Journal of Foot and Ankle Research
Do the effects of laterally wedged insoles decline after one month of wear?
Abstract (provisional)
Objective This study aimed to determine whether the effect of laterally wedged insoles on the adduction moment in knee osteoarthritis (OA) declined after one month of wear, and whether higher reported use of insoles was associated with a reduced effect on the adduction moment at one month. Methods Twenty people with medial compartment OA underwent gait analysis in their own shoes wearing i) no insoles and; ii) insoles wedged laterally 5 degrees in random order. Testing occurred at baseline and after one month of use of the insoles. Participants recorded daily use of insoles in a log-book. Outcomes were the first and second peak external knee adduction moment and the adduction angular impulse, compared across conditions and time with repeated measures general linear models. Correlations were obtained between total insole use and change in gait parameters with used insoles at one month, and change scores were compared between high and low users of insoles using general linear models. Results There was a significant main effect for condition, whereby insoles significantly reduced the adduction moment (all p<0.001). However there was no significant main effect for time, nor was an interaction effect evident. No significant associations were observed between total insole use and change in gait parameters with used insoles at one month, nor was there a difference in effectiveness of insoles between high and low users of the insoles at this time. Conclusions Effects of laterally wedged insoles on the adduction moment do not appear to decline after one month of continuous use, suggesting that significant wedge degradation does not occur over the short-term.
Posted by Hylton Menz at 09:14 Comments (0)
JFAR at the SCP Conference, Harrogate November 19-21
Journal of Foot and Ankle Research Editors-in-Chief, Hylton Menz and Mike Potter, will be at the Society of Chiropodists and Podiatrists stand at the Annual Conference in Harrogate, November 19-20. For more details about the conference, click here.
SCP editor, Clare Richards, with JFAR Deputy Editor-in-Chief, Dr Alan Borthwick, and Editor-in-Chief, Mike Potter:
Posted by Hylton Menz at 09:57 Comments (0)
Dynamic splinting home therapy for toe walking
Dynamic splinting home therapy for toe walking: a case report
Pamela Lundequam and F Buck Willis
Cases Journal 2009, 2:188doi:10.1186/1757-1626-2-188
Abstract
Serial casting is frequently prescribed for toe-walking but that does not allow continued physical therapy (PT). This report described a child and family who chose dynamic splinting (DS) with concurrent PT for treatment. The patient presented with right hemiparesis; below average motor skills and a gait pattern of toe contact (without ankle foot orthosis). Four months of PT plus 6 hours/night of DS as home therapy, the patient's passive dorsiflexion increased 14° and she gained the ability to walk in "flat foot" contact without the Ankle Foot Orthosis. This concurrent treatment achieved improved gait pattern and strength training not possible with casting.
Posted by Hylton Menz at 14:24 Comments (0)
Proximal tibiofibular dislocation associated with fracture of the tibia
Proximal tibiofibular dislocation associated with fracture of the tibia: a case report
Abstract (provisional)
Introduction
We report a case of proximal tibiofibular dislocation associated with an ipsilateral tibial fracture, a rare association of injuries that can remain undiagnosed. Case Report: A white 23-year-old man experienced a road accident and was diagnosed with proximal tibiofibular dislocation associated with an open fracture of the tibia and injury to the external popliteus sciatic nerve. He was treated urgently with an intramedullary tibial nail and a cancellous screw at the level of the proximal tibiofibular articulation.
Conclusion
In addition to this case and the surgical treatment, a review of the clinical cases described in the literature is provided, assessing the type of injury and the therapeutic options used, which depend mainly on the stage in which the condition is diagnosed.
Posted by Hylton Menz at 14:17 Comments (0)
Anomalous superficial peroneal nerve and variant cutaneous innervation of the sural nerve
Cases Journal 2009, 2:197doi:10.1186/1757-1626-2-197
Abstract (provisional)
Background
The superficial peroneal nerve is a branch of common peroneal nerve. There are reports about the variant course and distribution of this nerve. The sural nerve arises from the tibial nerve in the popliteal fossa. The variations of the above nerves described here are unique and provide significant information to surgeons dissecting lower limb.
Case presentation
The present case is about some important anatomic variations observed in left lower limb of approximately 55 - year - old male cadaver. The variations were; high division of superficial peroneal nerve into medial and lateral branches, lateral branch descending in the anterior intermuscular septum in a peroneal tunnel before piercing the deep fascia and variant distribution of sural nerve on the dorsum of the foot. The probable clinical significances of the variation are discussed.
Conclusion
Awareness of anatomical variations of superficial peroneal and sural nerves such as those presented here becomes important to avoid injury in real clinical situations.
Posted by Hylton Menz at 14:15 Comments (0)
Charcot foot in a patient with Parkinson's disease
A case of Charcot's feet in a patient with Parkinson's disease: a case report
Cases Journal 2009, 2:187doi:10.1186/1757-1626-2-187
| Published: | 9 November 2009 |
Abstract (provisional)
Introduction
Parkinson's Disease (PD), amongst its motor symptoms, can cause dystonia of the limbs and trunk. This can lead to subsequent deformities.
Case presentation
We describe a case where Parkinson's Disease has gone on to cause bilateral Charcot feet with rocker-bottom deformity.
Conclusion
There is recognised pattern of foot deformities seen in Parkinson's disease and it is important to realise that patients may go on to develop a Charcot joint. This would warrant early referral to an orthopaedic surgeon so that appropriate management can limit joint damage and deformity.
Posted by Hylton Menz at 12:56 Comments (0)
The Scientific Basis of Rheumatology: A Decade of Progress
This special collection of reviews - published to mark Arthritis Research & Therapy’s 10th anniversary - provides an in depth overview of the current status of basic and clinical research in rheumatology, and focuses particularly on developments in the past decade, during which there has been an explosion of new information in the field.
All papers are full-text open-access. To browse the list of papers, click here.
Posted by Hylton Menz at 10:25 Comments (0)
Nonclassical yellow nail syndrome in six-year-old girl
Nonclassical yellow nail syndrome in six-year-old girl: a case report
Cases Journal 2009, 2:165doi:10.1186/1757-1626-2-165
Abstract (provisional)
Introduction
The yellow nail syndrome is usually described as the combination of yellow nails with lymphoedema and often with respiratory manifestations such as pleural effusions, chronic sinusitis and bronchiectasis. The syndrome is most often seen in the middle-aged individuals.
Case presentation
We present a 6-year-old girl with yellow nail syndrome having pansinusitis and bronchiectasis.
Conclusion
The components comprising the classical triad of yellow nail syndrome in children may not necessarily be present altogether. Therefore, yellow nail syndrome should be suspected in children having only typical nail changes.
Posted by Hylton Menz at 11:06 Comments (0)
Missed diagnosis of ankle pseudoaneurysm following ankle arthroscopy: a case report
Missed diagnosis of ankle pseudoaneurysm following ankle arthroscopy: a case report
Cases Journal 2009, 2:162doi:10.1186/1757-1626-2-162
Abstract (provisional)
Background
Pseudoaneurysm formation is rare complication after arthroscopy with incidence of 0.008%, easy to misdiagnose. Its potential catastrophic sequelae should not be underestimated.
Case presentation
We present a case of missed diagnosis of traumatic anterior tibial artery pseudoaneurysm in a 39 year old female, instead treated as post operative arthroscopy infection. The diagnosis was confirmed with a duplex ultrasound scan and referred to the vascular surgeon with successful out come.
Conclusion
In view of rare presentation this complication it is easily missed. According to one study, incidence of anatomic variations of anterior tibial artery range from 2.4 to 12%. Because of this anatomical variation in course along with other factors, pseudoaneurysm formation at ankle is relatively high. In this report, we discuss the diagnosis, anatomical variations of anterior tibial artery and prevention of this complication following arthroscopy. We believe that surgeons operating in this region should take into account these anatomical variations preoperatively.
Posted by Hylton Menz at 10:54 Comments (0)
Selected foot and ankle presentations from the ACR/ARHP meeting, October 17-21, 2009
Selected foot and ankle presentations from the ACR/ARHP meeting, October 17-21, 2009
Impact of Chronic Gout on Foot Function
Chronic Foot Symptoms in Relation to Self-Reported and Performance-Based Physical Function
Erosive Osteoarthritis Is a Progressive Disease That Commonly Affects the Feet
A New Plantar Tender Point in Fibromyalgia: A Worthy Candidate for the ACR Classification Criteria?
Ultrasonography Shows Active Inflammation in Clinically Unaffected Joints in Chronic Tophaceous Gout
Posted by Hylton Menz at 13:59 Comments (0)
Why do ineffective treatments seem helpful?
Why do ineffective treatments seem helpful? A brief review
Chiropractic & Osteopathy 2009, 17:10doi:10.1186/1746-1340-17-10
Abstract (provisional)
After any therapy, when symptoms improve, healthcare providers (and patients) are tempted to award credit to treatment. Over time, a particular treatment can seem so undeniably helpful that scientific verification of efficacy is judged an inconvenient waste of time and resources. Unfortunately, practitioners' accumulated, day to day, informal impressions of diagnostic reliability and clinical efficacy are of limited value. To help clarify why even treatments entirely lacking in direct effect can seem helpful, I will explain why real signs and symptoms often improve, independent of treatment. Then, I will detail quirks of human perception, interpretation, and memory that often make symptoms seem improved, when they are not. I conclude that healthcare will grow to full potential only when judgments of clinical efficacy routinely are based in properly scientific, placebo controlled, outcome analysis.
Posted by Hylton Menz at 13:39 Comments (0)
Is visual estimation of passive range of motion in the pediatric lower limb reliable?
Is visual estimation of passive range of motion in the pediatric lower limb valid and reliable?
BMC Musculoskeletal Disorders 2009, 10:126doi:10.1186/1471-2474-10-126
Abstract (provisional)
Background
Visual estimation (VE) is an essential tool for evaluation of range of motion. Few papers discussed its validity in children orthopedics' practice. The purpose of our study was to assess validity and reliability of VE for passive range of motions (PROMs) of children's lower limbs.
Methods
Fifty typically developing children (100 lower limbs) were examined. Visual estimations for PROMs of hip (flexion, adduction, abduction, internal and external rotations), knee (flexion and popliteal angle) and ankle (dorsiflexion and plantarflexion) were made by a pediatric orthopaedic surgeon (POS) and a 5th year resident in orthopaedics. A last year medical student did goniometric measurements. Three weeks later, same measurements were performed to assess reliability of visual estimation for each examiner.
Results
Visual estimations of the POS were highly reliable for hip flexion, hip rotations and popliteal angle (rhoc [greater than or equal to] 0.8). Reliability was good for hip abduction, knee flexion, ankle dorsiflexion and plantarflexion (rhoc [greater than or equal to] 0.7) but poor for hip adduction (rhoc =0.5). Reproducibility for all PROMs was verified. Resident's VE showed high reliability (rhoc [greater than or equal to] 0.8) for hip flexion and popliteal angle. Good correlation was found for hip rotations and knee flexion (rhoc [greater than or equal to] 0.7). Poor results were obtained for ankle PROMs (rhoc < 0.6) as well as hip adduction and abduction, the results of which not being reproducible. Influence of experience was clearly demonstrated for PROMs of hip rotations, adduction and abduction as well as ankle plantarflexion.
Conclusions
Accuracy of VE of passive hip flexion and knee PROMs is high regardless of the examiner's experience. Same accuracy can be found for hip rotations and abduction whenever VE is performed by an experienced examiner. Goniometric evaluation is recommended for passive hip adduction and for ankle PROMs.
Posted by Hylton Menz at 13:20 Comments (0)
Predicting joint damage in RA with MRI
Editorial
Predicting joint damage in rheumatoid arthritis using MRI scanning
Abstract
Predicting prognosis in the patient with newly diagnosed rheumatoid arthritis is of key importance so that high-cost therapies can be tailored to the needs of the individual. In a recent issue of Arthritis Research and Therapy, the prognostic significance of MRI changes at the forefoot has been studied. While progression to radiographic erosion occurred rarely in this group of patients exposed to potent disease-suppressing therapies, including TNF inhibitors, MRI bone edema, representing osteitis, has been further implicated as a forerunner to bone erosion. Early MRI scans of the forefoot were helpful in defining those with the potential to progress as well as those in a good prognosis category.
Mundwiler et al. Arthritis Research & Therapy 2009 11:R94
Posted by Hylton Menz at 16:40 Comments (0)
Ankle patella? Case report of a large accessory bone in the ankle
Ankle patella: a report of a large accessory bone in the ankle: a case report
Abstract
Introduction: Sesamoids, which are ovoid bones with variable size and shape in the course of tendons, can be found in different parts of skeletal system.
Case presentation: As a case report we observed a large accessory bone which was located anterior to left ankle joint in a 61 years old woman. Since such accessory bones are found very infrequently, their presence may cause some diagnostic confusion.
Conclusion: Regarding complaints in foot area one has to be familiar with such bones in order to make a correct diagnosis.
Posted by Hylton Menz at 10:22 Comments (0)
Closed STJ dislocation: case report
Abstract
Posted by Hylton Menz at 10:13 Comments (0)