bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of Indian Indices with a Focus on Shariah Indices
Authors: Ahmad Moid U. , Siddiqui Saif
Published: March 2013

The question of Islamic economy being a social economy rather than a viable economy has been raised and debated time over time. To prove the viability of Islamic financial system as an alternative to the interest based financial system, it is an imperative to prove its commercial viability over the modern financial system. To provide Islamic economics as an alternative to modern financial system, its viability, application and logic needs to be studied and empirically tested. This study is an empirical attempt to verify the application of the concepts and beliefs of Islamic finance in various investment avenues, including Shariah and non Shariah investments. It attempts to compare and study the returns from Shariah and non-Shariah investments by taking relevant indices as a proxy for respective markets.
Implications of TQM and its Critical Success Factors into Business
Authors: Venkateshwarlu N. , Agarwal Ashish , Kulshreshtha Manoj
Published: March 2013

The objective of the paper is to provide comprehensive review on TQM. In the paper, critical success factors (CSF) of TQM have been identified for Indian manufacturing/service organisations. Most of these factors are considered significant by many companies for gaining competitiveness and quality improvement. The collection of data/papers from various sources, such as books and journals, is to gain the knowledge on TQM and its factors, principles, enablers and benefits. The findings indicate that success factors of TQM are critical for quality improvement and gaining competitiveness. This comprehensive review paper will provide the knowledge about, what is TQM? How TQM is different from other quality terms? The collection of definitions of TQM from different papers will clarify the idea about TQM and its effectiveness in various organisations.
Are Asian Stock Markets Weak-Form Efficient: An Evidence from India
Authors: Srivastava Aman
Published: March 2013

Market efficiency of the stock markets has been a great concern for researcher from a long time. The market environment is changing over the period of time and uncertainty in the environment is also increasing day-by-day. The vast majority of efficient market research to date has focused on the major United States and European securities market. Far fewer have investigated the developing and less developed countries markets; and very few studies on this area have been performed on the India stock markets. The study seeks evidence supporting the existence of at least weak-form efficiency of the market. The sample includes five most popular stock indices on the national stock exchange of India (NSE) for the period of January 1998 to December 2009. The hypothesis of the study is whether the Indian Stock Markets are weak form efficient. The analysis carried out in this paper is to test the efficiency level in Indian Stock market and the random walk nature of the stock market by using the run test, autocorrelation function ACF (k) and unit root test for the period from. The study carried out in this paper has presented the evidence of the weak and efficient forms of the Indian Stock Market.
Testing Alternative Models for Forecasting Volatility in Stock Futures Market: A Linear Approach
Authors: Srinivasan K. , Deo Malabika , Murugesan B.
Published: March 2013

Thanks to numerous empirical research studies, a general consensus has been reached on examining the various alternative models for forecasting and modeling volatility in stock futures contracts by using out-of-sample forecast according to statistic and risk management evaluation criteria. The dataset were retrieved from National Stock Exchange (NSE) website terminal for the period from April 1, 2003 and ending on December 31, 2008. The forecasting models that are considered here ranges from Random Walk, Linear Regression, Moving Average, Autoregressive Models. In order to evaluate the forecasting performance of different models we use two forecasting error statistics by considering the root mean square error (RMSE) and the mean absolute percentage error (MAPE) for testing the return characteristics. Our findings suggest that, according to RMSE statistics the autoregressive model and linear regression models rationally shared and ranked first for out-of-sample forecasts in the linear models. In addition, one cannot conclude that the success or failure of a particular type of forecasting model applied to one market carries over to a different market, because the size and liquidity of a market can affect the quality of volatility forecasts. Finally, one can learn more about the market movement and return volatility through studying the non linear approach.
Organizational Role Stress: An Empirical Study among Insurance Employees
Authors: Goyal Swati , Kashyap Vinay
Published: March 2013

This study examined the sources of organisational role stress among Insurance employees and to compare the level of stress vis-à-vis different demographic factors of the employees. The scope of study was insurance companies belonging to different cities of Punjab mainly in Jalandhar, Patiala, Ludhiana and Mandi Gobindgarh. The sample comprised of 250 respondents drawn from Private as well as public companies. The results revealed that there is a significant correlation among the sources of organisational role stress. It was found that Role Isolation was the main concern of the Insurance Employees that lead to stress at the work place. The results also indicated that certain Demographic variables do influence the level of stress among managers. Based on research findings, the current paper also puts forth relevant suggestions and policy recommendations aimed at improving the stress scenario in the industry.
Political Economy Indicators of Business Competitiveness Environment: Analysing Bangladesh's Performance in 2009–10
Authors: Hasanuzzaman  , Basak Kishore Kumer
Published: March 2013

The world has undergone significant changes since 2008. This paper, by blending in a mix of primary and secondary sources of information, seeks to investigate and report on a number of political economy (institutional and market) factors affecting Bangladesh's business environment. The evaluation of these constraints is also relevant from other least developed countries' perspectives. The paper concludes that if Bangladesh (and other South Asian countries) are to remain competitive, both in their respective and foreign markets, they ought to get on with the task of addressing the factors undermining their business environment through building and improving developmental capacities, and thereby, facilitating realisation of the country's full industrial potential.
Comparative Study of Conditional Volatility of Indian and US Stock Markets Using Garch (1, 1) Model
Authors: Rastogi Shailesh , Srivastava Vinay K.
Published: March 2013

Change is the most eternal phenomenon. An economy is sustainable only when it withstands the change and takes the change into its own stride. Indian economy has four such major changes in last two decades. This study is an attempt to find out how Indian securities market has faced these changes. Volatility is one of the best measures to study the impact of change on the securities market. We have used time-varying variance based GARCH process to capture the change in the volatility and study its impact on the Indian securities market. Further, change in the volatility of US securities market has been compared with change in volatility of Indian securities market at different time of uproar in the Indian Economy. It has been found that co-movement in terms of conditional volatility in both the market is not prominent.
An Overview of India's Intra-Industry Trade
Authors: Srivastava Amit , Medury Yaj
Published: March 2013

Intra-Industry Trade (IIT) is a simultaneous exports and imports of goods and services of the same industry and now it has become an integral part of the world trade. The present paper has tried to analyse the nature and pattern of India's IIT at 6-digit level. The paper shows that, with the passage of time, not only the degree of IIT but also the contribution of IIT in total trade have increased significantly. The paper also reveals that, overall, India's IIT is vertical in nature and decrease in tariff rate helped in increasing the degree of IIT.
Impact of Global Financial Crisis on Indian Stock Market — An Analytical Study
Authors: Muthukumaran T. , Raja A. Senthamil , Palanichamy P.
Published: March 2013

In this paper, an attempt has been made to measure the impact of Global Financial Crises on Indian economy in general and on the Indian Stock Market in particular. Additionally, this study intends to discuss the role of RBI in the present context and to examine the relationship between the Indian stock market and US stock markets. This paper employs the data from January 1, 1999 to December 31, 2008 to investigate the impact on Indian stock market and the integration of Indian stock market and US stock market. The result suggests that the Indian Stock market was affected by the Global financial crunches.
Determinants of Corporate Dividend Policy
Authors: Saravanakumar S.
Published: March 2013

This paper empirically analyzes the determinants of dividend payment for the top 50 companies in terms of market capitalization, listed in the National Stock Exchange. An important aspect of the dividend policy of any corporate is the division of net current earnings after tax into dividend to be paid to shareholders and retaining the residual. Dividend declaration is a crucial decision; it influences the growth of the company through retained earnings as well as the market value of the equity shares where dividends appear to play an important role. This paper makes an attempt in this direction with the objective of analyzing dividend policy and practices in respect of selected Indian corporates. It seeks to determine the influence of the factors like net profits, liquidity and reserve position, share prices, investors' expectations, volume of sales, windfall gains etc. on the dividend decisions of corporates This study analyses that the relationship with the factors and dividend decisions of the corporates is existant or not.
Performance Evaluation of Indian Airline Industry: An Application of DEA
Authors: Singh Alok Kumar
Published: March 2013

The airlines in our country are experiencing low fares, poor load factors, drop in premium travels, decline in cargo loads and low yields due to deteriorating market conditions. To tide over the situation, companies need to have clear game plan and management strategies to effect turnaround of the airlines. This can be achieved only if companies know their performance gap with the benchmarked airline. Present work is aimed at calculating the relative performances of different Indian domestic airline industry (total 11 in India) using DEA framework. Data Envelopment Analysis is used to construct performance indices on the basis of the multiple outputs which airlines produce and the multiple inputs which they utilize. The result is used to find which variables the managers have some control over and what the relative importance of each variable is that affecting performance. Data Envelopment Analysis (DEA) provides a clear answer to the airline manager's problem.
Impact of HRD Intervention on Women Entrepreneurship Development in Jharkhand
Authors: Sinha Arti , Sen Mitali , Pathak Pramod , Singh Saumya
Published: March 2013

The role of gender in economic development process has been increasingly recognized as crucial, both in terms of potential for success and in the nature of the impact of particular development strategies and programs. Gender becomes especially important to consider in case of micro-enterprise approach, as the traditional home-centered roles of women can make it far easier for women to participate in such programs as opposed to the more traditional, large and medium scale enterprises. The paper attempts to identify the influence of two HRD interventions, viz. Education and Training on women entrepreneurship development in the state of Jharkhand. The sample for the study comprises sixty two (62) women entrepreneurs in Dhanbad district of Jharkhand state. A survey, using questionnaire method, has been conducted to obtain data on the nature of enterprise, socio economic profile of the entrepreneurs and importance of Training and Education interventions in entrepreneurship development. Right-tailed “z” Test has been used to test the formulated hypothesis on Education and Training interventions. The findings of the study shows that there is no role of Education in starting an enterprise but it plays an important role in improving the entrepreneurial quality and performance of the enterprise.
Inclusive Growth through MFIs' Outreach in Assam
Authors: Roy Arup
Published: March 2013

Inclusive growth refers to ensuring that all the phases of development (designing, implementation, monitoring, evaluation) include the whole population of economy. The primary objective of this research is to illustrate and assess the role of microfinance outreach by MFIs towards bringing inclusive growth in Assam. Top 34 MFIs are selected based on their number of active clients. Primary data is collected from MFIs during June — October, 2010. The study concludes that the microfinance outreach by MFIs of Assam is growing at a faster pace of 38.51% in the last three years and also playing an important role in providing financial services to the poorer section of the society — not reached by the formal banking and other financial systems. The results of this study indicate that the aggregate outreach of the MFIs of Assam is 1.30% of the total population and 3.77% of the poor against the national outreach of 5%. Finally, the study concludes that the aggregate outreach rate of Assam is much lower than the national average, but given the policy environment growth in outreach by MFIs is satisfactory.
An Explorative Study on Client's Turnover Reasons Cited by Ad-Agencies and their Clients
Authors: Arul P.G.
Published: March 2013

The agency-client relationship is a very complex topic with many differing opinions on what makes a successful or unsuccessful relationship. There is no single factor which cements a strong bond between the agencies and the clients. It's a multitude of them, which makes it difficult to pinpoint a particular aspect and which could be responsible for making or breaking an agency-client relationship. A client does not approach an agency only because it produces creative stuff or it has media strength. The Client's turnover situation arises even when a thorough selection process has been used, and the various guidelines for liaison and coordination with the agency have been followed in the right spirit. In this context the research study has carried out by taking into consideration of 25 leading ad-agencies in New Delhi, offering services to both national and international clients and 50 clients these ad-agencies with the following specific objectives were i) the reasons behind the client's turnover from one ad-agency to another stated by the clients, ii) reasons quoted by the ad-agency for the clients turnover and iii) the steps taken by the ad-agency to retain their clients. The main finding of this study is the reasons for broken agency-client relationships are complex and very varied. However, the study reveals failure in understanding the clients needs, poor agency performance; lack of confidence, poor creativity appear to explain most failed agency-client relationships.
Evolutionary Approaches to Cross-Cultural Anthropology
Authors: Jordan Fiona M. , Huber Brad R.
Published: March 2013

This special issue “Evolutionary Approaches to Cross-Cultural Anthropology” brings together scholars from the fields of behavioral ecology, evolutionary psychology, and cultural evolution whose cross-cultural work draws on evolutionary theory and methods. The papers here are a subset of those presented at a symposium we organized for the 2011 meeting of the Society for Cross-Cultural Research held in Charleston, South Carolina. Collectively, our authors show how an engagement with cultural variation has enriched evolutionary anthropology, and these papers showcase how cross-cultural research can benefit from the theoretical and methodological contributions of an evolutionary approach.
Plantar Fascial Spaces of the Foot and a Proposed Surgical Approach
Authors: Loeffler Robert D. , Ballard Anthony
Published: March 2013

This study identified five plantar fascial spaces of the foot. The first space lies superficial to the calcaneus, the second lies between the plantar aponeurosis and the flexor digitorum brevis, the third lies between the flexor digitorum brevis and the quadratus plantae, the fourth lies above the quadratus, and the fifth lies above the adductor hallucis.

A plantar incision is proposed for exploration and drainage of foot injuries and infections. With this incision, the plantar neurovascular bundles, along with the five plantar spaces through which infection spreads, are visualized clearly. In our experience, the incision heals without a sensitive scar.
A Disabling Sports Injury of the Great Toe
Authors: Mullis Donald L. , Miller Wallace E.
Published: March 2013

An unusual and disabling sports injury of the hallux is described. This consisted of a torn lateral conjoined tendon, capsule, and collateral ligaments, causing varus metatarsophalangeal instability. The surgical treatment is described along with the follow-up evaluation.
Arthrodesis of the Interphalangeal Joint of the Great Toe—An Improved Technique
Authors: Shives Thomas C. , Johnson Kenneth A.
Published: March 2013

At the Mayo Clinic between 1950 and 1975, initial fusion of the interphalangeal joint of the great toe was attempted 166 times in 139 patients utilizing a Kirschner wire for stabilization. Follow-up examination of these patients disclosed an overall pseudarthrosis rate of 44%. Because of these disappointing results, a technique involving use of a longitudinal mini-cancellous bone screw was devised which provides increased stability and compression at the arthrodesis site. With this method, used 20 times in 18 patients, the pseudoarthrosis rate was decreased to 10%.
Congenital Convex Pes Valgus: Results of an Early Comprehensive Release and a Review of Congenital Vertical Talus at Richmond Crippled Children's Hospital and the University of Alabama in Birmingham
Authors: Adelaar Robert S. , Williams Randolph M. , Gould John S.
Published: March 2013

Nineteen patients with 28 feet with congenital vertical talus were reviewed. The male to female ratio was equal, and associated congenital abnormalities were found in 15 of the 19 patients. No genetic pattern was established. Fifteen of the 16 surgically corrected feet were reevaluated, with an average follow-up of 60 months. Ten of the 15 feet were found to be in the good to excellent category, and five were rated poor. Twelve of 12 feet treated by cast correction were poor. Poor prognostic signs include late age of surgical correction, associated arthrogryposis and cerebral palsy, and an increased space between the calcaneus and cuboid. Best results occurred in those patients who had early surgical correction, after 4 to 6 months of serial casting, using magnification. Surgical technique which yielded the best results involved total release of the talus from the posterior, medial, and lateral approach, with reduction of the talocalcaneal as well as the talonavicular joints with multiple pin fixation. Lengthening of the Achilles tendon, extensor tendons, and peroneal tendons and transfer of the anterior tibialis to the navicular are recommended. Navicular excision was not found to be necessary. Surgical results in those patients over 3½ years of age were found to be poor, and these individuals were considered for salvage procedures using a subtalar extra articular arthrodesis, excision of the navicular, or triple arthrodesis, depending on age.
Amputation of the Great Toe
Authors: Poppen Norman K. , Mann Roger A. , O'Konski Mark , Buncke Harry J. , Jahss Melvin H.
Published: March 2013

Four patients who had undergone reimplantation of the great toe to create a thumb were studied. The follow-up period ranged from 29 to 62 months. In all cases, the great toe was disarticulated at the metatarsophalangeal joint.

The patients felt their feet functioned at approximately 85% of normal, and none had any significant complaint of metatarsalgia. The one patient who participated in sports after the surgery noted that it was difficult to “push off” moving away from the involved foot. X-ray examination demonstrated retraction of the sesamoids, which accounted for the increased plantar flexion of the first metatarsal shaft. The second metatarsophalanageal joint drifted into varus an average of 8°. The Harris mat demonstrated that there was an increase in weightbearing beneath the second and third metatarsal heads. It appears as though, on the basis of this study, the loss of the great toe in this manner does not significantly affect the normal everyday function of an individual's foot.
Dwyer's Operation for the Rheumatoid Forefoot
Authors: MacClean Craig R. , Silver William A.
Published: March 2013

In 1970, A. F. Dwyer described an operation for severe toe deformities with the objectives of creating a more stable foot and improving toe function, in addition to relieving pain. This was achieved by fusing the metatar-sophalangeal joint of the hallux and the proximal interphalangeal joints of the lateral four toes. The metatarsal heads of the second, third, fourth, and fifth rays were then resected with their respective extensor tendons interposed so as to provide a tenodesis effect.

Our study presented in this paper consists of 36 consecutive procedures performed on 22 rheumatoid patients.

Follow-up of 33 operations in the 20 patients who were available for recall averaged 42.2 months. Assessment emphasized a subjective report including patient satisfaction, relief of pain, ability to fit shoes, cosmetic result, and walking ability. Objective examination was used to evaluate the presence of a successful arthrodesis of the metatarsophalangeal joint of the great toe, the position of this arthrodesis, the presence of tender callosities, the attitude of the lateral four toes, and symmetry.

Results were good or excellent in 76%, satisfactory in 12%, and poor in 12%.
Talonavicular Joint Surface Anatomy and Prototype Resurfacing Prostheses
Authors: Daniels A. U. , Samuelson K. M. , Rusin K. A.
Published: March 2013

The curvature and extent of a joint surface largely determine the type and range of motion possible. The talonavicular surface anatomy of 10 human foot specimens has been determined quantitatively, and the data have been compared with the design parameters for a prototype prosthetic joint.

It was found that, in general, the natural talus as compared with the navicular was slightly larger in surface area and in mean arc length, but slightly smaller in mean radius of curvature. The arc length of the joint was found to be generally slightly longer along an axis positioned from slightly medial of dorsal to slightly lateral of ventral. In contrast, no general orientation of the radius of curvature was observed. Also, it was found that the congruency between the talus and navicular surfaces, as indicated by corresponding radii of curvature, varied widely. In comparison to the human specimens, a previously designed prototype talonavicular prosthesis proved somewhat smaller in radius, arc length, and surface area.

Experimental studies related to other prosthesis design parameters, besides type and range of motion, are in progress.
Documenting Your Patient with Photography in Office Practice
Authors: Watanabe Robert S.
Published: March 2013

The basic requirements for the proper photographic documentation of the foot is a single lens reflex camera, electronic flash unit, and a closeup lens set. Preoperative photographs should be a routine part of the patient workup prior to any treatment or corrective surgery. Clinical photographs should be taken with the patient standing on a plain background and should include the front, side, and back views. The electronic flash unit gives a consistent light and is well balanced with daylight color film. Surgical photographs are best taken with a telephoto macro lens or a telephoto lens with a closeup attachment. An electronic flash unit provides a consistent light. The flash unit is utilized with the AC adapter in order to give a rapid recycling and a consistent light output. Any pathological specimen should be photographed immediately following the case. Excellent specimen photographs can be taken with the use of the electronic flash held at a 30° angle and a sheet of white paper on the opposite of the specimen to act as a reflector.

The most important aspect of the photography is to standardize the procedures so that consistent results may be obtained.
Graphing the Adult Foot and Ankle
Authors: Gould Nathaniel
Published: March 2013

When the patient appears in your office with foot and/or ankle complaints, what will be your standard routine X-rays for those areas and what information can you glean from your careful study of these films? What views portray the areas in question and what are suggestive pathognomonic signs?

The author has attempted to outline some of the roentgenological approaches to diagnosis of ailments of the foot and ankle and to point out some of the clues that can be found with their interpretations.

Many of the signs have, hitherto, not been recognized or are buried in the voluminous orthopaedic literature.
Office Care of the Insensitive Foot
Authors: Jacobs Richard L. , Karmody Allastair M.
Published: March 2013

Diabetes is the most common cause of foot insensitivity. Its treatment requires in depth education of the patient in the cause, effects, and danger signs of the disease. Circulatory studies are outlined with particular emphasis on the use of the ultrasonic Doppler in monitoring the course of any foot lesions particularly with regard to their healing.
Subtalar Arthrodesis for Adult Traumatic Arthritis
Authors: Johansson J.E. , Harrison J. , Greenwood F.A.H.
Published: March 2013

In this study the effectiveness of the modified Grice extra articular subtalar fusion in the treament of painful suntalar arthritis postintra-articular os calcis fractures was evaluted. Twenty-one patients with 23 Grice fusions returned for questioning, clinical assessment and roent genography. There were 16 males and 5 females. The ages ranged from 20 to 69 years (average 43.3 years). The follow-up period ranged from 2 to 9 years (average 4.3 years). The back-to-work time ranged from 2 weeks to 2 years (average 6.2 months). The patients were questioned and examined according to a described rating system. The back-to-work time ranged from 2 weeks to 2 years (average 6.2 months). The patients were questioned and examined according to a described rating system. The patients and surgeons rated 10 of 23 (43.5%) fusions good, 12 of 23 (52.2%) Satisfactory, and 1 of 23 (4.4%) fusions unsatisfactory. Eighteen patients (85.7%) were fully active, and 3 patients (13.3%) changed to lighter work or activities. All fusions were solid clinically and radiologically. Complications were few and included three mildly painful iliac crest fraft donor site scars, one superficial wound infection which resolved quickly, and one foot neuroma. In summary, the modified Grice extra articular subtalar fusion is simple, reliable, and effective in the treatment of painful traumatic subtalar arthritis.
Rheumatoid Arthritis in the Foot and Ankle—Diagnosis, Pathology, and Treatment: THE RELATIONSHIP BETWEEN FOOT AND ANKLE DEFORMITY AND DISEASE DURATION IN 50 PATIENTS
Authors: Spiegel Jane S. , Spiegel Timothy M.
Published: March 2013

Rheumatoid arthritis frequently results in synovitis and deformity of the ankle and foot. Rheumatoid vasculitis presents with skin ulceration, digital ischemia, nodules, and mononeuritis multiplex. The relationship of disease duration and deformity is discussed in 50 patients with rheumatoid arthritis.
Radiologic Evaluation of the Arthritic Foot
Authors: Gold Richard H. , Bassett Lawrence W.
Published: March 2013

The presence or absence of erosions, periosteal new bone, and osteoporosis, as well as differences in their character and distribution, serve as radiologic clues to the differential diagnosis of the various arthritides that affect the foot. In this article we have emphasized these differences as they pertain to the following conditions: rheumatoid arthritis of adult onset, psoriatic arthritis, Reiter disease, ankylosing spondylitis, rheumatoid arthritis of childhood onset, osteoarthritis, gout, systemic lupus erythematosus, progressive systemic slcerosis, calcium pyrophosphate dihydrate deposition disease, and neuropathic joint disease.
Development and Evolution of the ICLH Ankle Replacement
Authors: Samuelson Kent M. , Freeman Michael A. R. , Tuke Michael A.
Published: March 2013

In 1972 the original ICLH ankle was first used clinically, and since then the authors have implanted 75 ICLH ankles. The overall percentage of acceptable results in this series is about 70%.

The most frequent complication seen was delayed wound healing. Talomalleolar contact with resultant pain was a significant problem early in the series. Partial collapse of the talus has occurred in five ankles. Our experience has shown that it is possible to replace the ankle and initially achieve a functioning, pain-free arthroplasty. There are many factors that may adversely influence the ultimate outcome; and thus, the procedure should be approached with caution.
Talonavicular Arthrodesis for Isolated Arthrosis 9.5-Year Results and Gait Analysis
Authors: Fogel Guy R. , Katoh Yoshihisa , Rand James A. , Chao Edmund Y. S.
Published: March 2013

Eleven patients who were treated for talonavicular arthrosis with a talonavicular arthrodesis between 1961 and 1979 at the Mayo Clinic have been reviewed. Follow-up from surgery ranged from 2.5 to 21 years with a mean of 9.5 years. Clinical, radiographic, and gait analyses were obtained. All patients had satisfactory pain relief, but all noted difficulty in ambulating on irregular ground. Three patients had roentgenographic evidence of arthrosis affecting other tarsal joints that had not been involved before arthrodesis. Gait analysis revealed decreased terminal stance-phase plantarflexion and pronounced reduction of subtalar motion. Talonavicular arthrodesis does give predictable union and patient satisfaction but results in limitation of subtalar motion and loss of stance-phase plantarflexion.
Free Flap Coverage of Deep Tissue Defects of the Foot
Authors: Roth James H. , Urbaniak James R. , Koman L. Andrew , Goldner J. Leonard
Published: March 2013

This is a review of seven cutaneous or myocutaneous free flaps performed at the Duke University Medical Center for coverage of foot defects. The average follow-up is 19.3 months. The average anesthetic time was 7 h and 45 min. The average length of hospitalization was 14.1 days. There were no failures. The flaps provided excellent skin coverage and a good bed for further reconstructive procedures. Free myocutaneous and cutaneous flaps are useful tools in reconstructive surgery of the foot. The recently developed cutaneous scapular free flap is the authors’ preference for foot defect coverage.
Spontaneous Hallux Varus: Relation to Poliomyelitis and Congenital Absence of the Fibular Sesamoid
Authors: Jahss Melvin H.
Published: March 2013

Two case reports are presented of spontaneous hallux varus developing late in life. The first patient had longstanding poliomyelitis involving the foot, while the second patient had bilateral congenital absence of the lateral sesamoids. In the second patient the hallux varus was bilateral. The probable etiological relationship of these underlying disorders to the development of the spontaneous hallux varus is discussed.
Objective Technique for Evaluating Painful Heel Syndrome and Its Treatment
Authors: Katoh Y. , Chao E. Y. S. , Morrey B. F. , Laughman R. K.
Published: March 2013

The biomechanical evaluation of patients with painful heels has received only limited attention although the potential morbidity and disability associated with such an ailment can be severe. An objective analysis of the patient's foot function during gait can produce useful information to assess the underlying pathology. This method can also help to evaluate the efficacy of various existing treatment protocols. The impulse distribution based on foot-floor vertical reaction force and time under the hind-, mid-, and forefoot was determined in 32 normal subjects while walking in their usual street shoes. Variations related to shoe types were noted, with high heeled shoes causing the most significant deviations from normal.

The same technique was applied to 13 painful heel syndrome patients. Characteristic deviations from the normal impulse distribution were noted in these patients which provided the basis for differentiating the pathological condition between the patients with painful heel pads and those with plantar fasciitis. The effectiveness of using heel cups as a therapeutic device was also assessed. Although significant gait changes were not associated with the insertion of heel cups, they did seem to shift the foot-floor impulse forward from the heel region, which made them effective in patients afflicted with localized heel pain, but not in those with plantar fasciitis.
Interdigital Neuroma—A Critical Clinical Analysis
Authors: Mann Roger A. , Reynolds J. Christopher
Published: March 2013

A retrospective study of 56 patients upon whom 76 inter-digital neuromas were excised was carefully evaluated. There were 53 females and 3 males, with an average age of 55 years. The main preoperative symptom was pain in the plantar aspect of the foot which was increased by walking and relieved by rest. The main preoperative physical finding was that of tenderness in the involved interspace. There were an equal number of interdigital neu-romas removed from the second and third interspace. Postoperatively 65% of patients still noted some local plantar tenderness, and 68% noted numbness in the interspace. Postoperatively 80% of the patients were subjectively improved.
Impingement Exostoses of the Talus and Fibula Secondary to an Inversion Sprain: A case report
Authors: St. Pierre Rick K. , Velazco Anterior , Fleming Lamar L.
Published: March 2013

Impingement exostoses of the talus and fibula following an inversion sprain is an uncommon sequela to the initial injury. Although a high frequency of symptomatic tibial and talar impingement exostoses have been reported, changes on the lateral side of the ankle are more subtle with significant roentgenographic findings rarely seen. The authors present a rare case of impingement exostoses involving both the talus and fibula simultaneously. Arthroscopy visualized the tibiotalar and talomalleolar articulations. It revealed opposing exostoses of the talus and fibula, necessitating surgical resection. Arthroscopy is recommended for difficult diagnostic problems of the ankle and an awareness of the condition of post-traumatic impingement exostoses of the talus and fibula.
The Tensile Strength of the Anterior Talofibular Ligament
Authors: St. Pierre Rick K. , Rosen Jeffrey , Whitesides Thomas E. , Szczukowski Myron , Fleming Lamar L. , Hutton William C.
Published: March 2013

Cadaveric anterior talofibular ligaments, with their associated bone attachments, were tensile tested to destruction. The ligament ruptured by either bone avulsion from the talus or midsubstance failure. The values of tensile strength varied from 58 to 556 newtons with a mean strength of 206 newtons.
Foot Reflexes and the Use of the “Inhibitive Cast”
Authors: Duncan William R. , Mott Donald H.
Published: March 2013

The four diametrically opposed tonic relfex movements of the foot that can be elicited in normal children throughout the first year represent the peripheral segments of proximally cascaded reflex balance recovery systems. Clinical persistence of one or more of these obligatory movements in cerebral palsied children may habitually distort foot posture and recruit proximal reflex muscle activity and associated hypertonus. Inhibitive casting has proved to be a significant useful adjunct for management of both foot deformity and associated proximal hypertonicity.
Calcaneus Deformity in Cerebral Palsy
Authors: Dillin William , Samilson Robert L.
Published: March 2013

Most but not all calcaneus feet in cerebral palsied patients are iatrogenic. The cause is related to imbalance between plantarflexors and dorsiflexors in most instances. Injudicious heel cord lengthening, inadequate preoperative assessment of anterior tibial power, heel cord lengthening accompanied by gastrocsoleus neurectomy or transposition of peroneal and posterior tibial tendons, anterior to the malleoli, are all potential causes of calcaneus deformity in cerebral palsy.
The Simple Bunion: Anatomy at the Metatarsophalangeal Joint of the Great Toe
Authors: Alvarez Richard , Haddad Ray J. , Gould Nathaniel , Trevino Saul
Published: March 2013

The pathomechanics for the development of the hallux valgus deformity takes place at the first metatarsophalangeal joint-the sesamoid complex. The sesamoid complex consists of seven muscles, eight ligaments, and two sesamoid bones. When the first metatarsal escapes the complex and drifts medially, the sesamoids remain twisted in situ, several of the ligaments “fail,” and others contract. The authors propose reduction of the metatarsus primus varus by first metatarsal osteotomy and appropriate ligament releases and plications to restore alignment. A detailed understanding of the pathomechanics is essential for proper interpretation of the problems and anticipated lasting surgeries.
A Study of the Communicating Branch between the Medial and Lateral Plantar Nerves
Authors: Jones J. R. , Klenerman L.
Published: March 2013

A study of the communicating branch between the medial and lateral plantar nerves was carried out on the feet of 20 cadavers. The nerve was found to be present in all the feet examined, but in two women it was considerably enlarged bilaterally. It is suggested that this enlarged communicating branch may be a factor responsible for the frequent involvement of the nerve to the third interspace by Morton's neuroma.
Heel Pain—Operative Results
Authors: Baxter Donald E. , Thigpen C. Mark
Published: March 2013

In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti qpinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated.

Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.
The Subtalar Joint: Embryology and Morphology
Authors: Viladot Antonio , Lorenzo Juan Carlos , Salazar Javier , Rodriguez Alfonso
Published: March 2013

Several different aspects of the subtalar joint are studied. Embryology indicates that it is a recently acquired structure. The anterior subtalar joint does not have a uniform morphology, and it has been subdivided into three anatomical descriptions (ovoid, bean, and two part). To correct the confusion found in other papers, we intend to clearly describe the anatomy of the ligaments. The form and function of the retinacula, cervical ligament, and ligament of the canal are studied. The microscopic anatomy of ligaments is studied, dealing specifically with their innervation and the structure of their fibers.
Congenital Clubfoot: Results of Treatment of 54 Cases
Authors: Ricciardi-Pollini Pier T. , Ippolito Ernesto , Tudisco Cosimo , Farsetti Pasquale
Published: March 2013

Fifty-four patients with congenital clubfoot (total: 82 club feet) were observed at the 2nd Department of Orthopaedic Surgery of Rome University from 1970 to 1980. The conclusions of this study were the following: The patients with congenital clubfoot who had a uniform treatment from the beginning at the same hospital obtained better results than those who received previous treatments at other hospitals. A relapse was considered as a recurrence of the initial deformity after complete recovery and not as an incompletely corrected congenital clubfoot. In many of the patients with clubfoot who were treated, no direct correlations existed between the radiographic and clinical results. Of the patients with clubfoot who received an early treatment by posterior release, 89% had excellent and good results. One- or two-stage posteromedial releases did not prevent relapses, even though those done in one stage obtained better results. The transfer of the anterior tibial tendon to the third cuneiform proved to be the most effective procedure to prevent and correct relapses.
Morton's Neuroma: A Microscopic Evaluation
Authors: Graham Charles E. , Graham Dorcas M.
Published: March 2013

Microscopic evaluation of the interdigital neuroma is described in 24 nerves which were evaluated at six cross-section areas for size of the nerve and width of the perineural along with the fascicle diameter and the size and number of blood vessels inside each fascicle. A relationship was noted between the level of the distal edge of the intermetatarsal ligament. Cross-section that was taken at that area showed changes distally in nerve diameter, fascicle number and size, blood vessel number and size, and perineural width. These changes are consistent with the interdigital neuroma as an entrapment condition.
Osteochondritis Dissecans of the Talus (Transchondral Fractures of the Talus): Review of the Literature and New Surgical Approach for Medial Dome Lesions
Authors: Flick A. B. , Gould Nathaniel
Published: March 2013

A retrospective study of 22 ankles in 22 patients with osteochondral talar dome lesions between 1975 and 1983 has indicated that surgical treatment yields superior results to conservative therapy. Thirteen male and 9 female patients, ages 9 to 72 years, average age 28 years, showed 10 medial lesions (Berndt and Harty classification (stage I (one); stage II/III (nine)) and 12 lateral lesions (stage II/III (5), stage IV (7)). Examination follow-up on 19 patients (86%) has averaged 24 months. The initial diagnosis seen retrospectively on x-rays was missed 43% of the time by emergency room physicians. A history of trauma was verified in 100% of the lateral lesions and 80% of the medial talar dome lesions. Of the 22 ankles, 14 lesions were isolated injuries, while 8 had concomitant fractures, lateral ligament, or peroneal tendon damage.

Surgical treatment consisted of removal of the osteochondral fragment, curettage, and drilling of its bed. Two distinct surgical approaches were utilized. Lateral dome lesions were approached through the standard anterolateral incision, while medial dome lesions were approached through the anterior tibial tendon sheath with grooving of the anteromedial distal tibia articular surface. The medial approach allowed the somewhat posteriorly placed medial lesions to be reached, negating the need for a medial malleolar osteotomy and postoperative immobilization. On follow-up, no untoward ankle arthrosis was noted as a result of the grooving of the anteromedial distal tibia.

Nineteen of the 22 patients had surgical therapy with 79% excellent or good, 21% fair, and no poor results. Five of the eight patients who elected prolonged conservative therapy finally had surgery. Of the three remaining patients conservatively treated, there were two fair results and one poor result.
Acute Tears of the Medial Head of the Gastrocnemius
Authors: Shields Clarence L. , Redix Louis , Brewster Clive E.
Published: March 2013

Twenty-five patients with acute tears of the medial head of the gastrocnemius were evaluated in follow-up from 1 to 3 years after injury. The patients were treated with a heel lift, calf sleeve, and physical therapy. The majority of the patients were men who injured their dominant lower extremity in one explosive episode. Cybex II testing revealed no significant difference in the plantarflexion strength of the noninjured and injured extremity after healing. All patients returned to their previous level of athletic activity.
Congenital Duplication of the Foot and Toes
Authors: Leeson Mark C. , Wilcox Philip G. , Weiner Dennis S.
Published: March 2013

Congenital duplication of the foot and toes is a commonly diagnosed condition in newborn nurseries across the United States. The foot involvement varies from simple fleshy tags to complex attempts at whole extremity duplication. We reviewed 59 patients (82 feet) with a variety of duplications (excluding skin tags). During our review, we devised a new descriptive system of classification of congenital duplications of the foot based primarily on the type and complexity of the skeletal duplication. Variables related to sex, bilaterality, age at surgery, family history, and follow-up results were documented, and an exact classification of each foot was accomplished. Results and prognosis vary with the class of duplication being treated and must be individualized case by case.
Plantar Abscess in the Diabetic Patient
Authors: Livingston Robert , Jacobs Richard L. , Karmody Allastair
Published: March 2013

This is a report on 42 plantar abscesses in 40 patients with diabetes mellitus. Data concerning the mode of origin, the microorganisms involved, the antibiotics used, the end results or treatment, and the length of stay are given. Several typical cases are presented. Below-knee amputation can usually be avoided in diabetic patients with plantar abscess. The extremity can often be saved by a team consisting of specialists in infectious diseases, vascular surgery, and orthopaedic surgery.
Pressures on the Foot in Pointe Shoes
Authors: Teitz Carol C. , Harrington Richard M. , Wiley Hannah
Published: March 2013

This study was designed to determine the relative pressures on the first and second toes and first MTP joint when dancing en pointe, in addition to the variation of these pressures as a function of toe length, foot position, and padding. The first ray always bore the most pressure. Pressures on the second toe varied as a function of toe length and padding. Relevé in the everted position markedly increased first MTP joint pressures. Further research is required to determine whether properly designed padding and positioning of the foot en pointe could decrease the incidence of toe problems in the ballet dancer.
Chevron Osteotomy: Analysis of Factors in Patients' Dissatisfaction
Authors: Hattrup Steven J. , Johnson Kenneth A.
Published: March 2013

The results of all Chevron osteotomies for hallux valgus performed at the Mayo Clinic between January 1976 and June 1982 were reviewed at least 1 year after surgery. Of the total 157 patients with 228 operations eligible for inclusion in this study, 154 patients with 225 operations were interviewed. Complete satisfaction was expressed for 79.1% of the procedures, satisfaction with minor reservations for 12.9%, and dissatisfaction for 8%. For the osteotomies producing incomplete satisfaction, further investigation identified failure to achieve correction and technical errors as the most prominent factors. There were no cases of avascular necrosis, osteotomy nonunion, or hallux varus.