bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alignment of Ankle and Hindfoot in Early Stage Ankle Osteoarthritis
Authors: Lee Woo-Chun , Moon Jeong-Seok , Lee Ho Seong , Lee Kang 
Published: November 2011

Background: Supramalleolar osteotomy has been recommended to correct varus deformity of the tibial plafond; however, we have seen only a few ankles with significant deviation of alignment in early stage osteoarthritis, in which realignment treatments might be necessary to modify the course of the disease. Our hypothesis was that there are diverse radiographic features of the tibial plafond and hindfoot in varus ankle osteoarthritis. Materials and Methods: The study included 154 ankles of 98 patients with medial osteoarthritis, and 80 ankles of 80 normal subjects. On weightbearing AP radiographs, the tibial anterior surface angle (TAS), tibial axis-medial malleolus angle (TMM) and talar tilt angle was measured. On weightbearing lateral radiographs, tibial lateral surface angle (TLS) was measured. On the hindfoot alignment view, the heel alignment angle and heel alignment ratio were obtained. Inter- and intraobserver reliabilities were obtained for all radiographic parameters. The radiographic parameters were compared among the normal ankles and the ankles in different stages of ankle arthritis by the Takakura classification. Results: Inter- and intraobserver reliability were very high for all radiographic parameters except TLS. There was no statistically significant difference in TAS among Stages 2, 3a, and 3b. TAS was 86.9 ± 2.4 degrees, 86.2 ± 3.3 degrees, and 85.4 ± 3.1 degrees in Stages 2, 3a, and 3b, respectively. There was no significant difference in hindfoot alignment among normal, Stage 2, Stage 3a. The hindfoot alignment angle was 0.5 ± 8.1 degrees, 0.5 ± 6.8 degrees, and 9.6 ± 9.1 degrees in Stages 2, 3a, and 3b, respectively. Conclusion: Alignment of the tibial plafond and hindfoot was variable in early stage ankle osteoarthritis. Level of Evidence: III, Retrospective Case Control Study
Perfusion Pressures and Distal Oxygenation in Individuals with Diabetes Undergoing Chronic Hemodialysis
Authors: Kay David B. , Ray Susan , Haller Nairmeen Awad , Hewit Michael 
Published: November 2011

Background: The number of diabetic patients worldwide was estimated to be approximately 285 million in 2010. Approximately 5% of all diabetic patients have foot ulcers, often preceded by neuropathy and delayed healing resulting from peripheral vascular disease which leads to increased risk of infection. Additionally, there is a concern that blood flow to the feet may be reduced in patients with diabetes, which may be further compounded by changes in lower extremity perfusion pressure during hemodialysis. Current laser Doppler technology provides the opportunity to identify changes in vascularityin a non-invasive fashion. Materials and Methods: A prospective, parallel-arm, comparison, pilot study was conducted. A total of 15 patients were enrolled, ten of whom had a documented history of diabetes. All patients required hemodialysis. Peripheral perfusion and oxygenation measurements were obtained before, midway and at the conclusion of three separate dialysis sessions within a 3-week interval for each subject. Results: Preliminary results indicate a significant reduction in toe pressure during and after hemodialysis in the diabetic patient group compared to the non-diabetic group. Significant differences were not found in skin perfusion measurements or in the oxygenation measurements at any time in diabetic and non-diabetic patients undergoing hemodialysis. Conclusion: Preliminary results suggest hemodialysis may significantly affect pressure of the lower extremities in diabetic patients. Trends from these data indicate the need to further investigate the effect of hemodialysis on techniques used to heal wounds and ulcers in patients with diabetes. Level of Evidence: IV, Retrospective Case Series
Locked versus Nonlocked Plate Fixation for Hallux MTP Arthrodesis
Authors: Hunt Kenneth J. , Ellington J. Kent , Anderson Robert B. , Cohen Bruce E. , Davis W. Hodges , Jones Carroll P. 
Published: November 2011

Background: Dorsal plate fixation is used commonly for arthrodesis of the hallux first metatarsophalangeal (MTP) joint. Custom dorsal plates incorporating locking technology have been developed recently for applications in the foot to provide relative ease of application and theoretically superior mechanical properties. The purpose of this study is to compare the radiographic and clinical outcomes of patients undergoing hallux MTP joint arthrodesis using a locked plate, or a nonlocked plate. Materials and Methods: We compared consecutive patients who underwent hallux MTP arthrodesis for a variety of diagnoses with either a precontoured locked titanium dorsal plate (Group 1) or a precontoured, nonlocked stainless steel plate (Group 2). All patients were evaluated with radiographs, visual analog pain scale, American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and a detailed patient satisfaction survey. Results: There were 73 feet in Group 1 and 107 feet in Group 2. There was a trend toward a higher nonunion rate in Group 1 compared to Group 2. When considering only patients without rheumatoid arthritis (RA), the union rate was significantly higher in Group 2 compared to Group 1. Hardware failure and the overall complication rate was equivalent between the two Groups. Conclusion: As locked plate technology continues to gain popularity for procedures in the foot, it is important that clinical outcomes are reported. Locked titanium plates were associated with higher nonunion rates. Improved plate design, patient selection, and an understanding of plate biomechanics in this unique loading environment may optimize future outcomes for hallux MTP arthrodesis. Level of Evidence: III, Retrospective Comparative Study
Fore- and Rearfoot Kinematics in High- and Low-Arched Individuals during Running
Authors: Barnes Andrew , Wheat Jonathan , Milner Clare E. 
Published: November 2011

Background: Differences in the location and incidence of lower extremity injuries have been reported between high and low arched individuals. These differences might be related to functional differences between the two foot types. In particular, the characteristics of the medial longitudinal arch may influence foot function. The purpose of this study was to investigate forefoot and rearfoot kinematics as well as tibial shock in participants with both high and low arches. Materials and Methods: Fifteen high arched and 15 low arched males were recruited. Tibial acceleration as well as forefoot, rearfoot and shank kinematic data were collected as participants ran at 3.5 m/s wearing gait sandals. Variables of interest included peak tibial acceleration in addition to rearfoot eversion excursion, forefoot eversion excursion, forefoot eversion velocity, forefoot abduction excursion and forefoot abduction velocity. MANOVA and effect sizes were used to investigate kinematic differences between groups. Results: Multivariate analysis revealed that foot type had an effect on the kinematic variables of interest ( p = 0.04). Forefoot abduction excursion (High arched = 4.7 ± 1.3 degrees, Low arched 3.8 ± 1.0 degrees) and forefoot abduction velocity (High arched = 96.0 ± 24.8 degrees/s, Low arched = 69.3 ± 13.3 degrees/s) were greater in the high arched group. Tibial shock ( p = 0.24) and other kinematic variables were similar between groups. Conclusion: Clear evidence of forefoot and rearfoot motion as a shock attenuation mechanism was not found. Differences in the foot kinematics during early stance were highlighted by a smaller forefoot abduction excursion and reduced forefoot abduction velocity in low arched compared to high arched individuals. It is suggested that low arched feet may have a reduced available range of motion through which the forefoot can pass before reaching the end range of motion point. Clinical Relevance: Foot kinematics during early stance warrant further investigation to establish a specific link to injury risk.
Revision Rates after Total Ankle Arthroplasty in Sample-Based Clinical Studies and National Registries
Authors: Labek Gerold , Klaus Hermann , Schlichtherle Rainer , Williams Alexandra , Agreiter Mark 
Published: November 2011

Background: The aim of this study was to evaluate the outcome of specific implants in total ankle arthroplasty as reported in clinical studies and determined by national registries. Materials and Methods: A structured literature review was conducted regarding sample-based clinical studies and national registry data. To allow for comparative analyses, registry data had to be available for the implants included. These were STAR™ Ankle, Büchel-Pappas, Hintegra, Mobility, Agility, and Ramses Total Ankle Arthroplasty. The revision rate was used as the main outcome parameter. Results: On average, the revision rates published in sample-based clinical studies were about half the value found in registries. Implant developers represent a share of almost 50% of the published content and are therefore over-represented in scientific publications. The inventors of STAR™ Ankle and BP total ankle implants published data which was statistically significantly superior to the outcome achieved in average patients as documented in registries. Irrespective of the implant, the average revision rate to be expected according to the registry data available is 21.8% after 5 years, and 43.5% after 10 years. Conclusion: The average revision rate published in peer-reviewed scientific articles was significantly lower than the outcome achieved according to national arthroplasty registry data, which reflect actual average patient care in the respective countries. Publications by some research groups, particularly by implant inventors, show a deviation from the outcome published by other users and those shown in registry data. Level of Evidence: III, Retrospective, Comparative Study
Operative Correction of Arch Collapse with Forefoot Deformity: A Retrospective Analysis of Outcomes
Authors: Habbu Rohan , Holthusen Scott M. , Anderson John G. , Bohay Donald R. 
Published: November 2011

Background: There are many forefoot deformities, including hallux valgus, forefoot overload, and hammertoe that are treated as unrelated problems with multiple different techniques. Currently, there has been renewed interest in the role of a gastrocnemius contracture on foot deformities. Our objective was to review a specific surgical treatment plan for forefoot deformities classified by us as Type 2 arch collapse and evaluate the outcomes. Materials and Methods: We retrospectively reviewed the charts of 374 patients who underwent foot procedures to treat deformity classified as a Type 2 arch collapse. Data was collected regarding complications and need for secondary surgery. A phone survey was performed to assess patient satisfaction, pain level, and Foot Function Index (FFI) scores. Results: Of the 374 patients (412 feet), there was a 96% (357 of 371 feet) union rate at the first tarsometatarsal joint and 98% (227 of 232 feet) union rate at metatarsal shortening osteotomy sites. Recurrence of hallux valgus was 2.7% (7 of 256 feet), while hallux varus occurred in 1.6% (4 of 256 feet). There were 292 patients (78%) available for phone interview. Of those patients, 88% were satisfied with the results of the procedure. The subset of procedures relating to the highest mean FFI was hammertoe correction (22.2) and the highest mean pain score was related to metatarsal shortening osteotomy (2.6). Conclusion: Utilizing the arch collapse model, operative treatment of forefoot deformities with a combination of procedures including gastrocnemius recession, first TMT fusion, modified McBride, hammertoe correction, and metatarsal shortening osteotomy can produce good satisfaction rates with low complication rates. Level of Evidence: IV, Retrospective Case Series
Radiographic Evaluation of Foot Structure following Fifth Metatarsal Stress Fracture
Authors: Lee Kyung Tai , Kim Ki Chun , Park Young Uk , Kim Tae Won , Lee Young Koo 
Published: November 2011

Background: Correlation between foot structure and stress fracture risk has not been adequately evaluated or proven. The purpose of this study was to compare foot structure in fracture cases versus control with respect to radiological parameters in stress fractures of the fifth metatarsal. Materials and Methods: The study group consisted of 50 consecutive athletes with a diagnosis of fifth metatarsal stress fracture and a control group matched for sport type and age. Fifth metatarsopha-langeal (MTP-5) angle, fourth-fifth intermetatarsal (IMA4–5) angle, fifth metatarsal lateral deviation (MT5-LD) angle were measured on standing antero-posterior (AP) radiographs. Talo first metatarsal (T-MT1) angle, talo-calcaneal (TC) angle, and calcaneal pitch (CP) angle were measured on a standing lateral view, and MT5-LD angle was measured on a 30-degree medial oblique view. Results: Significant inter-group differences were found for TC angle ( p < 0.001) and calcaneal pitch angle ( p < 0.001) on lateral radiographs, and for IMA4–5 angle ( p = 0.003), MT5-LD angle ( p = 0.002) on AP radiographs, and for MT5-LD angle ( p < 0.001) on the 30-degree medial oblique radiographs. Conclusion: Fifth metatarsal stress fractures were found to be associated with elevated T-MT1 angle and CP angle representing a cavus foot and the increased curvature of fifth metatarsal. In addition, the extent of fifth metatarsal curvature on a 30-degree medial oblique view was found to be more related to the risk of fracture than on the AP view. Level of Evidence: IV, Retrospective Case Series
Biomechanical Comparison of Lag Screw versus Self-Drilling Screw Fixation of Oblique Metatarsal Osteotomy
Authors: Rabenhorst Brien M. , Smith Michael P. , James C. Roger , Grimes Jerry S. 
Published: November 2011

Background: Several fixation methods for a Weil metatarsal osteotomy have been proposed. Lag screw fixation has been described as the preferred fixation technique. The self-drilling screw has been introduced and can be used for fixation of the Weil osteotomy. The current study compared self-drilling screws with lag screw fixation. Materials and Methods: A Weil metatarsal osteotomy was performed on the second, third, and fourth metatarsals of five matched pairs of fresh frozen cadaver feet. The feet of each pair were randomly assigned to fixation with either a 2.0-mm cortical lag screw or a 2.0-mm self-drilling screw. The second metatarsals were stressed using cantilever bending. The third and fourth metatarsals were stressed under a shear force. Yield load, deformation at yield load, structural stiffness, and energy stored at yield load were recorded. Results: There were no statistically significant differences ( p < 0.05) noted. However, there was a trend toward greater biomechanical stability with the lag screw. Conclusion: There were no significant differences in the stability of fixation of the self-drilling screw and lag screw. There was a trend toward the lag screw fixation being more stable. Clinical Relevance: The clinical significance of this trend is uncertain but suggests there is not a large difference between the two methods of fixation.
Medial Approach for Hindfoot Arthrodesis with a Valgus Deformity
Authors: Saville Philip , Longman Charlotte F. , Srinivasan Sreebala C. M. , Kothari Paresh 
Published: November 2011

Background: Surgical correction of valgus deformity of the hindfoot has traditionally been via a lateral incision, often complicated by wound healing problems and sural nerve damage. Potential advantages of a medial approach especially for a valgus deformity include excellent wound healing, no risk of damage to the sural nerve and extensibility of the approach to include additional procedures such as navicular fusion or tendon transfer if indicated. Materials and Methods: We present a retrospective review of 18 consecutive patients with valgus deformity of the hindfoot, all undergoing arthrodesis via a medial approach. Indications included osteoarthritis, tibialis posterior dysfucntion, post-traumatic arthritis and rheumatoid arthritis. Results: All wounds healed by primary intention and there were no postoperative neurovascular complications. The mean preoperative subtalar valgus deformity was 32 (range, 12 to 49) degrees, which was improved to mean postoperative valgus deformity of 17 (range, 10 to 25) degrees. Fusion following the primary surgery was achieved in all but one of the patients (a heavy smoker and post-traumatic arthritis), with the mean time to fusion being 5.6 months. Conclusion: We provide further evidence to support previous documentation in the literature that the medial approach for the correction of hindfoot valgus deformity can be successfully used to achieve excellent exposure of the subtalar joint in order to correct the valgus deformity, avoiding the risks of wound healing and nerve damage associated with a lateral approach. Level of Evidence: IV, Retrospective Case Series
Esterase variability in the populations of culex quinquefasciatus say 1823 from two geographically isolated locations in Bangladesh
Authors: Shahjahan Reza Md , Begum Rowshan Ara , Rumman Marufa , Karim Farhana Sultana , Begum Anwara 
Published: November 2011

Indiscriminate and frequent use of insecticides are causing occurrence of resistance problem in the treated population in mosquitoes. Organo-phosphates are associated with esterase enzyme overproduction leading towards the selection of resistant population. Esterase pattern was studied from two geographically isolated populations of Culex quinquefasciatus by the Polyacrylamide Gel Electrophoresis (PAGE). The municipal area of Sirajganj (24°19'48" N, 89°37'12"E) is located 160 km away from Dhaka (23°42'0" N, 90°22'30"E), the capital of Bangladesh. In Dhaka insecticides are frequently sprayed with by the city corporation whereas in Sirajganj town insecticides usually not in use. Altogether eight and seven esterase bands were observed from above two populations. These were named as Est-1, Est-2, Est-3, Est-4, Est-5 Est-6, Est-7, Est-8, respectively. Sirajganj population in general showed less esterase activity in comparison with that of Hatirjheel. Est-5 in Hatirjheel population was found to be distinct and darkly stained. These reflect increasing insecticide resistance due to excessive use of insecticides in mosquito control program in the Dhaka city. Furthermore, in Sirajganj population two female samples were found to produce unique bands in Est-2, very thick (~50-100fold), although these specimens were morphologically similar to other samples, alleged to be the occurrence of species complex in Culex quinquefasciatus. Nation wide intensive sampling and large scale study in terms of esterase appears to be essential to reveal the entity of species complex and correlate resistance with the esterases for managerial purpose. Key Words: Esterase variability; Culex quinquefasciatus; Isolated locations DOI: http://dx.doi.org/10.3329/dujbs.v19i1.8939 DUJBS 2010; 19(1): 13-20
Bounded Rationality in the Centipede Game
Authors: Sperry-Taylor Ashton T. 
Published: November 2011

AbstractNormative game theory unsatisfactorily explains rational behavior. Real people do not behave as predicted, and what is prescribed as rational behavior is normally unattainable in real-life. The problem is that current normative analysis does not account for people's cognitive limitations – their bounded rationality. However, this paper develops an account of bounded rationality that explains the rationality of more realistic behavior. I focus on the Centipede Game, in which boundedly rational players explore and test others' immediate behavior, until they can apply limited backward induction. The result is that the game has a solution in the form of a subjective Nash equilibrium, which boundedly rational players can possibly realize.
Prevalence and Patterns of Environmental Tobacco Smoke Exposures among California Teachers
Authors: Reynolds Peggy , Goldberg Debbie E. , Hurley Susan ,   The California Teachers Study Steering Committee
Published: November 2011

Purpose. This study describes the prevalence and patterns of environmental tobacco smoke (ETS) exposure in a large, well-defined cohort of professional, female school employees in California. Design. This is a cross-sectional study based on survey responses from members of the California Teachers Study (CTS) cohort. Subjects. The analyses focused on lifetime nonsmokers (N = 61,899) in the CTS cohort who responded to detailed questions on lifetime ETS exposures in the home, workplace, and other social settings. Measures. Demographic characteristics, smoking status, and ETS exposure were based on self-reported data from two mailed surveys. Prevalence estimates within the cohort were compared with those from the California Behavioral Risk Factor Survey and the California Adult Tobacco Survey. Results. ETS exposures were highest for never smokers born in the 1930s (78% in the home, 66% in the workplace, and 48% in other social settings) and steadily declined among participants born in later years. ETS exposure from spousal smoking peaked during the 1950s (37%). In the 1980s, the workplace (28%) replaced the household (19%) as the primary exposure setting. Conclusions. Consideration of these patterns in the prevalence of ETS exposures is important in the interpretation and design of tobacco-related health studies.
Changing Patterns in Health Behaviors and Risk Factors Related to Chronic Diseases, 1990–2000
Authors: Winkleby Marilyn A. , Cubbin Catherine 
Published: November 2011

Purpose. Assess changes in chronic disease-related health behaviors and risk factors from 1990 to 2000, by race/ethnicity, age, and gender. Design. Stratified cross-sectional design. Setting. United States. Subjects. 16,948 black, 11,956 Hispanic, and 158,707 white women and men, ages 18 to 74. Measures. Cigarette smoking, obesity, sedentary behavior, low vegetable or fruit intake. From the Behavioral Risk Factor Surveillance System. Results. Young women and men, ages 18 to 24, had poor health profiles and experienced adverse changes from 1990 to 2000. After the variables were adjusted for education and income, these young people had the highest prevalence of smoking (34%–36% current smokers among white women and men), the largest increases in smoking (10%–12% increase among white women and men; 9% increase among Hispanic women), and large increases in obesity (4%–9% increase, all gender and racial/ethnic groups). Young women and men from each racial/ethnic group also had high levels of sedentary behavior (approximately 20%–30%) and low vegetable or fruit intake (approximately 35%–50%). In contrast, older Hispanic women and men and older black men, ages 65 to 74, showed some of the most positive changes. They had the largest decreases in smoking (Hispanic women), largest decreases in sedentary behavior (Hispanic women and black men), and largest increases in vegetable or fruit intake (Hispanic women and men, and black men). Conclusion. The poor and worsening health profile of young women and men is a particular concern, as they will soon enter the ages of high chronic disease burden.