bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Maxillomandibular Changes after Maxillary Distraction Osteogenesis in Growing Children with Cleft Lip with or without Palate
Authors: Honda Aya , Baba Yoshiyuki , Ogawa Takuya , Suzuki Shoichi , Moriyama Keiji 
Published: March 2012

Objective To evaluate the long-term maxillomandibular changes after maxillary distraction osteogenesis in growing children having cleft lip with or without cleft palate. Patients Eight Japanese patients with cleft lip with or without cleft palate aged 9.3 to 13.1 years. Measures The maxillary and mandibular positions before (TO), immediately after (T1), and 1, 3, and 5 years after distraction osteogenesis (T2, T3, and T4, respectively) measured on cephalograms superimposed at the sella turcica with the Frankfort horizontal plane as the horizontal reference. The anterior nasal spine (x, y), pogonion (x), and menton (y) were used for linear measurements, and sella turcica-nasion-point A, sella turcica-nasion-point B, and point A-nasion-point B angles were used for angular measurements. Results The mean horizontal maxillary advancement (anterior nasal spine [x]) was 12.3 mm during TO to T1, but -2.7, -1.1, and -0.1 mm of the posttreatment changes were observed during T1 to T2, T2 to T3, and T3 to T4, respectively. Anterior nasal spine (y) shifted 2.3 mm downward during TO to T1, and further downward changes were observed during T1 to T2 and T2 to T3 ( P < .05). Pogonion (x) did not show distinct changes due to individual variance, but menton (y) shifted downward from T1 to T4. Sella turcica-nasion-point A significantly decreased during T1 to T2 and T2 to T3 but not during T3–T4. Point A-nasion-point B significantly decreased only during T2 to T3, and sella turcica-nasion-point B did not show any distinct change. Conclusions There was no further maxillary advancement after distraction osteogenesis in the growing children with cleft lip with or without cleft palate. Therefore, long-term observation and management of occlusion in case of the mandibular growth pattern are important.
Effects of Financial Efficiency and Choice to Restrict Contributions on Individual Donations
Authors: Li Wei , McDowell Evelyn , Hu Michael 
Published: March 2012

SYNOPSIS
This study examines whether and how a nonprofit organization's financial efficiency and its solicitation type—namely, whether it allows donors the ability to restrict contributions to their preferred choices—influence individual donations. We find that a nonprofit organization's financial efficiency indirectly influences individual donations through its effect on donors' confidence. We also find that a nonprofit organization receives significantly more donations when it allows donors to restrict donations to their preferred choices than when it does not. This positive effect is greater when the organization reports low efficiency than when it reports high efficiency. Thus, allowing the restriction of donations not only influences individual donations directly, but also compensates for the effect of low efficiency on donations.
Clinical and Magnetic Resonance Imaging Outcomes following Platelet Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy
Authors: Owens Richard F. , Ginnetti John , Conti Stephen F. , Latona Carmen 
Published: March 2012

Background: The successful treatment of chronic mid-substance Achilles tendinopathy remains elusive. Approximately 25% to 50% of patients fail conservative treatment modalities. Scientific evidence has supported the use of platelet rich plasma (PRP) in the tendon healing process, however despite initial promise there is a paucity of clinical data to validate a role for PRP in the treatment of tendon disorders including chronic midsubstance Achilles tendinopathy. Methods: As an alternative to operative treatment, our practice offers patients with chronic midsubstance Achilles tendinopathy intratendinous injection of PRP. We retrospectively reviewed all patients treated for Achilles tendinopathy with PRP injection over a 2-year period. Baseline and post injection functional scores including the Foot and Ankle Ability Measure (FAAM), Foot and Ankle Ability Measure - Sports (FAAMS), and the Short Form health survey (SF-8) were examined. Patients also underwent post-injection magnetic resonance imaging (MRI), which were compared to available pre-injection MRI data. Results: Ten patients were identified for this study. Pre- and post-injection functional outcome scores were available for eight of ten patients. The average SF-8 score improved from 24.9 to 30.0, the average FAAM score improved from 55.4 to 65.8, and the average FAAMS score improved from 14.8 to 17.4. Complete MRI data was available for six patients. Only one in six Achilles tendons demonstrated qualitative MRI improvement post-injection. Conclusion: Patients who received PRP injection demonstrated modest improvement in functional outcome measures, however MRI appearance of diseased Achilles tendons remained largely unchanged following PRP injection. Level of Evidence: IV, Case Series
Osteochondral Lesions of the Talus: Predictors of Clinical Outcome
Authors: Cuttica Daniel J. , Smith W. Bret , Hyer Christopher F. , Philbin Terrence M. , Berlet Gregory C. 
Published: March 2012

Background: Osteochondral lesions of the talus (OLT) are a common and challenging condition treated by the orthopedic foot and ankle surgeon. Multiple operative treatment modalities have been recommended, and there are several factors that need to be considered when devising a treatment plan. In this study, we retrospectively reviewed a group of patients treated operatively for osteochondral lesions of the talus to determine factors that may have affected outcome. Methods: A retrospective chart review of clinical, radiographic and operative records was performed for all patients treated for OLTs via marrow stimulation technique. All had a minimum followup of 6 months or until return to full activity, preoperative magnetic resonance imaging (MRI) of the OLT to determine size, and failure of nonoperative treatment. Results: A total of 130 patients were included in the study. This included 64 males and 66 females. The average patient age at the time of surgery was 35.1 ± 13.7 (range, 12 to 73) years. The average followup was 37.2 ± 40.2 (range, 7.43 to 247) weeks. The average size of the lesion was 0.84 ± 0.67 cm2. There were 20 lesions larger than 1.5 cm2 and 110 lesions smaller than 1.5 cm2. There were 113 contained lesions and 17 uncontained lesions. OLTs larger than 1.5 cm2 and uncontained lesions were associated with a poor clinical outcome. Conclusions: The treatment of osteochondral lesions of the talus remains a challenge to the foot and ankle surgeon. Arthroscopic debridement and drilling will often provide satisfactory results. However, larger lesions and uncontained lesions are often associated with inferior functional outcomes and may require a more extensive initial procedure. Level of Evidence: IV, Retrospective Case Series
Complications Associated with Open Calcaneus Fractures
Authors: Wiersema Brent , Brokaw David , Weber Timothy , Psaradellis Telly , Panero Carlo , Weber Chad , Musapatika Dana 
Published: March 2012

Background: Literature on open calcaneus fractures is limited and inconsistent. This study's purpose was to report complications such as osteomyelitis, amputations, and soft tissue infections in open calcaneus fractures that were treated at a Level I Trauma Center. Methods: From January 1995 through December 2007, 1,157 calcaneus fractures were identified with 127 fractures being open (11.0%). Average followup time was 9.1 (range, 2 to 53) months. All open fractures were treated by a similar protocol of intravenous (IV) antibiotics, emergent irrigation and debridement (I&D), initial fracture stabilization if possible, subsequent I&Ds as needed, and delayed definitive fixation. One hundred fifteen open calcaneus fractures in 112 patients had sufficient followup for study inclusion. For this study complications were classified into four categories: superficial infections, deep infections, osteomyelitis, and amputations. Results: Medial based wounds occurred in 63 (54.8%) fractures. The overall complication rate was 23.5% with 16 fractures (13.9%) requiring a reoperation. Eleven (9.6%) fractures experienced superficial wound infection and 14 (12.2%) had deep wound infection. Six (5.2%) amputations were required with three being for either soft tissue infection or wound necrosis. Culture-positive osteomyelitis occurred in six (5.2%) patients. Conclusion: Utilizing a standardized protocol, open calcaneus fractures were found to have a lower complication rate than has been previously reported. Level of Evidence: III, Retrospective Comparative Study
Intraoperative Incidence of Hallux Valgus Interphalangeus following Basilar First Metatarsal Osteotomy and Distal Soft Tissue Realignment
Authors: Park Jae-Yong , Jung Hong-Geun , Kim Tae-Hoon , Kang Min-Seok 
Published: March 2012

Background: The premise of this study was that after the correction of hallux-metatarsophalangeal pronation, the intraoperative interphalangeal angle (HIA) increases significantly, and that an additional Akin osteotomy (AO) is often needed. Therefore, the purpose of this study was to evaluate whether HIAs in hallux valgus (HV) feet were underestimated, and to assess the need for AO during HV correction. Method: This study was conducted on 54 feet with moderate to severe HV treated from June 2007 to December 2008. HIAs and medial sesamoid subluxations (MSS) were measured initially and intraoperatively after a distal soft tissue procedure (DSTP) and proximal chevron metatarsal osteotomy (PCMO). An intraoperative technique was used to evaluate the incongruency of the metatarsophalangeal joint (MTPJ) to determine the need for additional Akin osteotomy. Results: After performing DSTP and PCMO, HIAs significantly increased from an average of 9 to 13.3 degrees and MSS reduced from average grade 2.5 to 0.5 ( p < 0.05). Akin ostetomy was added in 44 (81%) feet. After an average followup of 13.2 months in Akin group, average VAS pain score decreased from 5.7 to 1.2 and average AOFAS score increased from 57.8 to 90.2 ( p < 0.05). Final hallux MTPJ dorsiflexion in the Akin group was significantly larger than in the without-Akin group ( p < 0.05). Conclusion: Average HIA significantly increased after DSTP and PCMO for moderate to severe HV necessitating additional Akin osteotomy, to achieve ideal HV correction and, to preserve MTPJ motion. Level of Evidence: IV, Case Series
Paratenonitis of the Foot and Ankle in Young Female Dancers
Authors: Steinberg Nili , Hershkovitz Israel , Peleg Smadar , Dar Gali , Masharawi Youssef , Siev-Ner Itzhak 
Published: March 2012

Background: In their pursuit of excellence, dancers continually face the risk of injuries, such as paratenonitis. This attests to the strong need for preventive action, which is possible only if major risk factors are identified. The aim of the present descriptive study was to determine the association between risk factors and paratenonitis in young recreational female dancers. Methods: One thousand eighty-two non-professional female dancers, aged 8 to 16 years, were screened. The risk factors considered for paratenonitis were: joint range of motion (ROM), body structure, anatomic anomalies, dance technique, and dance discipline. All dancers were clinically examined for current ankle/foot paratenonitis. Results: Ninety-three dancers (8.6%) manifested a paratenonitis at the ankle or foot joints. ROM such as hyper ankle plantarflexion and hyper hip external rotation, false dance technique, and hours of practice per week were found to be associated with increased rate of injury. Regression analysis indicated that dancers with paratenonitis had greater hip external rotation ROM compared to dancers without paratenonitis. No association with injury was found with age of onset of menarche, body structure, and anatomic anomalies such as scoliosis. Conclusion: Precautionary steps, such as screening for joint ROM and dance technique, may reduce the risk of dance injury. Furthermore, our results led to a very significant justification of the dance maxim “don't force your natural joint ROM and especially your ‘turnout’ position,” as it could increase your chance to develop paratenonitis. Level of Evidence: IV, Case Series
Tendoscopic Treatment of Intrasheath Subluxation of the Peroneal Tendons
Authors: Vega Jordi , Golanó Pau , Dalmau Antoni , Viladot Ramón 
Published: March 2012

Background: Intrasheath subluxation of the peroneal tendons does not have an injury of the proximal retinaculum. The aim of this study was to describe the tendoscopic technique and preliminary results. Methods: Six patients with intrasheath subluxation of the peroneal tendons were treated tendoscopically. All patients had preoperative pain and a clicking sensation at the lateral retromalleolar area. Mean followup was 18.3 (range, 14 to 24) months. These six patients included three males and three females, with a mean age of 23.5 (range, 18 to 33) years. The AOFAS and Visual Analog Score for pain were used to evaluate the patients. Results: During tendoscopy, two patients had a peroneus quartus tendon which was removed; three had a low-lying peroneus brevis muscle that was resected; and in two cases deepening of the peroneal groove was performed. At followup, all patients reported excellent results, without pain or clicking sensation. The mean AOFAS score increased from 79 to 99, and Visual Analog Score at followup was 0 in four patients and 1 in two patients. Conclusion: Tendoscopic treatment of these pathologies led to improved function in a less aggressive manner than open surgery. Level of Evidence: IV, Retrospective Case Series
Validation and Precision of Model-Based Radiostereometric Analysis (MBRSA) for Total Ankle Arthroplasty
Authors: Fong Jason Wai-Yip , Veljkovic Andrea , Dunbar Michael J. , Wilson David A. , Hennigar Allan W. , Glazebrook Mark A. 
Published: March 2012

Background: The goal of this study was to design a RSA marker insertion protocol to evaluate the stability of the bone-implant interface of a TAA prosthesis, and to validate that this marker insertion protocol can be combined with MBRSA technology to provide clinically adequate precision in assessing the micromotion of the TAA prosthesis. Methods: The Mobility™ Total Ankle System was used in this study. A marker placement protocol was developed with a Phantom Protocol. The Improved Marker Placement Protocol was used in 20 patients. Postoperative RSA double exams were taken. Condition Numbers (CN) were used to assess the marker distribution. The system precision was defined as the standard deviation of the double exams (MTE, MRE). MBRSA software was used to evaluate the double exams. Results: The RSA marker insertion technique for the 20 in vivo cases provided satisfactory results. CNs in all subjects but one were below 50 mm−1 and implied a desirable marker configuration. The tibial sphere MTE was 0.07 mm and the talar was 0.09 mm. The talar MRE was 0.51 degrees. Conclusion: The system precision for these in vivo TAA implants was within the normal range identified by RSA studies, and comparable to the existing TAA RSA studies. This study demonstrated a reliable RSA marker insertion technique in both the tibia and talus. The study confirms that the insertion and MBRSA technique allows the typical high precision demonstrated in other RSA studies
Association of Hindfoot Ligament Tears and Osteochondral Lesions
Authors: Cromeens Barrett , Patterson Rita , Sheedlo Harold , Motley Travis A. , Stewart Donald , Fisher Cara , Suzuki Sumihiro , Su Fenghsiu , Reeves Rustin 
Published: March 2012

Background: This study aimed to identify the prevalence of ligament and joint surface anatomy variants, ligament tears, and osteochondral lesions (OCLs) in the hindfoot. These data were used to identify associations between anatomic variants or ligament tears and OCLs. Methods: Seventy-two cadaver hindfoot specimens were examined. Hindfoot ligament presence, number of ligament fascicles, variable ligament attachment sites, ligament tears, presence of joint facets, variable joint surface shape, and the location and grade of OCLs were identified in each specimen. The data were analyzed for significant associations between variables. Results: Fourteen of the 30 studied ligaments were always present and 14 had variable number of fascicles. The lateral talocalcaneal and dorsolateral calcaneocuboid ligaments had varying positional attachments. Osteochondral lesions were present in 86% of specimens with the majority in the talocrural joint. Of the 235 lesions identified, 31 were grade 3 or above. Ligament tears occurred in 2% of all ligaments observed. Tears in the lateral talocalcaneal, medial calcaneocuboid, and dorsolateral calcaneocuboid ligaments were associated with an increased number of hindfoot OCLs. Conclusion: We demonstrated the prevalence of morphologic ligament and joint surface variants, ligament tears, and osteochondral lesions in the hindfoot. Tears in ligaments stabilizing the calcaneocuboid joint were implicated in an increase in hindfoot joint damage. Clinical Relevance: We believe anatomic studies can be used to clarify the association between traumatic injuries and their sequelae.
Proximal Medial Gastrocnemius Release in the Treatment of Recalcitrant Plantar Fasciitis
Authors: Abbassian Ali , Kohls-Gatzoulis Julie , Solan Matthew C. 
Published: March 2012

Background: Isolated gastrocnemius contracture has been implicated as the cause of a number of foot and ankle conditions. Plantar fasciitis (PF) is one such condition that can be secondary to altered foot biomechanics as a result of gastrocnemius contracture. In this paper, we report our results with an isolated release of the proximal medial head of gastrocnemius for recalcitrant PF. Methods: We prospectively followed a consecutive series of 21 heels in 17 patients following a Proximal Medial Gastrocnemius Release (PMGR). PF was diagnosed clinically and confirmed radiologically in all cases. To be included, at least 1 year of conservative treatment must have been tried and an isolated gastrocnemius contracture confirmed clinically using Silfverskiold's test preoperatively. Outcome measures included a 5-point Likert scale as well as subjective and objective calf weakness assessments. Final followup was on average 24 (range, 8 to 36) months after the surgery. Results: Seventeen of the 21 heels (81%) reported total or significant pain relief following the surgery and none reported worsening of their symptoms. The majority did not have subjective or objective evidence of calf weakness. There were no ‘major’ complications and only one case that suffered a ‘minor’ complication. Conclusion: We believe a PMGR is a simple way of treating a patient with PF who has failed to respond to conservative management. In our series, the results were favorable, the recovery fast and the morbidity low. Level of Evidence: IV, Retrospective Case Series
Functional Outcome of Endoscopic Plantar Fasciotomy
Authors: Bader Lucas , Park Ken , Gu Yang , O'Malley Martin J. 
Published: March 2012

Background: The majority of cases of plantar fasciitis can be treated nonoperatively; however, a small number of patients remain refractory to nonoperative treatment and operative intervention is indicated. Historically, open treatment has been recommended, but more recently endoscopic plantar fasciotomy (EPF) has produced promising results. Methods: Forty-eight patients (56 feet) were identified who underwent endoscopic plantar fasciotomy. Forty-one patients (49 feet) were available for followup. There were 15 men and 26 women, with an average age of 53.8 (range, 42 to 68) years. The mean followup time was 49.5 (range, 6 to 142) months. An AOFAS Hind foot Scale was used for analysis. The influence of gender, duration of symptoms, severity of symptoms, and bilateral verses unilateral release were examined. Results: Pain resolved completely in 37 feet, decreased in 11 feet, and increased in one foot. The mean postoperative AOFAS Hindfoot score improved 39 points (54 to 93, p < 0.001). Patients with severe symptoms achieved higher mean improvement than the moderate symptom group ( p < 0.0001). Patients with symptoms greater than 24 months trended towards lower mean improvement and lower post operative AOFAS Hindfoot scores. Both gender and laterality did not significantly influence outcome. There was one superficial infection, one third and fourth metatarsal stress fracture in the same patient, and transient lateral hindfoot pain in five patients. Conclusion: EPF was an effective operation with reproducible results, low complication rate, and little risk of iatrogenic nerve injury with proper technique. Level of Evidence: IV, Retrospective Case Series
Mobility of the First Ray in Various Foot Disorders
Authors: Greisberg Justin , Sperber Lisa , Prince Daniel E. 
Published: March 2012

Background: Instability of the first ray has been proposed by Morton and others to be a major cause of several foot disorders, including hallux valgus, transfer metatarsalgia, lesser metatarsal stress fractures, and second metatarsophalangeal diseases. However, there are few studies to support these theories. In this study, we have used a simple device to measure first ray elevation and translation in a consecutive series of foot and ankle patients. We propose that mobility of the first ray will be increased in patients with hallux valgus, metatarsalgia, hallux rigidus, lesser metatarsal stress fractures, posterior tibial tendinitis, and interdigital neuromas. Methods: Measurements of first ray translation and elevation were made in 345 feet in 315 patients. One or more pathologic diagnoses were recorded for each foot, and data was analyzed by a statistician. Results: First ray mobility was increased in females compared to males. Patients with hallux valgus and metatarsalgia had greater mobility than other patients. Those feet with low arches showed greater mobility than those with high arches. Patients with hallux rigidus showed decreased mobility. We failed to find any differences for patients with stress fractures, posterior tibial tendinitis, or neuromas, but some of these groups may have had insufficient power. Conclusion: First ray translation and elevation are two different measures of medial column instability. Although they are distinct measures, they closely paralleled each other in this series. An association was found between increased first metatarsal elevation and several foot disorders. Although such an association does not prove causation, and it is likely other factors may play a role in many patients, this data does link instability of the first ray to some diseases. The decreased mobility seen in patients with hallux rigidus may offer new insights into the etiology of that disorder. Level of Evidence: III, Comparative Study