Puddu Classification of Achilles Tendon Disease
- Pure Peritendinitis
- Peritendinitis with tendinosis–can lead to rupture
- Tendinosis–can lead to rupture
Article from 1976, Am J Sports Med.
Kuwada Classification of Achilles Tendon Rupture with treatment options
- Type I: partial rupture < 25%
- Tx: cast immobilization
- Type II: partial rupture > 25% to complete rupture < 3cm
- Tx: end-to-end anastimosis
- Type III: complete rupture 3-6cm
- Tx: gastroc recession or autogenous central rotation graft
- Type IV: complete rupture > 6cm
- Tx: gastroc recession and/or autogenous rotation graft
Article from 1995, Clinic Pod Med Surg
What was the conclusion of Khan’s meta-analysis on treatment for acute Achilles tendon ruptures?
- 2005, JBJS
- Open operative tx reduced rate of re-rupture compared to non-operative treatment, but had significantly higher risks of other complications. Those other operative risks may be reduced with percutaneous tx.
What lab values correlate with increased healing rates for amputations in patients with PVD? Who is author?
- Pinzur, 1986, JBJS
- Lab values:
- ABI > 0.45 (> 0.5 in DM pts)
- Albumin > 3.0 g/dL
- Total Lymphocyte Count > 1,500
What are Ruedi & Allgower’s principles for Pilon fracture fixation?
- Restoration of length and axis of fibula (60%) or tibia (40%) as first step.
- Reconstruction of the articular surface of the distal tibia.
- Filling in of metaphyseal defect with cancellous autograft
- Support of medial side of tibia by buttress plating to prevent varus deformity
Article from 1969, Injury
What was the conclusion of the Kuwada article?
- 1995
- By following classification and corresponding treatment for Achilles tendon rupture, average return to pre-injury activity level was 5.1 months.
When was Lauge-Hansen’s fractures of the ankle article published in the archives of surgery?
- 1950
- Archives of Surgery
What was the conclusion of the Ramsey & Hamilton article?
- 1976, JBJS
- 1mm of lateral talar displacement = 42% decrease in tibiotalar contact
- As contact area decreases, stress per unit area increases –> more pathology
Advantages of anti-glide plate for distal fibular fixation over lateral plate?
- Schaffer & Manoli, 1987, JBJS
- Smaller area of dissection
- Decreased operative time
- Minimum bending of plate
- No chance for screws to enter joint
- Had higher torque/load to failure
Conclusion of Yamaguchi study concerning syndesmotic injuries?
- 1994, FAI
- Fixation was only found necessary if fibular fracture was greater than 4.5cm proximal to ankle joint
According to Wukich, what is the prevalence of Charcot in DM patients?
- 2008, JBJS
- 0.3%
Conclusion of Astion article concerning motion of hindfoot after simulated arthrodesis?
- 1997, JBJS
- TNJ severely limited motion of remaining joint to ~2˚
- CCJ fusion had little ROM effect on STJ
- STJ fusion reduced TNJ ROM by 26% and CCJ by 56%
- Motion of the TNJ is the key to motion of the triple joint complex
Conclusion of the Dwyer article?
- 1959, JBJS
- 8-12mm wedge removed laterally just below PL
- Correction of heel varus is most important to prevent recurrence
Conclusion of Coleman block test?
- Coleman & Chestnut, 1977, Clinic Ortho and Related Research
- Determines hindfoot flexibility in the cavovarus foot
- If the foot corrects, it is a flexible deformity, and attention should be paid to correction of the forefoot; if it doesn’t, treatment will involve for the FF and RF
Who added Stage 0 for Charcot and what was conclusion of his article?
- Shibata, 1990, JBJS
- Stage 0: swelling, local warmth, clinical instability due to laxity of ligaments (although radiographic signs are minimal or absent)
- There was decreased progression of mid or forefoot Charcot changes in patients that underwent ankle fusion
What radiographic measures were predictors of ulcer formation in DM Charcot of the midfoot?
- Bevan, 2008, FAI
- Lateral talar-1st met angle was significantly associated with skin pathology
- ONLY PATIENTS WITH LATERAL TALAR-1st MET > -27˚ HAD AN ULCER
What are some of the differences between OM and ACA mentioned in Wukich’s “Charcot Arthropathy of the Foot and Ankle: Modern Concepts and Management Review”?
- 2008, J of Diabetes and Its Complications
- In OM, pattern of bone marrow edema involves single bone with diffuse marrow involvement, whereas in ASA, pattern is periarticular and subchondral (Tan & Teh, 2007)
- In OM, distribution is focal involving WB surfaces of toes, met heads, or calc, whereas ASA has several joints/bones involved (Ledermann, Morrison, Schweitzer, 2002)
What signaling pathway may be involved in the vascular calcification and osteolysis seen in DM neuropathy?
- Jeffcoate, 2004, Diabetologia
- RANK-L
According to Jeffcoate, how often is contralateral foot affected by Charcot?
- 2005, Lower Extremity Wounds
- 20% of cases
Number of foot compartments according to Manoli & Weber and what incision technique is described?
- 1990, FAI
- 9 Compartments
- Medial (FHB, AbH)
- Superficial (FDL, FDB, Lumbricals, Med. Plantar n.)
- Lateral (ADQ, FDM)
- Adductor
- Interossei (4)
- Calcaneal (QP) (new compartment described in this article)
- 3 incision
- 1st interspace
- 3rd interspace
- Medial calcaneal
What was found in Wukich’s DVT article?
- 2008, JFAS
- Retrospective study
- OVER COURSE OF 1.5 YEARS, 4/1000 (0.4%) DEVELOPED DVT AND 3/1000 (0.3%) DEVELOPED NONFATAL PE
- THUS, INCIDENCE OF VTW FOLLOWING FOOT AND ANKLE SURGERY IS < 1%
Types of 5th met base fractures described by Torg?
- 1984, JBJS
- Acute Fx’s w/ narrow fx line and absent medullary sclerosis (tx with immobilization)
- Delayed union w/ widening fx line and medullary sclerosis (tx aggressively in athletes)
- Non-union w/ complete obliteration of medullary canal by sclerotic bone (tx surgically)
Conclusion of the Richli article on avulsion fx of 5th met?
- 1984, AJR
- The transverse fx results from inversion and plantarflexion of the FF and is an avulsion fx due to traction on the lateral cord of the plantar fascia.
What was the change in the IM angle in the Cronin article?
- 2006, FAI
- Following 1st MPJ arthrodesis for hallux valgus, the mean change in IM angle was 8.22˚
