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Series of lateral collateral ankle ligament all-inside arthroscopic repair
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
score improved from 40.24% to 24.24%. Both questionnaires were filled prior to surgery of the 1st, and 1 year after the surgery of the 2nd foot. Mean follow up was 27.63 months (range 12–50 months, S.D. ± 13.63; median = 27). Conclusion: Our results show that it is possible to achieve good functional results by rebalancing rigid cavovarus foot through tendon transfers and joint sparing approach. http://dx.doi.org/10.1016/j.fas.2017.07.287
199 Long-term radiographic outcome of resection arthroplasty for rheumatoid foot N. Otani ∗ , K. Yano, M. Shimazaki, K. Ikari Institute of Rheumatology, Tokyo Women’s Medical University, Japan Introduction: The aim of this study is to compare the long-term radiographic results of resection arthroplasty for rheumatoid forefoot deformities with and without a smooth curve of the excised metatarsals. Methods: From 1999 to 2010, a total of 100 ft in 67 rheumatoid arthritis patients were treated with pan resection arthroplasty. The mean duration of follow-up was 9.9 years. The 100 ft were divided into two groups according to the quality of the smooth curve of the radiograph immediately after surgery: Group W (65 ft) had a well-made smooth curve, and Group P (35 ft) had a poorlymade smooth curve. The radiographs at the most recent follow-up were reviewed to assess dorsal dislocations at excised sites and the recurrence of deformities using the hallux valgus angle (HVA), the intermetatarsal angle between the first and second metatarsals (M1M2A) and the first and fifth metatarsals (M1M5A). Results: The dorsal dislocations at excised sites at the most recent follow-up were 31/65 (47.7%) for Group W and 12/35 (34.3%) for Group P (Fisher’s exact test, p = 0.21). The average HVA, M1M2A and M1M5A at the most recent follow-up were 19.3◦ , 13.5◦ , and 33.3◦ respectively for Group W and 26.4◦ , 14.8◦ , and 32.7◦ respectively for Group P (unpaired t-test, p = 0.03, p = 0.18, p = 0.74, respectively). Conclusion: HVA of Group P was more significantly increased than Group W at the most recent follow-up. Reconstitution of the metatarsal parabola into a smooth curve prevents recurrence of deformity. http://dx.doi.org/10.1016/j.fas.2017.07.288
200 Series of lateral collateral ankle ligament all-inside arthroscopic repair S. Catalán Amigo ∗ , M.O. Moncusí, J.R. García Medina Hospital Fremap Barcelona, Spain Introduction: After an ankle sprain, between 10 and 48% of the patients present persistent instability or symptomatology that interfere their daily activities. The anatomical reconstruction techniques such as modified Brostrom, have been the gold standard for a long time. With improve of the arthroscopic techniques, we can find all-inside arthroscopic lateral ligament repair techniques described in the literature. We present our experience with the all-inside arthroscopic ATFL repair in the chronic instability.
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Materials and methods: A total of 34 patients have been treated from 2014 until 2016. Same surgeons have used the same technique, all-inside arthroscopic repair, and same postoperative protocol. The average follow up is 15.9 months. The results have been evaluated clinically (drawer test, talar tilt) and with the AOFAS score, Visual Analogic Scale and Overall Satisfaction Score. Results: Average age was 36 years, with an equal male to female ratio, 17:17. We have operated 17 right and 7 left ankles. 7 patients had additional procedures during the arthroscopy ATFL repair, including osteochondral talar injury debridement in 3 and anterolateral soft tissue impingement debridement in 4 patients. Only one patient had a complication, superficial peroneal nerve injury. We had no re-operations. The mean AOFAS score increased from 53.6 to 81.9. The VAS decreased from 7.61 to 3.5. The overall satisfaction was good and the results were good-excellent in 80%. Conclusion: Our results are good and similar to those previously reported in the literature. With this technique we can avoid the open surgery morbidity with good functional results. http://dx.doi.org/10.1016/j.fas.2017.07.289
201 Timing of open reduction and internal fixation of ankle fractures D. Tantigate ∗ , G. Ho, J. Kirschenbaum, C. Freibott, B. Ascherman, J. Greisberg, T. Vosseller Columbia University Medical Center, Columbia Background: Unstable ankle fractures are typically treated with open reduction and internal fixation (ORIF) in order to prevent posttraumatic arthritis. It is not uncommon for operative treatment to be performed in an ambulatory setting several days after injury. The purpose of this study is to compare the functional outcomes based on the amount of time between the injury and surgery. Methods: A retrospective chart review of 119 surgically treated acute, closed ankle fracture patients over a three-year period was performed. Sixty-one patients older than 18 years with a minimum of 24 months of follow-up were included. Demographic variables, duration from injury to surgery, complications, and Foot and Ankle Outcome Score (FAOS) were recorded. Comparison of each variable was performed between patients that underwent ORIF <14 days after injury and ≥14 days. Results: Fifty-eight patients were included. The mean age was 48 years. The mean follow-up time was 41 months. The average duration between injury and surgery was 7 and 18 days, respectively in the two groups. There was no statistically significant difference in demographic variables, length of operation, complication and FAOS between these two groups. Additionally, further analysis for the delayed fixation more than 7 days and 10 days also revealed no significant difference of FAOS. Conclusion: ORIF of ankle fracture more than 14 days does not significantly diminish functional outcome. Delay of operative treatment does not play a significant role in the functional outcome. http://dx.doi.org/10.1016/j.fas.2017.07.290
score improved from 40.24% to 24.24%. Both questionnaires were filled prior to surgery of the 1st, and 1 year after the surgery of the 2nd foot. Mean follow up was 27.63 months (range 12–50 months, S.D. ± 13.63; median = 27). Conclusion: Our results show that it is possible to achieve good functional results by rebalancing rigid cavovarus foot through tendon transfers and joint sparing approach. http://dx.doi.org/10.1016/j.fas.2017.07.287
199 Long-term radiographic outcome of resection arthroplasty for rheumatoid foot N. Otani ∗ , K. Yano, M. Shimazaki, K. Ikari Institute of Rheumatology, Tokyo Women’s Medical University, Japan Introduction: The aim of this study is to compare the long-term radiographic results of resection arthroplasty for rheumatoid forefoot deformities with and without a smooth curve of the excised metatarsals. Methods: From 1999 to 2010, a total of 100 ft in 67 rheumatoid arthritis patients were treated with pan resection arthroplasty. The mean duration of follow-up was 9.9 years. The 100 ft were divided into two groups according to the quality of the smooth curve of the radiograph immediately after surgery: Group W (65 ft) had a well-made smooth curve, and Group P (35 ft) had a poorlymade smooth curve. The radiographs at the most recent follow-up were reviewed to assess dorsal dislocations at excised sites and the recurrence of deformities using the hallux valgus angle (HVA), the intermetatarsal angle between the first and second metatarsals (M1M2A) and the first and fifth metatarsals (M1M5A). Results: The dorsal dislocations at excised sites at the most recent follow-up were 31/65 (47.7%) for Group W and 12/35 (34.3%) for Group P (Fisher’s exact test, p = 0.21). The average HVA, M1M2A and M1M5A at the most recent follow-up were 19.3◦ , 13.5◦ , and 33.3◦ respectively for Group W and 26.4◦ , 14.8◦ , and 32.7◦ respectively for Group P (unpaired t-test, p = 0.03, p = 0.18, p = 0.74, respectively). Conclusion: HVA of Group P was more significantly increased than Group W at the most recent follow-up. Reconstitution of the metatarsal parabola into a smooth curve prevents recurrence of deformity. http://dx.doi.org/10.1016/j.fas.2017.07.288
200 Series of lateral collateral ankle ligament all-inside arthroscopic repair S. Catalán Amigo ∗ , M.O. Moncusí, J.R. García Medina Hospital Fremap Barcelona, Spain Introduction: After an ankle sprain, between 10 and 48% of the patients present persistent instability or symptomatology that interfere their daily activities. The anatomical reconstruction techniques such as modified Brostrom, have been the gold standard for a long time. With improve of the arthroscopic techniques, we can find all-inside arthroscopic lateral ligament repair techniques described in the literature. We present our experience with the all-inside arthroscopic ATFL repair in the chronic instability.
67
Materials and methods: A total of 34 patients have been treated from 2014 until 2016. Same surgeons have used the same technique, all-inside arthroscopic repair, and same postoperative protocol. The average follow up is 15.9 months. The results have been evaluated clinically (drawer test, talar tilt) and with the AOFAS score, Visual Analogic Scale and Overall Satisfaction Score. Results: Average age was 36 years, with an equal male to female ratio, 17:17. We have operated 17 right and 7 left ankles. 7 patients had additional procedures during the arthroscopy ATFL repair, including osteochondral talar injury debridement in 3 and anterolateral soft tissue impingement debridement in 4 patients. Only one patient had a complication, superficial peroneal nerve injury. We had no re-operations. The mean AOFAS score increased from 53.6 to 81.9. The VAS decreased from 7.61 to 3.5. The overall satisfaction was good and the results were good-excellent in 80%. Conclusion: Our results are good and similar to those previously reported in the literature. With this technique we can avoid the open surgery morbidity with good functional results. http://dx.doi.org/10.1016/j.fas.2017.07.289
201 Timing of open reduction and internal fixation of ankle fractures D. Tantigate ∗ , G. Ho, J. Kirschenbaum, C. Freibott, B. Ascherman, J. Greisberg, T. Vosseller Columbia University Medical Center, Columbia Background: Unstable ankle fractures are typically treated with open reduction and internal fixation (ORIF) in order to prevent posttraumatic arthritis. It is not uncommon for operative treatment to be performed in an ambulatory setting several days after injury. The purpose of this study is to compare the functional outcomes based on the amount of time between the injury and surgery. Methods: A retrospective chart review of 119 surgically treated acute, closed ankle fracture patients over a three-year period was performed. Sixty-one patients older than 18 years with a minimum of 24 months of follow-up were included. Demographic variables, duration from injury to surgery, complications, and Foot and Ankle Outcome Score (FAOS) were recorded. Comparison of each variable was performed between patients that underwent ORIF <14 days after injury and ≥14 days. Results: Fifty-eight patients were included. The mean age was 48 years. The mean follow-up time was 41 months. The average duration between injury and surgery was 7 and 18 days, respectively in the two groups. There was no statistically significant difference in demographic variables, length of operation, complication and FAOS between these two groups. Additionally, further analysis for the delayed fixation more than 7 days and 10 days also revealed no significant difference of FAOS. Conclusion: ORIF of ankle fracture more than 14 days does not significantly diminish functional outcome. Delay of operative treatment does not play a significant role in the functional outcome. http://dx.doi.org/10.1016/j.fas.2017.07.290