al.
(författare)
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Asymmetrical loading of the human triceps surae: II. Differences in calcaneal moments
- 1999
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 20:7, s. 450-455
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Tidskriftsartikel (refereegranskat)abstract
- An in vitro experimental study is presented investigating differences in moments calculated at the calcaneus, resulting from tensile forces input in various configurations of triceps surae muscles. Results indicated significantly higher values for plantarflexion moments when forces were input in both gastrocnemii than in the soleus ( P ≤ 0.05). Tensile force applied solely to the gastrocnemius lateralis produced a mean eversion moment at the calcaneus, whereas all other configurations demonstrated the expected inversion moment. An abduction moment was reported throughout. The presented data provides valuable input for optimizing future biomechanical models.
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| 5. |
- Cöster, Maria C, et al.
(författare)
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Age- and Gender-Specific Normative Values for the Self-Reported Foot and Ankle Score (SEFAS)
- 2018
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Ingår i: Foot & Ankle International. - : SAGE Publications. - 1944-7876 .- 1071-1007. ; 39:11, s. 1328-1334
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Self-Reported Foot and Ankle Score (SEFAS) is a foot- and ankle-specific patient-reported outcome measurement (PROM) score that has been validated with good results for a variety of foot and ankle disorders. SEFAS is sensitive detecting improvement or deterioration after surgery. However, normative values, required to put a specific patient's summary score into perspective, are lacking.METHODS: In this report, we included 396 population-based men and 383 women (43% of the invited individuals), age 20-89 years, who had completed the SEFAS questionnaire and questions regarding anthropometrics and health. We used Mann-Whitney U test to test gender differences and Spearman correlation coefficients to determine any association between SEFAS score and age. We present gender-specific median SEFAS scores with range and 5th to 95th percentiles and mean with standard deviation.RESULTS: The SEFAS normative values were median 48 in men (range 11-48), 5th to 95th percentiles 31 to 48 and mean 45 ± 6, and in women, median 47 (range 6-48), 5th to 95th percentiles 23 to 48 and mean 43 ± 8 (gender comparison P < .001). SEFAS normative values correlated inversely with age (r = -0.12, P < .001).CONCLUSION: In the general population, older age was associated with lower SEFAS value, and men had higher values than women. The population-based normative SEFAS values provided in this study can facilitate quantification of disability related to foot and ankle with and without surgery in the foot and ankle.LEVEL OF EVIDENCE: Level II, prospective comparative study.
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| 6. |
- Cöster, Maria, et al.
(författare)
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Comparison of the Self-Reported Foot and Ankle Score (SEFAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS)
- 2014
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Ingår i: Foot & ankle international. - Thousand Oaks, CA : SAGE Publications (UK and US): 12 month Embargo. - 1071-1007 .- 1944-7876. ; 35:10, s. 1031-1036
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Self-reported Foot and Ankle Score (SEFAS) is a patient-reported outcome measure, while the American Orthopedic Foot and Ankle Society Score (AOFAS) is a clinician-based score, both used for evaluation of foot and ankle disorders. The purpose of this study was to compare the psychometric properties of these 2 scoring systems. Methods: A total of 95 patients with great toe disorders and 111 patients with ankle or hindfoot disorders completed the 2 scores before and after surgery. We evaluated time to complete the scores in seconds, correlations between scores with Spearmans correlation coefficient (r(s)), floor and ceiling effects by proportion of individuals who reached the minimum or maximum values, test-retest reliability and interobserver reliability by intraclass correlation coefficient (ICC), internal consistency by Cronbachs coefficient alpha (CA), and responsiveness by effect size (ES). Data are provided as correlation coefficients, means, and standard deviations. Results: SEFAS was completed 3 times faster than AOFAS. The scores correlated with an r(s) of .49 for great toe disorders and .67 for ankle/hindfoot disorders (both P less than .001). None of the scores had any floor or ceiling effect. SEFAS test-retest ICC values measured 1 week apart were .89 for great toe and .92 for ankle/hindfoot disorders, while the corresponding ICC values for AOFAS were .57 and .75. AOFAS interobserver reliability ICC values were .70 for great toe and .81 for ankle/hindfoot disorders. SEFAS CA values were .85 for great toe and .86 for ankle/hindfoot disorders, while the corresponding CA values for AOFAS were .15 and .42. SEFAS ES values were 1.15 for great toe and 1.39 for ankle/hindfoot disorders, while the corresponding ES values for AOFAS were 1.05 and 1.73. Conclusion: As SEFAS showed similar or better outcome in our tests and was completed 3 times faster than AOFAS, we recommend SEFAS for evaluation of patients with foot and ankle disorders.
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| 7. |
- Dahmen, J., et al.
(författare)
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Osteochondral Lesions of the Tibial Plafond and Ankle Instability With Ankle Cartilage Lesions: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle
- 2022
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Ingår i: Foot & Ankle International. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 43:3, s. 448-452
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Tidskriftsartikel (refereegranskat)abstract
- Background: An international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to present the consensus statements on osteochondral lesions of the tibial plafond (OLTP) and on ankle instability with ankle cartilage lesions developed at the 2019 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Forty-three experts in cartilage repair of the ankle were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 4 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed on in unanimous fashion within the working groups. A final vote was then held. Results: A total of 11 statements on OLTP reached consensus. Four achieved unanimous support and 7 reached strong consensus (greater than 75% agreement). A total of 8 statements on ankle instability with ankle cartilage lesions reached consensus during the 2019 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support, and seven reached strong consensus (greater than 75% agreement). Conclusions: These consensus statements may assist clinicians in the management of these difficult clinical pathologies.
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| 8. |
- Ekenman, I, et al.
(författare)
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A study of intrinsic factors in patients with stress fractures of the tibia
- 1996
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 17:8, s. 477-482
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to study intrinsic factors in 29 consecutive patients with well-documented unilateral stress fractures of the tibia. Anthropometry, range of motion, isokinetic plantar flexor muscle performance, and gait pattern were analyzed. The uninjured leg served as the control. A reference group of 30 uninjured subjects was compared regarding gait pattern. Anterior stress fractures of the tibia (N = 10) were localized in the push-off/ landing leg in 9/10 athletes, but were similarly distributed between legs in posteromedial injuries (N = 19). Ten (30%) of the stress fracture subjects had bilateral high foot arches, similar to those found in the reference group. There were no other systematic differences in anthropometry, range of motion, gait pattern, or isokinetic plantar flexor muscle peak torque and endurance between injured and uninjured legs. No other differences were found between anterior and posteromedial stress fractures. We conclude that anterior stress fractures of the tibia occur mainly in the push-off/landing leg in athletes. Within the limitations of our protocol, no registered intrinsic factor was found to be directly associated with the occurrence of a stress fracture of the tibia.
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| 9. |
- Ekenman, I, et al.
(författare)
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Local bone deformation at two predominant sites for stress fractures of the tibia: an in vivo study
- 1998
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Ingår i: Foot & ankle international. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 19:7, s. 479-484
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Tidskriftsartikel (refereegranskat)abstract
- Local bone deformation was registered at two predominant injury sites for tibial stress fractures in a healthy female volunteer. Two instrumented strain gauge staples were inserted under local anesthesia to the anterior middiaphysis (AM) and to the posteromedial part of the distal tibia (PD). Calibration and reliability of the instrumented staple system have previously been demonstrated in vitro. Concomitant ground reaction forces were registered with a Kistler force plate. Studying peak values, it was shown that during a voluntary 30-cm forward jump, PD deformation was greater during forefoot landing (2700–4200 microstrain) than during a heel strike landing (1200–1900 microstrain) and also compared with the concomitant AM deformation under both above testing conditions (1300–1900 microstrain). The stance phase during walking resulted in PD deformation of 950 microstrain, whereas the concomitant AM deformation was 334 microstrain. The greatest AM deformation (mean, 2128 microstrain) was registered during ground contact after a voluntary vertical drop from a height of 45 cm, concomitant with a PD deformation of 436 microstrain. These data are the first to show different local deformations at various sites of the tibia in vivo. The PD deformation was larger than previously noted from other parts of the tibia, whereas the middiaphysis data are consistent with other reports. The results may support the clinical assumption of different etiologies for stress fractures at these predominant sites.
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| 10. |
- Eneroth, Magnus, et al.
(författare)
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Clinical characteristics and outcome in 223 diabetic patients with deep foot infections
- 1997
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Ingår i: Foot and Ankle International. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 18:11, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature > 37.8°C, a sedimentation rate > 70 mm/hour, and white blood cell count (WBC) > 10 x 109/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of those unhealed at death or follow-up, 4 patients had had a major and 11 a minor amputation. After correction for age and sex, duration of diabetes < 14 years, palpable popliteal pulse, a toe pressure > 45 mmHg, and an ankle pressure > 80 mm Hg, absence of exposed bone and a white blood cell count < 12 x 109/liter were all related to healing without amputation in a logistic regression analysis. We conclude that although only 1 in 10 had a major amputation, nearly all diabetic patients with a deep foot infection needed surgery and more than one third had a minor amputation before healing or death in spite of a well- functioning diabetic foot-care team responsible for all included patients.
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